Neighbourhood-level effects on psychoses: re-examining the role of context

2007 ◽  
Vol 37 (10) ◽  
pp. 1413-1425 ◽  
Author(s):  
JAMES B. KIRKBRIDE ◽  
CRAIG MORGAN ◽  
PAUL FEARON ◽  
PAOLA DAZZAN ◽  
ROBIN M. MURRAY ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Capital ◽  
Voter Turnout ◽  
Social Stress ◽  
Protective Factor ◽  
Census Data ◽  
Individual Risk ◽  
Ethnic Density ◽  
Affective Psychoses ◽  
Neighbourhood Level

ABSTRACTBackgroundThe incidence of schizophrenia varies by individual-level characteristics and neighbourhood-level attributes. Few specific socio-environmental risk factors (SERFs) have been identified at the neighbourhood level. Cross-level interactions are poorly understood. We investigated these issues using data from the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study.MethodAll incidence cases of ICD-10 schizophrenia (F20) and other non-affective psychoses (F21–29), aged 16–64 years, across 33 wards in Southeast London were identified over a 2-year period (1997–1999). Census data provided the denominator for each ward. Multilevel Poisson regression simultaneously modelled individual- and neighbourhood-level SERFs, including socio-economic deprivation, voter turnout (proxy for social capital), ethnic fragmentation (segregation) and ethnic density.ResultsA total of 218 subjects were identified during 565 576 person-years at risk. Twenty-three per cent of variance in incidence of schizophrenia across wards could be attributed to neighbourhood-level risk factors [95% confidence interval (CI) 9·9–42·2]. Thus, 1% increases in voter turnout [incidence rate ratio (IRR) 0·95, 95% CI 0·92–0·99] and ethnic segregation (IRR 0·95, 95% CI 0·92–0·99) were both independently associated with a reduced incidence of 5%, independent of age, sex, ethnicity, deprivation and population density. This was similar for other non-affective psychoses. There was some evidence that ethnic minority individuals were at greater risk of schizophrenia in areas with smaller proportions of minority groups (p=0·07).ConclusionSERFs at individual and neighbourhood levels were implicated in the aetiology of psychosis, but we were unable to determine whether these associations were causal. Individual risk may be mediated by social capital, which could operate as a protective factor, perhaps moderating social stress in the onset of psychoses.

Testing the association between the incidence of schizophrenia and social capital in an urban area

2007 ◽  
Vol 38 (8) ◽  
pp. 1083-1094 ◽  
Author(s):  
J. B. Kirkbride ◽  
J. Boydell ◽  
G. B. Ploubidis ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Social Capital ◽  
Urban Area ◽  
Social Stress ◽  
Adult Population ◽  
Incidence Rates ◽  
Ethnic Density ◽  
Cross Sectional ◽  
Neighbourhood Level ◽  
Icd 10 ◽  
Using Data

BackgroundSocial capital has been considered aetiologically important in schizophrenia but the empirical evidence to support this hypothesis is absent. We tested whether social capital, measured at the neighbourhood level, was associated with the incidence of schizophrenia (ICD-10 F20).MethodWe administered a cross-sectional questionnaire on social capital to 5% of the adult population in 33 neighbourhoods (wards) in South London (n=16 459). The questionnaire contained items relating to two social capital constructs: social cohesion and trust (SC&T) and social disorganization (SocD). Schizophrenia incidence rates, estimated using data from the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study, provided the outcome. We used multi-level Poisson regression to test our hypothesis while controlling for individual- and neighbourhood-level characteristics.ResultsWe identified 148 cases during 565 576 person-years at-risk. Twenty-six per cent of the variation in incidence rates was attributable to neighbourhood-level characteristics. Response from the social capital survey was 25.7%. The association between SC&T and schizophrenia was U-shaped. Compared with neighbourhoods with medial levels of SC&T, incidence rates were significantly higher in neighbourhoods with low [incidence rates ratio (IRR) 2.0, 95% confidence interval (CI) 1.2–3.3] and high (IRR 2.5, 95% CI 1.3–4.8) levels of SC&T, independent of age, sex, ethnicity, ethnic density, ethnic fragmentation and socio-economic deprivation.ConclusionNeighbourhood variation in SC&T was non-linearly associated with the incidence of schizophrenia within an urban area. Neighbourhoods with low SC&T may fail to mediate social stress whereas high SC&T neighbourhoods may have greater informal social control or may increase the risk of schizophrenia for residents excluded from accessing available social capital.

