Heat Waves and Emergency Department Visits Among the Homeless, San Diego, 2012–2019

Objectives. To determine the effect of heat waves on emergency department (ED) visits for individuals experiencing homelessness and explore vulnerability factors. Methods. We used a unique highly detailed data set on sociodemographics of ED visits in San Diego, California, 2012 to 2019. We applied a time-stratified case–crossover design to study the association between various heat wave definitions and ED visits. We compared associations with a similar population not experiencing homelessness using coarsened exact matching. Results. Of the 24 688 individuals identified as experiencing homelessness who visited an ED, most were younger than 65 years (94%) and of non-Hispanic ethnicity (84%), and 14% indicated the need for a psychiatric consultation. Results indicated a positive association, with the strongest risk of ED visits during daytime (e.g., 99th percentile, 2 days) heat waves (odds ratio = 1.29; 95% confidence interval = 1.02, 1.64). Patients experiencing homelessness who were younger or elderly and who required a psychiatric consultation were particularly vulnerable to heat waves. Odds of ED visits were higher for individuals experiencing homelessness after matching to nonhomeless individuals based on age, gender, and race/ethnicity. Conclusions. It is important to prioritize individuals experiencing homelessness in heat action plans and consider vulnerability factors to reduce their burden. (Am J Public Health. 2022;112(1):98–106. https://doi.org/10.2105/AJPH.2021.306557 )

Adolescent, Radicalism, and Terrorism in Indonesia: Experts’ View

Terrorism involving adolescents in Indonesia has been started since 2009. Currently, the number has reached about 16.5% of the total number of terrorism cases in Indonesia. Referring to this critical situation, we gathered experts in radicalism and terrorism issues in two focus group discussions (FGD) to examine the situation of adolescents and radicalism and terrorism in Indonesia, the vulnerability factors of adolescents, and the prevention strategies that can be done in the future. As a result, we find that radicalism has penetrated in young groups in Indonesia, even at an earlier age. This situation is supported by their vulnerability as an adolescent, including physical, psychological, and psychosocial vulnerabilities. Physical changes that happen in adolescence impact on psychological and psychosocial changes. In general, the need for self-existence becomes the source of all their vulnerabilities. Adolescent efforts to achieve their self-existence in society place them at risk of becoming the target of recruitment by radical and terror groups. Therefore, in the context of preventing radicalism and terrorism among adolescents in Indonesia, alternative identity is important to be pursued further.

Identifying food fraud vulnerability factors in food fraud incidents – a review of global incidents 2000–2018

PurposeGlobal food fraud incidents are regularly reported and are on the rise due to the ineffectiveness of traditional food safety intervention strategies. The increase in food fraud opportunity is prevalent in the state of the COVID-19 pandemic as well. Food fraud vulnerability assessment (FFVA) is acknowledged as a critical requirement by the Global Food Safety Initiatives (GFSIs) and the World Health Organisation for an effective food fraud mitigation plan. However, there is no clear direction or ways to identify and analyse food fraud vulnerability factors based on real-data.Design/methodology/approachCombining the barrier analysis technique and the routine activity theory to review the 580 cases of food fraud recorded in the Decernis database, this paper identified new food fraud vulnerability dimensions and insights pinpointed to three categories of opportunity, motivation and countermeasures.FindingsNew dimensions of food fraud vulnerability factors are identified in this paper over the period 2000–2018. Where possible, new insights related to each food fraud vulnerability factor and dimension were identified, and literature evidence was used to confirm their contribution.Originality/valueThere is a gap observed in the first step of FFVA in the literature. This paper is the first study to undertake a FFVA based on evidence recorded in a global food fraud database. This paper offers critical insights into global food fraud regulations by exploring the new emerging root causes of food fraud and analysing them, supporting developing effective food fraud prevention plans (FFPPs).

Psychological Impact of the COVID-19 Pandemic on Pregnant Women: A Scoping Review

During the gestation period, pregnant women experience physical and psychological changes, which represent vulnerability factors that can boost the development of mental health conditions. The COVID-19 pandemic is producing new changes in the routines of the whole society, especially on lifestyle habits. The psychological impact associated with the COVID-19 pandemic and pregnant women remains unclear. A scoping review regarding the psychological impact of the COVID-19 pandemic on pregnant women was conducted. Searchers were conducted using the PubMed, Web of Science and CINAHL databases. Articles in Spanish, English and French were included. The search was conducted between November 2020 and September 2021. We identified 31 studies that evaluated 30,049 expectant mothers during the COVID-19 pandemic. Pregnant women showed high levels of anxiety and depression symptomatology. Fear of contagion and concerns regarding the health of the fetus were identified as the main variables related to psychological distress. An increase of the levels of depression, anxiety and stress during the COVID-19 pandemic amongst pregnant women has been observed. Moreover, an increased vulnerability of the fetus due to placental metabolic alterations is discussed. This review suggests that the COVID-19 pandemic is associated with a negative psychological impact on pregnant women. Thus, high levels of anxiety and depression symptoms suggest the need for a systematic approach.

