Association of the social disorganization index with time to first septic shock event in children with acute myeloid leukemia.

BACKGROUND: Pediatric acute myeloid leukemia (AML) chemotherapy increases the risk of life-threatening complications, including septic shock (SS). An area-based measure of social determinants of health, the social disorganization index (SDI), was hypothesized to be associated with SS and SS-associated death (SS-death). METHODS: Children treated for de novo AML on two Children's Oncology Group trials at institutions contributing to the Pediatric Health Information System (PHIS) database were included. The SDI was calculated via residential zip code data from the US Census Bureau. SS was identified via PHIS resource utilization codes. SS-death was defined as death within 2 weeks of an antecedent SS event. Patients were followed from 7 days after the start of chemotherapy until the first of end of front-line therapy, death, relapse, or removal from study. Multivariable-adjusted Cox regressions estimated hazard ratios (HRs) comparing time to first SS by SDI group. RESULTS: The assembled cohort included 700 patients, with 207 (29.6%) sustaining at least one SS event. There were 233 (33%) in the SDI-5 group (highest disorganization). Adjusted time to incident SS did not statistically significantly differ by SDI (reference, SDI-1; SDI-2: HR, 0.84 [95% confidence interval (CI), 0.51-1.41]; SDI-3: HR, 0.70 [95% CI, 0.42-1.16]; SDI-4: HR, 0.97 [95% CI, 0.61-1.53]; SDI-5: HR, 0.72 [95% CI, 0.45-1.14]). Nine patients (4.4%) with SS experienced SS-death; seven of these patients (78%) were in SDI-4 or SDI-5. CONCLUSIONS: In a large, nationally representative cohort of trial-enrolled pediatric patients with AML, there was no significant association between the SDI and time to SS.

Examining the health and wellness of solo self-employed workers through narratives of precarity: a qualitative study.

BACKGROUND: In recent decades, there has been a significant transformation in the world of work that is characterized by a shift from traditional manufacturing and managerial capitalism, which offered stable full-time employment, to new forms of entrepreneurial capitalism. This new paradigm involves various forms of insecure, contingent, and non-standard work arrangements. Within this context, there has been a noticeable rise in Self-Employed individuals, exhibiting a wide range of -working arrangements. Despite numerous investigations into the factors driving individuals towards Self-Employment and the associated uncertainties and insecurities impacting their lives and job prospects, studies have specifically delved into the connection between the precarious identity of Self-Employed workers and their overall health and well-being. This exploratory study drew on a 'precarity' lens to make contributions to knowledge about Self-Employed workers, aiming to explore how their vulnerable social position might have detrimental effects on their health and well-being. METHODS: Drawing on in-depth interviews with 24 solo Self-Employed people in Ontario (January - July 2021), narrative thematic analysis was conducted based on participants' narratives of their work experiences. The dataset was analyzed with the support of NVIVO qualitative data analysis software to elicit narratives and themes. FINDINGS: The findings showed that people opt into Self-Employment because they prefer flexibility and autonomy in their working life. However, moving forward, in the guise of flexibility, they encounter a life of precarity, in terms of job unsustainability, uncertainties, insecurities, unstable working hours and income, and exclusion from social benefits. As a result, the health and well-being of Self-Employed workers are adversely affected by anger, anomie, and anxiety, bringing forward potential risks for a growing population. CONCLUSION AND IMPLICATIONS: Neoliberalism fabricates a 'precariat' Self-Employed class. This is a social position that is vague, volatile, and contingent, that foreshadows potential threats of the health and wellbeing of a growing population in the changing workforce. The findings in this research facilitate some policy implications and practices at the federal or provincial government level to better support the health and wellbeing of SE'd workers.

Race, disadvantage, and violence: A spatial exploration of macrolevel covariates of police-involved homicides within and between US counties.

