Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey

PubMed Central

Driezen, Pete; Abdullah, Abu S.; Nargis, Nigar; Hussain, A. K. M. Ghulam; Fong, Geoffrey T.; Thompson, Mary E.; Quah, Anne C. K.; Xu, Steve

2016-01-01

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011–2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco’s harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO’s Framework Convention on Tobacco Control. PMID:27571090

Awareness of Tobacco-Related Health Harms among Vulnerable Populations in Bangladesh: Findings from the International Tobacco Control (ITC) Bangladesh Survey.

PubMed

Driezen, Pete; Abdullah, Abu S; Nargis, Nigar; Hussain, A K M Ghulam; Fong, Geoffrey T; Thompson, Mary E; Quah, Anne C K; Xu, Steve

2016-08-25

This study assessed the knowledge of the harmful effects of tobacco use among vulnerable populations in Bangladesh and whether vulnerability was associated with the presence of complete home smoking bans. Data came from Wave 3 (2011-2012) of the International Tobacco Control (ITC) Bangladesh Survey, a nationally-representative survey of 3131 tobacco users and 2147 non-users. Socio-demographic measures of disadvantage were used as proxy measures of vulnerability, including sex, residential location, education and income. Outcome measures were awareness of the harmful effects of (a) cigarette smoking and (b) smokeless tobacco use and (c) whether respondents had complete smoking bans in their homes. Logistic regression was used to examine whether the adjusted prevalence of each outcome differed by socio-demographic proxies of vulnerability. Smaller percentages of women, the illiterate, urban slum residents and low-income Bangladeshis were aware of the health harms of tobacco. These vulnerable groups generally had lower odds of awareness compared to the least disadvantaged groups. Incomplete knowledge of tobacco's harms may prevent vulnerable groups from taking steps to protect their health. Development goals, such as increasing literacy rates and empowering women, can complement the goals of WHO's Framework Convention on Tobacco Control.

Accounting for vulnerable populations in rural hazard mitigation plans: results of a survey of emergency managers.

PubMed

Horney, Jennifer A; Nguyen, Mai; Cooper, John; Simon, Matthew; Ricchetti-Masterson, Kristen; Grabich, Shannon; Salvesen, David; Berke, Philip

2013-01-01

Rural areas of the United States are uniquely vulnerable to the impacts of natural disasters. One possible way to mitigate vulnerability to disasters in rural communities is to have a high-quality hazard mitigation plan in place. To understand the resources available for hazard mitigation planning and determine how well hazard mitigation plans in rural counties meet the needs of vulnerable populations, we surveyed the lead planning or emergency management official responsible for hazard mitigation plans in 96 rural counties in eight states in the Southeastern United States. In most counties, emergency management was responsible for implementing the county's hazard mitigation plan and the majority of counties had experienced a presidentially declared disaster in the last 5 years. Our research findings demonstrated that there were differences in subjective measures of vulnerability (as reported by survey respondents) and objective measures of vulnerability (as determined by US Census data). In addition, although few counties surveyed included outreach to vulnerable groups as a part of their hazard mitigation planning process, a majority felt that their hazard mitigation plan addressed the needs of vulnerable populations "well" or "very well." These differences could result in increased vulnerabilities in rural areas, particularly for certain vulnerable groups.

Collecting data to evaluate the effect of health policies on vulnerable populations.

PubMed

Bindman, A B; Grumbach, K; Keane, D; Lurie, N

1993-02-01

Public health policies often have disproportionate effects on the poor and other vulnerable groups. Standard survey techniques are often difficult to apply to these vulnerable populations, and many data bases systematically omit such individuals. The purpose of this paper is to review our experience in collecting primary survey data from public hospital, mentally ill, HIV-infected, and non-English-speaking patients. Important issues in conducting research on these populations include proper selection of subjects and comparison groups and difficulties involved in recruitment and enrollment of subjects. Maintaining longitudinal data on these populations is difficult and often requires tracking, secondary contacts, home visits and community outreach, and the use of organizations, institutions, and networks. Investigators must also pay careful attention to ethical issues involved in conducting research on vulnerable populations.

Sensitive Interviewing in Qualitative Research.

PubMed

Dempsey, Laura; Dowling, Maura; Larkin, Philip; Murphy, Kathy

2016-12-01

In this paper we focus on important considerations when planning and conducting qualitative interviews on sensitive topics. Drawing on experiences of conducting interviews with dementia caregivers, a framework of essential elements in qualitative interviewing was developed to emphasize study participants' needs while also providing guidance for researchers. Starting with a definition of sensitive research, the framework includes preparing for interviews, interacting with gatekeepers of vulnerable groups, planning for interview timing, and location, building relationships and conducting therapeutic interactions, protecting ethically vulnerable participants, and planning for disengagement. This framework has the potential to improve the effectiveness of sensitive interviewing with vulnerable groups. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Medical Students' Empathy for Vulnerable Groups: Results From a Survey and Reflective Writing Assignment.

PubMed

Wellbery, Caroline; Saunders, Pamela A; Kureshi, Sarah; Visconti, Adam

2017-12-01

As medical education curricula increasingly acknowledge the contributions of the social determinants of health to individual health, new methods of engaging students in the care of vulnerable groups are needed. Empathy is one way to connect students with patients, but little is known about how to nurture students' empathy on behalf of populations. This study examined the relationship between individual and social empathy as groundwork for cultivating students' empathy for vulnerable groups. In 2014-2015, first-year medical students completed the Social Empathy Index at the start and end of a two-semester population health course, and they completed a reflective writing assignment exploring the challenges of caring for vulnerable patients. Pre- and posttest mean survey scores were compared, and reflective writing assignments were analyzed for themes concerning social empathy. Data from 130 students were analyzed. Scores for the contextual understanding of systemic barriers domain increased significantly. There was a trend toward increased cumulative social empathy scores that did not reach statistical significance. Students' essays revealed three themes relating to individual empathy as the foundation for social empathy; civic and moral obligations; and the role of institutional practices in caring for vulnerable groups. This study extends understanding of empathy beyond care for the individual to include care for vulnerable groups. Thus, social empathy may function as a valuable concept in developing curricula to support students' commitment to care for the underserved. Educators first need to address the many barriers students cited that impede both individual and social empathy.

American Indian Adolescent Girls: Vulnerability to Sex Trafficking, Intervention Strategies

ERIC Educational Resources Information Center

Pierce, Alexandra

2012-01-01

The Minnesota Indian Women's Resource Center offers harm reduction programming to at-risk adolescent American Indian girls, including outreach, case management, advocacy, healthy sexuality education, and support groups. To evaluate program impact, participants are assessed at intake and every 6 months afterward for current vulnerability to…

International Student-Workers in Australia: A New Vulnerable Workforce

ERIC Educational Resources Information Center

Nyland, Chris; Forbes-Mewett, Helen; Marginson, Simon; Ramia, Gaby; Sawir, Erlenawati; Smith, Sharon

2009-01-01

In the period immediately preceding the 2007 Australian election, much attention was accorded to the impact of the nation's labour laws on vulnerable employees. This debate centred on specific groups including women, youth, migrants and workers on individual employment contracts. International students, by contrast, were ignored in the debate.…

Vulnerable populations in healthcare.

PubMed

Waisel, David B

2013-04-01

This review is designed to update readers on recent discussions and research regarding vulnerable populations in medicine, including patients who are socioeconomically disadvantaged, queer, in prison or labeled with a stigmatizing complex medical disease. Recent studies have more closely examined the effects of being part of a vulnerable population. Greater societal income inequality impacts those at the lower end of the income curve by increasing mortality and heightening the importance of individual personal situations. Recommendations from an extensive WHO report on the social determinants of health may affect social policy and use of public resources in Europe. Clinicians are undereducated about the lives and concerns of vulnerable populations, including LGBTQI persons, immigrants, physicians, prisoners, and families of patients with diseases considered 'incompatible with life'. Greater understanding of the cause of the health effects of being socioeconomically disadvantaged or being a member of a vulnerable population may be the first steps toward specific policy recommendations. Professional medical organizations and advocacy groups should raise awareness, provide education, publish guidelines and define the goals for the medical care for certain vulnerable populations.Vulnerable populations are at risk for disparate healthcare access and outcomes because of economic, cultural, ethnic or health characteristics. Vulnerable populations include patients who are racial or ethnic minorities, children, elderly, socioeconomically disadvantaged, underinsured or those with certain medical conditions. Members of vulnerable populations often have health conditions that are exacerbated by unnecessarily inadequate healthcare.

Understanding the role of peer group membership in reducing HIV-related risk and vulnerability among female sex workers in Karnataka, India.

PubMed

Bhattacharjee, Parinita; Prakash, Ravi; Pillai, Priya; Isac, Shajy; Haranahalli, Mohan; Blanchard, Andrea; Shahmanesh, Maryam; Blanchard, James; Moses, Stephen

2013-01-01

In Karnataka state, South India, we analyzed the role of membership in peer groups in reducing HIV-related risk and vulnerability among female sex workers (FSWs). Data from three surveys conducted in Karnataka, a behavioral tracking survey and two rounds of integrated biological and behavioral assessments (IBBAs), were analyzed. Using propensity score matching, we examined the impact of group membership on selected outcomes, including condom use, experience of violence, access to entitlements, and the prevalence of sexually transmitted infections, including HIV infection. Focus group discussions were conducted with the FSWs to better understand their perceptions regarding membership in peer groups. Peer group members participating in the IBBAs had a lower prevalence of gonorrhea and/or chlamydia (5.2 vs 9.6%, p<0.001), and of syphilis (8.2 vs 10.3%, p<0.05), compared to non-members. The average treatment effect for selected outcome measures, from the propensity score matching, showed that FSWs who were members of any peer group reported significantly less experience of violence in the past six months, were less likely to have bribed police to avoid trouble in the past six months, and were more likely to have obtained at least one formal identification document in the past five years, compared to non-members. In focus group discussions, group members indicated that they had more confidence in dealing with situations of forced sex and violence. Including community mobilization and peer group formation in the context of HIV prevention programing can reduce HIV-related risk and vulnerability among FSWs.

Shared Decision Making With Vulnerable Populations in the Emergency Department.

PubMed

Castaneda-Guarderas, Ana; Glassberg, Jeffrey; Grudzen, Corita R; Ngai, Ka Ming; Samuels-Kalow, Margaret E; Shelton, Erica; Wall, Stephen P; Richardson, Lynne D

2016-12-01

The emergency department (ED) occupies a unique position within the healthcare system, serving as a safety net for vulnerable patients, regardless of their race, ethnicity, religion, country of origin, sexual orientation, socioeconomic status, or medical diagnosis. Shared decision making (SDM) presents special challenges when used with vulnerable population groups. The differing circumstances, needs, and perspectives of vulnerable groups invoke issues of provider bias, disrespect, judgmental attitudes, and lack of cultural competence, as well as patient mistrust and the consequences of their social and economic disenfranchisement. A research agenda that includes community-engaged approaches, mixed-methods studies, and cost-effectiveness analyses is proposed to address the following questions: 1) What are the best processes/formats for SDM among racial, ethnic, cultural, religious, linguistic, social, or otherwise vulnerable groups who experience disadvantage in the healthcare system? 2) What organizational or systemic changes are needed to support SDM in the ED whenever appropriate? 3) What competencies are needed to enable emergency providers to consider patients' situation/context in an unbiased way? 4) How do we teach these competencies to students and residents? 5) How do we cultivate these competencies in practicing emergency physicians, nurses, and other clinical providers who lack them? The authors also identify the importance of using accurate, group-specific data to inform risk estimates for SDM decision aids for vulnerable populations and the need for increased ED-based care coordination and transitional care management capabilities to create additional care options that align with the needs and preferences of vulnerable populations. © 2016 by the Society for Academic Emergency Medicine.

Protecting the unprotected: mixed-method research on drug use, sex work and rights in Pakistan's fight against HIV/AIDS.

PubMed

Mayhew, S; Collumbien, M; Qureshi, A; Platt, L; Rafiq, N; Faisel, A; Lalji, N; Hawkes, S

2009-04-01

To investigate the nature and extent of human rights abuses against three vulnerable groups (injecting drug users (IDUs) and male and female sex workers), to understand the social and sexual linkages between them and to examine how protecting their rights could enhance the impact of HIV prevention policies. In-depth interviews were carried out with 38 high-risk respondents (IDUs and female, male and transgender sex workers) and a bio-behavioural survey was performed of 813 IDU/sex worker respondents in Rawalpindi. People in all vulnerable groups interacted both sexually and socially. All groups experienced human rights abuses by state and non-state actors which increased their HIV risk. Non-state actors, including relations and sex worker clients, are responsible for verbal, physical and sexual violence. State actors (particularly police) perpetrate harassment, exploitation and abuse of all vulnerable groups with impunity. Health service providers fail to provide adequate services for vulnerable groups. High levels of discrimination and abuse of human dignity of all groups studied were revealed. This violates their physical and mental integrity and also leads to an increased risk of HIV. The sexual and social interactions between groups mean that human rights abuses experienced by one high-risk group can increase the risk of HIV both for them and other groups. The protection of human rights needs to become an integral part of a multisector response to the risk of HIV/AIDS by state and non-state agencies. The Government of Pakistan should work at both legal and programme levels to protect the rights of, and minimise discrimination against, groups vulnerable to HIV in order to reduce the potential for the spread of HIV before the epidemic takes hold.

Rehabilitation of vulnerable groups in emergencies and disasters: A systematic review

PubMed Central

Sheikhbardsiri, Hojjat; Yarmohammadian, Mohammad H.; Rezaei, Fatemeh; Maracy, Mohammad Reza

2017-01-01

BACKGROUND: Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters. METHODS: The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The key words “recovery”, “rehabilitation”, “reconstruction”, “transformation”, “transition”, “emergency”, “disaster”, “crisis”, “hazard”, “catastrophe”, “tragedy”, “mass casualty incident”, “women”, “female”, “children”, “pediatric”, “disable”, “handicap”, “elder”, “old” and “vulnerable” were used in combination with Boolean operators OR and AND. ISI Web of Science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar were searched. RESULTS: In this study a total of 11 928 articles were considered and 25 articles were selected for final review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-five studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic. CONCLUSION: The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups. PMID:29123602

Resourceful masculinities: exploring heterosexual Black men's vulnerability to HIV in Ontario, Canada.

PubMed

Husbands, Winston; Oakes, Wesley; Mbulaheni, Tola; Ongoïba, Fanta; Pierre-Pierre, Valérie; Luyombya, Henry

2017-10-29

Heterosexually active Black men are alleged to endorse masculine norms that increase their and their female partners' vulnerability to HIV. These norms include Black men's inability or reluctance to productively engage their own health-related personal and interpersonal vulnerabilities. We draw on data from the iSpeak research study in Ontario, Canada, to assess whether and how heterosexual Black men cope with personal and inter-personal vulnerability, namely that heterosexual Black men: avoid emotionally supportive relationships with other men (and women), which diminishes their capacity to productively acknowledge and resolve their health-related challenges; are reticent to productively acknowledge and address HIV and health on a personal level; and are pathologically secretive about their health, which compounds their vulnerability and precipitates poor health outcomes. iSpeak was implemented in 2011 to 2013, and included two focus groups with HIV-positive and HIV-negative self-identified heterosexual men (N = 14) in Toronto and London, a focus group with community-based health promotion practitioners who provide HIV-related services to Black communities in Ontario (N = 6), and one-on-one interviews with four researchers distinguished for their scholarship with/among Black communities in Toronto. Participants in the men's focus group were recruited discretely through word-of-mouth. Focus groups were audiotaped and transcribed verbatim. Team members independently read the transcripts, and then met to identify, discuss and agree on the emerging themes. We demonstrate that iSpeak participants (a) engage their personal and interpersonal vulnerabilities creatively and strategically, (b) complicate and challenge familiar interpretations of Black men's allegedly transgressive masculinity through their emotional and practical investment in their health, and (c) demonstrate a form of resourceful masculinity that ambiguously aligns with patriarchy. We conclude with a range of actionable recommendations to strengthen the discursive framework for understanding heterosexual Black men in relation to HIV and health, and substantively engaging them in community responses to HIV.

Mobilising "vulnerability" in the public health response to pandemic influenza.

PubMed

Stephenson, Niamh; Davis, Mark; Flowers, Paul; MacGregor, Casimir; Waller, Emily

2014-02-01

Analysis of public health's growing interest in "vulnerability" has largely focused on health policy, with little interrogation of how vulnerability is being actively appropriated, countered, ignored or reworked by the publics whose health such policy is designed to protect. Once the assemblage of public health is understood as comprised of different forms of expertise and actors, including publics, addressing this gap matters. We examine the use of vulnerability in the specific context of pandemic influenza preparedness. Pandemic preparedness raises some familiar dilemmas for public health governance: how to engage with publics without fuelling social divisions and disruption; and whether to invoke publics as passive recipients of public health advice or to recognise publics as collective agents responding to the threat of pandemic influenza. Thus, we ask how the mobilisation of vulnerability connects with these dilemmas. To examine vulnerability in pandemic preparedness, two forms of qualitative data are analysed: 1) interviews and focus groups with "vulnerable" and "healthy" people (conducted 2011-12) discussing seasonal and pandemic influenza and; 2) international, Australian national and state level pandemic plans (1999-2013). Vulnerability is variously used in plans as a way to identify groups at particular risk of infection because of pre-existing clinical conditions, and as a free-floating social category that could apply to a broad range of people potentially involved in the social disruption a pandemic might entail. Our interview and focus group data indicate that healthy people rework the free-floating extension of vulnerability, and that people designated vulnerable encounter an absence of any collective responsibility for the threat of pandemic influenza. Our analysis suggests that vulnerability's mobilisation in pandemic preparedness limits the connection between public health governance and its publics: here, the openness and unpredictability of people's collective agency is something to be tightly controlled by a government concerned with protecting people from themselves. Copyright © 2013 Elsevier Ltd. All rights reserved.

Using internet-based approaches to collect qualitative data from vulnerable groups: reflections from the field.

PubMed

Neville, Stephen; Adams, Jeffery; Cook, Catherine

2016-12-01

Undertaking qualitative research with vulnerable populations is a complex and challenging process for researchers. Traditional and common modes of collecting qualitative data with these groups have been via face-to-face recorded interviews. This article reports on three internet-based data collection methods; email and synchronous online interviews, as well as online qualitative survey. The key characteristics of using email, sychronous online interviews and an online qualitative survey including the strengths and limitations of each are presented. Reflections and insights on the use of these internet-based data collection methods are provided to encourage researchers to embrace technology and move away from using traditional face-to-face interviews when researching with vulnerable populations. Using the internet to collect qualitative data offers additional ways to gather qualitative data over traditional data collection methods. The use of alternative interview methods may encourage participation of vulnerable participants.

Psychological Vulnerability in Children Next-Born after Stillbirth: A Case-Control Follow-Up Study

ERIC Educational Resources Information Center

Turton, Penelope; Badenhorst, William; Pawlby, Susan; White, Sarah; Hughes, Patricia

2009-01-01

Background: Case studies and anecdotal accounts suggest that perinatal loss may impact upon other children in the family, including those born subsequent to loss. However, there is a dearth of systematically collected quantitative data on this potentially vulnerable group. Methods: Case-controlled follow-up of 52 mothers with history of stillbirth…

"They want to come to school": Work-based education programs to prevent the social exclusion of vulnerable youth.

PubMed

Hutchinson, Nancy L; Versnel, Joan; Poth, Cheryl; Berg, Derek; deLugt, Jenn; Dalton, C J; Chin, Peter; Munby, Hugh

2011-01-01

This paper describes and compares exemplary work-based education (WBE) programs in Ontario Canada designed to meet the needs of two groups of vulnerable youth - at-risk youth and youth with severe disabilities. Two focus group interviews were held, one with professionals from exemplary programs designed to meet the needs of at-risk youth and one with professionals from exemplary programs for youth with severe disabilities. Standard qualitative analyses were conducted on each focus group transcript to generate themes which were subsequently grouped into larger patterns. Then cross-case analyses identified consistencies and unique features within the two types of WBE programs. Two major patterns that characterize the WBE programs emerged from the analyses: the first pattern described the programmatic approaches to WBE appropriate for each type of type of student (which included themes such as the need for an alternative learning environment for at-risk youth), and the second pattern highlighted the rationale for each kind of program (which included themes like ensuring equity for youth with severe disabilities). The findings suggest that schools should continue to provide distinct WBE programs for each of these groups of vulnerable youth - at-risk youth and youth with severe disabilities.

Experiential avoidance in the vulnerability to depression among adolescent females.

PubMed

Mellick, William; Vanwoerden, Salome; Sharp, Carla

2017-01-15

Although various mechanisms in the maternal transmission of Major Depressive Disorder (MDD) have been investigated, it is unknown whether experiential avoidance (EA) is a vulnerability factor in the development of depression or a consequence of the illness. The present study utilized a high-risk design to determine if EA indeed poses vulnerability to adolescent MDD. Secondly, we examined the means by which adolescent EA may come to pose vulnerability, namely that it explains the relation between maternal EA and adolescent depressive symptoms. One-hundred and forty-six biological mother/adolescent daughter dyads comprised three diagnostic groups: mothers with a history of MDD and their depressed daughters (MDD; n=21), mothers with a history of MDD and their never-depressed daughters (high-risk, HR; n=69), and healthy controls (HCs; n=56). Groups differed on daughter EA such that the MDD group reported greater EA than the HR group, which in turn reported greater EA than HCs. Daughter EA mediated the relation between maternal EA and daughter depressive symptoms after controlling for maternal depressive symptoms. Strengths aside, this study included a relatively small group of depressed mother-daughter dyads and relied on cross-sectional self-report data. EA appears to serve as a vulnerability factor for adolescent MDD, and the mechanistic role of daughter EA highlights the significance of intergenerational EA in the maternal transmission of depression. Therapeutic approaches may therefore consider reducing the transmission of EA from mothers to daughters. Copyright © 2016 Elsevier B.V. All rights reserved.

Assessment of groundwater vulnerability to pollution: a combination of GIS, fuzzy logic and decision making techniques

NASA Astrophysics Data System (ADS)

Gemitzi, Alexandra; Petalas, Christos; Tsihrintzis, Vassilios A.; Pisinaras, Vassilios

2006-03-01

The assessment of groundwater vulnerability to pollution aims at highlighting areas at a high risk of being polluted. This study presents a methodology, to estimate the risk of an aquifer to be polluted from concentrated and/or dispersed sources, which applies an overlay and index method involving several parameters. The parameters are categorized into three factor groups: factor group 1 includes parameters relevant to the internal aquifer system’s properties, thus determining the intrinsic aquifer vulnerability to pollution; factor group 2 comprises parameters relevant to the external stresses to the system, such as human activities and rainfall effects; factor group 3 incorporates specific geological settings, such as the presence of geothermal fields or salt intrusion zones, into the computation process. Geographical information systems have been used for data acquisition and processing, coupled with a multicriteria evaluation technique enhanced with fuzzy factor standardization. Moreover, besides assigning weights to factors, a second set of weights, i.e., order weights, has been applied to factors on a pixel by pixel basis, thus allowing control of the level of risk in the vulnerability determination and the enhancement of local site characteristics. Individual analysis of each factor group resulted in three intermediate groundwater vulnerability to pollution maps, which were combined in order to produce the final composite groundwater vulnerability map for the study area. The method has been applied in the region of Eastern Macedonia and Thrace (Northern Greece), an area of approximately 14,000 km2. The methodology has been tested and calibrated against the measured nitrate concentration in wells, in the northwest part of the study area, providing results related to the aggregation and weighting procedure.

Immigrant workers in the United States: recent trends, vulnerable populations, and challenges for occupational health.

PubMed

McCauley, Linda A

2005-07-01

Immigrant workers are a rapidly growing segment of the U.S. work force, and these increasing numbers have resulted in a different ethnic mix in the work force than in previous decades. Immigrant workers are not a homogenous group, but are over-represented in low-paying occupations. Their diversity and vulnerability present distinct challenges for occupational health nurses. High-risk occupations in which a large proportion of immigrant workers are hired include agriculture, sweatshops, day laborers, and construction. Initiatives needed to improve the working conditions of this vulnerable population include improved surveillance and research, culturally competent care providers, improved health care access, advocacy, and changes in immigration and health policy.

Neighborhood Effects on Heat Deaths: Social and Environmental Predictors of Vulnerability in Maricopa County, Arizona

PubMed Central

Declet-Barreto, Juan H.; Stefanov, William L.; Petitti, Diana B.

2012-01-01

Background: Most heat-related deaths occur in cities, and future trends in global climate change and urbanization may amplify this trend. Understanding how neighborhoods affect heat mortality fills an important gap between studies of individual susceptibility to heat and broadly comparative studies of temperature–mortality relationships in cities. Objectives: We estimated neighborhood effects of population characteristics and built and natural environments on deaths due to heat exposure in Maricopa County, Arizona (2000–2008). Methods: We used 2000 U.S. Census data and remotely sensed vegetation and land surface temperature to construct indicators of neighborhood vulnerability and a geographic information system to map vulnerability and residential addresses of persons who died from heat exposure in 2,081 census block groups. Binary logistic regression and spatial analysis were used to associate deaths with neighborhoods. Results: Neighborhood scores on three factors—socioeconomic vulnerability, elderly/isolation, and unvegetated area—varied widely throughout the study area. The preferred model (based on fit and parsimony) for predicting the odds of one or more deaths from heat exposure within a census block group included the first two factors and surface temperature in residential neighborhoods, holding population size constant. Spatial analysis identified clusters of neighborhoods with the highest heat vulnerability scores. A large proportion of deaths occurred among people, including homeless persons, who lived in the inner cores of the largest cities and along an industrial corridor. Conclusions: Place-based indicators of vulnerability complement analyses of person-level heat risk factors. Surface temperature might be used in Maricopa County to identify the most heat-vulnerable neighborhoods, but more attention to the socioecological complexities of climate adaptation is needed. PMID:23164621

Inclusion of vulnerable groups in health policies: Regional policies on health priorities in Africa

PubMed Central

Eide, Arne Henning; Amin, Mutamad; MacLachlan, Malcom; Mannan, Hasheem

2013-01-01

Background If access to equitable health care is to be achieved for all, policy documents must mention and address in some detail different needs of groups vulnerable to not accessing such health care. If these needs are not addressed in the policy documents, there is little chance that they will be addressed at the stage of implementation. Objectives This paper reports on an analysis of 11 African Union (AU) policy documents to ascertain the frequency and the extent of mention of 13 core concepts in relation to 12 vulnerable groups, with a specific focus on people with disabilities. Method The paper applied the EquiFrame analytical framework to the 11 AU policy documents. The 11 documents were analysed in terms of how many times a core concept was mentioned and the extent of information on how the core concept should be addressed at the implementation level. Each core concept mention was further analysed in terms of the vulnerable group in referred to. Results The analysis of regional AU policies highlighted the broad nature of the reference made to vulnerable groups, with a lack of detailed specifications of different needs of different groups. This is confirmed in the highest vulnerable group mention being for ‘universal’. The reading of the documents suggests that vulnerable groups are homogeneous in their needs, which is not the case. There is a lack of recognition of different needs of different vulnerable groups in accessing health care. Conclusion The need for more information and knowledge on the needs of all vulnerable groups is evident. The current lack of mention and of any detail on how to address needs of vulnerable groups will significantly impair the access to equitable health care for all. PMID:28729986

[Food intake in indigenous and non-indigenous Chilean schoolchildren of different social vulnerability].

PubMed

García, Vanessa; Amigo, Hugo; Bustos, Patricia

2002-12-01

The study was based on a cross-sectional design of children from six to nine year olds. Indigenous children were those whose parents had all surnames of this ethnic origin. Non-indigenous children were those with Hispanic surnames. Participants belonged to one of the three social vulnerability groups: high vulnerability (extreme poverty) living in rural communities in a southern region of the country (n = 184); medium vulnerability living in urbanized settings in the same region (n = 248); low vulnerability living in Santiago of Chile (n = 336). Food intake was estimated using a 24-hours recall questionnaire. Total energy intake was similar in the two ethnic groups in all vulnerabilities. It was observed that energy and macronutrient intake increased with the improvement of the social vulnerability: High 1679 kcal. with a standard deviation (SD) of 461, Medium 1878 (SD 484), Low 1894 (SD 495). Children in the high social vulnerability group had a total energy intake below the WHO/FAO recommendations. Consumption of milk, meat, vegetables and fruits was insufficient in all social vulnerability levels but it was closer to the recommendation in the low vulnerability group. Bread accounted for almost 50% of the total energy intake in the high and medium vulnerability groups. It is concluded that differences in the access to an adequate feeding are related to social vulnerability and not ethnicity.

Legal physician-assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in "vulnerable" groups.

PubMed

Battin, Margaret P; van der Heide, Agnes; Ganzini, Linda; van der Wal, Gerrit; Onwuteaka-Philipsen, Bregje D

2007-10-01

Debates over legalisation of physician-assisted suicide (PAS) or euthanasia often warn of a "slippery slope", predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician-assisted dying is legal and data have been collected over a substantial period. The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998-2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government-commissioned nationwide studies of end-of-life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought. Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups. Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician-assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges.

Review Article: A comparison of flood and earthquake vulnerability assessment indicators

NASA Astrophysics Data System (ADS)

de Ruiter, Marleen C.; Ward, Philip J.; Daniell, James E.; Aerts, Jeroen C. J. H.

2017-07-01

In a cross-disciplinary study, we carried out an extensive literature review to increase understanding of vulnerability indicators used in the disciplines of earthquake- and flood vulnerability assessments. We provide insights into potential improvements in both fields by identifying and comparing quantitative vulnerability indicators grouped into physical and social categories. Next, a selection of index- and curve-based vulnerability models that use these indicators are described, comparing several characteristics such as temporal and spatial aspects. Earthquake vulnerability methods traditionally have a strong focus on object-based physical attributes used in vulnerability curve-based models, while flood vulnerability studies focus more on indicators applied to aggregated land-use classes in curve-based models. In assessing the differences and similarities between indicators used in earthquake and flood vulnerability models, we only include models that separately assess either of the two hazard types. Flood vulnerability studies could be improved using approaches from earthquake studies, such as developing object-based physical vulnerability curve assessments and incorporating time-of-the-day-based building occupation patterns. Likewise, earthquake assessments could learn from flood studies by refining their selection of social vulnerability indicators. Based on the lessons obtained in this study, we recommend future studies for exploring risk assessment methodologies across different hazard types.

Towards stressor-specific macroinvertebrate indices: Which traits and taxonomic groups are associated with vulnerable and tolerant taxa?

PubMed

Berger, Elisabeth; Haase, Peter; Schäfer, Ralf B; Sundermann, Andrea

2018-04-01

Monitoring of macroinvertebrate communities is frequently used to define the ecological health status of rivers. Ideally, biomonitoring should also give an indication on the major stressors acting on the macroinvertebrate communities supporting the selection of appropriate management measures. However, most indices are affected by more than one stressor. Biological traits (e.g. size, generation time, reproduction) could potentially lead to more stressor-specific indices. However, such an approach has rarely been tested. In this study we classify 324 macroinvertebrate taxa as vulnerable (decreasing abundances) or tolerant (increasing abundances) along 21 environmental gradients (i.e. nutrients, major ions, oxygen and micropollutants) from 422 monitoring sites in Germany using Threshold Indicator Taxa Analysis (TITAN). Subsequently, we investigate which biological traits and taxonomic groups are associated with taxa classified as vulnerable or tolerant with regard to specific gradients. The response of most taxa towards different gradients was similar and especially high for correlated gradients. Traits associated with vulnerable taxa across most gradients included: larval aquatic life stages, isolated cemented eggs, reproductive cycle per year <1, scrapers, aerial and aquatic active dispersal and plastron respiration. Traits associated with tolerant taxa included: adult aquatic life stages, polyvoltinism, ovoviviparity or egg clutches in vegetation, food preference for dead animals or living microinvertebrates, substrate preference for macrophytes, microphytes, silt or mud and a body size >2-4cm. Our results question whether stressor-specific indices based on macroinvertebrate assemblages can be achieved using single traits, because we observed that similar taxa responded to different gradients and also similar traits were associated with vulnerable and tolerant taxa across a variety of water quality gradients. Future studies should examine whether combinations of traits focusing on specific taxonomic groups achieve higher stressor specificity. Copyright © 2017 Elsevier B.V. All rights reserved.

Do we have a moral responsibility to compensate for vulnerable groups? A discussion on the right to health for LGBT people.

PubMed

Ekmekci, Perihan Elif

2017-09-01

Vulnerability is a broad concept widely addressed in recent scholarly literature. Lesbian, gay, bisexual, and transgender (LGBT) people are among the vulnerable populations with significant disadvantages related to health and the social determinants of health. Medical ethics discourse tackles vulnerability from philosophical and political perspectives. LGBT people experience several disadvantages from both perspectives. This article aims to justify the right to health for LGBT people and their particular claims regarding healthcare because they belong to a vulnerable group. Rawls' theory of justice and Norman Daniels' normal functioning approach will be discussed in this context. Despite the fact that the right to health can be justified by Daniels' normal functioning approach, there is still a theoretical gap in justifying the right to health for particular vulnerable populations such as LGBT peopleand discussing society's duty to compensate for these disadvantages. In search of solid theoretical grounds for the justification of the right to health for LGBT people, the present author takes the opportunity to utilize Daniels' flexible definition of normal functioning to show that normal functioning not only varies by age but also by different states of human existence, including sexual orientation and gender identity, and to propose replacing the life span approach with normal states of human existence.

Health-Related Quality of Life, Self-Efficacy and Enjoyment Keep the Socially Vulnerable Physically Active in Community-Based Physical Activity Programs: A Sequential Cohort Study

PubMed Central

Herens, Marion; Bakker, Evert Jan; van Ophem, Johan; Wagemakers, Annemarie; Koelen, Maria

2016-01-01

Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target these groups through community-based health-enhancing physical activity (CBHEPA) programs. As robust evidence on the effectiveness of this approach is limited, this study investigated whether CBHEPA programs contribute to an increase in and the maintenance of physical activity in socially vulnerable groups. In four successive cohorts, starting at a six-month interval, 268 participants from 19 groups were monitored for twelve months in seven CBHEPA programs. Data collection was based on repeated questionnaires. Socio-economic indicators, program participation and coping ability were measured at baseline. Physical activity, health-related quality of life and on-going program participation were measured three times. Self-efficacy and enjoyment were measured at baseline and at twelve months. Statistical analyses were based on a quasi-RCT design (independent t-tests), a comparison of participants and dropouts (Mann-Whitney test), and multilevel modelling to assess change in individual physical activity, including group level characteristics. Participants of CBHEPA programs are socially vulnerable in terms of low education (48.6%), low income (52.4%), non-Dutch origin (64.6%) and health-related quality of life outcomes. Physical activity levels were not below the Dutch average. No increase in physical activity levels over time was observed. The multilevel models showed significant positive associations between health-related quality of life, self-efficacy and enjoyment, and leisure-time physical activity over time. Short CBHEPA programs (10–13 weeks) with multiple trainers and gender-homogeneous groups were associated with lower physical activity levels over time. At twelve months, dropouts' leisure-time physical activity levels were significantly lower compared to continuing participants, as were health-related quality of life, self-efficacy and enjoyment outcomes. BMI and care consumption scored significantly higher among dropouts. In conclusion, Dutch CBHEPA programs reach socially vulnerable, but not necessarily inactive, groups in terms of socio-economic and health-related quality of life outcomes. Our findings suggest that CBHEPA programs particularly contribute to physical activity maintenance in socially vulnerable groups, rather than to an increase in physical activity behaviour over time. PMID:26909696

Health-Related Quality of Life, Self-Efficacy and Enjoyment Keep the Socially Vulnerable Physically Active in Community-Based Physical Activity Programs: A Sequential Cohort Study.

PubMed

Herens, Marion; Bakker, Evert Jan; van Ophem, Johan; Wagemakers, Annemarie; Koelen, Maria

2016-01-01

Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target these groups through community-based health-enhancing physical activity (CBHEPA) programs. As robust evidence on the effectiveness of this approach is limited, this study investigated whether CBHEPA programs contribute to an increase in and the maintenance of physical activity in socially vulnerable groups. In four successive cohorts, starting at a six-month interval, 268 participants from 19 groups were monitored for twelve months in seven CBHEPA programs. Data collection was based on repeated questionnaires. Socio-economic indicators, program participation and coping ability were measured at baseline. Physical activity, health-related quality of life and on-going program participation were measured three times. Self-efficacy and enjoyment were measured at baseline and at twelve months. Statistical analyses were based on a quasi-RCT design (independent t-tests), a comparison of participants and dropouts (Mann-Whitney test), and multilevel modelling to assess change in individual physical activity, including group level characteristics. Participants of CBHEPA programs are socially vulnerable in terms of low education (48.6%), low income (52.4%), non-Dutch origin (64.6%) and health-related quality of life outcomes. Physical activity levels were not below the Dutch average. No increase in physical activity levels over time was observed. The multilevel models showed significant positive associations between health-related quality of life, self-efficacy and enjoyment, and leisure-time physical activity over time. Short CBHEPA programs (10-13 weeks) with multiple trainers and gender-homogeneous groups were associated with lower physical activity levels over time. At twelve months, dropouts' leisure-time physical activity levels were significantly lower compared to continuing participants, as were health-related quality of life, self-efficacy and enjoyment outcomes. BMI and care consumption scored significantly higher among dropouts. In conclusion, Dutch CBHEPA programs reach socially vulnerable, but not necessarily inactive, groups in terms of socio-economic and health-related quality of life outcomes. Our findings suggest that CBHEPA programs particularly contribute to physical activity maintenance in socially vulnerable groups, rather than to an increase in physical activity behaviour over time.

Social identity and support for counteracting tobacco company marketing that targets vulnerable populations

PubMed Central

Baig, Sabeeh A.; Pepper, Jessica K.; Morgan, Jennifer C.; Brewer, Noel T.

2017-01-01

Rationale Tobacco companies use advertising to target vulnerable populations, including youth, racial/ethnic minorities, and sexual minorities. Objective We sought to examine how personal identity affects support for population-specific anti-smoking advertisements that could serve as countermeasures to industry practices. Methods In 2014–2015, we surveyed probability phone samples of adults and adolescents (n = 6,139) and an online convenience sample of adults (n = 4,137) in the United States. We experimentally varied the description of tobacco industry marketing practices (no description, general, or specific to a target group). The four prevention target groups were teens; African Americans; Latinos; and gays, lesbians, and bisexuals (GLBs). Participants were either members or non-members of their prevention target group. Results Support was highest for anti-smoking advertisements targeting teens, moderate for Latinos and African Americans, and lowest for GLBs. In-group members expressed higher support than out-group members when anti-smoking advertisements targeted African Americans, Latinos, and GLBs (all p < .05). However, when teens were the target prevention group, in-group members expressed lower support than out-group members (p < .05). The description of industry marketing practices did not have an effect. Results were similar across the phone and online studies. Conclusions Our findings suggest that the public strongly supports advertisements to prevent smoking among teens, but support for similar efforts among other vulnerable populations is comparatively low. Anti-smoking campaigns for vulnerable populations may benefit from a greater understanding of the role of social identity in shaping public support for such campaigns. PMID:28427731

Group decision-making approach for flood vulnerability identification using the fuzzy VIKOR method

NASA Astrophysics Data System (ADS)

Lee, G.; Jun, K. S.; Chung, E.-S.

2015-04-01

This study proposes an improved group decision making (GDM) framework that combines the VIKOR method with data fuzzification to quantify the spatial flood vulnerability including multiple criteria. In general, GDM method is an effective tool for formulating a compromise solution that involves various decision makers since various stakeholders may have different perspectives on their flood risk/vulnerability management responses. The GDM approach is designed to achieve consensus building that reflects the viewpoints of each participant. The fuzzy VIKOR method was developed to solve multi-criteria decision making (MCDM) problems with conflicting and noncommensurable criteria. This comprising method can be used to obtain a nearly ideal solution according to all established criteria. This approach effectively can propose some compromising decisions by combining the GDM method and fuzzy VIKOR method. The spatial flood vulnerability of the southern Han River using the GDM approach combined with the fuzzy VIKOR method was compared with the spatial flood vulnerability using general MCDM methods, such as the fuzzy TOPSIS and classical GDM methods (i.e., Borda, Condorcet, and Copeland). As a result, the proposed fuzzy GDM approach can reduce the uncertainty in the data confidence and weight derivation techniques. Thus, the combination of the GDM approach with the fuzzy VIKOR method can provide robust prioritization because it actively reflects the opinions of various groups and considers uncertainty in the input data.

The impact of epidemics on labor market: identifying victims of the Middle East Respiratory Syndrome in the Korean labor market.

PubMed

Lee, Ayoung; Cho, Joonmo

2016-12-01

The vulnerability approach suggests that disasters such as epidemics have different effects according not only to physical vulnerability but also to economic class (status). This paper examines the effect of the Middle East Respiratory Syndrome epidemic on the labor market to investigate whether vulnerable groups become more vulnerable due to an interaction between the socio-economic structure and physical risk. This paper examines the effect of the Middle East Respiratory Syndrome epidemic on the labor market by considering unemployment status, job status, working hours, reason for unemployment and underemployment status. In particular, the study investigates whether the U-shaped curve becomes a J-shaped curve due to the interaction between medical vulnerability and labor market vulnerability after an outbreak, assuming that the relative vulnerability in the labor market by age shows a U curve with peaks for the young group and middle aged and old aged groups using the Economically Active Population Survey. We use the difference in difference approach and also conduct a falsification check and robustness check. The results suggest that older workers faced a higher possibility of unemployment after the Middle East Respiratory Syndrome outbreak. In particular, they experienced higher involuntary unemployment and underemployment status as well as decreased working hours. It was confirmed that the relative vulnerability of the labor market for older workers was higher than for the other age groups after the epidemic outbreak due to the double whammy of vulnerability in the medical and labor market. The vulnerability in the young group partially increased compared to the 30s and 40s age groups due to their relative vulnerability in the labor market despite being healthy. We find that assuming the relative vulnerability in the existing labor market shows a U shape with age increase, the U-shaped curve became J-shaped after the outbreak. Disasters like epidemics can occur unexpectedly and affect certain groups more than other. Therefore, medical protection should be enhanced for groups vulnerable to disease and economic measures are also required for the protection of their livelihoods in the labor market to prevent unemployment stemming from inequality.

Vulnerable Bullies: Perpetration of Peer Harassment Among Youths Across Sexual Orientation, Weight, and Disability Status.

PubMed

Eisenberg, Marla E; Gower, Amy L; McMorris, Barbara J; Bucchianeri, Michaela M

2015-09-01

We examined perpetration of bullying among youths in vulnerable groups relative to youths in peer groups not categorized as vulnerable. Data were collected in 2013 from a large school-based survey of adolescents conducted in Minnesota (n = 122,180). We used the χ(2) test and logistic regression to compare measures of perpetration of physical and relational bullying, as well as experiences of victimization and perpetration (or both), across categories of sexual orientation, weight status, and disability status. Rates of physical and relational bullying perpetration were significantly higher among youths in vulnerable groups than among those not in vulnerable groups. With respect to context of victimization experiences, young men and women from vulnerable groups were overrepresented in the group comprising both perpetrators and victims. For example, odds of being both a perpetrator and a victim were 1.41 to 3.22 times higher among gay, lesbian, and bisexual youths than among heterosexual youths. Vulnerable youths, who are prone to peer harassment, may also act as perpetrators of bullying. Prevention strategies should address the particular needs of these populations; targeted programming may be appropriate.

Social vulnerability and climate variability in southern Brazil: a TerraPop case study

NASA Astrophysics Data System (ADS)

Adamo, S. B.; Fitch, C. A.; Kugler, T.; Doxsey-Whitfield, E.

2014-12-01

Climate variability is an inherent characteristic of the Earth's climate, including but not limited to climate change. It affects and impacts human society in different ways, depending on the underlying socioeconomic vulnerability of specific places, social groups, households and individuals. This differential vulnerability presents spatial and temporal variations, and is rooted in historical patterns of development and relations between human and ecological systems. This study aims to assess the impact of climate variability on livelihoods and well-being, as well as their changes over time and across space, and for rural and urban populations. The geographic focus is Southern Brazil-the states of Parana, Santa Catarina and Rio Grande do Sul-- and the objectives include (a) to identify and map critical areas or hotspots of exposure to climate variability (temperature and precipitation), and (b) to identify internal variation or differential vulnerability within these areas and its evolution over time (1980-2010), using newly available integrated data from the Terra Populus project. These data include geo-referenced climate and agricultural data, and data describing demographic and socioeconomic characteristics of individuals, households and places.

Research on subgroups is not research on equity attributes: Evidence from an overview of systematic reviews on vaccination.

PubMed

Bosch-Capblanch, Xavier; Zuske, Meike-Kathrin; Auer, Christian

2017-06-07

Equity remains a priority in the international health development agenda. However, major inequities in vaccination coverage jeopardise the achievement of the Sustainable Development Goals. We aim at comprehensively describing how research has addressed equity issues related to vaccination. We carried out an overview of systematic reviews (SRs) that explicitly explored the effects of interventions to improve vaccination in any context; for any vaccine and, in any language. We followed standard research synthesis methods to systematically search for SR, assess them for inclusion and extracting relevant data, particularly on vaccination related outcomes. To gather evidence on equity issues addressed in the SR, we used the PROGRESS-plus framework. Our search obtained 2,003 hits which resulted in 54 included SRs, published between 1994 and 2014. The quality of SRs was generally poor, with less than half complying with most of the quality criteria. Reported vaccines included, by order of frequency, influenza and Expanded Programme on Immunisation vaccines. The types of interventions more frequently reported were related to vaccination delivery strategies, financial support and information, education and communication. Most of the SRs suggested effects favouring intervention groups as opposed to comparison groups. The most frequently reported equity attribute was 'place of residence' and the least reported equity attributes were sexual orientation and religion. Very few estimates of effects actually measured differences or changes between groups having those attributes and all of them referred to the place of residence. No data was found about reducing equity gaps for vulnerable groups or minorities, or attributes such as sexual orientation, education or specific religious groups. Although research on vulnerable populations as a subgroup is abundant, it fails to report on the interventions that will actually reduce inequities and consider how redistribution of health care resources could shrink the gap between the privileged and most vulnerable groups including minorities. Research, if aiming at being responsive to global health policy trends, needs to report not only on specific attributes but also on how a better redistribution of health care resources could contribute to alleviating the unjust situation of the most vulnerable populations.

“They talk like that, but we keep working”: Sexual harassment and sexual assault experiences among Mexican Indigenous farmworker women in Oregon

PubMed Central

Murphy, Jeanne; Samples, Julie; Morales, Mavel; Shadbeh, Nargess

2014-01-01

In order to examine the experiences of sexual harassment and sexual assault among indigenous and non-indigenous Mexican immigrant farmworkers in Oregon's Willamette Valley, a community-academic participatory research partnership initiated a study, which included focus groups, conducted and analyzed by skilled practitioners and researchers. The themes that emerged from the focus groups included direct and indirect effects of sexual harassment and sexual assault on women and risk factors associated with the farmworker workplace environment, and the increased vulnerability of non-Spanish-speaking indigenous women due to low social status, poverty, cultural and linguistic issues, and isolation. Recommendations for prevention and improved services for vulnerable women will be discussed as well as limitations and future research directions. PMID:24514945

"They Talk Like That, But We Keep Working": Sexual Harassment and Sexual Assault Experiences Among Mexican Indigenous Farmworker Women in Oregon.

PubMed

Murphy, Jeanne; Samples, Julie; Morales, Mavel; Shadbeh, Nargess

2015-12-01

In order to examine the experiences of sexual harassment and sexual assault among indigenous and non-indigenous Mexican immigrant farmworkers in Oregon's Willamette Valley, a community-academic participatory research partnership initiated a study, which included focus groups, conducted and analyzed by skilled practitioners and researchers. The themes that emerged from the focus groups included direct and indirect effects of sexual harassment and sexual assault on women and risk factors associated with the farmworker workplace environment, and the increased vulnerability of non-Spanish-speaking indigenous women due to low social status, poverty, cultural and linguistic issues, and isolation. Recommendations for prevention and improved services for vulnerable women will be discussed as well as limitations and future research directions.

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru

PubMed Central

Perez-Brumer, Amaya G.; Reisner, Sari L.; McLean, Sarah A.; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H.; Sanchez, Jorge; Clark, Jesse L.; Mimiaga, Matthew J.; Lama, Javier R.

2017-01-01

Abstract Introduction: In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Methods: Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18–44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Results: Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). Conclusion: This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts. PMID:28362064

Leveraging social capital: multilevel stigma, associated HIV vulnerabilities, and social resilience strategies among transgender women in Lima, Peru.

PubMed

Perez-Brumer, Amaya G; Reisner, Sari L; McLean, Sarah A; Silva-Santisteban, Alfonso; Huerta, Leyla; Mayer, Kenneth H; Sanchez, Jorge; Clark, Jesse L; Mimiaga, Matthew J; Lama, Javier R

2017-02-28

In Peru, transgender women (TW) experience unique vulnerabilities for HIV infection due to factors that limit access to, and quality of, HIV prevention, treatment and care services. Yet, despite recent advances in understanding factors associated with HIV vulnerability among TW globally, limited scholarship has examined how Peruvian TW cope with this reality and how existing community-level resilience strategies are enacted despite pervasive social and economic exclusion facing the community. Addressing this need, our study applies the understanding of social capital as a social determinant of health and examines its relationship to HIV vulnerabilities to TW in Peru. Using qualitative methodology to provide an in-depth portrait, we assessed (1) intersections between social marginalization, social capital and HIV vulnerabilities; and (2) community-level resilience strategies employed by TW to buffer against social marginalization and to link to needed HIV-related services in Peru. Between January and February 2015, 48 TW participated (mean age = 29, range = 18-44) in this study that included focus group discussions and demographic surveys. Analyses were guided by an immersion crystallization approach and all coding was conducted using Dedoose Version 6.1.18. Themes associated with HIV vulnerability included experiences of multilevel stigma and limited occupational opportunities that placed TW at risk for, and limited their engagement with, existing HIV services. Emergent resiliency-based strategies included peer-to-peer and intergenerational knowledge sharing, supportive clinical services (e.g. group-based clinic attendance) and emotional support through social cohesion (i.e. feeling part of a community). This study highlights the importance of TW communities as support structures that create and deploy social resiliency-based strategies aimed at deterring and mitigating the impact of social vulnerabilities to discrimination, marginalization and HIV risk for individual TW in Peru. Public health strategies seeking to provide HIV prevention, treatment and care for this population will benefit from recognizing existing social capital within TW communities and incorporating its strengths within HIV prevention interventions. At the intersection of HIV vulnerabilities and collective agency, dimensions of bridging and bonding social capital emerged as resiliency strategies used by TW to access needed healthcare services in Peru. Fostering TW solidarity and peer support are key components to ensure acceptability and sustainability of HIV prevention and promotion efforts.

Vulnerable Bullies: Perpetration of Peer Harassment Among Youths Across Sexual Orientation, Weight, and Disability Status

PubMed Central

Gower, Amy L.; McMorris, Barbara J.; Bucchianeri, Michaela M.

2015-01-01

Objectives. We examined perpetration of bullying among youths in vulnerable groups relative to youths in peer groups not categorized as vulnerable. Methods. Data were collected in 2013 from a large school-based survey of adolescents conducted in Minnesota (n = 122 180). We used the χ2 test and logistic regression to compare measures of perpetration of physical and relational bullying, as well as experiences of victimization and perpetration (or both), across categories of sexual orientation, weight status, and disability status. Results. Rates of physical and relational bullying perpetration were significantly higher among youths in vulnerable groups than among those not in vulnerable groups. With respect to context of victimization experiences, young men and women from vulnerable groups were overrepresented in the group comprising both perpetrators and victims. For example, odds of being both a perpetrator and a victim were 1.41 to 3.22 times higher among gay, lesbian, and bisexual youths than among heterosexual youths. Conclusions. Vulnerable youths, who are prone to peer harassment, may also act as perpetrators of bullying. Prevention strategies should address the particular needs of these populations; targeted programming may be appropriate. PMID:26180987

Social identity and support for counteracting tobacco company marketing that targets vulnerable populations.

PubMed

Baig, Sabeeh A; Pepper, Jessica K; Morgan, Jennifer C; Brewer, Noel T

2017-06-01

Tobacco companies use advertising to target vulnerable populations, including youth, racial/ethnic minorities, and sexual minorities. We sought to examine how personal identity affects support for population-specific anti-smoking advertisements that could serve as countermeasures to industry marketing practices. In 2014-2015, we surveyed probability phone samples of adults and adolescents (n = 6,139) and an online convenience sample of adults (n = 4,137) in the United States. We experimentally varied the description of tobacco industry marketing practices (no description, general, or specific to a target group). The four prevention target groups were teens; African Americans; Latinos; and gays, lesbians, and bisexuals (GLBs). Participants were either members or non-members of their prevention target group. Support was highest for anti-smoking advertisements targeting teens, moderate for Latinos and African Americans, and lowest for GLBs. In-group members expressed higher support than out-group members when anti-smoking advertisements targeted African Americans, Latinos, and GLBs (all p < 0.05). However, when teens were the target prevention group, in-group members expressed lower support than out-group members (p < 0.05). The description of industry marketing practices did not have an effect. Results were similar across the phone and online studies. Our findings suggest that the public strongly supports advertisements to prevent smoking among teens, but support for similar efforts among other vulnerable populations is comparatively low. Anti-smoking campaigns for vulnerable populations may benefit from a greater understanding of the role of social identity in shaping public support for such campaigns. Copyright © 2017 Elsevier Ltd. All rights reserved.

Structural Vulnerability and Health: Latino Migrant Laborers in the United States

PubMed Central

Quesada, James; Hart, Laurie K.; Bourgois, Philippe

2011-01-01

Latino immigrants in the United States constitute a paradigmatic case of a population group subject to structural violence. Their subordinated location in the global economy and their culturally depreciated status in the United States are exacerbated by legal persecution. Medical Anthropology Volume 30, issues 4 and 5, include a series of ethnographic analyses of the processes that render undocumented Latino immigrants structurally vulnerable to ill-health. We hope to extend the social science concept of ‘structural vulnerability’ to make it a useful tool for health care. Defined as a positionality that imposes physical/emotional suffering on specific population groups and individuals in patterned ways, structural vulnerability is a product of two complementary forces: (1) class-based economic exploitation and cultural, gender/sexual, and racialized discrimination; and (2) processes of symbolic violence and subjectivity formation that have increasingly legitimized punitive neoliberal discourses of individual unworthiness. PMID:21777121

In Search of the Third Eye, When the Two Others Are Shamefacedly Shut? Comment on "Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development".

PubMed

Keygnaert, Ines

2016-02-11

Ivanova et al explored how vulnerable groups and principles of human rights are incorporated into national sexual and reproductive health (SRH) policies in 4 countries. They adapted the EquiFrame of Amin and colleagues of 2011, to SRH vulnerable groups which we believe could now be used for analysis of national SRH polices beyond those 4 countries. Although we fully agree with the authors' two main findings that vulnerable groups and human rights' principles are not sufficiently integrated in SRH policies nor granted the possibility to participate in the process of development in those four countries, we do believe that these shortcomings are not limited to those countries only nor to the identified vulnerable groups either. We are convinced that the issue of SRH as such is still framed within a very limited logic for all with vulnerable groups being perceived as an extra threat or an extra burden. © 2016 by Kerman University of Medical Sciences.

Equine road user safety: public attitudes, understandings and beliefs from a qualitative study in the United Kingdom.

PubMed

Chapman, Catherine; Musselwhite, Charles B A

2011-11-01

Horse riders represent a significant group of vulnerable road user and are involved in a number of accidents and near misses on the road. Despite this horse riders have received little attention both in terms of academic research and transport policy. Based on literature on vulnerable road user safety, including attitudes to road user safety and behaviour of drivers and their relationship with cyclists and motorcyclists, this paper examines the attitudes and reported behaviour of drivers and horse riders. A total of 46 participants took part in six focus groups divided into four groups of drivers with little or no horse riding experience and two groups of frequent horse riders. Each group investigated five key topic areas stemming from the literature review on vulnerable road users including hazard perception, risk perception, emotion, attitudes to sharing the road and empathy. It was found that drivers and horse riders are not always aware of the same hazards in the road and that this may lead drivers to under-estimate the risk when encountering horses. Drivers often had good intentions to overtake horses safely, but were unaware of how vulnerable passing very wide and slow made them feel until they had begun the manoeuvre and hence quickly reduced such feelings either by speeding up or cutting in too soon. However, other than this, drivers had good skills when encountering horses. But these skills could be impeded by frustration when encountering a slow moving horse which was further compounded by a feeling, mainly by younger drivers, that horse riding was for leisure and as such should not get in the way of necessary work journeys. There is a need for drivers to be more aware of the potential hazards a horse rider faces on the road and these could be achieved through inducing empathy amongst drivers for horse riders, creating nudges for drivers in the environment and better education for drivers. Copyright © 2011 Elsevier Ltd. All rights reserved.

Are Electronic Cigarettes an Effective Aid to Smoking Cessation or Reduction Among Vulnerable Groups? A Systematic Review of Quantitative and Qualitative Evidence.

PubMed

Gentry, Sarah; Forouhi, Nita; Notley, Caitlin

2018-03-28

Smoking prevalence remains high in some vulnerable groups, including those who misuse substances, have a mental illness, are homeless or are involved with the criminal justice system. E-cigarette use is increasing and may support smoking cessation/reduction. Systematic review of quantitative and qualitative data on the effectiveness of e-cigarettes for smoking cessation/reduction among vulnerable groups. Databases searched were MEDLINE, EMBASE, PsychINFO, CINAHL, ASSIA, ProQuest Dissertations and Theses and Open Grey. Narrative synthesis of quantitative data and thematic synthesis of qualitative data. 2628 records and 46 full texts were screened; 9 studies were identified for inclusion. Due to low quality of evidence, it is uncertain whether e-cigarettes are effective for smoking cessation in vulnerable populations. A moderate quality study suggested e-cigarettes were as effective as nicotine replacement therapy. Four studies suggested significant smoking reduction, however three were uncontrolled and had sample sizes below 30. A prospective cohort study found no differences between e-cigarette users and non-users. No significant adverse events and minimal side effects were identified. Qualitative thematic synthesis revealed barriers and facilitators associated with each component of the COM-B (capability, opportunity, motivation, behaviour) model, including practical barriers; perceptions of effectiveness for cessation/reduction; design features contributing to automatic and reflective motivation; smoking bans facilitating practical opportunity; and social connectedness increasing social opportunity. Further research is needed to identify the most appropriate device types for practicality and safety, level of support required in e-cigarette interventions, and to compare e-cigarettes with current best practice smoking cessation support among vulnerable groups. Smoking prevalence among people with mental illness, substance misuse, homelessness or criminal justice system involvement remains high. E-cigarettes could support cessation. This systematic review found limited quantitative evidence assessing effectiveness. No serious adverse events were identified. Qualitative thematic synthesis revealed barriers and facilitators mapping to each component of the COM-B (capability, opportunity, motivation, behaviour) model, including practical barriers; perceived effectiveness; design features contributing to automatic and reflective motivation; smoking bans facilitating practical opportunity; and social connectedness increasing social opportunity. Further research should consider appropriate devices for practicality and safety, concurrent support, and comparison with best practice smoking cessation support.

Access to genetic testing and genetic counseling in vulnerable populations: the d/Deaf and hard of hearing population.

PubMed

Cooke-Hubley, Sandra; Maddalena, Victor

2011-09-01

Genetic testing holds great potential for preventing morbidities and mortalities for a number of diseases through early detection and effective intervention. As the number of genetic tests expand, so will public demand for these services. Therefore, it is essential to evaluate access to genetic testing and genetic services to ensure that all Canadians, including vulnerable groups, have equitable access to all forms of health care, in keeping with the mandate of the Canadian Health Act. The purpose of this paper is to examine the literature to determine if and how the Deaf community, as a vulnerable group, is at an increased risk of inequitable access to genetic services in Canada and to discuss how those who are deaf and hard of hearing are subject to the same risks. First, we define vulnerability and describe why the Deaf community, as a social group, can be considered a vulnerable group, followed by a description of the benefits of genetic testing. Second, we describe the barriers to accessing genetic testing, and how the d/Deaf and hard of hearing population experience additional barriers. Third, we examine the difficulties incorporating genetic testing into medical practice, and how this creates additional barriers to those already at risk. Finally, we discuss the steps necessary to promote equitable access to genetic testing among the d/Deaf and hard of hearing populations within Canada, and provide recommendations for further research in this topic area. Lastly, we comment on how barriers to genetic testing vary among the d/Deaf and hard of hearing is dependent upon the type of health care system available (whether public or private).

Determinants of physician utilization, emergency room use, and hospitalizations among populations with multiple health vulnerabilities.

PubMed

Small, La Fleur F

2011-09-01

Understanding the factors that influence differing types of health care utilization within vulnerable groups can serve as a basis for projecting future health care needs, forecasting future health care expenditures, and influencing social policy. In this article the Behavioral Model for Vulnerable Populations is used to evaluate discretionary (physician visits) and non-discretionary (emergency room visits, and hospitalizations) health utilization patterns of a sample of 1466 respondents with one or more vulnerable health classification. Reported vulnerabilities include: (1) persons with substance disorders; (2) homeless persons; (3) persons with mental health problems; (4) victims of violent crime; (5) persons diagnosed with HIV/AIDS; (6) and persons in receipt of public benefits. Hierarchical logistic regression is used on three nested models to model factors that influence physician visits, emergency room visits, and hospitalizations. Additionally, bivariate logistic regression analyses are completed using a vulnerability index to evaluate the impact of increased numbers of vulnerability on all three forms of health care utilization. Findings from this study suggest the Behavioral Model of Vulnerable Populations be employed in future research regarding health care utilization patterns among vulnerable populations. This article encourages further research investigating the cumulative effect of health vulnerabilities on the use of non-discretionary services so that this behavior could be better understood and appropriate social policies and behavioral interventions implemented.

A vulnerability assessment of 300 species in Florida: threats from sea level rise, land use, and climate change.

PubMed

Reece, Joshua Steven; Noss, Reed F; Oetting, Jon; Hoctor, Tom; Volk, Michael

2013-01-01

Species face many threats, including accelerated climate change, sea level rise, and conversion and degradation of habitat from human land uses. Vulnerability assessments and prioritization protocols have been proposed to assess these threats, often in combination with information such as species rarity; ecological, evolutionary or economic value; and likelihood of success. Nevertheless, few vulnerability assessments or prioritization protocols simultaneously account for multiple threats or conservation values. We applied a novel vulnerability assessment tool, the Standardized Index of Vulnerability and Value, to assess the conservation priority of 300 species of plants and animals in Florida given projections of climate change, human land-use patterns, and sea level rise by the year 2100. We account for multiple sources of uncertainty and prioritize species under five different systems of value, ranging from a primary emphasis on vulnerability to threats to an emphasis on metrics of conservation value such as phylogenetic distinctiveness. Our results reveal remarkable consistency in the prioritization of species across different conservation value systems. Species of high priority include the Miami blue butterfly (Cyclargus thomasi bethunebakeri), Key tree cactus (Pilosocereus robinii), Florida duskywing butterfly (Ephyriades brunnea floridensis), and Key deer (Odocoileus virginianus clavium). We also identify sources of uncertainty and the types of life history information consistently missing across taxonomic groups. This study characterizes the vulnerabilities to major threats of a broad swath of Florida's biodiversity and provides a system for prioritizing conservation efforts that is quantitative, flexible, and free from hidden value judgments.

Heat Vulnerability Index Mapping for Milwaukee and Wisconsin.

PubMed

Christenson, Megan; Geiger, Sarah Dee; Phillips, Jeffrey; Anderson, Ben; Losurdo, Giovanna; Anderson, Henry A

Extreme heat waves elevate the population's risk for heat-related morbidity and mortality, specifically for vulnerable groups such as older adults and young children. In this context, we developed 2 Heat Vulnerability Indices (HVIs), one for the state of Wisconsin and one for the Milwaukee metropolitan area. Through the creation of an HVI, state and local agencies will be able to use the indices as a planning tool for extreme heat events. Data used for the HVIs were grouped into 4 categories: (1) population density; (2) health factors; (3) demographic and socioeconomic factors; and (4) natural and built environment factors. These categories were mapped at the Census block group level. Unweighted z-score data were used to determine index scores, which were then mapped by quantiles ranging from "high" to "low" vulnerability. Statewide, Menominee County exhibited the highest vulnerability to extreme heat. Milwaukee HVI findings indicated high vulnerability in the city's inner core versus low vulnerability along the lakeshore. Visualization of vulnerability could help local public health agencies prepare for future extreme heat events.

Region 9 - Social Vulnerability Index

EPA Pesticide Factsheets

The Social Vulnerability Index is derived from the 2000 US Census data. The fields included are percent minority, median household income, age (under 18 and over 64), population without a high school diploma, linguistically isolated households, and single female head of households with own children under 18 (single moms). The data is at the block group level. Each field for each block group is assigned an index score of 0-3, based on whether the value of that dataset falls in the top quartile (score=3), second quartile (score=2), third quartile (score=1), or bottom quartile (score=0). The scores for each field are then added together to assign a comprehensive score to each block group (0-21). The highest scores are block groups that have the highest percentage of sensitive populations (highest percent minority, lowest per capita income, highest percent of population under 18 and over 64, highest percentage of population without a high school degree, highest percent of linguistically isolated households, and highest percent of single female head of households). Zoe Heller of the US EPA Region 9's Communities and Ecosystems Division, is responsible for the design and development of the Social Vulnerability Index data set.

Arizona - Social Vulnerability Index

EPA Pesticide Factsheets

The Social Vulnerability Index is derived from the 2000 US Census data. The fields included are percent minority, median household income, age (under 18 and over 64), population without a high school diploma, linguistically isolated households, and single female head of households with own children under 18 (single moms). The data is at the block group level. Each field for each block group is assigned an index score of 0-3, based on whether the value of that dataset falls in the top quartile (score=3), second quartile (score=2), third quartile (score=1), or bottom quartile (score=0). The scores for each field are then added together to assign a comprehensive score to each block group (0-21). The highest scores are block groups that have the highest percentage of sensitive populations (highest percent minority, lowest per capita income, highest percent of population under 18 and over 64, highest percentage of population without a high school degree, highest percent of linguistically isolated households, and highest percent of single female head of households). Zoe Heller of the US EPA Region 9's Communities and Ecosystems Division, is responsible for the design and development of the Social Vulnerability Index data set.

"I feel like I am less than other people": Health-related vulnerabilities of male migrants travelling alone on their journey to Europe.

PubMed

Arsenijević, Jovana; Burtscher, Doris; Ponthieu, Aurelie; Severy, Nathalie; Contenta, Andrea; Moissaing, Stephane; Argenziano, Stefano; Zamatto, Federica; Zachariah, Rony; Ali, Engy; Venables, Emilie

2018-07-01

During 2015 and 2016, an unprecedented flow of approximately 800,000 migrants coming from Turkey towards Western Europe crossed the Balkans. Male migrants are perceived as being less vulnerable compared to other migrants and they are not given priority in service and support provision. This qualitative study examines the self-perceived vulnerabilities of male migrants travelling alone along the Balkan route to Europe. Twenty-four individual in-depth interviews, two group interviews and participant observation were conducted with male migrants in Belgrade, Serbia in 2017. Data was coded manually, and analysed thematically. Male migrants traveling alone face the cumulative vulnerability of various traumatic events and migration-related contextual circumstances. Three main themes emerged: the ongoing desperate journey, the better treatment of 'traditionally' well recognised vulnerable sub-groups and the impact of the continuous stress on mental health. Deterrence measures imposed for border control purposes in the form of push-backs, expulsions, detention and degrading, inhumane treatment amplify the psychological distress of male migrants. Feelings of hopelessness, desperation, lack of self-value and self-esteem were reported. 'Traditionally vulnerable' populations were said to have had better treatment throughout the journey from smugglers, border state authorities, governmental officials, civil society and international organizations. The devastating experiences of male migrants, as well as the better treatment offered to other groups of migrants like women and children, results in a perceived neglect of the needs of men in humanitarian response, rendering them vulnerable and exposing them to further health and protection risks. In a context where needs are unmet and people's dignity and health are at risk, specific strategies should be developed to include men in the assistance and protection offered, particularly in relation to exposure to violence. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Hydrologic vulnerability of tribal reservation lands across the U.S.

NASA Astrophysics Data System (ADS)

Jones, C., Jr.; Leibowitz, S. G.; Sawicz, K. A.; Comeleo, R. L.; Stratton, L. E.

2017-12-01

We apply the hydrologic landscapes (HL) concept to assess the hydrologic vulnerability to climate of the United States (U.S.) with special emphasis on tribal lands. The basic assumption of the HL approach is that catchments that share similar physical and climatic characteristics are expected to have similar hydrologic characteristics. We map climate vulnerability by integrating a retrospective analysis of historical climate and hydrology into the HL approach, comparing this baseline of variability with future projections of temperature, precipitation, potential evapotranspiration, snow accumulation, climatic moisture, surplus water, and seasonality of the water surplus. Projections that are not within two standard deviations of the historical decadal average contribute to the vulnerability index for each metric. This allows stakeholders and/or water resource managers to understand the potential impacts of future conditions. The resulting vulnerability maps show that temperature and potential evapotranspiration are consistently projected to have high vulnerability indices across the U.S. including all tribal reservations. Precipitation vulnerability is not as spatially-uniform as temperature. Most areas with snow are projected to experience significant changes in future snow accumulation. The seasonality vulnerability map shows that mountainous areas in the West are most prone to changes in seasonality. This paper illustrates how the HL approach can help assess climatic and hydrologic vulnerability for disadvantaged groups across the U.S. By combining the HL concept and climate vulnerability analyses, we provide an approach that can assist tribal resource managers to perform vulnerability assessments and adaptation plans, which is a major priority for the tribes nationwide.

Eating practices among low-income overweight /obese Brazilian mothers: a Bourdieusian approach.

PubMed

de Morais Sato, Priscila; Dimitrov Ulian, Mariana; Fernandez Unsain, Ramiro; Baeza Scagliusi, Fernanda

2018-05-16

We investigated the eating practices of socially vulnerable overweight and obese Brazilian mothers, exploring the relationships between eating practices, capitals, fields and excess-weight. We conducted a qualitative study involving in-depth interviews of 21 women living in three vulnerable urban regions. Content analyses were performed and codes were used to locate actors in relation to each other in terms of 'capitals' and 'fields', forming a typology based on Bourdieu's theory with five groups. Socioeconomic conditions during childhood and liking to cook were the main characteristics related to each group's distinct eating practices. While socioeconomic conditions during childhood were related to region of origin and food tastes, liking to cook worked as a type of cultural capital, called culinary capital, which produced pleasure and status. For each pattern of eating practices, different factors seemed to contribute to participants' excess weight, including liked foods, enjoying cooking, and financial constraints. One group combined a highly vulnerable economic situation and health problems, shedding light onto a habitus that demands special attention from public health studies and interventions. This study illustrates the complexity of practices within a seemingly homogeneous group and reinforces that health studies should not assume homogeneity within a group of overweight/obese low-income women. © 2018 Foundation for the Sociology of Health & Illness.

Children's adjustment to their divorced parents' new relationships.

PubMed

Isaacs, Ar

2002-08-01

With new relationships common after divorce, researchers have tried to determine the factors that predict how well children adjust to their stepfamily. The many potential factors are often grouped into the categories of family process, individual risk and vulnerability, and ecological variables. Family process is concentrated on the impact of disrupted family relationships; positive outcomes are associated with low conflict and authoritative parenting. Individual risk and vulnerability includes attributes of the child and the adults; positive outcomes are associated with children who have an easy temperament. Adolescents and girls may have particular difficulty adjusting. Ecological perspectives include the larger social environment such as peers and school.

Unlicensed care homes in the United States: a clandestine sector of long-term care.

PubMed

Lepore, Michael; Greene, Angela M; Porter, Kristie; Lux, Linda; Vreeland, Emily; Hawes, Catherine

2018-06-11

Residential care facilities operating without a state license are known to house vulnerable adults. Such unlicensed care homes (UCHs) commonly operate illegally, making them difficult to investigate. We conducted an exploratory, multimethod qualitative study of UCHs, including 18 subject matter expert interviews and site visits to three states, including a total of 30 stakeholder interviews, to understand UCH operations, services provided, and residents served. Findings indicate that various vulnerable groups reside in UCHs; some UCHs offer unsafe living environments; and some residents are reportedly abused, neglected, and financially exploited. Regulations, policies and practices that might influence UCH prevalence are discussed.

Attending to social vulnerability when rationing pandemic resources.

PubMed

Vawter, Dorothy E; Garrett, J Eline; Gervais, Karen G; Prehn, Angela Witt; DeBruin, Debra A

2011-01-01

Pandemic plans are increasingly attending to groups experiencing health disparities and other social vulnerabilities. Although some pandemic guidance is silent on the issue, guidance that attends to socially vulnerable groups ranges widely, some procedural (often calling for public engagement), and some substantive. Public engagement objectives vary from merely educational to seeking reflective input into the ethical commitments that should guide pandemic planning and response. Some plans that concern rationing during a severe pandemic recommend ways to protect socially vulnerable groups without prioritizing access to scarce resources based on social vulnerability per se. The Minnesota Pandemic Ethics Project (MPEP), a public engagement project on rationing scarce health resources during a severe influenza pandemic, agrees and recommends an integrated set of ways to attend to the needs of socially vulnerable people and avoid exacerbation of health disparities during a severe influenza pandemic. Among other things, MPEP recommends: 1. Engaging socially vulnerable populations to clarify unique needs and effective strategies; 2. Engaging socially vulnerable populations to elicit ethical values and perspectives on rationing; 3. Rejecting rationing based on race, socioeconomic class, citizenship, quality of life, length of life-extension and first-come, first-served; 4. Prioritizing those in the general population for access to resources based on combinations of risk (of death or severe complications from influenza, exposure to influenza, transmitting influenza to vulnerable groups) and the likelihood of responding well to the resource in question. 5. Protecting critical infrastructures on which vulnerable populations and the general public rely; 6. Identifying and removing access barriers during pandemic planning and response; and 7. Collecting and promptly analyzing data during the pandemic to identify groups at disproportionate risk of influenza-related mortality and serious morbidity and to optimize the distribution of resources.

Vulnerabilities to Health Disparities and Statin Use in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study.

