Socioenvironmental Stressors Research Articles

Social factors related to gun violence in urban United States

IntroductionGun violence (GV), acknowledged as a public health crisis, disproportionately affects urban centers in the United States. However, the precise connections between social factors and GV are not fully understood. This study, leveraging the Cardiff Model approach, evaluates whether there is a statistical and geospatial relationship between social vulnerability index (SVI) and GV. MethodsIn this cross-sectional study, we combined Gun Violence Archive (GVA), a dataset of firearm violence (2019–2023), with corresponding census tract level SVIs for three selected cities—Atlanta, GA; St. Louis, MO; and Washington, DC. The GVA was created, due to gaps in government-based data, from daily public records and media by an independent data collection group. Also, the SVI, derived from a place-based index from Centers for Disease Control (CDC), was originally used to evaluate the resiliency of communities to recover from socio-environmental stressors. GV data from these three cities, representative of major urban centers in the United States, were used to conduct various analyses. We used Poisson regression to assess whether nine of the sixteen SVI measures were statistically associated with GV incidents. Furthermore, we examined whether spatial relationships between SVI and GV differ by level of concentrated disadvantage in urban neighborhoods. ResultsOut of all GV incidents (10,442), corresponding to 488 census tracts, teenagers ages 12–17 were found to have higher GV rates in St. Louis (12 %) than Atlanta (7.6 %) and Washington DC (10.5 %). Children, ages 0–11, in St. Louis (3.1 %) were involved in more GV incidents than the other two (Washington DC-1.2 % and Atlanta-2.3 %) cities. In the composite model, census tract-level SVIs were statistically significantly associated with GV. Some of the most prominent SVIs, viewed as predictors of GV, included racial-ethnic minority [Incidence Rate Ratio (IRR): 1.02, 95 % CI: 1.01–1.02, p<0.001], 150 % of Federal Poverty Level (FPL) [IRR: 1.00, 95 % CI: 1.00–1.01, p<0.001], and unemployment (IRR: 1.01, p<0.001). Also, many of the SVI variables were found to be significantly associated with GV incidents in each of the three selected cities. ConclusionsIn this original study, we found that there was a strong statistically significant association between SVI-related disadvantaged neighborhoods and increased GV incidents. Additionally, we found that the geospatial distribution of GV incidents were more concentrated in neighborhoods with increased vulnerability throughout the three (Atlanta, GA; St. Louis, MO; and Washington, DC) selected cities than those neighborhoods with decreased vulnerability. Unique approaches such as integration of the SVI with gun control legislation, which informs ownership, use, and access to firearms, provides a better strategy to inform the implementation of an interdisciplinary approach such as the Cardiff Model. GV policy reform, from the public health and criminology lens, would help reduce the prevalence of GV through the promotion of social resilience within communities.

Allostatic load as a predictor of postoperative complications in patients with breast cancer

Allostatic load (AL) is a biological measure of cumulative exposure to socioenvironmental stressors (e.g., poverty). This study aims to examine the association between allostatic load (AL) and postoperative complications (POC) among patients with breast cancer. Females ages 18+ with stage I-III breast cancer who received surgical management between 01/01/2012-12/31/2020 were identified in the Ohio State Cancer registry. The composite AL measure included biomarkers from the cardiovascular, metabolic, immune, and renal systems. High AL was defined as composite scores greater than the cohort’s median (2.0). POC within 30 days of surgery were examined. Univariable and multivariable regression analysis examined the association between AL and POC. Among 4459 patients, 8.2% had POC. A higher percentage of patients with POC were unpartnered (POC 44.7% vs no POC 35.5%), government-insured (POC 48.2% vs no POC 38.3%) and had multiple comorbidities (POC 32% vs no POC 20%). Patients who developed POC were more likely to have undergone sentinel lymph node biopsy followed by axillary lymph node dissection (POC 51.2% vs no POC 44.6%). High AL was associated with 29% higher odds of POC (aOR 1.29, 95% CI 1.01–1.63). A one-point increase in AL was associated with 8% higher odds of POC (aOR 1.08, 95% CI 1.02-1.16) and a quartile increase in AL was associated with 13% increased odds of POC (aOR 1.13, 95% CI 1.01–1.26). Among patients undergoing breast cancer surgery, increased exposure to adverse socioenvironmental stressors, operationalized as AL, was associated with higher odds of postoperative complications.

