Socio-environmental Risk Factors Research Articles

Malnutrition and intestinal parasitosis: Current prevalences and risk factors among schoolchildren in Misiones (Argentina).

To assess the current prevalences of nutritional status and intestinal parasites, and their potential association with socio-environmental conditions among schoolchildren in Aristóbulo del Valle, Misiones. We measured body weight and height in 444 schoolchildren aged 3-14 years and evaluated their nutritional status following WHO criteria. We examined fecal samples and anal swabs from 234 schoolchildren and collected socio-environmental data through questionnaires. The prevalence of undernutrition was 4.5% and excess of weight was 24.1%. The prevalence of stunting and of being overweight reached 2.3% and 12.4%, respectively. About 42% of the schoolchildren were infected with at least one of the 12 species identified. The most prevalent species were Blastocystis sp., Enterobius vermicularis, and Giardia lamblia. Entamoeba dispar was recorded for the first time in the locality. The multiple correspondence analysis identified peri-urban, urban, and rural groups. Underweight, stunting and obesity were highest in the peri-urban group, while overweight, wasting and parasitism rates were highest in the rural group. The urban group showed the lowest parasitic prevalences. Bed-sharing, mother's education, and animal husbandry were associated with parasitic infections. The study highlights a decrease in undernutrition but a rise in overweight and obesity, indicating an ongoing nutritional transition. The association between socio-environmental risk factors and parasitic infections underscore the need for comprehensive interventions addressing both nutritional and socio-environmental conditions to improve the population's life quality.

One Health Approach to Toxoplasmosis: Owner and Dog Seropositivity as Spatial Indicators of Risk Areas for Acquired, Gestational and Congenital Transmission.

Toxoplasmosis has been of public health concern due to direct associations with socioeconomic vulnerability and inadequate living conditions. Accordingly, the present study aimed to assess antibodies against T. gondii, historical reported toxoplasmosis cases and associated socio-environmental risk factors in Pinhais, a full urban area of Curitiba, currently the eighth biggest metropolitan area of Brazil. Anti-Toxoplasma gondii antibodies were assessed by an indirect immunofluorescence reaction (RIFI). Owner and dog samples were also tested by IFAT to anti-Leishmania spp. and anti-Trypanosoma cruzi antibodies. Overall, 20/135 (14.8%) persons and 13/133 (9.8%) dogs from 25 different households were considered seropositive to T. gondii. All samples were seronegative to Leishmania spp. and Trypanosoma cruzi. Although no significant covariates were found in the regression model, statistically associated risk factors in the bivariate analysis included no public water use (p = 0.016) and drinking raw milk (p = 0.041) for owners, and obesity (p = 0.028) and tick infestation (p = 0.03) for dogs. In addition, a spatial cluster of T. gondii seropositivity for both owners and their dogs overlapped the location of historic reported cases of human acquired, gestational and congenital toxoplasmosis. Finally, the results herein showed tick infestation as an indicator of socio-environmental risk for T. gondii exposure in the household environment, and dogs may be used as sentinels for human toxoplasmosis cases.

Evidence for Environmental Risk Factors and Cumulative Stress Linking Racial/Ethnic Identity and Psychotic-Like Experiences in ABCD Study Data