Efforts to explore the macrolevel determinants of police-involved homicides have expanded in recent years due in part to increased scrutiny and media attention to such events, and increased data availability of these events through crowdsourced databases. However, little empirical research has examined the spatial determinants of such events. The present study extends the extant macrolevel research on police-involved homicides by employing an underutilized spatial econometric model, the spatial Durbin model (SDM), to assess the direct and indirect county effects of racial threat, economic threat, social disorganization, and community violence on police killings within and between US counties from 2013 through 2020. Results indicate a direct inverse relationship between racial threat and police-involved homicides, no support for economic threat, and a direct positive association with two measures of social disorganization. Additionally, we find firearm availability exhibits significant direct and indirect spatial dependence on focal county police-involved homicides, reflecting spatial spillover processes. In essence, as firearm availability in neighboring counties increases, police-involved homicides within a focal county increase. The implications of these findings for racial threat, economic threat, social disorganization, and community violence are discussed.

The Effect of Neighborhood Disorganization on Care Engagement Among Children With Chronic Conditions Living in a Large Urban City.

Neighborhood context plays an important role in producing and reproducing current patterns of health disparity. In particular, neighborhood disorganization affects how people engage in health care. We examined the effect of living in highly disorganized neighborhoods on care engagement, using data from the Coordinated Healthcare for Complex Kids (CHECK) program, which is a care delivery model for children with chronic conditions on Medicaid in Chicago. We retrieved demographic data from the US Census Bureau and crime data from the Chicago Police Department to estimate neighborhood-level social disorganization for the CHECK enrollees. A total of 6458 children enrolled in the CHECK between 2014 and 2017 were included in the analysis. Families living in the most disorganized neighborhoods, compared with areas with lower levels of disorganization, were less likely to engage in CHECK. Black families were less likely than Hispanic families to be engaged in the CHECK program. We discuss potential mechanisms through which disorganization affects care engagement. Understanding neighborhood context, including social disorganization, is key to developing more effective comprehensive care models.

Generalized Anxiety Disorder During the COVID-19 Outbreak in Iran: The Role of Social Dysfunction.

ABSTRACT: The COVID-19 epidemic has both physical and psychosocial consequences for the general population. The present study aimed to investigate the relationship between the prevalence of generalized anxiety disorder (GAD) and social dysfunction during the COVID-19 epidemic in Iran. This cross-sectional web-based study was conducted on 1000 Rafsanjani citizens in southeastern Iran. Data were collected by using the Generalized Anxiety Disorder-7 and the General Health Questionnaire from March 15 to March 30, 2020. The prevalence of GAD was 27.8%. The mean score of social functioning was 9.71 ± 2.66, and all participants had social dysfunction. Multivariate logistic regression test showed a significant correlation between anxiety and social functioning (confidence interval [CI], 1.16-1.30; p < 0.001), sex (CI, 1.49-3.04; p < 0.001), and concern about COVID-19 (CI, 1.38-2.73; p < 0.001). The COVID-19 epidemic had negative psychosocial consequences in the general population in Iran.

Neighborhood predictors of the gendered structure of non-lethal violent interactions.

Women are playing an increasing role in violent crime, both as offenders and victims. Yet, little research has examined how neighborhood structural characteristics might explain this involvement, or who women victimize relative to men. Drawing upon theories of social disorganization, strain, and a subculture of violence, we examine macro-level variation in the type and frequency of within and across group violence between men and women. Analyses are based on aggravated assaults and robberies reported to the Los Angeles Police Department between 2001 and 2007. Neighborhood disadvantage has a greater impact on women perpetrating violence against other women relative to any other sex dyad. Family structural variables are particularly important for understanding rates of within group robberies among women, and highlight that multiple measures of family structure are important for understanding gendered differences in rates of violent crime across dyads.

TRAUMA, PREJUDICE, LARGE-GROUP IDENTITY AND PSYCHOANALYSIS.

Escaping Nazi annexation of Austria, Sigmund Freud and his family left there in 1938 to live the rest of their lives in exile in the house now known as the Freud Museum in London. This paper is based upon the author's Holocaust Day Memorial Lecture delivered virtually at this museum on January 27, 2021, which marked the 75th anniversary of the liberation of Auschwitz-Birkenau, the largest Nazi death camp. Besides remembering those who were lost during World War II, the content of this paper includes a description of different types of massive traumas, with a focus on disasters at the hand of the Other, and their impact on individuals and large groups. Sigmund Freud's ideas about relationships between communities and countries with adjoining territories, as well as large-group psychology, are updated, and individuals' and large groups' needs to grasp onto large-group identities is explained and illustrated with case reports.