Financial Toxicity in Renal Patients (FINTORE) Study: A Cross-Sectional Italian Study on Financial Burden in Kidney Disease-A Project Protocol.

Financial toxicity (FT) refers to the negative impact of health-care costs on clinical conditions. In general, social determinants of health, especially poverty, socioenvironmental stressors, and psychological factors, are increasingly recognized as important determinants of non-communicable diseases, such as chronic kidney disease (CKD), and their consequences. We aim to investigate the prevalence of FT in patients at different stages of CKD treated in our universal health-care system and from pediatric nephrology, hemodialysis, peritoneal dialysis and renal transplantation clinics. FT will be assessed with the Patient-Reported Outcome for Fighting Financial Toxicity (PROFFIT) score, which was first developed by Italian oncologists. Our local ethics committee has approved the study. Our population sample will answer the sixteen questions of the PROFFIT questionnaire, seven of which are related to the outcome and nine the determinants of FT. Data will be analyzed in the pediatric and adult populations and by group stratification. We are confident that this study will raise awareness among health-care professionals of the high risk of adverse health outcomes in patients who have both kidney disease and high levels of FT. Strategies to reduce FT should be implemented to improve the standard of care for people with kidney disease and lead to truly patient-centered care.

Abstract 6123: Validating cancer modulated allostatic load as a composite biomarker for mortality in patients with cancer

Abstract Allostatic load (AL) is the cumulative burden of chronic stress and life events typically measured by lab and vital values routinely collected during standard care. AL has been associated with adverse socioenvironmental stressors and increased mortality rates including risk of cancer death. Despite modifications of AL as a result of progressing cancer and anti-cancer treatments, AL may serve as a valuable biomarker for cancer outcomes, and highlight similar disparities across sociodemographic groups agnostic of a history of cancer diagnosis. Recent investigations have shown associations of AL with overall mortality rates in patients with non-small cell lung cancer (NSCLC) and breast cancer, as well as various social determinants of health. The impact of AL on different malignancies, particularly in the context of genetic variations identified through genomic profiling, is yet to be thoroughly investigated. We identified a pan-cancer cohort of 29,433 patients sequenced with the MSK-IMPACT targeted panel sequencing assay, and collected clinical, genomic, and lab data. We first studied the association of AL with patient and tumor characteristics such as tumor type, stage, cancer genomics, comorbidities, social deprivation defined by the Yost index, and genetic ancestry. We derived AL using 10 standard biomarkers across cardiovascular, metabolic, renal, and immune systems, and created a composite AL summary score with a range between 0 and 10. Composite AL summary score into quartiles for comparisons. We found that AL was increased with higher cancer stage, older age, smoking, multiple comorbidities, African ancestry, and Yost index. Multivariate logistic regression analysis showed that AL was correlated with mutations e in KRAS and anti-correlated with EGFR mutations (FDR&amp;lt;0.02). Next, we investigated AL as a biomarker for mortality in patients with cancer and compared its prognostic value to other biomarkers. Using a Cox proportional hazard model we found that AL was significantly associated with shorter overall survival, controlling for stage and socioeconomic variables (HR=1.7, 2.2, 2.7 in AL Quartiles 2-4 respectively). Finally, we decomposed AL into its individual markers to quantify the most important features driving outcomes. Using a Random Survival Forest model with a focus on NSCLC patients, we found that albumin and alkaline phosphatase were the strongest features of shorter survival in our AL composite model. Our findings suggest that elevated AL is associated with a poorer prognosis across multiple cancer types, a trend observable across different stages of cancer. The association between AL and clinically actionable mutations highlights the importance of understanding the relationship between somatic alterations and social/environmental factors. The study underscores the utility of AL as a powerful prognostic tool that can be routinely collected in a clinical setting. Citation Format: Christopher J. Fong, Kaicheng U, Cheryl Phua, Xuechun Bai, Michele Waters, Tom Fu, Kanika Arora, Tomin Perea-Chamblee, Devika Jutagir, Michael Berger, Nikolaus Schultz, Adam Schoenfeld, Francesca Gany, Justin Jee, Jian Carrot-Zhang. Validating cancer modulated allostatic load as a composite biomarker for mortality in patients with cancer [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 6123.

