scholarly journals Loneliness in young people: A multilevel exploration of social ecological influences and geographic variation

2021 ◽  
Author(s):  
Jose Marquez ◽  
Claire Goodfellow ◽  
Deborah Hardoon ◽  
Joanna Inchley ◽  
Alastair Leyland ◽  
...  
Keyword(s):  
Young People ◽  
Local Level ◽  
Ecological Factors ◽  
Geographic Region ◽  
Mental Wellbeing ◽  
Health Concern ◽  
Cross Sectional ◽  
Community Factors ◽  
Social Ecological ◽  
Geographic Regions

Background: Loneliness is a growing public health concern, yet little is known about loneliness in young people. The current study aimed to identify social ecological factors related to loneliness and examine the extent to which geographic region accounts for differences in loneliness.Methods: The data come from a cross-sectional sample of 6503 young people living in the United Kingdom. Loneliness was measured using the UCLA 3-item scale. Bivariate analyses were used to test associations between each predictor and loneliness. Multilevel models were used to identify key social ecological factors related to loneliness, and the extent to which loneliness varied across geographic regions. Results: Socio-demographic, social, health and wellbeing, and community factors were found to be associated with loneliness. Geographic region accounted for 5-8% of the variation in loneliness. The effect of gender, sexual orientation, and minority ethnic background on loneliness differed across geographic regions. Conclusions: This is the first study to highlight modifiable social and community factors related to youth loneliness, and individual vulnerabilities, such as poor mental wellbeing. Results related to geographic differences suggest that local-level initiatives may be most appropriate in tackling loneliness, rather than wider, less contextualized national efforts.

scholarly journals Social ecological factors associated with experiencing violence among urban refugee and displaced adolescent girls and young women in informal settlements in Kampala, Uganda: a cross-sectional study

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Carmen H. Logie ◽  
Moses Okumu ◽  
Simon Mwima ◽  
Robert Hakiza ◽  
Kibathi Peter Irungi ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Food Insecurity ◽  
Childhood Abuse ◽  
Adolescent Girls ◽  
Ecological Factors ◽  
Sexual Relationship ◽  
Relationship Power ◽  
Cross Sectional ◽  
Factors Associated ◽  
Social Ecological

Abstract Background Research on violence targeting urban forcibly displaced adolescent girls and young women (AGYW) is limited, particularly regarding polyvictimization (exposure to multiple forms of violence). Yet there is a global trend of refugee urbanization, and urban AGYW are at the nexus of violence disparities among adolescents, forcibly displaced persons, and slum dwellers. This study explored factors associated with young adulthood violence (> 16 years) (YAV) and intimate partner violence (IPV) among forcibly displaced AGYW in Kampala, Uganda. Methods We conducted a cross-sectional survey with forcibly displaced AGYW aged 16–24 from five informal settlement (slum) communities across Kampala (Kabalagala, Rubaga, Kansanga, Katwe, Nsambya) using peer network sampling. We assessed YAV (experienced at age 16 or above) (sexual, physical, emotional violence) and recent (past 12-month) IPV (physical, sexual, control violence). We conducted descriptive statistics, followed by multinomial logistic regression analyses to explore social ecological factors (e.g., intrapersonal: depression; interpersonal: sexual relationship power, community: food insecurity) associated with experiencing YAV and YAV polyvictimization, and IPV and IPV polyvictimization. Results Over half of participants (n = 333; mean age = 19.31; SD = 2.56, range = 16–24) reported YAV (n = 179; 53.7%) and 9.3% (n = 41) reported YAV polyvictimization. Most participants that were in an intimate relationship in the last 12 months (n = 200; 85.8%) reported IPV, among these, 45.5% reported one form of IPV and 54.5% reported IPV polyvictimization. In adjusted analyses, experiencing any YAV was significantly associated with: adolescent sexual and reproductive health (SRH) stigma; sexual relationship power; mobile app usage; depressive symptoms; childhood abuse; and childhood polyvictimization. In adjusted analyses YAV polyvictimization was associated with: depressive symptoms; childhood polyvictimization; sexual relationship power; and food insecurity. Recent IPV polyvictimization in adjusted analyses was associated with owning/using a mobile phone and depressive symptoms. Participants with higher sexual relationship power had lower odds of recent IPV polyvictimization. Conclusion Findings suggest that YAV and IPV polyvictimization require urgent attention among forcibly displaced AGYW in Kampala. Multi-level strategies are required to address intrapersonal e.g. (depression), interpersonal (e.g. childhood abuse, sexual relationship power) and community (e.g. adolescent SRH stigma, food insecurity) factors associated with experiencing violence. Future research can tailor approaches to advance health, agency and human rights among urban forcibly displaced AGYW.

