Examining the relationship between adversity and suicidality and self-harm in Irish adolescents from 2020 to 2022

BACKGROUND

Research indicates that there is a strong association between childhood adversity and youth suicide and self-harm. However, there is currently a lack of understanding about the patterns of adversity most frequently experienced by youth across social settings, and whether these typologies differently predict youth engagement in suicide and self-harm. This study examines the dominant patterns of adversity experienced by adolescents across home, peer, and school contexts, and explores the relationship between youth's adversity profiles and their suicide and self-harm outcomes, across a two year period (2020-2022).

METHODS

Secondary analyses were performed on data collected from 10,281 (50 % male) adolescents who participated in the Irish Planet Youth questionnaire in 2020 (n = 5004) or 2022 (n = 5277).

RESULTS

Findings from clustered latent class analyses indicated that there are four dominant profiles of adversity experienced by adolescents. Class 1 (Multiple Adversity) was characterised by a high probability of experiencing adversity across multiple social settings. Class 2 (Parent Adversity) had a strong likelihood of experiencing adversity with parents. Class 3 (Peer Adversity) were likely to experience adversity within the peer/friend domain. Class 4 was characterised by a low probability of experiencing adversity. Findings from logistic regression models with BCH training weights indicated that there were significant differences in self-harm and suicidality across the adversity classes. In comparison to the low adversity group, adolescents in the multiple adversity group were more likely to self-harm and attempt suicide.

LIMITATIONS

These findings are based on cross-sectional data and rely on the use of single-item measurements, which may limit the generalisability of findings.

DISCUSSION

Results indicate that youth who experience adversity across home, peer and school contexts are at the greatest risk of engaging in suicide and self-harm. These findings have important implications for policy and practice, and suggest that youth experiencing adversity across multiple settings should be priority targets for intervention.

Shifting terrains: Understanding residential contaminants after flood disasters

Flood disasters can induce the mass transport of soils and sediments. This has the potential to distribute contaminants and present novel combinations to new locations - including residential neighborhoods. Even when soil contaminants cannot be directly attributed to the disaster, data on bacterial and heavy metal(loids) can facilitate an environmentally just recovery by enabling reconstruction decisions that fill data gaps to minimize future exposure. These data-gathering interventions may be especially useful in poor, rural, and racially diverse communities where there is a high probability of exposure to multiple hazards and a potential dependency on the financial resources of disaster aid as a means of reducing chronic exposures to other environmental pollutants. At the same time, entering these post-disasters spaces is ethically complex. To acknowledge this complexity, we pilot a framework for work that gathers social-ecological hazard information while retaining a fair-minded approach to transdisciplinary work. Assembled a transdisciplinary team to recruit participants from 90 households subjected to flooding in the southeastern US. Participating households agreed to interviews to elicit flood experience and environmental health concerns, soil sampling for fecal bacteria (E. coli) and soil sampling for selected heavy metals and metalloids (Pb, As, Cd) at their flooded residence. Soil sampling found a wide range of E. coli concentrations in soil (0.4-1115.7 CFU/ dry gram). Heavy metal(loid)s were detected at most residences (As 97.9 %; Ca 25.5 %; Pb 100 %). Individually, heavy metal(loid) concentrations did not exceed regulatory thresholds. Hazard, risk, and mitigation concerns expressed during interviews reveal that integrated human-nature concepts complicate common understandings of how hazard perceptibility (smell, sight, touch, and information) affects research-action spaces. Qualitative analysis of interviews and field notes revealed that soil-related hazards addressed by our biophysical protocols were less salient than changes with direct causal associations with flooding. We conclude by discussing the potential for the social-ecological hazard information that is fair-minded and transdisciplinary (SHIFT) framework to advance environmentally just approaches to research-action spaces after disasters.