Exploring the Role of Civic Monitoring of Coal Ash Pollution: (Re)gaining Agency by Crowdsourcing Environmental Information

Abstract Citizen-gathered evidence (CGE) gathered by individuals organized in collectives have the potential to demonstrate environmental and social wrongdoings in court. We identify (collective) agency and resistance in how individuals and communities that have been exposed to socio-environmental stressors turn to gather CGE. We explore the modes through which people gather scientific data, produce CGE, alert authorities to environmental harm, and the methods by which data can be shared with communities, beginning with the case studies of civic environmental monitoring addressing coal ash pollution in North Carolina. We analyze the case studies through a theoretical lens built on (1) the theory of civic monitoring “as resistance;” (2) the argument that CGE can embody “collective intelligence;” and (3) the concept of “crowd science” through a decentralized yet coordinated network. In the first part of the article, we introduce the case studies. Then, we illustrate our theoretical frame as applied to the analysis of the cases. We discuss the cases and in particular the CGE at issue through the prism of the frame. We demonstrate how CGE can be valuable not only for civil society and civic organizations, but also for competent authorities. In our conclusion, we identify critical junctures of our case studies, such as that of “knowledge crowdsourcing” to demand justice that triggers the government to take action and the existence of a “coordinated” yet decentralized crowd to capture the full extension of the problem. Lastly, we outline the limitations of our study, a future research agenda, and still open questions.

Networks of Neurodevelopmental Traits, Socioenvironmental Factors, Emotional Dysregulation in Childhood, and Depressive Symptoms Across Development in Two U.K. Cohorts.

Previous population-based studies have identified associations between childhood neurodevelopmental traits and depression in childhood, adolescence, and young adulthood. However, neurodevelopmental traits are highly correlated with each other, which could confound associations when traits are examined in isolation. The authors sought to identify unique associations between multiple neurodevelopmental traits in childhood and depressive symptoms across development, while taking into account co-occurring difficulties, in multivariate analyses. Data from two U.K. population-based cohorts, the Twins Early Development Study (TEDS) (N=4,407 independent twins) and the Avon Longitudinal Study of Parents and Children (ALSPAC) (N=10,351), were independently analyzed. Bayesian Gaussian graphical models were estimated to investigate pairwise conditional associations between neurodevelopmental traits (autism and ADHD symptoms and general cognitive, learning, and communication abilities), socioenvironmental stressors (academic performance and peer relations), and emotional dysregulation in childhood (ages 7-11) and depressive symptoms across development (ages 12, 16, and 21). In both cohorts, bivariate correlations indicated several associations between neurodevelopmental traits and depressive symptoms across development. However, based on replicated findings across cohorts, these pairs of variables were mostly conditionally independent, and none were conditionally associated, after accounting for socioenvironmental stressors and emotional dysregulation. In turn, socioenvironmental stressors and emotional dysregulation were conditionally associated with both neurodevelopmental traits and depressive symptoms. Based on replicated findings across cohorts, neurodevelopmental traits in childhood could be associated only indirectly with depressive symptoms across development. This study indicates that associations between childhood neurodevelopmental traits and depressive symptoms across development could be explained by socioenvironmental stressors and emotional dysregulation. The present findings could inform future research aimed at the prevention of depression in youths with neurodevelopmental disorders.