PubMed

Schroff, Praful; Gamboa, Christopher M; Durant, Raegan W; Oikeh, Asikhame; Richman, Joshua S; Safford, Monika M

2017-08-28

Statins may be underutilized in certain vulnerable populations, but the effect of cumulative vulnerabilities within 1 individual is not well described. We sought to determine the likelihood of receiving statins with an increasing number of vulnerabilities in an individual, after controlling for factors known to influence health services utilization. We identified 18 216 participants from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study who had a statin indication or who were taking statins, as verified by pill bottle review. Statin use was assessed with respect to 5 major vulnerability domains alone and in combination: older age, black race, female sex, high area-level poverty, and lack of health insurance. The study included 5286 white men, 4180 black men, 2791 white women, and 4194 black women; 5.6% of the sample had no vulnerabilities, 20.6% had 1 vulnerability, 29.2% had 2 vulnerabilities, 27.3% had 3 vulnerabilities, and 17.3% had 4 or 5 vulnerabilities. All race-sex groups were less likely than white men to use statins; prevalence of use was 0.80 in black women with reference to white men ( P <0.0001). In both unadjusted and adjusted models, as the number of vulnerabilities increased, statin use steadily decreased. After adjusting for factors that influence health services utilization, compared with those without any vulnerabilities, statin use prevalence was 0.91, 0.83, 0.74 and 0.68 ( P <0.0001) in those with 1, 2, 3, and 4 or 5 vulnerabilities, respectively. Participants with more simultaneously occurring vulnerabilities experienced the greatest disparities in statin use. Black women and those without health insurance were at particularly high risk of underutilization. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Vulnerability and mental health in Afghanistan: looking beyond war exposure.

PubMed

Trani, Jean-François; Bakhshi, Parul

2013-02-01

This study examined the prevalence of mental distress among groups in Afghanistan considered to be at risk. Data were drawn from a representative cross-sectional disability survey carried out in Afghanistan including 5,130 households in 171 clusters throughout the 34 provinces of the country. The sample included 838 nondisabled control participants aged above 14, and 675 disabled participants. Results showed that various vulnerable groups (disabled people, the unemployed, the elderly, minority ethnic groups, as well as widowed, divorced or separated women) were at higher risk of experiencing mild to severe mental health problems. The adjusted odds ratio for war-related disability compared to nondisabled was 4.09 (95% confidence interval 2.09 to 7.99) for mild mental distress disorders, and 7.10 (3.45-14.5) and 14.14 (3.38-59.00) for moderate or severe mental distress disorders, respectively. Women with disabilities (whatever the cause of impairment) when compared with nondisabled men, as well as poorer segments of society compared to the richest, had a higher prevalence of mental health problems. Women with non-war-related disabilities compared with nondisabled men were respectively 3.35 (1.27-8.81) and 8.57 (3.03-24.1) times more likely to experience mild or moderate mental distress disorders. People who experience multiple vulnerabilities are more at risk of deteriorating mental health in conflict zones. The study shows that mental health, in times of war, is influenced by a combination of demographic and socioeconomic characteristics linked to social exclusion mechanisms that were in place before the conflict began and that are redefined in relation to the changing social, cultural, and economic contexts. Mental health policies and programmes must prioritise the most vulnerable segments of Afghan society.

Vulnerability assessment including tangible and intangible components in the index composition: An Amazon case study of flooding and flash flooding.

PubMed

Andrade, Milena Marília Nogueira de; Szlafsztein, Claudio Fabian

2018-07-15

The vulnerability of cities and communities in the Amazon to flooding and flash flooding is increasing. The effects of extreme events on populations vary across landscapes, causing vulnerability to differ spatially. Traditional vulnerability studies in Brazil and across the world have used the vulnerability index for the country and, more recently, municipality scales. The vulnerability dimensions are exposure, sensitivity, and adaptive capacity. For each of these dimensions, there is a group of indicators that constitutes a vulnerability index using quantitative data. Several vulnerability assessments have used sensitivity and exposure analyses and, recently, adaptive capacity has been considered. The Geographical Information Systems (GIS) analysis allows spatial regional modeling using quantitative vulnerability indicators. This paper presents a local-scale vulnerability assessment in an urban Amazonian area, Santarém City, using interdisciplinary methods. Data for exposure and sensitivity were gathered by remote sensing and census data, respectively. However, adaptive capacity refers to local capacities, whether infrastructural or not, and the latter were gathered by qualitative participatory methods. For the mixed data used to study adaptive capacity, we consider tangible components for countable infrastructure that can cope with hazards, and intangible components that reflect social activities based on risk perceptions and collective action. The results indicate that over 80% of the area is highly or moderately vulnerable to flooding and flash flooding. Exposure and adaptive capacity were determinants of the results. Lower values of adaptive capacity play a significant role in vulnerability enhancement. Copyright © 2018 Elsevier B.V. All rights reserved.

IPCC Climate Change 2013: Impacts, Adaptation and Vulnerability: Key findings and lessons learned

NASA Astrophysics Data System (ADS)

Giorgi, Filippo; Field, Christopher; Barros, Vicente

2014-05-01

The Working Group II contribution to the Fifth Assessment Report of the Intergivernmental Panel on Climate Change, Impacts, Adaptation and Vulnerability, will be completed and approved in March 2014. It includes two parts, Part A covering Global and Sectoral Aspects, and Part B, covering Regional Aspects. The WGII report spans a very broad range of topics which are approached in a strong interdisciplinary context. It highlights how observed impacts of climate change are now widespread and consequential, particularly for natural systems, and can be observed on all continents and across the oceans. Vulnerability to climate change depends on interactions with non-climatic stressors and inequalities, resulting in highly differential risks associated with climate change. It is also found that adaptation is already occurring across scales and is embedded in many planning processes. Continued sustained warming thrughout the 21st century will exacerbate risks and vulnerabilities across multiple sectors, such as freshwater resources, terrestrial and inland water systems, coastal and marine systems, food production, human health, security and livelihood. The report stresses how risks and vulnerabilities need to be assessed within a multi-stressor and regionally specific context, and can be reduced and managed by adopting climate-resilient pathwyas combining suitable adaptation and mitigation options with synergies and tradeoffs occurring both within and across regions. The Working group II report includes a large number of Chapters (30) and contributors (310 including authors and review editors), with expertise in a broad range of disciplines, from the physical science to the impact and socio-economic sciences. The communication across chapters and disciplines has been a challenge, and will continue to be one as the Global Change problem will increasingly require a fully integrated and holistic approach. Note that text on this abstract is not approved at the time its submission, but it will be discussed in the report.

The invisibility of men in South African violence prevention policy: national prioritization, male vulnerability, and framing prevention

PubMed Central

van Niekerk, Ashley; Tonsing, Susanne; Seedat, Mohamed; Jacobs, Roxanne; Ratele, Kopano; McClure, Roderick

2015-01-01

Background South Africa has a significant violence problem. The exposure of girls and women to interpersonal violence is widespread, and the victimization of men, especially to severe and homicidal forms of aggression, is of considerable concern, with male homicide eight times the global rate. In the last two decades, there have been a plethora of South African policies to promote safety. However, indications suggest that the policy response to violence is not coherently formulated, comprehensive, or evenly implemented. Objective This study examines selected South African national legislative instruments in terms of their framing and definition of violence and its typology, vulnerable populations, and prevention. Design This study comprises a directed content analysis of selected legislative documents from South African ministries mandated to prevent violence and its consequences or tasked with the prevention of key contributors to violence. Documents were selected using an electronic keyword search method and analyzed independently by two researchers. Results The legislative documents recognized the high levels of violence, confirmed the prioritization of selected vulnerable groups, especially women, children, disabled persons, and rural populations, and above all drew on criminological perspectives to emphasize tertiary prevention interventions. There is a policy focus on the protection and support of victims and the prosecution of perpetrators, but near absent recognition of men as victims. Conclusions There is a need to broaden the policy framework from primarily criminological and prosecutorial perspectives to include public health contributions. It is likewise important to enlarge the conceptions of vulnerability to include men alongside other vulnerable groups. These measures are important for shaping and resourcing prevention decisions and strengthening primary prevention approaches to violence. PMID:26228996

The invisibility of men in South African violence prevention policy: national prioritization, male vulnerability, and framing prevention.

PubMed

van Niekerk, Ashley; Tonsing, Susanne; Seedat, Mohamed; Jacobs, Roxanne; Ratele, Kopano; McClure, Roderick

2015-01-01

South Africa has a significant violence problem. The exposure of girls and women to interpersonal violence is widespread, and the victimization of men, especially to severe and homicidal forms of aggression, is of considerable concern, with male homicide eight times the global rate. In the last two decades, there have been a plethora of South African policies to promote safety. However, indications suggest that the policy response to violence is not coherently formulated, comprehensive, or evenly implemented. This study examines selected South African national legislative instruments in terms of their framing and definition of violence and its typology, vulnerable populations, and prevention. This study comprises a directed content analysis of selected legislative documents from South African ministries mandated to prevent violence and its consequences or tasked with the prevention of key contributors to violence. Documents were selected using an electronic keyword search method and analyzed independently by two researchers. The legislative documents recognized the high levels of violence, confirmed the prioritization of selected vulnerable groups, especially women, children, disabled persons, and rural populations, and above all drew on criminological perspectives to emphasize tertiary prevention interventions. There is a policy focus on the protection and support of victims and the prosecution of perpetrators, but near absent recognition of men as victims. There is a need to broaden the policy framework from primarily criminological and prosecutorial perspectives to include public health contributions. It is likewise important to enlarge the conceptions of vulnerability to include men alongside other vulnerable groups. These measures are important for shaping and resourcing prevention decisions and strengthening primary prevention approaches to violence.

The Power of Interactive Groups: How Diversity of Adults Volunteering in Classroom Groups Can Promote Inclusion and Success for Children of Vulnerable Minority Ethnic Populations

ERIC Educational Resources Information Center

Valls, Rosa; Kyriakides, Leonidas

2013-01-01

Despite the limited success of grouping students by attainment in enhancing educational achievement for all, this practice is still widely followed in European schools. Aiming at identifying successful educational actions that promote high academic achievement and social inclusion and cohesion, part of the EU-sponsored Europe-wide INCLUD-ED…

Reproductive Toxicology: From Science to Public Policy

EPA Science Inventory

Male reproductive toxicology research substantially influences policies that protect men's health. US policy directs regulatory agencies to ensure environmental protection for vulnerable groups, including boys and men where factors like age- and sex-specific sensitivities are app...

Interprofessional Graduate Students' Perspectives on Caring for Vulnerable Populations.

PubMed

Wright, Patricia Moyle; Hanson, Mary Jane S

The purpose of this focus group study was to explore graduate students' clinical experiences with vulnerable populations, perceived barriers to care, and ethical issues related to caring for disenfranchised groups. Furthermore, based on their experiences, the students were asked to share suggestions for curricular changes that could enhance care for vulnerable populations through interdisciplinary collaboration and multidisciplinary projects. The responses of the participants add to what is known about the care of vulnerable populations, offering a first-hand description of students' preparation for work with vulnerable populations and the interdisciplinary team.

Disentangling Emotion Processes in Borderline Personality Disorder: Physiological and Self-reported Assessment of Biological Vulnerability, Baseline Intensity, and Reactivity to Emotionally-Evocative Stimuli

PubMed Central

Kuo, Janice R.; Linehan, Marsha M.

2014-01-01

This study investigated Linehan’s (1993) theory that individuals meeting criteria for borderline personality disorder (BPD) have high biological vulnerability to emotion dysregulation, including high baseline emotional intensity and high reactivity to emotionally-evocative stimuli. Twenty individuals with BPD, 20 age-matched individuals with generalized social anxiety disorder (SAD), and 20 age-matched normal controls (NC) participated in two separate emotion induction conditions, a standardized condition and a personally-relevant condition. Respiratory sinus arrhythmia (RSA), skin conductance response (SCR), and self-report measures were collected throughout the experiment. BPD participants displayed heightened biological vulnerability compared with NC as indicated by reduced basal RSA. BPD participants also exhibited high baseline emotional intensity, characterized by heightened SCR and heightened self-reported negative emotions at baseline. However, the BPD group did not display heightened reactivity as their physiological and self-reported changes from baseline to the emotion inductions tasks were not greater than the other two groups. PMID:19685950

A Vulnerability Assessment of 300 Species in Florida: Threats from Sea Level Rise, Land Use, and Climate Change

PubMed Central

Reece, Joshua Steven; Noss, Reed F.; Oetting, Jon; Hoctor, Tom; Volk, Michael

2013-01-01

Species face many threats, including accelerated climate change, sea level rise, and conversion and degradation of habitat from human land uses. Vulnerability assessments and prioritization protocols have been proposed to assess these threats, often in combination with information such as species rarity; ecological, evolutionary or economic value; and likelihood of success. Nevertheless, few vulnerability assessments or prioritization protocols simultaneously account for multiple threats or conservation values. We applied a novel vulnerability assessment tool, the Standardized Index of Vulnerability and Value, to assess the conservation priority of 300 species of plants and animals in Florida given projections of climate change, human land-use patterns, and sea level rise by the year 2100. We account for multiple sources of uncertainty and prioritize species under five different systems of value, ranging from a primary emphasis on vulnerability to threats to an emphasis on metrics of conservation value such as phylogenetic distinctiveness. Our results reveal remarkable consistency in the prioritization of species across different conservation value systems. Species of high priority include the Miami blue butterfly (Cyclargus thomasi bethunebakeri), Key tree cactus (Pilosocereus robinii), Florida duskywing butterfly (Ephyriades brunnea floridensis), and Key deer (Odocoileus virginianus clavium). We also identify sources of uncertainty and the types of life history information consistently missing across taxonomic groups. This study characterizes the vulnerabilities to major threats of a broad swath of Florida’s biodiversity and provides a system for prioritizing conservation efforts that is quantitative, flexible, and free from hidden value judgments. PMID:24260447

Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach.

PubMed

Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

2017-04-10

Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards.

Constructing the Indicators of Assessing Human Vulnerability to Industrial Chemical Accidents: A Consensus-based Fuzzy Delphi and Fuzzy AHP Approach

PubMed Central

Fatemi, Farin; Ardalan, Ali; Aguirre, Benigno; Mansouri, Nabiollah; Mohammadfam, Iraj

2017-01-01

Introduction: Industrial chemical accidents have been increased in developing countries. Assessing the human vulnerability in the residents of industrial areas is necessary for reducing the injuries and causalities of chemical hazards. The aim of this study was to explore the key indicators for the assessment of human vulnerability in the residents living near chemical installations. Methods: The indicators were established in the present study based on the Fuzzy Delphi method (FDM) and Fuzzy Analytic Hierarchy Process (FAHP). The reliability of FDM and FAHP was calculated. The indicators of human vulnerability were explored in two sets of social and physical domains. Thirty-five relevant experts participated in this study during March-July 2015. Results: According to experts, the top three indicators of human vulnerability according to the FDM and FAHP were vulnerable groups, population density, and awareness. Detailed sub-vulnerable groups and awareness were developed based on age, chronic or severe diseases, disability, first responders, and residents, respectively. Each indicator and sub-indicator was weighted and ranked and had an acceptable consistency ratio. Conclusions: The importance of social vulnerability indicators are about 7 times more than physical vulnerability indicators. Among the extracted indicators, vulnerable groups had the highest weight and the greatest impact on human vulnerability. however, further research is needed to investigate the applicability of established indicators and generalizability of the results to other studies. Key words: Fuzzy Delphi; Fuzzy AHP; Human vulnerability; Chemical hazards PMID:28480124

The Global Economic Crisis: Setbacks to the Educational Agenda for the Minority in Sub-Saharan Africa

ERIC Educational Resources Information Center

Ingubu, Moses Shiasha

2010-01-01

This paper captures the impact of the Global Economic Crisis on educational programs serving minority groups in developing countries. It has been established that the most vulnerable groupings include nomadic and pastoralist communities, slum dwellers, children in war zones, and women. Various educational interventions such as mobile schooling,…

A Systematic Review of Life Skill Development Through Sports Programs Serving Socially Vulnerable Youth.

PubMed

Hermens, Niels; Super, Sabina; Verkooijen, Kirsten T; Koelen, Maria A

2017-12-01

Despite the strong belief in sports programs as a setting in which socially vulnerable youth can develop life skills, no overview exists of life skill development in sports programs serving this youth group. Therefore, the present systematic review provides an overview of the evidence on life skill development in sports programs serving socially vulnerable youth and, insofar as it was investigated in the included studies, of the conditions conducive to life skill development in these sports programs. Potentially relevant studies published during 1990 to 2014 were identified by a search in 7 electronic databases. The search combined terms relating to (a) sport, (b) youth AND socially vulnerable, and (c) life skills. Eighteen of the 2,076 unique studies met the inclusion criteria. Each included study reported that at least 1 life skill improved in youth who participated in the studied sports program. Improvements in cognitive and social life skills were more frequently reported than were improvements in emotional life skills. Only a few of the included studies investigated the conditions in the studied sports programs that made these programs conducive to life skill development. Sports programs have the potential to make a difference in the life skill development of socially vulnerable youth. This conclusion needs to be treated with some caution, because the studies experienced many challenges in reducing the risk for bias. Several alternative research strategies are suggested for future studies in this field.

The use of whey or skimmed milk powder in fortified blended foods for vulnerable groups.

PubMed

Hoppe, Camilla; Andersen, Gregers S; Jacobsen, Stine; Mølgaard, Christian; Friis, Henrik; Sangild, Per T; Michaelsen, Kim F

2008-01-01

Fortified blended foods (FBF), especially corn soy blend, are used as food aid for millions of people worldwide, especially malnourished individuals and vulnerable groups. There are only a few studies evaluating the effect of FBF on health outcomes, and the potential negative effect of antinutrients has not been examined. Different lines of evidence suggest that dairy proteins have beneficial effects on vulnerable groups. Here we review the evidence on the effects of adding whey or skimmed milk powder to FBF used for malnourished infants and young children or people living with HIV or AIDS. Adding whey or skimmed milk powder to FBF improves the protein quality, allowing a reduction in total amount of protein, which could have potential metabolic advantages. It also allows for a reduced content of soy and cereal and thereby a reduction of potential antinutrients. It is possible that adding milk could improve weight gain, linear growth, and recovery from malnutrition, but this needs to be confirmed. Bioactive factors in whey might have beneficial effects on the immune system and muscle synthesis, but evidence from vulnerable groups is lacking. Milk proteins will improve flavor, which is important for acceptability in vulnerable groups. The most important disadvantage is a considerable increase in price. Adding 10-15% milk powder would double the price, which means that such a product should be used only in well-defined vulnerable groups with special needs. The potential beneficial effects of adding milk protein and lack of evidence in vulnerable groups call for randomized intervention studies.

Policies and Processes for Social Inclusion: Using EquiFrame and EquIPP for Policy Dialogue Comment on "Are Sexual and Reproductive Health Policies Designed for All? Vulnerable Groups in Policy Documents of Four European Countries and Their Involvement in Policy Development".

PubMed

MacLachlan, Malcolm; Mannan, Hasheem; Huss, Tessy; Munthali, Alister; Amin, Mutamad

2015-11-16

The application of EquiFrame in the analysis of sexual and reproductive health policies by Ivanova et al to a new thematic area, their selection of only some of the Core Concepts of human rights in health service provision and the addition of new vulnerable groups relevant to the purpose of their analysis, are all very welcome developments. We also applaud their application of EquiFrame to policies in countries where it has not previously been used, along with their use of interviews with policy-makers to produce a deeper understanding of policy processes. We argue that clear justification for the inclusion of additional, or replacement of some exiting vulnerable groups within EquiFrame should be accompanied by clear definitions of such groups, along with the evidence-base that justifies their classification as a vulnerable or marginalised group. To illustrate the versatility of EquiFrame, we summarise a range of ways in which it has been used across a number of regions; including a brief Case Study of its use to develop the National Health Policy of Malawi. While EquiFrame focuses on policy content, we preview a new policy analysis tool - Equity and Inclusion in Policy Processes (EquIPP) - which assesses the extent of equity and inclusion in broader policy processes. Together, EquiFrame and EquIPP can be used to help governments and civil society ensure that policies are addressing the much stronger emphasis on social inclusion, now apparent in the Sustainable Development Goals (SDGs). © 2016 by Kerman University of Medical Sciences.

Identifying the "vulnerables" in biomedical research: the vox populis from the Tuskegee Legacy Project.

PubMed

Chiu, Christopher T; Katz, Ralph V

2011-01-01

This report presents, for the first time, findings on the vox populis as to who constitutes the "vulnerables in biomedical research" The 3-City Tuskegee Legacy Project (TLP) study used the TLP questionnaire as administered via random-digit-dial telephone interviews to 1162 adult Black people, non-Hispanic White people, and two Puerto Rican (PR) Hispanic groups: Mainland United States and San Juan (SJ) in three cities. The classification schema was based upon respondents' answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Subjects provided 749 valid open-ended responses, which were grouped into 29 direct response categories, leading to a four-tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: (1) Race/ ethnicity; (2) Age; (3) SES; (4) Health; and, (5) Gender. Black people and Mainland United States PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1 percent of Black people and 42.6 percent of Mainland United States. PR Hispanics versus 15.4 percent of White people and 16.7 percent of SJ R Hispanics) (P < 0.007), while White people and SJ PR Hispanics most frequently identified Age (48.3 percent and 29.2 percent) as a vulnerability trait. The response patterns on "who was vulnerable" were similar for the two minority groups (Black people and Mainland US PR Hispanics), and notably different from the response patterns of the two majority groups (White people and SJ PR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government.

Heightened vulnerabilities and better care for all: disability and end-of-life care.

PubMed

Stienstra, Deborah; D'Aubin, April; Derksen, Jim

2012-03-01

The purpose of this study was to assess the extent to which vulnerability was present or heightened as a result of either disability or end-of-life policies, or both, when people with disabilities face end of life. People with disabilities and policy makers from four Canadian provinces and at the federal level were interviewed or participated in focus groups to identify interactions between disability policies and end-of-life policies. Relevant policy documents in each jurisdiction were also analyzed. Key theme analysis was used on transcripts and policy documents. Fact sheets identifying five key issues were developed and shared in the four provinces with policy makers and people with disabilities. Examples of heightened vulnerability are evident in discontinuity from formal healthcare providers with knowledge of conditions and impairments, separation from informal care providers and support systems, and lack of coordination with and gaps in disability-related supports. When policies seek to increase the dignity, autonomy, and capacity of all individuals, including those who experience heightened vulnerability, they can mitigate or lessen some of the vulnerability. Specific policies addressing access to community-based palliative care, coordination between long-standing formal care providers and new care providers, and support and respect for informal care providers, can redress these heightened vulnerabilities. The interactions between disability and end-of-life policies can be used to create inclusive end-of-life policies, resulting in better end-of-life care for all people, including people with disabilities.

Study on mobility-disadvantage group' risk perception and coping behaviors of abrupt geological hazards in coastal rural area of China.

PubMed

Pan, Anping

2016-07-01

China is a country highly vulnerable to abrupt geological hazards. The present study aims to investigate disaster preparedness and perception of abrupt geological disasters (such as rock avalanches, landslide, mud-rock flows etc) in mobility-disadvantage group living in coastal rural area of China. This research is to take into account all factors regarding disasters and to design the questionnaires accordingly. Two debris flow vulnerable townships are selected as study areas including Hedi Township in Qinyuan County and Xianxi Township in Yueqing City which are located in East China's Zhejiang Province. SPSS was applied to conduct descriptive analysis, which results in an effective empirical model for evacuation behavior of the disable groups. The result of this study shows mobility-disadvantage groups' awareness on disaster prevention and mitigation is poor and their knowledge about basic theory and emergency response is limited. Errors and distortions in public consciousness on disaster prevention and mitigation stimulate the development of areas with frequent disasters, which will expose more life and property to danger and aggravate the vulnerability of hazard bearing body. In conclusion, before drafting emergency planning, the government should consider more the disable group's expectations and actual evacuation behavior than the request of the situation to ensure the planning is good to work. Copyright © 2016 Elsevier Inc. All rights reserved.

Flavonoid content in ethanolic extracts of selected raw and traditionally processed indigenous foods consumed by vulnerable groups of Kenya: antioxidant and type II diabetes-related functional properties.

PubMed

Kunyanga, Catherine N; Imungi, Jasper K; Okoth, Michael W; Biesalski, Hans K; Vadivel, Vellingiri

2011-08-01

The present study evaluated the flavonoid content, antioxidant as well as type II diabetes-related enzyme inhibition activities of ethanolic extract of certain raw and traditionally processed indigenous food ingredients including cereals, legumes, oil seeds, tubers, vegetables and leafy vegetables, which are commonly consumed by vulnerable groups in Kenya. The vegetables exhibited higher flavonoid content (50-703 mg/100 g) when compared with the grains (47-343 mg/100 g). The ethanolic extract of presently studied food ingredients revealed 33-93% DPPH radical scavenging capacity, 486-6,389 mmol Fe(II)/g reducing power, 19-43% α-amylase inhibition activity and 14-68% α-glucosidase inhibition activity. Among the different food-stuffs, the drumstick and amaranth leaves exhibited significantly higher flavonoid content with excellent functional properties. Roasting of grains and cooking of vegetables were found to be suitable processing methods in preserving the functional properties. Hence, such viable processing techniques for respective food samples will be considered in the formulation of functional supplementary foods for vulnerable groups in Kenya.

History of abuse and organic difficulties in a convenience sample of 46 ultra-orthodox males with pedophilia.

PubMed

Witztum, Eliezer; Daie, Netzer; Daie-Gabai, Ayala; Rosler, Ariel

2012-01-01

Evidence has started to accumulate that relates pedophilia to a history of being a victim of sexual abuse as well as to comorbidity with organic vulnerabilities. During a naturalistic study regarding treatment of pedophilia, the authors had access to clinical and psychodiagnostic evaluations of Israeli Jewish ultraorthodox male pedophiles outside the forensic system. Using psychiatric examination as well as a battery of psychological tests, presence of history of trauma as well as comorbidity with organic vulnerabilities among this unique sub-group was examined. This survey was part of a larger scale research on the effectiveness of Decapeptyl injections as treatment for pedophilia. All participants in the original research underwent comprehensive psychological assessment including an extensive clinical interview as well as psychological tests (Bender, Rorschach and TAT). Of the patients participating in the research, this survey focused on the group of 46 ultra-orthodox male pedophiles. Cross-tabs analyses were conducted in order to examine prevalence of history of trauma and organic vulnerabilities in this specific group. Based on self reports combined with corroborating reports (obtained from parents, educators and medical staff), together with indications in psychological tests, we found that 82.6% of participants were victims of sexual trauma as children and 87% suffer from some kind of organic vulnerability (learning disabilities, disinhibitions, etc.). LIMITATIONS of this small convenience sample that influence ability to generalize are discussed. The current survey indicates that in this sample, the ultra-orthodox male pedophile was frequently a victim of childhood sexual trauma, and exhibited indications of organic vulnerabilities. This is more pronounced than findings in previous studies, and calls for further research in order to understand the underlying causes.

Compensatory Policies Attending Equality and Inequality in Mexico Educational Practice among Vulnerable Groups in Higher Education

ERIC Educational Resources Information Center

Flores, René Pedroza; Monroy, Guadalupe Villalobos; Fabela, Ana María Reyes

2015-01-01

This paper presents an estimate of the prevalence of social inequality in accessing higher education among vulnerable groups in Mexico. Estimates were determined from statistical data provided by governmental agencies on the level of poverty among the Mexican population. In Mexico, the conditions of poverty and vulnerability while trying to access…

Tsunami survivors' perspectives on vulnerability and vulnerability reduction: evidence from Koh Phi Phi Don and Khao Lak, Thailand.

PubMed

Steckley, Marylynn; Doberstein, Brent

2011-07-01

This paper presents the results of primary research with 40 survivors of the 2004 Indian Ocean tsunami in two communities: Khao Lak (n=20) and Koh Phi Phi Don (n=20), Thailand. It traces tsunami survivors' perceptions of vulnerability, determines whether residents felt that the tsunami affected different communities differently, identifies the populations and sub-community groups that survivors distinguished as being more vulnerable than others, highlights community-generated ideas about vulnerability reduction, and pinpoints a range of additional vulnerability reduction actions. Tsunami survivors most consistently identified the 'most vulnerable' community sub-populations as women, children, the elderly, foreigners, and the poor. In Khao Lak, however, respondents added 'Burmese migrants' to this list, whereas in Koh Phi Phi Don, they added 'Thai Muslims'. Results suggest that the two case study communities, both small, coastal, tourism-dominated communities no more than 100 kilometres apart, have differing vulnerable sub-groups and environmental vulnerabilities, requiring different post-disaster vulnerability reduction efforts. © 2011 The Author(s). Disasters © Overseas Development Institute, 2011.

Assessing Vulnerability to Urban Heat: A Study of Disproportionate Heat Exposure and Access to Refuge by Socio-Demographic Status in Portland, Oregon

PubMed Central

Hellman, Dana; Sakuma, Ryu; Shandas, Vivek

2018-01-01

Extreme urban heat is a powerful environmental stressor which poses a significant threat to human health and well-being. Exacerbated by the urban heat island phenomenon, heat events are expected to become more intense and frequent as climate change progresses, though we have limited understanding of the impact of such events on vulnerable populations at a neighborhood or census block group level. Focusing on the City of Portland, Oregon, this study aimed to determine which socio-demographic populations experience disproportionate exposure to extreme heat, as well as the level of access to refuge in the form of public cooling centers or residential central air conditioning. During a 2014 heat wave, temperature data were recorded using a vehicle-traverse collection method, then extrapolated to determine average temperature at the census block group level. Socio-demographic factors including income, race, education, age, and English speaking ability were tested using statistical assessments to identify significant relationships with heat exposure and access to refuge from extreme heat. Results indicate that groups with limited adaptive capacity, including those in poverty and non-white populations, are at higher risk for heat exposure, suggesting an emerging concern of environmental justice as it relates to climate change. The paper concludes by emphasizing the importance of cultural sensitivity and inclusion, in combination with effectively distributing cooling centers in areas where the greatest burden befalls vulnerable populations. PMID:29601546

Assessing Vulnerability to Urban Heat: A Study of Disproportionate Heat Exposure and Access to Refuge by Socio-Demographic Status in Portland, Oregon.

PubMed

Voelkel, Jackson; Hellman, Dana; Sakuma, Ryu; Shandas, Vivek

2018-03-30

Extreme urban heat is a powerful environmental stressor which poses a significant threat to human health and well-being. Exacerbated by the urban heat island phenomenon, heat events are expected to become more intense and frequent as climate change progresses, though we have limited understanding of the impact of such events on vulnerable populations at a neighborhood or census block group level. Focusing on the City of Portland, Oregon, this study aimed to determine which socio-demographic populations experience disproportionate exposure to extreme heat, as well as the level of access to refuge in the form of public cooling centers or residential central air conditioning. During a 2014 heat wave, temperature data were recorded using a vehicle-traverse collection method, then extrapolated to determine average temperature at the census block group level. Socio-demographic factors including income, race, education, age, and English speaking ability were tested using statistical assessments to identify significant relationships with heat exposure and access to refuge from extreme heat. Results indicate that groups with limited adaptive capacity, including those in poverty and non-white populations, are at higher risk for heat exposure, suggesting an emerging concern of environmental justice as it relates to climate change. The paper concludes by emphasizing the importance of cultural sensitivity and inclusion, in combination with effectively distributing cooling centers in areas where the greatest burden befalls vulnerable populations.

Health adaptation policy for climate vulnerable groups: a 'critical computational linguistics' analysis.

PubMed

Seidel, Bastian M; Bell, Erica

2014-11-28

Many countries are developing or reviewing national adaptation policy for climate change but the extent to which these meet the health needs of vulnerable groups has not been assessed. This study examines the adequacy of such policies for nine known climate-vulnerable groups: people with mental health conditions, Aboriginal people, culturally and linguistically diverse groups, aged people, people with disabilities, rural communities, children, women, and socioeconomically disadvantaged people. The study analyses an exhaustive sample of national adaptation policy documents from Annex 1 ('developed') countries of the United Nations Framework Convention on Climate Change: 20 documents from 12 countries. A 'critical computational linguistics' method was used involving novel software-driven quantitative mapping and traditional critical discourse analysis. The study finds that references to vulnerable groups are relatively little present or non-existent, as well as poorly connected to language about practical strategies and socio-economic contexts, both also little present. The conclusions offer strategies for developing policy that is better informed by a 'social determinants of health' definition of climate vulnerability, consistent with best practice in the literature and global policy prescriptions.

Endorsement of formal leaders: an integrative model.

PubMed

Michener, H A; Lawler, E J

1975-02-01

This experiment develops an integrative, path-analytic model for the endorsement accorded formal leaders. The model contains four independent variables reflecting aspects of group structure (i.e., group success-failure, the payoff distribution, the degree of support by others members for the leader, and the vulnerability of the leader). Also included are two intervening variables reflecting perceptual processes (attributed competence and attributed fairness), and one dependent variable endorsement). The results indicate that endorsement is greater when the group's success is high, when the payoff distribution is flat rather than hierarchial, and when the leader is not vulnerable to removal from office. Other support had no significant impact on endorsement. Analyses further demonstrate that the effect of success-failure on endorsement is mediated by attributed competence, while the effect of the payoff distributed is mediated by attributed fairness. These results suggest that moral and task evaluations are distinct bases of endorsement.

Fitness in animals correlates with proximity to discontinuities in body mass distributions.

USGS Publications Warehouse

Angeler, David G.; Allen, Craig R.; Vila-Gispert, Anna; Almeida, David

2014-01-01

Discontinuous structure in landscapes may cause discontinuous, aggregated species body-mass patterns, reflecting the scales of structure available to animal communities within a landscape. Empirical analyses have shown that the location of species within body mass aggregations, which reflect this scale-specific organization, is non-random with regard to several ecological phenomena, including species extinctions. The propensity of declining species to have body masses proximate to discontinuities suggests that transition zones between scaling regimes ultimately decreases the ecological fitness for some species. We test this proposition using vulnerable and unthreatened fish species in Mediterranean streams with differing levels of human impact. We show that the proximity to discontinuities in body mass aggregations (“distance-to-edge”) of more vs. less fit individuals within vulnerable and unthreatened populations differs. Specifically, regression analysis between the scaled mass index, a proxy of animal fitness, and distance-to-edge reveals negative and positive relationships for vulnerable and unthreatened species, respectively. That is, fitness is higher close to discontinuities in vulnerable populations and toward the center of body mass aggregation groups in unthreatened populations. Our results demonstrate the suitability of the discontinuity framework for scrutinizing non-random patterns of environmental impact in populations. Further exploration of the usefulness of this method across other ecosystems and organism groups is warranted.

Factors Contributing to Exacerbating Vulnerabilities in Global Clinical Trials

PubMed Central

da Silva, Ricardo E.; Amato, Angélica A.; Guilhem, Dirce B.; de Carvalho, Marta R.; Lima, Elisangela da C.; Novaes, Maria Rita C. G.

2018-01-01

Background: Although policies and guidelines make use of the concept of vulnerability, few define it. The European Union's directive for clinical trials does not include explanations for or the reasoning behind the designation of certain groups as vulnerable. Emerging economies from lower middle-income countries have, in recent years, had the largest average annual growth rate, as well as increase, in number of clinical trials registered in the US government's database. Nevertheless, careful supervision of research activities has to be ensured. Objective: To describe and analyze the features of the clinical trials involving vulnerable populations in various countries classified by development status and geographic region. Methods: Retrospective study that involved analysis of data obtained from the International Clinical Trials Registry Platform (ICTRP) database between 01/2014 and 12/2014 from countries with (i) highest trial densities during 2005 to 2012, (ii) highest average growth rate in clinical trials, and (iii) greatest trial capabilities. Results: Statistical analysis of this study showed that patients incapable of giving consent personally are 11.4 times more likely to be vulnerable patients than patients who are capable, and that patients in upper-middle-income countries are 1.7 times more likely to be vulnerable patients than patients from high-income countries when participating in global clinical trials. Malaysia (21%), Egypt (20%), Turkey (19%), Israel (18%), and Brazil (17%) had the highest percentages of vulnerable populations involving children. Conclusions: Although the inability to provide consent personally was a factor associated with vulnerability, arbitrary criteria may have been considered when classifying the populations of clinical trials as vulnerable. The EU Clinical Trials Register should provide guidance regarding exactly what aspects or factors should be taken into account to frame given populations as vulnerable, because vulnerability is not applicable to all risk situations. PMID:29403381

Factors Contributing to Exacerbating Vulnerabilities in Global Clinical Trials.

PubMed

da Silva, Ricardo E; Amato, Angélica A; Guilhem, Dirce B; de Carvalho, Marta R; Lima, Elisangela da C; Novaes, Maria Rita C G

2017-01-01

Background: Although policies and guidelines make use of the concept of vulnerability, few define it. The European Union's directive for clinical trials does not include explanations for or the reasoning behind the designation of certain groups as vulnerable. Emerging economies from lower middle-income countries have, in recent years, had the largest average annual growth rate, as well as increase, in number of clinical trials registered in the US government's database. Nevertheless, careful supervision of research activities has to be ensured. Objective: To describe and analyze the features of the clinical trials involving vulnerable populations in various countries classified by development status and geographic region. Methods: Retrospective study that involved analysis of data obtained from the International Clinical Trials Registry Platform (ICTRP) database between 01/2014 and 12/2014 from countries with (i) highest trial densities during 2005 to 2012, (ii) highest average growth rate in clinical trials, and (iii) greatest trial capabilities. Results: Statistical analysis of this study showed that patients incapable of giving consent personally are 11.4 times more likely to be vulnerable patients than patients who are capable, and that patients in upper-middle-income countries are 1.7 times more likely to be vulnerable patients than patients from high-income countries when participating in global clinical trials. Malaysia (21%), Egypt (20%), Turkey (19%), Israel (18%), and Brazil (17%) had the highest percentages of vulnerable populations involving children. Conclusions: Although the inability to provide consent personally was a factor associated with vulnerability, arbitrary criteria may have been considered when classifying the populations of clinical trials as vulnerable. The EU Clinical Trials Register should provide guidance regarding exactly what aspects or factors should be taken into account to frame given populations as vulnerable, because vulnerability is not applicable to all risk situations.

RESILIENCE IN VULNERABLE POPULATIONS WITH TYPE 2 DIABETES MELLITUS AND HYPERTENSION: A SYSTEMATIC REVIEW AND META-ANALYSIS

PubMed Central

Pesantes, M. Amalia; Lazo-Porras, María; Abu Dabrh, Abd Moain; Avila-Ramirez, Jaime R.; Caycho, Maria; Villamonte, Georgina Y.; Sanchez-Perez, Grecia P.; Málaga, Germán; Bernabé-Ortiz, Antonio; Miranda, J. Jaime

2015-01-01

Background Patients with chronic conditions and limited access to healthcare experience stressful challenges due to the burden of managing both their conditions and their daily life demands. Resilience provides a mechanism of adapting to stressful experiences. We conducted a systematic review and meta-analysis to synthesize the evidence about interventions to enhance resiliency in managing hypertension or type-2 diabetes in vulnerable populations, and to assess the efficacy of these interventions on clinical outcomes. Methods We searched multiple databases from early inception through February 2015 including randomized controlled trials that enrolled patients with type-2 diabetes or hypertension. All interventions that targeted resilience in vulnerable populations were included. Data were synthesized to describe the characteristics and efficacy of resilience interventions. We pooled the total effects by calculating standardized mean difference using the random-effects model. Results The final search yielded seventeen studies. All studies were conducted in the United States and generally targeted minority participants. Resiliency interventions used diverse strategies; discussion groups or workshops were the most common approach. Conclusions Interventions aimed at enhancing the resiliency of patients from vulnerable groups are diverse. Outcomes were not fully conclusive. There was some evidence that resilience interventions had a positive effect on HbA1c levels, but not blood pressure. The incorporation of resiliency-oriented interventions into the arsenal of prevention and management of chronic conditions appears to be an opportunity that remains to be better investigated and exploited, and there is need to pursue further understanding of the core components of any intervention that claims to enhance resilience. PMID:26239007

Vulnerability to stress in migratory contexts: a study with Eastern European immigrants residing in Portugal.

PubMed

de Almeida Vieira Monteiro, Ana Paula Teixeira; Serra, Adriano Vaz

2011-08-01

The assessment of individual vulnerability to stress emerges as a predictive factor of a higher risk of developing stress-related disorders. In the last decade, the geography of immigration in Portugal experienced intense transformations in terms of recruitment and patterns of geographic settlement, with an increasing and exponential inflow of new and diversified migratory groups. The immigrant populations coming from Eastern European countries are a recent migratory flow, with linguistic, cultural and socio-demographic specificities which are very different from the general Portuguese population. This makes them a paradigmatic group in potential transcultural studies on mental health issues. The primary aim of the study was to describe the characteristics of vulnerability to stress and determine their impact on the mental health status of Russian-speaking immigrants residing in Portugal. The relationship between vulnerability to stress, sociodemographic variables, mental health status and social support were analyzed, using the SSQ6, GHQ28, 23QVS and a socio-demographic questionnaire. A comparative analysis was carried out, using a control group of 110 Portuguese subjects without previous migratory experiences, matched by sex, age group and academic qualifications. The eastern European immigrants reported high levels of vulnerability to stress assessed by the cut-off point of the 23QVS. Immigrants also reported higher percentage of vulnerability to stress and lower social support levels of social support versus the control group. Several factors inherent to the dynamics of the migratory process were related to the presence of vulnerability to stress. The findings suggest that vulnerability to stress is positively correlated with worse mental health outcomes and negatively correlated with the social support perceived as available--number of supporters and satisfaction with social support.

Psychological vulnerability in children next-born after stillbirth: a case-control follow-up study.

PubMed

Turton, Penelope; Badenhorst, William; Pawlby, Susan; White, Sarah; Hughes, Patricia

2009-12-01

Case studies and anecdotal accounts suggest that perinatal loss may impact upon other children in the family, including those born subsequent to loss. However, there is a dearth of systematically collected quantitative data on this potentially vulnerable group. Case-controlled follow-up of 52 mothers with history of stillbirth with their next-born children aged 6-8 years, and 51 control mother-child dyads. Previously reported baseline data included maternal antenatal and postnatal psychological assessment, and infant security of attachment at 12 months. Follow-up assessments included maternal psychiatric and socio-demographic data, mother and teacher-rated scales of the child's strengths and difficulties, child IQ, observer-rated mother-child interaction and maternal reports of child health. There were no significant between-group differences in child cognitive or health assessments, or in teacher-rated child difficulties. However, mothers with history of stillbirth (the index group) reported increased child difficulties, in particular peer problems, and more adverse interaction was observed in respect of higher levels of maternal criticism of the child's actions, more overall controlling behaviour by the mother, a less harmonious emotional atmosphere and a lower level of maternal engagement with the child. Some of these effects appeared to be mediated by maternal perinatal psychological symptoms and family breakdown. This study provides no evidence to suggest that siblings born after stillbirth are clinically at risk but does lend empirical support to clinical reports that such children are seen by their mothers as having problems and that they are exposed to less optimal interaction with their mothers. Possible interpretations of these findings are discussed in the context of theoretical accounts of 'replacement child' and 'vulnerable child' syndromes.

Issues, considerations and recommendations on emergency preparedness for vulnerable population groups.

PubMed

Chen, Jing; Wilkinson, Diana; Richardson, Richard B; Waruszynski, Barbara

2009-06-01

The Workshop on Emergency Preparedness for Vulnerable Population Groups was held on 2 and 3 March 2009 in Ottawa, ON, Canada. The purpose of the workshop was to enhance communications within the emergency community response network and to identify the needs and gaps of emergency preparedness against chemical, biological, radiological, nuclear and explosives events for vulnerable population groups. The workshop was organised to enable extensive round-table discussions and provide a summary of key issues, considerations and recommendations for emergency response planners.

An Analysis of the Extent of Social Inclusion and Equity Consideration in Malawi’s National HIV and AIDS Policy Review Process

PubMed Central

Chinyama, Mathews Junior; MacLachlan, Malcolm; McVeigh, Joanne; Huss, Tessy; Gawamadzi, Sylvester

2018-01-01

Background: Equity and social inclusion for vulnerable groups in policy development processes and resulting documents remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent to which the Malawi Policy review process addressed regional and international health priorities of equity and social inclusion for vulnerable groups in the policy content and policy revision process. Methods: This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups. Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter, 10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations and development partners who participated in the policy revision process. Data was also collected from documented information of the policy processes. Results: Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation, monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy. Conclusion: While the findings indicate inclusive processes, commitment to Core Concepts of human rights and inclusion of Vulnerable Groups in relation to the Malawi HIV and AIDS Policy, the results also point to areas in which social inclusion and equity could be further strengthened. PMID:29626397

Legal physician‐assisted dying in Oregon and the Netherlands: evidence concerning the impact on patients in “vulnerable” groups

PubMed Central

Battin, Margaret P; van der Heide, Agnes; Ganzini, Linda; van der Wal, Gerrit

2007-01-01

Background Debates over legalisation of physician‐assisted suicide (PAS) or euthanasia often warn of a “slippery slope”, predicting abuse of people in vulnerable groups. To assess this concern, the authors examined data from Oregon and the Netherlands, the two principal jurisdictions in which physician‐assisted dying is legal and data have been collected over a substantial period. Methods The data from Oregon (where PAS, now called death under the Oregon Death with Dignity Act, is legal) comprised all annual and cumulative Department of Human Services reports 1998–2006 and three independent studies; the data from the Netherlands (where both PAS and euthanasia are now legal) comprised all four government‐commissioned nationwide studies of end‐of‐life decision making (1990, 1995, 2001 and 2005) and specialised studies. Evidence of any disproportionate impact on 10 groups of potentially vulnerable patients was sought. Results Rates of assisted dying in Oregon and in the Netherlands showed no evidence of heightened risk for the elderly, women, the uninsured (inapplicable in the Netherlands, where all are insured), people with low educational status, the poor, the physically disabled or chronically ill, minors, people with psychiatric illnesses including depression, or racial or ethnic minorities, compared with background populations. The only group with a heightened risk was people with AIDS. While extralegal cases were not the focus of this study, none have been uncovered in Oregon; among extralegal cases in the Netherlands, there was no evidence of higher rates in vulnerable groups. Conclusions Where assisted dying is already legal, there is no current evidence for the claim that legalised PAS or euthanasia will have disproportionate impact on patients in vulnerable groups. Those who received physician‐assisted dying in the jurisdictions studied appeared to enjoy comparative social, economic, educational, professional and other privileges. PMID:17906058

Individual, occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers.

PubMed

Lay, A Morgan; Saunders, Ron; Lifshen, Marni; Breslin, Curtis; LaMontagne, Anthony; Tompa, Emile; Smith, Peter

2016-02-01

To describe OH&S vulnerability across a diverse sample of Canadian workers. A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment. More than one third of the sample experienced some OH&S vulnerability. The type and magnitude of vulnerability varied by labor market sub-group. Younger workers and those in smaller workplaces experienced significantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness- and empowerment-related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability. Knowing how labor market sub-groups experience different types of vulnerability can inform better-tailored primary prevention interventions. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.

Socio-Economic Vulnerability to Climate Change in California

NASA Astrophysics Data System (ADS)

Heberger, M. G.; Cooley, H.; Moore, E.; Garzon, C.

2011-12-01

The western United States faces a range of impacts from global climate change, including increases in extreme heat, wildfires, and coastal flooding and erosion; changes are also likely to occur in air quality, water availability, and the spread of infectious diseases. To date, a great deal of research has been done to forecast the physical effects of climate change, while less attention has been given to the factors make different populations more or less vulnerable to harm from such changes. For example, mortality rates from Hurricane Audrey, which struck the coast of Louisiana in 1957, were more than eight times higher among blacks than among whites. While disaster events may not discriminate, impacts on human populations are shaped by "intervening conditions" that determine the human impact of the flood and the specific needs for preparedness, response, and recovery. In this study, we analyze the potential impacts of climate change by using recent downscaled climate model outputs, creating a variety of statistics and visualizations to communicate potential impacts to community groups and decision makers, after several meetings with these groups to ask, "What types of information are most useful to you for planning?" We relate climate impacts to social vulnerability - defined as the intersection of the exposure, sensitivity, and adaptive capacity of a person or group of people - with a focus on the U.S. state of California. Understanding vulnerability factors and the populations that exhibit these factors are critical for crafting effective climate change policies and response strategies. It is also important to the emerging study of climate justice, which is the concept that no group of people should disproportionately bear the burden of climate impacts or the costs of mitigation and adaptation.

Convergence Analysis of Micro-Lesions (CAML): An approach to mapping of diffuse lesions from carotid revascularization.

PubMed

Rosen, Allyson C; Soman, Salil; Bhat, Jyoti; Laird, Angela R; Stephens, Jeffrey; Eickhoff, Simon B; Fox, P Mickle; Long, Becky; Dinishak, David; Ortega, Mario; Lane, Barton; Wintermark, Max; Hitchner, Elizabeth; Zhou, Wei

2018-01-01

Carotid revascularization (endarterectomy, stenting) prevents stroke; however, procedure-related embolization is common and results in small brain lesions easily identified by diffusion weighted magnetic resonance imaging (DWI). A crucial barrier to understanding the clinical significance of these lesions has been the lack of a statistical approach to identify vulnerable brain areas. The problem is that the lesions are small, numerous, and non-overlapping. Here we address this problem with a new method, the Convergence Analysis of Micro-Lesions (CAML) technique, an extension of the Anatomic Likelihood Analysis (ALE). The method combines manual lesion tracing, constraints based on known lesion patterns, and convergence analysis to represent regions vulnerable to lesions as probabilistic brain atlases. Two studies were conducted over the course of 12 years in an active, vascular surgery clinic. An analysis in an initial group of 126 patients at 1.5 T MRI was cross-validated in a second group of 80 patients at 3T MRI. In CAML, lesions were manually defined and center points identified. Brains were aligned according to side of surgery since this factor powerfully determines lesion distribution. A convergence based analysis, was performed on each of these groups. Results indicated the most consistent region of vulnerability was in motor and premotor cortex regions. Smaller regions common to both groups included the dorsolateral prefrontal cortex and medial parietal regions. Vulnerability of motor cortex is consistent with previous work showing changes in hand dexterity associated with these procedures. The consistency of CAML also demonstrates the feasibility of this new approach to characterize small, diffuse, non-overlapping lesions in patients with multifocal pathologies.

Quantifying human vulnerability in rural areas: case study of Tutova Hills (Eastern Romania)

NASA Astrophysics Data System (ADS)

Stângă, I. C.; Grozavu, A.

2012-06-01

This paper aims to assess the vulnerability at regional level, the model and the proposed indicators being explicitly intended for an essentially rural region, in this case-Tutova Hills (Eastern Romania). Five categories of variables were taken into account to define the vulnerability components: rural habitat, demographic features, agriculture, environmental quality and emergency situations. For each one, five variables were analyzed and ranked based on the level of determination or subordination. In order to ensure the flexibility of the model and to avoid the criteria duplication in assessing vulnerability, only a single indicator of each category was retained and included in analysis: total number of inhabitants, dependency ratio, weight of arable land on slope categories, weight of land under forestry and road accessibility of villages. The selected indicators were mathematically processed in order to maximize their relevance and to unitary express the results in the spread 0-1. Also, values of each indicator were grouped into four classes, corresponding to the level of vulnerability: low, medium, high and very high. A general index was obtained through the integration of vulnerability factors in an equation based on the geometric mean. Spatial analysis was based on features of the MicroImages TNTmips 7.3. software, which allow the vulnerability mapping. This approach argues and states that vulnerability assessment through indicator-based methods can be made only according to the level and scale of analysis and related to natural or human conditions of a region.

Quantitative evaluation of specific vulnerability to nitrate for groundwater resource protection based on process-based simulation model.

PubMed

Huan, Huan; Wang, Jinsheng; Zhai, Yuanzheng; Xi, Beidou; Li, Juan; Li, Mingxiao

2016-04-15

It has been proved that groundwater vulnerability assessment is an effective tool for groundwater protection. Nowadays, quantitative assessment methods for specific vulnerability are scarce due to limited cognition of complicated contaminant fate and transport processes in the groundwater system. In this paper, process-based simulation model for specific vulnerability to nitrate using 1D flow and solute transport model in the unsaturated vadose zone is presented for groundwater resource protection. For this case study in Jilin City of northeast China, rate constants of denitrification and nitrification as well as adsorption constants of ammonium and nitrate in the vadose zone were acquired by laboratory experiments. The transfer time at the groundwater table t50 was taken as the specific vulnerability indicator. Finally, overall vulnerability was assessed by establishing the relationship between groundwater net recharge, layer thickness and t50. The results suggested that the most vulnerable regions of Jilin City were mainly distributed in the floodplain of Songhua River and Mangniu River. The least vulnerable areas mostly appear in the second terrace and back of the first terrace. The overall area of low, relatively low and moderate vulnerability accounted for 76% of the study area, suggesting the relatively low possibility of suffering nitrate contamination. In addition, the sensitivity analysis showed that the most sensitive factors of specific vulnerability in the vadose zone included the groundwater net recharge rate, physical properties of soil medium and rate constants of nitrate denitrification. By validating the suitability of the process-based simulation model for specific vulnerability and comparing with index-based method by a group of integrated indicators, more realistic and accurate specific vulnerability mapping could be acquired by the process-based simulation model acquiring. In addition, the advantages, disadvantages, constraint conditions and applying prospects of the quantitative approach for specific vulnerability assessment were discussed. Copyright © 2016 Elsevier B.V. All rights reserved.

Effect of infection control strategy on knowledge, attitude and practice towards hepatitis B transmission and prevention in vulnerable populations.

PubMed

Al-Tawil, M M; El-Gohary, E E; El-Sayed, M H

2013-01-01

Health care workers (HCWs) and hematological patients needing blood/ blood product transfusion are particularly vulnerable to blood born infections (BBI) including viral hepatitis. To evaluate knowledge, attitude and practice (KAP) of these target groups regarding viral hepatitis B (HBV) transmission and its change with implementing infection control policy and procedures. An anonymous questionnaire with closed questions was used to evaluate KAP including vaccination status in 2 target groups, in Children Hospital, Ain Shams University, Cairo, Egypt: 184 nurses and 210 children and adolescents with blood diseases. One year after instituting infection control as a part of hospital procedures, the same questionnaire was reused to evaluate KAP towards HBV. Baseline knowledge regarding HBV transmission, sequelae and preventive measures, was poor in both groups. Among nurses, only 62% wore gloves on withdrawing or giving blood to patients, 43.5% routinely washed hands between patients and 37.5% reported exposure after sharp injury. Only 38% of patients and 40% of nurses received HBV vaccination. Targeted infection control policy and procedures significantly improved KAP regarding HBV in both groups. Vaccination coverage significantly increased and reached 88.7% for nurses and 72% for patients. Hospital based infection control units with established policy and procedures against BBI significantly improved KAP towards HBV including a significant increase in vaccination intake.

How Does Iranian's Legal System Protect Human Vulnerability and Personal Integrity in Medical Research?

PubMed Central

Karoubi, Mohammad Taghi; Akhondi, Mohammad Mehdi

2011-01-01

The astonishing advance of medical science in recent decades has had endless advantages for humans, including improved level of health, prevention of disease and advances in treatment. These advances depend to a great extent on conducting continuous research. However, besides its enormous advantages, the sole interest of medical science undermines the principles of respect for human vulnerability and personal integrity, in both positive and negative approaches. The positive approach refers to the people who participate in research and practice, while the negative approach refers to people who are deprived of research and practice. The authors of this work, based on legal or moral grounds try to analyse the tension between the principle of respect for human vulnerability and personal integrity and the interest of medical science. Undoubtedly, in applying scientific knowledge and medical practice human vulnerability should be taken into account. In this regard, especially vulnerable individuals and groups should be protected and the personal integrity of such individuals respected. In the light of the merits of Islamic law, this paper is designed to examine the significance of the principles of human vulnerability and personal integrity in medical research by studying the international documents as formalised by UNESCO in order to explore the place of these principles in the Iranian legal system. PMID:23408269

Access to HIV community services by vulnerable populations: evidence from an enhanced HIV/AIDS surveillance system.

PubMed

Madden, H C E; Phillips-Howard, P A; Hargreaves, S C; Downing, J; Bellis, M A; Vivancos, R; Morley, C; Syed, Q; Cook, P A

2011-05-01

HIV disproportionately affects vulnerable populations such as black and minority ethnic groups, men who have sex with men (MSM) and migrants, in many countries including those in the UK. Community organisations in the UK are charitable non-governmental organisations with a proportion of the workforce who volunteer, and provide invaluable additional support for people living with HIV (PLWHIV). Information on their contribution to HIV care in vulnerable groups is relatively sparse. Data generated from an enhanced HIV surveillance system in North West England, UK, was utilised for this study. We aimed to determine the characteristics of individuals who chose to access community services in addition to clinical services (1375 out of 4195 records of PLWHIV in clinical services). Demographic information, risk factors including residency status, uniquely gathered in this region, and deprivation scores were examined. Multivariate logistic regression modelling was conducted to predict the relative effect of patient characteristics on attendance at community services. Attendance at community services was highest in those living in the most, compared with least, deprived areas (p<0.001), and was most evident in MSM and heterosexuals. Compared to white UK nationals attendance was significantly higher in non-UK nationals of uncertain residency status (Adjusted odds ratio [AOR] = 21.91, 95% confidence interval [CI] 10.48-45.83; p<0.001), refugees (AOR = 5.75, 95% CI 3.3-10.03; p<0.001), migrant workers (AOR = 5.48, 95% CI 2.22-13.51; p<0.001) and temporary visitors (AOR = 3.44, 95% CI 1.68-7.05; p<0.001). Community services, initially established predominantly to support MSM, have responded to the changing demography of HIV and reach the most vulnerable members of society. Consequent to their support of migrant populations, community services are vital for the management of HIV in black and minority groups. Paradoxically, this coincides with increasing funding pressures on these services.

Childhood adversity, parental vulnerability and disorder: examining inter-generational transmission of risk.

PubMed

Bifulco, A; Moran, P M; Ball, C; Jacobs, C; Baines, R; Bunn, A; Cavagin, J

2002-11-01

An investigation of intergenerational factors associated with psychiatric disorder in late adolescence/early adulthood was undertaken to differentiate influences from maternal disorder, maternal poor psychosocial functioning and poor parenting, on offspring. The sample comprised an intensively studied series of 276 mother-offspring pairs in a relatively deprived inner-city London area with high rates of lone parenthood and socio-economic disadvantage. The paired sample was collected over two time periods: first a consecutively screened series of mothers and offspring in 1985-90 (n = 172 pairs) and second a 'vulnerable' series of mothers and offspring in 1995-99 (n = 104 pairs). The vulnerable mothers were selected for poor interpersonal functioning and/or low self-esteem and the consecutive series were used for comparison. Rates of childhood adversity and disorder in the offspring were examined in the two groups. Maternal characteristics including psychosocial vulnerability and depression were then examined in relation to risk transmission. Offspring of vulnerable mothers had a fourfold higher rate of yearly disorder than those in the comparison series (43% vs. 11%, p < .001). They were twice as likely as those in the comparison series to have experienced childhood adversity comprising either severe neglect, physical or sexual abuse before age 17. Physical abuse, in particular, perpetrated either by mother or father/surrogate father was significantly raised in the vulnerable group. Analysis of the combined series showed that maternal vulnerability and neglect/abuse of offspring provided the best model for offspring disorder. Maternal history of depression had no direct effect on offspring disorder; its effects were entirely mediated by offspring neglect/abuse. Maternal childhood adversity also had no direct effect. Results are discussed in relation to psychosocial models of risk transmission for disorder. Maternal poor psychosocial functioning needs to be identified as a factor requiring intervention in order to stem escalation of risk across generations.

An allometric approach to quantify the extinction vulnerability of birds and mammals.

PubMed

Hilbers, J P; Schipper, A M; Hendriks, A J; Verones, F; Pereira, H M; Huijbregts, M A J

2016-03-01

Methods to quantify the vulnerability of species to extinction are typically limited by the availability of species-specific input data pertaining to life-history characteristics and population dynamics. This lack of data hampers global biodiversity assessments and conservation planning. Here, we developed a new framework that systematically quantifies extinction risk based on allometric relationships between various wildlife demographic parameters and body size. These allometric relationships have a solid theoretical and ecological foundation. Extinction risk indicators included are (1) the probability of extinction, (2) the mean time to extinction, and (3) the critical patch size. We applied our framework to assess the global extinction vulnerability of terrestrial carnivorous and non-carnivorous birds and mammals. Irrespective of the indicator used, large-bodied species were found to be more vulnerable to extinction than their smaller counterparts. The patterns with body size were confirmed for all species groups by a comparison with IUCN data on the proportion of extant threatened species: the models correctly predicted a multimodal distribution with body size for carnivorous birds and a monotonic distribution for mammals and non-carnivorous birds. Carnivorous mammals were found to have higher extinction risks than non-carnivores, while birds were more prone to extinction than mammals. These results are explained by the allometric relationships, predicting the vulnerable species groups to have lower intrinsic population growth rates, smaller population sizes, lower carrying capacities, or larger dispersal distances, which, in turn, increase the importance of losses due to environmental stochastic effects and dispersal activities. Our study is the first to integrate population viability analysis and allometry into a novel, process-based framework that is able to quantify extinction risk of a large number of species without requiring data-intensive, species-specific information. The framework facilitates the estimation of extinction vulnerabilities of data-deficient species. It may be applied to forecast extinction vulnerability in response to a changing environment, by incorporating quantitative relationships between wildlife demographic parameters and environmental drivers like habitat alteration, climate change, or hunting.

An assessment of vulnerability to HIV infection of boatmen in Teknaf, Bangladesh

PubMed Central

Gazi, Rukhsana; Mercer, Alec; Wansom, Tanyaporn; Kabir, Humayun; Saha, Nirod Chandra; Azim, Tasnim

2008-01-01

Background Mobile population groups are at high risk for contracting HIV infection. Many factors contribute to this risk including high prevalence of risky behavior and increased risk of violence due to conflict and war. The Naf River serves as the primary border crossing point between Teknaf, Bangladesh and Mynamar [Burma] for both official and unofficial travel of people and goods. Little is known about the risk behavior of boatmen who travel back and forth between Teknaf and Myanmar. However, we hypothesize that boatmen may act as a bridging population for HIV/AIDS between the high-prevalence country of Myanmar and the low-prevalence country of Bangladesh. Methods Methods included initial rapport building with community members, mapping of boatmen communities, and in-depth qualitative interviews with key informants and members from other vulnerable groups such as spouses of boatmen, commercial female sex workers, and injecting drug users. Information from the first three stages was used to create a cross-sectional survey that was administered to 433 boatmen. Results Over 40% of the boatmen had visited Myanmar during the course of their work. 17% of these boatmen had sex with CSW while abroad. There was a significant correlation found between the number of nights spent in Myanmar and sex with commercial sex workers. In the past year, 19% of all boatmen surveyed had sex with another man. 14% of boatmen had participated in group sex, with groups ranging in size from three to fourteen people. Condom use was rare {0 to 4.7% during the last month}, irrespective of types of sex partners. Regression analysis showed that boatmen who were 25 years and older were statistically less likely to have sexual intercourse with non- marital female partners in the last year compared to the boatmen aged less than 25 years. Similarly deep-sea fishing boatmen and non-fishing boatmen were statistically less likely to have sexual intercourse with non- marital female partners in the last year compared to the day long fishing boatmen adjusting for all other variables. Boatmen's knowledge regarding HIV transmission and personal risk perception for contracting HIV was low. Conclusion Boatmen in Teknaf are an integral part of a high-risk sexual behaviour network between Myanmar and Bangladesh. They are at risk of obtaining HIV infection due to cross border mobility and unsafe sexual practices. There is an urgent need for designing interventions targeting boatmen in Teknaf to combat an impending epidemic of HIV among this group. They could be included in the serological surveillance as a vulnerable group. Interventions need to address issues on both sides of the border, other vulnerable groups, and refugees. Strong political will and cross border collaboration is mandatory for such interventions. PMID:18341696

Antisocial Alcoholism in Parents of Adolescents and Young Adults with Childhood ADHD

PubMed Central

Molina, Brooke S.G.; Gnagy, Elizabeth M.; Joseph, Heather M.; Pelham, William E.

2017-01-01

Objective Test the hypothesis that alcoholism, including antisocial alcoholism, is more prevalent among mothers and fathers of children with versus without ADHD. Method Mothers (312 ADHD group, 235 non-ADHD group) and fathers (291 ADHD group, 227 non-ADHD group) in the Pittsburgh ADHD Longitudinal Study were interviewed along with their adolescent and young adult offspring. Results Maternal and paternal alcoholism, with and without comorbid antisociality, was more prevalent in the ADHD group. Paternal alcoholism without antisociality was only marginally higher for probands after controlling for paternal ADHD. Offspring conduct disorder comorbidity was associated with parental antisociality but not parental antisocial alcoholism. Conclusions Our findings that 44% of proband fathers and 25% of proband mothers experienced alcohol problems with or without antisociality, are further evidence of increased alcoholism prevalence in families affected by ADHD. Maternal alcoholism and antisociality are prominent contributors to this family-level vulnerability. These findings indicate the need to assess long-term offspring outcomes as a function of parental alcohol and externalizing comorbidities, and perhaps other indicators of parental alcoholism phenotype, as familial vulnerability unfolds across development. PMID:27895188

Are older people a vulnerable group? Philosophical and bioethical perspectives on ageing and vulnerability.

PubMed

Bozzaro, Claudia; Boldt, Joachim; Schweda, Mark

2018-05-01

The elderly are often considered a vulnerable group in public and academic bioethical debates and regulations. In this paper, we examine and challenge this assumption and its ethical implications. We begin by systematically delineating the different concepts of vulnerability commonly used in bioethics, before then examining whether these concepts can be applied to old age. We argue that old age should not, in and of itself, be used as a marker of vulnerability, since ageing is a process that can develop in a variety of different ways and is not always associated with particular experiences of vulnerability. We, therefore, turn to more fundamental phenomenological considerations in order to reconstruct from a first person perspective the intricate interconnections between the experiences of ageing and vulnerability. According to this account, ageing and old age are phenomena in which the basic anthropological vulnerability of human beings can manifest itself in an increased likelihood of harm and exploitation. Thus, we plead for a combined model of vulnerability that helps to avoid problems related to the current concepts of vulnerability. We conclude first that old age as such is not a sufficient criterion for being categorized as vulnerable in applied ethics, and second that reflections on ageing can help to develop a better understanding of the central role of vulnerability in human existence and in applied ethics. © 2018 John Wiley & Sons Ltd.

On underestimation of global vulnerability to tree mortality and forest die-off from hotter drought in the Anthropocene

USGS Publications Warehouse

Allen, Craig D.; Breshears, David D.; McDowell, Nathan G.

2015-01-01

Patterns, mechanisms, projections, and consequences of tree mortality and associated broad-scale forest die-off due to drought accompanied by warmer temperatures—“hotter drought”, an emerging characteristic of the Anthropocene—are the focus of rapidly expanding literature. Despite recent observational, experimental, and modeling studies suggesting increased vulnerability of trees to hotter drought and associated pests and pathogens, substantial debate remains among research, management and policy-making communities regarding future tree mortality risks. We summarize key mortality-relevant findings, differentiating between those implying lesser versus greater levels of vulnerability. Evidence suggesting lesser vulnerability includes forest benefits of elevated [CO2] and increased water-use efficiency; observed and modeled increases in forest growth and canopy greening; widespread increases in woody-plant biomass, density, and extent; compensatory physiological, morphological, and genetic mechanisms; dampening ecological feedbacks; and potential mitigation by forest management. In contrast, recent studies document more rapid mortality under hotter drought due to negative tree physiological responses and accelerated biotic attacks. Additional evidence suggesting greater vulnerability includes rising background mortality rates; projected increases in drought frequency, intensity, and duration; limitations of vegetation models such as inadequately represented mortality processes; warming feedbacks from die-off; and wildfire synergies. Grouping these findings we identify ten contrasting perspectives that shape the vulnerability debate but have not been discussed collectively. We also present a set of global vulnerability drivers that are known with high confidence: (1) droughts eventually occur everywhere; (2) warming produces hotter droughts; (3) atmospheric moisture demand increases nonlinearly with temperature during drought; (4) mortality can occur faster in hotter drought, consistent with fundamental physiology; (5) shorter droughts occur more frequently than longer droughts and can become lethal under warming, increasing the frequency of lethal drought nonlinearly; and (6) mortality happens rapidly relative to growth intervals needed for forest recovery. These high-confidence drivers, in concert with research supporting greater vulnerability perspectives, support an overall viewpoint of greater forest vulnerability globally. We surmise that mortality vulnerability is being discounted in part due to difficulties in predicting threshold responses to extreme climate events. Given the profound ecological and societal implications of underestimating global vulnerability to hotter drought, we highlight urgent challenges for research, management, and policy-making communities.

Group decision-making approach for flood vulnerability identification using the fuzzy VIKOR method

NASA Astrophysics Data System (ADS)

Lee, G.; Jun, K. S.; Cung, E. S.

2014-09-01

This study proposes an improved group decision making (GDM) framework that combines VIKOR method with fuzzified data to quantify the spatial flood vulnerability including multi-criteria evaluation indicators. In general, GDM method is an effective tool for formulating a compromise solution that involves various decision makers since various stakeholders may have different perspectives on their flood risk/vulnerability management responses. The GDM approach is designed to achieve consensus building that reflects the viewpoints of each participant. The fuzzy VIKOR method was developed to solve multi-criteria decision making (MCDM) problems with conflicting and noncommensurable criteria. This comprising method can be used to obtain a nearly ideal solution according to all established criteria. Triangular fuzzy numbers are used to consider the uncertainty of weights and the crisp data of proxy variables. This approach can effectively propose some compromising decisions by combining the GDM method and fuzzy VIKOR method. The spatial flood vulnerability of the south Han River using the GDM approach combined with the fuzzy VIKOR method was compared with the results from general MCDM methods, such as the fuzzy TOPSIS and classical GDM methods, such as those developed by Borda, Condorcet, and Copeland. The evaluated priorities were significantly dependent on the employed decision-making method. The proposed fuzzy GDM approach can reduce the uncertainty in the data confidence and weight derivation techniques. Thus, the combination of the GDM approach with the fuzzy VIKOR method can provide robust prioritization because it actively reflects the opinions of various groups and considers uncertainty in the input data.

Joining and leaving sex work: experiences of women in Kigali, Rwanda.

PubMed

Ingabire, Marie Chantal; Mitchell, Kirstin; Veldhuijzen, Nienke; Umulisa, Marie Michelle; Nyinawabega, Jeanine; Kestelyn, Evelyne; Van Steijn, Minouk; Van De Wijgert, Janneke; Pool, Robert

2012-10-01

Although sex work can bring significant economic benefit there are serious downsides, not least vulnerability to adverse sexual health outcomes. Focus-groups discussions and in-depth interviews were conducted with 70 female sex workers to explore the context in which they started sex work, their motivations to leave, and their experiences of trying to leave. The pathway to becoming a sex worker was underscored by poverty, with disruptive events leading to increasing vulnerability and increasingly difficult life choices. A sizeable minority of women became sex workers while working as house-girls, a position associated with financial, physical and sexual vulnerability. The majority of participants were still working as sex workers, citing financial reasons for not leaving. Motivations to leave sex work included experiencing a frightening incident, peer pressure and concerns about dependent children. Those who left often described a change in their financial circumstances that enabled them to leave. Some had left but had returned to sex work following a financial crisis or because they found their new life too hard. House-girls are particularly vulnerable and therefore an appropriate focus for prevention. Programmes assisting women to leave need to include financial safety nets so that a time of financial difficulty does not necessitate a return to sex work.

[Information hygiene and regulation of information for vulnerable groups of the population].

PubMed

Denisov, E I; Eremin, A L; Sivochalova, O V; Kurerov, N N

2014-01-01

Development of information society engenders the problem of hygienic regulation of information load for the population, first of all for vulnerable groups. There are presented international and Russian normative legal documents and experience in this area, there are described the negative effects of information (such as stress, depression, suicidal ideations). There are considered social-psychological characteristics of vulnerable groups that requires their best protection from loads of information, doing harm, particularly in terms of reproductive health, family relationships, children, etc. There was noted the desirability of improvement of sanitary, legislation on the regulation of the information load on the population, especially in vulnerable groups, in terms of optimization of parameters of the signal-carriers on volume, brightness and the adequacy of the volume and content of information in radio and television broadcasting, in an urban environment and at the plant to preserve the health and well-being of the population.

Chaos, co-existence, and the potential for collective action: HIV-related vulnerability in Brazil's international borders.

PubMed

Lippman, Sheri A; Kerrigan, Deanna; Chinaglia, Magda; Díaz, Juan

2007-06-01

In a country where quality HIV/AIDS prevention and care has been foremost on the national agenda, Brazil's extensive and diverse borders are one of the last unstudied potential hotbeds of HIV vulnerability. We carried out a rapid assessment of HIV-related services and the social context of HIV/AIDS at the Brazilian borders including current governmental and community response. The assessment was implemented in six frontier municipalities using the WHO's strategic approach methodology, which combines existing epidemiologic data with field-based qualitative data collection techniques, including observation of service delivery points and in-depth interviews and focus groups with local leaders, providers, and community members, in order to recommend context-specific HIV prevention strategies. This paper focuses on the qualitative findings regarding the role of the social context in shaping HIV vulnerability at the Brazilian borders. We documented a profound lack of governmental structure and response to HIV/AIDS at the borders as well as a notable absence of social cohesion and mobilization among the diverse population groups and communities situated at the borders with regard to HIV/AIDS. The weak governmental and community response is situated within a larger socio-political context of economic inequity and social division, which must be addressed if an effective response to HIV can be developed at Brazil's international borders. Possibilities for encouraging a collective response among the diverse border populations are explored.

Animal Ownership Among Vulnerable Populations in Regional South Australia: Implications for Natural Disaster Preparedness and Resilience.

PubMed

Thompson, Kirrilly; Trigg, Joshua; Smith, Bradley

Few studies have examined the prevalence of animal ownership among populations likely to be at greater risk from disaster events within a bushfire context. To investigate the proportion of vulnerable community members keeping animals and the types of animals kept, as well as perceived risk of harm to pets, and their inclusion in bushfire survival planning. Statewide anonymous online survey in 2014 of adult South Australian animal owners threatened by bushfire in January 2014. Respondents were asked about animal ownership, their bushfire risk perception, and household survival planning. Descriptive statistics are presented for 5 groups considered likely to contribute to increased risk of harm for households: linguistically diverse, older adults, families with young children, physically frail, and self-identifying disabled, as well as individuals with mental health considerations. An opt-in purposively targeted sample of anonymous South Australians living in high fire-risk locations. Adult South Australian animal owners threatened or directly impacted by bushfire events, including individuals matching 1 of the 5 vulnerable groups. Self-reported details of animal ownership, perceived fire risk, survival planning, and vulnerability characteristics. Animal ownership was found to be more prevalent in these 5 populations than in the wider South Australian population. Perceived risk to pets was low to moderately low in these individuals. Variation was observed in the role of animals generally and pets specifically as motivators for preparing bushfire survival plans. Emergency services and associated agencies need to consider how the unique needs of vulnerable populations that keep animals, and their potential differences in risk perception, relate to their bushfire survival planning and preparedness requirements.