Can We Uncouple Neighborhood Disadvantage and Delinquent Behaviors? An Experimental Test of Family Resilience Guided by the Social Disorganization Theory of Delinquent Behaviors.

Although the influence of neighborhood disadvantage on youth development of delinquent behavior is well established, findings from this research have yet to inform the development of family-centered prevention programming to protect youth from these erosive effects. The current paper examines the role of family integration in buffering the impact of social disadvantage in a sample of N = 298 families randomly assigned either to a control condition or to a family-based prevention program previously shown to enhance marriage and parenting. We first confirmed that neighborhood concentrated disadvantage predicted change in delinquent behaviors across the course of the study. Additionally, replicating prior work, parents participating in the Protecting Strong African American Families (ProSAAF) program, relative to those randomly assigned to the control group, significantly improved their use of effective communication strategies with each other and reduced ineffective conflict in front of youth. This resulted in a significant indirect effect of ProSAAF on change in youth delinquent behaviors. Furthermore, using mediated moderation analysis, the study tested the buffering effect of greater family integration, showing that experimentally produced change in interparental communication skills and the resulting reduction in youth exposure to parental conflict buffered the effect of neighborhood disadvantage on change in youth delinquent behaviors, supporting a mediated moderation model in which family environments buffer neighborhood effects.

Aunque la influencia de los barrios desfavorecidos en el desarrollo de conductas delictivas en los jóvenes está firmemente consolidada, los hallazgos de esta investigación contribuirán al desarrollo de un programa de prevención centrado en la familia para proteger a los jóvenes de estos efectos erosivos. El presente artículo analiza el papel de la integración familiar en la moderación del efecto de las desventajas sociales en una muestra de N = 298 familias asignadas aleatoriamente a una condición de control o a un programa de prevención basado en la familia que anteriormente ha demostrado mejorar el matrimonio y la crianza. Primero confirmamos que la desventaja concentrada de los barrios predijo el cambio de conductas delictivas a lo largo del transcurso del estudio. Además, replicando trabajos anteriores, los padres que participaron en el programa "Protección de Familias Afroamericanas Fuertes" (Protecting Strong African American Families, ProSAAF), en comparación con aquellos asignados aleatoriamente al grupo de control, mejoraron considerablemente su uso de estrategias de comunicación eficaz entre ellos y redujeron el conflicto ineficaz en frente de los jóvenes. Esto resultó en un efecto indirecto considerable del ProSAAF en el cambio de las conductas delictivas en los jóvenes. Además, mediante el uso del análisis de moderación mediada, el estudio evaluó el efecto moderador de una mayor integración familiar, lo cual demostró que el cambio producido experimentalmente en las habilidades de comunicación interparental y la reducción resultante de la exposición de los jóvenes al conflicto parental moderaron el efecto de la desventaja del barrio en el cambio de las conductas delictivas de los jóvenes. Todo esto respaldó un modelo de moderación mediada en el cual los entornos familiares moderan los efectos del barrio.

Dealing with dysnomia: Strategies for the cultivation of used concepts in social research.

This article follows recent calls to turn social theory away from its fixations on intellectual history and toward the mechanics and craft of creating social theories in the research process. The subject of this article is a dilemma common to theorizing in social science: dysnomia, or the phenomenon in which some object is poorly named. Specifically, this article focuses on how social scientists distinguish original concepts from their equivalents in everyday speech. Three tactics for dealing with dysnomia are named-academic arcana, classification and sociologism-and considered in order to ascertain the strengths and weaknesses of each.

Assessing Individuals' Exposure to Environmental Conditions Using Residence-based Measures, Activity Location-based Measures, and Activity Path-based Measures.