Surveillance of pesticide poisoning in an East and a West Malaysian hospital: characteristics of pesticide poisoning and the early impact of a national Paraquat ban

BackgroundPrevious studies have shown that pesticide bans were associated with reduced fatal pesticide self-poisoning cases in high, and low-and-middle-income countries. We aimed to investigate the characteristics of pesticide poisoning patients admitted to two Malaysian hospitals and the early impact of the national paraquat ban implemented on 1st January 2020 in a culturally heterogenous South-East-Asian upper-middle-income setting.MethodsData were collected from an East (Bintulu) and a West (Ipoh) Malaysian hospital medical records in 2015–2021 and 2018–2021, respectively. Logistic regression analyses were conducted to investigate the association of aspects such as socio-demographic and clinical characteristics, paraquat ban with the types of pesticides involved (paraquat versus non-paraquat versus unknown) ,and the outcomes (fatal versus non-fatal).ResultsFrom the study sample of 212 pesticide poisoning patients aged 15 years or above, the majority were self-poisoning cases (75.5%) with a disproportionate over-representation of Indian ethnic minority (44.8%). Most pesticide poisoning cases had socio-environmental stressors (62.30%). The commonest stressors were domestic interpersonal conflicts (61.36%). 42.15% of pesticide poisoning survivors had a psychiatric diagnosis. Paraquat poisoning accounted for 31.6% of all patients and 66.7% of fatalities. Case fatality was positively associated with male gender, current suicidal intent, and paraquat poisoning. After the paraquat ban, the proportion of pesticide poisoning cases using paraquat decreased from 35.8 to 24.0%, and the overall case-fatality dropped slightly from 21.2 to 17.3%.ConclusionsSocio-environmental stressors in specific domestic interpersonal conflicts, seemed more prominent in pesticide poisoning compared to psychiatric diagnosis. Paraquat accounted for the majority of pesticide-associated deaths occurring in hospitals in the study areas. There was preliminary evidence that the 2020 paraquat ban led to a fall in case fatality from pesticide poisoning.

Exploring Microbes in Breast Tumors From Women of Different Races

Exploring Microbes in Breast Tumors From Women of Different Races

Association of Allostatic Load With All-Cause Mortality in Patients With Breast Cancer

Elevated allostatic load (AL) has been associated with adverse socioenvironmental stressors and tumor characteristics that convey poor prognosis in patients with breast cancer. Currently, the association between AL and all-cause mortality in patients with breast cancer is unknown. To examine the association between AL and all-cause mortality in patients with breast cancer. This cohort study used data from an institutional electronic medical record and cancer registry at the National Cancer Institute Comprehensive Cancer Center. Participants were patients with breast cancer diagnoses (stage I-III) between January 1, 2012, through December 31, 2020. Data were analyzed from April 2022 through November 2022. AL was expressed as a summary score calculated by assigning 1 point for biomarkers in the worst sample quartile. High AL was defined as AL greater than the median. The main outcome was all-cause mortality. A Cox proportional hazard models with robust variance tested the association between AL and all-cause mortality. There were 4459 patients (median [IQR] age, 59 [49-67] years) with an ethnoracial distribution of 3 Hispanic Black patients (0.1%), 381 non-Hispanic Black patients (8.5%), 23 Hispanic White patients (0.5%), 3861 non-Hispanic White patients (86.6%), 27 Hispanic patients with other race (0.6%), and 164 non-Hispanic patients with other race (3.7%). The mean (SD) AL was 2.6 (1.7). Black patients (adjusted relative ratio [aRR], those with 1.11; 95% CI, 1.04-1.18), single marital status (aRR, 1.06; 95% CI, 1.00-1.12), and those with government-supplied insured (Medicaid aRR, 1.14; 95% CI, 1.07-1.21; Medicare aRR, 1.11; 95% CI, 1.03-1.19) had a higher adjusted mean AL than those who were White, married/living as married, or privately insured, respectively. Adjusting for sociodemographic, clinical, and treatment factors, high AL was associated with a 46% increase in mortality risk (hazard ratio [HR], 1.46; 95% CI, 1.11-1.93) over low AL. Similarly, compared with patients in the first AL quartile, those in the third quartile (HR, 1.53; 95% CI, 1.07-2.18) and the fourth quartile (HR, 1.79; 95% CI, 1.16-2.75) had significantly increased risks of mortality. There was a significant dose-dependent association between increased AL and a higher risk of all-cause mortality. Furthermore, AL remained significantly associated with higher all-cause mortality after adjusting for the Charlson Comorbidity Index. These findings suggest increased AL is reflective of socioeconomic marginalization and associated with all-cause mortality in patients with breast cancer.