Understanding Young Women's Sexual Relationship Experiences: The Nature and Role of Vulnerability

ERIC Educational Resources Information Center

Maxwell, Claire

2006-01-01

This paper seeks to operationalise the concept of social "vulnerability" and explore its usefulness as a framework for understanding sexual relationships. Data from 30 vulnerable and less vulnerable young women in one UK city were collected through in-depth interviews and focus groups. An analysis of differences and similarities in…

Resilience in Vulnerable Populations With Type 2 Diabetes Mellitus and Hypertension: A Systematic Review and Meta-analysis.

PubMed

Pesantes, M Amalia; Lazo-Porras, María; Abu Dabrh, Abd Moain; Ávila-Ramírez, Jaime R; Caycho, María; Villamonte, Georgina Y; Sánchez-Pérez, Grecia P; Málaga, Germán; Bernabé-Ortiz, Antonio; Miranda, J Jaime

2015-09-01

Patients with chronic conditions and limited access to health care experience stressful challenges resulting from the burden of managing both their conditions and their daily life demands. Resilience provides a mechanism of adapting to stressful experiences. We conducted a systematic review and meta-analysis to synthesize the evidence about interventions to enhance resiliency in managing hypertension or type 2 diabetes in vulnerable populations and to assess the efficacy of these interventions on clinical outcomes. We searched multiple databases from early inception through February 2015 including randomized controlled trials that enrolled patients with type 2 diabetes or hypertension. All interventions that targeted resilience in vulnerable populations were included. Data were synthesized to describe the characteristics and efficacy of resiliency interventions. We pooled the total effects by calculating standardized mean difference using the random-effects model. The final search yielded 17 studies. All studies were conducted in the United States and generally targeted minority participants. Resiliency interventions used diverse strategies; discussion groups or workshops were the most common approach. Interventions aimed at enhancing the resiliency of patients from vulnerable groups are diverse. Outcomes were not fully conclusive. There was some evidence that resiliency interventions had a positive effect on hemoglobin A1C levels but not blood pressure. The incorporation of resiliency-oriented interventions into the arsenal of preventing and managing chronic conditions appears to be an opportunity that remains to be better investigated and exploited, and there is need to pursue further understanding of the core components of any intervention that claims to enhance resilience. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Individual, occupational, and workplace correlates of occupational health and safety vulnerability in a sample of Canadian workers

PubMed Central

Saunders, Ron; Lifshen, Marni; Breslin, Curtis; LaMontagne, Anthony; Tompa, Emile; Smith, Peter

2015-01-01

Objective To describe OH&S vulnerability across a diverse sample of Canadian workers. Methods A survey was administered to 1,835 workers employed more than 15 hrs/week in workplaces with at least five employees. Adjusted logistic models were fitted for three specific and one overall measure of workplace vulnerability developed based on hazard exposure and access to protective OH&S policies and procedures, awareness of employment rights and responsibilities, and workplace empowerment. Results More than one third of the sample experienced some OH&S vulnerability. The type and magnitude of vulnerability varied by labor market sub‐group. Younger workers and those in smaller workplaces experienced significantly higher odds of multiple types of vulnerability. Temporary workers reported elevated odds of overall, awareness‐ and empowerment‐related vulnerability, while respondents born outside of Canada had significantly higher odds of awareness vulnerability. Conclusion Knowing how labor market sub‐groups experience different types of vulnerability can inform better‐tailored primary prevention interventions. Am. J. Ind. Med. 59:119–128, 2016. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc. PMID:26771101

Beyond the checklist: understanding rural health vulnerability in a South African context.

PubMed

Vergunst, Richard; Swartz, Leslie; Mji, Gubela; Kritzinger, Janis; Braathen, Stine Hellum

2016-01-01

Vulnerability in the past has sometimes been measured and understood in terms of checklists or common understanding. It is argued here that vulnerability is a more complex issue than this. Although checklists of vulnerable groups are important, they do not capture the essence and dynamics of vulnerability. The case of rural health vulnerability in South Africa is discussed to show that classifying people into vulnerable groups does not portray the complexity and intricacies of what it means to have vulnerability. We also wish to show that there are different kinds of vulnerabilities, and the difference between access vulnerability and illness vulnerability is highlighted. As part of a larger study, this case study is presented to show how vulnerability in a poor rural community in South Africa has to be understood in a contextual and dynamic manner as opposed to a static manner. Family and social dynamics can influence health. For example, fractured families were seen as a vulnerable issue within the community, while being a person with a disability can lead to isolation and callous attitudes towards them. It is these family and social dynamics that lead proximally to vulnerability to ill health. A contextual approach can assist in giving a more layered understanding of vulnerability than a checklist approach can do. Interventions to change health cannot be addressed simply by medical means. Social conditions need to be changed, and part of changing social conditions is the process of assisting those who are isolated or experience themselves as vulnerable to reconnect with others in the community. Poverty leads to social exclusion; social and family inclusion may be key to well-being.

The at-risk adolescent marijuana nonuser: expanding the standard distinction.

PubMed

Crano, William D; Siegel, Jason T; Alvaro, Eusebio M; Lac, Andrew; Hemovich, Vanessa

2008-06-01

This research expands the user/nonuser dichotomy commonly used in research on marijuana. By conceptualizing nonusers as homogeneous, vital nuances in susceptibility to risk and protective factors may be overlooked. Research operations tested the predictive validity of a brief measure that divided nonusers into resolute and vulnerable subcategories; determined whether variables that distinguished nonusers and users were more informative when a tripartite classification was used; and with an eye on future prevention, examined variables on which resolute nonusers were similar to vulnerable nonusers or users, and on which they differed from both. A nationally representative sample of respondents (N = 2,111; ages 12-16 years) from the National Survey of Parents and Youth was used in this secondary analysis. Panel data gathered yearly over four rounds included information on intentions and use of marijuana and other illicit substances, along with social, demographic, intrapersonal, and parental variables. The three groups differed significantly on associates' marijuana use, participants' approval of others' use, and cigarette and alcohol use. Resolute nonusers differed from vulnerable nonusers and users alike on religiosity, delinquency (self and friends'), refusal strength, sensation seeking, parental monitoring and warmth, and adult supervision. Results support the utility of distinguishing vulnerable from resolute nonusers, counsel against considering nonusers as a homogeneous group, and provide insight into variables that might prove useful in future prevention efforts.

a Novel Approach to Support Majority Voting in Spatial Group Mcdm Using Density Induced Owa Operator for Seismic Vulnerability Assessment

NASA Astrophysics Data System (ADS)

Moradi, M.; Delavar, M. R.; Moshiri, B.; Khamespanah, F.

2014-10-01

Being one of the most frightening disasters, earthquakes frequently cause huge damages to buildings, facilities and human beings. Although the prediction of characteristics of an earthquake seems to be impossible, its loss and damage is predictable in advance. Seismic loss estimation models tend to evaluate the extent to which the urban areas are vulnerable to earthquakes. Many factors contribute to the vulnerability of urban areas against earthquakes including age and height of buildings, the quality of the materials, the density of population and the location of flammable facilities. Therefore, seismic vulnerability assessment is a multi-criteria problem. A number of multi criteria decision making models have been proposed based on a single expert. The main objective of this paper is to propose a model which facilitates group multi criteria decision making based on the concept of majority voting. The main idea of majority voting is providing a computational tool to measure the degree to which different experts support each other's opinions and make a decision regarding this measure. The applicability of this model is examined in Tehran metropolitan area which is located in a seismically active region. The results indicate that neglecting the experts which get lower degrees of support from others enables the decision makers to avoid the extreme strategies. Moreover, a computational method is proposed to calculate the degree of optimism in the experts' opinions.

Youth and Violence: Phenomena and International Data

ERIC Educational Resources Information Center

Legge, Sandra

2008-01-01

The topic of youth, violence, and disintegration needs addressing because young women and men are the world's greatest capital. They have the energy, talent, and creativity for building a future. But this group also suffers grave vulnerabilities. The time of adolescence includes important and difficult periods of life (for example, becoming more…

Assessment of Coastal Communities' Vulnerability to Hurricane Surge under Climate Change via Probabilistic Map - A Case Study of the Southwest Coast of Florida

NASA Astrophysics Data System (ADS)

Feng, X.; Shen, S.

2014-12-01

The US coastline, over the past few years, has been overwhelmed by major storms including Hurricane Katrina (2005), Ike (2008), Irene (2011), and Sandy (2012). Supported by a growing and extensive body of evidence, a majority of research agrees hurricane activities have been enhanced due to climate change. However, the precise prediction of hurricane induced inundation remains a challenge. This study proposed a probabilistic inundation map based on a Statistically Modeled Storm Database (SMSD) to assess the probabilistic coastal inundation risk of Southwest Florida for near-future (20 years) scenario considering climate change. This map was processed through a Joint Probability Method with Optimal-Sampling (JPM-OS), developed by Condon and Sheng in 2012, and accompanied by a high resolution storm surge modeling system CH3D-SSMS. The probabilistic inundation map shows a 25.5-31.2% increase in spatially averaged inundation height compared to an inundation map of present-day scenario. To estimate climate change impacts on coastal communities, socioeconomic analyses were conducted using both the SMSD based probabilistic inundation map and the present-day inundation map. Combined with 2010 census data and 2012 parcel data from Florida Geographic Data Library, the differences of economic loss between the near-future and present day scenarios were used to generate an economic exposure map at census block group level to reflect coastal communities' exposure to climate change. The results show that climate change induced inundation increase has significant economic impacts. Moreover, the impacts are not equally distributed among different social groups considering their social vulnerability to hazards. Social vulnerability index at census block group level were obtained from Hazards and Vulnerability Research Institute. The demographic and economic variables in the index represent a community's adaptability to hazards. Local Moran's I was calculated to identify the clusters of highly exposed and vulnerable communities. The economic-exposure cluster map was overlapped with social-vulnerability cluster map to identify communities with low adaptive capability but high exposure. The result provides decision makers an intuitive tool to identify most susceptible communities for adaptation.

Climate volatility deepens poverty vulnerability in developing countries

NASA Astrophysics Data System (ADS)

Ahmed, Syud A.; Diffenbaugh, Noah S.; Hertel, Thomas W.

2009-07-01

Extreme climate events could influence poverty by affecting agricultural productivity and raising prices of staple foods that are important to poor households in developing countries. With the frequency and intensity of extreme climate events predicted to change in the future, informed policy design and analysis requires an understanding of which countries and groups are going to be most vulnerable to increasing poverty. Using a novel economic-climate analysis framework, we assess the poverty impacts of climate volatility for seven socio-economic groups in 16 developing countries. We find that extremes under present climate volatility increase poverty across our developing country sample—particularly in Bangladesh, Mexico, Indonesia, and Africa—with urban wage earners the most vulnerable group. We also find that global warming exacerbates poverty vulnerability in many nations.

Effect of dysfunctional attitudes and postpartum state on vulnerability to depressed mood.

PubMed

Dowlati, Yekta; Segal, Zindel V; Ravindran, Arun V; Steiner, Meir; Stewart, Donna E; Meyer, Jeffrey H

2014-06-01

Postpartum depression (PPD) is the most common complication of childbearing with a 13% prevalence. Vulnerability to depressed mood has an important role in the onset of major depressive episodes (MDE), but has not been investigated in postpartum. The aim is to assess whether day-5 postpartum blues and severity of dysfunctional attitudes predicts vulnerability to depressed mood. About 45 healthy women were recruited: group 1 (n=12) was day-5 postpartum during the typical peak of postpartum blues. Group 2 (n=11) was within 18 months postpartum and reported a vulnerability to cry (and had elevated dysfunctional attitudes but no MDE). Group 3 (n=11) was within 18 months postpartum and no vulnerability to cry. Group 4 (n=11) was not recently postpartum. Vulnerability to depressed mood was measured by the change in the visual analog scale from the sad mood induction procedure (MIP). Univariate analysis of covariance demonstrated that day-5 postpartum blues and level of dysfunctional attitudes were highly predictive of change in sad mood (postpartum blues: F(1,41)=12.9, p<0.005, dysfunctional attitudes scale score: F(1,41)=11.49, p<0.005). Although the effects were robust, sample sizes were 11-12 within each group. Two factors (day-5 postpartum and severity of dysfunctional attitudes) predicted vulnerability to sad mood. Since the severity of postpartum blues predicts PPD, MIP on day-5 postpartum represents a quantitative measure that can be applied to screen novel, early interventions for preventing PPD. Interventions to prevent PPD through increasing resilience against mood induction should target postpartum women with greater severity of dysfunctional attitudes. Copyright © 2014 Elsevier B.V. All rights reserved.

Identifying the ‘Vulnerables’ in Biomedical Research: the vox populis from the Tuskegee Legacy Project

PubMed Central

Wiley, John

2011-01-01

Objectives This report presents, for the first time, findings on the vox populis as to who constitutes the ‘vulnerables in biomedical research’. Methods The 3-City Tuskegee Legacy Project (TLP) study used the TLP Questionnaire as administered via RDD telephone interviews to 1,162 adult Blacks, non-Hispanic Whites, and two Puerto Rican (PR) Hispanic groups: Mainland U.S. and San Juan (SJ) in 3 cities. The classification schema was based upon respondents’ answers to an open-ended question asking which groups of people were the most vulnerable when participating in biomedical research. Results Subjects provided 749 valid open-ended responses which were grouped into 29 direct response categories, leading to a 4 tier classification schema for vulnerability traits. Tier 1, the summary tier, had five vulnerability categories: 1) Race/ethnicity; 2) Age; 3) SES; 4) Health; and, 5) Gender. Blacks and Mainland U.S. PR Hispanics most frequently identified Race/Ethnicity as a vulnerability trait (42.1% of Blacks and 42.6% of Mainland U.S. PR Hispanics vs. 15.4% of Whites and 16.7% of San Juan R Hispanics) (p<.007), while Whites and SJ PR Hispanics most frequently identified Age (48.3% and 29.2%) as a vulnerability trait. Conclusions The response patterns on ‘who was vulnerable’ were similar for the two minority groups (Blacks and Mainland U.S. PR Hispanics), and notably different from the response patterns of the two majority groups (Whites and SJPR Hispanics). Further, the vox populis definition of vulnerables differed from the current official definitions as used by the U.S. federal government. PMID:21972462

Interactions among variants in TXA2R, P2Y12 and GPIIIa are associated with carotid plaque vulnerability in Chinese population.

PubMed

Yi, Xingyang; Lin, Jing; Luo, Hua; Zhou, Ju; Zhou, Qiang; Wang, Yanfen; Wang, Chun

2018-04-03

The associations between variants in platelet activation-relevant genes and carotid plaque vulnerability are not fully understood. The aim of the present study was to investigate the associations of the variants in platelet activation-relevant genes and interactions among these variants with carotid plaque vulnerability. There were no significant differences in the frequencies of genotypes of the 11 variants between patients and controls. Among 396 patients, 102 patients had not carotid plaque, 106 had VP, and 188 had SP. The 11 variants were not independently associated with risk of carotid plaque vulnerability after adjusting for potential confounding variables. However, the GMDR analysis showed that there were synergistic effects of gene-gene interactions among TXA2Rr s1131882, GPIIIa rs2317676 and P2Y12 rs16863323 on carotid plaque vulnerability. The high-risk interactions among the three variants were associated with high platelet activation, and independently associated with the risk of carotid plaque vulnerability. Eleven variants in platelet activation-relevant genes were examined using mass spectrometry methods in 396 ischemic stroke patients and 291controls. Platelet-leukocyte aggregates and platelet aggregation were also measured. Carotid plaques were assessed by B-mode ultrasound. According to the results of ultrasound, the patients were stratified into three groups: non-plaque group, vulnerable plaque (VP) group and stable plaque (SP) group. Furthermore, gene-gene interactions were analyzed using generalized multifactor dimensionality reduction (GMDR) methods. The rs1131882, rs2317676, and rs16863323 three-loci interactions may confer a higher risk of carotid plaque vulnerability, and might be potential markers for plaque instability.

Elderly people coping with the aftermath of war: resilience versus vulnerability.

PubMed

Kimhi, Shaul; Hantman, Shira; Goroshit, Marina; Eshel, Yohanan; Zysberg, Leehu

2012-05-01

The present study compares coping of elderly people and two younger groups 1 year after a war. Coping was determined by stress symptoms and posttraumatic recovery and two levels of resiliency. Thirty-six streets (covering most of the city streets) were sampled randomly from the map of Kiryat Shemona (a town next to the Lebanese border) about a year after the end of the Second Lebanon War. The sample constituted 870 adult residents of the town. Participants were divided into three age groups: elderly (age 65 years and older, N = 108), adults (age 46-64 years, N = 252) and young adults (age 20-45 years, N = 462). 1) Stress symptoms measured by short version of Brief Symptom Inventory; 2) Individual resilience measured by Sense of Coherence Inventory; 3) Posttraumatic Recovery Inventory (PTR); and 4) Public Resilience Scale (included a scale for community and national resilience). The results indicated 1) The elderly group reported significantly higher levels of stress symptoms and lower levels of PTR; 2) Females in the three age groups reported higher levels of stress symptoms and lower levels of PTR and individual resilience than males; 3) Individual and public resilience negatively predicted stress symptoms and positively predicted posttraumatic recovery across three age groups; and 4) Public resilience has a differential effect on stress symptoms in each of the three age groups but not on PTR. Results question the division of older people into a vulnerable or inoculated group, indicating that the participants responded concurrently in a more vulnerable and a more resilient manner. Older people were characterized by higher levels of postwar stress symptoms, as well as a higher sense of coherence.

Conducting Science in Disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research.

PubMed

Packenham, Joan P; Rosselli, Richard T; Ramsey, Steve K; Taylor, Holly A; Fothergill, Alice; Slutsman, Julia; Miller, Aubrey

2017-09-25

Research involving human subjects after public health emergencies and disasters may pose ethical challenges. These challenges may include concerns about the vulnerability of prospective disaster research participants, increased research burden among disaster survivors approached by multiple research teams, and potentially reduced standards in the ethical review of research by institutional review boards (IRBs) due to the rush to enter the disaster field. The NIEHS Best Practices Working Group for Special IRB Considerations in the Review of Disaster Related Research was formed to identify and address ethical and regulatory challenges associated with the review of disaster research. The working group consists of a diverse collection of disaster research stakeholders across a broad spectrum of disciplines. The working group convened in July 2016 to identify recommendations that are instrumental in preparing IRBs to review protocols related to public health emergencies and disasters. The meeting included formative didactic presentations and facilitated breakout discussions using disaster-related case studies. Major thematic elements from these discussions were collected and documented into 15 working group recommendations, summarized in this article, that address topics such as IRB disaster preparedness activities, informed consent, vulnerable populations, confidentiality, participant burden, disaster research response integration and training, IRB roles/responsibilities, community engagement, and dissemination of disaster research results. https://doi.org/10.1289/EHP2378.

Conducting Science in Disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research

PubMed Central

Rosselli, Richard T.; Ramsey, Steve K.; Taylor, Holly A.; Fothergill, Alice; Slutsman, Julia; Miller, Aubrey

2017-01-01

Summary: Research involving human subjects after public health emergencies and disasters may pose ethical challenges. These challenges may include concerns about the vulnerability of prospective disaster research participants, increased research burden among disaster survivors approached by multiple research teams, and potentially reduced standards in the ethical review of research by institutional review boards (IRBs) due to the rush to enter the disaster field. The NIEHS Best Practices Working Group for Special IRB Considerations in the Review of Disaster Related Research was formed to identify and address ethical and regulatory challenges associated with the review of disaster research. The working group consists of a diverse collection of disaster research stakeholders across a broad spectrum of disciplines. The working group convened in July 2016 to identify recommendations that are instrumental in preparing IRBs to review protocols related to public health emergencies and disasters. The meeting included formative didactic presentations and facilitated breakout discussions using disaster-related case studies. Major thematic elements from these discussions were collected and documented into 15 working group recommendations, summarized in this article, that address topics such as IRB disaster preparedness activities, informed consent, vulnerable populations, confidentiality, participant burden, disaster research response integration and training, IRB roles/responsibilities, community engagement, and dissemination of disaster research results. https://doi.org/10.1289/EHP2378 PMID:28949918

GIS modelling of seismic vulnerability of residential fabrics considering geotechnical, structural, social and physical distance indicators in Tehran city using multi-criteria decision-making (MCDM) techniques

NASA Astrophysics Data System (ADS)

Rezaie, F.; Panahi, M.

2014-09-01

The main issue in determining the seismic vulnerability is having a comprehensive view to all probable damages related to earthquake occurrence. Therefore, taking factors such as peak ground acceleration (PGA) in the time of earthquake occurrence, the type of structures, population distribution among different age groups, level of education, the physical distance to a hospitals (or medical care centers), etc. into account and categorized under four indicators of geotechnical, structural, social and physical distance to needed facilities and distance from dangerous ones will provide us with a better and more exact outcome. To this end in this paper using analytic hierarchy process (AHP), the amount of importance of criteria or alternatives are determined and using geographical information system (GIS), the vulnerability of Tehran metropolitan as a result of an earthquake, is studied. This study focuses on the fact that Tehran is surrounded by three active and major faults of the Mosha, North Tehran and Rey. In order to comprehensively determine the vulnerability, three scenarios are developed. In each scenario, seismic vulnerability of different areas in Tehran city is analysed and classified into four levels including high, medium, low and safe. The results show that regarding seismic vulnerability, the faults of Mosha, North Tehran and Rey respectively make 6, 16 and 10% of Tehran area highly vulnerable and also 34, 14 and 27% are safe.

Exploring inside a shaggy aorta using non-obstructive angioscopy.

PubMed

Komatsu, Sei; Takahashi, Satoru; Toyama, Yasuyuki; Kodama, Kazuhisa

2017-05-22

A shaggy aorta is reportedly related to atheromatous embolisation, which causes serious ischaemic damage to various organs. However, its characteristics are poorly understood. Non-obstructive angioscopy (NOA) has been developed to safely detect aortic plaques and injuries. A 70-year-old woman who was found to have a shaggy aorta on CT angiography underwent NOA for precise evaluation of vulnerable aortic plaques and injuries inside the aorta. Vulnerable aortic plaques included puff-like ruptures, chandelier-like ruptures and erosions seen throughout the aorta. Aortic injuries included flaps, slits, subintimal bleeding, dissection and multilayered partitions. The patient had no embolic symptoms or an elevated eosinophil count, estimated glomerular filtration rate or C reactive protein level, compared with the baseline. Various changes in spontaneous vulnerable plaques and injuries inside the aorta that were not apparent on CT were safely revealed on NOA. Thus, NOA may reveal findings indicative of spontaneous and postoperative atheromatous embolisation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Parental style and vulnerability to depression: the role of core beliefs.

PubMed

Shah, R; Waller, G

2000-01-01

This study considers the potential role of core beliefs (unconditional schema-level representations) in the relationship between recalled parenting in childhood and major depression in adulthood, comparing a group of depressed outpatients (N = 60) with a healthy community sample (N = 67). The depressed group were differentiated by poorer perceived parenting (low care and high overprotection) and by three unhealthy core beliefs (defectiveness/shame, self-sacrifice, and insufficient self-control). Among nonclinical participants, it appears that vulnerability to harm beliefs act as a partial mediator of the relationship between poor paternal care and the development of depressive features. In contrast, a broader set of core beliefs appears to mediate the relationship of maternal bonding and paternal overprotection with depressive symptoms among the depressed group. The findings suggest that clinical work with adults with major depression might need to take account of parental style. Where parents are reported to be uncaring or overprotective, cognitive-behavioral therapy might need to include a schema-focused component.

Vulnerability and seismic damage scenarios for Barcelona (Spain) by using GIS

NASA Astrophysics Data System (ADS)

Lantada, N.; Pujades, L. G.; Barbat, A.

2003-04-01

An integrated GIS-based analysis (using ArcView GIS) is performed in order to estimate damage scenarios for VI, VII and VIII EMS-98 seismic intensities in Barcelona (Spain). The analysis of vulnerability and damage of individual buildings is performed according to a simplified method developed by Giovanazzi and Lagomarsino at the University of Genoa (Italy). An index of average vulnerability is associated to each building typology, which may be refined on the basis of behaviour modifiers. The index allows identification of an analytical relationship between seismic input (intensity) and damage, described by a binomial distribution. This methodology, which is based on the EMS-98 building typologies and preserves the compatibility with preceding methods, is applied to the two main residential building typologies of Barcelona, that is, unreinforced masonry and reinforced concrete buildings. Then, the specific residential buildings of Barcelona are classified in different groups characterized by a similar seismic behaviour. Therefore, all buildings belonging to each typology are cast in the most probable class according to vulnerability. In this way, the average vulnerability index is associated to each building typology of Barcelona and it is refined later on the basis of behaviour modifiers, linked to the number of stories, the year of construction and their state of maintenance. The ability of GIS tools to store, manage, analyse, and display the large amount of spatial and tabular data involved in this study allows to map average vulnerability indexes, and damage for the entire city. That is, vulnerability and damage scenarios. The obtained results show a high vulnerability and high expected seismic damage. For a VI degree of intensity, the maximum expected damage is in the range 15-30 % in the oldest zones of the city, the downtown, while for intensity VII it is in the range 45-60%. The developed GIS tool involves a friendly interface that allows new models and database information to be included in the same framework. As a new step to the seismic risk assessment, and in addition to the building characteristics, the destination of the building, as well as the essential buildings, and the density of population for census zones, have been included in the GIS database. Combining this information with the previous damage maps we will be able to obtain more complete damage scenarios including, deaths, injuries, and homeless.

Health complaints and regulatory reform: Implications for vulnerable populations?

PubMed

Carney, Terry; Beaupert, Fleur; Chiarella, Mary; Bennett, Belinda; Walton, Merrilyn; Kelly, Patrick J; Satchell, Claudette S

2016-03-01

Complaints and disciplinary processes play a significant role in health professional regulation. Many countries are transitioning from models of self-regulation to greater external oversight through systems including meta-regulation, responsive (risk-based) regulation, and "networked governance". Such systems harness, in differing ways, public, private, professional and non-governmental bodies to exert influence over the conduct of health professionals and services. Interesting literature is emerging regarding complainants' motivations and experiences, the impact of complaints processes on health professionals, and identification of features such as complainant and health professional profiles, types of complaints and outcomes. This article concentrates on studies identifying vulnerable groups and their participation in health care regulatory systems.

Parental stress and perceived vulnerability at 5 and 10 years after pediatric SCT.

PubMed

Vrijmoet-Wiersma, C M J; Egeler, R M; Koopman, H M; Bresters, D; Norberg, A L; Grootenhuis, M A

2010-06-01

With the aim of assessing parental stress after SCT, 73 parents of children and adolescents who underwent SCT 5 or 10 years ago responded to questionnaires on general distress (General Health Questionnaire (GHQ)), disease-related stress (Pediatric Inventory for Parents-short form (PIP-SF)) and perceptions of child vulnerability (Child Vulnerability Scale (CVS)). General distress scores were comparable with the reference groups, but 40% of the mothers at 5 years after SCT reported increased stress levels as compared with 26% in the community-based reference group. Disease-related stress was comparable with the reference group of parents of children who were just off cancer treatment, 5 years after SCT. At 10 years after SCT, scores were lower than the reference group. Perceived child vulnerability did diminish over time, but remained high in parents of SCT survivors, compared with parents of healthy children: 96% of the parents at 5 years after SCT and 76% of the parents at 10 years after SCT scored above the cutoff point. Perceived vulnerability was found to be a predictor for parental disease-related stress. To conclude, although most parents of SCT survivors are resilient, the majority of parents perceive their child to be much more vulnerable as compared with parents of healthy children. This perception is associated with disease-related stress and may induce overprotective parenting.

[Vulnerability of eco-economy in northern slope region of Tianshan Mountains].

PubMed

Wu, Jian-zhai; Li, Bo; Zhang, Xin-shi; Zhao, Wen-wu; Jiang, Guang-hui

2008-04-01

Based on the theoretical meaning of vulnerability, a vulnerability assessment of eco-econom in fifteen counties in the northern slope region of Tianshan Mountains was conducted. The ecosystem services change to land use was regarded as the impact, and based on the fourteen indices from resource holding, society development, and economy development statistic data, the adaptive ability was evaluated by using the methods of analytic hierarchy process (AHP) and fuzzy synthetic evaluation. On the basis of assessment results of impact and adaptive capacity, the fifteen counties were divided into five classes under the assessment principles, and the district with higher-class number was of more vulnerability. The first class included Usu City and Changji City, the second class included Hutubi County, Miquan County, Fukang City, Jimsar County, Qitai County and Mori Kazak Autonomous County, the third class included Karamay City and Urumqi City, the fourth class included Kuitun City and Shawan County, and the fifth class included Jinghe County, Shihezi City and Manas County. The vulnerability reflected the level of eco-environment change and socioeconomic development, and the vulnerability assessment could be a good way to ensure the sustainable development. Aiming to decrease the vulnerability, various districts belonging to different class of vulnerability should establish relevant tactics according to the vulnerability factors to accelerate the region's sustainable development.

School Functioning of a Particularly Vulnerable Group: Children and Young People in Residential Child Care

PubMed Central

González-García, Carla; Lázaro-Visa, Susana; Santos, Iriana; del Valle, Jorge F.; Bravo, Amaia

2017-01-01

A large proportion of the children and young people in residential child care in Spain are there as a consequence of abuse and neglect in their birth families. Research has shown that these types of adverse circumstances in childhood are risk factors for emotional and behavioral problems, as well as difficulties in adapting to different contexts. School achievement is related to this and represents one of the most affected areas. Children in residential child care exhibit extremely poor performance and difficulties in school functioning which affects their transition to adulthood and into the labor market. The main aim of this study is to describe the school functioning of a sample of 1,216 children aged between 8 and 18 living in residential child care in Spain. The specific needs of children with intellectual disability and unaccompanied migrant children were also analyzed. Relationships with other variables such as gender, age, mental health needs, and other risk factors were also explored. In order to analyze school functioning in this vulnerable group, the sample was divided into different groups depending on school level and educational needs. In the vast majority of cases, children were in primary or compulsory secondary education (up to age 16), this group included a significant proportion of cases in special education centers. The rest of the sample were in vocational training or post-compulsory secondary school. Results have important implications for the design of socio-educative intervention strategies in both education and child care systems in order to promote better school achievement and better educational qualifications in this vulnerable group. PMID:28725205

Parasite vulnerability to climate change: an evidence-based functional trait approach

PubMed Central

Cizauskas, Carrie A.; Clements, Chris F.; Dougherty, Eric R.; Harris, Nyeema C.; Phillips, Anna J.

2017-01-01

Despite the number of virulent pathogens that are projected to benefit from global change and to spread in the next century, we suggest that a combination of coextinction risk and climate sensitivity could make parasites at least as extinction prone as any other trophic group. However, the existing interdisciplinary toolbox for identifying species threatened by climate change is inadequate or inappropriate when considering parasites as conservation targets. A functional trait approach can be used to connect parasites' ecological role to their risk of disappearance, but this is complicated by the taxonomic and functional diversity of many parasite clades. Here, we propose biological traits that may render parasite species particularly vulnerable to extinction (including high host specificity, complex life cycles and narrow climatic tolerance), and identify critical gaps in our knowledge of parasite biology and ecology. By doing so, we provide criteria to identify vulnerable parasite species and triage parasite conservation efforts. PMID:28280551

Structural factors that increase HIV/STI vulnerability among indigenous people in the Peruvian amazon.

PubMed

Orellana, E Roberto; Alva, Isaac E; Cárcamo, Cesar P; García, Patricia J

2013-09-01

We examined structural factors-social, political, economic, and environmental-that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex-including transactional sex between passengers and boat crew and commercial sex work-often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource extraction camps, where heavy drinking and unprotected sex work are common. Multilevel, combination prevention strategies that integrate empirically based interventions with indigenous knowledge are urgently needed, not only to reduce vulnerability to HIV transmission, but also to eliminate the structural determinants of indigenous people's health.

Structural Factors That Increase HIV/STI Vulnerability Among Indigenous People in the Peruvian Amazon

PubMed Central

Orellana, E. Roberto; Alva, Isaac E.; Cárcamo, Cesar P.; García, Patricia J.

2015-01-01

We examined structural factors—social, political, economic, and environmental—that increase vulnerability to HIV among indigenous people in the Peruvian Amazon. Indigenous adults belonging to 12 different ethnic groups were purposively recruited in four Amazonian river ports and 16 indigenous villages. Qualitative data revealed a complex set of structural factors that give rise to environments of risk where health is constantly challenged. Ferryboats that cross Amazonian rivers are settings where unprotected sex—including transactional sex between passengers and boat crew and commercial sex work—often take place. Population mobility and mixing also occurs in settings like the river docks, mining sites, and other resource extraction camps, where heavy drinking and unprotected sex work are common. Multilevel, combination prevention strategies that integrate empirically based interventions with indigenous knowledge are urgently needed, not only to reduce vulnerability to HIV transmission, but also to eliminate the structural determinants of indigenous people’s health. PMID:23925407

Carotid artery stenting for vulnerable plaques on MR angiography and ultrasonography: utility of dual protection and blood aspiration method.

PubMed

Sakamoto, Shigeyuki; Kiura, Yoshihiro; Okazaki, Takahito; Shinagawa, Katsuhiro; Ishii, Daizo; Ichinose, Nobuhiko; Kurisu, Kaoru

2016-10-01

Carotid artery stenting (CAS) for internal carotid artery (ICA) stenosis with vulnerable plaques is controversial. We analyzed the effect of a dual protection and blood aspiration method during CAS in patients with vulnerable plaques. A total of 111 patients with ICA stenosis underwent CAS using the dual protection (simultaneous flow reversal and distal filter) and blood aspiration method. In 103 of 111 patients, preoperative carotid plaque was estimated by both 3 T MRI and ultrasonography (US). ICA plaques with a high intensity signal on time-of-flight-MR angiography (TOF-MRA) and/or mobile component on US were defined as vulnerable plaques. We assessed major adverse events (MAE) (ie, major stroke, myocardial infarction, and death) and hyperintense spots on diffusion-weighted images (DWI) after CAS. We then evaluated the visible debris captured by dual protection and blood aspiration during CAS. The preoperative ICA plaque on TOF-MRA and US was judged to be vulnerable in 48.5% (50/103 patients). The success rate of the CAS procedure was 100% with no MAE within 30 days. DWI showed small hyperintense spots in 18% (9/50 patients) and 18.9% (10/53 patients) in the vulnerable and non-vulnerable plaque groups, respectively. Visible debris was captured in 68% (34/50 patients) and 45.3% (24/53 patients) in the vulnerable and non-vulnerable plaque groups, respectively (p=0.0286). The combination of dual protection and blood aspiration could provide effective distal embolic protection although vulnerable plaques on TOF-MRA and US had a high incidence of debris during CAS. Thus, CAS using dual protection and blood aspiration is safe in patients with vulnerable plaques. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Disparities in Cardiac Rehabilitation Among Individuals from Racial and Ethnic Groups and Rural Communities-A Systematic Review.

PubMed

Castellanos, Luis R; Viramontes, Omar; Bains, Nainjot K; Zepeda, Ignacio A

2018-03-13

Despite the well-described benefits of cardiac rehabilitation (CR) on long-term health outcomes, CR is a resource that is underutilized by a significant proportion of patients that suffer from cardiovascular diseases. The main purpose of this study was to examine disparities in CR referral and participation rates among individuals from rural communities and racial and ethnic minority groups with coronary heart disease (CHD) when compared to the general population. A systematic search of standard databases including MedlLine, PubMed, and Cochrane databases was conducted using keywords that included cardiac rehabilitation, women, race and ethnicity, disparities, and rural populations. Twenty-eight clinical studies from 1990 to 2017 were selected and included 478,955 patients with CHD. The majority of available clinical studies showed significantly lower CR referral and participation rates among individuals from rural communities, women, and racial and ethnic groups when compared to the general population. Similar to geographic region, socioeconomic status (SES) appears to directly impact the use of CR programs. Patients of lower SES have significantly lower CR referral and participation rates than patients of higher SES. Data presented underscores the need for systematic referrals using electronic health records for patients with CHD in order to increase overall CR referral and participation rates of minority populations and other vulnerable groups. Educational programs that target healthcare provider biases towards racial and ethnic groups may help attenuate observed disparities. Alternative modalities such as home-based and internet-based CR programs may also help improve CR participation rates among vulnerable populations.

Methamphetamine use and dependence in vulnerable female populations.

PubMed

Kittirattanapaiboon, Phunnapa; Srikosai, Soontaree; Wittayanookulluk, Apisak

2017-07-01

The study reviews recent publications on methamphetamine use and dependence women in term of their epidemic, physical health impact, psychosocial impacts, and also in the identified vulnerable issues. Studies of vulnerable populations of women are wide ranging and include sex workers, sexual minorities, homeless, psychiatric patients, suburban women, and pregnant women, in which amphetamine type stimulants (ATSs) are the most commonly reported illicit drug used among them. The prenatal exposure of ATS demonstrated the small for gestational age and low birth weight; however, more research is needed on long-term studies of methamphetamine-exposed children. Intimate partner violence (IPV) is commonly reported by female methamphetamine users as perpetrators and victims. However, statistics and gendered power dynamics suggest that methamphetamine-related IPV indicates a higher chance of femicide. Methamphetamine-abusing women often have unresolved childhood trauma and are introduced to ATS through families or partners. Vulnerable populations of women at risk of methamphetamine abuse and dependence. Impacts on their physical and mental health, IPV, and pregnancy have been reported continuing, which guide that empowering and holistic substance abuse are necessary for specific group.

The effect of captopril and losartan on the electrophysiology of myocardial cells of myocardial ischemia rats.

PubMed

Shi, Xiangmin; Shan, Zhaoling; Yuan, Hongtao; Guo, Hongyang; Wang, Yutang

2014-01-01

This study aims to investigate the effect of captopril and losartan on the electrophysiology of myocardial cells parameters in ventricular vulnerable period and effective refractory period of myocardial ischemia rats. 96 wistar rats were enrolled in the study and divided into six groups: Captopril myocardial ischemia group, losartan myocardial ischemia group, myocardial ischemia control group, captopril normal group, losartan normal group and normal control group (n=16). We observed morphological changes of myocardial tissue in each group. The cardiac electrophysiological parameters in effective refractory period of each group were measured. Creatine kinase (CK), alanine aminotransferase (GOT), lactate dehydrogenase (LDH), the expression of Cardiotrophin 1 (CT-1) and malonaldehyde (MDA) were detected. Compared the losartan and captopril group with the control group, (P<0.05). Losartan and captopril can shorten the ventricular vulnerable period of the normal group and ischemic group. There was no interaction effect between losartan and captopril group and the acute myocardial ischemia group. The effect of losartan and captopril on time window in ventricular vulnerable period showed that compared with the control group (P<0.05). Losartan and captopril had a significant effect on prolonged effective refractory period of normal and ischemic rats. There was no interaction effect between losartan and captopril group and the acute myocardial ischemia group. Compared with the myocardial ischemia control group, CK, GOT, LDH and MDA decreased in captopril and losartan myocardial ischemia groups (P<0.05). Losartan and captopril had a significant effect on prolonged effective refractory period and shorten ventricular vulnerable period, they can also effectively prevent arrhythmias.

Policy reform to shift the health and human rights environment for vulnerable groups: the case of Kyrgyzstan's Instruction 417.

PubMed

Beletsky, Leo; Thomas, Rachel; Smelyanskaya, Marina; Artamonova, Irina; Shumskaya, Natalya; Dooronbekova, Aijan; Mukambetov, Aibek; Doyle, Heather; Tolson, Rebecca

2012-12-15

Police activities shape behavior and health outcomes among drug users, sex workers, and other vulnerable groups. Interventions to change the policing of drug consumption and sex work in ways that facilitate public health programming and respect for human rights have included policy reforms, education, and litigation. In 2009, the Kyrgyz government promulgated "Instruction 417," prohibiting police interference with "harm reduction" programs, re-enforcing citizen rights, addressing police occupational safety concerns, and institutionalizing police-public health collaboration. Although ample evidence points to gaps between intended and actual impact of policy and other structural interventions, there is little research on the impact of initiatives designed to align policing, health, and human rights. We conducted a police officer survey to assess links between Instruction 417 knowledge and legal and public health knowledge, attitudes towards harm reduction programs, and intended practices targeting vulnerable groups. In a 319-officer sample, 79% understood key due process regulations, 71.1% correctly characterized law on sex work, 54.3% understood syringe possession law, while only 44.4% reported familiarity with Instruction 417. Most (72.9%) expressed positive attitudes toward condom distribution, while only 56% viewed syringe access favorably. Almost half (44%) agreed that police should refer vulnerable groups to disease prevention programs, but only 20% reported doing so. In multivariate analysis, knowledge of Instruction 417 was associated with significantly better knowledge about (aOR=1.84, 95%CI: 1.12-3.00) and attitudes towards harm reduction programs (aOR=3.81, 95%CI:1.35-10.75), and knowledge of due process for the detention of sex workers (aOR=2.53, 95%CI:1.33-4.80). Younger, junior officers and those in rural areas may not be well-informed about the policy. While reflecting positively on Instruction 417 as a structural approach to aligning policing and public health, this analysis highlights gaps in policy dissemination and calls for further research to assess street-level impact of interventions on the health and human rights environment for vulnerable groups. Copyright © 2012 Beletsky et al. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Rural Parentage and Labor Market Disadvantage in a Sub-Saharan Setting: Sources and Trends

ERIC Educational Resources Information Center

Giroux, Sarah C.

2008-01-01

High unemployment in many developing countries is intensifying job competition and raising concern for the employment prospects of vulnerable groups, including children of rural parents. This paper examines the trends and sources in employment disadvantage associated with rural parentage in Cameroon. In documenting the sources of inequality, the…

Satanism as a Response to Abuse: The Dynamics and Treatment of Satanic Involvement in Male Youths.

ERIC Educational Resources Information Center

Belitz, Jerald; Schacht, Anita

1992-01-01

Asserts that male youths from abusive family environments may be particularly vulnerable to recruitment into satanic cults. Describes etiological factors and treatment approaches of 10 hospitalized boys who voluntarily involved themselves in repeated group satanic activities during their adolescence. Includes two case illustrations. Provides…

Ethical Challenges and Complexities of Including People with Intellectual Disability as Participants in Research

ERIC Educational Resources Information Center

Iacono, Teresa

2006-01-01

The aim of this article is to consider the implications for research involving people with intellectual disability--a vulnerable group--of ethics committees' attempts to apply these guidelines. The issue explored is whether committees such as Human Research Ethics Committees (HRECS) and Institutional Review Boards (IRBs) are becoming increasingly…

Discrimination and Good Practice Activities in Education: Trends and Developments in the 27 EU Member States

ERIC Educational Resources Information Center

Pollak, Alexander

2008-01-01

The European Union Agency for Fundamental Rights collects, through its network of observation points, information on discrimination and good practice in the areas of legislation, employment, housing, racist violence, and education. Data on education includes information on: access to education for vulnerable groups, discriminatory practices,…

Influencing health equity: role of the effective consumer scale in measuring skills and abilities in a middle income country.

PubMed

Rader, Tamara; Ueffing, Erin; Garcia-Elorrio, Ezequiel; Idzerda, Leanne; Ciapponi, Agustin; Irazola, Vilma; Welch, Vivian; Lyddiatt, Anne; Shea, Beverley; Newman, Stanton; Osborne, Richard; Tugwell, Peter S

2011-08-01

The 2008 World Health Report emphasizes the need for patient-centered primary care service delivery models in which patients are equal partners in the planning and management of their health. It is argued that this involvement will lead to improved management of disease, improved health outcomes and patient satisfaction, better informed decision-making, increased compliance with healthcare decisions, and better resource utilization. This article investigates the domains captured by the Effective Consumer Scale (EC-17) in relation to vulnerable population groups that experience health inequity. Particular focus is paid to the domain of health literacy as an area fundamental to patients' involvement in managing their condition and negotiating the healthcare system. In examining the possible influence of Outcome Measures in Rheumatology Clinical Trials (OMERACT) on health equity, we used the recent translation and validation of the EC-17 scale into Spanish and tested Argentina as an example. Future plans to use the EC-17 with vulnerable groups include formal collaboration and needs assessment with the community to tailor an intervention to meet its needs in a culturally relevant manner. Some systematic reviews have questioned whether interventions to improve effective consumer skills are appropriate in vulnerable populations. We propose that these populations may have the most to gain from such interventions since they might be expected to have relatively lower skills and health literacy than other groups.

[The Effects of a Health Mentoring Program in Community-dwelling Vulnerable Elderly Individuals with Diabetes].

PubMed

Sung, Ki Wol; Kang, Hye Seung; Nam, Ji Ran; Park, Mi Kyung; Park, Ji Hyeon

2018-04-01

This study aimed to estimate the effects of a health mentoring program on fasting blood sugar, total cholesterol, triglyceride, physical activity, self care behavior and social support changes among community-dwelling vulnerable elderly individuals with diabetes. A non-equivalent control group pre-post-test design was used. Participants were 70 community-dwelling vulnerable elderly individuals with diabetes. They were assigned to the experimental (n=30) or comparative (n=30) or control group (n=28). The experimental group participated in the health mentoring program, while the comparative group participated in health education program, the control group did not participate in any program. Data analyses involved a chi-square test, Fisher's exact test, a generalized linear model, and the Bonferroni correction, using SPSS 23.0. Compared to the control group, the experimental and comparative groups showed a significant decrease in fasting blood sugar, total cholesterol, and triglyceride. Compared to the comparative and control groups, the experimental group showed significant improvement in self care behavior. However, there were no statistical differences in physical activity or social support among the three groups. These findings indicate that the health mentoring program is an effective intervention for community-dwelling vulnerable elderly individuals with diabetes. This program can be used as an efficient strategy for diabetes self-management within this population. © 2018 Korean Society of Nursing Science.

The ethics of conducting a co-operative inquiry with vulnerable people.

PubMed

Tee, Stephen R; Lathlean, Judith A

2004-09-01

Mental health services users have been calling for greater participation in clinical research. Participation in this context means research 'with' rather than 'on' groups of people. Conducting a co-operative inquiry involving the participation of vulnerable individuals as co-researchers, in particular those with a history of mental health problems, places an obligation on researchers to articulate and justify sound ethical procedures. The aim of this paper is to consider how the ethical issues encountered when conducting participative research with vulnerable people can be addressed in the implementation of a co-operative inquiry with users of mental health services. The study was based on personal reflection and a critical review of associated literature obtained from a database search using Boolean logic. The findings, presented under the headings of the four prima facie moral principles, suggest the need for researchers using participative approaches to demonstrate the humanistic attributes required for engaging and working with people over a period of time. These include building and maintaining trusting relationships, assessing competence to participate, managing interpersonal and group dynamics and making complex collaborative decisions about participants' continued participation in a study. When using a co-operative inquiry approach involving vulnerable individuals, researchers need to demonstrate clearly how a balance between autonomy and paternalism will be achieved, how risks will be anticipated and managed and how fairness will be maintained throughout all procedures. Researchers using participative approaches need to have developed a level of personal insight and self-awareness through access to supervision which focuses on sources of unintended manipulation and interpersonal dynamics that may arise at the inception of a study and throughout its course. Researchers and ethics committees have a shared responsibility to ensure that vulnerable people are appropriately engaged to maintain the advancement of user knowledge which informs nursing practice.

Vulnerability of eco-environmental health to climate change: the views of government stakeholders and other specialists in Queensland, Australia.

PubMed

Strand, Linn B; Tong, Shilu; Aird, Rosemary; McRae, David

2010-07-28

There is overwhelming scientific evidence that human activities have changed and will continue to change the climate of the Earth. Eco-environmental health, which refers to the interdependencies between ecological systems and population health and well-being, is likely to be significantly influenced by climate change. The aim of this study was to examine perceptions from government stakeholders and other relevant specialists about the threat of climate change, their capacity to deal with it, and how to develop and implement a framework for assessing vulnerability of eco-environmental health to climate change. Two focus groups were conducted in Brisbane, Australia with representatives from relevant government agencies, non-governmental organisations, and the industry sector (n = 15) involved in the discussions. The participants were specialists on climate change and public health from governmental agencies, industry, and non-governmental organisations in South-East Queensland. The specialists perceived climate change to be a threat to eco-environmental health and had substantial knowledge about possible implications and impacts. A range of different methods for assessing vulnerability were suggested by the participants and the complexity of assessment when dealing with multiple hazards was acknowledged. Identified factors influencing vulnerability were perceived to be of a social, physical and/or economic nature. They included population growth, the ageing population with associated declines in general health and changes in the vulnerability of particular geographical areas due to for example, increased coastal development, and financial stress. Education, inter-sectoral collaboration, emergency management (e.g. development of early warning systems), and social networks were all emphasised as a basis for adapting to climate change. To develop a framework, different approaches were discussed for assessing eco-environmental health vulnerability, including literature reviews to examine the components of vulnerability such as natural hazard risk and exposure and to investigate already existing frameworks for assessing vulnerability. The study has addressed some important questions in regard to government stakeholders and other specialists' views on the threat of climate change and its potential impacts on eco-environmental health. These findings may have implications in climate change and public health decision-making.

Vulnerability of eco-environmental health to climate change: the views of government stakeholders and other specialists in Queensland, Australia

PubMed Central

2010-01-01

Background There is overwhelming scientific evidence that human activities have changed and will continue to change the climate of the Earth. Eco-environmental health, which refers to the interdependencies between ecological systems and population health and well-being, is likely to be significantly influenced by climate change. The aim of this study was to examine perceptions from government stakeholders and other relevant specialists about the threat of climate change, their capacity to deal with it, and how to develop and implement a framework for assessing vulnerability of eco-environmental health to climate change. Methods Two focus groups were conducted in Brisbane, Australia with representatives from relevant government agencies, non-governmental organisations, and the industry sector (n = 15) involved in the discussions. The participants were specialists on climate change and public health from governmental agencies, industry, and non-governmental organisations in South-East Queensland. Results The specialists perceived climate change to be a threat to eco-environmental health and had substantial knowledge about possible implications and impacts. A range of different methods for assessing vulnerability were suggested by the participants and the complexity of assessment when dealing with multiple hazards was acknowledged. Identified factors influencing vulnerability were perceived to be of a social, physical and/or economic nature. They included population growth, the ageing population with associated declines in general health and changes in the vulnerability of particular geographical areas due to for example, increased coastal development, and financial stress. Education, inter-sectoral collaboration, emergency management (e.g. development of early warning systems), and social networks were all emphasised as a basis for adapting to climate change. To develop a framework, different approaches were discussed for assessing eco-environmental health vulnerability, including literature reviews to examine the components of vulnerability such as natural hazard risk and exposure and to investigate already existing frameworks for assessing vulnerability. Conclusion The study has addressed some important questions in regard to government stakeholders and other specialists' views on the threat of climate change and its potential impacts on eco-environmental health. These findings may have implications in climate change and public health decision-making. PMID:20663227

Social media and gamification: Engaging vulnerable parents in an online evidence-based parenting program.

PubMed

Love, Susan M; Sanders, Matthew R; Turner, Karen M T; Maurange, Marianne; Knott, Theresa; Prinz, Ronald; Metzler, Carol; Ainsworth, Andrew T

2016-03-01

The aim of this study was to examine the feasibility (accessibility, engagement and impact) of adding social media and gaming features (e.g., social sharing with anonymity, badges to incentivize skills practice, an accredited facilitator for support) and access via smartphones to an evidenced-based parenting program, Triple P Online. The highly vulnerable population included 155 disadvantaged, high-risk parents (e.g., 76% had a family annual income of less than $15,000; 41% had been incarcerated; 38% were in drug/alcohol treatment; and 24% had had a child removed due to maltreatment). The ethnic groups most commonly identified were African American (24%) and Hispanic (66%). Respondents were primarily mothers (86%) from five community programs in Los Angeles. The study used a single group repeated measures design (pre, post, 6-month follow-up). Data collected included standardized self-report measures, post-intervention focus groups and interviews, website usage reports, and Google Analytics. Significant multivariate ANOVA time effects were found, demonstrating reductions in child behavioral problems, reduced lax/permissive and over-reactive parenting, and decreased parental stress. No effects were found for parental confidence, attributions, or depression and anxiety (which were in the normal range at baseline). Positive effects were maintained or improved at 6-month follow-up. The participants engaged in the online community and valued its flexibility, anonymity, and shared learning. This foundational implementation trial provides support for future rigorous evaluation of social media and gaming features as a medium for increasing parental engagement in evidence-based parenting programs online--a public health approach to protect and improve the development of vulnerable children. Copyright © 2016 Elsevier Ltd. All rights reserved.

Assessment of Yellow Fever Epidemic Risk: An Original Multi-criteria Modeling Approach

PubMed Central

Briand, Sylvie; Beresniak, Ariel; Nguyen, Tim; Yonli, Tajoua; Duru, Gerard; Kambire, Chantal; Perea, William

2009-01-01

Background Yellow fever (YF) virtually disappeared in francophone West African countries as a result of YF mass vaccination campaigns carried out between 1940 and 1953. However, because of the failure to continue mass vaccination campaigns, a resurgence of the deadly disease in many African countries began in the early 1980s. We developed an original modeling approach to assess YF epidemic risk (vulnerability) and to prioritize the populations to be vaccinated. Methods and Findings We chose a two-step assessment of vulnerability at district level consisting of a quantitative and qualitative assessment per country. Quantitative assessment starts with data collection on six risk factors: five risk factors associated with “exposure” to virus/vector and one with “susceptibility” of a district to YF epidemics. The multiple correspondence analysis (MCA) modeling method was specifically adapted to reduce the five exposure variables to one aggregated exposure indicator. Health districts were then projected onto a two-dimensional graph to define different levels of vulnerability. Districts are presented on risk maps for qualitative analysis in consensus groups, allowing the addition of factors, such as population migrations or vector density, that could not be included in MCA. The example of rural districts in Burkina Faso show five distinct clusters of risk profiles. Based on this assessment, 32 of 55 districts comprising over 7 million people were prioritized for preventive vaccination campaigns. Conclusion This assessment of yellow fever epidemic risk at the district level includes MCA modeling and consensus group modification. MCA provides a standardized way to reduce complexity. It supports an informed public health decision-making process that empowers local stakeholders through the consensus group. This original approach can be applied to any disease with documented risk factors. PMID:19597548

Assessment of yellow fever epidemic risk: an original multi-criteria modeling approach.

PubMed

Briand, Sylvie; Beresniak, Ariel; Nguyen, Tim; Yonli, Tajoua; Duru, Gerard; Kambire, Chantal; Perea, William

2009-07-14

Yellow fever (YF) virtually disappeared in francophone West African countries as a result of YF mass vaccination campaigns carried out between 1940 and 1953. However, because of the failure to continue mass vaccination campaigns, a resurgence of the deadly disease in many African countries began in the early 1980s. We developed an original modeling approach to assess YF epidemic risk (vulnerability) and to prioritize the populations to be vaccinated. We chose a two-step assessment of vulnerability at district level consisting of a quantitative and qualitative assessment per country. Quantitative assessment starts with data collection on six risk factors: five risk factors associated with "exposure" to virus/vector and one with "susceptibility" of a district to YF epidemics. The multiple correspondence analysis (MCA) modeling method was specifically adapted to reduce the five exposure variables to one aggregated exposure indicator. Health districts were then projected onto a two-dimensional graph to define different levels of vulnerability. Districts are presented on risk maps for qualitative analysis in consensus groups, allowing the addition of factors, such as population migrations or vector density, that could not be included in MCA. The example of rural districts in Burkina Faso show five distinct clusters of risk profiles. Based on this assessment, 32 of 55 districts comprising over 7 million people were prioritized for preventive vaccination campaigns. This assessment of yellow fever epidemic risk at the district level includes MCA modeling and consensus group modification. MCA provides a standardized way to reduce complexity. It supports an informed public health decision-making process that empowers local stakeholders through the consensus group. This original approach can be applied to any disease with documented risk factors.

The performance of social marketing in reaching the poor and vulnerable in AIDS control programmes.

PubMed

Price, N

2001-09-01

The article reviews evidence on the impact and effectiveness of condom social marketing programmes (CSMPs) in reaching the poor and vulnerable with information, services and products in the context of HIV/AIDS/STD prevention and control. Ideally, the success of CSMPs would be judged by whether they contribute to sustained improvements in sexual health outcomes at the population level. Given methodological and attribution difficulties, intermediary criteria are employed to assess effectiveness and impact, focusing on changes in behaviour (including condom use) among poor and vulnerable groups, and access by the poor and vulnerable to condoms, services and information. It remains difficult to reach definitive conclusions about the extent to which CSMPs meet the sexual health needs of the poor and vulnerable, due largely to reliance on sales data for CSMP monitoring and evaluation. CSMPs (like many health programme strategies) have traditionally collected little information on client profiles, health-seeking behaviour, condom use effectiveness, and supply-side issues. Recent data indicate that CSMPs are unlikely to be pro-poor in their early stages, in terms of the distribution of benefits, but as CSMPs mature, then inequities in access diminish, followed by reduced inequities in condom use. The paper assesses the extent to which social marketing is effective in improving access for the poor and vulnerable using a number of variables. In terms of economic access, it is evident that low-income groups are particularly sensitive to CSMP price increases, and that a cost-recovery focus excludes the poorest. Convenience is significantly improved for those who can afford to pay, and CSMPs appear to be addressing social and regulatory constraints to access. Conventional CSMP monitoring systems make it difficult to assess the effectiveness of behavioural change IEC strategies, although data on this dimension of the social marketing approach are beginning to emerge.

Adolescents' Exposure to Disasters and Substance Use.

PubMed

Schiff, Miriam; Fang, Lin

2016-06-01

This paper reviews the impact of exposure to man-made or natural disasters on adolescent substance use. It covers empirical studies published from 2005 to 2015 concerning (a) the scope of the problem, (b) vulnerable groups and risk and protective factors, and (c) evidence-based interventions. The review suggests a strong link between adolescent substance use and exposure to either man-made or natural disaster. Vulnerable groups include adolescents with previous exposure to traumatic events, living in areas that are continually exposed to disasters, and ethnic minorities. Risk and protective factors at the individual, familial, community, and societal levels are described based on the bioecological model of mass trauma. Given that mass trauma is unfortunately a global problem, it is important to establish international interdisciplinary working teams to set gold standards for comparative studies on the etiology for adolescent substance use in the context of disasters.

Livelihood Vulnerability Assessment Of Farmers and Nomads in Eastern Ecotone of Tibetan Plateau

NASA Astrophysics Data System (ADS)

Yan, J.; Zhang, Y.

2011-12-01

Livelihood vulnerability assessment provides a scientific basis for anti-poverty of people and regional sustainable development in vulnerable area. Although there are massive discussions on concept of vulnerability, it is still difficult to make it quantitative and to carry out comprehensive appraise. Vulnerability assessments based on sustainable livelihood frame are widely accepted in case studies for attentions to vulnerable groups. However, these case studies are always on regional scale and never reflect how climate change affects people's livelihood and adaptive capability of people. It is necessary to seek vulnerable assessment index system and means based on livelihood process of local people. This paper develops a livelihood vulnerability assessment index system on the basis of sustainable livelihood framework and appraises livelihood vulnerability values of 11 townships, using data of 879 sample households. Livelihood vulnerability assessment index system reflects main risks, livelihood assets and adaptation strategies of local people and government. The results show that livelihood vulnerability level of plateau region is higher than that of mountain to plateau region and mountain gorge region. Manzhang Township in plateau region is the most vulnerable township and nomads there cannot cope with risks of climate change, meadow degeneration and herbs degradation. Upper part of mountain to plateau region and the whole plateau region have high livelihood vulnerability values and local nomads would not cope with risks if no measures are taken by government. The driving forces of livelihood vulnerability include strikes of risks and deficiency of livelihood assets and adaptive capability. Farmers and nomads in high mountain gorge region and lower part of mountain to plateau region can cope with these risks, meanwhile, there are more employment opportunities in second and tertiary industries are needed to help them realize livelihood diversification. Therefore, plateau region and upper part of mountain to plateau region is vulnerable region and active steps should be taken by government to strengthen adaptive capabilities of farmers and nomads. Government relief should shift from improvement of natural assets to improvement of human assets and financial assets, such as technique training, hospitalization insurance, animal disease prevention and treatment, low interest or interest-free loan, restoring gazing areas to grassland in black beach, restoring other degraded pastures.

Methods and protocol of a mixed method quasi-experiment to evaluate the effects of a structural economic and food security intervention on HIV vulnerability in rural Malawi: The SAGE4Health Study.

PubMed

Weinhardt, Lance S; Galvao, Loren W; Mwenyekonde, Thokozani; Grande, Katarina M; Stevens, Patricia; Yan, Alice F; Mkandawire-Valhmu, Lucy; Masanjala, Winford; Kibicho, Jennifer; Ngui, Emmanuel; Emer, Lindsay; Watkins, Susan C

2014-01-01

Poverty and lack of a predictable, stable source of food are two fundamental determinants of ill health, including HIV/AIDS. Conversely, episodes of poor health and death from HIV can disrupt the ability to maintain economic stability in affected households, especially those that rely on subsistence farming. However, little empirical research has examined if, and how, improvements in people's economic status and food security translate into changes in HIV vulnerability. In this paper, we describe in detail the methods and protocol of an academic-NGO collaboration on a quasi-experimental, longitudinal study of the mechanisms and magnitude of the impact of a multilevel economic and food security program (Support to Able-Bodied Vulnerable Groups to Achieve Food Security; SAFE), as implemented by CARE. Primary outcomes include HIV vulnerability (i.e., HIV risk behaviors, HIV infection), economic status (i.e., income, household assets) and food security (including anthropometric measures). We recruited participants from two types of areas of rural central Malawi: traditional authorities (TA) selected by CARE to receive the SAFE program (intervention group) and TAs receiving other unrelated CARE programming (controls). In the intervention TAs, we recruited 598 program participants (398 women, 200 men) and interviewed them at baseline and 18- and 36-month follow-ups; we interviewed 301 control households. In addition, we conducted random surveys (n = 1002) in the intervention and control areas with a 36-month assessment interval, prior to and after implementation of SAFE. Thus, we are examining intervention outcomes both in direct SAFE program participants and their larger communities. We are using multilevel modeling to examine mediators and moderators of the effects of SAFE on HIV outcomes at the individual and community levels and determine the ways in which changes in HIV outcomes feed back into economic outcomes and food security at later interviews. Finally, we are conducting a qualitative end-of-program evaluation consisting of in-depth interviews with 90 SAFE participants. In addition to examining pathways linking structural factors to HIV vulnerability, this research will yield important information for understanding the impact of a multilevel environmental/structural intervention on HIV, with the potential for other sustainable long-term public health benefits.

Bird and bat species' global vulnerability to collision mortality at wind farms revealed through a trait-based assessment.

PubMed

Thaxter, Chris B; Buchanan, Graeme M; Carr, Jamie; Butchart, Stuart H M; Newbold, Tim; Green, Rhys E; Tobias, Joseph A; Foden, Wendy B; O'Brien, Sue; Pearce-Higgins, James W

2017-09-13

Mitigation of anthropogenic climate change involves deployments of renewable energy worldwide, including wind farms, which can pose a significant collision risk to volant animals. Most studies into the collision risk between species and wind turbines, however, have taken place in industrialized countries. Potential effects for many locations and species therefore remain unclear. To redress this gap, we conducted a systematic literature review of recorded collisions between birds and bats and wind turbines within developed countries. We related collision rate to species-level traits and turbine characteristics to quantify the potential vulnerability of 9538 bird and 888 bat species globally. Avian collision rate was affected by migratory strategy, dispersal distance and habitat associations, and bat collision rates were influenced by dispersal distance. For birds and bats, larger turbine capacity (megawatts) increased collision rates; however, deploying a smaller number of large turbines with greater energy output reduced total collision risk per unit energy output, although bat mortality increased again with the largest turbines. Areas with high concentrations of vulnerable species were also identified, including migration corridors. Our results can therefore guide wind farm design and location to reduce the risk of large-scale animal mortality. This is the first quantitative global assessment of the relative collision vulnerability of species groups with wind turbines, providing valuable guidance for minimizing potentially serious negative impacts on biodiversity. © 2017 The Author(s).

Socioeconomic Status, Race/Ethnicity, and Diurnal Cortisol Trajectories in Middle-Aged and Older Adults.

PubMed

Samuel, Laura J; Roth, David L; Schwartz, Brian S; Thorpe, Roland J; Glass, Thomas A

2018-03-02

Slow afternoon cortisol decline may be a marker of aging. We hypothesize that lower socioeconomic status (SES) and African American race are associated with lower waking cortisol and slower afternoon decline. Six salivary cortisol samples, collected within a 24-hr period from 566 cohort participants aged 56-78 years, were examined in random-effects models. SES measures included socioeconomic vulnerability (household income and assets <500% of poverty) and education (≥college, some college, and ≤high school). African Americans were compared with all others. Adjusting for age and sex, intermediate, but not low, education was associated with approximately 17% lower average waking cortisol and 1% slower decline, compared with high education. Socioeconomic vulnerability was not associated with waking cortisol or linear decline. Accounting for African American race/ethnicity, socioeconomic vulnerability was associated with a 3% faster decline, and education was not associated with cortisol. African Americans had 26% lower average waking cortisol and 1% slower decline than others. African American race/ethnicity, but not lower SES, was associated with lower waking cortisol and slower afternoon decline in middle-aged and older adults. This pattern is likely a marker of earlier biological aging in vulnerable groups. Race/ethnicity may compete with SES as a measure of cumulative vulnerability.

Prefrontal vulnerabilities and whole brain connectivity in aging and depression.

PubMed

Lamar, Melissa; Charlton, Rebecca A; Ajilore, Olusola; Zhang, Aifeng; Yang, Shaolin; Barrick, Thomas R; Rhodes, Emma; Kumar, Anand

2013-07-01

Studies exploring the underpinnings of age-related neurodegeneration suggest fronto-limbic alterations that are increasingly vulnerable in the presence of disease including late life depression. Less work has assessed the impact of this specific vulnerability on widespread brain circuitry. Seventy-nine older adults (healthy controls=45; late life depression=34) completed translational tasks shown in non-human primates to rely on fronto-limbic networks involving dorsolateral (Self-Ordered Pointing Task) or orbitofrontal (Object Alternation Task) cortices. A sub-sample of participants also completed diffusion tensor imaging for white matter tract quantification (uncinate and cingulum bundle; n=58) and whole brain tract-based spatial statistics (n=62). Despite task associations to specific white matter tracts across both groups, only healthy controls demonstrated significant correlations between widespread tract integrity and cognition. Thus, increasing Object Alternation Task errors were associated with decreasing fractional anisotropy in the uncinate in late life depression; however, only in healthy controls was the uncinate incorporated into a larger network of white matter vulnerability associating fractional anisotropy with Object Alternation Task errors using whole brain tract-based spatial statistics. It appears that the whole brain impact of specific fronto-limbic vulnerabilities in aging may be eclipsed in the presence of disease-specific neuropathology like that seen in late life depression. Copyright © 2013 Elsevier Ltd. All rights reserved.

Drivers and Pattern of Social Vulnerability to Flood in Metropolitan Lagos, Nigeria

NASA Astrophysics Data System (ADS)

Fasona, M.

2016-12-01

Lagos is Africa's second largest city and a city-state in southwest Nigeria. Population and economic activities in the city are concentrated in the greater Lagos metropolitan area - a group of barrier islands less than a thousand square kilometer. Several physical factors and critical human-environmental conditions contribute to high flood vulnerability across the city. Flood impact is highly denominated and the poor tend to suffer more due to higher risk of exposure and poor adaptive capacity. In this study we present the pattern of social vulnerability to flooding across the Lagos metropolis and argued that the pattern substantially reflects the pattern and severity of flooding impact on people across the metropolis. Twenty nine social indicators and experiences including poverty profile, housing conditions, education, population and demography, social network, and communication, among others, were considered. The data were collated through field survey and subjected to principal component analysis. The results were processed into raster surfaces using GIS for social vulnerability characterization at neighborhood levels. The results suggest the social status indicators, neighborhood standing and social networks indictors, the indicators of emergency responses and security, and the neighborhood conditions, in that order, are the most important determinants of social vulnerability. Six of the 16 LGAs in metropolitan Lagos have high social vulnerability. Neighborhoods that combine poor social status indicators and poor neighborhood standing and social networks are found to have high social vulnerability whereas other poor neighborhoods with strong social networks performed better. We conclude that improved human living condition and social network and communication in poor urban neighborhoods are important to reducing social vulnerability to flooding in the metropolis.

An Analysis of the Extent of Social Inclusion and Equity Consideration in Malawi's National HIV and AIDS Policy Review Process.

PubMed

Chinyama, Mathews Junior; MacLachlan, Malcolm; McVeigh, Joanne; Huss, Tessy; Gawamadzi, Sylvester

2017-07-29

Equity and social inclusion for vulnerable groups in policy development processes and resulting documents remain a challenge globally. Most often, the marginalization of vulnerable groups is overlooked in both the planning and practice of health service delivery. Such marginalization may occur because authorities deem the targeting of those who already have better access to healthcare a cheaper and easier way to achieve short-term health gains. The Government of Malawi wishes to achieve an equitable and inclusive HIV and AIDS Policy. The aim of this study is to assess the extent to which the Malawi Policy review process addressed regional and international health priorities of equity and social inclusion for vulnerable groups in the policy content and policy revision process. This research design comprised two phases. First, the content of the Malawi HIV and AIDS Policy was assessed using EquiFrame regarding its coverage of 21 Core Concepts of human rights and inclusion of 12 Vulnerable Groups. Second, the engagement of vulnerable groups in the policy process was assessed using the EquIPP matrix. For the latter, 10 interviews were conducted with a purposive sample of representatives of public sector, civil society organizations and development partners who participated in the policy revision process. Data was also collected from documented information of the policy processes. Our analyses indicated that the Malawi HIV and AIDS Policy had a relatively high coverage of Core Concepts of human rights and Vulnerable Groups; although with some notable omissions. The analyses also found that reasonable steps were taken to engage and promote participation of vulnerable groups in the planning, development, implementation, monitoring and evaluation processes of the HIV and AIDS Policy, although again, with some notable exceptions. This is the first study to use both EquiFrame and EquIPP as complimentary tools to assess the content and process of policy. While the findings indicate inclusive processes, commitment to Core Concepts of human rights and inclusion of Vulnerable Groups in relation to the Malawi HIV and AIDS Policy, the results also point to areas in which social inclusion and equity could be further strengthened. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Community interventions providing care and support to orphans and vulnerable children: a review of evaluation evidence.

PubMed

Schenk, Katie D

2009-07-01

Children affected by HIV in their families and communities face multiple risks to their health, education and psychosocial wellbeing. Community interventions for children who have been orphaned or rendered vulnerable take many forms, including educational assistance, home-based care, legal protection and psychosocial support. Despite a recent influx of funding for programme implementation, there exists little evidence to inform policymakers about whether their investments are improving the lives of vulnerable children and meeting key benchmarks including the Millennium Development Goals. This paper reviews the current evidence base on evaluations of community interventions for orphans and vulnerable children (OVC) in high HIV-prevalence African settings, focusing on studies' methodologies. Sources reviewed include published research studies and evidence from the unpublished programmatic "grey literature" located through database and internet searches. A total of 21 studies, varying in scope and generalisability, were identified. Interventions reviewed address children's wellbeing through various strategies within their communities. Evaluation methodologies reflect quantitative and qualitative approaches, including surveys (with and without baseline or comparison data), costing studies, focus groups, interviews, case studies, and participatory review techniques. Varied study methodologies reflect diverse research questions, various intervention types, and the challenges associated with evaluating complex interventions; highlighting the need to broaden the research paradigm in order to build the evidence base by including quasi-experimental and process evaluation approaches, and seeking further insights through participatory qualitative methodologies and costing studies. Although findings overall indicate the value of community interventions in effecting measurable improvements in child and family wellbeing, the quality and rigour of evidence is varied. A strategic research agenda is urgently needed to inform resource allocation and programme management decisions. Immediate imperatives include building local technical capacity to conduct quantitative and qualitative evaluation research, and strengthening monitoring and evaluation systems to collect process and outcome data (including costing) on key support models. Donors and implementers must support the collection of sound empirical evidence to inform the development and scale-up of OVC programmes.

Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations.

PubMed

Stevens, June; Pratt, Charlotte; Boyington, Josephine; Nelson, Cheryl; Truesdale, Kimberly P; Ward, Dianne S; Lytle, Leslie; Sherwood, Nancy E; Robinson, Thomas N; Moore, Shirley; Barkin, Shari; Cheung, Ying Kuen; Murray, David M

2017-01-01

The origins of obesity are complex and multifaceted. To be successful, an intervention aiming to prevent or treat obesity may need to address multiple layers of biological, social, and environmental influences. NIH recognizes the importance of identifying effective strategies to combat obesity, particularly in high-risk and disadvantaged populations with heightened susceptibility to obesity and subsequent metabolic sequelae. To move this work forward, the National Heart, Lung, and Blood Institute, in collaboration with the NIH Office of Behavioral and Social Science Research and NIH Office of Disease Prevention convened a working group to inform research on multilevel obesity interventions in vulnerable populations. The working group reviewed relevant aspects of intervention planning, recruitment, retention, implementation, evaluation, and analysis, and then made recommendations. Recruitment and retention techniques used in multilevel research must be culturally appropriate and suited to both individuals and organizations. Adequate time and resources for preliminary work are essential. Collaborative projects can benefit from complementary areas of expertise and shared investigations rigorously pretesting specific aspects of approaches. Study designs need to accommodate the social and environmental levels under study, and include appropriate attention given to statistical power. Projects should monitor implementation in the multiple venues and include a priori estimation of the magnitude of change expected within and across levels. The complexity and challenges of delivering interventions at several levels of the social-ecologic model require careful planning and implementation, but hold promise for successful reduction of obesity in vulnerable populations. Copyright © 2016. Published by Elsevier Inc.

Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations

PubMed Central

Stevens, June; Pratt, Charlotte; Boyington, Josephine; Nelson, Cheryl; Truesdale, Kimberly P.; Ward, Dianne S.; Lytle, Leslie; Sherwood, Nancy E.; Robinson, Thomas N.; Moore, Shirley; Barkin, Shari; Cheung, Ying Kuen; Murray, David M.