Abuse of reformulated OxyContin: Updated findings from a sentinel surveillance sample of individuals assessed for substance use disorder

2017 ◽  
Vol 13 (6) ◽  
pp. 425 ◽  
Author(s):  
Theresa A. Cassidy, MPH ◽  
Eileen Thorley, MPH ◽  
Ryan A. Black, PhD ◽  
Angela DeVeaugh-Geiss, PhD ◽  
Stephen F. Butler, PhD ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorder ◽  
The United States ◽  
Geographic Region ◽  
Addiction Severity Index ◽  
Prescription Opioid ◽  
Cross Sectional ◽  
Geographic Regions ◽  
Drug Problems ◽  
Treatment Settings

Objective: To examine abuse prevalence for OxyContin and comparator opioids over a 6-year period prior to and following market entry of reformulated OxyContin and assess consistency in abuse across treatment settings and geographic regions. Design: An observational study examining longitudinal changes using cross-sectional data from treatment centers for substance use disorder.Setting: A total of 874 facilities in 39 states in the United States within the National Addictions Vigilance Intervention and Prevention Program (NAVIPPRO®) surveillance system.Participants: Adults (72,060) assessed for drug problems using the Addiction Severity Index-Multimedia Version (ASI-MV®) from January 2009 through December 2015 who abused prescription opioids.Main outcome measure(s): Percent change in past 30-day abuse. Results: OxyContin had significantly lower abuse 5 years after reformulation compared to levels for original OxyContin. Consistency of magnitude in OxyContin abuse reductions across geographic regions, ranging from 41 to 52 percent with differences in abuse reductions in treatment setting categories occurred. Changes in geographic region and treatment settings across study years did not bias the estimate of lower OxyContin abuse through confounding.Conclusion: In the postmarket setting, limitations and methodologic challenges in abuse measurement exist and it is difficult to isolate singular impacts of any one intervention given the complexity of prescription opioid abuse. Expectations for a reasonable threshold of abuse for any one ADF product or ADF opioids as a class are still uncertain and undefined. A significant decline in abuse prevalence of reformulated OxyContin was observed 5 years after its reformulation among this treatment sample of individuals assessed for substance use disorder that was lower historically for the original formulation of this product.

scholarly journals Surgery course load in Brazilian medical schools

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Athos Paulo Santos Martini ◽  
Sofia Romay Oliveira ◽  
Suely Grosseman
Keyword(s):  
Medical Curriculum ◽  
National Level ◽  
Medical Schools ◽  
Geographic Region ◽  
Median Percentage ◽  
Cross Sectional ◽  
Test Analysis ◽  
Course Load ◽  
The Mean ◽  
Geographic Regions

Abstract: Introduction: Surgery is an important curricular component of undergraduate medical courses. This study was conducted because the surgery course load in Brazilian medical has not been systematically explored at the national level. Objective: To analyze the surgery course load in Brazilian medical schools. Method: A cross-sectional, descriptive study was carried out with Brazilian medical schools acknowledged by the Ministry of Education, which had begun their activities prior to December 31, 2017 and, as of September 2018, had their curriculum matrix and/or political-pedagogical project with the surgery course load available on the internet. The variables studied were total medical curriculum course load and surgery course load before and during clerkship, as well as the schools’ geographic region and fee status. Data analysis was performed using descriptive statistic Student t-test, analysis of variance, and Mann-Whitney U and Kruskal-Wallis tests, with the null hypothesis rejected for p < .05. Results: The study included 205 of the country’s 323 existing medical schools, of which 175 had available information on the surgery course load during the clerkship, 157 before the clerkship, and 129 had information on course load before and after the clerkship. The median total surgery course load in hours was 815.0 (P25 - 75 = 677.5 - 992.0; minimum = 340.0 h; maximum =1,665.0), while the mean surgery course load before clerkship in hours was 268.7 (SD = 140.3; minimum = 32.0; maximum = 780.0), with no difference between geographic regions or fee status. During the clerkship, the median course load was 540.0 hours (P25 - 75 = 400.0 - 712.0; minimum = 170.0 h; maximum = 1,410.0), with no difference between geographic regions, but with higher values in medical schools with no tuition fees. Regarding the total curriculum course load, the mean percentage of the surgery course load before clerkship was 3.2% (SD = 1.7), the median percentage during the clerkship was 6.4% (P25 - 75 = 5.0 - 8.2), the median percentage of the total surgery course load was 6.4% (P25 - 75 = 5.0 - 8.2%, and the median percentage of surgery course load (both periods) was 9.7% (P25 - 75 = 8.3 - 11.8%). Conclusions: Despite the considerable variation in the surgery course load limits, the median of total surgery and the mean of surgery course load before clerkship were similar across geographic regions and fee statuses. The median surgery course load during clerkship was also similar across regions but higher in tuition-free medical schools. The values found in this study can help schools’ administrators to assess and plan the surgery course load in their institutions.