Previous work has found increased endorsement of psychotic-like experiences (PLEs) among marginalized racial and ethnic groups. According to social determinants frameworks, marginalized groups are at increased risk for exposure to socio-environmental risk factors, including systemic factors (eg, poverty and poor housing conditions) and social stressors (eg, discrimination). We examine the extent to which environmental risk factors and stress account for associations between racial/ethnic groups with PLEs. Analyses included 11,876 young adolescents 9 to 10 years of age from the Adolescent Brain Cognitive Development (ABCD) study. Mediation models assessed whether stress at 1-year follow-up indirectly linked baseline environmental risk to later distressing PLEs at 2-year follow-up. Serial mediation models examined whether environmental risk and stress indirectly accounted for variation among racial/ethnic groups in self-reported distressing PLEs. Through principal component and mediation analyses, we found evidence that the link between environmental risk (eg, poverty and exposure to crime) and distressing PLEs was mediated by stress. There was also evidence that higher endorsement of distressing PLEs within the Black and Hispanic groups was serially mediated by greater environmental risk and greater stress. The analyses provide evidence that the associations between marginalized racial and ethnic identities with the endorsement of PLEs partially reflects the sequelae of systemic socio-environmental factors. Findings suggest the potential for intervening upon environmental risk factors to target the reduction of cumulative stress over time, which may in turn buffer against the development of PLEs. Using longitudinal data from 11,876 young adolescents aged 9-10 from the Adolescent Brain Cognitive Development (ABCD) study, this study examined environmental (e.g., poverty) and stress-related factors (e.g., experiences of discrimination, childhood adversity) that are associated with psychotic-like experiences, and whether these factors explain racial/ethnic differences in psychotic-like experiences. The authors found evidence that the association between these environmental risk factors and psychotic-like experiences is partially explained by cumulative stress, and that differences in psychotic-like experiences across racial/ethnic groups were accounted for by both environmental risk factors and stress. Results highlight that systemic factors may explain higher levels of psychotic-like experiences among historically marginalized racial/ethnic groups. Findings suggest the potential for intervening upon modifiable risk factors to buffer against stress, and in turn, the development of psychotic-like experiences over time. We worked to ensure sex and gender balance in the recruitment of human participants. 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 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 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.

WCN24-2590 Relationship Between Exposure to Socio-Environmental Risk Factors and Kidney Disease in the Pediatric Population of the State of Tlaxcala

WCN24-2590 Relationship Between Exposure to Socio-Environmental Risk Factors and Kidney Disease in the Pediatric Population of the State of Tlaxcala

The influence of socioenvironmental risk factors on risk-taking behaviors among Bahamian adolescents: a structural equation modeling analysis

ABSTRACT Background Adolescents’ risk-taking behaviors can have profound impacts on their future health. Few studies have established a relationship between multiple social environmental factors and adolescent risk behaviors. We used structural equation modeling to examine the role of parental monitoring and environmental risks on adolescents’ behavioral intentions and risk behaviors. Methods Data were collected through the baseline survey of a national implementation project among 2205 Grade 6 students in 24 government schools in The Bahamas in 2019. Structural equation modeling examined relations among parental monitoring, environmental risk factors, behavioral intentions, and risk behaviors. Results Students had engaged in various delinquent, substance use, and sexual risks. In the structural equation model, parental monitoring demonstrated direct negative (protective) effects on behavioral intentions and risk behaviors, whereas environmental risk factors had a direct positive effect on adolescent behavioral intentions and risk behaviors. The model had an R2 value of 0.57 for adolescent risk behaviors. Conclusion Parental monitoring and environmental risk factors had strong influences on risk-taking behaviors of early adolescents. Future adolescent health behavior interventions should consider offering additional prevention resources to early adolescents who are exposed to multiple environmental risk factors.

Sick individuals, sick populations revisited: a test of the Rose hypothesis for type 2 diabetes disparities

IntroductionThe Rose hypothesis predicts that since genetic variation is greater within than between populations, genetic risk factors will be associated with individuals’ risk of disease but not population disparities, and...

Greater socioenvironmental risk factors and higher chronic pain stage are associated with thinner bilateral temporal lobes.

Previous research indicates ethnic/race group differences in pain and neurodegenerative diseases. Accounting for socioenvironmental factors reduces ethnic/race group differences in clinical and experimental pain. In the current study sample, we previously reported that in individuals with knee pain, ethnic/race group differences were observed in bilateral temporal lobe thickness, areas of the brain associated with risk for Alzheimer's disease, and related dementias. The purpose of the study was to determine if socioenvironmental factors reduce or account for previously observed ethnic/race group differences and explore if a combined effect of socioenvironmental risk and chronic pain severity on temporal lobe cortices is evident. Consistent with the prior study, the sample was comprised of 147 adults (95 women, 52 men), 45-85 years of age, who self-identified as non-Hispanic Black (n =72) and non-Hispanic White (n =75), with knee pain with/at risk for osteoarthritis. Measures included demographics, health history, pain questionnaires, cognitive screening, body mass index, individual- and community-level socioenvironmental factors (education, income, household size, marital and insurance status, and area deprivation index), and brain imaging. We computed a summative socioenvironmental risk index. Regression analyses showed that with the inclusion of socioenvironmental factors, the model was significant (p<.001), and sociodemographic (ethnic/race) group differences were not significant (p = .118). Additionally, findings revealed an additive stress load pattern indicating thinner temporal lobe cortices with greater socioenvironmental risk and chronic pain severity (p = .048). Although individual socioenvironmental factors were not independent predictors, when collectively combined in models, ethnic/race group differences in bilateral temporal lobe structures were not replicated. Further, combined socioenvironmental risk factors and higher chronic pain severity were associated with thinner bilateral temporal lobes.