Population genetics of venous thromboembolism

2011 ◽  
Vol 105 (02) ◽  
pp. 221-231 ◽  
Author(s):  
Elvira Grandone ◽  
Maurizio Margaglione
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Protective Factor ◽  
Disease Susceptibility ◽  
Risk Profile ◽  
Individual Risk ◽  
Socioeconomic Differences ◽  
Genetic Studies ◽  
Individual Risk Factors ◽  
Insight Into

SummaryResults from epidemological studies are consistent with the hypothesis that disparities in venous thromboembolism (VTE) burden are attributable to differences in genetic structure among populations from different genetic backgrounds. To that end, recent genetic studies have demonstrated not only potential associations between certain alleles and VTE but also clear differences in the distribution of these alleles in patients stratified by ancestry. There are a number of notable clinical and pathophysiological questions that arise from these findings. First at all is defining the precise variant(s) that alter disease susceptibility. The comparatively lower rates of VTE recorded among Asians would imply that risk profile is devoid of many risk factors on comparison to Caucasian or African counterparts or that a putative protective factor is advocated in the former population. Identification of these variants provided specific insight into VTE disease in selected populations and also shed lights on the biology of the disease. The association observed between ancestry and VTE is likely to be multifactorial, possibly reflecting, in addition to genetic variation, also socioeconomic differences. Acknowledgment of this may provide useful information in biomedical contexts and help to identify individual risk factors for VTE.

Risk factors of problematic video game use among teenagers in Sfax

2017 ◽  
Vol 41 (S1) ◽  
pp. S453-S453 ◽  
Author(s):  
L. Cherif ◽  
C. Sahnoun ◽  
K. Khemakhem ◽  
H. Ayadi ◽  
A. Walha ◽  
...  
Keyword(s):  
Risk Factors ◽  
Secondary School ◽  
Video Game ◽  
Secondary School Students ◽  
Internet Use ◽  
Protective Factor ◽  
Problematic Internet Use ◽  
Individual Risk ◽  
School Students ◽  
Item Questionnaire

ObjectiveTo identify correlates that might constitute risk factors for problematic video game use (PVU) among urban Tunisian secondary school students.MethodsThis multivariate cross-sectional study was carried out on 587 secondary school students, aged 14 to 20 years. They were randomly selected from seven secondary schools in the urban area of Sfax. The self-administered Fisher's nine-item questionnaire was used in this survey. To identify an associated problematic internet use video game addiction, Young's eight-item questionnaire was used. A self-administered, anonymous questionnaire covered socio-demographic, individual and family data.ResultsThe prevalence of PVU was 14.01%. In multivariate logistic regression analysis, we found that the individual risk factors for problematic video game use were anxiety symptoms (P = 0.034) and an associated problematic Internet use (P < 0.001). Playing sport was a protective factor (P = 0.011). The poor relationships within the family (P = 0.001), the lack of parental supervision of time spent on playing video game (P < 0.001) and mother profession as mid-to upper level manager (P = 0.002), predicted PVU.ConclusionThe identification of risk factors can help to determine individuals at high risk, and alert mental health providers to be careful to screen these patients for PVU. Total avoidance of the Internet is unrealistic and inadvisable; but a sensibilisation outreach for youth, their families and health professionals may help to limit the onset of PVU among young people.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Social, Economic and Human Capital: Risk or Protective Factors in Sexual Violence?