Emotional and Behavioural Problems in School Going Children (5-16 years) in and around Meerut

Background: Adolescents are highly vulnerable to psychiatric disorders. This study aimed to explore theprevalence and patterns of behavioural and emotional problems in adolescents. It was also aimed to exploreassociations between socioenvironmental stressors and maladaptive outcomes.Method: A school based cross-sectional study was conducted between January and July 2008. A stratifiedrandom sampling was done. 1150 adolescents in 5-16 years age group in grades 7 to 12 in 10 co-educationalschools (government run and private) were the subjects of the study. Behavioural and emotional problems wereassessed using Youth Self-Report (2001) questionnaire. Family stressors were assessed using a pre-tested 23 itemquestionnaire. Univariate and multivariate analysis were performed. Multiple logistic regression analysis was alsodone.Results: Prevalence of behavioural and emotional problems in adolescents was found to be 30%, with girlsexceeding boys in all age groups. Internalizing syndrome was the most common (28.6%) psychiatric problem.On stepwise regression analysis, a perceived lack of emotional proximity to mother had the highest odds (3.489)followed by addiction in father (2.642) and marital discord in parents (1.402). Type of school, type of family,socioeconomic status, relationship with father, mother&amp;s employment and educational status were not found tobe significantly associated.Conclusion: An alarming number of our adolescents suffer from emotional and behavioural problems which havetheir roots in the family environment. These data suggest urgency in establishing a school based mental healthservice.

Pain-related stigma as a social determinant of health in diverse pediatric pain populations.

Pediatric patients with invisible symptomology, such as chronic pain syndromes, are more likely to experience pain-related stigma and associated discrimination by others, including medical providers, peers, school personnel, and family members. The degree of this pain-related stigma may depend on several social dimensions, including observer (e.g., attentional and implicit biases) and patient characteristics (e.g., racial identity, socioeconomic stressors). In this mini-review, we introduce the concept of pain-related stigma, and the intersectionality of stigma, within the context of social determinants of health in pediatric pain populations. Stigma theory, observer attentional biases, healthcare provider implicit/explicit biases, adverse childhood experience, and psychophysiology of socio-environmental stressors are integrated. Several ethical, clinical, and research implications are also discussed. Because the study of pain-related stigma in pediatric pain is in its infancy, the purpose of this conceptual review is to raise awareness of the nuances surrounding this social construct, propose avenues through which stigma may contribute to health inequities, present frameworks to advance the study of this topic, and identify areas for further investigation.

Bridging the environment and neurodevelopment for children’s health: Associations between real-time air pollutant exposures and cognitive outcomes