Agricultural practices and intestinal parasites: A study of socio-environmental risk factors associated with leafy vegetable production in La Plata horticultural area, Argentina

Foodborne diseases now represent one of the most important public health problems. The objectives were to analyze the leafy vegetables and crop soil to detect parasitic species and evaluate the factors that increase the risk of parasitic contamination in the productive units in La Plata horticultural area. The study included 261 leafy vegetable and 87 crop soil samples that were processed using washing, sedimentation, and flotation techniques. Socio-environmental characteristics and agricultural practices were surveyed, and a generalized linear model was used to assess the change in parasitic prevalence with different predictor variable. The 58.6% of leafy vegetable and 31.0% of crop soil samples contained parasitic species, the most prevalent being Blastocystis sp. and oocysts of Cryptosporidium spp. Risk factors were the limited access to health, dirt roads, children and dogs circulating in crops, field cultivation, furrow irrigation and lettuce cultivation. The high prevalence of intestinal parasites in the vegetable crops was mainly associated with the conditions of structural precariousness in the production units. These results elaborated with the participation of the population, provide valuable knowledge for the planning of epidemiological programs that include environmental health as a fundamental nexus in health campaigns.

A review of mental health issues in high-performance and elite-level cycling.

Despite the public health benefits of cycling in the general population, mental health issues may be evident in high-performance and elite-level competitive domains. With prominent riders disclosing their experiences with psychiatric symptoms, distinctive socioenvironmental factors could exacerbate psychopathological vulnerabilities. This suggests a need for greater mental health awareness amongst stakeholders, supplemented by actions from international and national federations and regulators. To synthesise relevant observations about psychiatric concerns in high-performance and elite-level cycling, we conducted a keyword search of articles in APA PsycINFO, PubMed, and Scopus based on specified exclusion criteria. Thirteen papers were identified that examined mental health issues in high-performance and/or elite-level cycling per classifications from the World Health Organization's International Classification of Diseases 11th Revision. A large proportion of articles illustrated eating disorder symptomatology, but others discussed attention deficit/hyperactivity disorder, anxiety disorder, depression, sleep wake disorders, and substance use disorder. Existing literature underlines important considerations for all stakeholders within the cycling community around mental health initiatives and care provisions, which are currently lacking across the sport. Such programmes could incorporate consensus statements, psychiatric screening, psychoeducation, stigma-reducing policies, and athlete advocacy. These can help mitigate socioenvironmental risk factors and prioritise athlete wellbeing over performance-centred motivations.

Risk Factors for Postpartum Depression and Severe Distress among Mothers of Very Preterm Infants at NICU Discharge.

To identify psychological, medical, and socioenvironmental risk factors for maternal postpartum depression (PPD) and severe psychological distress (SPD) at intensive care nursery discharge among mothers of very preterm infants. We studied 562 self-identified mothers of 641 infants born <30 weeks who were enrolled in the Neonatal Neurobehavior and Outcomes in Very Preterm Infants Study (NOVI) conducted in nine university-affiliated intensive care nurseries. Enrollment interviews collected socioenvironmental data, depression, and anxiety diagnoses prior to and during the study pregnancy. Standardized medical record reviews ascertained prenatal substance use, maternal and neonatal medical complications. The Edinburgh Postnatal Depression Scale and Brief Symptom Inventory were administered at nursery discharge to screen for PPD and SPD symptoms, respectively. Unadjusted analyses indicated mothers with positive screens for depression (n = 76, 13.5%) or severe distress (n = 102, 18.1%) had more prevalent prepregnancy/prenatal depression/anxiety, and their infants were born at younger gestational ages, with more prevalent bronchopulmonary dysplasia, and discharge after 40 weeks postmenstrual age. In multivariable analyses, prior depression or anxiety was associated with positive screens for PPD (risk ratio [RR]: 1.6, 95% confidence interval [CI]: 1.1-2.2) and severe distress (RR: 1.6, 95% CI: 1.1-2.2). Mothers of male infants had more prevalent depression risk (RR: 1.7, 95% CI: 1.1-2.4), and prenatal marijuana use was associated with severe distress risk (RR: 1.9, 95% CI: 1.1-2.9). Socioenvironmental and obstetric adversities were not significant after accounting for prior depression/anxiety, marijuana use, and infant medical complications. Among mothers of very preterm newborns, these multicenter findings extend others' previous work by identifying additional indicators of risk for PPD and SPD associated with a history of depression, anxiety, prenatal marijuana use, and severe neonatal illness. Findings could inform designs for continuous screening and targeted interventions for PPD and distress risk indicators from the preconception period onward. · Preconceptional and prenatal screening for postpartum depression and severe distress may inform care.. · Prior depression, anxiety, and neonatal complications predicted severe distress and depression symptoms at NICU discharge.. · Readily identifiable risk factors warrant continuous NICU screening and targeted interventions to improve outcomes..