Does Confinement Affect Treatment Dropout Rates in Patients With Gambling Disorder? A Nine-Month Observational Study

Background and Aims: COVID-19 pandemic and confinement have represented a challenge for patients with gambling disorder (GD). Regarding treatment outcome, dropout may have been influenced by these adverse circumstances. The aims of this study were: (a) to analyze treatment dropout rates in patients with GD throughout two periods: during and after the lockdown and (b) to assess clinical features that could represent vulnerability factors for treatment dropout.Methods: The sample consisted of n=86 adults, mostly men (n=79, 91.9%) and with a mean age of 45years old (SD=16.85). Patients were diagnosed with GD according to DSM-5 criteria and were undergoing therapy at a Behavioral Addiction Unit when confinement started. Clinical data were collected through a semi-structured interview and protocolized psychometric assessment. A brief telephone survey related to COVID-19 concerns was also administered at the beginning of the lockdown. Dropout data were evaluated at two moments throughout a nine-month observational period (T1: during the lockdown, and T2: after the lockdown).Results: The risk of dropout during the complete observational period was R=32/86=0.372 (37.2%), the Incidence Density Rate (IDR) ratio T2/T1 being equal to 0.052/0.033=1.60 (p=0.252). Shorter treatment duration (p=0.007), lower anxiety (p=0.025), depressive symptoms (p=0.045) and lower use of adaptive coping strategies (p=0.046) characterized patients who abandoned treatment during the lockdown. Briefer duration of treatment (p=0.001) and higher employment concerns (p=0.044) were highlighted in the individuals who dropped out after the lockdown. Treatment duration was a predictor of dropout in both periods (p=0.005 and p<0.001, respectively).Conclusion: The present results suggest an impact of the COVID-19 pandemic on treatment dropout among patients with GD during and after the lockdown, being treatment duration a predictor of dropout. Assessing vulnerability features in GD may help clinicians identify high-risk individuals and enhance prevention and treatment approaches in future similar situations.

Longitudinal Effects of the Pandemic and Confinement on the Anxiety Levels of a Sample of Spanish Children in Primary Education

(1) Background: The psychological effects of confinement due to the SARS-CoV-2 virus pandemic on children are only partially known. In Madrid, Spain, children suffered a strict confinement for 10 weeks and they returned to school under conditions that were far from normal. This work assesses the effects of the pandemic on the anxiety levels of a group of children living in Madrid. (2) Methods: Children were aged 6 to 11 years (N = 215). A self-report measure of anxiety was completed by participants at two time-points: (1) a few months before the beginning of the pandemic and (2) 1 year later. A smaller subgroup of participants also completed the measure during the confinement period (n = 60). (3) Results: A comparison of these three measures shows that the children’s anxiety was reduced during confinement, and that one year later these levels continue below those registered before the start of the pandemic. (4) Conclusions: These results contradict some previous studies, which found an increase in children’s anxiety as a result of confinement and the pandemic. The discussion considers protective and vulnerability factors in the context of the pandemic, which may affect children’s levels of anxiety.

Factors associated with female students’ past year experience of sexual violence in South African public higher education settings: A cross-sectional study

Background Intimate partner sexual violence and non-partner rape experiences are widely reported by female students in South African higher education institutions, as they are globally. However, limited research has focused on investigating vulnerability factors, which is vital for informing interventions. Objective To describe the factors and inter-relationships associated with female students’ increased vulnerability to past year experience of partner sexual violence and non-partner rape in South African higher education settings. Methods We interviewed 1293 female students, i.e., 519 students in six Technical Vocational Education and Training (TVET) college campuses and 774 students at three university campuses. Participants were volunteers aged 18–30. The measured vulnerability factors included childhood sexual abuse, other trauma, mental ill-health, risky sexual behaviours, food insecurity, partner violence, and controlling behaviours. We used bivariate analysis, logistic regression, and structural equation modelling methods. Results Twenty percent of participants experienced past-year sexual violence (17% partner sexual violence and 7.5% non-partner rape). Childhood sexual abuse had direct effects on experiencing past year sexual violence and physical, emotional partner violence or controlling behaviours. Risky sexual behaviours mediated the relationships of childhood sexual abuse or harmful alcohol use and past-year sexual violence experience. Mental ill-health mediated the relationships between childhood sexual abuse, other traumatic exposures, food insecurity, physical, emotional partner violence or controlling behaviours, and past-year partner sexual violence or non-partner rape experience. Conclusions Risky sexual behaviours, gender inequitable relationship dynamics, mental ill-health, and food insecurity are related and amenable vulnerability factors associated with female students’ sexual violence experiences. Therefore, addressing these through comprehensive campus interventions, which are implemented when students first enrol in higher education and are most vulnerable to sexual violence, is critical. Society-wide sexual violence prevention is also imperative.

Adolescent, Radicalism, and Terrorism in Indonesia: Experts’ View

Terrorism involving adolescents in Indonesia has been started since 2009. Currently, the number has reached about 16.5% of the total number of terrorism cases in Indonesia. Referring to this critical situation, we gathered experts in radicalism and terrorism issues in two focus group discussions (FGD) to examine the situation of adolescents and radicalism and terrorism in Indonesia, the vulnerability factors of adolescents, and the prevention strategies that can be done in the future. As a result, we find that radicalism has penetrated in young groups in Indonesia, even at an earlier age. This situation is supported by their vulnerability as an adolescent, including physical, psychological, and psychosocial vulnerabilities. Physical changes that happen in adolescence impact on psychological and psychosocial changes. In general, the need for self-existence becomes the source of all their vulnerabilities. Adolescent efforts to achieve their self-existence in society place them at risk of becoming the target of recruitment by radical and terror groups. Therefore, in the context of preventing radicalism and terrorism among adolescents in Indonesia, alternative identity is important to be pursued further.