2022 ◽  
Vol 19 (2) ◽  
pp. 777
Author(s):  
Paola Ilabaca Baeza ◽  
José Manuel Gaete Fiscella ◽  
Fuad Hatibovic Díaz ◽  
Helena Roman Alonso
Keyword(s):  
Risk Factors ◽  
Social Capital ◽  
Network Analysis ◽  
Protective Factors ◽  
Sexual Violence ◽  
Protective Factor ◽  
Social Economic ◽  
Protective Role ◽  
Artificial Neural Network Analysis ◽  
Structural Social Capital

In Chile, studies on protective factors and risk factors for sexual violence are limited and very few have incorporated analysis of different types of capital (social, economic, human) as social resources in the protection against sexual violence. The objective of this research is to evaluate to what extent the stock of different capitals act together, as either protective or risk factors in sexual violence in different interpersonal environments. The sample consisted of 1665 women between 15 and 30 years of age (M = 23.47, SD = 4.41). Artificial neural network analysis and social network analysis were used. The nodes representative of human and economic capital have a protective role of low relevance due to their position in the network, while the nodes of social capital acquire a structural relevance due to the central positions of the network. It is concluded that the structural social capital of neighborhood networks constitutes the main protective factor for sexual violence in all areas, and in turn, the structural social capital of networks with non-significant others was the main risk factor in sexual victimization.

Race, Ethnicity, and Street Gang Involvement in an American Context

2019 ◽  
Author(s):  
Adrienne Freng
Keyword(s):  
Risk Factors ◽  
African American ◽  
Ethnic Groups ◽  
Race And Ethnicity ◽  
Protective Factor ◽  
The United States ◽  
Gang Membership ◽  
Individual Risk ◽  
Race Ethnicity ◽  
The Relationship

Race and ethnicity represent a pivotal issue in almost any conversation regarding gang members. These two concepts have been invariably linked in both research and the larger social world. Images of this connection invade our social milieu and appear frequently in movies, television, news, and music. However, academic research also contributes to this perception. Much of the early work, as well as a significant portion of the qualitative work on gangs, perpetuates the continued examination of racial and ethnic homogeneous gangs, with a focus on African American and Hispanic groups. This work ignores increasing problems among other racial and ethnic groups, such as Asians and Native Americans, within the literature. More recently, however, the intricacies of this relationship are becoming clearer, including the growing involvement of White individuals and the fact that gangs are increasingly multiracial. Furthermore, with the development of the Eurogang project in the late 1990s, research regarding these groups in Europe, as well as in other countries across the world, has become more plentiful, further expanding our knowledge regarding gangs and the role of race and ethnicity, as well as immigration and migration. As the relationship between race and ethnicity and gang membership takes on more meaning, numerous explanations have been developed to account for this connection. Much of the research, both past and present, centers on the association between race and ethnicity and the impacts of social disorganization, discrimination, immigration, and cumulative disadvantage. Community and environmental factors play a crucial role in explaining why gangs thrive in communities often occupied by racial and ethnic minorities. Relatedly, external threats, specifically violence from other groups, can provide the impetus for gang development in neighborhoods marked by disorder; thus, other explanations center on violence and the role that gangs play in mitigating this threat while serving as a protective factor for the youth in the community. The risk factor approach, gaining more prominence in gang literature, investigates individual risk for gang membership, as well as the cumulative effects of risk factors. These various frameworks assist in beginning to understand the underlying factors contributing to gang membership. With regard to policy recommendations, investigating “race and ethnicity specific” risk factors as well how these risk factors might impact programming remain key. In order to fully comprehend the development of gangs, a number of gang researchers have called for the need to understand the different historical experiences of racial and ethnic groups within the United States. For example, the histories of Hispanic and African American groups impact their experiences and thus may result in different pathways to gang membership. And yet, in many respects, these groups are still treated as single entities, ignoring their distinct histories. In fact, there remains a paucity of information regarding cross-group comparisons that examine actual differences between racial and ethnic groups. Without a closer examination of the relationship between race, ethnicity, and gang membership, effective gang policies and practices will remain out of reach.

scholarly journals Multidrug-Resistant Pseudomonas aeruginosa: Risk Factors and Clinical Impact