The TRIBE model: How socioemotional processes fuel end-of-life treatment in the United States

Prior interventions have repeatedly failed to decrease the prescription and receipt of treatments and procedures that confer more harm than benefit at the End-of-Life (EoL); new approaches to intervention are needed. Ideally, future interventions would be informed by a social-ecological conceptual model that explains EoL healthcare utilization patterns, but current models ignore two facts: (1) healthcare is an inherently social activity, involving clinical teams and patients' social networks, and (2) emotions influence social activity. To address these omissions, we scaffolded Terror Management Theory and Socioemotional Selectivity Theory to create the Transtheoretical Model of Irrational Biomedical Exuberance (TRIBE). Based on Terror Management Theory, TRIBE suggests that the prospect of patient death motivates healthcare teams to conform to a biomedical norm of care, even when clinicians believe that biomedical interventions will likely be unhelpful. Based on Socioemotional Selectivity Theory, TRIBE suggests that the prospect of dwindling time motivates families to prioritize emotional goals, and leads patients to consent to disease-directed treatments they know will likely be unhelpful, as moral emotions motivate deference to the perceived emotional needs of their loved ones. TRIBE is unique among models of healthcare utilization in its acknowledgement that moral emotions and processes (e.g., shame, compassion, regret-avoidance) influence healthcare delivery, patients' interactions with family members, and patients' outcomes. TRIBE is especially relevant to potentially harmful EoL care in the United States, and it also offers insights into the epidemics of overtreatment in healthcare settings worldwide. By outlining the role of socioemotional processes in the care of persons with serious conditions, TRIBE underscores the critical need for psychological innovation in interventions, health policy and research on healthcare utilization.

Research priorities for the sustainability of coral-rich western Pacific seascapes

Nearly a billion people depend on tropical seascapes. The need to ensure sustainable use of these vital areas is recognised, as one of 17 policy commitments made by world leaders, in Sustainable Development Goal (SDG) 14 ('Life below Water') of the United Nations. SDG 14 seeks to secure marine sustainability by 2030. In a time of increasing social-ecological unpredictability and risk, scientists and policymakers working towards SDG 14 in the Asia-Pacific region need to know: (1) How are seascapes changing? (2) What can global society do about these changes? and (3) How can science and society together achieve sustainable seascape futures? Through a horizon scan, we identified nine emerging research priorities that clarify potential research contributions to marine sustainability in locations with high coral reef abundance. They include research on seascape geological and biological evolution and adaptation; elucidating drivers and mechanisms of change; understanding how seascape functions and services are produced, and how people depend on them; costs, benefits, and trade-offs to people in changing seascapes; improving seascape technologies and practices; learning to govern and manage seascapes for all; sustainable use, justice, and human well-being; bridging communities and epistemologies for innovative, equitable, and scale-crossing solutions; and informing resilient seascape futures through modelling and synthesis. Researchers can contribute to the sustainability of tropical seascapes by co-developing transdisciplinary understandings of people and ecosystems, emphasising the importance of equity and justice, and improving knowledge of key cross-scale and cross-level processes, feedbacks, and thresholds.

Multiple sexual partnership among adolescent boys and young men in Ghana: analysis of the 2003-2014 Ghana Demographic and Health Survey

BACKGROUND

Multiple sexual partnership (MSP) is a major cause of HIV/AIDS epidemic and unplanned pregnancies in sub-Saharan Africa. We investigate how individual, household, interpersonal, community and structural factors correlate with multiple sexual partnership of adolescent boys and young men in Ghana.

METHODS

We pooled secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys (GDHS). Analytic sample of 1422 males aged 15-24 years who are sexually active and never married were used for the study. The outcome variable for the study was two or more sexual partners in the last 12 months preceding the survey. Five models were fitted using multilevel mixed effects logistic regression to identify predictors of multiple sexual partners. Results were presented using adjusted odds ratios (ORadj) with its corresponding 95% confidence interval.

RESULTS

The pooled data prevalence of multiple sexual partnership was 28.1%, with 18.7%, 30.0% and 33.3% of adolescent boys and young men involved in multiple sexual partnerships in 2003, 2008 and 2014, respectively. Results of the study showed that young men aged 20-24 years [ORadj = 1.39, 95% CI = 1.01-1.91], being from household with richest wealth index [ORadj = 1.76, 95% CI = 1.01-3.06] and those with secondary/higher education [ORadj = 2.94, 95% CI = 1.44-6.06] were more likely to have multiple sexual partners. On the other hand, those who delayed their first sex [ORadj = 0.45, 95% CI = 0.29-0.70] and those currently using modern contraceptive methods [ORadj = 0.37, 95% CI = 0.28-0.50] were less likely to have multiple sexual partners.