Ethanol Metabolism and Melanoma.

Malignant melanoma is the deadliest form of skin cancer. Despite significant efforts in sun protection education, melanoma incidence is still rising globally, drawing attention to other socioenvironmental risk factors for melanoma. Ethanol and acetaldehyde (AcAH) are ubiquitous in our diets, medicines, alcoholic beverages, and the environment. In the liver, ethanol is primarily oxidized to AcAH, a toxic intermediate capable of inducing tumors by forming adducts with proteins and DNA. Once in the blood, ethanol and AcAH can reach the skin. Although, like the liver, the skin has metabolic mechanisms to detoxify ethanol and AcAH, the risk of ethanol/AcAH-associated skin diseases increases when the metabolic enzymes become dysfunctional in the skin. This review highlights the evidence linking cutaneous ethanol metabolism and melanoma. We summarize various sources of skin ethanol and AcAH and describe how the reduced activity of each alcohol metabolizing enzyme affects the sensitivity threshold to ethanol/AcAH toxicity. Data from the Gene Expression Omnibus database also show that three ethanol metabolizing enzymes (alcohol dehydrogenase 1B, P450 2E1, and catalase) and an AcAH metabolizing enzyme (aldehyde dehydrogenase 2) are significantly reduced in melanoma tissues.

Increased blood neutrophil extracellular traps (NETs) associated with early life stress: translational findings in recent-onset schizophrenia and rodent model

Higher levels of interleukin (IL)-6 and elevated neutrophil counts are consistently reported in the blood of patients with schizophrenia. Stressors during childhood and/or adolescence are major socioenvironmental risk factors for schizophrenia and may contribute to immune dysregulation. Previous studies using blood cytokines to stratify patients with schizophrenia suggest that only a subset presents a low-grade inflammatory state. However, these studies have not addressed whether environmental factors such as childhood maltreatment contributed to identifying inflammatory clusters. Moreover, a neutrophil-related mechanism (Neutrophil Extracellular Traps; NETs) central to both the initiation and chronicity of autoimmune and inflammatory diseases has never been investigated in psychiatry. Elevated NETs in schizophrenia may predispose patients to inflammatory and autoimmune diseases resulting in reduced life expectancy. We, therefore, investigated NETs as a novel mechanism and biological target in early schizophrenia and their role together with IL-6 and childhood maltreatment in identifying cluster subgroups. We found increased NETs in the plasma of patients with early schizophrenia (n = 78) compared to both their unaffected siblings (n = 25) and community controls (n = 78), irrespective of sex, body mass index, psychoactive drug use, or tobacco smoking. Increased NETs in patients were unrelated to antipsychotic treatment, which was further tested in vitro using fresh neutrophils. By applying unsupervised two-step clustering analysis, we integrated values of NETs, IL-6, and childhood maltreatment scores. We identified two main clusters; childhood maltreatment scores and NETs were the most important variables contributing to cluster separation (high-CL1 and low-CL2), while IL-6 was the least contributor. Patients allocated in the high-CL1 (61.5%) had significantly higher childhood maltreatment scores, NETs, and IL-6 levels than the remaining groups (patients low-CL2, siblings, and controls high-CL1 and low-CL2). We complemented these findings with a rat model based on stress exposure during adolescence that results in several schizophrenia-like changes in adulthood. We found that adolescent stressed rats had higher NETs and IL-6 levels in serum compared to non-stressed rats with a tendency to produce more NETs from the bone marrow. Altogether, this study brings a novel cellular-based mechanism in schizophrenia that, combined with early-stress, could be useful to identify subgroups for more personalised treatments.