scholarly journals Social-ecological factors associated with selling sex among men who have sex with men in Jamaica: results from a cross-sectional tablet-based survey

2018 ◽  
Vol 11 (1) ◽  
pp. 1424614 ◽  
Author(s):  
Carmen H. Logie ◽  
Ashley Lacombe-Duncan ◽  
Kathleen S. Kenny ◽  
Kandasi Levermore ◽  
Nicolette Jones ◽  
...  
Keyword(s):  
Ecological Factors ◽  
Cross Sectional ◽  
Factors Associated ◽  
Social Ecological ◽  
Sex With Men ◽  
Selling Sex

scholarly journals GP views on their role in bullying disclosure by children and young people in the community: a cross-sectional qualitative study in English primary care

2019 ◽  
Vol 69 (688) ◽  
pp. e752-e759
Author(s):  
Laura Condon ◽  
Vibhore Prasad
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Young People ◽  
Qualitative Study ◽  
Health Concern ◽  
Health Consequences ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Children And Young People ◽  
Being Bullied

BackgroundBullying among children and young people (CYP) is a major public health concern that can lead to physical and mental health consequences. CYP may disclose bullying, and seek help from a GP. However, there is currently little research on GPs’ views on and perceptions of their role in dealing with disclosures of bullying in primary care.AimTo explore GPs’ views about their role in dealing with CYPs’ disclosures of being bullied, especially factors that have an impact on GPs’ roles.Design and settingIn this cross-sectional qualitative study, semi-structured interviews were conducted with GPs in primary care in England from October to December 2017.MethodPurposive sampling was used to achieve variation in GP age, professional status in practice, profile of the patients served by the practice, practice size and location, and whether the GPs considered themselves to be actively in research or teaching.ResultsData from 14 semi-structured interviews revealed three main themes: remaining clinically vigilant; impact of bullying in schools; and training and guidance on dealing with bullying and cyberbullying. GPs felt that dealing with disclosures of bullying and cyberbullying came down to their clinical experience rather than guideline recommendations, which do not currently exist, and that bullying was a precipitating factor in presentations of CYPs’ mental health issues.ConclusionGPs feel they have a role to play in managing and supporting the health of CYP who disclose being bullied during consultations. However, they feel ill-equipped to deal with these disclosures because of lack of professional development opportunities, and guidance on treating and managing the health consequences of being bullied.

Child Sexual Abuse in Pakistan: Using Evidence Based Social Ecological Model for Explanation and Policy Formulation

2021 ◽  
pp. 0272684X2110131
Author(s):  
Syed Saleem Abbas ◽  
Tahira Jabeen
Keyword(s):  
Sexual Abuse ◽  
Child Sexual Abuse ◽  
Ecological Model ◽  
Ecological Factors ◽  
Policy Formulation ◽  
Social Ecological Model ◽  
Evidence Based ◽  
Cross Sectional ◽  
Effective Prevention ◽  
Social Ecological

Due to recent high profile media reported cases of child sexual abuse in Pakistan a serious public concern is observed with a strong punitive public demand rather than proactive and preventive approach as solution. Instead of reactive approach, it is needed to formulate a policy based on valid causal ground for solution of this problem. Purpose of this cross sectional study is to provide a causal ground based on evidence based social ecological model for holistic policy response for addressing issue of CSA. Using ICAST-R, equal number of male and female 274 university students were asked about experience of CSA, re-victimization, age at the time of CSA, perpetrators, disclosure patterns and social support after disclosure of CSA. On the basis of data, evidence based social ecological model was used for explanation of individual, family, societal and institutional factors related to CSA in Pakistan for formulation of effective prevention strategy. According to findings most frequent age at the time of CSA is between 6th to 18th year of age with 9th year as most frequently reported. Experience of CSA was reported more frequently by boys than girls. Peers were identified as highest reported perpetrators and majority of the perpetrators were known to the child. Instead of reactive and punitive approach towards issue of CSA it is needed to formulate a policy based on social ecological factors of society.

scholarly journals Mental Health and Wellbeing Implications of the COVID-19 Quarantine for Disabled and Disadvantaged Children and Young People: Evidence from a Cross-cultural Study in Zambia and Sierra Leone

2021 ◽  
Author(s):  
Darren Sharpe ◽  
Mohsen Rajabi ◽  
Clement Chileshe ◽  
Mayamba Sitali ◽  
Ibrahim Sesay ◽  
...  
Keyword(s):  
Mental Health ◽  
Young People ◽  
Sierra Leone ◽  
Peer Relationships ◽  
Mental Wellbeing ◽  
Planning Tool ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Children And Young People ◽  
Online Planning