CONCLUSION

The findings provide support for the social ecological argument that sexual health behaviours are influenced by individual, interpersonal, community and contextual characteristics. Future policies and interventions seeking to address the increasing prevalence of multiple sexual partnerships among adolescent boys and young men should take into consideration family planning programmes and sexual education in affluent communities, secondary and higher institutions.

Identifying the most proximal multi-level factors associated with meeting each of the 24-h movement behavior recommendations in a sample of autistic adults

BACKGROUND

Autistic adults have poorer 24-h movement behaviors, including lower levels of physical activity, more time spent being sedentary, and shorter sleep duration than neurotypical adults. Social ecological frameworks posit that 24-h movement behaviors are determined by multi-level domains; however, not known is which multi-level factors are most important to meeting each of the 24-h movement behavior guidelines among autistic adults.

OBJECTIVE

This study examined the relative importance of a range of multi-level determinants on meeting guidelines for the 24-h movement behaviors of aerobic physical activity, sedentary behavior, and sleep.

METHODS

We administered at cross-sectional electronic survey to a national self-selecting, convenience sample of autistic adults and caregivers of autistic adults residing in the USA. We used machine learning to examine the relative variable importance (VIMP) of 55 multi-level variables with meeting recommendations for physical activity, sedentary behavior, and sleep duration. VIMPs >0 indicate predictive variables/domains.

RESULTS

A greater number of group activities attended in the last 3-months, and greater independence in completing activities of daily living were most important to meeting aerobic physical activity guidelines. Group activity participation and marital status were important to meeting sedentary behavior guidelines while having a fewer number of comorbidities was most important to achieving adequate sleep.

CONCLUSIONS

These data support hypotheses about the role of family and social level interventions targeting movement behaviors in autistic adults.

How a water-resources crisis highlights social-ecological disconnects

The sustainable management of water resources is required to avoid water scarcity becoming widespread. This article explores the potential application of a social-ecological framework, used predominantly in the fields of ecology and conservation, as a tool to improve the sustainability and resilience of water resources. The "red-loop green-loop" (RL-GL) model has previously been used to map both sustainable and unsustainable social-ecological feedbacks between ecosystems and their communities in countries such as Sweden and Jamaica. In this article, we demonstrate the novel application of the RL-GL framework to water resources management using the 2017/18 Cape Town water crisis. We used the framework to analyse the social-ecological dynamics of pre-crisis and planned contingency scenarios. We found that the water resources management system was almost solely reliant on a single, non-ecosystem form of infrastructure, the provincial dam system. As prolonged drought impacted this key water resource, resilience to resource collapse was shown to be low and a missing feedback between the water resource and the Cape Town community was highlighted. The collapse of water resources ("Day Zero") was averted through a combination of government and community group led measures, incorporating both local ecosystem (green-loop) and non-local ecosystem (red-loop) forms of water resource management, and increased rainfall returning to the area. Additional disaster management plans proposed by the municipality included the tighter integration of red and green-loop water management approaches, which acted to foster a stronger connection between the Cape Town community and their water resources. We advocate the wider development and application of the RL-GL model, theoretically and empirically, to investigate missing feedbacks between water resources and their communities.

Our future in the Anthropocene biosphere

The COVID-19 pandemic has exposed an interconnected and tightly coupled globalized world in rapid change. This article sets the scientific stage for understanding and responding to such change for global sustainability and resilient societies. We provide a systemic overview of the current situation where people and nature are dynamically intertwined and embedded in the biosphere, placing shocks and extreme events as part of this dynamic; humanity has become the major force in shaping the future of the Earth system as a whole; and the scale and pace of the human dimension have caused climate change, rapid loss of biodiversity, growing inequalities, and loss of resilience to deal with uncertainty and surprise. Taken together, human actions are challenging the biosphere foundation for a prosperous development of civilizations. The Anthropocene reality-of rising system-wide turbulence-calls for transformative change towards sustainable futures. Emerging technologies, social innovations, broader shifts in cultural repertoires, as well as a diverse portfolio of active stewardship of human actions in support of a resilient biosphere are highlighted as essential parts of such transformations.