Conocimientos y factores de riesgo socioambientales en relación con arbovirosis urbanas en Barranquilla (Colombia)

Objetivo: Comparar el conocimiento sobre las arbovirosis urbanas y los factores de riesgo que favorecerían su presencia en barrios de estrato socioeconómico dos y tres de la Ciudad de Barranquilla. Metodología: Estudio descriptivo-transversal. Se aplicaron 100 encuestas (25 viviendas/barrio), para evaluar el conocimiento de la población sobre diferentes aspectos de las arbovirosis urbanas, así como las condiciones socioambientales de riesgo para la presencia de larvas y adultos de Aedes aegypti. Se realizaron charlas pedagógicas, jornadas de limpieza y la elaboración de un tríptico para informar a la población intervenida. Se aplicó la prueba Chi cuadrado-X2 con intervalos de confianza al 95% para analizar diferencias significativas entre conocimientos y factores de riesgo; y un Análisis de Componentes Principales-ACP para inferir las variables determinantes entre los conocimientos y los factores de riesgo. La información fue analizada con el programa SPSS versión 25. Resultados: Los encuestados reconocieron a los mosquitos como transmisores de agentes causantes de dengue, Zika o chikungunya. Se identificaron larvas y adultos de Ae. aegypti, en nichos del intra y peridomicilio como factores de riesgo. Las jornadas pedagógicas incentivaron los buenos hábitos de prevención donde fue posible eliminar los potenciales criaderos para Ae. aegypti. Conclusión: No se encontraron diferencias significativas entre el nivel de conocimiento sobre arbovirosis; los barrios estrato dos presentaron mayores atributos de factores de riesgo; la presencia de Ae. aegypti parece ser uno de los componentes principales que condicionarían la aparición de arbovirosis en las poblaciones evaluadas.

Ethnoracial Variation in Risk for Psychotic Experiences.

Psychotic disorders are inequitably distributed by race in the United States, although it is not known whether this is due to assessment biases or inequitable distributions of risk factors. Psychotic experiences are subclinical hallucinations and delusions used to study the etiology of psychosis, which are based on self-report and therefore not subject to potential clinician biases. In this study, we test whether the prevalence of psychotic experiences (PE) varies by race and if this variance is explained by socioenvironmental risk factors. Data on demographics, PE, and socioenvironmental risk factors were collected through the National Survey of Poly-victimization and Mental Health, a national probability sample of US young adults. Logistic regression analyses were used to determine whether PE prevalence varied by race/ethnicity and, if so, whether this was attenuated with inclusion of indicators of income, education, urban/rural living, discrimination, and trauma exposure. Black and Hispanic respondents reported PE at significantly greater rates than White or "other" ethnoracial groups, with hallucinations more commonly reported by Hispanic respondents. PE were significantly associated with police violence exposure, discrimination, adverse childhood experiences, and educational attainment. These factors statistically explained ethnoracial differences in the likelihood of overall PE occurrence and of nearly all PE subtypes. Previously observed racial differences in psychosis extend beyond clinical schizophrenia, and therefore, are unlikely to be explained entirely by clinician biases. Instead, racial disparities in PE appear to be driven by features of structural racism, trauma, and discrimination.

Mothers who kill their children: A systematic review of perinatal risk factors

This review examines the association between the perinatal period and thoughts and behaviours of neonaticide, infanticide, and filicide, highlighting mothers' risk factors. A literature search was conducted on PubMed, PsycINFO, and ScienceDirect, with 2,957 articles screened and 13 determined as eligible for inclusion. Inclusion criteria were: 1) studies on neonaticide, infanticide and filicide; 2) studies conducted on women; 3) studies with perinatal population; 4) original, peer-reviewed studies; 5) studies written in English or Italian language. Single-case reports and qualitative studies were excluded, as were those studies written in any other language, and any studies for which the full-text version could not be obtained (i.e. conference abstracts). Two reviewers independently reviewed titles and abstracts, reviewed relevant articles' full text, and extracted the data. Several individuals and socio-environmental risk factors were identified for neonaticide, infanticide, and filicide during the perinatal period, highlighting the importance of paying particular attention to the mother's well-being in this critical phase. Women who committed neonaticide, infanticide, or filicide faced a variety of challenges in their lives. Such life events might prompt mental health professionals to address the possibility of harmful acts in their patients.