Research suggests that children's exposure to pollutants may impact their neurocognitive development. While researchers have found associations between air pollutants and cognitive development, these associations remain underspecified. Further, these exposures occur in the context of the built environment and may be exacerbated by local social vulnerability; in this context, individuals may experience a suite of socioenvironmental stressors that lead to increased cumulative risk exposure. In this pilot study, we tested whether real-time-measured personal exposure to PM2.5 relates to children's executive function and mathematical skills, outcomes that may predict later mathematical performance, general academic performance and even employment outcomes. We recruited 30 families to participate in two rounds in Winter 2020 and Summer 2021. We collected children's demographic data, as well as data about their living environment. In each round, children carried a small device that collected real-time ambient air pollution data for 3 days; parents logged their children's activities each day. On the last day, children completed cognitive assessments indexing their working memory (n-back), inhibitory control (Go/No-Go), nonsymbolic math skills (dot comparison), and arithmetic skills (equation verification). Overall, 29 participants had pollutant readings from both rounds, and 21 had a full dataset. Nonparametric statistical analysis revealed no significant differences in ambient air pollution and cognitive performance over time, Spearman's rho correlation assessment found that PM2.5 was not significantly correlated with cognitive outcomes in R1 and R2. However, the correlations suggested that an increase in PM2.5 was associated with worse working memory, inhibitory control, nonsymbolic skills, and arithmetic skills, at least in R1. We used each participant's zip code-aggregated Social Vulnerability Index, which range from 0 to 1, with higher numbers indicating more social vulnerability. Wilcoxon Rank-Sum tests indicated that participants living in higher SVI zip codes (≥0.70; n = 15) were not significantly different from those living in lower SVI zip codes (<0.70; n = 14), in terms of their PM2.5 exposures and cognitive performance in each round. We also found that socioeconomic characteristics mattered, such that children whose parent (s) had at least a Master's degree or earned more than $100,000 a year had lower PM2.5 exposures than children in the other end.

Maternal stress, child behavior and the promotive role of older siblings

BackgroundIn the first years of their lives, children develop the cognitive, social and emotional skills that will provide the foundations for their lifelong health and achievements. To increase their life prospects and reduce the long-term effects of early aversive conditions, it is therefore crucial to understand the risk factors that negatively affect child development and the factors that are instead beneficial. In this study, we tested (i) the effects of different social and environmental stressors on maternal stress levels, (ii) the dynamic relationship between maternal stress and child behavior problems during development, and (iii) the potential promotive (i.e. main) or protective (i.e. buffering) effect of siblings on child behavior problems during development.MethodsWe used longitudinal data from 373 mother–child pairs (188 daughters, 185 sons) from pregnancy until 10 years of age. We assessed maternal stress and child behavior problems (internalizing and externalizing) with validated questionnaires, and then used linear mixed models, generalized linear mixed models and longitudinal cross-lagged models to analyze the data.ResultsOur results showed that higher maternal stress levels were predicted by socio-environmental stressors (i.e. the lack of sufficient social areas in the neighborhood). Moreover, prenatal maternal stress reliably predicted the occurrence of behavior problems during childhood. Finally, the presence of older siblings had a promotive function, by reducing the likelihood that children developed externalizing problems.ConclusionsOverall, our results confirm the negative effects that maternal stress during pregnancy may have on the offspring, and suggest an important main effect of older siblings in promoting a positive child development.

The Association Between Perceived Discrimination and BMI Trajectory: A Prospective Study of African American and White Adults.

Evidence suggests that socioenvironmental stressors, such as discrimination, may serve as determinants of the ongoing obesity epidemic and persisting disparities in obesity prevalence. The objectives of these analyses were to examine whether perceived discrimination was associated with body mass index (BMI) trajectory and whether this relationship differed by race or sex. Data for these analyses came from the Healthy Aging in Neighborhoods of Diversity across the Life Span study, a prospective cohort study in Baltimore City. Mixed-effects linear regression was used in a sample of 1962 African American and white adults to test our hypotheses. We found that race was an effect modifier in the relationship between perceived discrimination and BMI trajectory (B = 0.063, P = .014). Specifically, higher baseline perceived discrimination was associated with positive BMI trajectory in African American adults (B = 0.031, P = .033) but not in white adults (B = -0.032 P = .128). In this longitudinal study of African American and white adults, the relationship between perceived discrimination and BMI trajectory differed by race. Future research should be conducted in diverse samples to understand the risk socioenvironmental stressors pose on the development and progression of overweight and obesity, in addition to how these differ in subgroups.

Invited Perspective: Oil and Gas Development and Adverse Birth Outcomes: What More Do We Need to Know?

Invited Perspective: Oil and Gas Development and Adverse Birth Outcomes: What More Do We Need to Know?