BackgroundThe mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone. MethodIn this cross-sectional study which conducted from 21st June to 8th August 2020, 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and outdoor activities during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the online planning tool. The participants were vulnerable children and adolescents (e.g. disadvantaged or living with a disability) living in different provinces of Zambia and Sierra Leone.ResultsMean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental wellbeing scores were lower in women, younger children and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating.ConclusionThe results show that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.

scholarly journals Household and climate factors influence Aedes aegypti presence in the arid city of Huaquillas, Ecuador

2021 ◽  
Vol 15 (11) ◽  
pp. e0009931
Author(s):  
James L. Martin ◽  
Catherine A. Lippi ◽  
Anna M. Stewart-Ibarra ◽  
Efraín Beltrán Ayala ◽  
Erin A. Mordecai ◽  
...  
Keyword(s):  
Public Health ◽  
Aedes Aegypti ◽  
Disease Surveillance ◽  
Local Level ◽  
Human Movement ◽  
Breeding Habitat ◽  
Health Concern ◽  
Septic Systems ◽  
Household Level ◽  
Social Ecological

Arboviruses transmitted by Aedes aegypti (e.g., dengue, chikungunya, Zika) are of major public health concern on the arid coastal border of Ecuador and Peru. This high transit border is a critical disease surveillance site due to human movement-associated risk of transmission. Local level studies are thus integral to capturing the dynamics and distribution of vector populations and social-ecological drivers of risk, to inform targeted public health interventions. Our study examines factors associated with household-level Ae. aegypti presence in Huaquillas, Ecuador, while accounting for spatial and temporal effects. From January to May of 2017, adult mosquitoes were collected from a cohort of households (n = 63) in clusters (n = 10), across the city of Huaquillas, using aspirator backpacks. Household surveys describing housing conditions, demographics, economics, travel, disease prevention, and city services were conducted by local enumerators. This study was conducted during the normal arbovirus transmission season (January—May), but during an exceptionally dry year. Household level Ae. aegypti presence peaked in February, and counts were highest in weeks with high temperatures and a week after increased rainfall. Univariate analyses with proportional odds logistic regression were used to explore household social-ecological variables and female Ae. aegypti presence. We found that homes were more likely to have Ae. aegypti when households had interruptions in piped water service. Ae. aegypti presence was less likely in households with septic systems. Based on our findings, infrastructure access and seasonal climate are important considerations for vector control in this city, and even in dry years, the arid environment of Huaquillas supports Ae. aegypti breeding habitat.

scholarly journals Social-Ecological Interactions Influencing Primate Harvest: Insights From Madagascar

2021 ◽  
Vol 2 ◽  
Author(s):  
Christian J. Rivera ◽  
Dominic Mayo ◽  
Vanessa Hull
Keyword(s):  
Social Factors ◽  
Systems Approach ◽  
Local Level ◽  
Ecological Factors ◽  
Primate Species ◽  
Future Research ◽  
Ecological Interactions ◽  
Social Ecological ◽  
Context Specific ◽  
Human Primate

Globally, non-human primates face mounting threats due to unsustainable harvest by humans. There is a need to better understand the diverse drivers of primate harvest and the complex social-ecological interactions influencing harvest in shared human-primate systems. Here, we take an interdisciplinary, systems approach to assess how complex interactions among primate biological and ecological characteristics and human social factors affect primate harvest. We apply our approach through a review and synthesis of the literature on lemur harvest in Madagascar, a country with one of the highest primate species richness in the world coupled with high rates of threatened primate species and populations in decline. We identify social and ecological factors affecting primate harvest, including the characteristics of lemurs that may make them vulnerable to harvest by humans; factors describing human motivations for (or deterrents to) harvest; and political and governance factors related to power and accessibility. We then discuss social-ecological interactions that emerge from: (1) the prevalence of informal institutions (e.g., cultural taboos), (2) adoption of human predatory strategies, (3) synergies with habitat use and habitat loss, and (4) interactions among regional- and local-scale factors (multi-level interactions). Our results illustrate that social-ecological interactions influencing lemur harvest in Madagascar are complex and context-specific, while influenced by a combination of interactions between species-specific characteristics and human social factors. These context-specific interactions may be also influenced by local-level cultural practices, land use change, and effects from regional-level social complexities such as political upheaval and food insecurity. We conclude by discussing the importance of identifying and explicitly accounting for nuances in underlying social-ecological systems and putting forth ideas for future research on primate harvest in shared human-primate systems, including research on social-ecological feedbacks and the application of Routine Activities Theory.

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