Risk perception and communal coping in families affected by type 2 diabetes

Despite a recent decline, rates of type 2 diabetes remain high among older adults. Preventing and delaying the onset of the condition with lifestyle changes is key to reducing disease burden in the population. Type 2 diabetes is a complex disease, likely a result from the joint effect of genetic, socio-environmental and lifestyle risk factors that are clustered in families. As such, the prevention of type 2 diabetes is a communal coping process, where individuals communicate about risk and establish routines to facilitate one another’s health habits and compliance with therapeutics. This poster investigates how such a process is affected by one’s perception of risk based on his/her knowledge about family health history (FHH). We collected family network data from families of different racial backgrounds in the greater Cincinnati area (28 white and 17 black/ African American households; 127 participants). The analysis focuses on how the density of diabetes diagnosis in one’s FHH affects communication about shared risk for type 2 diabetes and encouragement to maintain or adopt a healthy lifestyle. Results suggest a higher concentration of diabetes diagnosis in one’s FHH is associated with a higher number of risk communication ties in all families. With regards to encouragement ties, high rates of diabetes diagnosis in FHH are associated with an increased number of encouragement ties only in families of black/African heritage. The findings highlight the need and promise of using FHH to motivate co-encouragement to maintain/adopt a healthier lifestyle in families of black/African heritage.

Socio-environmental and psychosocial predictors of smoking susceptibility among adolescents with contrasting socio-cultural characteristics: a comparative analysis

BackgroundDespite a steady decline in adolescent smoking globally, it remains a prevalent risk factor for non-communicable disease. Previous research points to differences in socio-environmental and psychosocial risk factors for smoking and how they vary across different settings with disparate social and cultural characteristics. As a result, smoking rates have remained disproportionately higher in some settings while decreasing in others. This study explored the socio-environmental and psychosocial risk factors for smoking susceptibility in a high-income and upper-middle income setting.MethodsCross-sectional data were obtained from 1,573 male and female adolescents aged 11-15 years who completed self-administered questionnaires in schools in Northern Ireland and Bogotá, Colombia. Using logistic regression analysis, we examined how socio-environmental and psychosocial predictors of smoking susceptibility compared across the two countries.ResultsIn Northern Ireland, reduced odds of smoking susceptibility were significantly associated with less family smoking (OR: 0.64, 95% CI: 0.41-1.00); having access to information about smoking in school (OR: 0.75, 95% CI: 0.59-0.96); negative attitudes towards smoking (OR: 0.35, 95% CI: 0.23-0.51); higher levels of openness (OR: 0.59, 95% CI: 0.50-0.69); and higher levels of self-reported wellbeing (OR: 0.57, 95% CI: 0.44-0.74). Increased odds of smoking susceptibility were associated with reporting less smoking of a mother (OR: 1.37, 95% CI: 1.06-1.76); higher levels of extraversion (OR: 1.40, 95% CI: 1.04-1.90); and receiving pocket money (OR: 1.20, 95% CI: 1.06-1.37). In Bogotá, reduced odds of smoking susceptibility were significantly associated with reporting less smoking among friends (OR: 0.86, 95% CI: 0.76-0.98); higher levels of self-efficacy (OR: 0.58, 95% CI: 0.40-0.83); greater perceived behavioural control to quit smoking (OR: 0.71, 95% CI: 0.56-0.90); and lower levels of truancy (OR: 0.69, 95% CI: 0.52-0.92). In Bogotá, no factors were associated with increased odds of smoking susceptibility in the final model.ConclusionsThe findings illustrate that there were differences in predictors of adolescent smoking susceptibility across the two settings. By using a comparative approach we demonstrate that smoking interventions and policies must be sensitive to the cultural and normative context within which they are implemented.

Factor Analysis of Suicidal Risk and Protective Mechanisms of Pedagogical Students in Kazakhstan.