2017-01-01

Introduction The origins of obesity are complex and multifaceted. To be successful, an intervention aiming to prevent or treat obesity may need to address multiple layers of biological, social, and environmental influences. Methods NIH recognizes the importance of identifying effective strategies to combat obesity, particularly in high-risk and disadvantaged populations with heightened susceptibility to obesity and subsequent metabolic sequelae. To move this work forward, the National Heart, Lung, and Blood Institute, in collaboration with the NIH Office of Behavioral and Social Science Research and NIH Office of Disease Prevention convened a working group to inform research on multilevel obesity interventions in vulnerable populations. The working group reviewed relevant aspects of intervention planning, recruitment, retention, implementation, evaluation, and analysis, and then made recommendations. Results Recruitment and retention techniques used in multilevel research must be culturally appropriate and suited to both individuals and organizations. Adequate time and resources for preliminary work are essential. Collaborative projects can benefit from complementary areas of expertise and shared investigations rigorously pretesting specific aspects of approaches. Study designs need to accommodate the social and environmental levels under study, and include appropriate attention given to statistical power. Projects should monitor implementation in the multiple venues and include a priori estimation of the magnitude of change expected within and across levels. Conclusions The complexity and challenges of delivering interventions at several levels of the social—ecologic model require careful planning and implementation, but hold promise for successful reduction of obesity in vulnerable populations. PMID:28340973

Intimate Partner Violence Is As Important As Client violence in Increasing Street-based Female Sex Workers’ Vulnerability to HIV in India

PubMed Central

Panchanadeswaran, Subadra; Johnson, Sethulakshmi C.; Sivaram, Sudha; Srikrishnan, A.K.; Latkin, Carl; Bentley, Margaret E.; Solomon, Suniti; Go, Vivian F.; Celentano, David

2008-01-01

Objectives There are no studies that examine street-based female sex workers’ vulnerability to HIV from both clients and intimate partners. This study documents street-based female sex workers’ experiences of client and intimate partners, examines the intersections of violence, alcohol use in condom use, and highlights survival strategies used to avert harm. Methods Ethnographic data were collected from 49 female sex workers though focus group discussions and in-depth interviews. Results Female sex workers experienced multifarious forms of severe client and intimate partner violence. Sexual coercion and forced group sex in the context of alcohol use posed formidable barriers for condom use negotiation. Further, traditional gender norms dictated women’s inabilities to negotiate condom-use with intimate partners. However, there was evidence of adoption of successful survival strategies in the face of danger and women’s positive evaluations of the benefits of sex work and their contributions to family well-being. Conclusions Harm reduction efforts with female sex workers need to account for their vulnerability to HIV from intimate partners in addition to clients. HIV prevention programmes need to include male clients in order to reduce harm among street-based female sex workers. There is an urgent need to build on sex workers’ strengths and involve them in designing individual level, community, and structural interventions that could help in reducing women’s vulnerability to intimate partner violence and HIV in India. PMID:18187314

Motivation to serve in the military influences vulnerability to future posttraumatic stress disorder.

PubMed

Kaplan, Zeev; Weiser, Mark; Reichenberg, Abraham; Rabinowitz, Jonathan; Caspi, Asaf; Bodner, Ehud; Zohar, Joseph

2002-01-31

High motivation and belief in a cause have been reported to be protective against posttraumatic stress disorder (PTSD), while below-average intellectual functioning and poor educational achievements have been reported to increase vulnerability to PTSD. The main goal of this study was to assess the effect of education, and intellectual and behavioral functioning on the risk for future PTSD. Data collected before exposure to trauma, on intellectual and behavioral functioning, and educational achievements of 901 male Israeli adolescents who had performed pre-induction screening tests by the Israeli Draft Board, and were later diagnosed with PTSD, were compared with a control group of adolescents who were not later diagnosed with PTSD. Future PTSD patients had significantly lower intelligence, fewer years of formal education and lower scores on a scale assessing motivation to serve in the military, in comparison with the control group, with effect sizes (ES) ranging from 0.14-0.34. In contrast, future PTSD patients scored significantly higher on a scale assessing social functioning, ES=0.13. However, when controlling for the differences in motivation to serve, all of these differences disappeared. In this cohort, although slightly below average intellectual functioning and formal education, and better social functioning, independently increased vulnerability to suffer from PTSD, these associations disappeared when the future PTSD patients' lower motivation to serve in the military was included in the analysis. This suggests that low motivation to serve in the military might increase vulnerability for PTSD.

[The vulnerability of the human atrium. I. Correlations between vulnerability, sinus node recovery time and intraatrial conduction time (author's transl)].

PubMed

Pop, T; Fleischmann, D; Effert, S

1976-09-01

Using the extrastimulus method in 100 patients, premature impulses were applied during the relative refractory period of the right atrium. Depending on the atrial response to these impulses we divided our patients in the following 3 groups: Group A: no repetitive firing (61 patients); group B: 1 to 5 additional atrial extrasystoles with a total duration of maximum 1.5 s (27 patients); group C: runs of atrial flutter or fibrilation for at least 8 s (12 patients). The statistical analysis of the following parameters: age, PA interval, absolute and corrected sinus node recovery time did not show any significant difference between the 3 groups. These results suggest that the investigated parameters are of no great importance in the genesis of the atrial vulnerability.

Vulnerability assessment and risk perception: the case of the Arieş River Middle Basin

NASA Astrophysics Data System (ADS)

Ozunu, Al.; Botezan, C.

2012-04-01

Vulnerability assessment is influenced by a number of factors, including risk perception. This paper investigates the vulnerability of people living in the middle basin of the Aries river region, a former mining area, to natural and technologic hazards. The mining industry lead to significant environmental changes, which combined with the social problems caused by its decline (high unemployment rate, low income and old age) raised the level of the vulnerability in the area. This case study is unique, as it includes an evaluation of risk perception and its influence on the social vulnerability and resilience of local communities to disasters. Key words: vulnerability assessment, natural hazards, social vulnerability, risk perception

Identifying typical patterns of vulnerability: A 5-step approach based on cluster analysis

NASA Astrophysics Data System (ADS)

Sietz, Diana; Lüdeke, Matthias; Kok, Marcel; Lucas, Paul; Carsten, Walther; Janssen, Peter

2013-04-01

Specific processes that shape the vulnerability of socio-ecological systems to climate, market and other stresses derive from diverse background conditions. Within the multitude of vulnerability-creating mechanisms, distinct processes recur in various regions inspiring research on typical patterns of vulnerability. The vulnerability patterns display typical combinations of the natural and socio-economic properties that shape a systems' vulnerability to particular stresses. Based on the identification of a limited number of vulnerability patterns, pattern analysis provides an efficient approach to improving our understanding of vulnerability and decision-making for vulnerability reduction. However, current pattern analyses often miss explicit descriptions of their methods and pay insufficient attention to the validity of their groupings. Therefore, the question arises as to how do we identify typical vulnerability patterns in order to enhance our understanding of a systems' vulnerability to stresses? A cluster-based pattern recognition applied at global and local levels is scrutinised with a focus on an applicable methodology and practicable insights. Taking the example of drylands, this presentation demonstrates the conditions necessary to identify typical vulnerability patterns. They are summarised in five methodological steps comprising the elicitation of relevant cause-effect hypotheses and the quantitative indication of mechanisms as well as an evaluation of robustness, a validation and a ranking of the identified patterns. Reflecting scale-dependent opportunities, a global study is able to support decision-making with insights into the up-scaling of interventions when available funds are limited. In contrast, local investigations encourage an outcome-based validation. This constitutes a crucial step in establishing the credibility of the patterns and hence their suitability for informing extension services and individual decisions. In this respect, working at the local level provides a clear advantage since, to a large extent, limitations in globally available observational data constrain such a validation on the global scale. Overall, the five steps are outlined in detail in order to facilitate and motivate the application of pattern recognition in other research studies concerned with vulnerability analysis, including future applications to different vulnerability frameworks. Such applications could promote the refinement of mechanisms in specific contexts and advance methodological adjustments. This would further increase the value of identifying typical patterns in the properties of socio-ecological systems for an improved understanding and management of the relation between these systems and particular stresses.

Assessing intrinsic and specific vulnerability models ability to indicate groundwater vulnerability to groups of similar pesticides: A comparative study

USGS Publications Warehouse

Douglas, Steven; Dixon, Barnali; Griffin, Dale W.

2018-01-01

With continued population growth and increasing use of fresh groundwater resources, protection of this valuable resource is critical. A cost effective means to assess risk of groundwater contamination potential will provide a useful tool to protect these resources. Integrating geospatial methods offers a means to quantify the risk of contaminant potential in cost effective and spatially explicit ways. This research was designed to compare the ability of intrinsic (DRASTIC) and specific (Attenuation Factor; AF) vulnerability models to indicate groundwater vulnerability areas by comparing model results to the presence of pesticides from groundwater sample datasets. A logistic regression was used to assess the relationship between the environmental variables and the presence or absence of pesticides within regions of varying vulnerability. According to the DRASTIC model, more than 20% of the study area is very highly vulnerable. Approximately 30% is very highly vulnerable according to the AF model. When groundwater concentrations of individual pesticides were compared to model predictions, the results were mixed. Model predictability improved when concentrations of the group of similar pesticides were compared to model results. Compared to the DRASTIC model, the AF model more accurately predicts the distribution of the number of contaminated wells within each vulnerability class.

Validation of a social vulnerability index in context to river-floods in Germany

NASA Astrophysics Data System (ADS)

Fekete, A.

2009-03-01

Social vulnerability indices are a means for generating information about people potentially affected by disasters that are e.g. triggered by river-floods. The purpose behind such an index is in this study the development and the validation of a social vulnerability map of population characteristics towards river-floods covering all counties in Germany. This map is based on a composite index of three main indicators for social vulnerability in Germany - fragility, socio-economic conditions and region. These indicators have been identified by a factor analysis of selected demographic variables obtained from federal statistical offices. Therefore, these indicators can be updated annually based on a reliable data source. The vulnerability patterns detected by the factor analysis are verified by using an independent second data set. The interpretation of the second data set shows that vulnerability is revealed by a real extreme flood event and demonstrates that the patterns of the presumed vulnerability match the observations of a real event. It comprises a survey of flood-affected households in three federal states. By using logistic regression, it is demonstrated that the theoretically presumed indications of vulnerability are correct and that the indicators are valid. It is shown that indeed certain social groups like the elderly, the financially weak or the urban residents are higher risk groups.

The VCOP Scale: A Measure of Overprotection in Parents of Physically Vulnerable Children.

ERIC Educational Resources Information Center

Wright, Logan; And Others

1993-01-01

Developed Vulnerable Child/Overprotecting Parent Scale to measure overprotecting versus optimal developmental stimulation tendencies for parents of physically vulnerable children. Items were administered to parents whose parenting techniques had been rated as either highly overprotective or as optimal by group of physicians and other…

Transforming vulnerability.

PubMed

Jones, Patricia S; Zhang, Xinwei Esther; Meleis, Afaf I

2003-11-01

Asian American immigrant women engaged in filial caregiving are at special risk for health problems due to complex contextual factors related to immigration, cultural traditions, and role transition. This study examines the experience of two groups of immigrant Asian American women who are caring for older parents. A total of 41 women (22 Chinese American and 19 Filipino American) were interviewed in a study based on Strauss and Corbin's grounded theory methodology. The women were determined to be loyal to their traditional culture, which included strong filial values, while adapting to a new culture. Through the struggle of meeting role expectations and coping with paradox, the women mobilized personal and family resources to transform vulnerability into strength and well-being.

Quantitative assessment of Vulnerability of Forest ecosystem to Climate Change in Korea

NASA Astrophysics Data System (ADS)

Byun, J.; Lee, W.; Choi, S.; Oh, S.; Climate Change Model Team

2011-12-01

The purpose of this study was to assess the vulnerability of forest ecosystem to climate change in Korea using outputs of vegetation models(HyTAG and MC1) and socio-ecological indicators. Also it suggested adaptation strategies in forest management through analysis of three vulnerability components: exposure, sensitivity and adaptive capacity. For the model simulation of past years(1971-2000), the climatic data was prepared by the Korea Meteorological Administration(KMA). In addition, for the future simulation, the Fifth-Generation NCAR/Penn State Mesoscale Model(MM5) coupling with atmosphere-ocean circulation model(ECHO-G) provide the future climatic data under the A1B scenarios. HyTAG (Hydrological and Thermal Analogy Groups), korean model of forest distribution on a regional-scale, could show extent of sensitivity and adaptive capacity in connection with changing frequency and changing direction of vegetation. MC1 model could provide variation and direction of NPP(Net Primary Production) and SCS(Soil Carbon Storage). In addition, the sensitivity and adaptation capacity were evaluated for each. Besides indicators from models, many other indicators such as financial affairs and number of officers were included in the vulnerability components. As a result of the vulnerability assessment, south western part and Je-ju island of Korea had relatively high vulnerability. This finding is considered to come from a distinctively adaptative capacity. Using these results, we could propose actions against climate change and develop decision making systems on forest management.

Ranking terrestrial vertebrate species for utility in biomonitoring and vulnerability to environmental contaminants

USGS Publications Warehouse

Golden, N.H.; Rattner, B.A.

2003-01-01

The measurement of contaminant tissue concentrations or exposure-related effects in biota has been used extensively to monitor pollution and environmental health. Terrestrial vertebrates have historically been an important group of species in such evaluations, not only because many are excellent sentinels of environmental contamination, but also because they are valued natural resources in their own right that may be adversely affected by toxicant exposure. Selection of appropriate vertebrates for biomonitoring studies frequently relies on expert opinion, although a few rigorous schemes are in use for predicting vulnerability of birds to the adverse effects of petroleum crude oil. A Utility Index that ranks terrestrial vertebrate species as potential sentinels of contaminants in a region, and a Vulnerability Index that assesses the threat of specific groups of contaminants to these species, have been developed to assist decision makers in risk assessments of persistent organic pollutants, cholinesterase-inhibiting pesticides, petroleum crude oil, mercury, and lead shot. Twenty-five terrestrial vertebrate species commonly found in Atlantic Coast estuarine habitat were ranked for their utility as biomonitors of contamination and their vulnerability to pollutants in this region. No single species, taxa or class of vertebrates was found to be an ideal sentinel for all groups of contaminants. Although birds have overwhelmingly been used to monitor contaminants compared to other terrestrial vertebrate classes, the non-migratory nature and dietary habits of the snapping turtle and mink consistently resulted in ranking these species excellent sentinels as well. Vulnerability of Atlantic Coast populations of these species varied considerably among groups of contaminants. Usually a particular species was found to be at high risk to only one or two groups of contaminants, although a noteworthy exception is the bald eagle that is highly vulnerable to all five of the contaminant groups examined. This index could be further enhanced by generation of additional comparative toxicity data to facilitate interspecific extrapolations. The Utility and Vulnerability Indices have application to many types of habitat types in addition to estuaries, and are of value to natural resource and risk managers that routinely conduct local, regional or national environmental quality assessments.

How Should We Treat the Vulnerable?: Qualitative Study of Authoritative Ethics Documents.

PubMed

Zagorac, Ivana

2016-01-01

The aim of this study is to explore what actual guidance is provided by authoritative ethics documents regarding the recognition and protection of the vulnerable. The documents included in this analysis are the Belmont Report, the Declaration of Helsinki, The Council for International Organizations of Medical Sciences (CIOMS) Guidelines, and the UNESCO Universal Declaration on Bioethics and Human Rights, including its supplementary report on vulnerability. A qualitative analysis of these documents was conducted in light of three questions: what is vulnerability, who are the vulnerable, and how should the vulnerable be protected? The results show significant differences among the documents regarding the first two questions. None of the documents provides any guidance on the third question (how to protect the vulnerable). These results suggest a great discrepancy between the acknowledged importance of the concept of vulnerability and a general understanding of the scope, content, and practical implications of vulnerability.

Measuring Sexual Violence on Campus: Climate Surveys and Vulnerable Groups

ERIC Educational Resources Information Center

de Heer, Brooke; Jones, Lynn

2017-01-01

Since the 2014 "Not Alone" report on campus sexual assault, the use of climate surveys to measure sexual violence on campuses across the United States has increased considerably. The current study utilizes a quasi meta-analysis approach to examine the utility of general campus climate surveys, which include a measure of sexual violence,…

Better Safe than Sorry: Panic Buttons as a Security Measure in an Academic Medical Library

ERIC Educational Resources Information Center

McMullen, Karen D.; Kane, Laura Townsend

2008-01-01

In the wake of recent tragedies, campus security has become a hot issue nationwide. Campus libraries, as traditional meeting spots for varied groups of people, are particularly vulnerable to security issues. Safety and security problems that can occur at any library generally include theft, vandalism, arson, antisocial behavior, and assaults on…

75 FR 62841 - Award of a Single-Source Grant to Chapin Hall at the University of Chicago, Chicago, IL

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-13

... the child-only Temporary Assistance for Needy Families (TANF) client population. Chapin Hall's... and more detailed picture of the TANF child-only caseload, including the dynamics of client entry and..., to gather policy information about a vulnerable and important ACF client group. OPRE will administer...

Can We Use Young People's Knowledge to Develop Teachers and HIV-Related Education?

ERIC Educational Resources Information Center

McLaughlin, Colleen; Swartz, Sharlene

2011-01-01

Despite recent progress in meeting the goals of the Education for All agenda, certain groups of young people are particularly vulnerable to exclusion and underachievement, including children with HIV/AIDS, children living in poverty, and children with disabilities. HIV/AIDS has reduced many young people's rights to access education, to live a full…

Social Determinants of Health, Disaster Vulnerability, Severe and Morbid Obesity in Adults: Triple Jeopardy?

PubMed Central

2017-01-01

Severe and morbid obesity are associated with highly elevated risks of adverse health outcomes and the prevalence of severe obesity is increasing globally. To date, disaster literature has not considered severe and morbid obesity as a specific vulnerability, despite reports of people being left behind during disasters because of their body size, shape or weight. The complex causes of obesity are associated with the social determinants of health and one’s potential vulnerability to disasters. The absence of appropriate considerations may lead to people being exposed to disproportionate and potentially avoidable risk. The intersection of the social determinants of health, disaster vulnerability, severe and morbid obesity is explored. Previously identified vulnerable groups are also represented in severe and morbid obesity data. This poses the prospect for ‘triple jeopardy’ compounding the social determinants of health, disaster vulnerability and considerations with and for people with morbid obesity. When working to reduce disaster risk for vulnerable groups, the author proposes specific consideration is required to ensure ‘all-of-society engagement and partnership’ in an inclusive, accessible and non-discriminatory manner, to ensure no one is left behind.

Extending Vulnerability Assessment to Include Life Stages Considerations

PubMed Central

Hodgson, Emma E.; Essington, Timothy E.; Kaplan, Isaac C.

2016-01-01

Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill–Euphausia pacifica and Thysanoessa spinifera, pteropod–Limacina helicina, pink shrimp–Pandalus jordani, Dungeness crab–Metacarcinus magister and Pacific hake–Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species’ vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate. PMID:27416031

Extending Vulnerability Assessment to Include Life Stages Considerations.

PubMed

Hodgson, Emma E; Essington, Timothy E; Kaplan, Isaac C

2016-01-01

Species are experiencing a suite of novel stressors from anthropogenic activities that have impacts at multiple scales. Vulnerability assessment is one tool to evaluate the likely impacts that these stressors pose to species so that high-vulnerability cases can be identified and prioritized for monitoring, protection, or mitigation. Commonly used semi-quantitative methods lack a framework to explicitly account for differences in exposure to stressors and organism responses across life stages. Here we propose a modification to commonly used spatial vulnerability assessment methods that includes such an approach, using ocean acidification in the California Current as an illustrative case study. Life stage considerations were included by assessing vulnerability of each life stage to ocean acidification and were used to estimate population vulnerability in two ways. We set population vulnerability equal to: (1) the maximum stage vulnerability and (2) a weighted mean across all stages, with weights calculated using Lefkovitch matrix models. Vulnerability was found to vary across life stages for the six species explored in this case study: two krill-Euphausia pacifica and Thysanoessa spinifera, pteropod-Limacina helicina, pink shrimp-Pandalus jordani, Dungeness crab-Metacarcinus magister and Pacific hake-Merluccius productus. The maximum vulnerability estimates ranged from larval to subadult and adult stages with no consistent stage having maximum vulnerability across species. Similarly, integrated vulnerability metrics varied greatly across species. A comparison showed that some species had vulnerabilities that were similar between the two metrics, while other species' vulnerabilities varied substantially between the two metrics. These differences primarily resulted from cases where the most vulnerable stage had a low relative weight. We compare these methods and explore circumstances where each method may be appropriate.

MAHILA: a protocol for evaluating a nurse-delivered mHealth intervention for women with HIV and psychosocial risk factors in India.

PubMed

Reynolds, Nancy R; Satyanarayana, Veena; Duggal, Mona; Varghese, Meiya; Liberti, Lauren; Singh, Pushpendra; Ranganathan, Mohini; Jeon, Sangchoon; Chandra, Prabha S

2016-08-04

Women living with HIV are vulnerable to a variety of psychosocial barriers that limit access and adherence to treatment. There is little evidence supporting interventions for improving access and treatment adherence among vulnerable groups of women in low- and middle-income countries. The M obile Phone-Based A pproach for H ealth I mprovement, L iteracy and A dherence (MAHILA) trial is assessing the feasibility, acceptability and preliminary efficacy of a novel, theory-guided mobile health intervention delivered by nurses for enhancing self-care and treatment adherence among HIV-infected women in India. Women (n = 120) with HIV infection who screen positive for depressive symptoms and/or other psychosocial vulnerabilities are randomly assigned in equal numbers to one of two treatment arms: treatment as usual plus the mobile phone intervention (experimental group) or treatment as usual (control group). In addition to treatment as usual, the experimental group receives nurse-delivered self-care counselling via mobile phone at fixed intervals over 16 weeks. Outcome measures are collected at baseline and at 4, 12, 24 and 36 weeks post-baseline. Outcomes include antiretroviral treatment adherence, HIV-1 RNA, depressive symptoms, illness perceptions, internalized stigma and quality of life. The MAHILA trial will provide information about how a mobile health counselling intervention delivered by non specialist nurses may improve access to care and support the adherence and clinical outcomes of women with HIV infection living in low- and middle-income countries such as India. NCT02319330 (First received: July 30, 2014; Last verified: January 2016).

[Immunization and equity in the Regional Initiative of the Mesoamerican Health Initiative].

PubMed

Franco-Paredes, Carlos; Hernández-Ramos, Isabel; Santos-Preciado, José Ignacio

2011-01-01

National immunization rates indicate high vaccine coverage in Mesoamerica, but there is growing evidence that the most vulnerable groups are not being reached by immunization programs. Therefore, there is likely low effective vaccine coverage in the region, leading to persistent and growing health inequity. The planning phase of this project was from June to December 2009. The project will be conducted in the target populations which includes children under five, pregnant women, and women of child-bearing age from the most vulnerable populations within countries of the Mesoamerican region, as indicated geographically by a low human development index (HDI) and/or high prevalence of poverty at the municipal level and through the use of participatory methods to define poverty and vulnerability in local contexts. We defined three lines of action for vaccine-preventable disease interventions: 1) pilot projects to fill gaps in knowledge; 2) strengthening immunization policy; and 3) implementation of evidence-based practices. Health system strengthening through health equity is the central regional objective of the immunization workgroup. We hope to have a transformational impact on health systems so as to improve effective coverage, including vaccine and other integrated primary healthcare services.

Does topological information matter for power grid vulnerability?

PubMed

Ouyang, Min; Yang, Kun

2014-12-01

Power grids, which are playing an important role in supporting the economy of a region as well as the life of its citizens, could be attacked by terrorists or enemies to damage the region. Depending on different levels of power grid information collected by the terrorists, their attack strategies might be different. This paper groups power grid information into four levels: no information, purely topological information (PTI), topological information with generator and load nodes (GLNI), and full information (including component physical properties and flow parameters information), and then identifies possible attack strategies for each information level. Analyzing and comparing power grid vulnerability under these attack strategies from both terrorists' and utility companies' point of view give rise to an approach to quantify the relative values of these three types of information, including PTI, GLNI, and component parameter information (CPI). This approach can provide information regarding the extent to which topological information matters for power system vulnerability decisions. Taking several test systems as examples, results show that for small attacks with p ≤ 0.1, CPI matters the most; when taking attack cost into consideration and assuming that the terrorists take the optimum cost-efficient attack intensity, then CPI has the largest cost-based information value.

Does topological information matter for power grid vulnerability?

NASA Astrophysics Data System (ADS)

Ouyang, Min; Yang, Kun

2014-12-01

Power grids, which are playing an important role in supporting the economy of a region as well as the life of its citizens, could be attacked by terrorists or enemies to damage the region. Depending on different levels of power grid information collected by the terrorists, their attack strategies might be different. This paper groups power grid information into four levels: no information, purely topological information (PTI), topological information with generator and load nodes (GLNI), and full information (including component physical properties and flow parameters information), and then identifies possible attack strategies for each information level. Analyzing and comparing power grid vulnerability under these attack strategies from both terrorists' and utility companies' point of view give rise to an approach to quantify the relative values of these three types of information, including PTI, GLNI, and component parameter information (CPI). This approach can provide information regarding the extent to which topological information matters for power system vulnerability decisions. Taking several test systems as examples, results show that for small attacks with p ≤ 0.1, CPI matters the most; when taking attack cost into consideration and assuming that the terrorists take the optimum cost-efficient attack intensity, then CPI has the largest cost-based information value.

Vulnerability of Coastal Communities from Storm Surge and Flood Disasters

PubMed Central

Bathi, Jejal Reddy; Das, Himangshu S.

2016-01-01

Disasters in the form of coastal storms and hurricanes can be very destructive. Preparing for anticipated effects of such disasters can help reduce the public health and economic burden. Identifying vulnerable population groups can help prioritize resources for the most needed communities. This paper presents a quantitative framework for vulnerability measurement that incorporates both socioeconomic and flood inundation vulnerability. The approach is demonstrated for three coastal communities in Mississippi with census tracts being the study unit. The vulnerability results are illustrated as thematic maps for easy usage by planners and emergency responders to assist in prioritizing their actions to vulnerable populations during storm surge and flood disasters. PMID:26907313

Vulnerability to heatwaves and implications for public health interventions - A scoping review.

PubMed

Mayrhuber, Elisabeth Anne-Sophie; Dückers, Michel L A; Wallner, Peter; Arnberger, Arne; Allex, Brigitte; Wiesböck, Laura; Wanka, Anna; Kolland, Franz; Eder, Renate; Hutter, Hans-Peter; Kutalek, Ruth

2018-05-31

Heatwaves form a serious public health threat, especially for vulnerable groups. Interventions such as active outreach programs, exposure reduction measures and monitoring and mapping of at-risk groups are increasingly implemented across the world but little is known about their effect. To assess how vulnerable groups are identified and reached in heat health interventions, to understand the effectiveness and efficiency of those interventions, and to identify research gaps in existing literature. We performed a literature search in relevant scientific literature databases and searched with a four element search model for articles published from 1995 onward. We extracted data on intervention measures, target group and evaluation of effectiveness and efficiency. We identified 23 eligible studies. Patterns exist in type of interventions 1) to detect and 2) to influence extrinsic and intrinsic risk and protective factors. Results showed several intervention barriers related to the variety and intersection of these factors, as well as the self-perception of vulnerable groups, and misconceptions and unfavorable attitudes towards intervention benefits. While modest indications for the evidence on the effectiveness of interventions were found, efficiency remains unclear. Interventions entailed logical combinations of measures, subsumed as packages. Evidence for effective and efficient intervention is limited by the difficulty to determine effects and because single measures are mutually dependent. Interventions prioritized promoting behavioral change and were based on behavioral assumptions that remain untested and mechanisms not worked out explicitly. Multifaceted efforts are needed to tailor interventions, compiled in heat health warning systems and action plans for exposure reduction and protection of vulnerable populations, to fit the social, economic and geographical context. Besides adequately addressing relevant risk and protective factors, the challenge is to integrate perspectives of vulnerable groups. Future research should focus on intervention barriers and improving the methods of effectiveness and efficiency evaluation. Copyright © 2018 Elsevier Inc. All rights reserved.

Spatial-explicit modeling of social vulnerability to malaria in East Africa

PubMed Central

2014-01-01

Background Despite efforts in eradication and control, malaria remains a global challenge, particularly affecting vulnerable groups. Despite the recession in malaria cases, previously malaria free areas are increasingly confronted with epidemics as a result of changing environmental and socioeconomic conditions. Next to modeling transmission intensities and probabilities, integrated spatial methods targeting the complex interplay of factors that contribute to social vulnerability are required to effectively reduce malaria burden. We propose an integrative method for mapping relative levels of social vulnerability in a spatially explicit manner to support the identification of intervention measures. Methods Based on a literature review, a holistic risk and vulnerability framework has been developed to guide the assessment of social vulnerability to water-related vector-borne diseases (VBDs) in the context of changing environmental and societal conditions. Building on the framework, this paper applies spatially explicit modeling for delineating homogeneous regions of social vulnerability to malaria in eastern Africa, while taking into account expert knowledge for weighting the single vulnerability indicators. To assess the influence of the selected indicators on the final index a local sensitivity analysis is carried out. Results Results indicate that high levels of malaria vulnerability are concentrated in the highlands, where immunity within the population is currently low. Additionally, regions with a lack of access to education and health services aggravate vulnerability. Lower values can be found in regions with relatively low poverty, low population pressure, low conflict density and reduced contributions from the biological susceptibility domain. Overall, the factors characterizing vulnerability vary spatially in the region. The vulnerability index reveals a high level of robustness in regard to the final choice of input datasets, with the exception of the immunity indicator which has a marked impact on the composite vulnerability index. Conclusions We introduce a conceptual framework for modeling risk and vulnerability to VBDs. Drawing on the framework we modeled social vulnerability to malaria in the context of global change using a spatially explicit approach. The results provide decision makers with place-specific options for targeting interventions that aim at reducing the burden of the disease amongst the different vulnerable population groups. PMID:25127688

Hierarchical statistical modeling of xylem vulnerability to cavitation.

PubMed

Ogle, Kiona; Barber, Jarrett J; Willson, Cynthia; Thompson, Brenda

2009-01-01

Cavitation of xylem elements diminishes the water transport capacity of plants, and quantifying xylem vulnerability to cavitation is important to understanding plant function. Current approaches to analyzing hydraulic conductivity (K) data to infer vulnerability to cavitation suffer from problems such as the use of potentially unrealistic vulnerability curves, difficulty interpreting parameters in these curves, a statistical framework that ignores sampling design, and an overly simplistic view of uncertainty. This study illustrates how two common curves (exponential-sigmoid and Weibull) can be reparameterized in terms of meaningful parameters: maximum conductivity (k(sat)), water potential (-P) at which percentage loss of conductivity (PLC) =X% (P(X)), and the slope of the PLC curve at P(X) (S(X)), a 'sensitivity' index. We provide a hierarchical Bayesian method for fitting the reparameterized curves to K(H) data. We illustrate the method using data for roots and stems of two populations of Juniperus scopulorum and test for differences in k(sat), P(X), and S(X) between different groups. Two important results emerge from this study. First, the Weibull model is preferred because it produces biologically realistic estimates of PLC near P = 0 MPa. Second, stochastic embolisms contribute an important source of uncertainty that should be included in such analyses.

Adolescents from families of divorce: vulnerability to physiological and psychological disturbances.

PubMed

Thompson, P

1998-03-01

Multiple factors contribute to the vulnerability of adolescents to physiological and psychological disturbances following parental divorce. These include father absence, interparental conflict, economic distress, multiple life stressors, parent adjustment, and short-term crisis. Clinical and societal problems manifested in these vulnerable adolescents are discussed. Systems theory is used to explain this vulnerability of adolescents and to identify appropriate interventions and policies to promote health in this population. Policies recommended include required divorce mediation, early referrals for family and sibling therapy, and school programs to identify and support those most vulnerable.

Lack of evidence on mental health and well-being impacts of individual-level interventions for vulnerable adolescents: systematic mapping review.

PubMed

Vojt, G; Skivington, K; Sweeting, H; Campbell, M; Fenton, C; Thomson, H

2018-05-30

To review empirical evaluations of individual-level interventions intended to improve mental health or well-being for vulnerable adolescents. This is a systematic mapping review. Thirteen databases covering academic and gray literature were searched for published reviews and randomised controlled trials, and gray literature (2005-2016) and the results quality-assessed to prioritise best available evidence. We aimed to identify well-conducted systematic reviews and trials that evaluated individual-level interventions, for mental health/well-being outcomes, where the population was adolescents aged 10-24 years in any of 12 vulnerable groups at high risk of poor health outcomes (e.g. homeless, offenders, 'looked after', carers). Thirty systematic reviews and 16 additional trials were identified. There was insufficient evidence to identify promising individual-level interventions that improve the mental health/well-being of any of the vulnerable groups. Despite Western policy to promote health and well-being among vulnerable young people, the dearth of evidence suggests a lack of interest in evaluating interventions targeting these groups in respect of their mental health/well-being outcomes. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Psychosocial Vulnerability Among Patients Contacting a Norwegian Sexual Assault Center.

PubMed

Vik, Bjarte Frode; Nöttestad, Jim Aage; Schei, Berit; Rasmussen, Kirsten; Hagemann, Cecilie Therese

2016-07-01

In this study, the objective was to assess the occurrence of specific vulnerability factors among adult and adolescent females attending a Norwegian sexual assault center (SAC). We also explored assault characteristics and investigated whether these characteristics differed between the group of patients with vulnerability factors compared with the group without such factors. We conducted a retrospective descriptive study of 573 women ≥ 12 years of age attending the SAC at St. Olavs Hospital, Trondheim, Norway, between July 1, 2003 and December 31, 2010. A patient was considered vulnerable if at least one of the following features was present: intellectual or physical disability; history of present/former mental health problems; history of present/former alcohol/substance abuse; or former sexual assault. At least one vulnerability factor was present in 59% of the cases. More than one vulnerability factor was present in 29%. Reporting at least one vulnerability factor was associated with a higher patient age, unemployment, a higher frequency of reported light/moderate physical violence, and the documentation of minor body injury. In contrast, those without vulnerability more often were students assaulted during night time, by a casual or stranger assailant and reporting a higher intake of alcohol prior to the assault. There are obvious patterns of differences in the nature of sexual assaults reported among victims with specific vulnerability factors compared with victims without these factors. Future research should address these differences and possible solutions for better protection of especially vulnerable individuals against sexual offenses, such as those with mental health and substance abuse difficulties.

Vulnerability of Oyster Resource Users to Ecological Change: Case Study from Terrebonne Parish, Louisiana

NASA Astrophysics Data System (ADS)

Humphries, A.; La Peyre, M.; Hall, S.; Dowty Beech, R.

2016-02-01

Knowledge of vulnerability provides the foundation for developing actions that minimize impacts on people while maximizing the sustainability of ecosystem goods and services including fisheries. As a result, it is becoming increasingly important to determine if resource-dependent people are vulnerable to ecological change as anthropogenic and climate-induced stressors affect resources in different ways. In coastal Louisiana, the current era of rapid marsh loss and abrupt environmental variation (e.g., sediment diversions) has the potential to undermine oyster-associated livelihoods for those most vulnerable. To evaluate vulnerability, we examined dimensions of social sensitivity and adaptive capacity using semi-structured interviews with three stakeholder groups in the oyster fishery of Terrebonne Parish, Louisiana. Results indicate that oyster owners/operators are highly dependent, and thus sensitive, to changes in the ecological conditions of the fishery due to high levels of occupational identity; however they are likely adaptable, reflected in their willingness to learn about new practices and evolve over time. In contrast, oyster fishers that do not own any portion of the business in which they operate are bad at coping with change and frequently hold negative or fatalistic views on financial planning. Overall, oyster resource users most vulnerable to ecological change will be those with high levels of stewardship, open-minded values, and a balanced perception of environment, as well as low to moderate levels of personal and financial buffers and trust. These results suggest that resource users with higher sensitivity to change are not necessarily most vulnerable because sensitivity may be offset by adaptive capacity. In other words, while sensitivity may determine the potential impact of a climate- or human-induced ecological change to the oyster fishery, adaptive capacity can be a major influence on what impacts actually eventuate.

The effectiveness of tobacco control policies on vulnerable populations in the USA: a review.

PubMed

Vijayaraghavan, Maya; Schroeder, Steven A; Kushel, Margot

2016-09-22

Despite population-wide efforts to reduce tobacco use, low-income populations in the USA have much higher rates of tobacco use compared with the general population. The principal components of tobacco control policies in the USA include cigarette taxes, clean indoor air laws and comprehensive interventions to increase access to tobacco cessation services. In this review, we describe the effectiveness of these policies and interventions in reducing tobacco use among vulnerable populations, focusing on persons with mental health disorders and substance use disorders, persons who have experienced incarceration or homelessness, and low-income tenants of public housing. We discuss the challenges that evolving tobacco and nicotine products pose to tobacco control efforts. We conclude by highlighting the clinical implications of treating tobacco dependence in healthcare settings that serve vulnerable populations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The Occurrence and Prevention of Foodborne Disease in Vulnerable People

PubMed Central

O'Brien, Sarah J.

2011-01-01

Abstract In developed countries, such as the United Kingdom and the United States, between 15% and 20% of the population show greater susceptibility than the general population to foodborne disease. This proportion includes people with primary immunodeficiency, patients treated with radiation or with immunosuppressive drugs for cancer and diseases of the immune system, those with acquired immune-deficiency syndrome and diabetics, people suffering from liver or kidney disease or with excessive iron in the blood, pregnant women, infants, and the elderly. Malnutrition and use of antacids, particularly proton-pump inhibitors, also increase susceptibility. We review the occurrence of infection by foodborne pathogens in these groups of people and measures to prevent infection. The nature and use of low microbial diets to reduce the risk of foodborne disease in immunocompromised patients are very variable. Diets for vulnerable people in care should exclude higher-risk foods, and vulnerable people in the community should receive clear advice about food safety, in particular avoidance of higher-risk foods and substitution of safer, nutritious foods. PMID:21561383

[Vulnerability and health problems while traveling: the viewpoint of the tourist in the city of Rio de Janeiro].

PubMed

Matos, Vanina; Barcellos, Christovam; Camargo, Luiz Octávio de Lima

2013-01-01

This article examines how a group of tourists perceives health issues related to safety, prevention and health care during their travels. Interviews were conducted with Brazilian tourists visiting the city of Rio de Janeiro, as well as local residents leaving the city on trips. The interviews were analyzed in accordance with the dimensions of vulnerability, information, prevention and health care, from which vulnerability emerged as a category of analysis. The reports of the trajectory of the tourists made it possible to identify problems and opportunities that could be used by the health sector for actions of prevention and promotion. The means of transport determines the trajectory of tourists and their security alternatives. Traveling in groups and visiting tourist attractions are seen as protective factors, which reinforces the role of information and social support networks as resources used by tourists in the absence of specific policies geared to this highly mobile and vulnerable population group.

Characterization of Vulnerable and Resilient Spanish Adolescents in Their Developmental Contexts

PubMed Central

Moreno, Carmen; García-Moya, Irene; Rivera, Francisco; Ramos, Pilar

2016-01-01

Research on resilience and vulnerability can offer very valuable information for optimizing design and assessment of interventions and policies aimed at fostering adolescent health. This paper used the adversity level associated with family functioning and the positive adaptation level, as measured by means of a global health score, to distinguish four groups within a representative sample of Spanish adolescents aged 13–16 years: maladaptive, resilient, competent and vulnerable. The aforementioned groups were compared in a number of demographic, school context, peer context, lifestyles, psychological and socioeconomic variables, which can facilitate or inhibit positive adaptation in each context. In addition, the degree to which each factor tended to associate with resilience and vulnerability was examined. The majority of the factors operated by increasing the likelihood of good adaptation in resilient adolescents and diminishing it in vulnerable ones. Overall, more similarities than differences were found in the factors contributing to explaining resilience or vulnerability. However, results also revealed some differential aspects: psychological variables showed a larger explicative capacity in vulnerable adolescents, whereas factors related to school and peer contexts, especially the second, showed a stronger association with resilience. In addition, perceived family wealth, satisfaction with friendships and breakfast frequency only made a significant contribution to the explanation of resilience. The current study provides a highly useful characterization of resilience and vulnerability phenomena in adolescence. PMID:27458397

Vulnerability to shocks in the global seafood trade network

NASA Astrophysics Data System (ADS)

Gephart, Jessica A.; Rovenskaya, Elena; Dieckmann, Ulf; Pace, Michael L.; Brännström, Åke

2016-03-01

Trade can allow countries to overcome local or regional losses (shocks) to their food supply, but reliance on international food trade also exposes countries to risks from external perturbations. Countries that are nutritionally or economically dependent on international trade of a commodity may be adversely affected by such shocks. While exposure to shocks has been studied in financial markets, communication networks, and some infrastructure systems, it has received less attention in food-trade networks. Here, we develop a forward shock-propagation model to quantify how trade flows are redistributed under a range of shock scenarios and assess the food-security outcomes by comparing changes in national fish supplies to indices of each country’s nutritional fish dependency. Shock propagation and distribution among regions are modeled on a network of historical bilateral seafood trade data from UN Comtrade using 205 reporting territories grouped into 18 regions. In our model exposure to shocks increases with total imports and the number of import partners. We find that Central and West Africa are the most vulnerable to shocks, with their vulnerability increasing when a willingness-to-pay proxy is included. These findings suggest that countries can reduce their overall vulnerability to shocks by reducing reliance on imports and diversifying food sources. As international seafood trade grows, identifying these types of potential risks and vulnerabilities is important to build a more resilient food system.

The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

PubMed Central

Løberg, Else-Marie; Helle, Siri; Nygård, Merethe; Berle, Jan Øystein; Kroken, Rune A.; Johnsen, Erik

2014-01-01

There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical findings PMID:25477825

Effects of discontinuing a high-fat diet on mitochondrial proteins and 6-hydroxydopamine-induced dopamine depletion in rats.

PubMed

Ma, Delin; Shuler, Jeffrey M; Raider, Kayla D; Rogers, Robert S; Wheatley, Joshua L; Geiger, Paige C; Stanford, John A

2015-07-10

Diet-induced obesity can increase the risk for developing age-related neurodegenerative diseases including Parkinson's disease (PD). Increasing evidence suggests that mitochondrial and proteasomal mechanisms are involved in both insulin resistance and PD. The goal of this study was to determine whether diet intervention could influence mitochondrial or proteasomal protein expression and vulnerability to 6-Hydroxydopamine (6-OHDA)-induced nigrostriatal dopamine (DA) depletion in rats' nigrostriatal system. After a 3 month high-fat diet regimen, we switched one group of rats to a low-fat diet for 3 months (HF-LF group), while the other half continued with the high-fat diet (HF group). A chow group was included as a control. Three weeks after unilateral 6-OHDA lesions, HF rats had higher fasting insulin levels and higher Homeostasis model assessment of insulin resistance (HOMA-IR), indicating insulin resistance. HOMA-IR was significantly lower in HF-LF rats than HF rats, indicating that insulin resistance was reversed by switching to a low-fat diet. Compared to the Chow group, the HF group exhibited significantly greater DA depletion in the substantia nigra but not in the striatum. DA depletion did not differ between the HF-LF and HF group. Proteins related to mitochondrial function (such as AMPK, PGC-1α), and to proteasomal function (such as TCF11/Nrf1) were influenced by diet intervention, or by 6-OHDA lesion. Our findings suggest that switching to a low-fat diet reverses the effects of a high-fat diet on systemic insulin resistance, and mitochondrial and proteasomal function in the striatum. Conversely, they suggest that the effects of the high-fat diet on nigrostriatal vulnerability to 6-OHDA-induced DA depletion persist. Copyright © 2015 Elsevier B.V. All rights reserved.

Cognitive style, personality and vulnerability to postnatal depression.

PubMed

Jones, Lisa; Scott, Jan; Cooper, Caroline; Forty, Liz; Smith, Katherine Gordon; Sham, Pak; Farmer, Anne; McGuffin, Peter; Craddock, Nick; Jones, Ian

2010-03-01

Only some women with recurrent major depressive disorder experience postnatal episodes. Personality and/or cognitive styles might increase the likelihood of experiencing postnatal depression. To establish whether personality and cognitive style predicts vulnerability to postnatal episodes over and above their known relationship to depression in general. We compared personality and cognitive style in women with recurrent major depressive disorder who had experienced one or more postnatal episodes (postnatal depression (PND) group, n=143) with healthy female controls (control group, n=173). We also examined parous women with recurrent major depressive disorder who experienced no perinatal episodes (non-postnatal depression (NPND) group, n=131). The PND group had higher levels of neuroticism and dysfunctional beliefs, and lower self-esteem than the control group. However, there were no significant differences between the PND and NPND groups. Established personality and cognitive vulnerabilities for depression were reported by women with a history of postnatal depression, but there was no evidence that any of these traits or styles confer a specific risk for the postnatal onset of episodes.

Depression vulnerable and nonvulnerable smokers after a failure experience: examining cognitive self-regulation and motivation.

PubMed

Scott, Walter D; Beevers, Christopher G; Mermelstein, Robin J

2008-07-01

The present study extended previous tests of cognitive priming theories of depression by examining cognitive self-regulatory, motivational, and affective functioning of depression-vulnerable and nonvulnerable individuals after a failure experience. Participants were enrolled in a clinic-based smoking cessation program that consisted of seven group meetings. Major findings show that compared to the nonvulnerable group, depression-vulnerable individuals were less motivated to quit and experienced more negative affect, but only after a failure to quit smoking. However, after controlling for actual smoking rate, depression-vulnerable individuals did not evaluate their success any more negatively, nor did they indicate lower self-efficacy for quitting. Results are discussed in terms of cognitive self-regulatory and affect temperament models of motivation and depression.

Meta-Synthesis of Literacy for the Empowerment of Vulnerable Groups

ERIC Educational Resources Information Center

Camilli-Trujillo, Celia; Römer-Pieretti, Max

2017-01-01

The vulnerability translates in concrete human groups that, although they know what occurs around them in a digital matter, by his own social and cultural condition they are alienated and, in this sense, away of the exercise of the information right. The aim has been to analyze the critical, media and digital literacy for the empowerment of…

'These are not luxuries, it is essential for access to life': Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa.

PubMed

Hanass-Hancock, Jill; Nene, Siphumelele; Deghaye, Nicola; Pillay, Simmi

2017-01-01

With the dawn of the new sustainable development goals, we face not only a world that has seen great successes in alleviating poverty but also a world that has left some groups, such as persons with disabilities, behind. Middle-income countries (MICs) are home to a growing number of persons with disabilities. As these countries strive to achieve the new goals, we have ample opportunity to include persons with disabilities in the emerging poverty alleviation strategies. However, a lack of data and research on the linkages between economic vulnerability and disability in MICs hampers our understanding of the factors increasing economic vulnerability in people with disabilities. This article aims to present data related to elements of this vulnerability in one MIC, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs. A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices. The development of poverty alleviation and social protection mechanisms in MICs like South Africa needs to better consider diverse disability-related care and support needs not only to improve access to services such as education and health (National Health Insurance schemes, accessible clinics) but also to increase the effect of disability-specific benefits and employment equity policies.

Understanding factors influencing vulnerable older people keeping warm and well in winter: a qualitative study using social marketing techniques

PubMed Central

Lusambili, Adelaide; Homer, Catherine; Abbott, Joanne; Cooke, Joanne Mary; Stocks, Amanda Jayne; McDaid, Kathleen Anne

2012-01-01

Objectives To understand the influences and decisions of vulnerable older people in relation to keeping warm in winter. Design A qualitative study incorporating in-depth, semi-structured individual and group interviews, framework analysis and social marketing segmentation techniques. Setting Rotherham, South Yorkshire, UK. Participants 50 older people (>55) and 25 health and social care staff underwent individual interview. The older people also had household temperature measurements. 24 older people and 19 health and social care staff participated in one of the six group interviews. Results Multiple complex factors emerged to explain whether vulnerable older people were able to keep warm. These influences combined in various ways that meant older people were not able to or preferred not to access help or change home heating behaviour. Factors influencing behaviours and decisions relating to use of heating, spending money, accessing cheaper tariffs, accessing benefits or asking for help fell into three main categories. These were situational and contextual factors, attitudes and values, and barriers. Barriers included poor knowledge and awareness, technology, disjointed systems and the invisibility of fuel and fuel payment. Findings formed the basis of a social marketing segmentation model used to develop six pen portraits that illustrated how factors that conspire against older people being able to keep warm. Conclusions The findings illustrate how and why vulnerable older people may be at risk of a cold home. The pen portraits provide an accessible vehicle and reflective tool to raise the capacity of the NHS in responding to their needs in line with the Cold Weather Plan. PMID:22798252

Understanding factors influencing vulnerable older people keeping warm and well in winter: a qualitative study using social marketing techniques.

PubMed

Tod, Angela Mary; Lusambili, Adelaide; Homer, Catherine; Abbott, Joanne; Cooke, Joanne Mary; Stocks, Amanda Jayne; McDaid, Kathleen Anne

2012-01-01

To understand the influences and decisions of vulnerable older people in relation to keeping warm in winter. A qualitative study incorporating in-depth, semi-structured individual and group interviews, framework analysis and social marketing segmentation techniques. Rotherham, South Yorkshire, UK. 50 older people (>55) and 25 health and social care staff underwent individual interview. The older people also had household temperature measurements. 24 older people and 19 health and social care staff participated in one of the six group interviews. Multiple complex factors emerged to explain whether vulnerable older people were able to keep warm. These influences combined in various ways that meant older people were not able to or preferred not to access help or change home heating behaviour. Factors influencing behaviours and decisions relating to use of heating, spending money, accessing cheaper tariffs, accessing benefits or asking for help fell into three main categories. These were situational and contextual factors, attitudes and values, and barriers. Barriers included poor knowledge and awareness, technology, disjointed systems and the invisibility of fuel and fuel payment. Findings formed the basis of a social marketing segmentation model used to develop six pen portraits that illustrated how factors that conspire against older people being able to keep warm. The findings illustrate how and why vulnerable older people may be at risk of a cold home. The pen portraits provide an accessible vehicle and reflective tool to raise the capacity of the NHS in responding to their needs in line with the Cold Weather Plan.

Science Center Public Forums: Engaging Lay-Publics in Resilience Deliberations Through Informal Science Education

NASA Astrophysics Data System (ADS)

Sittenfeld, D.; Choi, F.; Farooque, M.; Helmuth, B.

2017-12-01

Because climate hazards present a range of potential impacts and considerations for different kinds of stakeholders, community responses to increase resilience are best considered through the inclusion of diverse, informed perspectives. The Science Center Public Forums project has created multifaceted modules to engage diverse publics in substantive deliberations around four hazards: heat waves, drought, extreme precipitation, and sea level rise. Using a suite of background materials including visualization and narrative components, each of these daylong dialogues engage varied groups of lay-participants at eight US science centers in learning about hazard vulnerabilities and tradeoffs of proposed strategies for building resilience. Participants listen to and consider the priorities and perspectives of fellow residents and stakeholders, and work together to formulate detailed resilience plans reflecting both current science and informed public values. Deliverables for the project include visualizations of hazard vulnerabilities and strategies through immersive planetarium graphics and Google Earth, stakeholder perspective narratives, and detailed background materials for each project hazard. This session will: communicate the process for developing the hazard modules with input from subject matter experts, outline the process for iterative revisions based upon findings from formative focus groups, share results generated by participants of the project's first two pilot forums, and describe plans for broader implementation. These activities and outcomes could help to increase the capacity of informal science education institutions as trusted conveners for informed community dialogue by educating residents about vulnerabilities and engaging them in critical thinking about potential policy responses to critical climate hazards while sharing usable public values and priorities with civic planners.

How Researchers Define Vulnerable Populations in HIV/AIDS Clinical Trials

PubMed Central

Lo, Bernard; Strauss, Ronald P.; Eron, Joseph; Gifford, Allen L.

2010-01-01

In this study, we interviewed researchers, asking them to define vulnerable populations in HIV/AIDS clinical trials, and provide feedback on the federal regulations for three vulnerable populations. Interview data informed a conceptual framework, and were content analyzed to identify acceptability or disagreement with the regulations. Beginning with several characteristics of vulnerable enrollees identified by researchers, the conceptual framework illustrates possible scenarios of how enrollees could be considered vulnerable in clinical research. Content analysis identified barriers affecting HIV/AIDS researchers’ ability to conduct clinical trials with pregnant women, prisoners, and children, for which the regulations specify additional protections. This study challenges current thinking about federal regulations’ group-based approach to defining vulnerable populations. PMID:20721614

Getting the Message: Intuition and Reflexivity in Professional Interpretations of Non-Verbal Behaviours in People with Profound Learning Disabilities

ERIC Educational Resources Information Center

Phelvin, Andrew

2013-01-01

This paper describes the current challenges facing nurses and other professionals who care for people with profound and multiple intellectual disabilities. This particularly vulnerable group of service users often rely on a repertoire of non-verbal behaviours to communicate their needs and wishes. These challenges include the requirements of…

Pregnant adolescents living with HIV: what we know, what we need to know, where we need to go.

PubMed

Callahan, Tegan; Modi, Surbhi; Swanson, Jennifer; Ng'eno, Bernadette; Broyles, Laura N

2017-08-04

HIV-infected pregnant and breastfeeding adolescents are a particularly vulnerable group that require special attention and enhanced support to achieve optimal maternal and infant outcomes. The objective of this paper is to review published evidence about antenatal care (ANC) service delivery and outcomes for HIV-infected pregnant adolescents in low-income country settings, identify gaps in knowledge and programme services and highlight the way forward to improve clinical outcomes of this vulnerable group. Emerging data from programmes in sub-Saharan Africa highlight that HIV-infected pregnant adolescents have poorer prevention of mother-to-child HIV transmission (PMTCT) service outcomes, including lower PMTCT service uptake, compared to HIV-infected pregnant adults. In addition, the limited evidence available suggests that there may be higher rates of mother-to-child HIV transmission among infants of HIV-infected pregnant adolescents. While the reasons for the inferior outcomes among adolescents in ANC need to be further explored and addressed, there is sufficient evidence that immediate operational changes are needed to address the unique needs of this population. Such changes could include integration of adolescent-friendly services into PMTCT settings or targeting HIV-infected pregnant adolescents with enhanced retention and follow-up activities.

Preparing for pandemic influenza.

PubMed

Rebmann, Terri

2008-01-01

Influenza is a highly contagious, acute febrile respiratory illness that results in global morbidity and mortality annually. Avian influenza (H5N1) has the potential to cause a pandemic. Avian influenza's epidemiology and clinical description, including common signs/symptoms, transmission, vaccination, and treatment, are presented. Recommended isolation practices for labor and delivery, and proper procedures for identifying and managing infected patients are provided. Potential maternal and newborn outcomes related to influenza and avian influenza are discussed. Pandemic planning issues are outlined, including hospital surge capacity, medical equipment and staffing availability, and the need for altered standards of care. Communities need to designate sites (whether in hospital or in alternative care centers) for labor and delivery services as part of their disaster plan. Pregnant women and newborns are vulnerable groups during routine times and are expected to be disproportionately affected during a pandemic in terms of morbidity and mortality. Therefore, it is essential that hospitals and communities take steps to protect these vulnerable groups as part of the disaster planning process. It is not known whether or when a pandemic will occur, but perinatal and neonatal nurses should become familiar with avian influenza's clinical description and proper infection control procedures to halt potential disease spread.

Environmental Health Related Socio-Spatial Inequalities: Identifying “Hotspots” of Environmental Burdens and Social Vulnerability

PubMed Central

Shrestha, Rehana; Flacke, Johannes; Martinez, Javier; van Maarseveen, Martin

2016-01-01

Differential exposure to multiple environmental burdens and benefits and their distribution across a population with varying vulnerability can contribute heavily to health inequalities. Particularly relevant are areas with high cumulative burdens and high social vulnerability termed as “hotspots”. This paper develops an index-based approach to assess these multiple burdens and benefits in combination with vulnerability factors at detailed intra-urban level. The method is applied to the city of Dortmund, Germany. Using non-spatial and spatial methods we assessed inequalities and identified “hotspot” areas in the city. We found modest inequalities burdening higher vulnerable groups in Dortmund (CI = −0.020 at p < 0.05). At the detailed intra-urban level, however, inequalities showed strong geographical patterns. Large numbers of “hotspots” exist in the northern part of the city compared to the southern part. A holistic assessment, particularly at a detailed local level, considering both environmental burdens and benefits and their distribution across the population with the different vulnerability, is essential to inform environmental justice debates and to mobilize local stakeholders. Locating “hotspot” areas at this detailed spatial level can serve as a basis to develop interventions that target vulnerable groups to ensure a health conducive equal environment. PMID:27409625

49 CFR 15.5 - Sensitive security information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... requirements of Federal law. (5) Vulnerability assessments. Any vulnerability assessment directed, created... security requirements of Federal law that could reveal a security vulnerability, including the identity of... Guard responsible for conducting vulnerability assessments, security boardings, or engaged in operations...

Rich, white, and vulnerable: rethinking oppressive socialization in the euthanasia debate.

PubMed

Krag, Erik

2014-08-01

Anita Silvers (1998) has criticized those who argue that members of marginalized groups are vulnerable to a special threat posed by physician-assisted suicide (PAS) and voluntary active euthanasia (VAE). She argues that paternalistic measures prohibiting PAS/VAE in order to protect these groups only serve to marginalize them further by characterizing them as belonging to a definitively weak class. I offer a new conception of vulnerability, one that demonstrates how rich, educated, white males, who are typically regarded as having their autonomy enhanced by their social status, are just as, if not more, vulnerable to threats posed by PAS/VAE as a result of the harmful social messages at work just below the surface of contemporary Western culture. I use this new conception of vulnerability to reinforce arguments for continued statutory prohibitions on PAS/VAE. © The Author 2014. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Recognizing Risk and Vulnerability in Research Ethics: Imagining the "What Ifs?"

PubMed

Peter, Elizabeth; Friedland, Judith

2017-04-01

Research ethics committees (RECs) may misunderstand the vulnerability of participants, given their distance from the field. What RECs identify as the vulnerabilities that were not adequately recognized in protocols and how they attempt to protect the perceived vulnerability of participants and mitigate risks were examined using the response letters sent to researchers by three university-based RECs. Using a critical qualitative method informed by feminist ethics, we identified an overarching theme of recognizing and responding to cascading vulnerabilities and four subthemes: identifying vulnerable groups, recognizing potentially risky research, imagining the "what ifs," and mitigating perceived risks. An ethics approach that is up-close, as opposed to distant, is needed to foster closer relationships among participants, researchers, and RECs and to understand participant vulnerability and strength better.

High-resolution magnetic resonance imaging of carotid atherosclerotic plaques - a correlation study with histopathology.

PubMed

Xia, Zhangyong; Yang, Hua; Yuan, Xiaochun; Wang, Jiyue; Zhang, Shigang; Zhang, Liyong; Qu, Yang; Chen, Jun; Jiao, Liqun; Wang, Le-Xin; Du, Yifeng

2017-07-01

This study aimed to utilize high-resolution magnetic resonance imaging (MRI) to investigate the characteristics of stable and vulnerable carotid arteriosclerotic plaques, with correlations to histopathological findings. High-resolution MRI was performed in 817 patients, using three-dimensional magnetic resonance angiography. Plaque composition was evaluated by measuring the areas occupied by calcification, a lipid-rich necrotic core, intra-plaque haemorrhage, and fibrous cap rupture. Plaque morphology was analysed by measuring vessel wall area, thickness, and luminal area at the bifurcation of the common carotid artery. Plaque tissues were sampled during carotid endarterectomy and examined using haematoxylin-eosin, Oil Red O, Masson trichrome staining, and immunohistochemical staining for CD68. Patients were divided into stable plaque group (n = 462) and vulnerable plaque group (n = 355), based on intraoperative observations and postoperative histopathological findings. Compared to the stable plaque group, the vulnerable plaque group exhibited increased vessel wall areas and thickness, and decreased mean luminal areas (P < 0.001). The vulnerable plaque group also had a lower collagen content, a higher lipid content, and higher CD68 expression in plaque tissues on histological examinations (P < 0.01). Incidences of lipid-rich necrotic core (38.1 % vs. 34.3 %), intra-plaque haemorrhage (26.9 % vs. 22.8 %), plaque calcification (45.2 % vs. 40.9 %), and fibrous cap rupture (36.0 % vs 39.8 %) in the plaques were concordant with MRI observations and histopathological findings (p > 0.05). Stable and vulnerable carotid plaques had different morphologies and compositions. High-resolution MRI can assess such differences qualitatively and quantitatively in vivo and provide guidance for risk stratification and management.

The relevance of work-related learning for vulnerable groups. Dutch case study of a Health Impact Assessment with equity focus.

PubMed

Storm, Ilse; Uiters, Ellen; Busch, Mirjam C M; den Broeder, Lea; Schuit, Albertine J

2015-07-01

Learning is essential for sustainable employability. However, various factors make work-related learning more difficult for certain groups of workers, who are consequently at a disadvantage in the labour market. In the long term, that in turn can have adverse health implications and can make those groups vulnerable. With a view to encouraging workers to continue learning, the Netherlands has a policy on work-related learning, which forms part of the 'Vitality Package'. A Health Impact Assessment with equity focus (HIAef) was undertaken to determine whether the policy on work-related learning affected certain groups of workers and their health in different ways, and whether the differences were avoidable. The HIAef method involved the standard phases: screening, scoping, appraisal and recommendations. Equity was the core principle in this method. Data were collected by means of both literature searches (e.g., Scopus, Medline) and interviews with experts and stakeholders (e.g., expertise regarding work, training and/or health). The HIAef identified the following groups as potentially vulnerable in the field of work-related learning: the chronically sick, older people, less educated people, flexi-workers/the self-employed and lay carers (e.g., thresholds to learning). Published literature indicates that work-related learning may have a positive influence on health through (work-related) factors such as pay, employability, longer employment rate and training-participation. According to experts and stakeholders, work-related learning policy could be adapted to take more account of vulnerable groups through alignment with their particular needs, such as early support, informal learning and e-learning. With a view to reducing avoidable inequalities in work-related learning, it is recommended that early, low-threshold, accessible opportunities are made available to identified vulnerable groups. Making such opportunities available may have a positive effect on (continued) participation in the labour market and thus on the health of the relevant groups. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The Contribution of Game Genre and other Use Patterns to Problem Video Game Play among Adult Video Gamers.

PubMed

Elliott, Luther; Ream, Geoffrey; McGinsky, Elizabeth; Dunlap, Eloise

2012-12-01

AIMS: To assess the contribution of patterns of video game play, including game genre, involvement, and time spent gaming, to problem use symptomatology. DESIGN: Nationally representative survey. SETTING: Online. PARTICIPANTS: Large sample (n=3,380) of adult video gamers in the US. MEASUREMENTS: Problem video game play (PVGP) scale, video game genre typology, use patterns (gaming days in the past month and hours on days used), enjoyment, consumer involvement, and background variables. FINDINGS: Study confirms game genre's contribution to problem use as well as demographic variation in play patterns that underlie problem video game play vulnerability. CONCLUSIONS: Identification of a small group of game types positively correlated with problem use suggests new directions for research into the specific design elements and reward mechanics of "addictive" video games. Unique vulnerabilities to problem use among certain groups demonstrate the need for ongoing investigation of health disparities related to contextual dimensions of video game play.

Sending-country violence and receiving-country discrimination: effects on the health of Colombian refugees in Ecuador.

PubMed

Shedlin, Michele G; Decena, Carlos U; Noboa, Hugo; Betancourt, Óscar

2014-02-01

This study explored factors affecting the health and well being of recent refugees from Colombia in Ecuador. Data collection focused on how sending-country violence and structural violence in a new environment affect immigrant health vulnerability and risk behaviors. A qualitative approach included ethnographic observation, media content analysis, focus groups, and individual interviews with refugees (N = 137). The focus groups (5) provided perspectives on the research domains by sex workers; drug users; male and female refugees; and service providers. Social and economic marginalization are impacting the health and well being of this growing refugee population. Data illustrate how stigma and discrimination affect food and housing security, employment and health services, and shape vulnerabilities and health risks in a new receiving environment. Widespread discrimination in Ecuador reflects fears, misunderstanding, and stereotypes about Colombian refugees. For this displaced population, the sequelae of violence, combined with survival needs and lack of support and protections, shape new risks to health and well-being.

Enforcing Enrollment in Health Insurance Exchanges: Evidence From the Netherlands, Switzerland, and Germany.

PubMed

van Ginneken, Ewout; Rice, Thomas

2015-08-01

Experience from the Netherlands, Switzerland, and Germany suggests that there may be a looming problem concerning uninsured individuals and defaulters that could derail coverage projection numbers in the United States under the Affordable Care Act. In those countries, the young, people with migrant backgrounds, and those with lower incomes-precisely the groups the Affordable Care Act is seeking to cover-are overrepresented in the numbers of the uninsured and defaulters, frequently because of difficulty in paying for their premiums. In these three countries, penalties or suspension of coverage alone has not led everyone to purchase coverage or prevented some from defaulting. Help in addressing the vulnerable position of the uninsured may be needed. Examples include using a multifaceted approach in which public authorities help with debt restructuring, freeing some funds in the exchanges to help vulnerable groups, and compensating insurers for their outstanding payments if they follow an agreed protocol instead of canceling coverage. © The Author(s) 2015.

Ethnicity- and socio-economic status-related stresses in context: an integrative review and conceptual model.

PubMed

Myers, Hector F

2009-02-01

There continues to be debate about how best to conceptualize and measure the role of exposure to ethnicity-related and socio-economic status-related stressors (e.g. racism, discrimination, class prejudice) in accounting for ethnic health disparities over the lifecourse and across generations. In this review, we provide a brief summary of the evidence of health disparities among ethnic groups, and the major evidence on the role of exposure to ethnicity- and SES-related stressors on health. We then offer a reciprocal and recursive lifespan meta-model that considers the interaction of ethnicity and SES history as impacting exposure to psychosocial adversities, including ethnicity-related stresses, and mediating biopsychosocial mechanisms that interact to result in hypothesized cumulative biopsychosocial vulnerabilities. Ultimately, group differences in the burden of cumulative vulnerabilities are hypothesized as contributing to differential health status over time. Suggestions are offered for future research on the unique role that ethnicity- and SES-related processes are likely to play as contributors to persistent ethnic health disparities.

The Contribution of Game Genre and other Use Patterns to Problem Video Game Play among Adult Video Gamers

PubMed Central

Ream, Geoffrey; McGinsky, Elizabeth; Dunlap, Eloise

2012-01-01

Aims To assess the contribution of patterns of video game play, including game genre, involvement, and time spent gaming, to problem use symptomatology. Design Nationally representative survey. Setting Online. Participants Large sample (n=3,380) of adult video gamers in the US. Measurements Problem video game play (PVGP) scale, video game genre typology, use patterns (gaming days in the past month and hours on days used), enjoyment, consumer involvement, and background variables. Findings Study confirms game genre's contribution to problem use as well as demographic variation in play patterns that underlie problem video game play vulnerability. Conclusions Identification of a small group of game types positively correlated with problem use suggests new directions for research into the specific design elements and reward mechanics of “addictive” video games. Unique vulnerabilities to problem use among certain groups demonstrate the need for ongoing investigation of health disparities related to contextual dimensions of video game play. PMID:23284310

Sending-Country Violence & Receiving-Country Discrimination: Effects on the Health of Colombian Refugees in Ecuador

PubMed Central

Shedlin, Michele G.; Decena, Carlos U.; Noboa, Hugo; Betancourt, Óscar

2013-01-01

BACKGROUND This study explored factors affecting the health and well being of recent refugees from Colombia in Ecuador. Data collection focused on how sending-country violence and structural violence in a new environment affect immigrant health vulnerability and risk behaviors. METHODS A qualitative approach included ethnographic observation, media content analysis, focus groups, and individual interviews with refugees (N=137). The focus groups (5) provided perspectives on the research domains by sex workers; drug users; male and female refugees; and service providers. RESULTS Social and economic marginalization are impacting the health and well being of this growing refugee population. Data illustrate how stigma and discrimination affect food and housing security, employment and health services, and shape vulnerabilities and health risks in a new receiving environment. DISCUSSION Widespread discrimination in Ecuador reflects fears, misunderstanding, and stereotypes about Colombian refugees. For this displaced population, the sequelae of violence, combined with survival needs and lack of support and protections, shape new risks to health and well-being. PMID:23377565

Narrowing the Gap in Outcomes for Vulnerable Groups: A Review of the Research Evidence

ERIC Educational Resources Information Center

Kendall, Sally; Straw, Suzanne; Jones, Megan; Springate, Iain; Grayson, Hilary

2008-01-01

This report presents findings from a review of the best evidence on narrowing the gap in outcomes across the five Every Child Matters (ECM) areas for vulnerable groups in the context of improving outcomes for all. The review was commissioned to prepare the ground for work on "Narrowing the Gap" with participating local authorities (LAs).…

Differences in health care utilization between parents who perceive their child as vulnerable versus overprotective parents.

PubMed

Thomasgard, M; Metz, W P

1996-06-01

While a parental perception of child vulnerability to illness/injury is often used interchangeably with parental overprotection, research suggests that they are independent constructs. We hypothesized more frequent pediatric nonwell-child visits for perceived child vulnerability, but not for parental overprotection. The parents of 300 children, ages 2-5 years, enrolled in a health maintenance organization, were sampled. For children without medical conditions, there were no differences in nonwell-child care visits between the high perceived vulnerability and high parental protection groups (Wilcoxon Rank Sum Test, WRST, P = .31). As expected, high parental protection was not significantly associated with increased nonwell-child care visits compared with the low parental protection group (WRST, P = .14). These findings suggest that markers other than health care utilization are required to identify these forms of parent-child relationship disorders.

Enhancing Defense Support of Civil Authorities within the National Capital Region

DTIC Science & Technology

2011-04-04

tenorist organizations center of gravity, critical capabilities, critical requirements, and critical vulnerabilities. For example, to execute the...London Underground bombings ( critical capability), the group (center of gravity) needed money ( critical requirement! critical vulnerability). 8 Usually...the movement of large amounts of money through banks, the internet, or via credit cards creates a critical vulnerability because law enforcement

Securing General Aviation

DTIC Science & Technology

2009-03-03

ajor vulnerabilities still exist in ... general aviation security ,”3 the commission did not further elaborate on the nature of those vulnerabilities...commercial operations may make them an attractive alternative to terrorists seeking to identify and exploit vulnerabilities in aviation security . In this...3, 2003, p. A7. 2 See Report of the Aviation Security Advisory Committee Working Group on General Aviation Airport Security (October 1, 2003); and

Vulnerability to alcohol-related problems: a policy brief with implications for the regulation of alcohol marketing.

PubMed

Babor, Thomas F; Robaina, Katherine; Noel, Jonathan K; Ritson, E Bruce

2017-01-01

The concern that alcohol advertising can have detrimental effects on vulnerable viewers has prompted the development of codes of responsible advertising practices. This paper evaluates critically the concept of vulnerability as it applies to (1) susceptibility to alcohol-related harm and (2) susceptibility to the effects of marketing, and describes its implications for the regulation of alcohol marketing. We describe the findings of key published studies, review papers and expert reports to determine whether these two types of vulnerability apply to population groups defined by (1) age and developmental history; (2) personality characteristics; (3) family history of alcoholism; (4) female sex and pregnancy risk; and (5) history of alcohol dependence and recovery status. Developmental theory and research suggest that groups defined by younger age, incomplete neurocognitive development and a history of alcohol dependence may be particularly vulnerable because of the disproportionate harm they experience from alcohol and their increased susceptibility to alcohol marketing. Children may be more susceptible to media imagery because they do not have the ability to compensate for biases in advertising portrayals and glamorized media imagery. Young people and people with a history of alcohol dependence appear to be especially vulnerable to alcohol marketing, warranting the development of new content and exposure guidelines focused on protecting those groups to improve current self-regulation codes promoted by the alcohol industry. If adequate protections cannot be implemented through this mechanism, statutory regulations should be considered. © 2016 Society for the Study of Addiction.

Participatory flood vulnerability assessment: a multi-criteria approach

NASA Astrophysics Data System (ADS)

Madruga de Brito, Mariana; Evers, Mariele; Delos Santos Almoradie, Adrian

2018-01-01

This paper presents a participatory multi-criteria decision-making (MCDM) approach for flood vulnerability assessment while considering the relationships between vulnerability criteria. The applicability of the proposed framework is demonstrated in the municipalities of Lajeado and Estrela, Brazil. The model was co-constructed by 101 experts from governmental organizations, universities, research institutes, NGOs, and private companies. Participatory methods such as the Delphi survey, focus groups, and workshops were applied. A participatory problem structuration, in which the modellers work closely with end users, was used to establish the structure of the vulnerability index. The preferences of each participant regarding the criteria importance were spatially modelled through the analytical hierarchy process (AHP) and analytical network process (ANP) multi-criteria methods. Experts were also involved at the end of the modelling exercise for validation. The final product is a set of individual and group flood vulnerability maps. Both AHP and ANP proved to be effective for flood vulnerability assessment; however, ANP is preferred as it considers the dependences among criteria. The participatory approach enabled experts to learn from each other and acknowledge different perspectives towards social learning. The findings highlight that to enhance the credibility and deployment of model results, multiple viewpoints should be integrated without forcing consensus.

[Medical research and vulnerable subjects: unemployed people].

PubMed

Niebrój, Lesław

2006-01-01

Although the importance of medical research for the diagnosis and treatment of human diseases is unquestionable, the use of human subjects, however, still presents a complex ethical problem. Moral difficulties occur in particular when the medical research deals with vulnerable subjects. Vulnerable individuals are defined as those who experience diminished actual autonomy. Among the groups which should be considered as being vulnerable are usually listed the following: children, pregnant women, mentally or emotionally disabled, physically disabled, homeless, and institutionalized people. This study addresses key concerns that gave rise to the question of whether unemployed people had to be recognized as vulnerable subjects. The term "vulnerability" was clarified and it was assumed that the "vulnerability" of medical research subjects' had to be understood as a form of continuum from potential, through the circumstantial, temporal, episodic, permanent to inevitable vulnerability. The conclusion was drawn that unemployed people were, at least, potentially vulnerable subjects. Research involving unemployed people presents important moral challenges to researchers and should be undertaken very carefully, following special ethical guidelines.

Not the usual suspects: addressing layers of vulnerability.

PubMed

Luna, Florencia; Vanderpoel, Sheryl

2013-07-01

This paper challenges the traditional account of vulnerability in healthcare which conceptualizes vulnerability as a list of identifiable subpopulations. This list of 'usual suspects', focusing on groups from lower resource settings, is a narrow account of vulnerability. In this article we argue that in certain circumstances middle-class individuals can be also rendered vulnerable. We propose a relational and layered account of vulnerability and explore this concept using the case study of cord blood (CB) banking. In the first section, two different approaches to 'vulnerability' are contrasted: categorical versus layered. In the second section, we describe CB banking and present a case study of CB banking in Argentina. We examine the types of pressure that middle-class pregnant women feel when considering CB collection and storage. In section three, we use the CB banking case study to critique the categorical approach to vulnerability: this model is unable to account for the ways in which these women are vulnerable. A layered account of vulnerability identifies several ways in which middle-class women are vulnerable. Finally, by utilizing the layered approach, this paper suggests how public health policies could be designed to overcome vulnerabilities. © 2013 John Wiley & Sons Ltd.