Neighborhood disadvantage is associated with stable deficits in neurocognitive functioning in traumatically-injured adults.

In trauma-exposed adults, the relationship between an individual's socioeconomic position (SEP) and post-traumatic stress disorder (PTSD) has been well demonstrated. One potential mechanism by which the stress associated with lower SEPs may impact trauma outcomes is through changes in neurocognition. In both healthy and clinical samples, area-level factors also appear to be independently related to neurocognition. Far less is known about how neighborhood socioeconomic disadvantage, may impact cognition in traumatically-injured adults. The current study employed hierarchical linear modeling to longitudinally investigate whether neighborhood disadvantage was associated with neurocognitive functioning in five domains: processing speed, sustained attention, controlled attention, cognitive flexibility, and response inhibition. One-hundred and ninety-five socioeconomically diverse traumatically-injured subjects (mean age=32.8, 52.8% female) were recruited from an Emergency Department. Two-weeks, three-months, and six-months post-trauma, participants completed self-report measures and a computerized test battery to evaluate neurocognition. An Area Deprivation Index (ADI) score, a measure of a neighborhood's socioeconomic disadvantage, was derived from each participants' home address. Greater neighborhood disadvantage was significantly related to lower scores in all domains. Results of hierarchical linear models revealed neighborhood disadvantage was significantly associated with processing speed, controlled attention, cognitive flexibility, and response inhibition across time, even after adjusting for individual annual household income, baseline PTSD symptoms, and previous adverse life experiences. This relationship was stable for all domains except sustained attention, which varied across time. These findings indicate neighborhood disadvantage contributes uniquely to neurocognitive functioning and, for the majority of domains, these contributions are stable across time. The relationship between area-level variables and cognitive function may underlie individual vulnerability to developing psychiatric disorders. Future work should continue to examine the interaction between socioenvironmental stressors and PTSD symptoms longitudinally.

Impact of a Model Used to Simulate Chronic Socio-Environmental Stressors Encountered during Spaceflight on Murine Intestinal Microbiota

During deep-space travels, crewmembers face various physical and psychosocial stressors that could alter gut microbiota composition. Since it is well known that intestinal dysbiosis is involved in the onset or exacerbation of several disorders, the aim of this study was to evaluate changes in intestinal microbiota in a murine model used to mimic chronic psychosocial stressors encountered during a long-term space mission. We demonstrate that 3 weeks of exposure to this model (called CUMS for Chronic Unpredictable Mild Stress) induce significant change in intracaecal β-diversity characterized by an important increase of the Firmicutes/Bacteroidetes ratio. These alterations are associated with a decrease of Porphyromonadaceae, particularly of the genus Barnesiella, a major member of gut microbiota in mice and humans where it is described as having protective properties. These results raise the question of the impact of stress-induced decrease of beneficial taxa, support recent data deduced from in-flight experimentations and other ground-based models, and emphasize the critical need for further studies exploring the impact of spaceflight on intestinal microbiota in order to propose strategies to countermeasure spaceflight-associated dysbiosis and its consequences on health.

Contextual factors associated with depression among urban refugee and displaced youth in Kampala, Uganda: findings from a cross-sectional study