The study aims to identify the underlying causes, risks and protection factors in the field of suicidal behavior among pedagogical students to understand and reduce the prevalence of victimization and suicide in the education system. The analysis of suicidal risk factors and protective mechanisms among pedagogical students is carried out based on the results of psychological testing, correlation and factor analysis. Results of the study show that the following two factors greatly influence suicidal behavior among pedagogical students. Firstly, there is "Psychological (personal) risk factor of suicidal behavior", which combines indicators of destructive personality of students, leading to suicidal behavior. Secondly, there is "Conflict socio-environmental risk factor of suicidal behavior" that combines indicators of disharmonious upbringing and disharmonious relationships with the immediate environment. Moreover, in stressful situations, most future teachers from the "risk group" use non-constructive strategies of the protective mechanisms "projection" and "regression" and have a high level of an overall tension index of these mechanisms. It is found that the suicidal factors, characteristic for pedagogical students, do not differ from the suicidal factors characteristic for students from other specialties. These factors affect a large number of pedagogical students (41.5%). There might be several risk factors at once, which increases the likelihood of suicidal thoughts and actions. The results of the study can be used to predict and prevent suicidal behavior among pedagogical students and increase the effectiveness of the psychological services of universities.

Multidrug-resistant enteric pathogens in older children and adults with diarrhea in Bangladesh: epidemiology and risk factors

BackgroundAntimicrobial resistance (AMR) is a global public health threat and is increasingly prevalent among enteric pathogens in low- and middle-income countries (LMICs). However, the burden of multidrug-resistant organisms (MDROs) in older children, adults, and elderly patients with acute diarrhea in LMICs is poorly understood. This study’s aim was to characterize the prevalence of MDR enteric pathogens isolated from patients with acute diarrhea in Dhaka, Bangladesh, and assess a wide range of risk factors associated with MDR.MethodsThis study was a secondary analysis of data collected from children over 5 years, adults, and elderly patients with acute diarrhea at the International Centre for Diarrhoeal Disease Research, Bangladesh Dhaka Hospital between March 2019 and March 2020. Clinical, historical, socio-environmental information, and a stool sample for culture and antimicrobial susceptibility testing were collected from each patient. Univariate statistics and multiple logistic regression were used to assess the prevalence of MDR among enteric pathogens and the association between independent variables and presence of MRDOs among culture-positive patients.ResultsA total of 1198 patients had pathogens isolated by stool culture with antimicrobial susceptibility results. Among culture-positive patients, the prevalence of MDR was 54.3%. The prevalence of MDR was highest in Aeromonas spp. (81.5%), followed by Campylobacter spp. (72.1%), Vibrio cholerae (28.1%), Shigella spp. (26.2%), and Salmonella spp. (5.2%). Factors associated with having MDRO in multiple logistic regression included longer transport time to hospital (>90 min), greater stool frequency, prior antibiotic use prior to hospital presentation, and non-flush toilet use. However, pseudo-R2 was low 0.086, indicating that other unmeasured variables need to be considered to build a more robust predictive model of MDR.ConclusionsMDR enteric pathogens were common in this study population with clinical, historical, and socio-environmental risk factors associated with MDROs. These findings may help guide clinical decision-making regarding antibiotic use and selection in patients at greatest risk of complications due to MDROs. Further prospective research is urgently needed to determine what additional factors place patients at greatest risk of MDRO, and the best strategies to mitigate the spread of MDR in enteric pathogens.

A review of models applied to the geographic spread of Zika virus.

In recent years, Zika virus (ZIKV) has expanded its geographic range and in 2015–2016 caused a substantial epidemic linked to a surge in developmental and neurological complications in newborns. Mathematical models are powerful tools for assessing ZIKV spread and can reveal important information for preventing future outbreaks. We reviewed the literature and retrieved modelling studies that were developed to understand the spatial epidemiology of ZIKV spread and risk. We classified studies by type, scale, aim and applications and discussed their characteristics, strengths and limitations. We examined the main objectives of these models and evaluated the effectiveness of integrating epidemiological and phylogeographic data, along with socioenvironmental risk factors that are known to contribute to vector–human transmission. We also assessed the promising application of human mobility data as a real-time indicator of ZIKV spread. Lastly, we summarised model validation methods used in studies to ensure accuracy in models and modelled outcomes. Models are helpful for understanding ZIKV spread and their characteristics should be carefully considered when developing future modelling studies to improve arbovirus surveillance.