Assessment of serum leptin, pregnancy-associated plasma protein A and CRP levels as indicators of plaque vulnerability in patients with acute coronary syndrome.

PubMed

Lodh, Moushumi; Goswami, Binita; Parida, Ashok; Patra, Surajeet; Saxena, Alpana

2012-07-01

A multifactorial aetiology of coronary artery disease (CAD) has been established in the recent past. Extensive research is now underway to understand the mechanisms responsible for plaque vulnerability. The identification of a novel biomarker that will help in the assessment of plaque status is urgently needed for the purpose of patient stratification and prognostication. The aim of the present study was to evaluate leptin, pregnancy-associated plasma protein A (PAPP-A) and C-reactive protein (CRP) levels in patients with acute coronary syndrome and to assess their diagnostic efficacy in the identification of vulnerable plaques. The study group comprised 105 patients who had chest pain along with ECG changes (ST elevation, ST depression, T inversion) and raised cardiac enzyme levels. Sixty-two patients with chest pain and ECG changes but with normal cardiac enzyme profiles were included in the control group. Lipid profiles, and leptin, PAPP-A and CRP levels were assessed in these two groups. Receiver operating characteristics (ROC) curves were plotted to determine the utility of the parameters under study as markers of plaque vulnerability. Significantly higher levels of serum lipoprotein (a), leptin, PAPP-A and high-sensitivity CRP (hs-CRP) were observed in the cases than in the controls. A positive correlation was observed between CRP and PAPP-A levels as well as CRP and leptin concentrations. ROC curve analysis revealed similar efficacies of CRP and PAPP-A levels in their ability to detect unstable plaques with areas under the curve of 0.762 and 0.732, respectively. Multivariate analysis established the superiority of hs-CRP as a predictor of plaque instability. Our study highlights the utility of both CRP and PAPP-A levels as determinants of plaque instability. Our findings necessitate population-based follow-up studies to establish the superiority of either of the two biomarkers in the field of preventive cardiology.

Local Communities and Glacial Lake Outburst Flood Mitigation: Lessons from Peru

NASA Astrophysics Data System (ADS)

Carey, Mark

2010-05-01

Discourse in recent years among scientists and non-scientists increasingly promotes the involvement of local people in hazard mitigation, including inhabitants of floodplains in valleys below moraine-dammed glacial lakes. Despite advances in understanding human vulnerability to glacial lake outburst floods, there has been much less research on how these vulnerable populations are involved (or ignored) in the actual outburst flood mitigation process. Which groups should be involved? Are they in fact participating? Is that involvement successful? Peru's Cordillera Blanca mountain range provides an ideal site to help answer these questions because its moraine-dammed glacial lakes have produced more than a dozen outburst floods since ~1860. After floods in 1941, 1945, and 1950 killed approximately 6,000, the national government created a state agency, which still exists today, to monitor glacial lakes and prevent future outburst floods. Using this region as a case study to answer the above questions, this paper has three components. First, it provides historical examples of local people's participation in disaster mitigation, but shows that the outcome of such local involvement frequently turned out differently than scientists, engineers, and planners anticipated. Second, it shows the challenges and difficulties of involving local groups. Recent efforts in workshops, aid projects, and government programs show only limited success in community participation in disaster mitigation agendas. Third, the paper suggests that in many cases local indigenous people, as icons of the Andean region but often not the most vulnerable group, are disproportionately victimized and tacitly invited into disaster mitigation discussions. Poor urban residents inhabiting floodplains are often neglected, even though they are the most vulnerable to outburst floods. As other world regions such as the Himalayas increasingly contend with potential glacial lake outburst floods, these lessons from the Peruvian Andes may help make mitigation efforts elsewhere more successful and less contentious.

A qualitative exploration of work-related head injury: vulnerability at the intersection of workers' decision making and organizational values.

PubMed

Kontos, P; Grigorovich, A; Nowrouzi, B; Sharma, B; Lewko, J; Mollayeva, T; Colantonio, A

2017-10-18

Work-related head injury is a critical public health issue due to its rising prevalence; the association with profound disruption of workers' lives; and significant economic burdens in terms of medical costs and lost wages. Efforts to understand and prevent these types of injuries have largely been dominated by epidemiological research and safety science, which has focused on identifying risk at the level of the individual worker, population group, or organizational sector. Limited research has focused on the perspectives of the workers, a key stakeholder group for informing understanding of vulnerability to work-related head injury. This study explored workers' perspectives to better understand their decision-making and how and why their injuries occurred. We conducted a qualitative study using in-depth semi-structured interviews with thirty-two adult workers who had sustained a work-related head injury. Workers were recruited from an urban clinic in central Ontario, Canada. Labour Process Theory informed the thematic analysis. Three hazardous work conditions were identified: insufficient training; inadequate staffing; and inattention to the physical environment. In addition, professional and organizational norms were implicated in vulnerability to head injury including putting the client before the worker and the pressure to work unsafely. The findings also highlight a complex interrelationship between workers' decision-making and professional and organizational norms that produces vulnerability to head injury, a vulnerability which oftentimes is reproduced by workers' decisions to work despite hazardous conditions. Our findings suggest that, beyond the need to redress the inattention to hazards in the physical environment, there is a need to address norms that influence worker decision-making to improve the safety of workers. Using Labour Process Theory highlights an important social dynamic within workplace sectors that could inform future development and implementation of multi-level and integrated public health strategies to reduce work-related head injury.

Injury protection and accident causation parameters for vulnerable road users based on German In-Depth Accident Study GIDAS.

PubMed

Otte, Dietmar; Jänsch, Michael; Haasper, Carl

2012-01-01

Within a study of accident data from GIDAS (German In-Depth Accident Study), vulnerable road users are investigated regarding injury risk in traffic accidents. GIDAS is the largest in-depth accident study in Germany. Due to a well-defined sampling plan, representativeness with respect to the federal statistics is also guaranteed. A hierarchical system ACASS (Accident Causation Analysis with Seven Steps) was developed in GIDAS, describing the human causation factors in a chronological sequence. The accordingly classified causation factors - derived from the systematic of the analysis of human accident causes ("7 steps") - can be used to describe the influence of accident causes on the injury outcome. The bases of the study are accident documentations over ten years from 1999 to 2008 with 8204 vulnerable road users (VRU), of which 3 different groups were selected as pedestrians n=2041, motorcyclists n=2199 and bicyclists n=3964, and analyzed on collisions with cars and trucks as well as vulnerable road users alone. The paper will give a description of the injury pattern and injury mechanisms of accidents. The injury frequencies and severities are pointed out considering different types of VRU and protective measures of helmet and clothes of the human body. The impact points are demonstrated on the car, following to conclusion of protective measures on the vehicle. Existing standards of protection devices as well as interdisciplinary research, including accident and injury statistics, are described. With this paper, a summarization of the existing possibilities on protective measures for pedestrians, bicyclists and motorcyclists is given and discussed by comparison of all three groups of vulnerable road users. Also the relevance of special impact situations and accident causes mainly responsible for severe injuries are pointed out, given the new orientation of research for the avoidance and reduction of accident patterns. 2010 Elsevier Ltd. All rights reserved.

Socio-economic vulnerability to natural hazards - proposal for an indicator-based model

NASA Astrophysics Data System (ADS)

Eidsvig, U.; McLean, A.; Vangelsten, B. V.; Kalsnes, B.; Ciurean, R. L.; Argyroudis, S.; Winter, M.; Corominas, J.; Mavrouli, O. C.; Fotopoulou, S.; Pitilakis, K.; Baills, A.; Malet, J. P.

2012-04-01

Vulnerability assessment, with respect to natural hazards, is a complex process that must consider multiple dimensions of vulnerability, including both physical and social factors. Physical vulnerability refers to conditions of physical assets, and may be modeled by the intensity and magnitude of the hazard, the degree of physical protection provided by the natural and built environment, and the physical robustness of the exposed elements. Social vulnerability refers to the underlying factors leading to the inability of people, organizations, and societies to withstand impacts from the natural hazards. Social vulnerability models can be used in combination with physical vulnerability models to estimate both direct losses, i.e. losses that occur during and immediately after the impact, as well as indirect losses, i.e. long-term effects of the event. Direct impact of a landslide typically includes casualties and damages to buildings and infrastructure while indirect losses may e.g. include business closures or limitations in public services. The direct losses are often assessed using physical vulnerability indicators (e.g. construction material, height of buildings), while indirect losses are mainly assessed using social indicators (e.g. economical resources, demographic conditions). Within the EC-FP7 SafeLand research project, an indicator-based method was proposed to assess relative socio-economic vulnerability to landslides. The indicators represent the underlying factors which influence a community's ability to prepare for, deal with, and recover from the damage associated with landslides. The proposed model includes indicators representing demographic, economic and social characteristics as well as indicators representing the degree of preparedness and recovery capacity. Although the model focuses primarily on the indirect losses, it could easily be extended to include more physical indicators which account for the direct losses. Each indicator is individually ranked from 1 (lowest vulnerability) to 5 (highest vulnerability) and weighted, based on its overall degree of influence. The indicator weights range from 1 (least influential) to 3 (most influential) and have been selected on the basis of expert judgment. The final vulnerability score is taken as the weighted average of the individual indicators. The method was applied for locations in Norway, Greece, France, Andorra and Romania. The purpose of the case studies was to compare vulnerability levels and to test and possibly improve the methodology. In the case studies, similar vulnerability scores were obtained for the locations in Norway, Andorra and France. A higher vulnerability score was obtained for the location in Greece, while the highest vulnerability score was obtained for the location in Romania. The higher score for the locations in Greece and Romania are mainly due to economic conditions and conditions regarding preparedness and recovery.

Diet behaviour among young people in transition to adulthood (18-25 year olds): a mixed method study.

PubMed

Poobalan, Amudha S; Aucott, Lorna S; Clarke, Amanda; Smith, William Cairns S

2014-01-01

Background : Young people (18-25 years) during the adolescence/adulthood transition are vulnerable to weight gain and notoriously hard to reach. Despite increased levels of overweight/obesity in this age group, diet behaviour, a major contributor to obesity, is poorly understood. The purpose of this study was to explore diet behaviour among 18-25 year olds with influential factors including attitudes, motivators and barriers. Methods : An explanatory mixed method study design, based on health Behaviour Change Theories was used. Those at University/college and in the community, including those Not in Education, Employment or Training (NEET) were included. An initial quantitative questionnaire survey underpinned by the Theory of Planned Behaviour and Social Cognitive Theory was conducted and the results from this were incorporated into the qualitative phase. Seven focus groups were conducted among similar young people, varying in education and socioeconomic status. Exploratory univariate analysis was followed by multi-staged modelling to analyse the quantitative data. 'Framework Analysis' was used to analyse the focus groups. Results : 1313 questionnaires were analysed. Self-reported overweight/obesity prevalence was 22%, increasing with age, particularly in males. Based on the survey, 40% of young people reported eating an adequate amount of fruits and vegetables and 59% eating regular meals, but 32% reported unhealthy snacking. Based on the statistical modelling, positive attitudes towards diet and high intention (89%), did not translate into healthy diet behaviour. From the focus group discussions, the main motivators for diet behaviour were 'self-appearance' and having 'variety of food'. There were mixed opinions on 'cost' of food and 'taste'. Conclusion : Elements deemed really important to young people have been identified. This mixed method study is the largest in this vulnerable and neglected group covering a wide spectrum of the community. It provides evidence base to inform tailored interventions for a healthy diet within this age group.

Diet behaviour among young people in transition to adulthood (18–25 year olds): a mixed method study

PubMed Central

Poobalan, Amudha S.; Aucott, Lorna S.; Clarke, Amanda; Smith, William Cairns S.

2014-01-01

Background : Young people (18–25 years) during the adolescence/adulthood transition are vulnerable to weight gain and notoriously hard to reach. Despite increased levels of overweight/obesity in this age group, diet behaviour, a major contributor to obesity, is poorly understood. The purpose of this study was to explore diet behaviour among 18–25 year olds with influential factors including attitudes, motivators and barriers. Methods: An explanatory mixed method study design, based on health Behaviour Change Theories was used. Those at University/college and in the community, including those Not in Education, Employment or Training (NEET) were included. An initial quantitative questionnaire survey underpinned by the Theory of Planned Behaviour and Social Cognitive Theory was conducted and the results from this were incorporated into the qualitative phase. Seven focus groups were conducted among similar young people, varying in education and socioeconomic status. Exploratory univariate analysis was followed by multi-staged modelling to analyse the quantitative data. ‘Framework Analysis’ was used to analyse the focus groups. Results: 1313 questionnaires were analysed. Self-reported overweight/obesity prevalence was 22%, increasing with age, particularly in males. Based on the survey, 40% of young people reported eating an adequate amount of fruits and vegetables and 59% eating regular meals, but 32% reported unhealthy snacking. Based on the statistical modelling, positive attitudes towards diet and high intention (89%), did not translate into healthy diet behaviour. From the focus group discussions, the main motivators for diet behaviour were ‘self-appearance’ and having ‘variety of food’. There were mixed opinions on ‘cost’ of food and ‘taste’. Conclusion: Elements deemed really important to young people have been identified. This mixed method study is the largest in this vulnerable and neglected group covering a wide spectrum of the community. It provides evidence base to inform tailored interventions for a healthy diet within this age group. PMID:25750826

The Naïve nurse: revisiting vulnerability for nursing

PubMed Central

2012-01-01

Background Nurses in the Western world have given considerable attention to the concept of vulnerability in recent decades. However, nurses have tended to view vulnerability from an individualistic perspective, and have rarely taken into account structural or collective dimensions of the concept. As the need grows for health workers to engage in the global health agenda, nurses must broaden earlier works on vulnerability, noting that conventional conceptualizations and practical applications on the notion of vulnerability warrant extension to include more collective conceptualizations thereby making a more complete understanding of vulnerability in nursing discourse. Discussion The purpose of this paper is to examine nursing contributions to the concept of vulnerability and consider how a broader perspective that includes socio-political dimensions may assist nurses to reach beyond the immediate milieu of the patient into the dominant social, political, and economic structures that produce and sustain vulnerability. Summary By broadening nurse’s conceptualization of vulnerability, nurses can obtain the consciousness needed to move beyond a peripheral role of nursing that has been dominantly situated within institutional settings to contribute in the larger arena of social, economic, political and global affairs. PMID:22520841

HandiVIH--A population-based survey to understand the vulnerability of people with disabilities to HIV and other sexual and reproductive health problems in Cameroon: protocol and methodological considerations.

PubMed

De Beaudrap, Pierre; Pasquier, Estelle; Tchoumkeu, Alice; Touko, Adonis; Essomba, Frida; Brus, Aude; Desgrées du Loû, Annabel; Aderemi, Toyin Janet; Hanass-Hancock, Jill; Eide, Arne Henning; Mont, Daniel; Mac-Seing, Muriel; Beninguisse, Gervais

2016-02-04

In resource-limited countries, people with disabilities seem to be particularly vulnerable to HIV infection due to barriers to accessing information and services, frequent exposure to sexual violence and social exclusion. However, they have often been left behind in the HIV response, probably because of the lack of reliable epidemiological data measuring this vulnerability. Multiple challenges in conducting good quality epidemiological surveys on people with disabilities require innovative methods to better understand the link between disability and HIV. This paper describes how the design and methods of the HandiVIH study were adapted to document the vulnerability of people with disabilities to HIV, and to compare their situation with that of people without disabilities. The HandiVIH project aims to combine quantitative and qualitative data. The quantitative component is a cross-sectional survey with a control group conducted in Yaoundé (Cameroon). A two-phase random sampling is used (1) to screen people with disabilities from the general population using the Washington Group questionnaire and, (2) to create a matched control group. An HIV test is proposed to each study participant. Additionally, a questionnaire including a life-event interview is used to collect data on respondents' life-course history of social isolation, employment, sexual partnership, HIV risk factors and fertility. Before the cross-sectional survey, a qualitative exploratory study was implemented to identify challenges in conducting the survey and possible solutions. Information on people with disabilities begging in the streets and members of disabled people's organisations is collected separately. This study has been approved by the two ethical committees. Special attention has been paid on how to adapt the consenting process to persons with intellectual disabilities. The methodological considerations discussed in this paper may contribute to the development of good practices for conducting quantitative health surveys on people with disabilities. NCT02192658. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

A new approach for computing a flood vulnerability index using cluster analysis

NASA Astrophysics Data System (ADS)

Fernandez, Paulo; Mourato, Sandra; Moreira, Madalena; Pereira, Luísa

2016-08-01

A Flood Vulnerability Index (FloodVI) was developed using Principal Component Analysis (PCA) and a new aggregation method based on Cluster Analysis (CA). PCA simplifies a large number of variables into a few uncorrelated factors representing the social, economic, physical and environmental dimensions of vulnerability. CA groups areas that have the same characteristics in terms of vulnerability into vulnerability classes. The grouping of the areas determines their classification contrary to other aggregation methods in which the areas' classification determines their grouping. While other aggregation methods distribute the areas into classes, in an artificial manner, by imposing a certain probability for an area to belong to a certain class, as determined by the assumption that the aggregation measure used is normally distributed, CA does not constrain the distribution of the areas by the classes. FloodVI was designed at the neighbourhood level and was applied to the Portuguese municipality of Vila Nova de Gaia where several flood events have taken place in the recent past. The FloodVI sensitivity was assessed using three different aggregation methods: the sum of component scores, the first component score and the weighted sum of component scores. The results highlight the sensitivity of the FloodVI to different aggregation methods. Both sum of component scores and weighted sum of component scores have shown similar results. The first component score aggregation method classifies almost all areas as having medium vulnerability and finally the results obtained using the CA show a distinct differentiation of the vulnerability where hot spots can be clearly identified. The information provided by records of previous flood events corroborate the results obtained with CA, because the inundated areas with greater damages are those that are identified as high and very high vulnerability areas by CA. This supports the fact that CA provides a reliable FloodVI.

Graph modeling systems and methods

DOEpatents

Neergaard, Mike

2015-10-13

An apparatus and a method for vulnerability and reliability modeling are provided. The method generally includes constructing a graph model of a physical network using a computer, the graph model including a plurality of terminating vertices to represent nodes in the physical network, a plurality of edges to represent transmission paths in the physical network, and a non-terminating vertex to represent a non-nodal vulnerability along a transmission path in the physical network. The method additionally includes evaluating the vulnerability and reliability of the physical network using the constructed graph model, wherein the vulnerability and reliability evaluation includes a determination of whether each terminating and non-terminating vertex represents a critical point of failure. The method can be utilized to evaluate wide variety of networks, including power grid infrastructures, communication network topologies, and fluid distribution systems.

Narrowing the Gap in Outcomes: Further Overview of Data and Evidence on the ECM Outcomes for Vulnerable Groups. Progress Report and Update

ERIC Educational Resources Information Center

Morris, Marian; Easton, Claire

2008-01-01

Narrowing the Gap (NtG) is a two-year development and research programme, funded by the Department for Children, Schools and Families (DCSF) and the Local Government Association (LGA), working in partnership with other agencies, including local authorities. It seeks to make a significant difference, on a national scale, to the performance of…

Stealing the Smile from My Child's Face: A Preliminary Evaluation of the "Being a Dad" Programme in a Northern Ireland Prison

ERIC Educational Resources Information Center

McCrudden, Eunan; Braiden, Hannah Jane; Sloan, Deirdre; McCormack, Patricia; Treacy, Austin

2014-01-01

Children who have a parent in prison are a vulnerable group. Research suggests that such children experience a range of poor outcomes in relation to well-being, education and relationships. These outcomes are mediated by a range of factors including contact with the incarcerated parent. Similarly, prisoners who maintain contact with their families…

Narrowing the Gap in Outcomes for Vulnerable Groups. A Review of the Research Evidence: Summary of Key Findings

ERIC Educational Resources Information Center

Kendall, Sally; Straw, Suzanne; Jones, Megan; Springate, Iain; Lord, Pippa; Stoney, Sheila

2007-01-01

In 2007, the Local Government Association (LGA) commissioned the NFER to review the best evidence on what works in narrowing the gap in outcomes for vulnerable groups across the five Every Child Matters areas. The review aimed to underpin the Narrowing the Gap Programme, a major development programme being implemented by the LGA and the DCSF. …

Relational Factors of Vulnerability and Protection for Adolescent Pregnancy: A Cross-Sectional Comparative Study of Portuguese Pregnant and Nonpregnant Adolescents of Low Socioeconomic Status

ERIC Educational Resources Information Center

Pereira, Ana I. F.; Canavarro, Maria C.; Cardoso, Margarida F.; Mendonca, Denisa

2005-01-01

This study explores multiple relational contexts that promote vulnerability and protection against early pregnancy in a potential risk group of Portuguese adolescents. A comparative analysis was made between two groups of female adolescents of low socioeconomic status: pregnant adolescents (n = 57) and adolescents without a history of pregnancy (n…

Core concepts of human rights and inclusion of vulnerable groups in the mental health policies of Malawi, Namibia, and Sudan

PubMed Central

2013-01-01

Background One of the most crucial steps towards delivering judicious and comprehensive mental health care is the formulation of a policy and plan that will navigate mental health systems. For policy-makers, the challenges of a high-quality mental health system are considerable: the provision of mental health services to all who need them, in an equitable way, in a mode that promotes human rights and health outcomes. Method EquiFrame, a novel policy analysis framework, was used to evaluate the mental health policies of Malawi, Namibia, and Sudan. The health policies were assessed in terms of their coverage of 21 predefined Core Concepts of human rights (Core Concept Coverage), their stated quality of commitment to said Core Concepts (Core Concept Quality), and their inclusion of 12 Vulnerable Groups (Vulnerable Group Coverage). In relation to these summary indices, each policy was also assigned an Overall Summary Ranking, in terms of it being of High, Moderate, or Low quality. Results Substantial variability was identified across EquiFrame’s summary indices for the mental health policies of Malawi, Namibia, and Sudan. However, all three mental health policies scored high on Core Concept Coverage. Particularly noteworthy was the Sudanese policy, which scored 86% on Core Concept Coverage, and 92% on Vulnerable Group Coverage. Particular deficits were evident in the Malawian mental health policy, which scored 33% on Vulnerable Group Coverage and 47% on Core Concept Quality, and was assigned an Overall Summary Ranking of Low accordingly. The Overall Summary Ranking for the Namibian Mental Health Policy was High; for the Sudanese Mental Health Policy was Moderate; and for the Malawian Mental Health Policy was Low. Conclusions If human rights and equity underpin policy formation, it is more likely that they will be inculcated in health service delivery. EquiFrame may provide a novel and valuable tool for mental health policy analysis in relation to core concepts of human rights and inclusion of vulnerable groups, a key practical step in the successful realization of the Millennium Development Goals. PMID:23406583

Research should not ignore the power of elite groups.

PubMed

Gregory, Robert J

2002-02-01

For a long time, public health research has focused on many and diverse types of vulnerable groups in society. Whether drug abusers, prison inmates, smokers, poverty-stricken, mentally ill, HIV positive, or any number of other ailments, the public health system and, in particular, researchers have addressed and reported on people and populations with so-called deficits. Research on these vulnerable groups has been designed, conducted, reported, discussed and analysed, but vulnerable groups continue and, in fact, appear to be increasing in number, size, and range. An alternative approach that begins with entirely different questions is possible and advisable. Public health research could, and in the author's point of view, should, examine the lifestyles and, specifically, decision-making by members of elite groups. Studying up the economic and political ladder calls for examination of how a few reap enormous benefits for themselves, leaving the rest of us to our misfortune. Such decisions as the elite groups make affects resource allocation, use of information, and results in the public health and other social, economic, military, and political sectors in society.

Video feedback promotes relations between infants and vulnerable first-time mothers: a quasi-experimental study.

PubMed

Kristensen, Ingeborg Hedegaard; Simonsen, Marianne; Trillingsgaard, Tea; Kronborg, Hanne

2017-11-15

Supporting early mother-infant relationships to ensure infants' future health has been recommended. The aim of this study was to investigate whether video feedback using the Marte Meo method promotes a healthy early relationship between infants and vulnerable first-time mothers. Video feedback or usual care was delivered by health visitors during home visits in Danish municipalities. This quasi-experimental study included pre- and post-tests of 278 vulnerable families. Mothers were allocated to an intervention group (n = 69), a comparison group (n = 209) and an exactly matched video subsample from the comparison group (n = 63). Data consisted of self-reported questionnaires and video recordings of mother-infant interactions. Outcomes were mother-infant dyadic synchrony (CARE-Index), maternal confidence (KPCS), parental stress (PSS), maternal mood (EPDS) and infant socialemotional behaviours (ASQ:SE). The data were analysed using descriptive and linear multiple regression analysis. The levels of dyadic synchrony in the intervention group had significantly improved (p < 0.001) at follow-up with a mean score of 9.51 (95%CI;8.93-10.09) compared with 7.62 (95%CI;7.03-8.21). The intervention group also showed a higher level of maternal sensitivity with a mean score of 9.55 (95%CI;8.96-10.14) compared with 7.83 (95%CI;7.19-8.46) in the matched video subsample (p < 0.001). With respect to infant cooperation, similar improvements were found with a mean score of 9.43 (95% CI;8.88-9.99) in the intervention group compared with 7.73 (95%CI;7.13-8.33) in the matched video subsample from the comparison group (p < 0.001). Furthermore, mothers in the intervention group reported significantly lower levels of parental stress with a mean score of 32.04 (95%CI;30.13-33.94) compared with 35.29 (95%CI;34.07-36.52) in the comparison group (p = 0.03), as well as higher levels of maternal confidence with a mean score of 41.10 (95%CI;40.22-41.98) compared with 40.10 (95%CI;39.65-40.56) in the comparison group (p = 0.04). No significant differences were found in EPDS and ASQ:SE. The findings support the assumption that video feedback using the Marte Meo method early after birth may strengthen the relationship between infants and vulnerable firsttime mothers as well as improve maternal psychosocial functioning. Further research applying random assignment is needed to strengthen these conclusions; further research is also needed to assess any long term effects of the video feedback intervention using the Marte Meo method. This study was registered on 24 January 2013 in ClinicalTrials.gov with the identifier: NCT01799447 .

Divorce transition differences of midlife women.

PubMed

Sakraida, Teresa J

2005-01-01

Divorce transition experienced by and its influence upon midlife women's health is not fully understood. Interviews were conducted with 24 divorced women who self-classified into decider status groups: initiator (who first decided to end marriage), non-initiator (recipient of end of marriage decision), and mutual decider (shared decision to end marriage). Interpretive content analysis involving pattern coding was conducted. The divorce transition by initiators (n=8) included self-focused growth, optimism, and social support losses and opportunities, while the divorce transition by non-initiators (n=8) included being left, ruminating, vulnerability, and spiritual comfort. No profile emerged for the mutual-decider group (n=8). This study supports that differences in divorce transition exist for initiators and non-initiators.

"You cannot eat rights": a qualitative study of views by Zambian HIV-vulnerable women, youth and MSM on human rights as public health tools.

PubMed

Muzyamba, Choolwe; Broaddus, Elena; Campbell, Catherine

2015-10-05

Human rights approaches now dominate the HIV prevention landscape across sub-Saharan Africa, yet little is known about how they are viewed by the populations they are designed to serve. Health interventions are most effective when they resonate with the worldviews and interests of target groups. This study examined local Zambian understandings of human rights approaches to HIV-prevention among three highly HIV-vulnerable groups: women, youth, and men-who-have-sex-with-men (MSM). Focus groups included 23 women, youth, and MSM who had participated in activities organized by local non-governmental organizations (NGOs) using rights-based approaches, and interviews included 10 Zambian employees of these NGOs. Topics included participants' experiences and views of the utility of these activities. Thematic analysis mapped out diverse ways participants viewed the concept of human rights in relation to HIV-prevention. Whilst NGO workers noted the need for human rights programs to address the complex drivers of the HIV epidemic, they struggled to tailor them to the Zambian context due to donor stipulations. Women program beneficiaries noted that the concept of human rights helped challenge harmful sexual practices and domestic abuse, and youth described rights-based approaches as more participatory than previous HIV-prevention efforts. However, they criticized the approach for conflicting with traditional values such as respect for elders and 'harmonious' marital relationships. They also critiqued it for threatening the social structures and relationships that they relied on for material survival, and for failing to address issues like poverty and unemployment. In contrast, MSM embraced the rights approach, despite being critical of its overly confrontational implementation. A rights-based approach seeks to tackle the symbolic drivers of HIV-its undeniable roots in cultural and religious systems of discrimination. Yet, it fails to resonate with youth and women's own understandings of their needs and priorities due to its neglect of material drivers of HIV such as poverty and unemployment. MSM, who suffer extreme stigma and discrimination, have less to lose and much to gain from an approach that challenges inequitable social systems. Developing effective HIV-prevention strategies requires careful dialogue with vulnerable groups and greater flexibility for context-specific implementation rather than a one-size-fits-all conceptualization of human rights.

Displacement and HIV: Factors Influencing Antiretroviral Therapy Use by Ethnic Shan Migrants in Northern Thailand

PubMed Central

Murray, Jordan K.; DiStefano, Anthony S.; Yang, Joshua S.; Wood, Michele M.

2016-01-01

Migrant populations face increased HIV vulnerabilities, including limited access to antiretroviral therapy (ART). Civil conflict in Myanmar has displaced thousands of people from the minority Shan ethnic group into northern Thailand, where they bear a disproportionate HIV burden. To identify barriers and facilitators of ART use in this population, we conducted a rapid ethnographic assessment and case study with a clinical sample of Shan migrants receiving treatment for HIV in a district hospital in Chiang Mai, Thailand, Thai nurses providing their care, and health care administrators (n = 23). Barriers included fears of arrest and deportation, communication difficulties, perceived social marginalization, limited HIV knowledge, and lack of finances. Facilitating factors included hospital-based migrant registration services and community outreach efforts involving support group mobilization, referral practices, and radio broadcasts. These findings provided a contextualized account to inform policies, community interventions, and nursing practice to increase treatment access for minority migrant groups. PMID:27188762

Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes

PubMed Central

Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne; Krasnik, Allan; Norredam, Marie

2014-01-01

Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups. PMID:25233017

Ethical practice in internet research involving vulnerable people: lessons from a self-harm discussion forum study (SharpTalk).

PubMed

Sharkey, Siobhan; Jones, Ray; Smithson, Janet; Hewis, Elaine; Emmens, Tobit; Ford, Tamsin; Owens, Christabel

2011-12-01

The internet is widely used for health information and support, often by vulnerable people. Internet-based research raises both familiar and new ethical problems for researchers and ethics committees. While guidelines for internet-based research are available, it is unclear to what extent ethics committees use these. Experience of gaining research ethics approval for a UK study (SharpTalk), involving internet-based discussion groups with young people who self-harm and health professionals is described. During ethical review, unsurprisingly, concerns were raised about the vulnerability of potential participants. These were dominated by the issue of anonymity, which also affected participant safety and consent. These ethical problems are discussed, and our solutions, which included: participant usernames specific to the study, a closed website, private messaging facilities, a direct contact email to researchers, information about forum rules displayed on the website, a 'report' button for participants, links to online support, and a discussion room for forum moderators. This experience with SharpTalk suggests that an approach to ethics, which recognises the relational aspects of research with vulnerable people, is particularly useful for internet-based health research. The solutions presented here can act as guidance for researchers developing proposals and for ethics committees reviewing them.

Prenatal stress increases adult vulnerability to cocaine reward without affecting pubertal anxiety or novelty response.

PubMed

Pastor, Verónica; Pallarés, María Eugenia; Antonelli, Marta C

2018-02-26

Prenatal stress (PS) induces long-lasting molecular alterations in brain circuits of the offspring and increases the propensity to develop neuropsychiatric diseases during adulthood, including mood disorders and drug addiction. A major goal of this study was to assess the impact of PS on pubertal behaviour and adult vulnerability to cocaine-induced conditioning place preference (CPP). We therefore evaluated pubertal novelty response and anxiety-like behaviour in control (C) and PS rats, and then, we examined cocaine-induced CPP in those animals during adulthood. We found no differences between C and PS groups on pubertal behaviour, however, only PS rats showed a significant cocaine-induced CPP. To further analyze our results, we classified cocaine-treated rats regarding their CPP score in Low CPP or High CPP and we then analysed their pubertal behaviour. We found different relations of anxiety-like behaviour to cocaine reward as a function of PS exposure: for C group, High CPP and Low CPP had shown similar levels of anxiety-like behaviour at puberty; on the contrary, for PS group, High CPP had shown lower anxiety-like behaviour than Low CPP rats. This study underscores the importance of considering prenatal exposure to stress when analysing the relationship between anxiety and cocaine vulnerability. Moreover, the evaluation of behavioural traits at puberty opens the possibility of early intervention and will allow the development of specific prevention strategies to avoid the devastating consequences of drug addiction later in life. Copyright © 2017 Elsevier B.V. All rights reserved.

Preventing Childhood Malaria in Africa by Protecting Adults from Mosquitoes with Insecticide-Treated Nets

PubMed Central

Killeen, Gerry F; Smith, Tom A; Ferguson, Heather M; Mshinda, Hassan; Abdulla, Salim; Lengeler, Christian; Kachur, Steven P

2007-01-01

Background Malaria prevention in Africa merits particular attention as the world strives toward a better life for the poorest. Insecticide-treated nets (ITNs) represent a practical means to prevent malaria in Africa, so scaling up coverage to at least 80% of young children and pregnant women by 2010 is integral to the Millennium Development Goals (MDG). Targeting individual protection to vulnerable groups is an accepted priority, but community-level impacts of broader population coverage are largely ignored even though they may be just as important. We therefore estimated coverage thresholds for entire populations at which individual- and community-level protection are equivalent, representing rational targets for ITN coverage beyond vulnerable groups. Methods and Findings Using field-parameterized malaria transmission models, we show that high (80% use) but exclusively targeted coverage of young children and pregnant women (representing <20% of the population) will deliver limited protection and equity for these vulnerable groups. In contrast, relatively modest coverage (35%–65% use, with this threshold depending on ecological scenario and net quality) of all adults and children, rather than just vulnerable groups, can achieve equitable community-wide benefits equivalent to or greater than personal protection. Conclusions Coverage of entire populations will be required to accomplish large reductions of the malaria burden in Africa. While coverage of vulnerable groups should still be prioritized, the equitable and communal benefits of wide-scale ITN use by older children and adults should be explicitly promoted and evaluated by national malaria control programmes. ITN use by the majority of entire populations could protect all children in such communities, even those not actually covered by achieving existing personal protection targets of the MDG, Roll Back Malaria Partnership, or the US President's Malaria Initiative. PMID:17608562

Protecting water quality in the watershed

DOE Office of Scientific and Technical Information (OSTI.GOV)

James, C.R.; Johnson, K.E.; Stewart, E.H.

1994-08-01

This article highlights the water quality component of a watershed management plan being developed for the San Francisco (CA) Water Department. The physical characteristics of the 63,000-acre watersheds were analyzed for source and transport vulnerability for five groups of water quality parameters--particulates, THM precursors, microorganisms (Giardia and cryptosporidium), nutrients (nitrogen and phosphorus), and synthetic organic chemicals--and vulnerability zones were mapped. Mapping was achieved through the use of an extensive geographic information system (GIS) database. Each water quality vulnerability zone map was developed based on five watershed physical characteristics--soils, slope, vegetation, wildlife concentration, and proximity to water bodies--and their relationships tomore » each of the five groups of water quality parameters. An approach to incorporate the watershed physical characteristics information into the five water quality vulnerability zone maps was defined and verified. The composite approach was based in part on information gathered from existing watershed management plans.« less

African American adolescent perceptions of vulnerability and resilience to HIV.

PubMed

Glenn, Betty L; Wilson, Kathleen P

2008-07-01

HIV/AIDS is growing at a disproportional rate among African American adolescents. This trend has occurred despite the fact that 89% of schools have educational programs on HIV/AIDS. Barriers to effective HIV prevention may be related to a failure to develop educational programs based on the cultural competencies of vulnerable populations such as adolescents who are at risk for HIV. The purpose of this qualitative study was to explore African American adolescent perceptions of vulnerability and resilience to HIV/AIDS within a cultural competency paradigm. A group of 8 adolescents at an African American church participated in a focus group to discuss vulnerability and resilience to HIV. To facilitate discussion, the adolescents developed collages from pictures in African American magazines. Content analysis was used to identify themes. The themes revealed were confidence, safe social activities, innocence, image, music/drug culture, and peer pressure.

Rodent models of depression: learned helplessness using a triadic design in rats.

PubMed

Durgam, R C

2001-05-01

Certain types of human depression are precipitated by stressful life events, and vulnerable individuals experiencing these stressors may develop clinical depression. Understanding the neurobiology of stress vulnerability (depression) as well as stress resiliency (coping) is critical for guiding the development of novel pharmacotherapeutic agents for stress-related disorders such as depression in humans. The use of a triadic design (escapable shock, yoked-inescapable shock and restrained control) allows the investigator to examine the various sequella of stress exposure, while manipulating and quantifying the impact of psychological dynamics of stress such as active behavioral coping (i.e., stress control). Both escape and yoked subjects are exposed to the identical amount, intensity, pattern and duration of stress. The critical distinction between these two groups is that the escape group has the opportunity to terminate the shock stress by turning a wheel at the front of a chamber, while wheel-turning for the yoked subject is of no consequence. Any difference observed between the escape and yoked subjects is a result of the effects of coping, rather than stress exposure per se. The restrained group is included to control for the effects of handling. Any differences between this group and the escape and yoked subjects reflects the impact of stress per se.

‘These are not luxuries, it is essential for access to life’: Disability related out-of-pocket costs as a driver of economic vulnerability in South Africa

PubMed Central

Nene, Siphumelele; Deghaye, Nicola; Pillay, Simmi

2017-01-01

Background With the dawn of the new sustainable development goals, we face not only a world that has seen great successes in alleviating poverty but also a world that has left some groups, such as persons with disabilities, behind. Middle-income countries (MICs) are home to a growing number of persons with disabilities. As these countries strive to achieve the new goals, we have ample opportunity to include persons with disabilities in the emerging poverty alleviation strategies. However, a lack of data and research on the linkages between economic vulnerability and disability in MICs hampers our understanding of the factors increasing economic vulnerability in people with disabilities. Methods This article aims to present data related to elements of this vulnerability in one MIC, South Africa. Focusing on out-of-pocket costs, it uses focus group discussions with 73 persons with disabilities and conventional content analysis to describe these costs. Results A complex and nuanced picture of disability-driven costs evolved on three different areas: care and support for survival and safety, accessibility of services and participation in community. Costs varied depending on care and support needs, accessibility (physical and financial), availability, and knowledge of services and assistive devices. Conclusions The development of poverty alleviation and social protection mechanisms in MICs like South Africa needs to better consider diverse disability-related care and support needs not only to improve access to services such as education and health (National Health Insurance schemes, accessible clinics) but also to increase the effect of disability-specific benefits and employment equity policies. PMID:28730066

Defining HIV risk and determining responsibility in postsocialist Poland.

PubMed

Owczarzak, Jill

2009-12-01

Drawing on 15 months of ethnographic research on HIV prevention programs in Poland, I explore the consequences of the shift from models of HIV prevention that emphasize "risk groups" and AIDS blame, to models that focus on "risky behaviors" and universal risk. The centrality of choice making and individual risk management in these models suggests objective risk assessment free from moralizing arguments. The Polish national prevention strategy shifted to focus on choice making, address all risk groups, and include concrete prevention strategies. This shift created a backlash that resulted in the reassertion of moral arguments about risk and risk groups that positioned those most vulnerable to HIV outside the purview of prevention efforts. AIDS organizations working with marginalized, "morally problematic" populations used the label "at risk" to legitimize claims to resources. They enacted a model of risk reduction in which the relevant actor is the individual buffeted by social forces; behavior change, and therefore HIV risk reduction, is a long process because of myriad forms of vulnerability clients face. Despite efforts to reconceptualize risk, organizations positioned the individual as the locus of HIV prevention interventions, rather than attempting to address the social context that shapes risk.

Why are older peoples' health needs forgotten post-natural disaster relief in developing countries? A healthcare provider survey of 2005 Kashmir, Pakistan earthquake.

PubMed

Chan, Emily Ying Yang

2009-01-01

Although older people may be recognized as a vulnerable group post-natural disasters, their particular needs are rarely met by the providers of emergency services. Studies about older people's health needs post disasters in the South East Asia Tsunami, Kashmir, Pakistan, China, and United States has revealed the lack of concern for older people's health needs. Recent study of older people's health needs post the Kashmir Pakistan earthquake (2005) found older peoples' health needs were masked within the general population. This survey study examines the providers' perceptions of older people's vulnerabilities post-2005 Pakistan earthquake. It aims to understand the awareness of geriatric issues and issues related to current service provision/planning for older people's health needs post disasters. Specifically, service delivery patterns will be compared among different relief agencies. Cross-sectional, structured stakeholder interviews were conducted within a 2 weeks period in February 2006, 4 months post-earthquake in Pakistan-administrated Kashmir. Health/medical relief agencies of three different types of organizational nature: international nongovernmental organization (INGO), national organization, and local/community group were solicited to participate in the study. Descriptive analysis was conducted. Important issues identified include the need to sensitize relief and health workers about older people's health needs post disaster the development of relevant clinical guidelines for chronic disease management postdisaster in developing countries and the advocacy of building in geriatric related components in natural disaster medical relief programs. To effectively address the vulnerability of older people, it is important for governments, relief agencies, and local partners to include and address these issues during their relief operations and policy planning.

Falling through the cracks: a qualitative study of HIV risks among women who use drugs and alcohol in Northeast India

PubMed Central

2013-01-01

Background HIV risks for women who inject drugs and those who engage in sex work are well documented. Women who are dependent on non-injecting drugs and alcohol are also likely to have increased vulnerability to HIV infection, but until they actually inject drugs or engage in sex work, are unlikely to come to the attention of HIV prevention programs. Methods We undertook a qualitative study involving nine focus group discussions (FGDs) and 27 key informant interviews to investigate the context of female drug and alcohol use in two high HIV prevalence states of India (Manipur and Nagaland) and to describe their HIV risks. The FGD and interview transcripts were thematically analyzed Results The women were relatively young (mean age 31 years in Manipur and 28 years in Nagaland), but 64% in Manipur and 35% in Nagaland were widowed or divorced. Both heroin and alcohol were commonly used by the women from Manipur, while alcohol was primarily used by the women from Nagaland, especially in the context of ‘booze joints’ (illicit bars). Reasons for drug and alcohol use included: to avoid symptoms of withdrawal, to suppress emotional pain, to overcome the shame of sex work, pleasure, and widowhood. HIV vulnerability was clearly described, not only in relation to injecting drug use and sex work, but also alcohol consumption. Conclusions The contribution of alcohol use to the HIV vulnerability of women is not currently considered when HIV prevention programs are being designed and implemented leaving a group of high-risk women uncovered by much needed services such as treatment for a range of health problems including alcohol dependence. PMID:23360360

Factors influencing to earthquake caused economical losses on urban territories

NASA Astrophysics Data System (ADS)

Nurtaev, B.; Khakimov, S.

2005-12-01

Questions of assessment of earthquake economical losses on urban territories of Uzbekistan, taking into account damage forming factors, which are increqasing or reducing economical losses were discussed in the paper. Buildings and facilities vulnerability factors were classified. From total value (equal to 50) were selected most important ones. Factors ranging by level of impact and weight function in loss assessment were ranged. One group of damage forming factors includs seismic hazard assessment, design, construction and maintenance of building and facilities. Other one is formed by city planning characteristics and includes : density of constructions and population, area of soft soils, existence of liquefaction susceptible soils and etc. To all these factors has been given weight functions and interval values by groups. Methodical recomendations for loss asessment taking into account above mentioned factors were developed. It gives possibility to carry out preventive measures for protection of vulnerable territories, to differentiate cost assessment of each region in relation with territory peculiarity and damage value. Using developed method we have ranged cities by risk level. It has allowed to establish ratings of the general vulnerability of urban territories of cities and on their basis to make optimum decisions, oriented to loss mitigation and increase of safety of population. Besides the technique can be used by insurance companies for estimated zoning of territory, development of effective utilization schema of land resources, rational town-planning, an economic estimation of used territory for supply with information of the various works connected to an estimation of seismic hazard. Further improvement of technique of establishment of rating of cities by level of damage from earthquakes will allow to increase quality of construction, rationality of accommodation of buildings, will be an economic stimulator for increasing of seismic resistance of building.

Giving voice to vulnerable people: the value of shadowing for phenomenological healthcare research.

PubMed

van der Meide, Hanneke; Leget, Carlo; Olthuis, Gert

2013-11-01

Phenomenological healthcare research should include the lived experiences of a broad group of healthcare users. In this paper it is shown how shadowing can give a voice to people in vulnerable situations who are often excluded from interview studies. Shadowing is an observational method in which the researcher observes an individual during a relatively long time. Central aspects of the method are the focus on meaning expressed by the whole body, and an extended stay of the researcher in the phenomenal event itself. Inherent in shadowing is a degree of ambivalence that both challenges the researcher and provides meaningful insights about the phenomenon. A case example of a phenomenological study on the experiences of elderly hospital patients is used to show what shadowing yields.

Social determinants of health: poverty, national infrastructure and investment.

PubMed

Douthit, Nathan T; Alemu, Haimanot Kasahun

2016-06-22

This case presentation of a 19-year-old Ethiopian woman diagnosed with nasopharyngeal carcinoma reveals the barriers the patient has to medical treatment, including poverty and a lack of national infrastructure. The patient lives a life of poverty, and the outcome of her illness is a result of her being unable to overcome barriers to accessing health care due to inability to afford transport, lodging and treatment. In this case, the patient's vulnerability to disease due to her poverty is not overcome because of lack of infrastructure. The infrastructure fails to develop because of inadequate investment and other delays in building. The end result is that the patient is vulnerable to disease. Her disease process impacts her family and their contribution to Ethiopia's development. 2016 BMJ Publishing Group Ltd.

Live to 70 Years and Older or Suffer in Silence: Understanding Health Insurance Status Among the Elderly Under the NHIS in Ghana.

PubMed

Fenny, Ama P

2017-01-01

Ghana has introduced a National Health Insurance Scheme (NHIS). Embedded in the NHIS is a policy to exempt poor and vulnerable groups from premiums and user fees. There has been some debate as to why the start-off age for exemption among the elderly is 70 years. Ghana has a shorter life expectancy than middle- and high-income countries and its current age of retirement is 60 years. This study explores the financial and social implications of continuing to charge premiums to people aged 60 to 69 years. Based on the analysis of data from a representative household survey, it is recommended that the exemption policy should be expanded to include all vulnerable elderly persons, regardless of age.

Facilitators and Barriers to Dental Care Among Mexican Migrant Women and Their Families in North San Diego County.

PubMed

Velez, Diane; Palomo-Zerfas, Ana; Nunez-Alvarez, Arcela; Ayala, Guadalupe X; Finlayson, Tracy L

2017-10-01

To qualitatively examine facilitators and barriers to dental care access and quality services among Mexican migrant women and their families living in North San Diego County, California. Six focus groups were conducted, with 52 participants. Three focus groups were with community residents (average group size of 10), and three were with community health workers/leaders (called Lideres; average group size of 7). The behavioral model for vulnerable populations theoretical framework guided qualitative data analyses. Predisposing factors to dental care access varied and included immigration status, language, and dental care experiences. Barriers to accessing quality dental services included high cost, lack of insurance coverage, dissatisfaction with providers, long wait times and discrimination. Participants expressed a desire for health policy changes, including affordable coverage for immigrants and their families. This study provided insights into how dental care providers, community health centers, and policymakers can improve dental care access and services to migrant populations.

The safety of yellow fever vaccine 17D or 17DD in children, pregnant women, HIV+ individuals, and older persons: systematic review.

PubMed

Thomas, Roger E; Lorenzetti, Diane L; Spragins, Wendy; Jackson, Dave; Williamson, Tyler

2012-02-01

Yellow fever vaccine provides long-lasting immunity. Rare serious adverse events after vaccination include neurologic or viscerotropic syndromes or anaphylaxis. We conducted a systematic review of adverse events associated with yellow fever vaccination in vulnerable populations. Nine electronic bibliographic databases and reference lists of included articles were searched. Electronic databases identified 2,415 abstracts for review, and 32 abstracts were included in this review. We identified nine studies of adverse events in infants and children, eight studies of adverse events in pregnant women, nine studies of adverse events in human immunodeficiency virus-positive patients, five studies of adverse events in persons 60 years and older, and one study of adverse events in individuals taking immunosuppressive medications. Two case studies of maternal-neonate transmission resulted in serious adverse events, and the five passive surveillance databases identified very small numbers of cases of yellow fever vaccine-associated viscerotropic disease, yellow fever vaccine-associated neurotropic disease, and anaphylaxis in persons ≥ 60 years. No other serious adverse events were identified in the other studies of vulnerable groups.

Narrowing the Gap in Outcomes for Vulnerable Groups: Overview and Analysis of Available Datasets on Vulnerable Groups and the Five ECM Outcomes. Executive Summary

ERIC Educational Resources Information Center

Morris, Marian

2007-01-01

This summary presents the main findings from a data mapping and analysis study commissioned by the Local Government Association (LGA) from the National Foundation for Educational Research (NFER) as part of a two-year development and research programme, Narrowing the Gap. This programme seeks to make a significant difference in "narrowing the…

The KnowRISK project: Tools and strategies for risk communication and learning

NASA Astrophysics Data System (ADS)

Musacchio, Gemma; Amaral Ferreira, Mónica; Falsaperla, Susanna; Piangiamore, Giovanna Lucia; Pino, Nicola Alessandro; Solarino, Stefano; Crescimbene, Massimo; Eva, Elena; Reitano, Danilo; Þorvaldsdottir, Solveig; Sousa Silva, Delta; Rupakhety, Rajesh; Sousa Oliveira, Carlos

2016-04-01

Damage of non-structural elements of buildings (i.e. partitions, ceilings, cladding, electrical and mechanical systems and furniture) is known to cause injuries and human losses. Also it has a significant impact on earthquake resilience and is yet being worldwide underestimated. The project KnowRISK (Know your city, Reduce seISmic risK through non-structural elements) is financed by the European Commission to develop prevention measures that may reduce non-structural damage in urban areas. Pilot areas of the project are within the three European participating countries, namely Portugal, Iceland and Italy. They were chosen because they are prone to damage level 2 and 3 (EMS-98, European Macroseismic Scale) that typically affects non-structural elements. We will develop and test a risk communication strategy taking into account the needs of households and schools, putting into practice a portfolio of best practice to reduce the most common non-structural vulnerabilities. We will target our actions to different societal groups, considering their cultural background and social vulnerabilities, and implement a participatory approach that will promote engagement and interaction between the scientific community, practitioners and citizens to foster knowledge on everyone's own neighborhoods, resilience and vulnerability. A Practical Guide for citizens will highlight that low-cost actions can be implemented to increase safety of households, meant as being the places where the most vulnerable societal groups, including children and elderly people, spend much of their time. Since our actions towards communication will include education, we will define tools that allow a clear and direct understanding of elements exposed to risk. Schools will be one of our target societal groups and their central role played at the community level will ensure spreading and strengthening of the communication process. Schools are often located in old or re-adapted buildings, formerly used for other uses, or when the growing number of students or new needs require adapting the space to the necessities, often without taking enough care of safety. Moreover, in urban areas, schools may be hosted in tall buildings where the shaking of moderate-to-low magnitude earthquakes can cause damage level 2 and 3. Students will be involved into looking after their own situation in terms of non-structural vulnerability to promote education and prevention, while increasing resilience in terms of societal capacity to cope with future disasters. The actions will undergo specific effectiveness assessment with ex-ante and ex-post surveys. The results of this assessment will allow an evaluation of on-site risk communication activities, the comparability between pilot-areas achievements, and an opportunity for learning and guidance for future risk communication.

Food security and nutritional outcomes among urban poor orphans in Nairobi, Kenya.

PubMed

Kimani-Murage, Elizabeth W; Holding, Penny A; Fotso, Jean-Christophe; Ezeh, Alex C; Madise, Nyovani J; Kahurani, Elizabeth N; Zulu, Eliya M

2011-06-01

The study examines the relationship between orphanhood status and nutritional status and food security among children living in the rapidly growing and uniquely vulnerable slum settlements in Nairobi, Kenya. The study was conducted between January and June 2007 among children aged 6-14 years, living in informal settlements of Nairobi, Kenya. Anthropometric measurements were taken using standard procedures and z scores generated using the NCHS/WHO reference. Data on food security were collected through separate interviews with children and their caregivers, and used to generate a composite food security score. Multiple regression analysis was done to determine factors related to vulnerability with regards to food security and nutritional outcomes. The results show that orphans were more vulnerable to food insecurity than non-orphans and that paternal orphans were the most vulnerable orphan group. However, these effects were not significant for nutritional status, which measures long-term food deficiencies. The results also show that the most vulnerable children are boys, those living in households with lowest socioeconomic status, with many dependants, and female-headed and headed by adults with low human capital (low education). This study provides useful insights to inform policies and practice to identify target groups and intervention programs to improve the welfare of orphans and vulnerable children living in urban poor communities.

Fleshing out vulnerability.

PubMed

Tavaglione, Nicolas; Martin, Angela K; Mezger, Nathalie; Durieux-Paillard, Sophie; François, Anne; Jackson, Yves; Hurst, Samia A

2015-02-01

In the literature on medical ethics, it is generally admitted that vulnerable persons or groups deserve special attention, care or protection. One can define vulnerable persons as those having a greater likelihood of being wronged - that is, of being denied adequate satisfaction of certain legitimate claims. The conjunction of these two points entails what we call the Special Protection Thesis. It asserts that persons with a greater likelihood of being denied adequate satisfaction of their legitimate claims deserve special attention, care or protection. Such a thesis remains vague, however, as long as we do not know what legitimate claims are. This article aims at dispelling this vagueness by exploring what claims we have in relation to health care - thus fleshing out a claim-based conception of vulnerability. We argue that the Special Protection Thesis must be enriched as follows: If individual or group X has a greater likelihood of being denied adequate satisfaction of some of their legitimate claims to (i) physical integrity, (ii) autonomy, (iii) freedom, (iv) social provision, (v) impartial quality of government, (vi) social bases of self-respect or (vii) communal belonging, then X deserves special attention, care or protection. With this improved understanding of vulnerability, vulnerability talk in healthcare ethics can escape vagueness and serve as an adequate basis for practice. © 2013 John Wiley & Sons Ltd.

Unified communication to reach vulnerable mothers.

PubMed

Tezcan, B; Von Rege, I; Henkson, H; Oteng-Ntim, E

2011-01-01

The feasibility of using a mobile text to reach vulnerable patient groups was assessed in this study. A total of 121 pregnant or postnatal women were randomly asked to complete a questionnaire. The questionnaire was given to them in the antenatal clinic, postnatal ward, antenatal ward or in the day assessment unit at St Thomas' Hospital, London. The forms were collected and analysed using an Excel database. The results of this survey show that mobile technology is readily available for 97% of the obstetric population. In mothers from vulnerable groups and in mothers from deprived areas, 61% possessed 3rd generation mobile technology. The majority of mothers surveyed wanted their care supplemented by the use of their mobile phones.

Messages about appearance, food, weight and exercise in "tween" television.

PubMed

Simpson, Courtney C; Kwitowski, Melissa; Boutte, Rachel; Gow, Rachel W; Mazzeo, Suzanne E

2016-12-01

Tweens (children ages ~8-14years) are a relatively recently defined age group, increasingly targeted by marketers. Individuals in this age group are particularly vulnerable to opinions and behaviors presented in media messages, given their level of cognitive and social development. However, little research has examined messages about appearance, food, weight, and exercise in television specifically targeting tweens, despite the popularity of this media type among this age group. This study used a content analytic approach to explore these messages in the five most popular television shows for tweens on the Disney Channel (as of 2015). Using a multiple-pass approach, relevant content in episodes from the most recently completed seasons of each show was coded. Appearance related incidents occurred in every episode; these most frequently mentioned attractiveness/beauty. Food related incidents were also present in every episode; typically, these situations were appearance and weight neutral. Exercise related incidents occurred in 53.3% of episodes; the majority expressed resistance to exercise. Weight related incidents occurred in 40.0% of the episodes; the majority praised the muscular ideal. Women were more likely to initiate appearance incidents, and men were more likely to initiate exercise incidents. These results suggest that programs specifically marketed to tweens reinforce appearance ideals, including stereotypes about female attractiveness and male athleticism, two constructs linked to eating pathology and body dissatisfaction. Given the developmental vulnerability of the target group, these findings are concerning, and highlight potential foci for prevention programming, including media literacy, for tweens. Copyright © 2016 Elsevier Ltd. All rights reserved.

Extreme heat and cultural and linguistic minorities in Australia: perceptions of stakeholders

PubMed Central

2014-01-01

Background Despite acclimatisation to hot weather, many individuals in Australia are adversely affected by extreme heat each summer, placing added pressure on the health sector. In terms of public health, it is therefore important to identify vulnerable groups, particularly in the face of a warming climate. International evidence points to a disparity in heat-susceptibility in certain minority groups, although it is unknown if this occurs in Australia. With cultural diversity increasing, the aim of this study was to explore how migrants from different cultural backgrounds and climate experiences manage periods of extreme heat in Australia. Methods A qualitative study was undertaken across three Australian cities, involving interviews and focus groups with key informants including stakeholders involved in multicultural service provision and community members. Thematic analysis and a framework approach were used to analyse the data. Results Whilst migrants and refugees generally adapt well upon resettlement, there are sociocultural barriers encountered by some that hinder environmental adaptation to periods of extreme heat in Australia. These barriers include socioeconomic disadvantage and poor housing, language barriers to the access of information, isolation, health issues, cultural factors and lack of acclimatisation. Most often mentioned as being at risk were new arrivals, people in new and emerging communities, and older migrants. Conclusions With increasing diversity within populations, it is important that the health sector is aware that during periods of extreme heat there may be disparities in the adaptive capacity of minority groups, underpinned by sociocultural and language-based vulnerabilities in migrants and refugees. These factors need to be considered by policymakers when formulating and disseminating heat health strategies. PMID:24889099

Extreme heat and cultural and linguistic minorities in Australia: perceptions of stakeholders.

PubMed

Hansen, Alana; Nitschke, Monika; Saniotis, Arthur; Benson, Jill; Tan, Yan; Smyth, Val; Wilson, Leigh; Han, Gil-Soo; Mwanri, Lillian; Bi, Peng

2014-06-03

Despite acclimatisation to hot weather, many individuals in Australia are adversely affected by extreme heat each summer, placing added pressure on the health sector. In terms of public health, it is therefore important to identify vulnerable groups, particularly in the face of a warming climate. International evidence points to a disparity in heat-susceptibility in certain minority groups, although it is unknown if this occurs in Australia. With cultural diversity increasing, the aim of this study was to explore how migrants from different cultural backgrounds and climate experiences manage periods of extreme heat in Australia. A qualitative study was undertaken across three Australian cities, involving interviews and focus groups with key informants including stakeholders involved in multicultural service provision and community members. Thematic analysis and a framework approach were used to analyse the data. Whilst migrants and refugees generally adapt well upon resettlement, there are sociocultural barriers encountered by some that hinder environmental adaptation to periods of extreme heat in Australia. These barriers include socioeconomic disadvantage and poor housing, language barriers to the access of information, isolation, health issues, cultural factors and lack of acclimatisation. Most often mentioned as being at risk were new arrivals, people in new and emerging communities, and older migrants. With increasing diversity within populations, it is important that the health sector is aware that during periods of extreme heat there may be disparities in the adaptive capacity of minority groups, underpinned by sociocultural and language-based vulnerabilities in migrants and refugees. These factors need to be considered by policymakers when formulating and disseminating heat health strategies.

Engineering Safety- and Security-Related Requirements for Software-Intensive Systems

DTIC Science & Technology

2010-04-27

Requirements Negative (shall not) Requirements Hardware Requirements equ remen s System / Documentation Requirements eve oper Requirements Operational ...Validation Actual / Proposed Defensibility C li Operational Vulnerability Analysis VulnerabilityVulnerability Safety Vulnerability performs System ...including suggestions for reducing this burden, to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson

[Aged woman's vulnerability related to AIDS].

PubMed

Silva, Carla Marins; Lopes, Fernanda Maria do Valle Martins; Vargens, Octavio Muniz da Costa

2010-09-01

This article is a systhematic literature review including the period from 1994 to 2009, whose objective was to discuss the aged woman's vulnerability in relation to Acquired Imunodeficiency Syndrome (Aids). The search for scientific texts was accomplished in the following databases: Biblioteca Virtual em Saúde, Scientific Eletronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) and Medical Literature Analysis and Retrieval System Online (MEDLINE). The descriptors used were vulnerability, woman and Aids. Eighteen texts were analyzed, including articles in scientific journals, thesis and dissertations. As a conclusion, it was noted that aged women and vulnerability to Aids are directly related, through gender characteristics including submission and that were built historical and socially. We consider as fundamental the development of studies which may generate publications accessible to women, in order to help them see themselves as persons vulnerable to Aids contagion just for being women.

Identifying Two Groups of Entitled Individuals: Cluster Analysis Reveals Emotional Stability and Self-Esteem Distinction.

PubMed

Crowe, Michael L; LoPilato, Alexander C; Campbell, W Keith; Miller, Joshua D

2016-12-01

The present study hypothesized that there exist two distinct groups of entitled individuals: grandiose-entitled, and vulnerable-entitled. Self-report scores of entitlement were collected for 916 individuals using an online platform. Model-based cluster analyses were conducted on the individuals with scores one standard deviation above mean (n = 159) using the five-factor model dimensions as clustering variables. The results support the existence of two groups of entitled individuals categorized as emotionally stable and emotionally vulnerable. The emotionally stable cluster reported emotional stability, high self-esteem, more positive affect, and antisocial behavior. The emotionally vulnerable cluster reported low self-esteem and high levels of neuroticism, disinhibition, conventionality, psychopathy, negative affect, childhood abuse, intrusive parenting, and attachment difficulties. Compared to the control group, both clusters reported being more antagonistic, extraverted, Machiavellian, and narcissistic. These results suggest important differences are missed when simply examining the linear relationships between entitlement and various aspects of its nomological network.

Contexts, Mechanisms, and Outcomes That Matter in Dutch Community-Based Physical Activity Programs Targeting Socially Vulnerable Groups.

PubMed

Herens, Marion; Wagemakers, Annemarie; Vaandrager, Lenneke; van Ophem, Johan; Koelen, Maria

2017-09-01

This article presents a practitioner-based approach to identify key combinations of contextual factors (C) and mechanisms (M) that trigger outcomes (O) in Dutch community-based health-enhancing physical activity (CBHEPA) programs targeting socially vulnerable groups. Data were collected in six programs using semi-structured interviews and focus groups using a timeline technique. Sessions were recorded, anonymized, and transcribed. A realist synthesis protocol was used for data-driven and thematic analysis of CMO configurations. CMO configurations related to community outreach, program sustainability, intersectoral collaboration, and enhancing participants' active lifestyles. We have refined the CBHEPA program theory by showing that actors' passion for, and past experiences with, physical activity programs trigger outcomes, alongside their commitment to socially vulnerable target groups. Project discontinuity, limited access to resources, and a trainer's stand-alone position were negative configurations. The authors conclude that local governance structures appear often to lack adaptive capacity to accommodate multilevel processes to sustain programs.

Psychotherapy of Bereavement After Homicide

PubMed Central

RYNEARSON, TED

1994-01-01

The author presents guidelines for the assessment and initial treatment of bereavement after a homicide. Early interventions include nonverbal techniques applied in individual and group therapy. Because patients are over-whelmed and reactive, initial treatment strategy is supportive and focuses on reestablishing resiliency rather than on preexisting vulnerabilities (ambivalence, guilt, repression, denial). Adjustment to homicidal dying is lifelong, and therapist and patient should acknowledge that change may be limited. PMID:22700202

Detection of Vulnerable Atherosclerotic Plaques in Experimental Atherosclerosis with the USPIO-Enhanced MRI.

PubMed

Qi, Chun-Mei; Du, Lili; Wu, Wei-Heng; Li, Dong-Ye; Hao, Ji; Gong, Lei; Deng, Liangrong; Zhang, Tao; Zhang, Chao; Zhang, Yu

2015-11-01

This study's goal was to assess the diagnostic value of the USPIO-(ultra-small superparamagnetic iron oxide) enhanced magnetic resonance imaging (MRI) in detection of vulnerable atherosclerotic plaques in abdominal aorta in experimental atherosclerosis. Thirty New Zealand rabbits were randomly divided into two groups, Group A and Group B. Each group comprised 15 animals which were fed with high cholesterol diet for 8 weeks and then subjected to balloon-induced endothelial injury of the abdominal aorta. After another 8 weeks, animals in Group B received adenovirus carrying p53 gene that was injected through a catheter into the aortic segments rich in plaques. Two weeks later, all rabbits were challenged with the injection of Chinese Russell's viper venom and histamine. Pre-contrast images and USPIO-enhanced MRI images were obtained after pharmacological triggering with injection of USPIO for 5 days. Blood specimens were taken for biochemical and serological tests at 0 and 18 weeks. Abdominal aorta was histologically studied. The levels of serum ICAM-1 and VCAM-1 were quantified by ELISA. Vulnerable plaques appeared as a local hypo-intense signal on the USPIO-enhanced MRI, especially on T2*-weighted sequences. The signal strength of plaques reached the peak at 96 h. Lipid levels were significantly (p < 0.05) higher in both Group A and B compared with the levels before the high cholesterol diet. The ICAM-1 and VCAM-1 levels were significantly (p < 0.05) higher in Group B compared with Group A. The USPIO-enhanced MRI efficiently identifies vulnerable plaques due to accumulation of USPIO within macrophages in abdominal aorta plaques.

Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya.

PubMed

Kimani-Murage, E W; Schofield, L; Wekesah, F; Mohamed, S; Mberu, B; Ettarh, R; Egondi, T; Kyobutungi, C; Ezeh, A

2014-12-01

Food and nutrition security is critical for economic development due to the role of nutrition in healthy growth and human capital development. Slum residents, already grossly affected by chronic poverty, are highly vulnerable to different forms of shocks, including those arising from political instability. This study describes the food security situation among slum residents in Nairobi, with specific focus on vulnerability associated with the 2007/2008 postelection crisis in Kenya. The study from which the data is drawn was nested within the Nairobi Urban Health and Demographic Surveillance System (NUHDSS), which follows about 70,000 individuals from close to 30,000 households in two slums in Nairobi, Kenya. The study triangulates data from qualitative and quantitative sources. It uses qualitative data from 10 focus group discussions with community members and 12 key-informant interviews with community opinion leaders conducted in November 2010, and quantitative data involving about 3,000 households randomly sampled from the NUHDSS database in three rounds of data collection between March 2011 and January 2012. Food security was defined using the Household Food Insecurity Access Scale (HFIAS) criteria. The study found high prevalence of food insecurity; 85% of the households were food insecure, with 50% being severely food insecure. Factors associated with food security include level of income, source of livelihood, household size, dependence ratio; illness, perceived insecurity and slum of residence. The qualitative narratives highlighted household vulnerability to food insecurity as commonplace but critical during times of crisis. Respondents indicated that residents in the slums generally eat for bare survival, with little concern for quality. The narratives described heightened vulnerability during the 2007/2008 postelection violence in Kenya in the perception of slum residents. Prices of staple foods like maize flour doubled and simultaneously household purchasing power was eroded due to worsened unemployment situation. The use of negative coping strategies to address food insecurity such as reducing the number of meals, reducing food variety and quality, scavenging, and eating street foods was prevalent. In conclusion, this study describes the deeply intertwined nature of chronic poverty and acute crisis, and the subsequent high levels of food insecurity in urban slum settings. Households are extremely vulnerable to food insecurity; the situation worsening during periods of crisis in the perception of slum residents, engendering frequent use of negative coping strategies. Effective response to addressing vulnerability to household food insecurity among the urban poor should focus on both the underlying vulnerabilities of households due to chronic poverty and added impacts of acute crises.

Family vulnerability index to disability and dependence (FVI-DD), by social and health conditions.

PubMed

Amendola, Fernanda; Alvarenga, Márcia Regina Martins; Latorre, Maria do Rosário Dias de Oliveira; Oliveira, Maria Amélia de Campos

2017-06-01

The Family Vulnerability Index to Disability and Dependence (FVI-DD) aims to summarize the dimensions of vulnerability to disability and dependence using family data monitored by Family Health Strategy (ESF) teams. This study aims to analyze the FVI-DD according to the social and health vulnerability, to validate and extract a cutoff point for each dimension. The FVI-DD was built with a sample of 248 families living in a region of São Paulo. The dimension related to health conditions was validated with good internal consistency, with respect to the Katz Index and the Lawton Scale, whereas the dimension related to social conditions was only validated in relation to Lawton Scale. Thus, a vulnerable family was defined as one with 15 or more points in the Total FVI-DD, and a vulnerable family in health conditions that with a score of 6 or more points in that dimension. Therefore, it is possible to classify families as not vulnerable, vulnerable in the social aspects, vulnerable in the health aspects and the more vulnerable family (social and health) using social indicators of empowerment and wear and health indicators related not only to the biological sphere, but also in the access to health services, health self-assessment and existing vulnerable groups.

Coping capacity among women with abusive partners.

PubMed

Nurius, P S; Furrey, J; Berliner, L

1992-01-01

Coping capacity, although increasingly implicated as a mediating force in how individuals respond to personal threat, is an underrecognized factor in work with women of abusive partners. To explore the utility of coping capacity as a multivariable set to guide intervention with women of abusive partners, findings are reported comparing four groups of women: those whose partners do not engage in abuse, are abusive toward them, are sex offenders of children for whom the woman is a parent, or are offenders of children for whom the woman is not a parent. Three variable sets were included: vulnerability factors that may negatively influence appraisals of threat and ability to cope with abuse; coping responses that include cognitive, emotional, and behavioral reactions to the abuse; and coping resources expected to mediate effects of vulnerability factors and to influence the mobilization (of lack thereof) of coping responses. There were significant differences in coping capacity profiles across the four groups. These appeared to be a continuum of coping capacity, with women who were most directly threatened showing the lowest and women who were least directly threatened showing the highest levels of coping capacity. In order from the lowest to the highest levels of coping capacity were (1) battered women, (2) women whose partners are offenders against their children, (3) women whose partners are offenders against children of whom they are not the parent, and (4) control group women. The paper ends with a conceptual interpretation of the mediating functions of coping resources and implications for intervention and further study.

Economic Analysis of Cyber Security

DTIC Science & Technology

2006-07-01

vulnerability databases and track the number of incidents reported by U.S. organizations. Many of these are private organizations, such as the security...VULNERABILITY AND ATTACK ESTIMATES Numerous organizations compile vulnerability databases and patch information, and track the number of reported incidents... database / security focus Databases of vulnerabilities identifying the software versions that are susceptible, including information on the method of

Obsessional and Eating Disorder-related Intrusive Thoughts: Differences and Similarities Within and Between Individuals Vulnerable to OCD or to EDs.

PubMed

Belloch, Amparo; Roncero, María; Perpiñá, Conxa

2016-11-01

Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive-compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no-risk group (n = 100). EDITs were more frequent than OITs in the two risk groups. Within-group comparisons showed that in the OCD-risk group, the OIT had more negative consequences (interference, emotional distress, dysfunctional appraisals and neutralizing strategies) than the EDIT, whereas in the ED-risk group, the OIT and the EDIT instigated similar negative consequences. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Vulnerabilities of ecosystems across U.S. National Parks to biome shifts, wildfire changes, and invasive species due to climate change

NASA Astrophysics Data System (ADS)

Gonzalez, P.; Eigenbrod, F.; Early, R.; Wang, F.; Notaro, M.; Williams, J. W.

2016-12-01

U.S. national parks conserve globally unique biodiversity. Yet, historical impacts of climate change and future vulnerabilities threaten species and ecosystems across this system of protected areas. Spatial analyses of historical climate and downscaled future climate projections show climate trends across the system. Spatial analyses of vegetation and wildfire (using a dynamic global vegetation model), habitat fragmentation (using remote sensing-derived land cover), and invasive species introduction and establishment show patterns of future vulnerability across the 50 U.S. states and 412 U.S. national parks. Results reveal high historical and projected temperature increases and precipitation changes, projected increases of wildfire across western U.S. national parks, high vulnerability to biome shifts and habitat fragmentation of up to one-third of National Park System area, and high vulnerability to invasive species of one-ninth of National Park System area. Ecosystems in the Sierra Nevada, Cascade Range, desert Southwest, and Laurentian Great Lakes are highly vulnerable to upslope and poleward shifts of the North America sequence of biomes: temperate shrubland - temperate broadleaf forest - temperate mixed forest - temperate conifer forest - subalpine and boreal forest - alpine and tundra. These areas include Grand Canyon, Mount Rainier, and Yosemite National Parks. The southwestern U.S., including Grand Canyon and Sequoia National Parks, is vulnerable to increases in wildfire. The eastern and midwestern U.S., including Great Smokey Mountains and Voyageurs National Parks, are highly vulnerable to invasive species. These results identify vulnerable areas and potential refugia to help prioritize areas for future natural resource management actions and biodiversity conservation in U.S. national parks.

Do Children Orphaned by AIDS Experience Distress Over Time? A Latent Growth Curve Analysis of Depressive Symptoms

PubMed Central

Chi, Peilian; Li, Xiaoming; Barnett, Douglas; Zhao, Junfeng; Zhao, Guoxiang

2014-01-01

This longitudinal study aimed to examine the enduring effects of parental HIV/AIDS on children's psychological well-being in Asia. A sample of 1625 children aged from 6 to 18 years old were assessed annually for their depressive symptoms over three years. Latent growth curve modeling (LGCM) was used to examine the trajectories of depressive symptoms among AIDS orphans and vulnerable children in comparison with children from HIV-free families. AIDS orphans demonstrated the highest initial level of depressive symptoms among the three groups. On average, children's depressive symptoms scores can be expected to realize an approximate 25% decrease for AIDS orphans, 19% decrease for vulnerable children and 15% decrease for comparison children over a 3-year period. Individual differences within the groups showed that children with higher initial level of depressive symptoms can be expected to decrease slower over time. Multiple group LGCM showed that the three groups of children demonstrated significantly different trajectories of depressive symptoms. Among the key demographic factors, only age exerted an effect on the trajectory of depressive symptoms of vulnerable children, indicating that the younger children showed higher level of initial depressive symptoms and lower rate of decrease than the older children. The current study enriched our knowledge on the longitudinal effect of parental HIV/AIDS on children's emotional distress. Future psychological support might take the children's developmental stages and cultural appropriateness into consideration and deliver service for the most vulnerable group of children affected by HIV/AIDS. PMID:24090100

Association Between Medicare Accountable Care Organization Implementation and Spending Among Clinically Vulnerable Beneficiaries.