2006 ◽  
Vol 50 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Valerie Aloush ◽  
Shiri Navon-Venezia ◽  
Yardena Seigman-Igra ◽  
Shaltiel Cabili ◽  
Yehuda Carmeli
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Intensive Care ◽  
Hospital Stay ◽  
Clinical Outcomes ◽  
Protective Factor ◽  
Multidrug Resistant ◽  
Clinical Impact ◽  
Individual Risk ◽  
Individual Risk Factors

ABSTRACT Pseudomonas aeruginosa, a leading nosocomial pathogen, may become multidrug resistant (MDR). Its rate of occurrence, the individual risk factors among affected patients, and the clinical impact of infection are undetermined. We conducted an epidemiologic evaluation and molecular typing using pulsed-field gel electrophoresis (PFGE) of 36 isolates for 82 patients with MDR P. aeruginosa and 82 controls matched by ward, length of hospital stay, and calendar time. A matched case-control study identified individual risk factors for having MDR P. aeruginosa, and a retrospective matched-cohort study examined clinical outcomes of such infections. The 36 isolates belonged to 12 PFGE clones. Two clones dominated, with one originating in an intensive care unit (ICU). Cases and controls had similar demographic characteristics and numbers of comorbid conditions. A multivariate model identified ICU stay, being bedridden, having high invasive devices scores, and being treated with broad-spectrum cephalosporins and with aminoglycosides as significant risk factors for isolating MDR P. aeruginosa. Having a malignant disease was a protective factor (odds ratio [OR] = 0.2; P = 0.03). MDR P. aeruginosa was associated with severe outcomes compared to controls, including increased mortality (OR = 4.4; P = 0.04), hospital stay (hazard ratio, 2; P = 0.001), and requirement for procedures (OR = 5.4; P = 0.001). The survivors functioned more poorly at discharge than the controls, and more of the survivors were discharged to rehabilitation centers or chronic care facilities. The epidemiology of MDR P. aeruginosa is complex. Critically ill patients that require intensive care and are treated with multiple antibiotic agents are at high risk. MDR P. aeruginosa infections are associated with severe adverse clinical outcomes.

A Model for Analyzing Suicide Prevention

Crisis ◽  
2000 ◽  
Vol 21 (2) ◽  
pp. 80-89 ◽  
Author(s):  
Maila Upanne
Keyword(s):  
Risk Factors ◽  
Theoretical Model ◽  
Protective Factors ◽  
Suicide Prevention ◽  
Suicide Risk ◽  
Practical Work ◽  
Individual Risk ◽  
Self Assessment ◽  
Prevention Project ◽  
Individual Risk Factors

This study monitored the evolution of psychologists' (n = 31) conceptions of suicide prevention over the 9-year course of the National Suicide Prevention Project in Finland and assessed the feasibility of the theoretical model for analyzing suicide prevention developed in earlier studies [ Upanne, 1999a , b ]. The study was formulated as a retrospective self-assessment where participants compared their earlier descriptions of suicide prevention with their current views. The changes in conceptions were analyzed and interpreted using both the model and the explanations given by the subjects themselves. The analysis proved the model to be a useful framework for revealing the essential features of prevention. The results showed that the freely-formulated ideas on prevention were more comprehensive than those evolved in practical work. Compared to the earlier findings, the conceptions among the group had shifted toward emphasizing a curative approach and the significance of individual risk factors. In particular, greater priority was focused on the acute suicide risk phase as a preventive target. Nonetheless, the overall structure of prevention ideology remained comprehensive and multifactorial, stressing multistage influencing. Promotive aims (protective factors) also remained part of the prevention paradigm. Practical working experiences enhanced the psychologists' sense of the difficulties of suicide prevention as well as their criticism and feeling of powerlessness.

Therapeutic options in male osteoporosis

2013 ◽  
Vol 22 (04) ◽  
pp. 271-276 ◽  
Author(s):  
P. Farahmand ◽  
J. D. Ringe
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Public Health Problem ◽  
Male Osteoporosis ◽  
Individual Risk ◽  
Modes Of Action ◽  
Increased Risk ◽  
Study Results ◽  
Long Term Treatment ◽  
Male Patients

SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.

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