BackgroundAdvancing mental health among refugee and displaced adolescents and youth is critically important, as chronic psychological stress can have lifelong harmful impacts. These groups experience socio-environmental stressors that can harm mental health. Informed by a social contextual framework, this study explored the prevalence of depression among urban refugee and displaced youth in Kampala, Uganda and associations with symbolic (violence), relational (social support), and material (food and community insecurity) contexts.MethodsWe implemented a cross-sectional survey with refugee and displaced adolescent girls and young women and adolescent boys and young men aged 16–24 living in Kampala’s informal settlements. We conducted peer-driven recruitment, whereby peer navigators shared study information with their networks and in turn participants were invited to recruit their peers. We conducted gender disaggregated analyses, including stepwise multiple regression to examine factors associated with depression. We then conducted structural equation modeling (SEM) using weighted least squares estimation to examine direct paths from violence, food insecurity, and community insecurity to depression, and indirect effects through social support.ResultsAmong participants (n = 445), young women (n = 333) reported significantly higher depression symptoms than young men (n = 112), including any symptoms (73.9% vs. 49.1%, p < 0.0001), mild to moderate symptoms (60.4% vs. 45.5%, p = 0.008), and severe symptoms (13.5% vs 3.6%, p = 0.002). SEM results among young women indicate that the latent violence factor (lifetime sexual and physical violence) had direct effects on depression and social support, but social support did not mediate the path from violence to depression. The model fit the data well: χ2(3) = 9.82, p = 0.020; RMSEA = 0.08, 90% CI [0.03, 0.14], CFI = 0.96). Among young men, SEM findings indicate that food insecurity had direct effects on social support, and an indirect effect on depression through the mediating role of social support. Fit indices suggest good model fit: χ2(3) = 2.09, p = 0.352; RMSEA = 0.02, 90% CI [0.000, 0.19], CFI = 0.99.ConclusionsFindings reveal widespread depression among urban refugee and displaced youth in Kampala, disproportionately impacting young women. Contextual factors, including food insecurity and violence, increase depression risks. Strategies that reduce gender-based violence and food insecurity, and increase social support networks, have the potential to promote mental health among urban refugee and displaced youth.

DyNet-LCCA: a simulation framework for dynamic network-level life- cycle cost analysis in evolving infrastructure systems

ABSTRACT Civil infrastructure systems transform over the long-term due to complex interactions among socio-environmental stressors, degradation of physical networks, and decision-making processes of infrastructure agencies. To incorporate such complex transformation mechanisms into infrastructure cost management, this study integrates simulation modeling and life-cycle cost analysis (LCCA) to create a framework for dynamic network-level LCCA in infrastructure systems. The proposed framework was implemented using a multi-agent simulation model in a numerical case study related to a road network affected by sea-level rise, population growth, and uncertain maintenance funding. The results include identification of several state transition, and tipping point behaviors at which small changes in service demand, maintenance budget, and adaptation investment may result in significant improvement in network cost and performance conditions. The results show the capability of the proposed framework in modeling the long-term trajectories of life-cycle costs at the network level under different stressors and decision scenarios.

Ethnoracial sleep disparities among college students living in dormitories in the United States: a nationally representative study

ObjectivesEthnoracial disparities in sleep health across the lifecourse, may underlie other disparities in health and well-being among adults in the United States (U.S.). We evaluated if socioenvironmental stressors, which likely differ by the race/ethnicity of college students, may contribute to sleep disparities in this demographic group. Design/MeasurementsNational Health Interview Survey data pooled from 2004 to 2017 were used to test the hypothesis that ethnoracial disparities in sleep exist among college students residing in dormitories in the U.S. SettingNationally representative survey data. ParticipantsA total of 2,119 college students residing in dormitories (71% White, 16% Black/African-American, 7% Hispanic/Latino, and 6% Asian) participated in the study. ResultsThe prevalence of short sleep duration was higher among Black/African-Americans than among White students, but not among Hispanics/Latinos and Asians, after adjusting for age, gender, and region of residence. In fully adjusted models, Black/African-Americans, although no longer statistically significant after adjustments, were more likely to report short sleep duration compared with White students (adjusted prevalence ratio; [aPR] = 1.30, 95% confidence interval [CI]: 0.98-1.71). The prevalence of separate insomnia symptoms did not differ by ethnoracial group in adjusted models. Only Asian students had a higher prevalence (aPR = 1.40, 95% CI: 1.12-1.75) of nonrestorative sleep than White students. ConclusionBlack/African-American but not Hispanic/Latino or Asian college students were more likely to report short sleep duration than Whites. Insomnia symptoms did not differ between groups, while Asians experienced more nonrestorative sleep. Future studies should investigate the socioenvironmental causes of disparities using longitudinal designs, larger sample sizes, better socioeconomic status (SES) indicators, and objective sleep measures.