PubMed

Colla, Carrie H; Lewis, Valerie A; Kao, Lee-Sien; O'Malley, A James; Chang, Chiang-Hua; Fisher, Elliott S

2016-08-01

Accountable care contracts hold physician groups financially responsible for the quality and cost of health care delivered to patients. Focusing on clinically vulnerable patients, those with serious conditions who are responsible for the greatest proportion of spending, may result in the largest effects on both patient outcomes and financial rewards for participating physician groups. To estimate the effect of Medicare accountable care organization (ACO) contracts on spending and high-cost institutional use for all Medicare beneficiaries and for clinically vulnerable beneficiaries. For this cohort study, 2 study populations were defined: the overall Medicare population and the clinically vulnerable subgroup of Medicare beneficiaries. The overall Medicare population was based on a random 40% sample drawn from continuously enrolled fee-for-service beneficiaries with at least 1 evaluation and management visit in a calendar year. The clinically vulnerable study population included all Medicare beneficiaries 66 years or older who had at least 3 Hierarchical Condition Categories (HCCs). Beneficiaries entered the cohort during the quarter between January 2009 to December 2011 when they first had at least 3 HCCs and remained in the cohort until death. Cohort entry was restricted to the preperiod to account for potential changes in coding practices after ACO implementation. Difference-in-difference estimations were used to compare changes in health care outcomes for Medicare beneficiaries attributed to physicians in ACOs with those attributed to non-ACO physicians from January 2009 to December 2013. Medicare ACOs beginning contracts in January 2012, April 2012, July 2012, and January 2013 through the Pioneer and Medicare Shared Savings Programs. Total spending per beneficiary-quarter, spending categories, use of hospitals and emergency departments, ambulatory care sensitive admissions, and 30-day readmissions. Total spending decreased by $34 (95% CI, -$52 to -$15) per beneficiary-quarter after ACO contract implementation across the overall Medicare population (n = 15 592 600) and decreased $114 in clinically vulnerable patients (n = 8 673 823) (95% CI, -$178 to -$50). In the overall Medicare cohort, hospitalizations and emergency department visits decreased by 1.3 and 3.0 events per 1000 beneficiaries per quarter, respectively (95% CIs: -2.1 to -0.4 and -4.8 to -1.3), and hospitalizations and emergency department visits decreased in the clinically vulnerable cohort by 2.9 and 4.1 events per 1000 beneficiaries per quarter, respectively (95% CIs: -5.2 to -0.7 and -7.1 to -1.2). Changes in total spending associated with ACOs did not vary by clinical condition of beneficiaries. Medicare ACO programs are associated with modest reductions in spending and use of hospitals and emergency departments. Savings were realized through reductions in use of institutional settings in clinically vulnerable patients.

Multiscale Assessment of Listed and At-Risk Species’ Climate Change Vulnerabilities

DTIC Science & Technology

2017-07-15

Anthropogenically altered landscapes (e.g., urban or agricultural areas) that may hinder the dispersal of a species. B3. Land Use Changes from Climate Change...vulnerable (HV) and ex- tremely vulnerable (EV). Federal land management agencies include: Agricultural Research Service (ARS), Bu- reau of Land...agencies include: Agricultural Research Service (ARS), Bu- reau of Land Management (BLM), Bureau of Reclamation (BOR), Department of Defense (DoD

How diet modification challenges are magnified in vulnerable or marginalized people with diabetes and heart disease: a systematic review and qualitative meta-synthesis.

PubMed

Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

2013-01-01

Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Qualitative meta-synthesis was used to integrate findings across primary research studies. Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here--and of this synthesis--do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes.

How Diet Modification Challenges Are Magnified in Vulnerable or Marginalized People With Diabetes and Heart Disease

PubMed Central

Vanstone, M; Giacomini, M; Smith, A; Brundisini, F; DeJean, D; Winsor, S

2013-01-01

Background Diet modification is an important part of self-management for patients with diabetes and/or heart disease (including coronary artery disease, heart failure, and atrial fibrillation). Many health care providers and community-based programs advise lifestyle and diet modification as part of care for people with these conditions. This report synthesizes qualitative information on how patients respond differently to the challenges of diet modification. Qualitative and descriptive evidence can illuminate challenges that may affect the success and equitable impact of dietary modification interventions. Objectives To (a) examine the diet modification challenges faced by diabetes and/or heart disease patients; and (b) compare and contrast the challenges faced by patients who are members of vulnerable and nonvulnerable groups as they change their diet in response to clinical recommendations. Data Sources This report synthesizes 65 primary qualitative studies on the topic of dietary modification challenges encountered by patients with diabetes and/or heart disease. Included papers were published between 2002 and 2012 and studied adult patients in North America, Europe, and Australia/New Zealand. Review Methods Qualitative meta-synthesis was used to integrate findings across primary research studies. Results Analysis identified 5 types of challenges that are common to both vulnerable and nonvulnerable patients: self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. Vulnerable patients may experience additional barriers, many of which can magnify or exacerbate those common challenges. Limitations While qualitative insights are robust and often enlightening for understanding experiences and planning services in other settings, they are not intended to be generalizable. The findings of the studies reviewed here—and of this synthesis—do not strictly generalize to the Ontario (or any specific) population. This evidence must be interpreted and applied carefully, in light of expertise and the experiences of the relevant community. Conclusions Diet modification is not simply a matter of knowing what to eat and making the rational choice to change dietary practices. Rather, diet and eating practices should be considered as part of the situated lives of patients, requiring an individualized approach that is responsive to the conditions in which each patient is attempting to make a change. Common challenges include self-discipline, knowledge, coping with everyday stress, negotiating with family members, and managing the social significance of food. An individualized approach is particularly important when working with patients who have vulnerabilities. Plain Language Summary Health care providers often encourage people with diabetes and/or heart disease to change their diet. They advise people with diabetes to eat less sugar, starch, and fat. They advise people with heart disease to eat less fat and salt. However, many patients find it difficult to change what they eat. This report examines the challenges people may face when making such changes. It also examines the special challenges faced by people who are vulnerable due to other factors, such as poverty, lack of education, and difficulty speaking English. Five themes were common to all people who make diet changes: self-discipline, knowledge, coping with stress, negotiating with family members, and managing the social aspect of food. Members of vulnerable groups also reported other challenges, such as affording fresh fruit and vegetables or understanding English instructions. This report may help health care providers work with patients more effectively to make diet changes. PMID:24228077

Changes to criminal records checks used to safeguard vulnerable patients.

PubMed

Griffith, Richard; Tengnah, Cassam

2012-07-01

The Protection of Freedoms Act 2012 is introducing changes to the Criminal Records Bureau (CRB) checks carried out on those people who work with vulnerable groups. The new law is the coalition Government's response to the criticism of the Safeguarding Vulnerable Group Act 2006. It will merge the CRB and Independent Safeguarding Authority into a new Disclosure and Barring Service and will enhance the rights of applicants to challenge the CRB's right to disclose non-conviction information as part of an enhanced criminal records check. In the first of two articles on the Protection of Freedoms Act 2012, Richard Griffith and Cassam Tengnah discuss the current framework for disclosing criminal records and the impact of the changes on district nurses applying for new posts.

Vulnerability and agency: beyond an irreconcilable dichotomy for social service providers working with young refugees in the UK.

PubMed

O'Higgins, Aoife

2012-01-01

Many young refugees face significant difficulties in securing support from social services providers. This study invited 21 young refugees aged 16 to 21 to take part in focus groups and follow-up interviews about their experiences of accessing this support. The findings reveal that young refugees may deliberately conform to expectations about their vulnerability in order to benefit from greater support from service providers. Social workers may fail to consider young refugees' abilities and understand the ways in which each individual is vulnerable. The study suggests that group work may be an effective way to engage young refugees to overcome this. Copyright © 2012 Wiley Periodicals, Inc., A Wiley Company.

Assessing the Vulnerability of Agriculture to Climate Change in Jordan

NASA Astrophysics Data System (ADS)

Khresat, Sa'eb; Shraidaeh, Fadi; Maddat, Amer

2015-04-01

Climate change represents one of the greatest environmental, social and economic threats facing Jordan. In particular, the combined effects of climate change and water scarcity threaten to affect food and water resources that are critical for livelihoods in Jordan. This is especially true for those communities who live in the dryland area in the country and who rely wholly on rain-fed agriculture. The exact nature and extent of the impact of climate change on temperature and precipitation distribution pattern remain uncertain and it is the poor and vulnerable who will be the most susceptible to climate change adverse effects. A vulnerability assessment of rain fed agriculture to climate change and variability in semi-arid parts of Jordan was conducted in 2014. The purpose of this study is to assess the vulnerability and resilience of the most vulnerable groups where rainfed and irrigated agriculture is practiced. Also, the study focused on quantifying the impacts on agricultural productivity in response to climate change. This will help policymakers and researchers better understand and anticipate the likely impacts of climate change on agriculture and on vulnerable communities in Jordan. Also, it will provide them with tools to identify and implement appropriate adaptation strategies. The data used includes; Representative Concentration Pathways (RCPs), RCP 4.5 and RCP 8.5 adopted by the IPCC for its fifth Assessment Report (AR5). Those pathways were used for climate modeling. A decision support system (DSSAT) for agricultural production was used to assess the impact of climate changes on agricultural production. This approach was used for the Identification of climate change risk and their impacts on Agriculture. Outputs from models are used to assess the vulnerability of farmers and crops to climate and socio-economic change by estimating their sensitivity and capacity to adapt to external factors as a means of identifying what causes the differences in their vulnerability. Based on the projection models for the area, average temperature in Jordan is projected to increase between 1.2 and 1.6°C by 2050. These upward temperature trends are projected to continue beyond 2050. Projections for precipitation trends are projected to decrease by 16% by the year 2050. Evaporation is likely to increase due to higher temperatures. This is likely to increase the incidence of drought potential since precipitation is projected to decrease. It is concluded that the Overall vulnerability of agriculture to climate change in Jordan is high, where impacts such as drought and increased temperatures and decreased precipitation will be more pronounced. Major implications on rain fed agriculture are possible shorter growing season, increasing moisture and heat stress to field and horticultural crops and eventually low income and food insecurity. There were different impacts among studied communities, which is related to the: economic capability, local knowledge, physical infrastructure, institutional capacity, modern technology used, age group of farmers and diversification of their income.

Vulnerability assessments as a political creation: tsunami management in Portugal.

PubMed

Pronk, Maartje; Maat, Harro; Crane, Todd A

2017-10-01

Vulnerability assessments are a cornerstone of contemporary disaster research. This paper shows how research procedures and the presentation of results of vulnerability assessments are politically filtered. Using data from a study of tsunami risk assessment in Portugal, the paper demonstrates that approaches, measurement instruments, and research procedures for evaluating vulnerability are influenced by institutional preferences, lines of communication, or lack thereof, between stakeholder groups, and available technical expertise. The institutional setting and the pattern of stakeholder interactions form a filter, resulting in a particular conceptualisation of vulnerability, affecting its operationalisation via existing methods and technologies and its institutional embedding. The Portuguese case reveals a conceptualisation that is aligned with perceptions prevalent in national government bureaucracies and the exclusion of local stakeholders owing to selected methodologies and assessment procedures. The decisions taken by actors involved in these areas affect how vulnerability is assessed, and ultimately which vulnerability reduction policies will be recommended in the appraisal. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Psychological Vulnerability and Problem Gambling: The Mediational Role of Cognitive Distortions.

PubMed

Lévesque, David; Sévigny, Serge; Giroux, Isabelle; Jacques, Christian

2018-01-03

Despite numerous studies demonstrating the influence of cognitive distortions on gambling problem severity, empirical data regarding the role of psychological vulnerability on the latter is limited. Hence, this study assesses the mediating effect of cognitive distortions between psychological vulnerability (personality and mood), and gambling problem severity. It also verifies whether the relationships between these variables differs according to the preferred gambling activity. The sample is composed of 272 male gamblers [191 poker players; 81 video lottery terminal (VLT) players] aged between 18 and 82 years (M = 35.2). Bootstrap analysis results revealed that cognitive distortions mediate the effect of narcissism on gambling problem severity for both groups. The level of depression for VLT players significantly predicted gambling problem severity, both directly and indirectly via the mediating effect of cognitive distortions. Mediation analyses also indicated that narcissism had an indirect impact on problem gambling through cognitive distortions for both groups. These findings suggest that certain vulnerabilities related to personality and mood may influence cognitive distortion intensity and gambling problem severity. In addition, psychological vulnerabilities could differ based on preferred gambling activity. These results may be useful for prevention policies, identifying high risk gamblers and planning psychological interventions.

Bullying victimization and emotional distress: is there strength in numbers for vulnerable youth?

PubMed

Eisenberg, Marla E; McMorris, Barbara J; Gower, Amy L; Chatterjee, Debanjana

2016-07-01

The present study examines whether the prevalence of vulnerable peers in school protects the emotional health of youth who are lesbian, gay, bisexual or questioning (LGBQ), overweight, or have a disability, and if the adverse emotional effects of bullying victimization are mitigated by the presence of these peers. Survey data come from a large school-based sample of adolescents attending 505 schools. The primary independent variable was the percent of students in school with each vulnerability characteristic. Multilevel logistic regression models estimated the odds of internalizing problems, self-harm, suicidal ideation and suicide attempts among students who were LGBQ, overweight or had a disability. Cross-level interaction terms were added to determine if the association between being victimized and emotional distress was moderated by the presence of vulnerable peers. Greater presence of similar students was, on average, protective against emotional distress for LGBQ girls and overweight boys. In contrast, greater presence of students with a disability was, on average, a risk factor among girls with a disability. Several tests of effect modification indicated that odds of emotional distress for those who had been victimized were lower in schools with a higher proportion of vulnerable youth. The presence of a similar peer group may increase the likelihood that a bystander or witness to bullying will react in a helpful way. School personnel, health care providers and other youth service professionals should inquire about social relationships at school, including experiences of harassment and perceptions of peer support, to buffer negative experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

Groundwater vulnerability to climate change: A review of the assessment methodology.

PubMed

Aslam, Rana Ammar; Shrestha, Sangam; Pandey, Vishnu Prasad

2018-01-15

Impacts of climate change on water resources, especially groundwater, can no longer be hidden. These impacts are further exacerbated under the integrated influence of climate variability, climate change and anthropogenic activities. The degree of impact varies according to geographical location and other factors leading systems and regions towards different levels of vulnerability. In the recent past, several attempts have been made in various regions across the globe to quantify the impacts and consequences of climate and non-climate factors in terms of vulnerability to groundwater resources. Firstly, this paper provides a structured review of the available literature, aiming to critically analyse and highlight the limitations and knowledge gaps involved in vulnerability (of groundwater to climate change) assessment methodologies. The effects of indicator choice and the importance of including composite indicators are then emphasised. A new integrated approach for the assessment of groundwater vulnerability to climate change is proposed to successfully address those limitations. This review concludes that the choice of indicator has a significant role in defining the reliability of computed results. The effect of an individual indicator is also apparent but the consideration of a combination (variety) of indicators may give more realistic results. Therefore, in future, depending upon the local conditions and scale of the study, indicators from various groups should be chosen. Furthermore, there are various assumptions involved in previous methodologies, which limit their scope by introducing uncertainty in the calculated results. These limitations can be overcome by implementing the proposed approach. Copyright © 2017 Elsevier B.V. All rights reserved.

Is there a neuroanatomical basis of the vulnerability to suicidal behavior? A coordinate-based meta-analysis of structural and functional MRI studies

PubMed Central

van Heeringen, Kees; Bijttebier, Stijn; Desmyter, Stefanie; Vervaet, Myriam; Baeken, Chris

2014-01-01

Objective: We conducted meta-analyses of functional and structural neuroimaging studies comparing adolescent and adult individuals with a history of suicidal behavior and a psychiatric disorder to psychiatric controls in order to objectify changes in brain structure and function in association with a vulnerability to suicidal behavior. Methods: Magnetic resonance imaging studies published up to July 2013 investigating structural or functional brain correlates of suicidal behavior were identified through computerized and manual literature searches. Activation foci from 12 studies encompassing 475 individuals, i.e., 213 suicide attempters and 262 psychiatric controls were subjected to meta-analytical study using anatomic or activation likelihood estimation (ALE). Result: Activation likelihood estimation revealed structural deficits and functional changes in association with a history of suicidal behavior. Structural findings included reduced volumes of the rectal gyrus, superior temporal gyrus and caudate nucleus. Functional differences between study groups included an increased reactivity of the anterior and posterior cingulate cortices. Discussion: A history of suicidal behavior appears to be associated with (probably interrelated) structural deficits and functional overactivation in brain areas, which contribute to a decision-making network. The findings suggest that a vulnerability to suicidal behavior can be defined in terms of a reduced motivational control over the intentional behavioral reaction to salient negative stimuli. PMID:25374525

Distinct subtypes of behavioral-variant frontotemporal dementia based on patterns of network degeneration

PubMed Central

Ranasinghe, Kamalini G; Rankin, Katherine P; Pressman, Peter S; Perry, David C; Lobach, Iryna V; Seeley, William W; Coppola, Giovanni; Karydas, Anna M; Grinberg, Lea T; Shany-Ur, Tal; Lee, Suzee E; Rabinovici, Gil D; Rosen, Howard J; Gorno-Tempini, Maria Luisa; Boxer, Adam L; Miller, Zachary A; Chiong, Winston; DeMay, Mary; Kramer, Joel H; Possin, Katherine L; Sturm, Virginia E; Bettcher, Brianne M; Neylan, Michael; Zackey, Diana D; Nguyen, Lauren A; Ketelle, Robin; Block, Nikolas; Wu, Teresa Q; Dallich, Alison; Russek, Natanya; Caplan, Alyssa; Geschwind, Daniel H; Vossel, Keith A; Miller, Bruce L

2016-01-01

Importance Clearer delineation of the phenotypic heterogeneity within behavioral variant frontotemporal dementia (bvFTD) will help uncover underlying biological mechanisms, and will improve clinicians’ ability to predict disease course and design targeted management strategies. Objective To identify subtypes of bvFTD syndrome based on distinctive patterns of atrophy defined by selective vulnerability of specific functional networks targeted in bvFTD, using statistical classification approaches. Design, Setting and Participants In this retrospective observational study, 104 patients meeting the Frontotemporal Dementia Consortium consensus criteria for bvFTD were evaluated at the Memory and Aging Center of Department of Neurology at University of California, San Francisco. Patients underwent a multidisciplinary clinical evaluation, including clinical demographics, genetic testing, symptom evaluation, neurological exam, neuropsychological bedside testing, and socioemotional assessments. Ninety patients underwent structural Magnetic Resonance Imaging at their earliest evaluation at the memory clinic. From each patients’ structural imaging, the mean volumes of 18 regions of interest (ROI) comprising the functional networks specifically vulnerable in bvFTD, including the ‘salience network’ (SN), with key nodes in the frontoinsula and pregenual anterior cingulate, and the ‘semantic appraisal network’ (SAN) anchored in the anterior temporal lobe and subgenual cingulate, were estimated. Principal component and cluster analyses of ROI volumes were used to identify patient clusters with anatomically distinct atrophy patterns. Main Outcome Measures We evaluated brain morphology and other clinical features including presenting symptoms, neurologic exam signs, neuropsychological performance, rate of dementia progression, and socioemotional function in each patient cluster. Results We identified four subgroups of bvFTD patients with distinct anatomic patterns of network degeneration, including two separate salience network–predominant subgroups: frontal/temporal (SN-FT), and frontal (SN-F), and a semantic appraisal network–predominant group (SAN), and a subcortical–predominant group. Subgroups demonstrated distinct patterns of cognitive, socioemotional, and motor symptoms, as well as genetic compositions and estimated rates of disease progression. Conclusions Divergent patterns of vulnerability in specific functional network components make an important contribution to clinical heterogeneity of bvFTD. The data-driven anatomical classification identifies biologically meaningful phenotypes and provides a replicable approach to disambiguate the bvFTD syndrome. PMID:27429218

Language and use of cancer screening services among border and non-border Hispanic Texas women.

PubMed

Fernández, Leticia E; Morales, Alfonso

2007-06-01

Compared to other groups, Mexican American women screen less frequently for cervical and breast cancer. The most significant barriers reported by previous researchers include not having a usual source of care, lacking health insurance and English-language difficulties. In this paper we document and examine the factors associated with disparities in cancer screening between border and non-border residents by language of interview (Spanish or English) among Texas Hispanic women. We hypothesize that, controlling for socioeconomic and demographic characteristics, border residents are more likely to utilize screening services than non-border residents because of the greater presence of bilingual services in border counties. We follow the framework of the Behavioral Model for Vulnerable Populations proposed by Gelberg et al. (Health Services Research, vol. 34, no. 6, pp. 1273-1302, 2000). This model conceptualizes use of health care as an outcome of the interplay of predisposing, enabling and need factors and recognizes that vulnerable groups face additional barriers to health care utilization. Data come from the 2000, 2002 and 2004 Texas Behavioral Risk Factor Surveillance surveys. Group differences in cancer screenings are explained largely by socioeconomic characteristics and structural barriers to access. The significance of language of interview and of border residence disappear after controlling for factors such as health insurance, income and a usual source of care. Women who selected to be interviewed in Spanish were less likely to report age-appropriate cancer examinations, health insurance and a regular health care provider than those who selected to be interviewed in English. Disparities in cancer screenings among vulnerable Hispanic populations could be reduced by promoting the establishment of a regular health care provider.

Recruiting vulnerable populations into research: a systematic review of recruitment interventions.

PubMed

UyBico, Stacy J; Pavel, Shani; Gross, Cary P

2007-06-01

Members of vulnerable populations are underrepresented in research studies. To evaluate and synthesize the evidence regarding interventions to enhance enrollment of vulnerable populations into health research studies. Studies were identified by searching MEDLINE, the Web of Science database, personal sources, hand searching of related journals, and article references. Studies that contained data on recruitment interventions for vulnerable populations (minority, underserved, poor, rural, urban, or inner city) and for which the parent study (study for which recruitment was taking place) was an intervention study were included. A total of 2,648 study titles were screened and 48 articles met inclusion criteria, representing 56 parent studies. Two investigators extracted data from each study. African Americans were the most frequently targeted population (82% of the studies), while 46% targeted Hispanics/Latinos. Many studies assessed 2 or more interventions, including social marketing (82% of studies), community outreach (80%), health system recruitment (52%), and referrals (28%). The methodologic rigor varied substantially. Only 40 studies (71%) incorporated a control group and 21% used statistical analysis to compare interventions. Social marketing, health system, and referral recruitment were each found to be the most successful intervention about 35-45% of the studies in which they were attempted, while community outreach was the most successful intervention in only 2 of 16 studies (13%) in which it was employed. People contacted as a result of social marketing were no less likely to enroll than people contacted through other mechanisms. Further work with greater methodologic rigor is needed to identify evidence-based strategies for increasing minority enrollment in research studies; community outreach, as an isolated strategy, may be less successful than other strategies.

Recruiting Vulnerable Populations into Research: A Systematic Review of Recruitment Interventions

PubMed Central

UyBico, Stacy J.; Pavel, Shani

2007-01-01

Background Members of vulnerable populations are underrepresented in research studies. Objective To evaluate and synthesize the evidence regarding interventions to enhance enrollment of vulnerable populations into health research studies. Data sources Studies were identified by searching MEDLINE, the Web of Science database, personal sources, hand searching of related journals, and article references. Studies that contained data on recruitment interventions for vulnerable populations (minority, underserved, poor, rural, urban, or inner city) and for which the parent study (study for which recruitment was taking place) was an intervention study were included. A total of 2,648 study titles were screened and 48 articles met inclusion criteria, representing 56 parent studies. Two investigators extracted data from each study. Results African Americans were the most frequently targeted population (82% of the studies), while 46% targeted Hispanics/Latinos. Many studies assessed 2 or more interventions, including social marketing (82% of studies), community outreach (80%), health system recruitment (52%), and referrals (28%). The methodologic rigor varied substantially. Only 40 studies (71%) incorporated a control group and 21% used statistical analysis to compare interventions. Social marketing, health system, and referral recruitment were each found to be the most successful intervention about 35–45% of the studies in which they were attempted, while community outreach was the most successful intervention in only 2 of 16 studies (13%) in which it was employed. People contacted as a result of social marketing were no less likely to enroll than people contacted through other mechanisms. Conclusions Further work with greater methodologic rigor is needed to identify evidence-based strategies for increasing minority enrollment in research studies; community outreach, as an isolated strategy, may be less successful than other strategies. PMID:17375358

The Untapped Potential of Patient and Family Engagement in the Organization of Critical Care.

PubMed

Haines, Kimberley J; Kelly, Phillipa; Fitzgerald, Peter; Skinner, Elizabeth H; Iwashyna, Theodore J

2017-05-01

There is growing interest in patient and family participation in critical care-not just as part of the bedside, but as part of educational and management organization and infrastructure. This offers tremendous opportunities for change but carries risk to patients, families, and the institution. The objective is to provide a concise definitive review of patient and family organizational participation in critical care as a high-risk population and other vulnerable groups. A pragmatic, codesigned model for critical care is offered as a suggested approach for clinicians, researchers, and policy-makers. To inform this review, a systematic search of Ovid Medline, PubMed, and Embase was undertaken in April 2016 using the MeSH terms: patient participation and critical care. A second search was undertaken in PubMed using the terms: patient participation and organizational models to search for other examples of engagement in vulnerable populations. We explicitly did not seek to include discussions of bedside patient-family engagement or shared decision-making. Two reviewers screened citations independently. Included studies either actively partnered with patients and families or described a model of engagement in critical care and other vulnerable populations. Data or description of how patient and family engagement occurred and/or description of model were extracted into a standardized form. There was limited evidence of patient and family engagement in critical care although key recommendations can be drawn from included studies. Patient and family engagement is occurring in other vulnerable populations although there are few described models and none which address issues of risk. A model of patient and family engagement in critical care does not exist, and we propose a pragmatic, codesigned model that takes into account issues of psychologic safety in this population. Significant opportunity exists to document processes of engagement that reflect a changing paradigm of healthcare delivery.

Redox proteomic profiling of neuroketal-adducted proteins in human brain: Regional vulnerability at middle age increases in the elderly.

PubMed

Domínguez, Mayelín; de Oliveira, Eliandre; Odena, María Antonia; Portero, Manuel; Pamplona, Reinald; Ferrer, Isidro

2016-06-01

Protein lipoxidation was assessed in the parietal cortex (PC), frontal cortex (FC), and cingulate gyrus (CG) in middle-aged and old-aged individuals with no clinical manifestations of cognitive impairment, in order to increase understanding of regional brain vulnerability to oxidative damage during aging. Twenty-five lipoxidized proteins were identified in all the three regions although with regional specificities, by using redox proteomics to detect target proteins of neuroketals (NKT) adduction. The number of cases with NKT-adducted proteins was higher in old-aged individuals but most oxidized proteins were already present in middle-aged individuals. Differences in vulnerability to oxidation were dependent on the sub-cellular localization, secondary structure, and external exposition of certain amino acids. Lipoxidized proteins included those involved in energy metabolism, cytoskeleton, proteostasis, neurotransmission and O2/CO2, and heme metabolism. Total NKT and soluble oligomer levels were estimated employing slot-blot, and these were compared between age groups. Oligomers increased with age in PC and FC; NKT significantly increased with age in FC, whereas total NKT and oligomer levels were not modified in CG, thus highlighting differences in brain regional vulnerability with age. Oligomers significantly correlated with NKT levels in the three cortical regions, suggesting that protein NKT adduction parallels soluble oligomer formation. Copyright © 2016 Elsevier Inc. All rights reserved.

Assuring the USAF Core Missions in the Information Age

DTIC Science & Technology

2016-09-01

cyberspace operators, to include focusing on response capabilities such as emergency and incident- response teams and plans.6 One of the best ways to...accomplish this shift is through aggressive and thorough red teaming . A red team is a group of friendly attackers who attempt to attack systems to find...vulnerabilities but also giving defenders practice in how to rec- ognize and respond to attacks to keep their systems functioning. Red teams are

Are Muslim Diaspora in the U.S. Vulnerable to Islamic Extremism?

DTIC Science & Technology

2015-06-12

it is common for at least one member of the group to travel overseas to a country with known terrorist training camps. Destinations include Pakistan...Dagestan and Chechnya.39 The Federal Bureau of Investigation interviewed Tamerlan but found no links to terrorism. Subsequently, Tamerlan traveled to...eventually had two children. Born in Colorado, Huma often traveled to Pakistan for summer vacations and had lived in Qatar with her family for an

The use of incentives in vulnerable populations for a telephone survey: a randomized controlled trial.

PubMed

Knoll, Megan; Soller, Lianne; Ben-Shoshan, Moshe; Harrington, Daniel; Fragapane, Joey; Joseph, Lawrence; La Vieille, Sebastien; St-Pierre, Yvan; Wilson, Kathi; Elliott, Susan; Clarke, Ann

2012-10-19

Poor response rates in prevalence surveys can lead to nonresponse bias thereby compromising the validity of prevalence estimates. We conducted a telephone survey of randomly selected households to estimate the prevalence of food allergy in the 10 Canadian provinces between May 2008 and March 2009 (the SCAAALAR study: Surveying Canadians to Assess the Prevalence of Common Food Allergies and Attitudes towards Food LAbeling and Risk). A household response rate of only 34.6% was attained, and those of lower socioeconomic status, lower education and new Canadians were underrepresented. We are now attempting to target these vulnerable populations in the SPAACE study (Surveying the Prevalence of Food Allergy in All Canadian Environments) and are evaluating strategies to increase the response rate. Although the success of incentives to increase response rates has been demonstrated previously, no studies have specifically examined the use of unconditional incentives in these vulnerable populations in a telephone survey. The pilot study will compare response rates between vulnerable Canadian populations receiving and not receiving an incentive. Randomly selected households were randomly assigned to receive either a $5 incentive or no incentive. The between group differences in response rates and 95% confidence intervals (CIs) were calculated. The response rates for the incentive and non-incentive groups were 36.1% and 28.7% respectively, yielding a between group difference of 7.4% (-0.7%, 15.6%). Although the wide CI precludes definitive conclusions, our results suggest that unconditional incentives are effective in vulnerable populations for telephone surveys.

Extension of the behavioral model of healthcare utilization with ethnically diverse, low-income women.

PubMed

Keenan, Lisa A; Marshall, Linda L; Eve, Susan

2002-01-01

Psychosocial vulnerabilities were added to a model of healthcare utilization. This extension was tested among low-income women with ethnicity addressed as a moderator. Structured interviews were conducted at 2 points in time, approximately 1 year apart. The constructs of psychosocial vulnerability, demographic predisposing, barriers, and illness were measured by multiple indicators to allow use of Structural Equation Modeling to analyze results. The models were tested separately for each ethnic group. Community office. African-American (N = 266), Euro-American (N = 200), and Mexican-American (N = 210) women were recruited from the Dallas Metropolitan area to participate in Project Health Outcomes of Women, a multi-year, multi-wave study. Face-to-face interviews were conducted with this sample. Participants had been in heterosexual relationships for at least 1 year, were between 20 and 49 years of age, and had incomes less than 200% of the national poverty level. Healthcare utilization, defined as physician visits and general healthcare visits. Illness mediated the effect of psychosocial vulnerability on healthcare utilization for African Americans and Euro-Americans. The model for Mexican Americans was the most complex. Psychosocial vulnerability on illness was partially mediated by barriers, which also directly affected utilization. Psychosocial vulnerabilities were significant utilization predictors for healthcare use for all low-income women in this study. The final models for the 2 minority groups, African Americans and Mexican Americans, were quite different. Hence, women of color should not be considered a homogeneous group in comparison to Euro-Americans.

Linking degradation status with ecosystem vulnerability to environmental change

USGS Publications Warehouse

Angeler, David G.; Baho, Didier L.; Allen, Craig R.; Johnson, Richard K.

2015-01-01

Environmental change can cause regime shifts in ecosystems, potentially threatening ecosystem services. It is unclear if the degradation status of ecosystems correlates with their vulnerability to environmental change, and thus the risk of future regime shifts. We assessed resilience in acidified (degraded) and circumneutral (undegraded) lakes with long-term data (1988–2012), using time series modeling. We identified temporal frequencies in invertebrate assemblages, which identifies groups of species whose population dynamics vary at particular temporal scales. We also assessed species with stochastic dynamics, those whose population dynamics vary irregularly and unpredictably over time. We determined the distribution of functional feeding groups of invertebrates within and across the temporal scales identified, and in those species with stochastic dynamics, and assessed attributes hypothesized to contribute to resilience. Three patterns of temporal dynamics, consistent across study lakes, were identified in the invertebrates. The first pattern was one of monotonic change associated with changing abiotic lake conditions. The second and third patterns appeared unrelated to the environmental changes we monitored. Acidified and the circumneutral lakes shared similar levels and patterns of functional richness, evenness, diversity, and redundancy for species within and across the observed temporal scales and for stochastic species groups. These similar resilience characteristics suggest that both lake types did not differ in vulnerability to the environmental changes observed here. Although both lake types appeared equally vulnerable in this study, our approach demonstrates how assessing systemic vulnerability by quantifying ecological resilience can help address uncertainty in predicting ecosystem responses to environmental change across ecosystems.

Ethical, social, and legal issues surrounding studies of susceptible populations and individuals.

PubMed Central

Soskolne, C L

1997-01-01

Calls for professional accountability have resulted in the development of ethics guidelines by numerous specialty and subspecialty groups of scientists. Indeed, guidelines among some health professions now address vulnerable and dependent groups: but these are silent on issues related to biomarkers. In parallel, attention has been drawn to human rights concerns associated with attempts to detect hypersusceptible workers, especially in democratic countries. Despite this, concern for vulnerable populations grows as advances in biomarker technology make the identification of genetic predisposition and susceptibility markers of both exposure and outcome more attainable. In this article, the principles derived from the ethical theory of utilitarianism provide the basis for principle-based ethical analysis. In addition, the four principles of biomedical ethics--respect for autonomy, beneficence, nonmaleficence, and social justice--are considered for biomarker studies. The need for a context in which ethical analysis is conducted and from which prevailing social values are shown to drive decisions of an ethical nature is emphasized; these include statutory regulation and law. Because biomarker studies can result in more harm than good, special precautions to inform research participants prior to any involvement in the use of biomarkers are needed. In addition, safeguards to maintain the privacy of data derived from biomarker studies must be developed and implemented prior to the application of these new technologies. Guidelines must be expanded to incorporate ethical, social, and legal considerations surrounding the introduction of new technologies for studying susceptible populations and individuals who may be vulnerable to environmental exposures. PMID:9255569

Agroterrorism: where are we in the ongoing war on terrorism?

PubMed

Crutchley, Tamara M; Rodgers, Joel B; Whiteside, Heustis P; Vanier, Marty; Terndrup, Thomas E

2007-03-01

The U.S. agricultural infrastructure is one of the most productive and efficient food-producing systems in the world. Many of the characteristics that contribute to its high productivity and efficiency also make this infrastructure extremely vulnerable to a terrorist attack by a biological weapon. Several experts have repeatedly stated that taking advantage of these vulnerabilities would not require a significant undertaking and that the nation's agricultural infrastructure remains highly vulnerable. As a result of continuing criticism, many initiatives at all levels of government and within the private sector have been undertaken to improve our ability to detect and respond to an agroterrorist attack. However, outbreaks, such as the 1999 West Nile outbreak, the 2001 anthrax attacks, the 2003 monkeypox outbreak, and the 2004 Escherichia coli O157:H7 outbreak, have demonstrated the need for improvements in the areas of communication, emergency response and surveillance efforts, and education for all levels of government, the agricultural community, and the private sector. We recommend establishing an interdisciplinary advisory group that consists of experts from public health, human health, and animal health communities to prioritize improvement efforts in these areas. The primary objective of this group would include establishing communication, surveillance, and education benchmarks to determine current weaknesses in preparedness and activities designed to mitigate weaknesses. We also recommend broader utilization of current food and agricultural preparedness guidelines, such as those developed by the U.S. Department of Agriculture and the U.S. Food and Drug Administration.

Involving Communities in the Targeting of Cash Transfer Programs for Vulnerable Children: Opportunities and Challenges☆

PubMed Central

Robertson, Laura; Mushati, Phyllis; Skovdal, Morten; Eaton, Jeffrey W.; Makoni, Jeremiah C.; Crea, Tom; Mavise, Gideon; Dumba, Lovemore; Schumacher, Christina; Sherr, Lorraine; Nyamukapa, Constance; Gregson, Simon

2014-01-01

Summary We used baseline data, collected in July–September 2009, from a randomized controlled trial of a cash transfer program for vulnerable children in eastern Zimbabwe to investigate the effectiveness, coverage, and efficiency of census- and community-based targeting methods for reaching vulnerable children. Focus group discussions and in-depth interviews with beneficiaries and other stakeholders were used to explore community perspectives on targeting. Community members reported that their participation improved ownership and reduced conflict and jealousy. However, all the methods failed to target a large proportion of vulnerable children and there was poor agreement between the community- and census-based methods. PMID:24748713

Promoting community readiness for physical activity among older adults in Germany--protocol of the ready to change intervention trial.

PubMed

Brand, Tilman; Gansefort, Dirk; Rothgang, Heinz; Röseler, Sabine; Meyer, Jochen; Zeeb, Hajo

2016-02-01

Healthy ageing is an important concern for many societies facing the challenge of an ageing population. Physical activity (PA) is a major contributor to healthy ageing; however insufficient PA levels are prevalent in old age in Germany. Community capacity building and community involvement are often recommended as key strategies to improve equitable access to prevention and health promotion. However, evidence for the effectiveness of these strategies is scarce. This study aims to assess the community readiness for PA promotion in local environments and to analyse the utility of strategies to increase community readiness for reaching vulnerable groups. We designed a mixed method intervention trial comprising three study modules. The first module includes an assessment of community readiness for PA interventions in older adults. The assessment is carried out in a sample of 24 municipalities in the Northwest of Germany using structured key informant interviews. In the second module, eight municipalities with the low community readiness are selected from the sample and randomly assigned to one of two study groups: active enhancement of community readiness (intervention) versus no enhancement (control). After enhancing community readiness in the active enhancement group, older adults in both study groups will be recruited for participation in a PA intervention. Participation rates are compared between the study groups to evaluate the effects of the intervention. In addition, a cost-effectiveness analysis is carried out calculating recruitment costs per person reached in the two study groups. In the third module, qualitative interviews are conducted with participants and non-participants of the PA intervention exploring reasons for participation or non-participation. This study offers the potential to contribute to the evidence base of reaching vulnerable older adults for PA interventions and provide ideas on how to reduce participation barriers. Its findings will inform governmental authorities, professionals, academics, and NGOs with an estimate of resources necessary to achieve equitable access to physical activity programs for vulnerable older adults. German Clinical Trials Register DRKS00009564 (Date of registration 03-11-2015).

Risky business: focus-group analysis of sexual behaviors, drug use and victimization among incarcerated women in St. Louis.

PubMed

Millay, Tamara A; Satyanarayana, Veena A; O'Leary, Catina C; Crecelius, Robert; Cottler, Linda B

2009-09-01

Incarcerated women report multiple vulnerabilities and, yet, are under-represented in research. This study used focus-group methodology to explore high-risk sexual behaviors, drug use, and victimization among female offenders in St. Louis. Inmates of the St. Louis Medium Security Institution (MSI) were invited to participate in one of five focus groups between May and September 2005 in preparation for an NIH/NINR HIV-prevention intervention study among female offenders in Drug Court. The focus group sample of 30 women was 70% African-American, with a mean age of 36 years. Results indicated that oral sex was the most common sex trade activity. Consistent with the literature, condom usage was described as irregular. In terms of drug use, participants reported that crack was most commonly used, with binges often lasting for several days. Regarding victimization, women frequently reported sexual abuse in childhood, and some described abusive relationships as adults. Participants also reported being beaten and raped by customers, which led to their concealing knives in purses and razors under the tongue. Consequently, perpetrated violence, including murder, was reported as protection against further violence. These findings confirm the vulnerability of this population of women who are at high risk for HIV. Effective HIV-prevention interventions are needed to assist these incarcerated women in making lifestyle changes during incarceration and sustaining them after release.

Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned.

PubMed

Tuberville, Tracey D; Andrews, Kimberly M; Sperry, Jinelle H; Grosse, Andrew M

2015-10-01

Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself.

Use of the NatureServe Climate Change Vulnerability Index as an Assessment Tool for Reptiles and Amphibians: Lessons Learned

NASA Astrophysics Data System (ADS)

Tuberville, Tracey D.; Andrews, Kimberly M.; Sperry, Jinelle H.; Grosse, Andrew M.

2015-10-01

Climate change threatens biodiversity globally, yet it can be challenging to predict which species may be most vulnerable. Given the scope of the problem, it is imperative to rapidly assess vulnerability and identify actions to decrease risk. Although a variety of tools have been developed to assess climate change vulnerability, few have been evaluated with regard to their suitability for certain taxonomic groups. Due to their ectothermic physiology, low vagility, and strong association with temporary wetlands, reptiles and amphibians may be particularly vulnerable relative to other groups. Here, we evaluate use of the NatureServe Climate Change Vulnerability Index (CCVI) to assess a large suite of herpetofauna from the Sand Hills Ecoregion of the southeastern United States. Although data were frequently lacking for certain variables (e.g., phenological response to climate change, genetic variation), sufficient data were available to evaluate all 117 species. Sensitivity analyses indicated that results were highly dependent on size of assessment area and climate scenario selection. In addition, several ecological traits common in, but relatively unique to, herpetofauna are likely to contribute to their vulnerability and need special consideration during the scoring process. Despite some limitations, the NatureServe CCVI was a useful tool for screening large numbers of reptile and amphibian species. We provide general recommendations as to how the CCVI tool's application to herpetofauna can be improved through more specific guidance to the user regarding how to incorporate unique physiological and behavioral traits into scoring existing sensitivity factors and through modification to the assessment tool itself.

A probabilistic framework for assessing vulnerability to climate variability and change: The case of the US water supply system

Treesearch

Romano Foti; Jorge A. Ramirez; Thomas C. Brown

2014-01-01

We introduce a probabilistic framework for vulnerability analysis and use it to quantify current and future vulnerability of the US water supply system. We also determine the contributions of hydro-climatic and socio-economic drivers to the changes in projected vulnerability. For all scenarios and global climatemodels examined, the US Southwest including California and...

Improving vulnerability models: lessons learned from a comparison between flood and earthquake assessments

NASA Astrophysics Data System (ADS)

de Ruiter, Marleen; Ward, Philip; Daniell, James; Aerts, Jeroen

2017-04-01

In a cross-discipline study, an extensive literature review has been conducted to increase the understanding of vulnerability indicators used in both earthquake- and flood vulnerability assessments, and to provide insights into potential improvements of earthquake and flood vulnerability assessments. It identifies and compares indicators used to quantitatively assess earthquake and flood vulnerability, and discusses their respective differences and similarities. Indicators have been categorized into Physical- and Social categories, and further subdivided into (when possible) measurable and comparable indicators. Physical vulnerability indicators have been differentiated to exposed assets such as buildings and infrastructure. Social indicators are grouped in subcategories such as demographics, economics and awareness. Next, two different vulnerability model types have been described that use these indicators: index- and curve-based vulnerability models. A selection of these models (e.g. HAZUS) have been described, and compared on several characteristics such as temporal- and spatial aspects. It appears that earthquake vulnerability methods are traditionally strongly developed towards physical attributes at an object scale and used in vulnerability curve models, whereas flood vulnerability studies focus more on indicators applied to aggregated land-use scales. Flood risk studies could be improved using approaches from earthquake studies, such as incorporating more detailed lifeline and building indicators, and developing object-based vulnerability curve assessments of physical vulnerability, for example by defining building material based flood vulnerability curves. Related to this, is the incorporation of time of the day based building occupation patterns (at 2am most people will be at home while at 2pm most people will be in the office). Earthquake assessments could learn from flood studies when it comes to the refined selection of social vulnerability indicators. Based on the lessons obtained in this study, we recommend future studies to further explore cross-hazard studies.

Patients' perspectives on quality of life after burn.

PubMed

Kool, Marianne B; Geenen, Rinie; Egberts, Marthe R; Wanders, Hendriët; Van Loey, Nancy E

2017-06-01

The concept quality of life (QOL) refers to both health-related outcomes and one's skills to reach these outcomes, which is not yet incorporated in the burn-related QOL conceptualisation. The aim of this study was to obtain a comprehensive overview of relevant burn-specific domains of QOL from the patient's perspective and to determine its hierarchical structure. Concept mapping was used comprising a focus group (n=6), interviews (n=25), and a card-sorting task (n=24) in burn survivors. Participants sorted aspects of QOL based on content similarity after which hierarchical cluster analysis was used to determine the hierarchical structure of burn-related QOL. Ninety-nine aspects of burn-related QOL were selected from the interviews, written on cards, and sorted. The hierarchical structure of burn-related QOL showed a core distinction between resilience and vulnerability. Resilience comprised the domains positive coping and social sharing. Vulnerability included 5 domains subdivided in 13 subdomains: the psychological domain included trauma-related symptoms, cognitive symptoms, negative emotions, body perception and depressive mood; the economical domain comprised finance and work; the social domain included stigmatisation/invalidation; the physical domain comprised somatic symptoms, scars, and functional limitations; and the intimate/sexual domain comprised the relationship with partner, and anxiety/avoidance in sexual life. From the patient's perspective, QOL following burns includes a variety of vulnerability and resilience factors, which forms a fresh basis for the development of a screening instrument. Whereas some factors are well known, this study also revealed overlooked problem and resilience areas that could be considered in client-centred clinical practice in order to customize self-management support. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Mesenchymal Stem Cells Stabilize Atherosclerotic Vulnerable Plaque by Anti-Inflammatory Properties.

PubMed

Wang, Shuang-shuang; Hu, Si-wang; Zhang, Qing-hua; Xia, Ai-xiang; Jiang, Zhi-xin; Chen, Xiao-min

2015-01-01

Formation and progression of atherosclerotic vulnerable plaque (VP) is the primary cause of many cardio-cerebrovascular diseases such as acute coronary syndrome and stroke. It has been reported that bone marrow mesenchymal stem cells (MSC) exhibit protective effects against many kinds of diseases including myocardial infarction. Here, we examined the effects of intravenous MSC infusion on a VP model and provide novel evidence of its influence as a therapy in this animal disease model. Thirty healthy male New Zealand white rabbits were randomly divided into a MSC, VP or stable plaque (SP) group (n = 10/group) and received high fat diet and cold-induced common carotid artery intimal injury with liquid nitrogen to form atherosclerotic plaques. Serum hs-CRP, TNF-α, IL-6 and IL-10 levels were measured by ELISA at 1, 2, 3, 7, 14, 21 and 28 days after MSC transplantation. The animals were sacrificed at 4 weeks after MSC transplantation. Lesions in the right common carotid were observed using H&E and Masson staining, and the fibrous cap/lipid core ratio of atherosclerotic plaques were calculated. The expression of nuclear factor κB (NF-κB) and matrix metalloproteinase 1, 2, 9 (MMP-1,2,9) in the plaque were detected using immunohistochemistry, and apoptotic cells in the plaques were detected by TUNEL. In addition, the level of TNF-α stimulated gene/protein 6 (TSG-6) mRNA and protein were measured by quantitative Real-Time PCR and Western blotting, respectively. Two rabbits in the VP group died of lung infection and cerebral infarction respectively at 1 week after plaque injury by liquid nitrogen. Both H&E and Masson staining revealed that the plaques from the SP and MSC groups had more stable morphological structure and a larger fibrous cap/lipid core ratio than the VP group. Serum hs-CRP, TNF-α and IL-6 were significantly down-regulated, whereas IL-10 was significantly up-regulated in the MSC group compared with the VP group. .Immunohistochemistry analysis revealed that NF-κB and MMP expression was reduced in the MSC and SP groups compared to the VP group. Cell apoptosis decreased significantly in both the MSC and SP groups in comparison to the VP group. TSG-6 mRNA and protein expression were higher in the plaques of the MSC group compared to the VP and SP groups. Our study results suggest that MSC transplantation can effectively stabilize vulnerable plaques in atherosclerotic rabbits. This may potentially offer a new clinical application of MSC in atherosclerosis.

Development and implementation of a Bayesian-based aquifer vulnerability assessment in Florida

USGS Publications Warehouse

Arthur, J.D.; Wood, H.A.R.; Baker, A.E.; Cichon, J.R.; Raines, G.L.

2007-01-01

The Florida Aquifer Vulnerability Assessment (FAVA) was designed to provide a tool for environmental, regulatory, resource management, and planning professionals to facilitate protection of groundwater resources from surface sources of contamination. The FAVA project implements weights-of-evidence (WofE), a data-driven, Bayesian-probabilistic model to generate a series of maps reflecting relative aquifer vulnerability of Florida's principal aquifer systems. The vulnerability assessment process, from project design to map implementation is described herein in reference to the Floridan aquifer system (FAS). The WofE model calculates weighted relationships between hydrogeologic data layers that influence aquifer vulnerability and ambient groundwater parameters in wells that reflect relative degrees of vulnerability. Statewide model input data layers (evidential themes) include soil hydraulic conductivity, density of karst features, thickness of aquifer confinement, and hydraulic head difference between the FAS and the watertable. Wells with median dissolved nitrogen concentrations exceeding statistically established thresholds serve as training points in the WofE model. The resulting vulnerability map (response theme) reflects classified posterior probabilities based on spatial relationships between the evidential themes and training points. The response theme is subjected to extensive sensitivity and validation testing. Among the model validation techniques is calculation of a response theme based on a different water-quality indicator of relative recharge or vulnerability: dissolved oxygen. Successful implementation of the FAVA maps was facilitated by the overall project design, which included a needs assessment and iterative technical advisory committee input and review. Ongoing programs to protect Florida's springsheds have led to development of larger-scale WofE-based vulnerability assessments. Additional applications of the maps include land-use planning amendments and prioritization of land purchases to protect groundwater resources. ?? International Association for Mathematical Geology 2007.

Stuck in the catch 22: attitudes towards smoking cessation among populations vulnerable to social disadvantage.

PubMed

Pateman, Kelsey; Ford, Pauline; Fizgerald, Lisa; Mutch, Allyson; Yuke, Kym; Bonevski, Billie; Gartner, Coral

2016-06-01

To explore how smoking and smoking cessation is perceived within the context of disadvantage, across a broad cross-section of defined populations vulnerable to social disadvantage. Qualitative focus groups with participants recruited through community service organizations (CSO). Metropolitan and regional settings in Queensland, Australia. Focus groups were held at the respective CSO facilities. Fifty-six participants across nine focus groups, including people living with mental illness, people experiencing or at risk of homelessness (adult and youth populations), people living with HIV, people living in a low-income area and Indigenous Australians. Thematic, in-depth analysis of focus group discussions. Participant demographic information and smoking history was recorded. Smoking behaviour, smoking identity and feelings about smoking were reflective of individual circumstances and social and environmental context. Participants felt 'trapped' in smoking because they felt unable to control the stressful life circumstances that triggered and sustained their smoking. Smoking cessation was viewed as an individual's responsibility, which was at odds with participants' statements about the broader factors outside of their own control that were responsible for their smoking. Highly disadvantaged smokers' views on smoking involve contradictions between feeling that smoking cessation involves personal responsibility, while at the same time feeling trapped by stressful life circumstances. Tobacco control programmes aiming to reduce smoking among disadvantaged groups are unlikely to be successful unless the complex interplay of social factors is carefully considered. © 2015 Society for the Study of Addiction.

ISIBINDI, creating circles of care for orphans and vulnerable children in South Africa: post-programme outcomes.

PubMed

Visser, Maretha; Zungu, Nompumelelo; Ndala-Magoro, Nkateko

2015-01-01

This paper presents the evaluation of post-programme outcomes of the ISIBINDI model, a community-based intervention to promote physical and psychosocial well-being of orphans and vulnerable children (OVC) in South Africa. A mixed methods quasi-experimental design was used to investigate the differences between former ISIBINDI participants (18 years and older) and a control group of similar background. ISIBINDI ex-participants at 12 sites (n=427) and a control group of non-participants (n=177) completed a questionnaire which explored level of education and employment, psychosocial well-being and HIV risk behaviour. Focus group discussions were conducted with various stakeholders. Ex-participants reported higher self-esteem and problem-solving abilities, family support and lower HIV risk behaviour than the control group. High levels of unemployment especially in rural areas resulted in unemployment of out-of-school OVC which creates new forms of vulnerability. The benefits of the programme may be compromised by the lack of community resources. An effective exit strategy is needed to contribute to financial independence of OVC after exiting the programme.

Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

PubMed Central

Merino, Hipólito; Ferreiro, Fátima

2016-01-01

This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms. PMID:27243462

Are Worry and Rumination Specific Pathways Linking Neuroticism and Symptoms of Anxiety and Depression in Patients with Generalized Anxiety Disorder, Major Depressive Disorder and Mixed Anxiety-Depressive Disorder?

PubMed

Merino, Hipólito; Senra, Carmen; Ferreiro, Fátima

2016-01-01

This study examines the relationships between neuroticism (higher-order vulnerability factor), the cognitive styles of worry, brooding and reflection (second-order vulnerability factors) and symptoms of anxiety and depression in three groups of patients: patients with Generalized Anxiety Disorder (GAD), with Major Depressive Disorder (MDD) and with Mixed Anxiety-Depressive Disorder (MADD). One hundred and thirty four patients completed a battery of questionnaires including measures of neuroticism, worry, rumination (brooding and reflection), anxiety and depression. Multiple mediation analyses indicate that worry may act as a mediating mechanism linking neuroticism and anxiety symptoms in the three diagnostic groups, whereas brooding-rumination may play a mediating role between neuroticism and depressive symptoms in patients with MDD and MADD and, with less certainty, in patients with GAD. Overall, our findings suggest that neuroticism may increase the risk of anxious and depressive symptoms via specific links involving either worry or brooding, respectively, and that both worry and brooding may operate in the three groups examined, irrespectively of whether anxiety or depression are the main emotions or whether they coexist without any clear predominance; consequently, we hypothesize the existence of "specific transdiagnostic" mechanisms.

Health is Power: an ecological, theory-based health intervention for women of color.

PubMed

Lee, Rebecca E; Medina, Ashley V; Mama, Scherezade K; Reese-Smith, Jacqueline Y; O'Connor, Daniel P; Brosnan, Marcella; Cubbin, Catherine; McMillan, Tracy; Estabrooks, Paul A

2011-11-01

Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. This manuscript describes the rationale, design and methodology of Health Is Power (HIP), a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity and improve dietary habits in African American and Hispanic or Latina women in Houston and Austin, Texas. The intervention development was guided by group dynamics principles anchored within an ecologic model. Women participated in three health assessments and a six month face to face intervention that included evidence-based behavioral methods - integrated into strategies to promote group cohesion - framed to account for environmental factors contributing to health disparities. Women participated in team building activities, environmental mapping exercises, and supervised walks or taste tests. Neighborhood contextual and environmental measures are described to test ecologic factors that may contribute to behavioral maintenance. Theoretically guided interventions that account for multiple levels of influence in behavior initiation and maintenance stand to improve health outcomes in vulnerable populations. Copyright © 2011 Elsevier Inc. All rights reserved.

Health Is Power: an Ecological Theory-based Health Intervention for Women of Color

PubMed Central

Lee, Rebecca E.; Medina, Ashley V.; Mama, Scherezade K.; Reese-Smith, Jacqueline Y.; O’Connor, Daniel P.; Brosnan, Marcella; Cubbin, Catherine; McMillan, Tracy; Estabrooks, Paul A.

2011-01-01

Objective Physical inactivity and poor dietary habits plague Americans as health challenges, with women of color most vulnerable to their detrimental effects. Individually focused interventions have not demonstrated lasting success, possibly due to the lack of focus on sustainable social and physical environment factors. This manuscript describes the rationale, design and methodology of Health Is Power (HIP), a transcultural, community based, randomized controlled trial that investigated the effectiveness of a group cohesion intervention to increase physical activity and improve dietary habits in African American and Hispanic or Latina women in Houston and Austin, Texas. Methods The intervention development was guided by group dynamics principles anchored within an ecologic model. Results Women participated in three health assessments and a six month face to face intervention that included evidence-based behavioral methods—integrated into strategies to promote group cohesion—framed to account for environmental factors contributing to health disparities. Women participated in team building activities, environmental mapping exercises, and supervised walks or taste tests. Conclusions Neighborhood contextual and environmental measures are described to test ecologic factors that may contribute to behavioral maintenance. Theoretically guided interventions that account for multiple levels of influence in behavior initiation and maintenance stand to improve health outcomes in vulnerable populations. PMID:21782975

Confidence in public institutions: A focus group study on views on the Swedish Social Insurance Agency.

PubMed

Holmgren, K; Rosstorp, F; Rohdén, H

2016-09-27

From a public health perspective among the working population, it is very important that confidence in the welfare system is high, ensuring the citizens economic security and protecting them from economic stress when falling ill. The aim of this study was to explore how people with experience of health insurance perceive their confidence in the Swedish Social Insurance Agency (SSIA). Eight focus groups (n = 41) were conducted and each group met on one occasion. The participants described a systemic change in the work of the SSIA where the rule-of-law was disregarded, with arbitrary assessment, and no transparency. The reception by the SSIA shaped the image of the SSIA. The participants described vulnerability in relation to the SSIA. They felt mistrusted, which left a feeling of impotence that worsened their health. Experiencing vulnerability left a strong impression and affected the participants' confidence negatively. The following has to be acknowledged to prevent clients from experiencing impaired health, promote return-to-work possibilities, and to push public confidence in the institution in a more positive direction: Politicians and public administrators need to clarify the regulations. The decision-making process needs to be transparent and just. The entire procedure, including continuity as well as a personal, nice reception, has to be ensured.

Me, us, or them: who is more conformist? Perception of conformity and political orientation.

PubMed

Cavazza, Nicoletta; Mucchi-Faina, Angelica

2008-06-01

Research has shown that people perceive others as more vulnerable than themselves to media communication, and their political out-group as more vulnerable than their political in-group. In the present study, the authors predicted that the same two biases would appear with respect to another kind of influence--conformity--but that participants' judgments would display a different pattern according to their political orientations. Right-wing and left-wing university students were asked to evaluate conformity and to estimate how conformist they, their political in-group, their political out-group, and other groups are. As hypothesized, right-wingers expressed more ambivalence toward conformity and viewed it less negatively than did left-wingers. Political orientation had no impact on the discrepancy between self and others, but it did moderate the in-group-out-group discrepancy.

Bullying and Cyberbullying in Minorities: Are They More Vulnerable than the Majority Group?

PubMed

Llorent, Vicente J; Ortega-Ruiz, Rosario; Zych, Izabela

2016-01-01

Inclusion in education of all the children is necessary for the success, equality and peace among individuals and societies. In this context, special attention needs to be paid to the minorities. These groups might encounter additional difficulties which make them more vulnerable to be involved in bullying and cyberbullying. The current study was conducted with the objective of describing the involvement in bullying and cyberbullying of students from the majority group and also from sexual and ethnic-cultural minorities. The second objective was to explore if the implication is predicted by the interaction with gender, grade and the size of the population where the schools are located. It is an ex post facto transversal descriptive study with a survey on a representative sample of adolescents enrolled in the Compulsory Secondary Education in the south of Spain (Andalusia). The survey was answered by 2139 adolescents (50.9% girls) in 22 schools. These participants were selected through the random multistage cluster sampling with the confidence level of 95% and a sampling error of 2.1%. The results show that the minority groups, especially sexual minorities, are more involved in bullying and cyberbullying. Regression analyses show that being in the majority or a minority group predicts a small but significant percentage of variance of being involved in bullying and cyberbullying. Results are discussed taking into account the social vulnerability of being a part of a minority group and the need of designing educational programs which would prevent this vulnerability thorough the inclusion in education. There is a need for an educational policy that focuses on convivencia and ciberconvivencia which would promote the social and educational development of all the students.

Bullying and Cyberbullying in Minorities: Are They More Vulnerable than the Majority Group?

PubMed Central

Llorent, Vicente J.; Ortega-Ruiz, Rosario; Zych, Izabela

2016-01-01

Inclusion in education of all the children is necessary for the success, equality and peace among individuals and societies. In this context, special attention needs to be paid to the minorities. These groups might encounter additional difficulties which make them more vulnerable to be involved in bullying and cyberbullying. The current study was conducted with the objective of describing the involvement in bullying and cyberbullying of students from the majority group and also from sexual and ethnic-cultural minorities. The second objective was to explore if the implication is predicted by the interaction with gender, grade and the size of the population where the schools are located. It is an ex post facto transversal descriptive study with a survey on a representative sample of adolescents enrolled in the Compulsory Secondary Education in the south of Spain (Andalusia). The survey was answered by 2139 adolescents (50.9% girls) in 22 schools. These participants were selected through the random multistage cluster sampling with the confidence level of 95% and a sampling error of 2.1%. The results show that the minority groups, especially sexual minorities, are more involved in bullying and cyberbullying. Regression analyses show that being in the majority or a minority group predicts a small but significant percentage of variance of being involved in bullying and cyberbullying. Results are discussed taking into account the social vulnerability of being a part of a minority group and the need of designing educational programs which would prevent this vulnerability thorough the inclusion in education. There is a need for an educational policy that focuses on convivencia and ciberconvivencia which would promote the social and educational development of all the students. PMID:27803677

Pretreatment Clinical and Risk Correlates of Substance Use Disorder Patients With Primary Depression*

PubMed Central

Cohn, Amy M.; Epstein, Elizabeth E.; McCrady†, Barbara S.; Jensen, Noelle; Hunter-Reel, Dorian; Green, Kelly E.; Drapkin, Michelle L.

2011-01-01

Objective: The current study examined the distinction between primary and secondary depression among substance use patients to test whether the primary depressed subgroup presents to treatment with a unique profile of clinical and vulnerability characteristics. Method: The heterogeneous sample comprised 286 individuals (76% male) with alcohol and/or drug abuse or dependence (according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised) across four treatment outcome studies conducted at the alcohol research center at the Rutgers University Center of Alcohol Studies. Participants were classified as having comorbid lifetime history of primary depression (21%), secondary depression (24%), or no depression (55%). Results: Participants in the primary depression and secondary depression groups were comparable in severity of substance use, and both of these groups had more severe substance use problems than the no-depression group. The primary depression group presented with more severe depression histories, higher levels of current depressive symptoms, and higher rates of additional Axis I comorbidity at treatment entry. In terms of vulnerability indices, the primary depression subgroup had a uniquely high family history risk for major depressive disorder; underlying personality vulnerability to depression was also evident in the primary depression group, with higher neuroticism and lower ex-traversion relative to secondary depression patients. Conclusions: The findings suggest that careful assessment of lifetime depression symptoms vis-à-vis substance use history and severity yields important information identifying the primary depression subtype of substance use patients as a group with a unique and more severely affected clinical presentation of depression and other Axis I psychopathology relative to secondary depression patients. Effectiveness of substance use interventions may be augmented with depression treatment for primary depression patients, given their more severe clinical presentation and vulnerability characteristics. PMID:21138705

Parental overprotection, perceived child vulnerability, and parenting stress: a cross-illness comparison.

PubMed

Hullmann, Stephanie E; Wolfe-Christensen, Cortney; Ryan, Jamie L; Fedele, David A; Rambo, Philip L; Chaney, John M; Mullins, Larry L

2010-12-01

The current study sought to investigate differences in parenting capacity variables across four disease groups. Parents (N = 425), the majority of whom were mothers, of children with either cancer, asthma, Type 1 diabetes, or cystic fibrosis, completed measures of parental overprotection, perceived child vulnerability, and parenting stress. After controlling for significant demographic variables, parents of children with cystic fibrosis and asthma reported higher perceived child vulnerability than parents of children with either diabetes or cancer, while parents of children with asthma and diabetes reported higher parenting stress than parents of children with cancer or cystic fibrosis. No differences between disease groups were found for parental overprotection. The current study provides support for an illness-specific approach to understanding parenting capacity variables in the context of childhood chronic illnesses.

Parent-child relationship disorders. Part II. The vulnerable child syndrome and its relation to parental overprotection.

PubMed

Thomasgard, M; Shonkoff, J P; Metz, W P; Edelbrock, C

1995-08-01

Parents who are excessively concerned about their child's health are often characterized as being overprotective. We hypothesized that parental overprotection is independent of parental perception of child vulnerability to illness or injury despite their presumed interchangeability. A community-based sample of 892 parents (92% white, 84% married, 88% middle-upper socioeconomic status, 90% mothers) completed a three-part protocol (clinical background data, the Child Vulnerability Scale, and the Parent Protection Scale). Correlates of high parental perception of child vulnerability included a medical condition in the child, a history of life-threatening illness or injury, and the child being seen for a sick visit. Correlates of high parental overprotection included younger age of child and parent. Only 20% of those parents who considered their child vulnerable were also considered overprotective.

Saving Children, Saving Haiti? Child Vulnerability and Narratives of the Nation

ERIC Educational Resources Information Center

Hoffman, Diane M

2012-01-01

Long before the earthquake in Haiti on 12 January 2010, but particularly since, international media and humanitarian groups have drawn attention to the "vulnerable child" in Haiti, a child often portrayed as needing "saving". Focusing in particular on the "restavek" (child domestic laborer), this article first…

78 FR 19565 - Call for Expert Reviewers to the U.S. Government Review of the Working Group II Contribution to...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

... Climate Change (IPCC), Impacts, Adaptation & Vulnerability. SUMMARY: The United States Global Change... on Climate Change (IPCC), Impacts, Adaptation & Vulnerability. The United Nations Environment... socio-economic information for understanding the scientific basis of climate change, potential impacts...

Examining social, physical, and environmental dimensions of tornado vulnerability in Texas.

PubMed

Siebeneck, Laura

2016-01-01

To develop a vulnerability model that captures the social, physical, and environmental dimensions of tornado vulnerability of Texas counties. Guided by previous research and methodologies proposed in the hazards and emergency management literature, a principle components analysis is used to create a tornado vulnerability index. Data were gathered from open source information available through the US Census Bureau, American Community Surveys, and the Texas Natural Resources Information System. Texas counties. The results of the model yielded three indices that highlight geographic variability of social vulnerability, built environment vulnerability, and tornado hazard throughout Texas. Further analyses suggest that counties with the highest tornado vulnerability include those with high population densities and high tornado risk. This article demonstrates one method for assessing statewide tornado vulnerability and presents how the results of this type of analysis can be applied by emergency managers towards the reduction of tornado vulnerability in their communities.

[Peer group influence and illicit drug use among adolescent students in Brazil: a cross-sectional study].

PubMed

Jorge, Kelly Oliva; Ferreira, Raquel Conceição; Ferreira, Efigênia Ferreira E; Kawachi, Ichiro; Zarzar, Patrícia Maria; Pordeus, Isabela Almeida

2018-03-08

The aim of the present cross-sectional study was to examine illicit drug use and associations with socioeconomic factors as well as peer group influence among Brazilian adolescents aged 15 to 19 years. Two-stage cluster sampling was adopted, involving the random selection of public and private schools from the nine administrative districts of a Brazilian state capital and the random selection of classrooms at each school. Illicit drug use was the outcome and was measured through the question: "Have you ever used any illicit drugs (marijuana, inhalants, hypnotics, cocaine/crack, hallucinogens, amphetamines and opioids) in your life?". The most important group of friends was ranked as school, family, religious activities and sports/culture. The area-based Health Vulnerability Index (HVI) was used to assess socioeconomic status. Data from 891 adolescents were analyzed using the chi-squared test and logistic regression. The overall rate of illicit drug use was 15.2%. Gender heterogeneity within groups (OR = 3.14; 95%CI: 1.63-6.06), religion-based friendships (OR = 0.36; 95%CI: 0.17-0.75) and sports/culture-based friendships (OR = 0.44; 95%CI: 0.22-0.87) remained significantly associated with illicit drug use. Adolescents who lived in less vulnerable areas had higher chance of drug use in comparison with those living in more vulnerable areas. Religion-based and sports/culture-based friendships seem to demonstrate a protective effect against lifetime illicit drug use. Gender heterogeneity within groups and residing in a less vulnerable area increased the chances of adolescents reporting illicit drug use.

Impacts of Extreme Events on Human Health. Chapter 4

NASA Technical Reports Server (NTRS)

Bell, Jesse E.; Herring, Stephanie C.; Jantarasami, Lesley; Adrianopoli, Carl; Benedict, Kaitlin; Conlon, Kathryn; Escobar, Vanessa; Hess, Jeremy; Luvall, Jeffrey; Garcia-Pando, Carlos Perez;

Racial/ethnic harassment and discrimination, its antecedents, and its effect on job-related outcomes.

PubMed

Bergman, Mindy E; Palmieri, Patrick A; Drasgow, Fritz; Ormerod, Alayne J

2012-01-01

A general model of workplace prejudice acts, their antecedents, and their consequences is proposed and examined in the context of racial/ethnic harassment and discrimination (REHD). Antecedents proposed and tested here include context and climate, whereas consequences proposed and tested here include work, supervisor, and opportunity satisfaction and turnover intentions. The theoretical model is first tested and cross-validated in two ethnically diverse subsamples (approximately 2,000 each). Then, hierarchical multigroup modeling was conducted to determine whether the relationships among REHD, its antecedents, and its outcomes are equivalent across five racial/ethnic groups (N = 1,000 per group) in the U.S. military. This addresses the issue of differential exposure (i.e., varying amounts of stressors across groups) versus differential vulnerability (i.e., discrepant impact of a stressor on outcomes across groups) across racial/ethnic groups. Consistent with expectations, results suggest that although racial/ethnic groups differ in their mean exposure to REHD, the relationships among REHD and its outcomes are the same across race/ethnicity, supporting the differential exposure view. In addition, the results show some differences between antecedents and REHD across race/ethnicity.

Risk-Reduction Strategies to Expand Radon Care Planning with Vulnerable Groups

PubMed Central

Larsson, Laura S.

2016-01-01

Objectives Radon is the second leading cause of lung cancer in the United States and the leading cause of lung cancer among nonsmokers. Residential radon is the cause of approximately 21,000 U.S. lung cancer deaths each year. Dangerous levels of radon are just as likely to be found in low-rise apartments and townhomes as single-family homes in the same area. The preferred radon mitigation strategy can be expensive and requires structural modifications to the home. The public health nurse (PHN) needs a collection of low-cost alternatives when working with low-income families or families who rent their homes. Method A review of the literature was performed to identify evidence-based methods to reduce radon risk with vulnerable populations. Results Fourteen recommendations for radon risk reduction were categorized into four strategies. Nine additional activities for raising awareness and increasing testing were also included. Discussion The results pair the PHN with practical interventions and the underlying rationale to develop radon careplans with vulnerable families across housing types. The PHN has both the competence and the access to help families reduce their exposure to this potent carcinogen. PMID:24547763

Risk-reduction strategies to expand radon care planning with vulnerable groups.

PubMed

Larsson, Laura S

2014-01-01

Radon is the second leading cause of lung cancer in the United States and the leading cause of lung cancer among nonsmokers. Residential radon is the cause of approximately 21,000 U.S. lung cancer deaths each year. Dangerous levels of radon are just as likely to be found in low-rise apartments and townhomes as single-family homes in the same area. The preferred radon mitigation strategy can be expensive and requires structural modifications to the home. The public health nurse (PHN) needs a collection of low-cost alternatives when working with low-income families or families who rent their homes. A review of the literature was performed to identify evidence-based methods to reduce radon risk with vulnerable populations. Fourteen recommendations for radon risk reduction were categorized into four strategies. Nine additional activities for raising awareness and increasing testing were also included. The results pair the PHN with practical interventions and the underlying rationale to develop radon careplans with vulnerable families across housing types. The PHN has both the competence and the access to help families reduce their exposure to this potent carcinogen. © 2014 Wiley Periodicals, Inc.

Sustained and selective attention deficits as vulnerability markers to psychosis.

PubMed

Mulet, B; Valero, J; Gutiérrez-Zotes, A; Montserrat, C; Cortés, M J; Jariod, M; Martorell, L; Vilella, E; Labad, A

2007-04-01

The first descriptions of schizophrenia emphasized attention problems patients with schizophrenia have but recent results evidence that other psychotic disorders share them. We compared the performance in sustained and selective attention between psychotic patients (P), their healthy first degree relatives (R) and healthy volunteers (C) to prove whether these alterations could be an endophenotype of vulnerability to psychosis. We also compared the performance of schizophrenic patients (SZP) and that of patients with other functional psychoses (OP) in order to prove whether these alterations are specific of any psychotic disorder. Seventy-six P, 70 R and 39 C were included in the study. A selective attention index, comprising TMT A and B and Stroop Test, and a sustained attention index comprising the Continuous Performance Test were calculated. We conducted an univariant general linear model to compare three group performances in these indexes, with age, sex and years of education as a covariables. We found significant differences between the indexes when we compared P, R and C. No differences in performance were found between SZP and OP. Our data showed that sustained and selective attention alterations could be a vulnerability factor to psychotic disorders in general, but they were not specific of schizophrenia.

AVQS: attack route-based vulnerability quantification scheme for smart grid.

PubMed

Ko, Jongbin; Lim, Hyunwoo; Lee, Seokjun; Shon, Taeshik

2014-01-01

A smart grid is a large, consolidated electrical grid system that includes heterogeneous networks and systems. Based on the data, a smart grid system has a potential security threat in its network connectivity. To solve this problem, we develop and apply a novel scheme to measure the vulnerability in a smart grid domain. Vulnerability quantification can be the first step in security analysis because it can help prioritize the security problems. However, existing vulnerability quantification schemes are not suitable for smart grid because they do not consider network vulnerabilities. We propose a novel attack route-based vulnerability quantification scheme using a network vulnerability score and an end-to-end security score, depending on the specific smart grid network environment to calculate the vulnerability score for a particular attack route. To evaluate the proposed approach, we derive several attack scenarios from the advanced metering infrastructure domain. The experimental results of the proposed approach and the existing common vulnerability scoring system clearly show that we need to consider network connectivity for more optimized vulnerability quantification.