An exploration of clinical, behavioral, and community factors associated with sleep duration and efficiency among middle-aged Black/African American smokers

STUDY OBJECTIVES

We examined the most important correlates to sleep duration and efficiency from a comprehensive array of multilevel factors.

METHODS

Baseline data from a cohort of 216 Black/African American smokers aged 40-65 years were examined. The binary outcomes of healthy sleep duration (6-8 h/night) and efficiency (≥85%) were ascertained from 14 consecutive days of actigraphy. Seventy-three independent variables from socio-demographic, individual behavioral, individual physiological, interpersonal, and community domains were assessed. Random survival forest decision trees were generated for each outcome, and variable importance metrics used to rank the predictive abilities of exposure variables. The 5 most predictive exposure variables for each outcome were entered into a regression model of the respective outcome (with age and sex).

RESULTS

Study participants (N = 216) had a mean age of 54.57 years (SD = 6.17) and 57% were male. Healthy sleep duration was achieved by 56.5% and healthy sleep efficiency by 13.6% of the sample. Regression models showed every additional minute of light physical activity was associated with 1% increased odds, while every unit decrease in the inflammation marker of interleukin-8 was associated with 12% increased odds, of achieving a healthy sleep duration. Every unit increase in total social support was associated with a 34% increased odds, while every unit increase in the hazardous drinking score corresponded with 30% decreased odds, of achieving healthy sleep efficiency.

CONCLUSIONS

Light physical activity, social support, and alcohol consumption may be key modifiable intervention targets to improving sleep duration and sleep efficiency in this population.

Early steps for successful management in small-scale fisheries: An analysis of fishers', managers' and scientists' opinions preceding implementation

This study analyzes fishers', managers' and scientists' opinions on management measures to facilitate the initiation of management processes towards more sustainable small-scale seagrass fisheries in Zanzibar, Tanzania. The results show that most fishers and managers agreed on the need to include seagrasses specifically in future management. There was further agreement on dragnets being the most destructive gears, and the use of dragnets being a major threat to local seagrass ecosystems. Gear restrictions excluding illegal dragnets were the favored management measure among fishers. Differences between fishers and managers were found concerning seaweed farming, eutrophication and erosion being potential threats to seagrass meadows. A majority of the interviewed fishers were willing to participate in monitoring and controls, and most fishers thought that they themselves and their communities would benefit the most from establishing seagrass management. Co-managed gear restrictions and the inclusion of different key actos in the management process including enforcement are promising starting points for management implementation.

Digital Media Use in Families: Theories and Strategies for Intervention

Family dynamics are increasingly being influenced by digital media. Three frameworks are described to help clinicians to understand and respond to this influence. First, a social-ecological framework shows how media has both a direct and indirect impact on individuals, relationships, communities, and society. Next, family systems theory is introduced to demonstrate digital media-related interactions within families. Finally, a developmental framework explores the role of digital media in shaping parenting. These theories are then integrated into practical strategies that clinicians can use, including recommendations and resources from the American Academy of Pediatrics.

Using expert informed GIS to locate important marine social-ecological hotspots

The marine environment provides significant benefits to many local communities. Pressure to develop coastal waterways worldwide creates an urgent need for tools to locate marine spaces that have important social or ecological values, and to quantify their relative importance. The primary objective of this study was to develop, apply and critically assess a tool to identify important social-ecological hotspots in the marine environment. The study was conducted in a typical coastal community in northern British Columbia, Canada. This expert-informed GIS, or xGIS, tool used a survey instrument to draw on the knowledge of local experts from a range of backgrounds with respect to a series of 12 social-ecological value attributes, such as biodiversity, cultural and economic values. We identified approximately 1500 polygons on marine maps and assigned relative values to them using a token distribution exercise. A series of spatial statistical analyses were performed to locate and quantify the relative social-ecological importance of marine spaces and the results were ultimately summarized in a single hotspot map of the entire study area. This study demonstrates the utility of xGIS as a useful tool for stakeholders and environmental managers engaged in the planning and management of marine resources at the local and regional levels.