Mapping global vulnerability index in mining sectors: A case study Moulares-Redayef aquifer system, southwestern Tunisia

NASA Astrophysics Data System (ADS)

Khelif, Nadia; Jmal, Ikram; Bouri, Salem

2016-09-01

Contrary to the DRASTIC model grouping together the saturated and unsaturated zones to compute a global intrinsic vulnerability index, the global vulnerability index method incorporates both hydrogeological and hydrochemical data for a comprehensive index mapping for the saturated zones. This concept depends on the behavior and the uses of the groundwater. The main aim of this study is to propose a scientific basis for sustainable land use planning and groundwater management of the Moulares-Reayef aquifer, located in Southwestern Tunisia. The overexploitation of this aquifer causes the threat of groundwater quality by various sources of pollution. The global vulnerability index was applied in the Moulares-Reayef aquifer. The results show that the most favorable zones to pollutant percolation are situated along the wadis (Tabaddit, Zallaz, Berka, …) which are drained by continuous discharges. The global vulnerability values were correlated with nitrates values for validation. It revealed a significant correlation showing that high values of nitrates occurred in highly vulnerable zones with a value of 0.69 for the Pearson coefficient. The global vulnerability evaluation shows that the aquifer is characterized by high vertical vulnerability and high susceptibility.

A Climate Change Vulnerability Assessment of California's At-Risk Birds

PubMed Central

Gardali, Thomas; Seavy, Nathaniel E.; DiGaudio, Ryan T.; Comrack, Lyann A.

2012-01-01

Conservationists must develop new strategies and adapt existing tools to address the consequences of anthropogenic climate change. To support statewide climate change adaptation, we developed a framework for assessing climate change vulnerability of California's at-risk birds and integrating it into the existing California Bird Species of Special Concern list. We defined climate vulnerability as the amount of evidence that climate change will negatively impact a population. We quantified climate vulnerability by scoring sensitivity (intrinsic characteristics of an organism that make it vulnerable) and exposure (the magnitude of climate change expected) for each taxon. Using the combined sensitivity and exposure scores as an index, we ranked 358 avian taxa, and classified 128 as vulnerable to climate change. Birds associated with wetlands had the largest representation on the list relative to other habitat groups. Of the 29 state or federally listed taxa, 21 were also classified as climate vulnerable, further raising their conservation concern. Integrating climate vulnerability and California's Bird Species of Special Concern list resulted in the addition of five taxa and an increase in priority rank for ten. Our process illustrates a simple, immediate action that can be taken to inform climate change adaptation strategies for wildlife. PMID:22396726

Depressive vulnerabilities predict depression status and trajectories of depression over 1 year in persons with acute coronary syndrome.

PubMed

Doyle, Frank; McGee, Hannah; Delaney, Mary; Motterlini, Nicola; Conroy, Ronán

2011-01-01

Depression is prevalent in patients hospitalized with acute coronary syndrome (ACS). We determined whether theoretical vulnerabilities for depression (interpersonal life events, reinforcing events, cognitive distortions, Type D personality) predicted depression, or depression trajectories, post-hospitalization. We followed 375 ACS patients who completed depression scales during hospital admission and at least once during three follow-up intervals over 1 year (949 observations). Questionnaires assessing vulnerabilities were completed at baseline. Logistic regression for panel/longitudinal data predicted depression status during follow-up. Latent class analysis determined depression trajectories. Multinomial logistic regression modeled the relationship between vulnerabilities and trajectories. Vulnerabilities predicted depression status over time in univariate and multivariate analysis, even when controlling for baseline depression. Proportions in each depression trajectory category were as follows: persistent (15%), subthreshold (37%), never depressed (48%). Vulnerabilities independently predicted each of these trajectories, with effect sizes significantly highest for the persistent depression group. Self-reported vulnerabilities - stressful life events, reduced reinforcing events, cognitive distortions, personality - measured during hospitalization can identify those at risk for depression post-ACS and especially those with persistent depressive episodes. Interventions should focus on these vulnerabilities. Copyright © 2011 Elsevier Inc. All rights reserved.

A climate change vulnerability assessment of California's at-risk birds.

PubMed

Gardali, Thomas; Seavy, Nathaniel E; DiGaudio, Ryan T; Comrack, Lyann A

2012-01-01

Conservationists must develop new strategies and adapt existing tools to address the consequences of anthropogenic climate change. To support statewide climate change adaptation, we developed a framework for assessing climate change vulnerability of California's at-risk birds and integrating it into the existing California Bird Species of Special Concern list. We defined climate vulnerability as the amount of evidence that climate change will negatively impact a population. We quantified climate vulnerability by scoring sensitivity (intrinsic characteristics of an organism that make it vulnerable) and exposure (the magnitude of climate change expected) for each taxon. Using the combined sensitivity and exposure scores as an index, we ranked 358 avian taxa, and classified 128 as vulnerable to climate change. Birds associated with wetlands had the largest representation on the list relative to other habitat groups. Of the 29 state or federally listed taxa, 21 were also classified as climate vulnerable, further raising their conservation concern. Integrating climate vulnerability and California's Bird Species of Special Concern list resulted in the addition of five taxa and an increase in priority rank for ten. Our process illustrates a simple, immediate action that can be taken to inform climate change adaptation strategies for wildlife.

Measuring and Managing Army Supply Chain Risk: A Quantitative Approach by Item Number and Commercial Entity Code

DTIC Science & Technology

2015-01-01

services to the end user across the modes of transport .” As such, the supply chain “may include vendors, manufacturing facilities, logistics providers...sharing them with a group, before ranking each. For more information, see Van De Ven and Delbecq, 1974. 12 “When working through the vulnerability...are cost-effective (Kiser and Cantrell, 2006), avoiding higher production and transportation costs. Figure 2.5 outlines two prevalent supply chain

Remote Sensing of Chaparral Fire Potential: Case Study in Topanga Canyon, California.

DTIC Science & Technology

Remote sensing techniques, especially the use of color infrared aerial photography, provide a useful tool for fire hazard analysis, including interpetive information about fuel volumes, physiognomic plant groupings, the relationships of buildings to both natural and planted vegetation, and fire vulnerability of roofing materials. In addition, the behavior of the September, 1970 Wright Fire in the Topanga study area suggested the validity of the fire potential analysis which had been made prior to that conflagration.

Legal professionals and witness statements from people with a suspected mental health diagnosis.

PubMed

Reavey, Paula; Wilcock, Rachel; Brown, Steven D; Batty, Richard; Fuller, Serina

2016-01-01

Individuals with mental health problems are considered to be part of a group labeled 'vulnerable' in forensic psychology literature and the legal system more generally. In producing witness statements, there are numerous guidelines in the UK, designed to facilitate the production of reliable and valid accounts by those deemed to be vulnerable witnesses. And yet, it is not entirely clear how mental health impacts on reliability and validity within the judicial system, partly due to the diversity of those who present with mental health difficulties. In this paper, we set out to explore how legal professionals operating in the UK understand the impact of mental distress on the practical production of witness testimonies. Twenty legal professionals, including police officers, judges, magistrates and detectives were involved in a semi-structured interview to examine their knowledge and experience of working with mental health problems, and how they approached and worked with this group. A thematic analysis was conducted on the data and specific themes relevant to the overall research question are presented. These include a) dilemmas and deficiencies in knowledge of mental health, b) the abandonment of diagnosis and c) barriers to knowledge: time restrictions, silence, professional identity and fear. Finally, we explore some of the implications of these barriers, with regard to professional practice. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

The concept of 'vulnerability' in research ethics: an in-depth analysis of policies and guidelines.

PubMed

Bracken-Roche, Dearbhail; Bell, Emily; Macdonald, Mary Ellen; Racine, Eric

2017-02-07

The concept of vulnerability has held a central place in research ethics guidance since its introduction in the United States Belmont Report in 1979. It signals mindfulness for researchers and research ethics boards to the possibility that some participants may be at higher risk of harm or wrong. Despite its important intended purpose and widespread use, there is considerable disagreement in the scholarly literature about the meaning and delineation of vulnerability, stemming from a perceived lack of guidance within research ethics standards. The aim of this study was to assess the concept of vulnerability as it is employed in major national and international research ethics policies and guidelines. We conducted an in-depth analysis of 11 (five national and six international) research ethics policies and guidelines, exploring their discussions of the definition, application, normative justification and implications of vulnerability. Few policies and guidelines explicitly defined vulnerability, instead relying on implicit assumptions and the delineation of vulnerable groups and sources of vulnerability. On the whole, we found considerable richness in the content on vulnerability across policies, but note that this relies heavily on the structure imposed on the data through our analysis. Our results underscore a need for policymakers to revisit the guidance on vulnerability in research ethics, and we propose that a process of stakeholder engagement would well-support this effort.

Assessing the geomorphological vulnerability of arid beach-dune systems.

PubMed

Peña-Alonso, Carolina; Gallego-Fernández, Juan B; Hernández-Calvento, Luis; Hernández-Cordero, Antonio I; Ariza, Eduard

2018-09-01

In this study, an arid dune vulnerability index (ADVI) is developed using a system of indicators to evaluate the geomorphological vulnerability of beach-dune systems of arid regions. The indicators are comprised of three analytical dimensions (susceptibility, exposure and resilience) and their corresponding sub-indices and variables and were assessed for eleven sites located in four aeolian sedimentary systems of the Canary archipelago (Spain). The selected sites have varying geomorphological characteristics, vegetation types, marine and wind conditions and human pressure degrees, and have seen different trends in their geomorphological evolution since 1960. The eleven sites were separated into three groups according to their different conservation status and different management needs, and the results of the ADVI dimensions and variables were compared and analyzed for these three groups. In general, the results obtained in the analyzed sites reveal that susceptibility and exposure dimensions are related to low-moderate values, while resilience was high. Only one site presented a state of critical vulnerability, due to the loss of its capacity to maintain its geomorphological function in recent decades. Given the lack of knowledge about geomorphological vulnerability processes in foredunes of arid regions, ADVI is the first approximation to geomorphological diagnostic in these environments and can be useful for managers. Copyright © 2018 Elsevier B.V. All rights reserved.

Inclusive and relevant language: the use of the concepts of autonomy, dignity and vulnerability in different contexts.

PubMed

Haugen, Hans Morten

2010-08-01

The article analyses the three terms autonomy, dignity and vulnerability. The relevance and practical application of the terms is tested in two spheres. First, as guiding principles in the area of ethics of medicines and science. Second, as human rights principles, serving to guide the conduct of public policies for an effective realization of human rights. The article argues that all human beings have the same dignity, but that the autonomy--and therefore vulnerability--differs considerably. Simply said, with reduced autonomy comes increased vulnerability, implying extra attention to the protective dimensions. The article finds that the three terms approach the protection of human beings in different ways and that all are relevant and applicable in both spheres, but that an isolated notion of autonomy and a 'group-based' notion of vulnerability are not adequate.

The perils of protection: vulnerability and women in clinical research.

PubMed

Schonfeld, Toby

2013-06-01

Subpart B of 45 Code of Federal Regulations Part 46 (CFR) identifies the criteria according to which research involving pregnant women, human fetuses, and neonates can be conducted ethically in the United States. As such, pregnant women and fetuses fall into a category requiring "additional protections," often referred to as "vulnerable populations." The CFR does not define vulnerability, but merely gives examples of vulnerable groups by pointing to different categories of potential research subjects needing additional protections. In this paper, I assess critically the role of this categorization of pregnant women involved in research as "vulnerable," both as separate entities and in combination with the fetuses they carry. In particular, I do three things: (1) demonstrate that pregnant women qua pregnancy are either not "vulnerable" according to any meaningful definition of that term or that such vulnerability is irrelevant to her status as a research participant; (2) argue that while a fetus may be vulnerable in terms of dependency, this categorization does not equate to the vulnerability of the pregnant woman; and (3) suggest that any vulnerability that appends to women is precisely the result of federal regulations and dubious public perceptions about pregnant women. I conclude by demonstrating how this erroneous characterization of pregnant women as "vulnerable" and its associated protections have not only impeded vital research for pregnant women and their fetuses, but have also negatively affected the inclusion of all women in clinical research.

Relations between species rarity, vulnerability, and range contraction for a beetle group in a densely populated region in the Mediterranean biodiversity hotspot.

PubMed

Fattorini, Simone

2014-02-01

Rarity is often considered an indication of species extinction risk, and it is frequently used to obtain measures of species vulnerability. However, there is no strong evidence of a correlation between species vulnerability and threat. Moreover, there is no consensus about how rarity should be measured. I used a multidimensional characterization of species rarity to calculate a vulnerability index for tenebrionid beetles inhabiting an Italian region in the Mediterranean biodiversity hotspot. I used different metrics to examine 3 dimensions of rarity: species range, ecology, and population. Species with rarity values below the median were scored as rare for each dimension. I combined rarity scores into a vulnerability index. I then correlated species vulnerability with range trends (expanded vs. contracted). Different measures of the same rarity dimension were strongly correlated and produced similar vulnerability scores. This result indicates rarity-based vulnerability estimates are slightly affected by the way a certain rarity dimension is measured. Vulnerability was correlated with range trends; species with the highest vulnerability had the strongest range contraction. However, a large number of common species also underwent range contraction in the last 50 years, and there was no clear relation between range contraction and their ecology. This indicates that in general human-induced environmental changes affected species irrespective of their assumed vulnerability and that focusing only on rare species may severely bias perceptions of the extent of species decline. © 2013 Society for Conservation Biology.

Electronic Cigarette Expectancies in Smokers with Psychological Distress.

PubMed

Miller, Mollie E; Tidey, Jennifer W; Rohsenow, Damaris J; Higgins, Stephen T

2017-01-01

Very few studies have evaluated perceptions of electronic nicotine delivery systems (ENDS) among smokers with mental illness. This study assessed expectancies about the effects of smoking combustible cigarettes or using ENDS among current smokers with and without severe psychological distress (SPD). We used a crowdsourcing system to survey 268 smokers on their expectancies for the effects of combustible cigarettes and ENDS. Positive expectancies assessed included negative affect reduction, stimulation, positive social effects and weight control, and negative expectancies included negative physical effects, negative psychosocial effects and future health concerns. Smokers with SPD had higher positive expectancies for weight control and social effects of both products compared to those without such distress, and higher expectancies for stimulation from combustible cigarettes compared to ENDS. All participants had significantly lower negative expectancies for ENDS compared to combustible cigarettes, with no significant differences between the groups. Smokers with SPD may be more vulnerable toward ENDS use, as they are for combustible cigarette use, due to greater positive expectancies of the products. Challenging positive expectancies may increase the efficacy of tobacco control efforts in this vulnerable population.

Electronic Cigarette Expectancies in Smokers with Psychological Distress

PubMed Central

Miller, Mollie E.; Tidey, Jennifer W.; Rohsenow, Damaris J.; Higgins, Stephen T.

2017-01-01

Objectives Very few studies have evaluated perceptions of electronic nicotine delivery systems (ENDS) among smokers with mental illness. This study assessed expectancies about the effects of smoking combustible cigarettes or using ENDS among current smokers with and without severe psychological distress (SPD). Methods We used a crowdsourcing system to survey 268 smokers on their expectancies for the effects of combustible cigarettes and ENDS. Positive expectancies assessed included negative affect reduction, stimulation, positive social effects and weight control, and negative expectancies included negative physical effects, negative psychosocial effects and future health concerns. Results Smokers with SPD had higher positive expectancies for weight control and social effects of both products compared to those without such distress, and higher expectancies for stimulation from combustible cigarettes compared to ENDS. All participants had significantly lower negative expectancies for ENDS compared to combustible cigarettes, with no significant differences between the groups. Conclusions Smokers with SPD may be more vulnerable toward ENDS use, as they are for combustible cigarette use, due to greater positive expectancies of the products. Challenging positive expectancies may increase the efficacy of tobacco control efforts in this vulnerable population. PMID:28653023

Employment effects of the Danish rehabilitation benefit.

PubMed

Pallesen, Palle B; Lynge, Elsebeth

2012-06-01

Social benefits aim to bring marginalised citizens back into the labour force. As benefits constitute a burden for tax payers, attention has been given to measure the effect. We used register data to assess the employment effect of rehabilitation benefit; the most liberal social benefit in Denmark. We used data on rehabilitation benefits paid during 1994-2004. In the study design, special care was given to overcome selection bias. We identified municipalities with most frequent (generous) and least frequent (stingy) use of rehabilitation benefit, controlling for confounders (step 1). From the generous municipalities, population subgroups where ≥10% received rehabilitation benefit (vulnerable group) were identified based on age, sex, education, cohabitation, children, and health (step 2). Outcome measure was employment rate in 2005 for vulnerable groups in generous municipalities compared with vulnerable groups in stingy municipalities, controlled for municipality employment rate, i.e. a ratio of ratios (step 3). Use of rehabilitation benefit varied 10-fold across the 271 Danish municipalities. The employment rate in 2005 for vulnerable groups was lower in generous than in stingy municipalities. The ratio of ratios was 0.915 (95% CI 0.888-0.945) for men and 0.919 (95% CI 0.896-0.942) for women. No positive employment effect of generous use of rehabilitation benefit was found. Although residual confounding cannot be excluded, it is nevertheless remarkable that the possibly positive effect of rehabilitation benefit was not sufficiently large to become visible, even in a study particularly designed to eliminate selection biases and to control for confounding.

Use of expert judgment elicitation to estimate seismic vulnerability of selected building types

USGS Publications Warehouse

Jaiswal, K.S.; Aspinall, W.; Perkins, D.; Wald, D.; Porter, K.A.

2012-01-01

Pooling engineering input on earthquake building vulnerability through an expert judgment elicitation process requires careful deliberation. This article provides an overview of expert judgment procedures including the Delphi approach and the Cooke performance-based method to estimate the seismic vulnerability of a building category.

The usefulness of optical analyses for detecting vulnerable plaques using rabbit models

NASA Astrophysics Data System (ADS)

Nakai, Kanji; Ishihara, Miya; Kawauchi, Satoko; Shiomi, Masashi; Kikuchi, Makoto; Kaji, Tatsumi

2011-03-01

Purpose: Carotid artery stenting (CAS) has become a widely used option for treatment of carotid stenosis. Although technical improvements have led to a decrease in complications related to CAS, distal embolism continues to be a problem. The purpose of this research was to investigate the usefulness of optical methods (Time-Resolved Laser- Induced Fluorescence Spectroscopy [TR-LIFS] and reflection spectroscopy [RS] as diagnostic tools for assessment of vulnerable atherosclerotic lesions, using rabbit models of vulnerable plaque. Materials & Methods: Male Japanese white rabbits were divided into a high cholesterol diet group and a normal diet group. In addition, we used a Watanabe heritable hyperlipidemic (WHHL) rabbit, because we confirmed the reliability of our animal model for this study. Experiment 1: TR-LIFS. Fluorescence was induced using the third harmonic wave of a Q switch Nd:YAG laser. The TR-LIFS was performed using a photonic multi-channel analyzer with ICCD (wavelength range, 200 - 860 nm). Experiment 2: RS. Refection spectra in the wavelength range of 900 to 1700 nm were acquired using a spectrometer. Results: In the TR-LIFS, the wavelength at the peak was longer by plaque formation. The TR-LIFS method revealed a difference in peak levels between a normal aorta and a lipid-rich aorta. The RS method showed increased absorption from 1450 to 1500 nm for lipid-rich plaques. We observed absorption around 1200 nm due to lipid only in the WHHL group. Conclusion: These methods using optical analysis might be useful for diagnosis of vulnerable plaques. Keywords: Carotid artery stenting, vulnerable plaque, Time-Resolved Laser-Induced Fluorescence

Poverty, vulnerability, and provision of healthcare in Afghanistan.

PubMed

Trani, Jean-Francois; Bakhshi, Parul; Noor, Ayan A; Lopez, Dominique; Mashkoor, Ashraf

2010-06-01

This paper presents findings on conditions of healthcare delivery in Afghanistan. There is an ongoing debate about barriers to healthcare in low-income as well as fragile states. In 2002, the Government of Afghanistan established a Basic Package of Health Services (BPHS), contracting primary healthcare delivery to non-state providers. The priority was to give access to the most vulnerable groups: women, children, disabled persons, and the poorest households. In 2005, we conducted a nationwide survey, and using a logistic regression model, investigated provider choice. We also measured associations between perceived availability and usefulness of healthcare providers. Our results indicate that the implementation of the package has partially reached its goal: to target the most vulnerable. The pattern of use of healthcare provider suggests that disabled people, female-headed households, and poorest households visited health centres more often (during the year preceding the survey interview). But these vulnerable groups faced more difficulties while using health centres, hospitals as well as private providers and their out-of-pocket expenditure was higher than other groups. In the model of provider choice, time to travel reduces the likelihood for all Afghans of choosing health centres and hospitals. We situate these findings in the larger context of current debates regarding healthcare delivery for vulnerable populations in fragile state environments. The 'scaling-up process' is faced with several issues that jeopardize the objective of equitable access: cost of care, coverage of remote areas, and competition from profit-orientated providers. To overcome these structural barriers, we suggest reinforcing processes of transparency, accountability and participation. Copyright 2010 Elsevier Ltd. All rights reserved.

Accounting for adaptive capacity and uncertainty in assessments of species’ climate-change vulnerability

USGS Publications Warehouse

Wade, Alisa A.; Hand, Brian K.; Kovach, Ryan; Luikart, Gordon; Whited, Diane; Muhlfeld, Clint C.

2016-01-01

Climate change vulnerability assessments (CCVAs) are valuable tools for assessing species’ vulnerability to climatic changes, yet failure to include measures of adaptive capacity and to account for sources of uncertainty may limit their effectiveness. Here, we provide a more comprehensive CCVA approach that incorporates all three elements used for assessing species’ climate change vulnerability: exposure, sensitivity, and adaptive capacity. We illustrate our approach using case studies of two threatened salmonids with different life histories – anadromous steelhead trout (Oncorhynchus mykiss) and non-anadromous bull trout (Salvelinus confluentus) – within the Columbia River Basin, USA. We identified general patterns of high vulnerability in low-elevation and southernmost habitats for both species. However, vulnerability rankings varied widely depending on the factors (climate, habitat, demographic, and genetic) included in the CCVA and often differed for the two species at locations where they were sympatric. Our findings illustrate that CCVA results are highly sensitive to data inputs and that spatial differences can complicate multi-species conservation. Our results highlight how CCVAs should be considered within a broader conceptual and computational framework for refining hypotheses, guiding research, and comparing plausible scenarios of species’ vulnerability for ongoing and projected climate change.

The conflation of gender and sex: Gaps and opportunities in HIV data among transgender women and MSM

PubMed Central

Poteat, Tonia; German, Danielle; Flynn, Colin

2016-01-01

Historically, HIV studies have conflated men who have sex with men (MSM) with transgender (trans) women, explicitly excluded trans individuals, or included sample sizes of trans people that are too small to reach meaningful conclusions. Despite the heavy burden of HIV among trans women, conflation of this population with MSM has limited the information available on the social and behavioural factors that increase HIV vulnerability among trans women and how these factors may differ from MSM. Using data sets from quantitative studies among MSM (n = 645) and trans women (n = 89), as well as qualitative in-depth interviews with 30 trans women in Baltimore, we explore what these data tell us about similarities and differences in HIV vulnerability between the two groups and where they leave gaps in our understanding. We conclude with implications for data collection and intervention development. PMID:26785751

The conflation of gender and sex: Gaps and opportunities in HIV data among transgender women and MSM.

PubMed

Poteat, Tonia; German, Danielle; Flynn, Colin

2016-01-01

Historically, HIV studies have conflated men who have sex with men (MSM) with transgender (trans) women, explicitly excluded trans individuals, or included sample sizes of trans people that are too small to reach meaningful conclusions. Despite the heavy burden of HIV among trans women, conflation of this population with MSM has limited the information available on the social and behavioural factors that increase HIV vulnerability among trans women and how these factors may differ from MSM. Using data sets from quantitative studies among MSM (n = 645) and trans women (n = 89), as well as qualitative in-depth interviews with 30 trans women in Baltimore, we explore what these data tell us about similarities and differences in HIV vulnerability between the two groups and where they leave gaps in our understanding. We conclude with implications for data collection and intervention development.

Sexual sensation seeking, transactional sex, and rural African American cocaine users

PubMed Central

Gullette, Donna; Booth, Brenda M.; Wright, Patricia B.; Montgomery, Brooke E. E.; Stewart, Katharine E.

2014-01-01

The purpose of this study was to explore correlates of sexual sensation seeking (SSS) in a sample of rural African American cocaine users. Respondent-driven sampling was used to recruit 251 participants from two impoverished rural counties in eastern Arkansas. Consistent with previous investigations, SSS scores were associated with being younger, being male, having more sexual partners, and having more unprotected sexual encounters in the previous 30 days. Multiple regression revealed SSS was correlated with number of oral sex acts, transactional sex (exchanging sex for food, shelter, drugs, money, or other commodities), and Addiction Severity Index (ASI) drug composite. SSS continues to demonstrate a strong association with sexual risk behaviors in diverse populations, including vulnerable groups like this community. Interventions to reduce unsafe sexual behaviors among high-risk groups, including drug users and individuals who engage in transactional sex, should incorporate approaches that include high sensation seekers' needs for novelty and variety. PMID:24070647

Identifying bird and reptile vulnerabilities to climate change in the southwestern United States

USGS Publications Warehouse

Hatten, James R.; Giermakowski, J. Tomasz; Holmes, Jennifer A.; Nowak, Erika M.; Johnson, Matthew J.; Ironside, Kirsten E.; van Riper, Charles; Peters, Michael; Truettner, Charles; Cole, Kenneth L.

2016-07-06

Current and future breeding ranges of 15 bird and 16 reptile species were modeled in the Southwestern United States. Rather than taking a broad-scale, vulnerability-assessment approach, we created a species distribution model (SDM) for each focal species incorporating climatic, landscape, and plant variables. Baseline climate (1940–2009) was characterized with Parameter-elevation Regressions on Independent Slopes Model (PRISM) data and future climate with global-circulation-model data under an A1B emission scenario. Climatic variables included monthly and seasonal temperature and precipitation; landscape variables included terrain ruggedness, soil type, and insolation; and plant variables included trees and shrubs commonly associated with a focal species. Not all species-distribution models contained a plant, but if they did, we included a built-in annual migration rate for more accurate plant-range projections in 2039 or 2099. We conducted a group meta-analysis to (1) determine how influential each variable class was when averaged across all species distribution models (birds or reptiles), and (2) identify the correlation among contemporary (2009) habitat fragmentation and biological attributes and future range projections (2039 or 2099). Projected changes in bird and reptile ranges varied widely among species, with one-third of the ranges predicted to expand and two-thirds predicted to contract. A group meta-analysis indicated that climatic variables were the most influential variable class when averaged across all models for both groups, followed by landscape and plant variables (birds), or plant and landscape variables (reptiles), respectively. The second part of the meta-analysis indicated that numerous contemporary habitat-fragmentation (for example, patch isolation) and biological-attribute (for example, clutch size, longevity) variables were significantly correlated with the magnitude of projected range changes for birds and reptiles. Patch isolation was a significant trans-specific driver of projected bird and reptile ranges, suggesting that strategic actions should focus on restoration and enhancement of habitat at local and regional scales to promote landscape connectivity and conservation of core areas.

Strategic use of communication to market cancer prevention and control to vulnerable populations.

PubMed

Kreps, Gary L

2008-01-01

There are significant challenges to communicating relevant cancer prevention and control information to health care consumers due both to the complexities of the health information to be communicated and the complexities of health communication, especially with vulnerable populations. The need for effective communication about cancer risks, early detection, prevention, care, and survivorship is particularly acute, yet also tremendously complex, for reaching vulnerable populations, those groups of people who are most likely to suffer significantly higher levels of morbidity and mortality from cancers than other segments of the population. These vulnerable populations, typically the poorest, lowest educated, and most disenfranchised members of modern society, are heir to serious cancer-related health disparities. Vulnerable populations often have health literacy difficulties, cultural barriers, and economic challenges to accessing and making sense of relevant health information. This paper examines these challenges to communicating relevant information to vulnerable populations and suggests strategies for effectively using different communication media for marketing cancer prevention and control to reduce health disparities and promote public health.

A dynamic vulnerability evaluation model to smart grid for the emergency response

NASA Astrophysics Data System (ADS)

Yu, Zhen; Wu, Xiaowei; Fang, Diange

2018-01-01

Smart grid shows more significant vulnerability to natural disasters and external destroy. According to the influence characteristics of important facilities suffered from typical kinds of natural disaster and external destroy, this paper built a vulnerability evaluation index system of important facilities in smart grid based on eight typical natural disasters, including three levels of static and dynamic indicators, totally forty indicators. Then a smart grid vulnerability evaluation method was proposed based on the index system, including determining the value range of each index, classifying the evaluation grade standard and giving the evaluation process and integrated index calculation rules. Using the proposed evaluation model, it can identify the most vulnerable parts of smart grid, and then help adopting targeted emergency response measures, developing emergency plans and increasing its capacity of disaster prevention and mitigation, which guarantee its safe and stable operation.

Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study.

PubMed

Atujuna, Millicent; Newman, Peter A; Wallace, Melissa; Eluhu, Megan; Rubincam, Clara; Brown, Ben; Bekker, Linda-Gail

2018-01-01

New biomedical prevention technologies (NPTs) may contribute to substantially reducing incident HIV infections globally. We explored acceptability and preferences for NPTs among key and other vulnerable populations in two South African townships. We conducted six focus groups and 12 in-depth interviews with adolescents, and adult heterosexual men, women, and men who have sex with men (MSM) (n = 48), and eight in-depth interviews with key informant healthcare workers. The interview guide described pre-exposure prophylaxis (PrEP), vaginal rings, rectal microbicides and HIV vaccines, and explored acceptability and product preferences. Focus groups and in-depth interviews (45-80 minutes) were conducted in Xhosa, audiotaped, and transcribed and translated into English. Data were coded and reviewed using framework analysis with NVivo software. Overall, initial enthusiasm and willingness to use NPTs evolved into concerns about how particular NPTs might affect or require alterations in one's everyday lifestyle and practices. Different product preferences and motivations emerged by population based on similarity to existing practices and contexts of vulnerability. Adult women and female adolescents preferred a vaginal ring and HIV vaccine, motivated by longer duration of protection to mitigate feared repercussions from male partners, including threats to their marriage and safety, and a context of ubiquitous rape. Male adolescents preferred an HIV vaccine, seen as protection in serodiscordant relationships and convenient in obviating the HIV stigma and cost involved in buying condoms. Adult men preferred PrEP, given familiarity with oral medications and mistrust of injections, seen as enabling serodiscordant couples to have a child. MSM preferred a rectal microbicide given familiarity with gel-based lubricants, with concerns about duration of protection in the context of unplanned consensual sex and rape. Biomedical interventions to prevent HIV transmission, rather than obviating social-structural factors that produce vulnerability, may be limited by these same factors. Implementation of NPTs should engage local communities to understand real-world constraints and strategise to deliver effective, multi-level combination prevention.

Understanding Vulnerability: From Categories to Experiences of Young Congolese People in Uganda

ERIC Educational Resources Information Center

Clark, Christina R.

2007-01-01

This article problematises the "vulnerables" category that the United Nations High Commissioner for Refugees applies to groups of refugees. Drawing on 9 months' qualitative research with young Congolese refugees in Uganda, it presents research subjects' self-identification and lived realities that do not correspond to the homogenous,…

Hearing Voices: Qualitative Research with Postsecondary Students Experiencing Mental Illness

ERIC Educational Resources Information Center

Venville, Annie; Street, Annette F.

2014-01-01

Vocational Education and Training (VET) students experiencing mental illness have been described as one of the most vulnerable student groups in the Australian post-secondary sector. This vulnerability can be attributed to the impacts of illness, the oft-reported experiences of stigma and discrimination, and low educational outcomes. There is…

The Transcription Factor Orthodenticle Homeobox 2 Influences Axonal Projections and Vulnerability of Midbrain Dopaminergic Neurons

ERIC Educational Resources Information Center

Chung, Chee Yeun; Licznerski, Pawel; Alavian, Kambiz N.; Simeone, Antonio; Lin, Zhicheng; Martin, Eden; Vance, Jeffery; Isacson, Ole

2010-01-01

Two adjacent groups of midbrain dopaminergic neurons, A9 (substantia nigra pars compacta) and A10 (ventral tegmental area), have distinct projections and exhibit differential vulnerability in Parkinson's disease. Little is known about transcription factors that influence midbrain dopaminergic subgroup phenotypes or their potential role in disease.…

Support Needs of the Most Vulnerable Student Groups in Non-University Higher Education

ERIC Educational Resources Information Center

Tamuliene, Rasa

2014-01-01

This article presents the research on support needs of the most vulnerable students in nonuniversity higher education. The research results have revealed that older, part-time students who have family and/or work responsibilities focus on academic information and counselling, foreign language training, distance study centre, legal counselling and…

Stereotype Threat Vulnerability: A Psychometric Investigation of the Social Identities and Attitudes Scale

ERIC Educational Resources Information Center

Smith, Leann V.; Cokley, Kevin

2016-01-01

The authors investigated the psychometric properties of the Social Identities and Attitudes Scale developed by Picho and Brown, which captures an individual's vulnerability to Stereotype Threat effects. Confirmatory factor analyses and group invariance tests conducted on a diverse sample of 516 college students revealed adequate reliability and…

Youth Work with Vulnerable Young People. Interchange No. 51.

ERIC Educational Resources Information Center

Powney, Janet; Furlong, Andy; Cartmel, Fred; Hall, Stuart

Research was conducted in Scotland to evaluate the effectiveness of youth work with vulnerable young people, primarily between the ages of 13 and 16. Four complementary methods were adopted: (1) a survey of secondary school students; (2) a series of focus group interviews with young people with experience of youth work; (3) interviews with…

Intervention Strategies for Populations at Risk: A Behavioral Approach to Prevention.

ERIC Educational Resources Information Center

Hartman, Lorne M.; Poser, Ernest G.

This report presents a preliminary series of investigations dealing with the detection of populations at psychological risk. The investigation relies primarily on the variable of vulnerability, as defined empirically by self-esteem, psychological discomfort, and social skills. Two vulnerability groups, high (HV) and low(LV) are compared on their…

Emotionally-Vulnerable Subjects and New Inequalities: The Educational Implications of an "Epistemology of the Emotions"

ERIC Educational Resources Information Center

Ecclestone, Kathryn

2011-01-01

Motivated by very different goals, various interest groups argue that the British government should address problems with citizens' emotional well-being. Concerns about emotional vulnerability and poor emotional well-being amongst growing numbers of children, young people and adults produce ideas and approaches from different branches of…

Association Between Medicare Accountable Care Organization Implementation and Spending Among Clinically Vulnerable Beneficiaries

PubMed Central

Colla, Carrie H.; Lewis, Valerie A.; Kao, Lee-Sien; O’Malley, A. James; Chang, Chiang-Hua; Fisher, Elliott S.

2016-01-01

IMPORTANCE Accountable care contracts hold physician groups financially responsible for the quality and cost of health care delivered to patients. Focusing on clinically vulnerable patients, those with serious conditions who are responsible for the greatest proportion of spending, may result in the largest effects on both patient outcomes and financial rewards for participating physician groups. OBJECTIVE To estimate the effect of Medicare accountable care organization (ACO) contracts on spending and high-cost institutional use for all Medicare beneficiaries and for clinically vulnerable beneficiaries. DESIGN, SETTING, AND PARTICIPANTS For this cohort study, 2 study populations were defined: the overall Medicare population and the clinically vulnerable subgroup of Medicare beneficiaries. The overall Medicare population was based on a random 40% sample drawn from continuously enrolled fee-for-service beneficiaries with at least 1 evaluation and management visit in a calendar year. The clinically vulnerable study population included all Medicare beneficiaries 66 years or older who had at least 3 Hierarchical Condition Categories (HCCs). Beneficiaries entered the cohort during the quarter between January 2009 to December 2011 when they first had at least 3 HCCs and remained in the cohort until death. Cohort entry was restricted to the preperiod to account for potential changes in coding practices after ACO implementation. Difference-in-difference estimations were used to compare changes in health care outcomes for Medicare beneficiaries attributed to physicians in ACOs with those attributed to non-ACO physicians from January 2009 to December 2013. EXPOSURES Medicare ACOs beginning contracts in January 2012, April 2012, July 2012, and January 2013 through the Pioneer and Medicare Shared Savings Programs. MAIN OUTCOMES AND MEASURES Total spending per beneficiary-quarter, spending categories, use of hospitals and emergency departments, ambulatory care sensitive admissions, and 30-day readmissions. RESULTS Total spending decreased by $34 (95% CI, −$52 to −$15) per beneficiary-quarter after ACO contract implementation across the overall Medicare population (n = 15 592 600) and decreased $114 in clinically vulnerable patients (n = 8 673 823) (95% CI, −$178 to −$50). In the overall Medicare cohort, hospitalizations and emergency department visits decreased by 1.3 and 3.0 events per 1000 beneficiaries per quarter, respectively (95% CIs: −2.1 to −0.4 and −4.8 to −1.3), and hospitalizations and emergency department visits decreased in the clinically vulnerable cohort by 2.9 and 4.1 events per 1000 beneficiaries per quarter, respectively (95% CIs: −5.2 to −0.7 and −7.1 to −1.2). Changes in total spending associated with ACOs did not vary by clinical condition of beneficiaries. CONCLUSIONS AND RELEVANCE Medicare ACO programs are associated with modest reductions in spending and use of hospitals and emergency departments. Savings were realized through reductions in use of institutional settings in clinically vulnerable patients. PMID:27322485

Interactive exploration of the vulnerability of the human infrastructure: an approach using simultaneous display of similar locations

NASA Astrophysics Data System (ADS)

Ceré, Raphaël; Kaiser, Christian

2015-04-01

Currently, three quarters of the Swiss population is living in urban areas. The total population is still increasing, and urbanized space is increasing event faster. Consequently, the intensity of use has decreased but the exposure of the urban space to natural events has grown along with the cost related to the impact of hazards. In line with this fact, during the 20th century there has been a noticeable increase of natural disasters accompanied by the rapid increase of the world population, leading to higher costs. Additionally to the fact that more people are exposed to natural hazards, the value of goods globally has increased more than proportionally. Consequently, the vulnerability of urban space is, more than ever before, a major issue for socio-economic development. Here, vulnerability is defined as the potential human loss or loss of infrastructure caused by a hazardous event. It encompasses factors of urban infrastructure, population and the environment, which increase the susceptibility of a location to the impact of hazards. This paper describes a novel method for improving the interactive use of exploratory data analysis in the context of minimizing vulnerability and disaster risk by prevention or mitigation. This method is used to assess the similarity between different locations with respect to several characteristics relevant to vulnerability at different scales, allowing for automatic display of multiple locations similar to the one under investigation by an expert. Visualizing vulnerability simultaneously for several locations allows for analyzing and comparing of metric characteristics between multiple places and at different scales. The interactivity aspect is also useful for understanding vulnerability patterns and it facilitates disaster risk management and decisions on global preventive measures in urban spaces. Metrics for vulnerability assessment can be extracted from extensive geospatial datasets such as high-resolution digital elevation models (DEM) or individual building vector layers. Morphological properties can be calculated for different scales using different moving window sizes. Multi-scale measures such as fractal or lacunarity can be integrated into the analysis. Other properties such as different densities and ratios are also easy to calculate and include. Based on a rather extensive set of properties or features, a feature selection or extraction method such as Principal Component Analysis can be used to obtain a subset of relevant properties. In a second step, an unsupervised classification algorithm such as Self-Organizing Maps can be used to group similar locations together, and criteria such as the intra-group distance and geographic distribution can be used for selecting relevant locations to be displayed in an interactive data exploration interface along with a given main location. A case study for a part of Switzerland illustrates the presented approach within a working interactive tool, showing the feasibility and allowing for an investigation of the usefulness of our method.

Livelihood Cycle and Vulnerability of Rural Households to Climate Change and Hazards in Bangladesh.

PubMed

Alam, G M Monirul

2017-05-01

Rural riverine households in Bangladesh are confronted with many climate-driven hazards, including riverbank erosion, which results in loss of productive land and other natural resources of the riverine households, and thus threatens their livelihoods and food security. This study assesses the main drivers of vulnerability and livelihood cycle of vulnerable riparian households in Bangladesh. The study utilises the IPCC framework of vulnerability and develops a weighted approach by employing the livelihood vulnerability index and the climate vulnerability index. The results reveal that the livelihood vulnerability index and the climate vulnerability index differ across locations, however, a high index value for both measures indicates the households' high livelihood vulnerability to climate change and hazards. The main drivers that influence the vulnerability dimensions are livelihood strategies and access to food, water and health facilities. These hazard-prone households are also vulnerable due to their existing low livelihood status that leads to a vicious cycle of poverty. The findings of this study are crucial for policymakers to formulate and implement effective strategies and programs to minimise vulnerability and to enhance the local adaptation processes in order to improve such households' livelihood across Bangladesh.

Livelihood Cycle and Vulnerability of Rural Households to Climate Change and Hazards in Bangladesh

NASA Astrophysics Data System (ADS)

Alam, G. M. Monirul

2017-05-01

Rural riverine households in Bangladesh are confronted with many climate-driven hazards, including riverbank erosion, which results in loss of productive land and other natural resources of the riverine households, and thus threatens their livelihoods and food security. This study assesses the main drivers of vulnerability and livelihood cycle of vulnerable riparian households in Bangladesh. The study utilises the IPCC framework of vulnerability and develops a weighted approach by employing the livelihood vulnerability index and the climate vulnerability index. The results reveal that the livelihood vulnerability index and the climate vulnerability index differ across locations, however, a high index value for both measures indicates the households' high livelihood vulnerability to climate change and hazards. The main drivers that influence the vulnerability dimensions are livelihood strategies and access to food, water and health facilities. These hazard-prone households are also vulnerable due to their existing low livelihood status that leads to a vicious cycle of poverty. The findings of this study are crucial for policymakers to formulate and implement effective strategies and programs to minimise vulnerability and to enhance the local adaptation processes in order to improve such households' livelihood across Bangladesh.

Physical assessment of coastal vulnerability under enhanced land subsidence in Semarang, Indonesia, using multi-sensor satellite data

NASA Astrophysics Data System (ADS)

Husnayaen; Rimba, A. Besse; Osawa, Takahiro; Parwata, I. Nyoman Sudi; As-syakur, Abd. Rahman; Kasim, Faizal; Astarini, Ida Ayu

2018-04-01

Research has been conducted in Semarang, Indonesia, to assess coastal vulnerability under enhanced land subsidence using multi-sensor satellite data, including the Advanced Land Observing Satellite (ALOS) Phased Array type L-band SAR (PALSAR), Landsat TM, IKONOS, and TOPEX/Poseidon. A coastal vulnerability index (CVI) was constructed to estimate the level of vulnerability of a coastline approximately 48.68 km in length using seven physical variables, namely, land subsidence, relative sea level change, coastal geomorphology, coastal slope, shoreline change, mean tidal range, and significant wave height. A comparison was also performed between a CVI calculated using seven parameters and a CVI using six parameters, the latter of which excludes the land subsidence parameter, to determine the effects of land subsidence during the coastal vulnerability assessment. This study showed that the accuracy of coastal vulnerability was increased 40% by adding the land subsidence factor (i.e., CVI 6 parameters = 53%, CVI 7 parameters = 93%). Moreover, Kappa coefficient indicated very good agreement (0.90) for CVI 7 parameters and fair agreement (0.3) for CVI 6 parameters. The results indicate that the area of very high vulnerability increased by 7% when land subsidence was added. Hence, using the CVI calculation including land subsidence parameters, the very high vulnerability area is determined to be 20% of the total coastline or 9.7 km of the total 48.7 km of coastline. This study proved that land subsidence has significant influence on coastal vulnerability in Semarang.

Assessing social vulnerability in African urban context. The challenge to cope with climate change induced hazards by communities and households

NASA Astrophysics Data System (ADS)

Kabisch, Sigrun; Jean-Baptiste, Nathalie

2013-04-01

Social vulnerability assessment remains central in discourses on global climatic change and takes a more pertinent meaning considering that natural disasters in African countries continue to deeply affect human settlements and destroys human livelihoods. In recent years, in particular large territories and growing cities have experienced severe weather events. Among them are river and flash floods, affecting the social and economic assets of local populations. The impact of the damage related to floods is not only perceptible during seasonal events but also during unexpected larger disasters which place a particular burden on local population and institutions to adapt effectively to increasing climatic pressures. Important features for social vulnerability assessment are the increasing severity of the physical damages, the shortcoming of social and technical infrastructure, the complexity of land management/market, the limited capacity of local institutions and last but not least the restricted capacities of local population to resist these events. Understanding vulnerability implies highlighting and interlinking relevant indicators and/or perceptions encompassed in four main dimensions: social, institutional, physical and attitudinal vulnerability. Case studies in Dar es Salaam, Ouagadougou and Addis Ababa were carried out to obtain insights into the context-related conditions, behavior routines and survival networks in urban areas in west and east Africa. Using a combination of tools (e.g. focus group discussions, transect walks, interviews) we investigated in close cooperation with African partners how households and communities are being prepared to cope with, as well as to recover from floods. A comprehensive process of dealing with floods can be described based on sequential attributes concerning i) Anticipation before a flood occurs, ii) Resistance and coping activities during a flood event and, iii) Recovery and reconstruction afterwards. A participatory approach at household level provides detailed knowledge about the preparedness, the susceptibility and the coping capacities of identified community including its leaders and members. Assessing and ranking the weaknesses and limitations help strengthen awareness and initiate measures for improving coping capacities to social vulnerability in case of flooding. Examples of social vulnerability and the spectrum of coping activities are demonstrated through to use of empirical research results.

Parent and Self-Report Ratings on the Perceived Levels of Social Vulnerability of Adults with Williams Syndrome.

PubMed

Lough, Emma; Fisher, Marisa H

2016-11-01

The current study took a multi-informant approach to compare parent to self-report ratings of social vulnerability of adults with Williams syndrome (WS). Participants included 102 pairs of adults with WS and their parents. Parents completed the Social Vulnerability Questionnaire and adults with WS completed an adapted version of the questionnaire. Parents consistently reported higher levels of social vulnerability for their son/daughter than the individual with WS reported, with the exception of emotional abuse. The lower ratings of social vulnerability by adults with WS, compared to their parents, offer new information about their insight into their own vulnerability. These findings highlight the importance of teaching self-awareness as a part of a multi-informant approach to interventions designed to target social vulnerability.

General vulnerability to stuttering: The experience of stuttering and conditions bringing about invulnerability.

PubMed

Briley, P M; Kalinowski, J S

2016-08-01

General vulnerability to stuttering is the broad awareness of stuttering and the ever-present, experiential sense of a person who stutters (PWS). It is defined by stuttering in all its forms and the awareness of its presence, both in moments of stuttering and moments of perceivably fluent speech. Under the heading of general vulnerability to stuttering is specific vulnerability to stuttering, which includes the actual events of stuttering (i.e., overt symptoms, covert symptoms, subperceptual stuttering, and anticipation of stuttering). The differentiation between the two is that specific vulnerability requires a specific moment of stuttering where general vulnerability does not. Copyright © 2016 Elsevier Ltd. All rights reserved.

Use of the male condom by heterosexual adolescents and young people: literature review.

PubMed

East, Leah; Jackson, Debra; O'Brien, Louise; Peters, Kathleen

2007-07-01

This paper is a report of a literature review to explore issues influencing condom use in heterosexual adolescents and young people. Sexually transmitted infections (STIs) are a major international health issue and adolescents and young people are particularly vulnerable. Efforts to address the rapid spread of STIs have largely focused on promoting the use of condoms as a protective 'safer sex' measure. However, use of the male condom is still inconsistent and the incidence of STIs continues to increase. A search of the literature using EBSCO Host databases was undertaken in 2006, with a focus on women, young people, condoms and STIs. Papers published in English from 1992 to 2006 were sought. Only research papers are included in this review. Factors impeding decisions to use protection by young people include lack of knowledge about prevalence of STIs, ambiguity around contraception and safer sex practices, and the difficulty faced by young women in particular in negotiating safer sex. The notion of romantic love confounds the assessment of risk and can render young people, particularly young women, ineffective in negotiating safer sex practices. Adolescents and young adults are particularly vulnerable in relation to STIs. There is a need to ensure that accurate messages are delivered about safer sex and contraception to this very vulnerable group. Furthermore, it is important to recognize that romantic love comprises strong emotions that have a role in decision-making and options for reducing personal-health risk during sexual activity.

Traditional Chinese medication Tongxinluo attenuates apoptosis in ox-LDL-stimulated macrophages by enhancing Beclin-1-induced autophagy.

PubMed

Chen, Yifei; Li, Mengmeng; Zhang, Yu; Di, Mingxue; Chen, Weijia; Liu, Xiaolin; Yu, Fangpu; Wang, Han; Zhen, Xi; Zhang, Mei

2018-06-22

In advanced atherosclerosis, a large number of necrotic core increases plaque vulnerability, which leads to the occurrence of acute atherothrombotic cardiovascular events. Macrophage apoptosis plays an important role in secondary necrosis. The present study aimed to examine and describe the effect of the traditional Chinese medication Tongxinluo (TXL) on macrophage apoptosis in advanced atherosclerotic plaques and to explore its mechanism. By observing the effect of TXL on ox-LDL-stimulated macrophage apoptosis, it was shown that TXL significantly inhibited ox-LDL-induced apoptosis of macrophages by enhancing autophagy. Therapeutic mechanism of TXL included increasing the expression of Beclin-1 and improving the dissociation of Bcl-2-Beclin-1 Complex. Apolipoprotein E knockout (apoE-/-) mice with a high fat diet were divided into four groups: saline group (Saline gavage), low dose TXL group (0.38 g/kg/d, gavage), medium dose TXL group (0.75 g/kg/day, gavage), and high dose TXL group (1.5 g/kg/day, gavage). 4 weeks after carotid-artery surgery, lentiviral of Beclin-1 silencing was injected through the tail vein. TXL treatment significantly reduced macrophage apoptosis dose-dependently and the result was blocked by Beclin-1 silencing. In addition, the increased Lc3b dots by TXL almost localized to macrophages in advanced atherosclerotic plaque. Compared with the same dose of TXL shBeclin-1 group, plaque area and vulnerability index of TXL groups decreased. The anti-apoptosis effects of TXL on atherosclerosis was related to the improvement of autophagy via Beclin-1. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

A population-based study of cognitive impairment in socially vulnerable adults in Argentina. The Matanza Riachuelo study preliminary results

PubMed Central

Bartoloni, Leonardo; Blatt, Graciela; Insua, Iván; Furman, Mariano; González, María Agustina; Hermann, Bárbara; Kesselman, Mariana; Massautis, Alicia; Reinado, Alejandra; Senas, Patricia; Yavitz, Claudia; Lejarraga, Horacio; Nunes, Fernando; Arizaga, Raúl Luciano; Allegri, Ricardo F

2014-01-01

Population aging has taken place intensively worldwide, even in developing countries. These countries have population groups with low resources and basic unmet needs that are frequently omitted from epidemiological studies. Objective The purpose of this study was to determine the prevalence of cognitive impairment (CI) and dementia in an economic and socially vulnerable population from Argentina. Methods A door-to-door observational population-based survey among adults over 60 years of cognitive impairment and dementia in the social vulnerable area of the Matanza Riachuelo Basin, in the suburban area of Buenos Aires, Argentina was conducted. Trained psychologists interviewed subjects and a proxy informant. A standardized protocol including a socio-demographic questionnaire, the Mini-Mental State Examination, the Geriatric Depression Scale and a functional inventory for IADL and ADL was administered. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment-no dementia (CIND) and dementia. Results and Conclusions A total of 2437 elderly persons were assessed, of which 73.6% fulfilled inclusion criteria. The prevalence of CI among those over 60 was 26.4% (18.1% CIND and 8.3% dementia) with higher prevalence of dementia in younger individuals than rates reported in developed counties, probably due to low control of vascular risk factors. This information can help inform health public decisions in the generation of programs and plans for the prevention, diagnosis and treatment of cognitive impairment in this type of socially vulnerable population. PMID:29213923

A population-based study of cognitive impairment in socially vulnerable adults in Argentina. The Matanza Riachuelo study preliminary results.

PubMed

Bartoloni, Leonardo; Blatt, Graciela; Insua, Iván; Furman, Mariano; González, María Agustina; Hermann, Bárbara; Kesselman, Mariana; Massautis, Alicia; Reinado, Alejandra; Senas, Patricia; Yavitz, Claudia; Lejarraga, Horacio; Nunes, Fernando; Arizaga, Raúl Luciano; Allegri, Ricardo F

2014-01-01

Population aging has taken place intensively worldwide, even in developing countries. These countries have population groups with low resources and basic unmet needs that are frequently omitted from epidemiological studies. The purpose of this study was to determine the prevalence of cognitive impairment (CI) and dementia in an economic and socially vulnerable population from Argentina. A door-to-door observational population-based survey among adults over 60 years of cognitive impairment and dementia in the social vulnerable area of the Matanza Riachuelo Basin, in the suburban area of Buenos Aires, Argentina was conducted. Trained psychologists interviewed subjects and a proxy informant. A standardized protocol including a socio-demographic questionnaire, the Mini-Mental State Examination, the Geriatric Depression Scale and a functional inventory for IADL and ADL was administered. Diagnoses were divided into three general categories: normal cognitive function, cognitive impairment-no dementia (CIND) and dementia. A total of 2437 elderly persons were assessed, of which 73.6% fulfilled inclusion criteria. The prevalence of CI among those over 60 was 26.4% (18.1% CIND and 8.3% dementia) with higher prevalence of dementia in younger individuals than rates reported in developed counties, probably due to low control of vascular risk factors. This information can help inform health public decisions in the generation of programs and plans for the prevention, diagnosis and treatment of cognitive impairment in this type of socially vulnerable population.

Climate change and marine fisheries: Least developed countries top global index of vulnerability

PubMed Central

Blasiak, Robert; Spijkers, Jessica; Tokunaga, Kanae; Pittman, Jeremy; Yagi, Nobuyuki; Österblom, Henrik

2017-01-01

Future impacts of climate change on marine fisheries have the potential to negatively influence a wide range of socio-economic factors, including food security, livelihoods and public health, and even to reshape development trajectories and spark transboundary conflict. Yet there is considerable variability in the vulnerability of countries around the world to these effects. We calculate a vulnerability index of 147 countries by drawing on the most recent data related to the impacts of climate change on marine fisheries. Building on the Intergovernmental Panel on Climate Change framework for vulnerability, we first construct aggregate indices for exposure, sensitivity and adaptive capacity using 12 primary variables. Seven out of the ten most vulnerable countries on the resulting index are Small Island Developing States, and the top quartile of the index includes countries located in Africa (17), Asia (7), North America and the Caribbean (4) and Oceania (8). More than 87% of least developed countries are found within the top half of the vulnerability index, while the bottom half includes all but one of the Organization for Economic Co-operation and Development member states. This is primarily due to the tremendous variation in countries’ adaptive capacity, as no such trends are evident from the exposure or sensitivity indices. A negative correlation exists between vulnerability and per capita carbon emissions, and the clustering of states at different levels of development across the vulnerability index suggests growing barriers to meeting global commitments to reducing inequality, promoting human well-being and ensuring sustainable cities and communities. The index provides a useful tool for prioritizing the allocation of climate finance, as well as activities aimed at capacity building and the transfer of marine technology. PMID:28632781

Patterns of Freshwater Species Richness, Endemism, and Vulnerability in California

PubMed Central

Furnish, Joseph; Gardali, Thomas; Grantham, Ted; Katz, Jacob V. E.; Kupferberg, Sarah; McIntyre, Patrick; Moyle, Peter B.; Ode, Peter R.; Peek, Ryan; Quiñones, Rebecca M.; Rehn, Andrew C.; Santos, Nick; Schoenig, Steve; Serpa, Larry; Shedd, Jackson D.; Slusark, Joe; Viers, Joshua H.; Wright, Amber; Morrison, Scott A.

2015-01-01

The ranges and abundances of species that depend on freshwater habitats are declining worldwide. Efforts to counteract those trends are often hampered by a lack of information about species distribution and conservation status and are often strongly biased toward a few well-studied groups. We identified the 3,906 vascular plants, macroinvertebrates, and vertebrates native to California, USA, that depend on fresh water for at least one stage of their life history. We evaluated the conservation status for these taxa using existing government and non-governmental organization assessments (e.g., endangered species act, NatureServe), created a spatial database of locality observations or distribution information from ~400 data sources, and mapped patterns of richness, endemism, and vulnerability. Although nearly half of all taxa with conservation status (n = 1,939) are vulnerable to extinction, only 114 (6%) of those vulnerable taxa have a legal mandate for protection in the form of formal inclusion on a state or federal endangered species list. Endemic taxa are at greater risk than non-endemics, with 90% of the 927 endemic taxa vulnerable to extinction. Records with spatial data were available for a total of 2,276 species (61%). The patterns of species richness differ depending on the taxonomic group analyzed, but are similar across taxonomic level. No particular taxonomic group represents an umbrella for all species, but hotspots of high richness for listed species cover 40% of the hotspots for all other species and 58% of the hotspots for vulnerable freshwater species. By mapping freshwater species hotspots we show locations that represent the top priority for conservation action in the state. This study identifies opportunities to fill gaps in the evaluation of conservation status for freshwater taxa in California, to address the lack of occurrence information for nearly 40% of freshwater taxa and nearly 40% of watersheds in the state, and to implement adequate protections for freshwater taxa where they are currently lacking. PMID:26147215

Arsenic in private well water part 3 of 3: Socioeconomic vulnerability to exposure in Maine and New Jersey.

PubMed

Flanagan, Sara V; Spayd, Steven E; Procopio, Nicholas A; Marvinney, Robert G; Smith, Andrew E; Chillrud, Steven N; Braman, Stuart; Zheng, Yan

2016-08-15

Arsenic is a naturally occurring toxic element often concentrated in groundwater at levels unsafe for human consumption. Private well water in the United States is mostly unregulated by federal and state drinking water standards. It is the responsibility of the over 13 million U.S. households regularly depending on private wells for their water to ensure it is safe for drinking. There is a consistent graded association with health outcomes at all levels of socioeconomic status (SES) in the U.S. Differential exposure to environmental risk may be contributing to this persistent SES-health gradient. Environmental justice advocates cite overwhelming evidence that income and other SES measures are consistently inversely correlated with exposure to suboptimal environmental conditions including pollutants, toxins, and their impacts. Here we use private well household surveys from two states to investigate the association between SES and risks for arsenic exposure, examining the potentially cumulative effects of residential location, testing and treatment behavior, and psychological factors influencing behavior. We find that the distribution of natural arsenic hazard in the environment is socioeconomically random. There is no evidence that higher SES households are avoiding areas with arsenic or that lower SES groups are disproportionately residing in areas with arsenic. Instead, disparities in exposure arise from differing rates of protective action, primarily testing well water for arsenic, and secondly treating or avoiding contaminated water. We observe these SES disparities in behavior as well as in the psychological factors that are most favorable to these behaviors. Assessment of risk should not be limited to the spatial occurrence of arsenic alone. It is important that social vulnerability factors are incorporated into risk modeling and identifying priority areas for intervention, which should include strategies that specifically target socioeconomically vulnerable groups as well as all the conditions which cause these disparities in testing and treatment behavior. Copyright © 2016 Elsevier B.V. All rights reserved.

Ecosystem services and emergent vulnerability in managed ecosystems: A geospatial decision-support tool

Treesearch

Colin M. Beier; Trista M. Patterson; F. Stuart Chapin III

2008-01-01

Managed ecosystems experience vulnerabilities when ecological resilience declines and key flows of ecosystem services become depleted or lost. Drivers of vulnerability often include local management actions in conjunction with other external, larger scale factors. To translate these concepts to management applications, we developed a conceptual model of feedbacks...

International Space Station: Meteoroid/Orbital Debris Survivability and Vulnerability

NASA Technical Reports Server (NTRS)

Graves, Russell

2000-01-01

This slide presentation reviews the surviability and vulnerability of the International Space Station (ISS) from the threat posed by meteoroid and orbital debris. The topics include: (1) Space station natural and induced environments (2) Meteoroid and orbital debris threat definition (3) Requirement definition (4) Assessment methods (5) Shield development and (6) Component vulnerability

Impact of hydrogeological factors on groundwater salinization due to ocean-surge inundation

NASA Astrophysics Data System (ADS)

Yang, Jie; Zhang, Huichen; Yu, Xuan; Graf, Thomas; Michael, Holly A.

2018-01-01

Ocean surges cause seawater inundation of coastal inland areas. Subsequently, seawater infiltrates into coastal aquifers and threatens the fresh groundwater resource. The severity of resulting salinization can be affected by hydrogeological factors including aquifer properties and hydrologic conditions, however, little research has been done to assess these effects. To understand the impacts of hydrogeological factors on groundwater salinization, we numerically simulated an ocean-surge inundation event on a two-dimensional conceptual coastal aquifer using a coupled surface-subsurface approach. We varied model permeability (including anisotropy), inland hydraulic gradient, and recharge rate. Three salinization-assessment indicators were developed, based on flushing time, depth of salt penetration, and a combination of the two, weighted flushing time, with which the impact of hydrogeological factors on groundwater vulnerability to salinization were quantitatively assessed. The vulnerability of coastal aquifers increases with increasing isotropic permeability. Low horizontal permeability (kx) and high vertical permeability (kz) lead to high aquifer vulnerability, and high kx and low kz lead to low aquifer vulnerability. Vulnerability decreases with increasing groundwater hydraulic gradient and increasing recharge rate. Additionally, coastal aquifers with a low recharge rate (R ≤ 300 mm yr-1) may be highly vulnerable to ocean-surge inundation. This study shows how the newly introduced indicators can be used to quantitatively assess coastal aquifer vulnerability. The results are important for global vulnerability assessment of coastal aquifers to ocean-surge inundation.

Vulnerability related to oral health in early childhood: a concept analysis.

PubMed

Mattheus, Deborah J

2010-09-01

This article is a report of the analysis of the concept of vulnerability and its relationship to oral health in early childhood. Poor oral health is a continued problem for children worldwide. Vulnerability increases the probability of poor oral health outcomes. The lack of clarity of the concept of vulnerability creates difficulty in understanding this multi-factoral condition. Data source included 34 articles covering the period 2000-2009 from a variety of disciplines, including nursing, dentistry, medicine and public health. The concept analysis was conducted using Rodgers' evolutionary method. The literature was analysed and a social ecology model was used to frame the discussion, recognizing family and community influences on children's oral health. The context of oral health in early childhood contributes to the changes in the concept vulnerability. The attributes are closely related to family and community factors and identified as limited parental income, parental education, community-based services and fluoride; and exposure to poor parental habits, parental neglect and harmful toxins. The primary antecedent is identified as a form of limited protection from exposure to various circumstances. Children with limited protection have increased vulnerability and greater probability of poor health outcomes. Nurses who understand the concept of vulnerability related to oral health and can identify factors that create protection and are capable of decreasing vulnerability through parent education, community awareness and policy changes that support children and families.

Gaps, conflicts, and consensus in the ethics statements of professional associations, medical groups, and health plans.

PubMed

Berkman, N D; Wynia, M K; Churchill, L R

2004-08-01

Patients today interact with physicians, physician groups, and health plans, each of which may follow distinct ethical guidelines. We systematically compared physician codes of ethics with ethics policies at physician group practices and health plans, using the 1998-99 policies of 38 organisations-18 medical associations (associations), nine physician group practices (groups), and 12 health plans (plans)-selected using random and stratified purposive sampling. A clinician and a social scientist independently abstracted each document, using a 397-item health care ethics taxonomy; a reconciled abstraction form was used for analysis. This study focuses on ethics policies regarding professional obligation towards patients, resource allocation, and care for the vulnerable in society. A majority in all three groups mention "fiduciary obligations" of one sort or another, but associations generally address physician/patient relations but not health plan obligations, while plans rarely endorse physicians' obligations of advocacy, beneficence, and non-maleficence. Except for occasional mentions of cost effectiveness or efficiency, ethical considerations in resource allocation rarely arise in the ethics policies of all three organisational types. Very few associations, groups, or plans specifically endorse obligations to vulnerable populations. With some important exceptions, we found that the ethics policies of associations, groups, and plans are narrowly focused and often ignore important ethical concerns for society, such as resource allocation and care for vulnerable populations. More collaborative work is needed to build integrated sets of ethical standards that address the aims and responsibilities of the major stakeholders in health care delivery.

Coastal vulnerability assessment with the use of environmental and socio-economic indicators

NASA Astrophysics Data System (ADS)

Alexandrakis, George; Petrakis, Stelios; Vousdoukas, Mixalis; Ghionis, George; Hatziyanni, Eleni; Kampanis, Nikolaos

2014-05-01

Climate change has significant repercussions on the natural environment, triggering obvious changes in the natural processes that have a severe socio-economic impact on the coastal zone; where a great number of human activities are concentrated. So far, the estimation of coastal vulnerability was based primarily on the natural processes and less on socio-economic variables, which would assist in the identification of vulnerable areas. The present investigation proposes a methodology to examine the vulnerability of a highly touristic area in the Island of Crete to an expected sea level rise of up to ~40 cm by the year 2100, according to the A1B scenario of IPCC 2007. The methodology includes the combination of socio-economic indicators into a GIS-based coastal vulnerability index for wave-induced erosion. This approach includes three sub-indices that contribute equally to the overall index. The sub-indices refer to coastal forcing, socio-economic and coastal characteristics. All variables are ranked on a 1-5 scale with 5 indicating higher vulnerability. The socio-economic sub-index includes, as indicators, the population of the study area, cultural heritage sites, transport networks, land use and protection measures. The coastal forcing sub-index includes the frequency of extreme events, while the Coastal Vulnerability Index includes the geological variables (coastal geomorphology, historical coastline changes, and regional coastal slope) and the variables representing the marine processes (relative sea level rise, mean significant wave height, and tidal range). The main difficulty for the estimation of the index lies in assessing and ranking the socio-economic indicators. The whole approach was tested and validated through field and desktop studies, using as a case study the Elouda bay, Crete Isl., an area of high cultural and economic value, which combines monuments from ancient and medieval times, with a very high touristic development since the 1970s.

Adaptation strategies to climate change in the Arctic: a global patchwork of reactive community-scale initiatives

NASA Astrophysics Data System (ADS)

Loboda, Tatiana V.

2014-11-01

Arctic regions have experienced and will continue to experience the greatest rates of warming compared to any other region of the world. The people living in the Arctic are considered among most vulnerable to the impacts of environmental change ranging from decline in natural resources to increasing mental health concerns (IPCC 2014 Climate Change 2014: Impacts, Adaptation and Vulnerability. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change (Cambridge: Cambridge University Press)). A meta-analysis study by Ford et al (2014 Environ. Res. Lett. 9 104005) has assessed the volume, scope and geographic distribution of reported in the English language peer-reviewed literature initiatives for adaptation to climate change in the Arctic. Their analysis highlights the reactive nature of the adopted policies with a strong emphasis on local and community-level policies mostly targeting indigenous population in Canada and Alaska. The study raises concerns about the lack of monitoring and evaluation mechanism to track the success rate of the existing policies and the need for long-term strategic planning in adaption policies spanning international boundaries and including all groups of population.

Iodine insufficiency: a global health problem?

PubMed

Swanson, Christine A; Pearce, Elizabeth N

2013-09-01

As a result of collaborative efforts with international organizations and the salt industry, many developing and developed countries practice universal salt iodization (USI) or have mandatory salt fortification programs. As a consequence, the prevalence of iodine deficiency decreased dramatically. The United States and Canada are among the few developed countries that do not practice USI. Such an undertaking would require evidence of deficiency among vulnerable population groups, including pregnant women, newborns, and developing infants. Government agencies in the United States rely heavily on data from NHANES to assess the iodine status of the general population and pregnant women in particular. NHANES data suggest that pregnant women in the United States remain mildly deficient. This is important, because the developing fetus is dependent on maternal iodine intake for normal brain development throughout pregnancy. Professional societies have recommended that pregnant and lactating women, or those considering pregnancy, consume a supplement providing 150 μg iodine daily. The United States and Canada collaborate on the daily recommended intake and are also confronted with the challenge of identifying the studies needed to determine if USI is likely to be beneficial to vulnerable population groups without exposing them to harm.

Defining HIV Risk and Determining Responsibility in Postsocialist Poland

PubMed Central

Owczarzak, Jill

2014-01-01

Drawing on 15 months of ethnographic research on HIV prevention programs in Poland, I explore the consequences of the shift from models of HIV prevention that emphasize “risk groups” and AIDS blame, to models that focus on “risky behaviors” and universal risk. The centrality of choice making and individual risk management in these models suggests objective risk assessment free from moralizing arguments. The Polish national prevention strategy shifted to focus on choice making, address all risk groups, and include concrete prevention strategies. This shift created a backlash that resulted in the reassertion of moral arguments about risk and risk groups that positioned those most vulnerable to HIV outside the purview of prevention efforts. AIDS organizations working with marginalized, “morally problematic” populations used the label “at risk” to legitimize claims to resources. They enacted a model of risk reduction in which the relevant actor is the individual buffeted by social forces, and behavior change, and therefore HIV risk reduction, is a long process because of myriad forms of vulnerability clients face. Despite efforts to reconceptualize risk, organizations positioned the individual as the locus of HIV prevention interventions, rather than attempting to address the social context that shapes risk. PMID:20092052

Vulnerability to alcohol consumption, spiritual transcendence and psychosocial well-being: test of a theory 1

PubMed Central

Heredia, Luz Patricia Díaz; Sanchez, Alba Idaly Muñoz

2016-01-01

Abstract Objective: to demonstrate the relations among vulnerability, self-transcendence and well-being in the young adult population and the effect of each of these variables on the adoption of low-risk consumption conducts. Method: quantitative and cross-sectional correlation study using structural equations analysis to test the relation among the variables. Results: an inverse relation was evidenced between vulnerability to alcohol consumption and spiritual transcendence (β-0.123, p 0.025) and a direct positive relation between spiritual transcendence and psychosocial well-being (β 0.482, p 0.000). Conclusions: the relations among the variables spiritual transcendence, vulnerability to alcohol consumption and psychosocial well-being, based on Reed's Theory, are confirmed in the population group of young college students, concluding that psychosocial well-being can be achieved when spiritual transcendence is enhanced, as the vulnerability to alcohol consumption drops. PMID:27276017

Extinction vulnerability of coral reef fishes.

PubMed

Graham, Nicholas A J; Chabanet, Pascale; Evans, Richard D; Jennings, Simon; Letourneur, Yves; Aaron Macneil, M; McClanahan, Tim R; Ohman, Marcus C; Polunin, Nicholas V C; Wilson, Shaun K

2011-04-01

With rapidly increasing rates of contemporary extinction, predicting extinction vulnerability and identifying how multiple stressors drive non-random species loss have become key challenges in ecology. These assessments are crucial for avoiding the loss of key functional groups that sustain ecosystem processes and services. We developed a novel predictive framework of species extinction vulnerability and applied it to coral reef fishes. Although relatively few coral reef fishes are at risk of global extinction from climate disturbances, a negative convex relationship between fish species locally vulnerable to climate change vs. fisheries exploitation indicates that the entire community is vulnerable on the many reefs where both stressors co-occur. Fishes involved in maintaining key ecosystem functions are more at risk from fishing than climate disturbances. This finding is encouraging as local and regional commitment to fisheries management action can maintain reef ecosystem functions pending progress towards the more complex global problem of stabilizing the climate. © 2011 Blackwell Publishing Ltd/CNRS.

Extinction vulnerability of coral reef fishes

PubMed Central

Graham, Nicholas A J; Chabanet, Pascale; Evans, Richard D; Jennings, Simon; Letourneur, Yves; Aaron MacNeil, M; McClanahan, Tim R; Öhman, Marcus C; Polunin, Nicholas V C; Wilson, Shaun K

2011-01-01

With rapidly increasing rates of contemporary extinction, predicting extinction vulnerability and identifying how multiple stressors drive non-random species loss have become key challenges in ecology. These assessments are crucial for avoiding the loss of key functional groups that sustain ecosystem processes and services. We developed a novel predictive framework of species extinction vulnerability and applied it to coral reef fishes. Although relatively few coral reef fishes are at risk of global extinction from climate disturbances, a negative convex relationship between fish species locally vulnerable to climate change vs. fisheries exploitation indicates that the entire community is vulnerable on the many reefs where both stressors co-occur. Fishes involved in maintaining key ecosystem functions are more at risk from fishing than climate disturbances. This finding is encouraging as local and regional commitment to fisheries management action can maintain reef ecosystem functions pending progress towards the more complex global problem of stabilizing the climate. PMID:21320260

Cult membership: What factors contribute to joining or leaving?

PubMed

Rousselet, M; Duretete, O; Hardouin, J B; Grall-Bronnec, M

2017-11-01

We assumed that, as in the case of addiction disorders, former cult members exhibit vulnerability and protective factors for cult commitment and membership. Thus, the aim of our study was to identify vulnerability factors that are involved in the commitment and in the retention in the group, as well as protective factors that are involved in the departure. We interviewed 31 former cult members, using semi-structured interviews to evaluate their clinical profile, characteristics of the cultic group and their experience in the group. Cult membership and addictive disorders share some characteristics: persistence despite damage, initial psychological relief, occupation of an exclusive place in the thoughts of members, high psychiatric comorbidity prevalence, high accessibility, leading to social precariousness and the importance of familial support when leaving. Three main axes of improvement were highlighted: regulations concerning cults in order to limit their social presence, which appears to be a vulnerability factor for commitment; social and therapeutic follow-up when a member leaves a group so that social precariousness does not become an obstacle to departure; and familial support to maintain a link with the member, as the intervention of a person from outside of the group is an important protective factor for leaving. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Latent vulnerability in cognitive performance following chronic cocaine self-administration in rhesus monkeys.

PubMed

Porter, Jessica N; Gurnsey, Kate; Jedema, Hank P; Bradberry, Charles W

2013-03-01

Cocaine use is associated with cognitive impairment which impacts treatment outcome. A clearer understanding of those deficits, and whether particular environments exacerbate them, is needed. This study evaluated whether previously observed domain-specific cognitive deficits persisted following a 3-month cessation from chronic cocaine self-administration, as well as the impact of novel and cocaine-associated attentional distractors. Control and experimental groups of monkeys performed stimulus discrimination, stimulus reversal, and delayed match-to-sample (DMS) tasks. After establishing post-cocaine baseline performance, we examined general distractibility in both groups, using brief novel distractors counterbalanced across each task. After testing the novel distractor, an identical approach was used for exposure to an appetitive distractor previously associated with cocaine in the experimental group or water in the control group. Post-administration baseline performance was equivalent between groups on all tasks. In the cocaine group, stimulus discrimination was unaffected by either distractor, whereas reversal performance was disrupted by both the novel and appetitive distractors. DMS performance was impaired in the cocaine group in the presence of the novel distractor. The control group's performance was not affected by the presentation of either distractor on any task. Our results reveal that despite normalized performance between groups, there exists in the cocaine group a domain-specific latent vulnerability of cognitive performance to impairment by environmental distractors. The pattern of vulnerability recapitulates the frank impairments seen in drug-free animals during an active self-administration phase. A greater impact of the cocaine-associated distractor over the novel one was not observed.

AVQS: Attack Route-Based Vulnerability Quantification Scheme for Smart Grid

PubMed Central

Lim, Hyunwoo; Lee, Seokjun; Shon, Taeshik

2014-01-01

A smart grid is a large, consolidated electrical grid system that includes heterogeneous networks and systems. Based on the data, a smart grid system has a potential security threat in its network connectivity. To solve this problem, we develop and apply a novel scheme to measure the vulnerability in a smart grid domain. Vulnerability quantification can be the first step in security analysis because it can help prioritize the security problems. However, existing vulnerability quantification schemes are not suitable for smart grid because they do not consider network vulnerabilities. We propose a novel attack route-based vulnerability quantification scheme using a network vulnerability score and an end-to-end security score, depending on the specific smart grid network environment to calculate the vulnerability score for a particular attack route. To evaluate the proposed approach, we derive several attack scenarios from the advanced metering infrastructure domain. The experimental results of the proposed approach and the existing common vulnerability scoring system clearly show that we need to consider network connectivity for more optimized vulnerability quantification. PMID:25152923

Frailty and Organization of Health and Social Care.

PubMed

Clegg, Andrew; Young, John

2015-01-01

In this chapter, we consider how health and social care can best be organized for older people with frailty. We will consider the merits of routine frailty identification, including risk stratification methods, to inform the provision of evidence-based treatment and holistic, goal-oriented care. We will also consider how best to place older people with frailty at the heart of health and social care systems so that the complex challenges associated with this vulnerable group are addressed. 2015 S. Karger AG, Basel.

Perceptions of vulnerability to a future outbreak: a study of horse managers affected by the first Australian equine influenza outbreak

PubMed Central

2013-01-01

Background A growing body of work shows the benefits of applying social cognitive behavioural theory to investigate infection control and biosecurity practices. Protection motivation theory has been used to predict protective health behaviours. The theory outlines that a perception of a lack of vulnerability to a disease contributes to a reduced threat appraisal, which results in poorer motivation, and is linked to poorer compliance with advised health protective behaviours. This study, conducted following the first-ever outbreak of equine influenza in Australia in 2007, identified factors associated with horse managers’ perceived vulnerability to a future equine influenza outbreak. Results Of the 200 respondents, 31.9% perceived themselves to be very vulnerable, 36.6% vulnerable and 31.4% not vulnerable to a future outbreak of equine influenza. Multivariable logistic regression modelling revealed that managers involved in horse racing and those on rural horse premises perceived themselves to have low levels of vulnerability. Managers of horse premises that experienced infection in their horses in 2007 and those seeking infection control information from specific sources reported increased levels of perceived vulnerability to a future outbreak. Conclusion Different groups across the horse industry perceived differing levels of vulnerability to a future outbreak. Increased vulnerability contributes to favourable infection control behaviour and hence these findings are important for understanding uptake of recommended infection control measures. Future biosecurity communication strategies should be delivered through information sources suitable for the horse racing and rural sectors. PMID:23902718

Perceptions of vulnerability to a future outbreak: a study of horse managers affected by the first Australian equine influenza outbreak.

PubMed

Schemann, Kathrin; Firestone, Simon M; Taylor, Melanie R; Toribio, Jenny-Ann L M L; Ward, Michael P; Dhand, Navneet K

2013-07-31

A growing body of work shows the benefits of applying social cognitive behavioural theory to investigate infection control and biosecurity practices. Protection motivation theory has been used to predict protective health behaviours. The theory outlines that a perception of a lack of vulnerability to a disease contributes to a reduced threat appraisal, which results in poorer motivation, and is linked to poorer compliance with advised health protective behaviours. This study, conducted following the first-ever outbreak of equine influenza in Australia in 2007, identified factors associated with horse managers' perceived vulnerability to a future equine influenza outbreak. Of the 200 respondents, 31.9% perceived themselves to be very vulnerable, 36.6% vulnerable and 31.4% not vulnerable to a future outbreak of equine influenza. Multivariable logistic regression modelling revealed that managers involved in horse racing and those on rural horse premises perceived themselves to have low levels of vulnerability. Managers of horse premises that experienced infection in their horses in 2007 and those seeking infection control information from specific sources reported increased levels of perceived vulnerability to a future outbreak. Different groups across the horse industry perceived differing levels of vulnerability to a future outbreak. Increased vulnerability contributes to favourable infection control behaviour and hence these findings are important for understanding uptake of recommended infection control measures. Future biosecurity communication strategies should be delivered through information sources suitable for the horse racing and rural sectors.

Capturing subregional variability in regional-scale climate change vulnerability assessments of natural resources.

PubMed

Buotte, Polly C; Peterson, David L; McKelvey, Kevin S; Hicke, Jeffrey A

2016-03-15

Natural resource vulnerability to climate change can depend on the climatology and ecological conditions at a particular site. Here we present a conceptual framework for incorporating spatial variability in natural resource vulnerability to climate change in a regional-scale assessment. The framework was implemented in the first regional-scale vulnerability assessment conducted by the US Forest Service. During this assessment, five subregional workshops were held to capture variability in vulnerability and to develop adaptation tactics. At each workshop, participants answered a questionnaire to: 1) identify species, resources, or other information missing from the regional assessment, and 2) describe subregional vulnerability to climate change. Workshop participants divided into six resource groups; here we focus on wildlife resources. Participants identified information missing from the regional assessment and multiple instances of subregional variability in climate change vulnerability. We provide recommendations for improving the process of capturing subregional variability in a regional vulnerability assessment. We propose a revised conceptual framework structured around pathways of climate influence, each with separate rankings for exposure, sensitivity, and adaptive capacity. These revisions allow for a quantitative ranking of species, pathways, exposure, sensitivity, and adaptive capacity across subregions. Rankings can be used to direct the development and implementation of future regional research and monitoring programs. The revised conceptual framework is equally applicable as a stand-alone model for assessing climate change vulnerability and as a nested model within a regional assessment for capturing subregional variability in vulnerability. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effect of adjusting model inputs to achieve mass balance on time-dynamic simulations in a food-web model of Lake Huron

USGS Publications Warehouse

Langseth, Brian J.; Jones, Michael L.; Riley, Stephen C.

2014-01-01

Ecopath with Ecosim (EwE) is a widely used modeling tool in fishery research and management. Ecopath requires a mass-balanced snapshot of a food web at a particular point in time, which Ecosim then uses to simulate changes in biomass over time. Initial inputs to Ecopath, including estimates for biomasses, production to biomass ratios, consumption to biomass ratios, and diets, rarely produce mass balance, and thus ad hoc changes to inputs are required to balance the model. There has been little previous research of whether ad hoc changes to achieve mass balance affect Ecosim simulations. We constructed an EwE model for the offshore community of Lake Huron, and balanced the model using four contrasting but realistic methods. The four balancing methods were based on two contrasting approaches; in the first approach, production of unbalanced groups was increased by increasing either biomass or the production to biomass ratio, while in the second approach, consumption of predators on unbalanced groups was decreased by decreasing either biomass or the consumption to biomass ratio. We compared six simulation scenarios based on three alternative assumptions about the extent to which mortality rates of prey can change in response to changes in predator biomass (i.e., vulnerabilities) under perturbations to either fishing mortality or environmental production. Changes in simulated biomass values over time were used in a principal components analysis to assess the comparative effect of balancing method, vulnerabilities, and perturbation types. Vulnerabilities explained the most variation in biomass, followed by the type of perturbation. Choice of balancing method explained little of the overall variation in biomass. Under scenarios where changes in predator biomass caused large changes in mortality rates of prey (i.e., high vulnerabilities), variation in biomass was greater than when changes in predator biomass caused only small changes in mortality rates of prey (i.e., low vulnerabilities), and was amplified when environmental production was increased. When standardized to mean changes in biomass within each scenario, scenarios when vulnerabilities were low and when fishing mortality was increased explained the most variation in biomass. Our findings suggested that approaches to balancing Ecopath models have relatively little effect on changes in biomass over time, especially when compared to assumptions about how mortality rates of prey change in response to changes in predator biomass. We concluded that when constructing food-web models using EwE, determining the effect of changes in predator biomass on mortality rates of prey should be prioritized over determining the best way to balance the model.

Role of Livelihood Capital in Reducing Climatic Vulnerability: Insights of Australian Wheat from 1990-2010.

PubMed

Huai, Jianjun

2016-01-01

In many agricultural countries, development of rural livelihood through increasing capital is a major regional policy to adapt to climate change. However, the role of livelihood capital in reducing climatic vulnerability is uncertain. This study assesses vulnerability and identifies the effects of common capital indicators on it, using Australian wheat as an example. We calculate exposure (a climate index) and sensitivity (a wheat failure index) to measure vulnerability and classify the resilient and sensitive cases, and express adaptive capacity through financial, human, natural, physical, and social capital indicators for 12 regions in the Australian wheat-sheep production zone from 1991-2010. We identify relationships between 12 indicators of five types of capital and vulnerability with t-tests and six logistic models considering the capital indicator itself, its first-order lag and its square as dependent variables to test the hypothesis that a high level of each capital metric results in low vulnerability. Through differing adaptive capacities between resilient and sensitive groups, we found that only four of the 12 (e.g., the access to finance, cash income level, total crop gross revenues, and family share of farm income) relate to vulnerability, which challenges the hypothesis that increasing capital reduces vulnerability. We conclude that further empirical reexaminations are required to test the relationships between capital measures and vulnerability under the sustainable livelihood framework (SLF).

Role of Livelihood Capital in Reducing Climatic Vulnerability: Insights of Australian Wheat from 1990–2010

PubMed Central

Huai, Jianjun

2016-01-01

In many agricultural countries, development of rural livelihood through increasing capital is a major regional policy to adapt to climate change. However, the role of livelihood capital in reducing climatic vulnerability is uncertain. This study assesses vulnerability and identifies the effects of common capital indicators on it, using Australian wheat as an example. We calculate exposure (a climate index) and sensitivity (a wheat failure index) to measure vulnerability and classify the resilient and sensitive cases, and express adaptive capacity through financial, human, natural, physical, and social capital indicators for 12 regions in the Australian wheat–sheep production zone from 1991–2010. We identify relationships between 12 indicators of five types of capital and vulnerability with t-tests and six logistic models considering the capital indicator itself, its first-order lag and its square as dependent variables to test the hypothesis that a high level of each capital metric results in low vulnerability. Through differing adaptive capacities between resilient and sensitive groups, we found that only four of the 12 (e.g., the access to finance, cash income level, total crop gross revenues, and family share of farm income) relate to vulnerability, which challenges the hypothesis that increasing capital reduces vulnerability. We conclude that further empirical reexaminations are required to test the relationships between capital measures and vulnerability under the sustainable livelihood framework (SLF). PMID:27022910

Mapping the Drivers of Climate Change Vulnerability for Australia’s Threatened Species

PubMed Central

Lee, Jasmine R.; Maggini, Ramona; Taylor, Martin F. J.; Fuller, Richard A.

2015-01-01

Effective conservation management for climate adaptation rests on understanding the factors driving species’ vulnerability in a spatially explicit manner so as to direct on-ground action. However, there have been only few attempts to map the spatial distribution of the factors driving vulnerability to climate change. Here we conduct a species-level assessment of climate change vulnerability for a sample of Australia’s threatened species and map the distribution of species affected by each factor driving climate change vulnerability across the continent. Almost half of the threatened species assessed were considered vulnerable to the impacts of climate change: amphibians being the most vulnerable group, followed by plants, reptiles, mammals and birds. Species with more restricted distributions were more likely to show high climate change vulnerability than widespread species. The main factors driving climate change vulnerability were low genetic variation, dependence on a particular disturbance regime and reliance on a particular moisture regime or habitat. The geographic distribution of the species impacted by each driver varies markedly across the continent, for example species impacted by low genetic variation are prevalent across the human-dominated south-east of the country, while reliance on particular moisture regimes is prevalent across northern Australia. Our results show that actions to address climate adaptation will need to be spatially appropriate, and that in some regions a complex suite of factors driving climate change vulnerability will need to be addressed. Taxonomic and geographic variation in the factors driving climate change vulnerability highlights an urgent need for a spatial prioritisation of climate adaptation actions for threatened species. PMID:26017785

Speed of perceptual grouping in acquired brain injury.

PubMed

Kurylo, Daniel D; Larkin, Gabriella Brick; Waxman, Richard; Bukhari, Farhan

2014-09-01

Evidence exists that damage to white matter connections may contribute to reduced speed of information processing in traumatic brain injury and stroke. Damage to such axonal projections suggests a particular vulnerability to functions requiring integration across cortical sites. To test this prediction, measurements were made of perceptual grouping, which requires integration of stimulus components. A group of traumatic brain injury and cerebral vascular accident patients and a group of age-matched healthy control subjects viewed arrays of dots and indicated the pattern into which stimuli were perceptually grouped. Psychophysical measurements were made of perceptual grouping as well as processing speed. The patient group showed elevated grouping thresholds as well as extended processing time. In addition, most patients showed progressive slowing of processing speed across levels of difficulty, suggesting reduced resources to accommodate increased demands on grouping. These results support the prediction that brain injury results in a particular vulnerability to functions requiring integration of information across the cortex, which may result from dysfunction of long-range axonal connection.

"All is well": professionals' documentation of social determinants of health in Swedish Child Health Services health records concerning maltreated children - a mixed method approach.

PubMed

Köhler, Marie; Rosvall, Maria; Emmelin, Maria

2016-08-15

Knowledge about social determinants of health has influenced global health strategies, including early childhood interventions. Some psychosocial circumstances - such as poverty, parental mental health problems, abuse and partner violence - increase the risk of child maltreatment and neglect. Healthcare professionals' awareness of psychosocial issues is of special interest, since they both have the possibility and the obligation to identify vulnerable children. Child Health Services health records of 100 children in Malmö, Sweden, who had been placed in, or were to be placed in family foster care, were compared with health records of a matched comparison group of 100 children who were not placed in care. A mixed-method approach integrating quantitative and qualitative analysis was applied. The documentation about the foster care group was more voluminous than for the comparison group. The content was problem-oriented and dominated by severe parental health and social problems, while the child's own experiences were neglected. The professionals documented interaction with healthcare and social functions, but very few reports to the Social Services were noted. For both groups, notes about social structures were almost absent. Child Health Service professionals facing vulnerable children document parental health issues and interaction with healthcare, but they fail to document living conditions thereby making social structures invisible in the health records. The child perspective is insufficiently integrated in the documentation and serious child protection needs remain unmet, if professionals avoid reporting to Social Services.

Neuropsychological characteristics of child and adolescent offspring of patients with bipolar disorder.

PubMed

de la Serna, Elena; Vila, Monserrat; Sanchez-Gistau, Vanessa; Moreno, Dolores; Romero, Soledad; Sugranyes, Gisela; Baeza, Immaculada; Llorente, Cloe; Rodriguez-Toscano, Elisa; Sánchez-Gutierrez, Teresa; Castro-Fornieles, Josefina

2016-02-04

Bipolar disorder (BD) is a severe mental disorder with a strong genetic component. The assessment of child and adolescent offspring of patients diagnosed with BD (BDoff) provides an opportunity to investigate vulnerability factors and the first abnormalities associated with the disorder. Previous literature in child and adolescent BDoff is scarce and controversial. However, some studies concur in identifying significant impairment in executive functions, memory and attention. The present study aims to compare global neuropsychological characteristics of child and adolescent offspring of patients with bipolar disorder with a group of offspring of parentswith no history of psychotic disorder, and to assess the influence of psychopathology on neuropsychological performance. This research was part of The Bipolar and Schizophrenia Young Offspring Study (BASYS). A group of BDoff (N= 90) and a group of offspring of parents with no history of psychotic disorder (CC) (N = 107) were assessed with a complete neuropsychological battery. Intellectual quotient, working memory, processing speed, verbal memory and learning, visual memory, attention and executive functions were included in the cognitive assessment. BDoff showed significantly worse performance in processing speed and immediate recall of visual memory relative to CC. When the presence of any lifetime psychopathology was analysed, the results showed that belonging to the BDoff group was the main explicative factor for the scores obtained in both processing speed and visual memory immediate recall, regardless of the presence of psychopathology. These findings suggest that processing speed and visualmemory should be taken into consideration in future research on vulnerability markers of BD.

Mental Health Research in Correctional Settings: Perceptions of Risk and Vulnerabilities

PubMed Central

Johnson, Mark E.; Kondo, Karli K.; Brems, Christiane; Ironside, Erica F.; Eldridge, Gloria D.

2015-01-01

With over half of individuals incarcerated having serious mental health concerns, correctional settings offer excellent opportunities for epidemiological, prevention, and intervention research. However, due to unique ethical and structural challenges, these settings create risks and vulnerabilities for participants not typically encountered in research populations. We surveyed 1,224 researchers, IRB members, and IRB prisoner representatives to assess their perceptions of risks associated with mental health research conducted in correctional settings. Highest-ranked risks were related to privacy, stigma, and confidentiality; lowest-ranked risks were related to prisoners’ loss of privileges or becoming targets of violence due to having participated in research. Cognitive impairment, mental illness, lack of autonomy, and limited access to services emerged as the greatest sources of vulnerability; being male, being female, being over age of 60, being a minority, and being pregnant were the lowest-ranked sources of vulnerability. Researchers with corrections experience perceived lower risks and vulnerabilities than all other groups, raising the question whether these researchers accurately appraise risk and vulnerability based on experience, or if their lower risk and vulnerability perceptions reflect potential bias due to their vested interests. By identifying areas of particular risk and vulnerability, this study provides important information for researchers and research reviewers alike. PMID:27092025

Old age and vulnerability between first, second and third person perspectives. Ethnographic explorations of aging in contemporary Denmark.

PubMed

Grøn, Lone

2016-12-01

This paper is based on an ethnographic fieldwork aimed at exploring ethnographically how vulnerability in old age is perceived and experienced in contemporary Denmark. The fieldwork showed remarkable differences between two phases of the fieldwork: the first addressing vulnerability from the "outside" through group interviews with professionals, leaders and older people who were not (yet) vulnerable; and the second from the "inside" through more in depth fieldwork with older people who in diverse ways could be seen as vulnerable. After a short introduction to anthropological and social gerontological literature on characteristics of "Western" aging: medicalization, successful, healthy and active aging, I present findings from both phases of this ethnographic fieldwork arguing that the ethnographic approach reveals the composite and complex nature of vulnerability in old age and the constant interactions between first, second and third person perspectives. Through these methodological and analytical moves a complex and empirically tenable understanding of vulnerability in old age has emerged which 1. moves beyond rigid dichotomies that have characterized the study of old age, 2. integrates individual experience, social interaction and the structural and discursive context into the analysis, and 3. reveals the complex interplay between vulnerability and agency in diverse situations and settings of old age. Copyright © 2016 Elsevier Inc. All rights reserved.

Early intervention and recovery among children with failure to thrive: follow-up at age 8.

PubMed

Black, Maureen M; Dubowitz, Howard; Krishnakumar, Ambika; Starr, Raymond H

2007-07-01

We sought to examine the impact of a randomized, controlled trial of home visiting among infants with failure to thrive on growth, academic/cognitive performance, and home/classroom behavior at age 8. Infants with failure to thrive (N = 130) or adequate growth (N = 119) were recruited from pediatric primary care clinics serving low-income, urban communities. Eligibility criteria included age <25 months, gestational age >36 weeks, birth weight >2500 g, and no significant medical conditions. Evaluation included anthropometries, Bayley scales, maternal anthropometries, demographics, negative affect, IQ, and the Home Observation for Measurement of the Environment scale. Infants with failure to thrive were treated in an interdisciplinary growth and nutrition clinic and randomized into clinical-intervention-plus-home-intervention or clinical-care-only groups. The home-visiting curriculum promoted maternal sensitivity, parent-infant relationships, and child development. Follow-up visits were conducted by evaluators who were unaware of the children's growth or intervention history. At age 8, the evaluation included anthropometries, the Wechsler Intelligence Scale for Children III, and the Wide Range Achievement Test, Revised. Mothers completed the Child Behavior Checklist and teachers completed the Teacher Report Form. Multivariate analyses of variance were used to examine differences in growth, cognitive/academic performance, and home/school behavior, adjusted by maternal education, public assistance, and, when appropriate, infant Bayley score, maternal BMI, height, negative affect, IQ, and Home Observation for Measurement of the Environment scores. Retention was 74% to 78%. Children in the adequate-growth group were significantly taller, heavier, and had better arithmetic scores than the clinical-intervention-only group, with the clinical-intervention-plus-home-intervention group intermediate. There were no group differences in IQ, reading, or mother-reported behavior problems. Children in the clinical-intervention-plus-home-intervention group had fewer teacher-reported internalizing problems and better work habits than the clinical-intervention-only group. Early failure to thrive increased children's vulnerability to short stature, poor arithmetic performance, and poor work habits. Home visiting attenuated some of the negative effects of early failure to thrive, possibly by promoting maternal sensitivity and helping children build strong work habits that enabled them to benefit from school. Findings provide evidence for early intervention programs for vulnerable infants.

Vulnerability curves vs. vulnerability indicators: application of an indicator-based methodology for debris-flow hazards

NASA Astrophysics Data System (ADS)

Papathoma-Köhle, Maria

2016-08-01

The assessment of the physical vulnerability of elements at risk as part of the risk analysis is an essential aspect for the development of strategies and structural measures for risk reduction. Understanding, analysing and, if possible, quantifying physical vulnerability is a prerequisite for designing strategies and adopting tools for its reduction. The most common methods for assessing physical vulnerability are vulnerability matrices, vulnerability curves and vulnerability indicators; however, in most of the cases, these methods are used in a conflicting way rather than in combination. The article focuses on two of these methods: vulnerability curves and vulnerability indicators. Vulnerability curves express physical vulnerability as a function of the intensity of the process and the degree of loss, considering, in individual cases only, some structural characteristics of the affected buildings. However, a considerable amount of studies argue that vulnerability assessment should focus on the identification of these variables that influence the vulnerability of an element at risk (vulnerability indicators). In this study, an indicator-based methodology (IBM) for mountain hazards including debris flow (Kappes et al., 2012) is applied to a case study for debris flows in South Tyrol, where in the past a vulnerability curve has been developed. The relatively "new" indicator-based method is being scrutinised and recommendations for its improvement are outlined. The comparison of the two methodological approaches and their results is challenging since both methodological approaches deal with vulnerability in a different way. However, it is still possible to highlight their weaknesses and strengths, show clearly that both methodologies are necessary for the assessment of physical vulnerability and provide a preliminary "holistic methodological framework" for physical vulnerability assessment showing how the two approaches may be used in combination in the future.

Tennessee's In-state Vulnerability Assessment for a "Rapid Dissemination of Human Immunodeficiency Virus or Hepatitis C Virus Infection" Event Utilizing Data About the Opioid Epidemic.

PubMed

Rickles, Michael; Rebeiro, Peter F; Sizemore, Lindsey; Juarez, Paul; Mutter, Mitchell; Wester, Carolyn; McPheeters, Melissa

2018-05-17

Knowing which factors contribute to county-level vulnerability to a human immunodeficiency virus (HIV)/hepatitis C virus (HCV) outbreak, and which counties are most vulnerable, guides public health and clinical interventions. We therefore examined the impact of locally available indicators related to the opioid epidemic on prior national models of HIV/HCV outbreak vulnerability. Tennessee's 95 counties were the study sample. Predictors from 2012 and 2013 were used, mirroring prior methodology from the US Centers for Disease Control and Prevention (CDC). Acute HCV incidence was the proxy measure of county-level vulnerability. Seventy-eight predictors were identified as potentially predictive for HIV/HCV vulnerability. We used multiple dimension reduction techniques to determine predictors for inclusion and Poisson regression to generate a composite index score ranking county-level vulnerability for HIV/HCV. There was overlap of high-risk counties with the national analysis (25 of 41 counties). The distribution of vulnerability reinforces earlier research indicating that eastern Tennessee is at particularly high risk but also demonstrates that the entire state has high vulnerability. Prior research placed Tennessee among the top states for opioid prescribing, acute HCV infection, and greatest risk for an HIV/HCV outbreak. Given this confluence of risk, the Tennessee Department of Health expanded upon prior work to include more granular, local data, including on opioid prescribing. We also explored nonfatal and fatal overdoses. The more complete statewide view of risk generated, not only in eastern counties but also in the western corridor, will enable local officials to monitor vulnerability and better target resources.

The Vulnerabilities of Orphaned Children Participating in Research: A Critical Review and Factors for Consideration for Participation in Biomedical and Behavioral Research

PubMed Central

Thompson, Rachel T.; Meslin, Eric M.; Braitstein, Paula K. A.; Nyandiko, Winstone M.; Ayaya, Samuel O.; Vreeman, Rachel C.

2013-01-01

Orphans are a subpopulation with a unique set of additional vulnerabilities. Increasing focus on children’s rights, pediatric global health, and pediatric research makes it imperative to recognize and address unique vulnerabilities of orphaned children. This paper describes the unique vulnerabilities of the orphaned pediatric population and offers a structured set of factors that require consideration when including orphans in biomedical research. Pediatric orphans are particularly vulnerable due to decreased economic resources, psychosocial instability, increased risk of abuse, and delayed/decreased access to healthcare. These vulnerabilities are significant. By carefully considering each issue in a population in a culturally specific and study-specific manner, researchers can make valuable contributions to the overall health and well-being of this uniquely vulnerable population. PMID:23086048

NV: Nessus Vulnerability Visualization for the Web

DOE Office of Scientific and Technical Information (OSTI.GOV)

Harrison, Lane; Spahn, Riley B; Iannacone, Michael D

2012-01-01

Network vulnerability is a critical component of network se- curity. Yet vulnerability analysis has received relatively lit- tle attention from the security visualization community. In this paper we describe nv, a web-based Nessus vulnerability visualization. Nv utilizes treemaps and linked histograms to allow system administrators to discover, analyze, and man- age vulnerabilities on their networks. In addition to visual- izing single Nessus scans, nv supports the analysis of sequen- tial scans by showing which vulnerabilities have been fixed, remain open, or are newly discovered. Nv was also designed to operate completely in-browser, to avoid sending sensitive data to outside servers.more » We discuss the design of nv, as well as provide case studies demonstrating vulnerability analysis workflows which include a multiple-node testbed and data from the 2011 VAST Challenge.« less

Meaning-Making through Psychological Autopsy Interviews: The Value of Participating in Qualitative Research for Those Bereaved by Suicide

ERIC Educational Resources Information Center

Dyregrov, Kari Madeleine; Dieserud, Gudrun; Hjelmeland, Heidi Marie; Straiton, Melanie; Rasmussen, Mette Lyberg; Knizek, Birthe Loa; Leenaars, Antoon Adrian

2011-01-01

Too often ethical boards delay or stop research projects with vulnerable populations, influenced by presumed rather than empirically documented vulnerability. The article investigates how participation is experienced by those bereaved by suicide. Experiences are divided into 3 groups: (a) overall positive (62%), (b) unproblematic (10%), and (c)…

A Systematic Review of Life Skill Development through Sports Programs Serving Socially Vulnerable Youth

ERIC Educational Resources Information Center

Hermens, Niels; Super, Sabina; Verkooijen, Kirsten T.; Koelen, Maria A.

2017-01-01

Purpose: Despite the strong belief in sports programs as a setting in which socially vulnerable youth can develop life skills, no overview exists of life skill development in sports programs serving this youth group. Therefore, the present systematic review provides an overview of the evidence on life skill development in sports programs serving…

A Peer-to-Peer Health Education Program for Vulnerable Children in Uganda

ERIC Educational Resources Information Center

Falk, Diane S.; Pettet, Kristen; Mpagi, Charles

2016-01-01

In this paper, children attending a U.S.-sponsored private primary school serving orphaned and vulnerable children in Uganda were interviewed in focus groups about their participation in a peer-to-peer health education program in which they used music, dance, poetry, art, and drama to convey health information. The children reported enhanced…

Pathways Fostering Mobility to Higher Education for Vulnerable Immigrants in France, Switzerland and Canada

ERIC Educational Resources Information Center

Murdoch, Jake; Guégnard, Christine; Koomen, Maarten; Imdorf, Christian; Kamanzi, Canisius; Meyer, Thomas

2017-01-01

In this article we wish to clarify not only if, but also how--through which institutional settings--higher education (HE) is accessed by students from vulnerable immigrant groups in France, Switzerland and Canada. We are interested in the possible educational mobility that immigrant youths can experience arising from country-specific educational…

Using Geographical Information Systems (GIS) to Identify the Geographic Regions Where People That Use Ground Water are Most Vulnerable to Impacts from Underground Storage

EPA Science Inventory

Using Geographic Information Systems (GIS), the vulnerability of ground water supplies to contamination from underground storage tanks (USTs) was assessed. The analysis was conducted for the 48 contiguous states, and then again for groups of states corresponding to the EPA Regio...

Providing legal aid to members of vulnerable minorities in Ukraine.

PubMed

Topolilo, Andrei

2006-12-01

The rights of vulnerable groups--particularly injection drug users, people living with HIV/AIDS and sex workers--are routinely violated in Ukraine. In this article, which is based on a presentation from an abstract-driven session at the conference, Andrei Tolopilo describes a legal aid project undertaken to help people understand and defend their rights.

Clinical Models of Learning Disability in a Study of Intact Groups of Six-Year-Olds.

ERIC Educational Resources Information Center

Hagin, Rosa A.; And Others

This paper discusses the definition of learning disability through the concept of early identification of vulnerable children, based on a study of 650 inner-city preschool children. While the study's first step, scanning, identified the children who were vulnerable to learning disability, the second step, diagnosis, attempted to find the reasons…

Energy technology evaluation report: Energy security

NASA Astrophysics Data System (ADS)

Koopman, R.; Lamont, A.; Schock, R.

1992-09-01

Energy security was identified in the National Energy Strategy (NES) as a major issue for the Department of Energy (DOE). As part of a process designed by the DOE to identify technologies important to implementing the NES, an expert working group was convened to consider which technologies can best contribute to reducing the nation's economic vulnerability to future disruptions of world oil supplies, the working definition of energy security. Other working groups were established to deal with economic growth, environmental quality, and technical foundations. Energy Security working group members were chosen to represent as broad a spectrum of energy supply and end-use technologies as possible and were selected for their established reputations as experienced experts with an ability to be objective. The time available for this evaluation was very short. The group evaluated technologies using criteria taken from the NES which can be summarized for energy security as follows: diversifying sources of world oil supply so as to decrease the increasing monopoly status of the Persian Gulf region; reducing the importance of oil use in the US economy to diminish the impact of future disruptions in oil supply; and increasing the preparedness of the US to deal with oil supply disruptions by having alternatives available at a known price. The result of the first phase of the evaluation process was the identification of technology groups determined to be clearly important for reducing US vulnerability to oil supply disruptions. The important technologies were mostly within the high leverage areas of oil and gas supply and transportation demand but also included hydrogen utilization, biomass, diversion resistant nuclear power, and substitute industrial feedstocks.

Using educational games to promote the seeking of a pharmacist and to teach key medication use messages: results from an inner city health party.

PubMed

Burghardt, Kyle J; Bowman, Margo R; Hibino, Maho; Opong-Owusu, Barima K; Pokora, Tiffany D; Reeves, Katherine; Vile, Kellie M

2013-01-01

Low health literacy affects 80-90 million Americans with low-income, minority populations being more vulnerable to this condition. One method of addressing limited literacy that may be particularly well accepted within vulnerable populations is the use of educational board games in order to emphasize seeking health information from reliable sources such as pharmacists. The research objective was to determine if the use of educational board games could impact community pharmacy patron intentions to seek pharmacist advice in an urban, minority, economically-disadvantaged population. Four medication-related educational games were played at an urban community pharmacy under the leadership of pharmacy students in the setting of a health party. Game messages, design, and evaluation processes were uniquely guided by community members' input. A verbally administered questionnaire measured game impact via knowledge and perception questions with responses compared between a non-randomly allocated intervention group and a control group. Ninety-nine adults were included in the intervention (or game) group and 94 adults were in the control group. Game participants were significantly more likely than the control group to indicate they would seek pharmacist medication advice in the future. Educational board games played in the setting of a health party can be a fun and effective way to convey selected health messages within an urban, minority, economically disadvantaged population. Community input into game development and layering multiple strategies for overcoming health literacy barriers were essential components of this initiative. Published by Elsevier Inc.

Declining vulnerability to river floods and the global benefits of adaptation

NASA Astrophysics Data System (ADS)

Jongman, Brenden; Winsemius, Hessel; Aerts, Jeroen; Coughlan de Perez, Erin; Van Aalst, Maarten; Kron, Wolfgang; Ward, Philip

2016-04-01

The global impacts of river floods are substantial and rising. Effective adaptation to the increasing risks requires an in-depth understanding of the physical and socioeconomic drivers of risk. Whilst the modeling of flood hazard and exposure has improved greatly, compelling evidence on spatiotemporal patterns in vulnerability of societies around the world is lacking. Hence, the effects of vulnerability on global flood risk are not fully understood, and future projections of fatalities and losses available today are based on simplistic assumptions or do not include vulnerability. In this study, we show that trends and fluctuations in vulnerability to river floods around the world can be estimated by dynamic high-resolution modeling of flood hazard and exposure. We show that fatalities and losses as a share of exposed population and gross domestic product are decreasing with rising income. We also show that there is a tendency of convergence in vulnerability levels between low- and high-income countries. Based on these findings, we simulate future flood impacts per country using traditional assumptions of static vulnerability through time, but also using future assumptions on reduced vulnerability in the future. We show that future risk increases can be largely contained using effective disaster risk reduction strategies, including a reduction of vulnerability. The study was carried out using the global flood risk model, GLOFRIS, combined with high-resolution time-series maps of hazard and exposure at the global scale. Based on: Jongman et al., 2015. Proceedings of the National Academy of Sciences of the United States of America, doi:10.1073/pnas.1414439112.

Latent vulnerability in cognitive performance following chronic cocaine self-administration in rhesus monkeys

PubMed Central

Porter, Jessica N.; Gurnsey, Kate; Jedema, Hank P.; Bradberry, Charles W.

2012-01-01

Rationale Cocaine use is associated with cognitive impairment which impacts treatment outcome. A clearer understanding of those deficits, and whether particular environments exacerbate them, is needed. Objectives This study evaluated whether previously observed domain-specific cognitive deficits persisted following a three month cessation from chronic cocaine self-administration, as well as the impact of novel and cocaine-associated attentional distractors. Methods Control and experimental groups of monkeys performed stimulus discrimination, stimulus reversal, and delayed match-to-sample (DMS) tasks. After establishing post-cocaine baseline performance, we examined general distractibility in both groups, using brief novel distractors counterbalanced across each task. After testing the novel distractor, an identical approach was used for exposure to an appetitive distractor previously associated with cocaine in the experimental group, or water in the control group. Results Post-administration baseline performance was equivalent between groups on all tasks. In the cocaine group, stimulus discrimination was unaffected by either distractor, whereas reversal performance was disrupted by both the novel and appetitive distractors. DMS performance was impaired in the cocaine group in the presence of the novel distractor. The control group’s performance was not affected by the presentation of either distractor on any task. Conclusion Our results reveal that despite normalized performance between groups, there exists in the cocaine group a domain-specific latent vulnerability of cognitive performance to impairment by environmental distractors. The pattern of vulnerability recapitulates the frank impairments seen in drug free animals during an active self-administration phase. A greater impact of the cocaine-associated distractor over the novel one was not observed. PMID:23108938

Mesenchymal Stem Cells Stabilize Atherosclerotic Vulnerable Plaque by Anti-Inflammatory Properties

PubMed Central

Wang, Shuang-shuang; Hu, Si-wang; Zhang, Qing-hua; Xia, Ai-xiang

2015-01-01

Background and objectives Formation and progression of atherosclerotic vulnerable plaque (VP) is the primary cause of many cardio-cerebrovascular diseases such as acute coronary syndrome and stroke. It has been reported that bone marrow mesenchymal stem cells (MSC) exhibit protective effects against many kinds of diseases including myocardial infarction. Here, we examined the effects of intravenous MSC infusion on a VP model and provide novel evidence of its influence as a therapy in this animal disease model. Subjects and methods Thirty healthy male New Zealand white rabbits were randomly divided into a MSC, VP or stable plaque (SP) group (n = 10/group) and received high fat diet and cold-induced common carotid artery intimal injury with liquid nitrogen to form atherosclerotic plaques. Serum hs-CRP, TNF-α, IL-6 and IL-10 levels were measured by ELISA at 1, 2, 3, 7, 14, 21 and 28 days after MSC transplantation. The animals were sacrificed at 4 weeks after MSC transplantation. Lesions in the right common carotid were observed using H&E and Masson staining, and the fibrous cap/lipid core ratio of atherosclerotic plaques were calculated. The expression of nuclear factor κB (NF-κB) and matrix metalloproteinase 1, 2, 9 (MMP-1,2,9) in the plaque were detected using immunohistochemistry, and apoptotic cells in the plaques were detected by TUNEL. In addition, the level of TNF-α stimulated gene/protein 6 (TSG-6) mRNA and protein were measured by quantitative Real-Time PCR and Western blotting, respectively. Results Two rabbits in the VP group died of lung infection and cerebral infarction respectively at 1 week after plaque injury by liquid nitrogen. Both H&E and Masson staining revealed that the plaques from the SP and MSC groups had more stable morphological structure and a larger fibrous cap/lipid core ratio than the VP group. Serum hs-CRP, TNF-α and IL-6 were significantly down-regulated, whereas IL-10 was significantly up-regulated in the MSC group compared with the VP group. .Immunohistochemistry analysis revealed that NF-κB and MMP expression was reduced in the MSC and SP groups compared to the VP group. Cell apoptosis decreased significantly in both the MSC and SP groups in comparison to the VP group. TSG-6 mRNA and protein expression were higher in the plaques of the MSC group compared to the VP and SP groups. Conclusions Our study results suggest that MSC transplantation can effectively stabilize vulnerable plaques in atherosclerotic rabbits. This may potentially offer a new clinical application of MSC in atherosclerosis. PMID:26288013

Longitudinal analysis of time, engagement, and achievement in at-risk versus non-risk students.

PubMed

Greenwood, C R

1991-05-01

This longitudinal study investigated the effects of time spent in academic instruction and time engaged on elementary students' academic achievement gains. Three groups were compared over grades as follows: (a) an at-risk experimental group of low-socioeconomic status (SES) students for whom teachers implemented classwide peer tutoring (CWPT) beginning with the second semester of first grade continuing through Grade 3; (b) an equivalent at-risk control group; and (c) a non-risk comparison group of students of average- to high-SES. In both the control and comparison groups, teachers employed conventional instructional practices over Grades 1 through 3. Results indicated significant group differences in the time spent in academic instruction, engagement, and gains on the subtests of the Metropolitan Achievement Test that favored the experimental and comparison groups over the control group. Implications include the effectiveness of CWPT for at-risk students and the continuing vulnerability of at-risk students whose daily instructional programs provide less instructional time and foster lower levels of active academic engagement.

Socio-cultural reflections on heat in Australia with implications for health and climate change adaptation

PubMed Central

Banwell, Cathy; Dixon, Jane; Bambrick, Hilary; Edwards, Ferne; Kjellström, Tord

2012-01-01

Background Australia has a hot climate with maximum summer temperatures in its major cities frequently exceeding 35°C. Although ‘heat waves’ are an annual occurrence, the associated heat-related deaths among vulnerable groups, such as older people, suggest that Australians could be better prepared to deal with extreme heat. Objective To understand ways in which a vulnerable sub-population adapt their personal behaviour to cope with heat within the context of Australians’ relationship with heat. Design We draw upon scientific, historical and literary sources and on a set of repeat interviews in the suburbs of Western Sydney with eight older participants and two focus group discussions. We discuss ways in which this group of older people modifies their behaviour to adapt to heat, and reflect on manifestations of Australians’ ambivalence towards heat. Results Participants reported a number of methods for coping with extreme heat, including a number of methods of personal cooling, changing patterns of daily activity and altering dietary habits. The use of air-conditioning was near universal, but with recognition that increasing energy costs may become more prohibitive over time. Conclusions While a number of methods are employed by older people to stay cool, these may become limited in the future. Australians’ attitudes may contribute to the ill-health and mortality associated with excessive heat. PMID:23078748

Nursing care of vulnerable populations using a framework of cultural competence, social justice and human rights.

PubMed

Pacquiao, Dula F

2008-04-01

The article attempts to present a model linking cultural competence with advocacy for social justice and protection of human rights in caring for vulnerable groups such as refugees and asylum seekers. Using the human rights principle focuses the moral obligation to address social inequities and suffering of vulnerable populations. Cultural competent care and culturally-congruent actions place the universal principles of social justice and protection of human rights within the cultural contexts of people's lives and the environment in which they are situated. Compassion is identified as the key component for culturally-competent advocacy for social justice and human rights protection. Compassion compels actions advocating social justice and protection of human rights for marginalised and powerless groups. Educational strategies for developing compassion are centered on collaboration, partnership and advocacy. Integration of experiential and didactic learning relevant to cultural competent care for refugees and asylum seekers are recommended.

Researcher-researched relationship in qualitative research: Shifts in positions and researcher vulnerability.

PubMed

Råheim, Målfrid; Magnussen, Liv Heide; Sekse, Ragnhild Johanne Tveit; Lunde, Åshild; Jacobsen, Torild; Blystad, Astrid

2016-01-01

The researcher role is highly debated in qualitative research. This article concerns the researcher-researched relationship. A group of health science researchers anchored in various qualitative research traditions gathered in reflective group discussions over a period of two years. Efforts to establish an anti-authoritarian relationship between researcher and researched, negotiation of who actually "rules" the research agenda, and experiences of shifts in "inferior" and "superior" knowledge positions emerged as central and intertwined themes throughout the discussions. The dual role as both insider and outsider, characteristic of qualitative approaches, seemed to lead to power relations and researcher vulnerability which manifested in tangible ways. Shifting positions and vulnerability surfaced in various ways in the projects. They nonetheless indicated a number of similar experiences which can shed light on the researcher-researched relationship. These issues could benefit from further discussion in the qualitative health research literature.

Researcher–researched relationship in qualitative research: Shifts in positions and researcher vulnerability

PubMed Central

Råheim, Målfrid; Magnussen, Liv Heide; Sekse, Ragnhild Johanne Tveit; Lunde, Åshild; Jacobsen, Torild; Blystad, Astrid

2016-01-01

Background The researcher role is highly debated in qualitative research. This article concerns the researcher-researched relationship. Methods A group of health science researchers anchored in various qualitative research traditions gathered in reflective group discussions over a period of two years. Results Efforts to establish an anti-authoritarian relationship between researcher and researched, negotiation of who actually “rules” the research agenda, and experiences of shifts in “inferior” and “superior” knowledge positions emerged as central and intertwined themes throughout the discussions. The dual role as both insider and outsider, characteristic of qualitative approaches, seemed to lead to power relations and researcher vulnerability which manifested in tangible ways. Conclusion Shifting positions and vulnerability surfaced in various ways in the projects. They nonetheless indicated a number of similar experiences which can shed light on the researcher-researched relationship. These issues could benefit from further discussion in the qualitative health research literature. PMID:27307132

Tripartite Governance: Enabling Successful Implementations with Vulnerable Populations.

PubMed

Kennedy, Margaret Ann

2016-01-01

Vulnerable populations are often at a distinct disadvantage when it comes to the implementation of health information systems in an equitable, appropriate, and timely manner. The disadvantages experienced by vulnerable populations are innumerable and include lack of representation, lack of appropriate levels of funding, lack of resources and capacity, and lack of representation. Increasingly, models of representation for complex implementations involve a tripartite project governance model. This tripartite partnership distributes accountability across all partners, and ensures that vulnerable populations have an equitable contribution to the direction of implementation according to their needs. This article shares lessons learned and best practices from complex tripartite partnerships supporting implementations with vulnerable populations in Canada.

Inclusion and Human Rights in Health Policies: Comparative and Benchmarking Analysis of 51 Policies from Malawi, Sudan, South Africa and Namibia

PubMed Central

MacLachlan, Malcolm; Amin, Mutamad; Mannan, Hasheem; El Tayeb, Shahla; Bedri, Nafisa; Swartz, Leslie; Munthali, Alister; Van Rooy, Gert; McVeigh, Joanne

2012-01-01

While many health services strive to be equitable, accessible and inclusive, peoples’ right to health often goes unrealized, particularly among vulnerable groups. The extent to which health policies explicitly seek to achieve such goals sets the policy context in which services are delivered and evaluated. An analytical framework was developed – EquiFrame – to evaluate 1) the extent to which 21 Core Concepts of human rights were addressed in policy documents, and 2) coverage of 12 Vulnerable Groups who might benefit from such policies. Using this framework, analysis of 51 policies across Malawi, Namibia, South Africa and Sudan, confirmed the relevance of all Core Concepts and Vulnerable Groups. Further, our analysis highlighted some very strong policies, serious shortcomings in others as well as country-specific patterns. If social inclusion and human rights do not underpin policy formation, it is unlikely they will be inculcated in service delivery. EquiFrame facilitates policy analysis and benchmarking, and provides a means for evaluating policy revision and development. PMID:22649488

Effect of Lactation on myocardial vulnerability to ischemic insult in rats

PubMed Central

Askari, Sahar; Imani, Alireza; Sadeghipour, Hamidreza; Faghihi, Mahdieh; Edalatyzadeh, Zohreh; Choopani, Samira; Karimi, Nasser; Fatima, Sulail

2017-01-01

Background Cardiovascular diseases are the leading cause of mortality and long-term disability worldwide. Various studies have suggested a protective effect of lactation in reducing the risk of cardiovascular diseases. Objective This study was designed to assess the effects of pregnancy and lactation on the vulnerability of the myocardium to an ischemic insult. Methods Eighteen female rats were randomly divided into three groups: ischemia-reperfusion (IR), in which the hearts of virgin rats underwent IR (n = 6); lactating, in which the rats nursed their pups for 3 weeks and the maternal hearts were then submitted to IR (n = 6); and non-lactating, in which the pups were separated after birth and the maternal hearts were submitted to IR (n = 6). Outcome measures included heart rate (HR), left ventricular developed pressure (LVDP), rate pressure product (RPP), ratio of the infarct size to the area at risk (IS/AAR %), and ventricular arrhythmias - premature ventricular contraction (PVC) and ventricular tachycardia (VT). Results The IS/AAR was markedly decreased in the lactating group when compared with the non-lactating group (13.2 ± 2.5 versus 39.7 ± 3.5, p < 0.001) and the IR group (13.2 ± 2.5 versus 34.0 ± 4.7, p < 0.05). The evaluation of IR-induced ventricular arrhythmias indicated that the number of compound PVCs during ischemia, and the number and duration of VTs during ischemia and in the first 5 minutes of reperfusion in the non-lactating group were significantly (p < 0.05) higher than those in the lactating and IR groups. Conclusion Lactation induced early-onset cardioprotective effects, while rats that were not allowed to nurse their pups were more susceptible to myocardial IR injury. PMID:28444063

Work disability prevention in rural healthcare workers.

PubMed

Franche, Renée L; Murray, Eleanor J; Ostry, Aleck; Ratner, Pamela A; Wagner, Shannon L; Harder, Henry G

2010-01-01

Approximately 20% of healthcare workers in high-income countries such as Australia, Canada and the USA work in rural areas. Healthcare workers are known to be vulnerable to occupational injury and poor work disability outcomes; given their rural-urban distribution, it is possible to compare work disability prevention in rural and urban areas. However, little attention has been paid to work disability prevention issues specific to rural workers, including rural healthcare workers. A comprehensive review of the literature was conducted to identify rural-urban differences in work disability outcomes (defined as the incidence of occupational injury and the duration of associated work absence), as well as risk factors for poor work disability outcomes in rural healthcare workers. The databases MEDLINE, CINAHL, and EMBASE were searched, as were relevant research centers and government agencies, to identify all quantitative and qualitative English-language studies published between 1 January 2000 and 6 October 2009 that discussed occupational injury, work absence duration, work disability management, or risk factors for poor work disability outcomes, for rural workers specifically, or in comparison with urban workers. To ensure inclusion of studies of healthcare workers as a distinct group among other sector-specific groups, a broad search for literature related to all industrial sectors was conducted. Of 860 references identified, 5 discussed work disability outcomes and 25 discussed known risk factors. Known risk factors were defined as factors firmly established to be associated with poor work disability outcomes in the general worker population based on systematic reviews, well-established conceptual models of work disability prevention, and public health literature. Although somewhat conflicting, the evidence suggests that rural healthcare workers experience higher rates of occupational injury compared with urban healthcare workers, within occupational categories. Rural workers also appear to be more vulnerable to prolonged work absence although the data are limited. No studies directly compared risk factors for work disability prevention outcomes between rural and urban healthcare workers. However, potential risk factors were identified at the level of the environment, worker, job, organization, worker compensation system and healthcare access. Important methodological limitations were noted, including unclear definitions of rurality, inadequate methods of urban-rural comparisons such as comparing samples from different countries, and a paucity of studies applying longitudinal or multivariate designs. There is a notable lack of evidence about work disability prevention issues for healthcare workers in rural areas. Available evidence supports the hypothesis that rural healthcare workers are vulnerable to occupational injury, and suggests they are vulnerable to prolonged work absence. They may be particularly vulnerable to poor work disability prevention outcomes due to complex patient needs in the context of risk factors such as heavy workloads, long hours, heavy on-call demands, high stress levels, limited support and workplace violence. Additional vulnerability may occur because their work conditions are managed in distant urban administrative centers, and due to barriers in their own healthcare access. Although rural healthcare workers seem generally at greater risk of injury, one study suggests that urban emergency medical service workers experience a high vulnerability to injury that may outweigh the effects of rurality. Additional research is needed to document rural-urban disparities in work disability outcomes and to identify associated sources and risk factors. Other issues to address are access to and quality of healthcare for rural healthcare workers, streamlining the compensation system, the unique needs of Aboriginal healthcare workers, and the management of prolonged work absence. Finally, occupational injury and work absence duration programs should be tailored to meet the needs of rural workers.

The Department of Defense energy vulnerabilities: Potential problems and observations

NASA Astrophysics Data System (ADS)

Freiwald, D. A.; Berger, M. E.; Roach, J. F.

1982-08-01

The Department of Defense is almost entirely dependent on civilian energy supplies to meet its needs in both peacetime and periods of heightened conflict. There are a number of potential vulnerabilities to the continual and timely supply of energy to both the civilian and military sectors. These include denial of the energy resources themselves, disruption of critical transportation networks, destruction of storage facilities, and interruption of electrical power. This report briefly reviews the present situation for provision of energy from the civilian sector to the military. General vulnerabilities of the existing energy supply system are identified, along with the potential for armed aggression (including terrorist and sabotage activities) against the energy network. Conclusions and some tentative observations are made as to a proper response to the existing vulnerabilities.

Coastal vulnerability assessment of Puducherry coast, India using analytical hierarchical process

NASA Astrophysics Data System (ADS)

Mani Murali, R.; Ankita, M.; Amrita, S.; Vethamony, P.

2013-03-01

Increased frequency of natural hazards such as storm surge, tsunami and cyclone, as a consequence of change in global climate, is predicted to have dramatic effects on the coastal communities and ecosystems by virtue of the devastation they cause during and after their occurrence. The tsunami of December 2004 and the Thane cyclone of 2011 caused extensive human and economic losses along the coastline of Puducherry and Tamil Nadu. The devastation caused by these events highlighted the need for vulnerability assessment to ensure better understanding of the elements causing different hazards and to consequently minimize the after-effects of the future events. This paper advocates an Analytical Hierarchical Process (AHP) based approach to coastal vulnerability studies as an improvement to the existing methodologies for vulnerability assessment. The paper also encourages the inclusion of socio-economic parameters along with the physical parameters to calculate the coastal vulnerability index using AHP derived weights. Seven physical-geological parameters (slope, geomorphology, elevation, shoreline change, sea level rise, significant wave height and tidal range) and four socio-economic factors (population, Land-use/Land-cover (LU/LC), roads and location of tourist places) are considered to measure the Physical Vulnerability Index (PVI) as well as the Socio-economic Vulnerability Index (SVI) of the Puducherry coast. Based on the weights and scores derived using AHP, vulnerability maps are prepared to demarcate areas with very low, medium and high vulnerability. A combination of PVI and SVI values are further utilized to compute the Coastal Vulnerability Index (CVI). Finally, the various coastal segments are grouped into the 3 vulnerability classes to obtain the final coastal vulnerability map. The entire coastal extent between Muthiapet and Kirumampakkam as well as the northern part of Kalapet is designated as the high vulnerability zone which constitutes 50% of the coastline. The region between the southern coastal extent of Kalapet and Lawspet is the medium vulnerability zone and the rest 25% is the low vulnerability zone. The results obtained, enable to identify and prioritize the more vulnerable areas of the region to further assist the government and the residing coastal communities in better coastal management and conservation.

Coastal vulnerability assessment of Puducherry coast, India, using the analytical hierarchical process

NASA Astrophysics Data System (ADS)

Mani Murali, R.; Ankita, M.; Amrita, S.; Vethamony, P.

2013-12-01

As a consequence of change in global climate, an increased frequency of natural hazards such as storm surges, tsunamis and cyclones, is predicted to have dramatic affects on the coastal communities and ecosystems by virtue of the devastation they cause during and after their occurrence. The tsunami of December 2004 and the Thane cyclone of 2011 caused extensive human and economic losses along the coastline of Puducherry and Tamil Nadu. The devastation caused by these events highlighted the need for vulnerability assessment to ensure better understanding of the elements causing different hazards and to consequently minimize the after- effects of the future events. This paper demonstrates an analytical hierarchical process (AHP)-based approach to coastal vulnerability studies as an improvement to the existing methodologies for vulnerability assessment. The paper also encourages the inclusion of socio-economic parameters along with the physical parameters to calculate the coastal vulnerability index using AHP-derived weights. Seven physical-geological parameters (slope, geomorphology, elevation, shoreline change, sea level rise, significant wave height and tidal range) and four socio-economic factors (population, land use/land cover (LU/LC), roads and location of tourist areas) are considered to measure the physical vulnerability index (PVI) as well as the socio-economic vulnerability index (SVI) of the Puducherry coast. Based on the weights and scores derived using AHP, vulnerability maps are prepared to demarcate areas with very low, medium and high vulnerability. A combination of PVI and SVI values are further utilized to compute the coastal vulnerability index (CVI). Finally, the various coastal segments are grouped into the 3 vulnerability classes to obtain the coastal vulnerability map. The entire coastal extent between Muthiapet and Kirumampakkam as well as the northern part of Kalapet is designated as the high vulnerability zone, which constitutes 50% of the coastline. The region between the southern coastal extent of Kalapet and Lawspet is the medium vulnerability zone and the remaining 25% is the low vulnerability zone. The results obtained enable the identification and prioritization of the more vulnerable areas of the region in order to further assist the government and the residing coastal communities in better coastal management and conservation.

Ozone distribution in remote ecologically vulnerable terrain of the southern Sierra Nevada, CA.

PubMed

Panek, Jeanne; Saah, David; Esperanza, Annie; Bytnerowicz, Andrzej; Fraczek, Witold; Cisneros, Ricardo

2013-11-01

Ozone concentration spatial patterns remain largely uncharacterized across the extensive wilderness areas of the Sierra Nevada, CA, despite being downwind of major pollution sources. These natural areas, including four national parks and four national forests, contain forest species that are susceptible to ozone injury. Forests stressed by ozone are also more vulnerable to other agents of mortality, including insects, pathogens, climate change, and ultimately fire. Here we analyze three years of passive ozone monitor data from the southern Sierra Nevada and interpolate landscape-scale spatial and temporal patterns during the summer-through-fall high ozone concentration period. Segmentation analysis revealed three types of ozone exposure sub-regions: high, low, and variable. Consistently high ozone exposure regions are expected to be most vulnerable to forest mortality. One high exposure sub-region has been documented elsewhere as being further vulnerable to increased drought and fire potential. Identifying such hot-spots of forest vulnerability has utility for prioritizing management. Copyright © 2013 Elsevier Ltd. All rights reserved.

Identification and ranking of environmental threats with ecosystem vulnerability distributions.

PubMed

Zijp, Michiel C; Huijbregts, Mark A J; Schipper, Aafke M; Mulder, Christian; Posthuma, Leo

2017-08-24

Responses of ecosystems to human-induced stress vary in space and time, because both stressors and ecosystem vulnerabilities vary in space and time. Presently, ecosystem impact assessments mainly take into account variation in stressors, without considering variation in ecosystem vulnerability. We developed a method to address ecosystem vulnerability variation by quantifying ecosystem vulnerability distributions (EVDs) based on monitoring data of local species compositions and environmental conditions. The method incorporates spatial variation of both abiotic and biotic variables to quantify variation in responses among species and ecosystems. We show that EVDs can be derived based on a selection of locations, existing monitoring data and a selected impact boundary, and can be used in stressor identification and ranking for a region. A case study on Ohio's freshwater ecosystems, with freshwater fish as target species group, showed that physical habitat impairment and nutrient loads ranked highest as current stressors, with species losses higher than 5% for at least 6% of the locations. EVDs complement existing approaches of stressor assessment and management, which typically account only for variability in stressors, by accounting for variation in the vulnerability of the responding ecosystems.

Genetic Vulnerability as a Distal Risk Factor for Suicidal Behaviour: Historical Perspective and Current Knowledge

PubMed Central

ANDRIESSEN, Karl; VIDETIC-PASKA, Alja

2015-01-01

Introduction Suicide is a multidimensional problem. Observations of family history of suicide suggest the existence of a genetic vulnerability to suicidal behaviour. Aim Starting with a historical perspective, the article reviews current knowledge of a genetic vulnerability to suicidal behaviour, distinct from the genetic vulnerability to psychiatric disorders, focused on clinical and population-based studies, and findings from recent molecular genetics association studies. Method The review includes peer-reviewed research articles and review papers from the professional literature in English language, retrieved from PubMed/Medline and PsycINFO. Results The research literature confirms a existence of a genetic vulnerability to suicidal behaviour. Even though the results of individual studies are difficult to compare, genetic influences could explain up to half of the variance of the occurrence of suicide. Conclusion Genetic vulnerability could be a distal risk factor for suicide, which helps us to understand the occurrence of suicide among vulnerable people. Ethical implications of such vulnerability are highlighted. PMID:27646732

[Vulnerability assessment of eco-environment in Yimeng mountainous area of Shandong Province based on SRP conceptual model].

PubMed

Liu, Zheng-jia; Yu, Xing-xiu; Li, Lei; Huang, Mei

2011-08-01

Based on the ecological sensitivity-resilience-pressure (SRP) conceptual model, and selecting 13 indices including landscape diversity index, soil erosion, and elevation, etc. , the vulnerability of the eco-environment in Yimeng mountainous area of Shandong Province was assessed under the support of GIS and by using principal component analysis and hierarchy analytical method. According to the eco-environmental vulnerability index (EVI) values, the eco-environment vulnerability of study area was classified into 5 levels, i.e., slight (<1.8), light (1.8-2.8), moderate (2.8-3.5), heavy (3.5-4.0), and extreme vulnerability (>4.0). In the study area, moderately vulnerable area occupied 43.3% of the total, while the slightly, lightly, heavily, and extremely vulnerable areas occupied 6.1%, 33.8%, 15.9%, and 0.9%, respectively. The heavily and extremely vulnerable areas mainly located in the topographically complicated hilly area or the hill-plain ecotone with frequent human activities.

Statistics of software vulnerability detection in certification testing

NASA Astrophysics Data System (ADS)

Barabanov, A. V.; Markov, A. S.; Tsirlov, V. L.

2018-05-01

The paper discusses practical aspects of introduction of the methods to detect software vulnerability in the day-to-day activities of the accredited testing laboratory. It presents the approval results of the vulnerability detection methods as part of the study of the open source software and the software that is a test object of the certification tests under information security requirements, including software for communication networks. Results of the study showing the allocation of identified vulnerabilities by types of attacks, country of origin, programming languages used in the development, methods for detecting vulnerability, etc. are given. The experience of foreign information security certification systems related to the detection of certified software vulnerabilities is analyzed. The main conclusion based on the study is the need to implement practices for developing secure software in the development life cycle processes. The conclusions and recommendations for the testing laboratories on the implementation of the vulnerability analysis methods are laid down.

6 CFR 27.255 - Recordkeeping requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... audit required under § 27.225(e)) or Security Vulnerability Assessment, a record of the audit, including... retain records of submitted Top-Screens, Security Vulnerability Assessments, Site Security Plans, and all...

Beyond police crisis intervention: moving "upstream" to manage cases and places of behavioral health vulnerability.

PubMed

Wood, Jennifer D; Beierschmitt, Laura

2014-01-01

Law enforcement officers continue to serve on the front lines as mental health interventionists, and as such have been subject to a wave of "first generation" reform designed to enhance their crisis response capabilities. Yet, this focus on crisis intervention has not answered recent calls to move "upstream" and bolster early intervention in the name of long-term recovery. This paper reports on findings from an action research project in Philadelphia aimed at exploring opportunities for enhanced upstream engagement. Study methods include spatial analyses of police mental health transportations from an eight year period (2004-2011) and qualitative data from twenty-three "framing conversations" with partners and other stakeholders, seven focus groups with police and outreach workers, five key informant interviews as well as document reviews of the service delivery system in Philadelphia. Recommendations include the need to move beyond a focus on what police can do to a wider conception of city agencies and business stakeholders who can influence vulnerable people and vulnerable spaces of the city. We argue for the need to develop shared principles and rules of engagement that clarify roles and stipulate how best to enlist city resources in a range of circumstances. Since issues of mental health, substance use and disorder are so tightly coupled, we stress the importance of establishing a data-driven approach to crime and disorder reduction in areas of the city we term "hotspots of vulnerability". In line with a recovery philosophy, such an approach should reduce opportunities for anti-social behavior among the "dually labeled" in ways consistent with "procedural justice". Furthermore, crime and disorder data flowing from police and security to behavioral health analysts could contribute to a more focused case management of "repeat utilizers" across the two systems. Our central argument is that a twin emphasis on "case management" and "place management" may provide the pillars needed to move upstream and strengthen interventions along a continuum of engagement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Measuring vulnerability to disaster displacement

NASA Astrophysics Data System (ADS)

Brink, Susan A.; Khazai, Bijan; Power, Christopher; Wenzel, Friedemann

2015-04-01

Large scale disasters can cause devastating impacts in terms of population displacement. Between 2008 and 2013, on average 27 million people were displaced annually by disasters (Yonetani 2014). After large events such as hurricane Katrina or the Port-au-Prince earthquake, images of inadequate public shelter and concerns about large scale and often inequitable migration have been broadcast around the world. Population displacement can often be one of the most devastating and visible impacts of a natural disaster. Despite the importance of population displacement in disaster events, measures to understand the socio-economic vulnerability of a community often use broad metrics to estimate the total socio-economic risk of an event rather than focusing on the specific impacts that a community faces in a disaster. Population displacement is complex and multi-causal with the physical impact of a disaster interacting with vulnerability arising from the response, environmental issues (e.g., weather), cultural concerns (e.g., expectations of adequate shelter), and many individual factors (e.g., mobility, risk perception). In addition to the complexity of the causes, population displacement is difficult to measure because of the wide variety of different terms and definitions and its multi-dimensional nature. When we speak of severe population displacement, we may refer to a large number of displaced people, an extended length of displacement or associated difficulties such as poor shelter quality, risk of violence and crime in shelter communities, discrimination in aid, a lack of access to employment or other difficulties that can be associated with large scale population displacement. We have completed a thorough review of the literature on disaster population displacement. Research has been conducted on historic events to understand the types of negative impacts associated with population displacement and also the vulnerability of different groups to these impacts. We aggregate these ideas into a framework of disaster displacement vulnerability that distinguishes between three main aspects of disaster displacement. Disaster displacement can be considered in terms of the number of displaced people and the length of that displacement. However, the literature emphasizes that the severity of disaster displacement can not be measured completely in quantitative terms. Thus, we include a measure representing people who are trapped and unable to leave their homes due to mobility, resources or for other reasons. Finally the third main aspect considers the difficulties that are associated with displacement and reflects the difference between the experiences of those who are displaced into safe and supportive environments as compared to those whose only alternate shelter is dangerous and inadequate for their needs. Finally, we apply the framework to demonstrate a methodology to estimate vulnerability to disaster displacement. Using data from the Global Earthquake Model (GEM) Social and Economic Vulnerability sub-National Database, we generate an index to measure the vulnerability of Japanese prefectures to the dimensions of displacement included in the framework. References Yonitani, M. (2014). Global Estimates 2014: People displaced by disasters. http://www.internal-displacement.org/publications/2014/global-estimates-2014-people-displaced-by-disasters/

Security Vulnerability Profiles of Mission Critical Software: Empirical Analysis of Security Related Bug Reports

NASA Technical Reports Server (NTRS)

Goseva-Popstojanova, Katerina; Tyo, Jacob

2017-01-01

While some prior research work exists on characteristics of software faults (i.e., bugs) and failures, very little work has been published on analysis of software applications vulnerabilities. This paper aims to contribute towards filling that gap by presenting an empirical investigation of application vulnerabilities. The results are based on data extracted from issue tracking systems of two NASA missions. These data were organized in three datasets: Ground mission IVV issues, Flight mission IVV issues, and Flight mission Developers issues. In each dataset, we identified security related software bugs and classified them in specific vulnerability classes. Then, we created the security vulnerability profiles, i.e., determined where and when the security vulnerabilities were introduced and what were the dominating vulnerabilities classes. Our main findings include: (1) In IVV issues datasets the majority of vulnerabilities were code related and were introduced in the Implementation phase. (2) For all datasets, around 90 of the vulnerabilities were located in two to four subsystems. (3) Out of 21 primary classes, five dominated: Exception Management, Memory Access, Other, Risky Values, and Unused Entities. Together, they contributed from 80 to 90 of vulnerabilities in each dataset.

Is a clean river fun for all? Recognizing social vulnerability in watershed planning.

PubMed

Cutts, Bethany B; Greenlee, Andrew J; Prochaska, Natalie K; Chantrill, Carolina V; Contractor, Annie B; Wilhoit, Juliana M; Abts, Nancy; Hornik, Kaitlyn

2018-01-01

Watershed planning can lead to policy innovation and action toward environmental protection. However, groups often suffer from low engagement with communities that experience disparate impacts from flooding and water pollution. This can limit the capacity of watershed efforts to dismantle pernicious forms of social inequality. As a result, the benefits of environmental changes often flow to more empowered residents, short-changing the power of watershed-based planning as a tool to transform ecological, economic, and social relationships. The objectives of this paper are to assess whether the worldview of watershed planning actors are sufficiently attuned to local patterns of social vulnerability and whether locally significant patterns of social vulnerability can be adequately differentiated using conventional data sources. Drawing from 35 in-depth interviews with watershed planners and community stakeholders in the Milwaukee River Basin (WI, USA), we identify five unique definitions of social vulnerability. Watershed planners in our sample articulate a narrower range of social vulnerability definitions than other participants. All five definitions emphasize spatial and demographic characteristics consistent with existing ways of measuring social vulnerability. However, existing measures do not adequately differentiate among the spatio-temporal dynamics used to distinguish definitions. In response, we develop two new social vulnerability measures. The combination of interviews and demographic analyses in this study provides an assessment technique that can help watershed planners (a) understand the limits of their own conceptualization of social vulnerability and (b) acknowledge the importance of place-based vulnerabilities that may otherwise be obscured. We conclude by discussing how our methods can be a useful tool for identifying opportunities to disrupt social vulnerability in a watershed by evaluating how issue frames, outreach messages, and engagement tactics. The approach allows watershed planners to shift their own culture in order to consider socially vulnerable populations comprehensively.

Is a clean river fun for all? Recognizing social vulnerability in watershed planning

PubMed Central

Greenlee, Andrew J.; Prochaska, Natalie K.; Chantrill, Carolina V.; Contractor, Annie B.; Wilhoit, Juliana M.; Abts, Nancy; Hornik, Kaitlyn

2018-01-01

Watershed planning can lead to policy innovation and action toward environmental protection. However, groups often suffer from low engagement with communities that experience disparate impacts from flooding and water pollution. This can limit the capacity of watershed efforts to dismantle pernicious forms of social inequality. As a result, the benefits of environmental changes often flow to more empowered residents, short-changing the power of watershed-based planning as a tool to transform ecological, economic, and social relationships. The objectives of this paper are to assess whether the worldview of watershed planning actors are sufficiently attuned to local patterns of social vulnerability and whether locally significant patterns of social vulnerability can be adequately differentiated using conventional data sources. Drawing from 35 in-depth interviews with watershed planners and community stakeholders in the Milwaukee River Basin (WI, USA), we identify five unique definitions of social vulnerability. Watershed planners in our sample articulate a narrower range of social vulnerability definitions than other participants. All five definitions emphasize spatial and demographic characteristics consistent with existing ways of measuring social vulnerability. However, existing measures do not adequately differentiate among the spatio-temporal dynamics used to distinguish definitions. In response, we develop two new social vulnerability measures. The combination of interviews and demographic analyses in this study provides an assessment technique that can help watershed planners (a) understand the limits of their own conceptualization of social vulnerability and (b) acknowledge the importance of place-based vulnerabilities that may otherwise be obscured. We conclude by discussing how our methods can be a useful tool for identifying opportunities to disrupt social vulnerability in a watershed by evaluating how issue frames, outreach messages, and engagement tactics. The approach allows watershed planners to shift their own culture in order to consider socially vulnerable populations comprehensively. PMID:29715285

Centrifuge technique consistently overestimates vulnerability to water-stress induced cavitation in grapevines as confirmed with high resolution computed tomography

USDA-ARS?s Scientific Manuscript database

Vulnerability to cavitation is a key variable defining the limits to drought resistance in woody plants (e.g. Kursar et al., 2009). This trait is typically assessed by a vulnerability curve, which can be generated by a range of methods including dehydration (Sperry et al., 1988) air injection (Cocha...

Parent and Self-Report Ratings on the Perceived Levels of Social Vulnerability of Adults with Williams Syndrome

ERIC Educational Resources Information Center

Lough, Emma; Fisher, Marisa H.

2016-01-01

The current study took a multi-informant approach to compare parent to self-report ratings of social vulnerability of adults with Williams syndrome (WS). Participants included 102 pairs of adults with WS and their parents. Parents completed the "Social Vulnerability Questionnaire" and adults with WS completed an adapted version of the…

Family Background, Sexual Behaviour, and HIV/AIDS Vulnerability of Female Street Hawkers in Lagos Metropolis, Nigeria

ERIC Educational Resources Information Center

Oyefara, John Lekan

2005-01-01

This article examines the sexual behaviour and the HIV/AIDS knowledge and vulnerability of female street hawkers in Lagos metropolis, Nigeria. A total of 126 female street hawkers under 18 were sampled in a cross-sectional survey and six Focus Group Discussions (FGDs) were conducted to generate data from respondents. Data on sexual behaviour…

Safeguarding Vulnerable Groups Act 2006: The Implications for Employers in Educational Settings

ERIC Educational Resources Information Center

Oliver, Hazel; White, Laura

2008-01-01

Vetting those who work with children and vulnerable adults is an emotive topic and one which can prove a challenging area for employers. The legitimate interest that parents, carers and employers have in screening those charged with the care of others can be in direct conflict with the most fundamental principles of economic freedom and employees'…

Sexual Maltreatment of Unaccompanied Asylum-Seeking Minors from the Horn of Africa: A Mixed Method Study Focusing on Vulnerability and Prevention

ERIC Educational Resources Information Center

Lay, Margaret; Papadopoulos, Irena

2009-01-01

Objectives: The study described in this paper sought to identify the social, cultural, and political factors that effect African unaccompanied asylum-seeking minors' (UASM) vulnerability to sexual maltreatment in England. It aimed to illuminate how child protection measures could be strengthened for this highly marginalized group. Methods: A mixed…

Left Unsupervised: A Look at the Most Vulnerable Children. Child Trends Research Brief.

ERIC Educational Resources Information Center

Vandivere, Sharon; Tout, Kathryn; Capizzano, Jeffrey; Zaslow, Martha

While self care is not always harmful, research finds that when children under 13 are regularly left to spend time alone or to be cared for by young siblings, they may be at risk for injuries and developmental problems. This research brief focuses on two groups of children that may be particularly vulnerable when they lack regular adult…

A systematic review of dynamics in climate risk and vulnerability assessments

NASA Astrophysics Data System (ADS)

Jurgilevich, Alexandra; Räsänen, Aleksi; Groundstroem, Fanny; Juhola, Sirkku

2017-01-01

Understanding climate risk is crucial for effective adaptation action, and a number of assessment methodologies have emerged. We argue that the dynamics of the individual components in climate risk and vulnerability assessments has received little attention. In order to highlight this, we systematically reviewed 42 sub-national climate risk and vulnerability assessments. We analysed the assessments using an analytical framework with which we evaluated (1) the conceptual approaches to vulnerability and exposure used, (2) if current or future risks were assessed, and (3) if and how changes over time (i.e. dynamics) were considered. Of the reviewed assessments, over half addressed future risks or vulnerability; and of these future-oriented studies, less than 1/3 considered both vulnerability and exposure dynamics. While the number of studies that include dynamics is growing, and while all studies included socio-economic aspects, often only biophysical dynamics was taken into account. We discuss the challenges of assessing socio-economic and spatial dynamics, particularly the poor availability of data and methods. We suggest that future-oriented studies assessing risk dynamics would benefit from larger stakeholder involvement, discussion of the assessment purpose, the use of multiple methods, inclusion of uncertainty/sensitivity analyses and pathway approaches.

Synergistic vulnerabilities: antiretroviral treatment among women in Uganda.

PubMed

Winchester, Margaret S

2015-01-01

Despite being an early success story in the reduction of HIV infection rates, Uganda faces myriad challenges in the recent era of accelerated antiretroviral treatment (ARV) scale-up. For those able to access treatment, ongoing vulnerabilities of poverty and violence compound treatment-related costs and concerns. This paper explores experiences of one particularly vulnerable population - women on ARVs who have also experienced intimate partner violence (IPV). Data were collected over 12 months in Uganda. They include ethnographic interviews (n = 40) drawn from a larger sample of women on ARV and semi-structured interviews with policy-makers and service providers (n = 42), examining the intersection of experiences and responses to treatment from multiple perspectives. Women's narratives show that due to treatment, immediate health concerns take on secondary importance, while other forms of vulnerability, including IPV and poverty, can continue to shape treatment experiences and the decision to stay in violent relationships. Providers likewise face difficulties in overburdened clinics, though they recognise women's concerns and the importance of considering other forms of vulnerability in treatment. This analysis makes the case for integrating treatment with other types of social services and demonstrates the importance of understanding the ways in which synergistic and compounding vulnerabilities confound treatment scale-up efforts.