BACKGROUND: Many approaches are available to researchers who wish to measure individuals' exposure to environmental conditions. Different approaches may yield different estimates of associations with health outcomes. Taking adolescents' exposure to alcohol outlets as an example, we aimed to (1) compare exposure measures and (2) assess whether exposure measures were differentially associated with alcohol consumption. METHODS: We tracked 231 adolescents 14-16 years of age from the San Francisco Bay Area for 4 weeks in 2015/2016 using global positioning systems (GPS). Participants were texted ecologic momentary assessment surveys six times per week, including assessment of alcohol consumption. We used GPS data to calculate exposure to alcohol outlets using three approach types: residence-based (e.g., within the home census tract), activity location-based (e.g., within buffer distances of frequently attended places), and activity path-based (e.g., average outlets per hour within buffer distances of GPS route lines). Spearman correlations compared exposure measures, and separate Tobit models assessed associations with the proportion of ecologic momentary assessment responses positive for alcohol consumption. RESULTS: Measures were mostly strongly correlated within approach types (ρ ≥ 0.7), but weakly (ρ < 0.3) to moderately (0.3 ≤ ρ < 0.7) correlated between approach types. Associations with alcohol consumption were mostly inconsistent within and between approach types. Some of the residence-based measures (e.g., census tract: ß = 8.3, 95% CI = 2.8, 13.8), none of the activity location-based approaches, and most of the activity path-based approaches (e.g., outlet-hours per hour, 100 m buffer: ß = 8.3, 95% CI = 3.3, 13.3) were associated with alcohol consumption. CONCLUSIONS: Methodologic decisions regarding measurement of exposure to environmental conditions may affect study results.

"Our Country Needs a Strong Leader Right Now": Economic Inequality Enhances the Wish for a Strong Leader.

Societal inequality has been found to harm the mental and physical health of its members and undermine overall social cohesion. Here, we tested the hypothesis that economic inequality is associated with a wish for a strong leader in a study involving 28 countries from five continents (Study 1, N = 6,112), a study involving an Australian community sample (Study 2, N = 515), and two experiments (Study 3a, N = 96; Study 3b, N = 296). We found correlational (Studies 1 and 2) and experimental (Studies 3a and 3b) evidence for our prediction that higher inequality enhances the wish for a strong leader. We also found that this relationship is mediated by perceptions of anomie, except in the case of objective inequality in Study 1. This suggests that societal inequality enhances the perception that society is breaking down (anomie) and that a strong leader is needed to restore order (even when that leader is willing to challenge democratic values).

Concurrent and Time-Lagged Effects of Social Disorganization on Chlamydia Rate Trajectories Among United States Counties and the District of Columbia, 2010-2015.

OBJECTIVE: To examine the longitudinal relationship between social disorganization (SD) and genital Chlamydia trachomatis infection. METHODS: US county-level data for 2010 to 2015 were used. Reliability and principal component analysis revealed 2 SD factors: socioeconomic deprivation and demographic instability. Growth curve models examined the degree to which SD factors affected chlamydia rates (number of new reported cases per 100,000 population) at baseline and over time adjusting for population percentage aged 15 to 24 years, male to female ratio for population aged 15 to 24 years, and rural percentage. Regression models explored 1- and 3-year time-lagged effects. RESULTS: Among 2961 counties, the average baseline chlamydia rate was 320.3 with an average increase of 7.7 cases per year. Higher baseline deprivation was associated with higher baseline chlamydia rates (P < 0.0001) but lower increases over time (P < 0.0001). Higher demographic instability was associated with lower baseline rates (P < 0.0001) but higher increases over time (P < 0.0001). Deprivation was associated with 1- and 3-year lagged rates (P < 0.0001). CONCLUSIONS: On average, chlamydia rates increased across US counties, and more rapidly for counties with the highest demographic instability.

The social disorganization of eating: a neglected determinant of the Australian epidemic of overweight/obesity.

BACKGROUND: Over the last 150 years, advanced economies have seen the burden of disease shift to non-communicable diseases. The risk factors for these diseases are often co-morbidities associated with unhealthy weight. The prevalence of overweight/obesity among adults in the advanced countries of the English-speaking world is currently more than two-thirds of the adult population. However, while much attention has concentrated on changes in diet that might have provoked this rapid increase in unhealthy weight, changes in patterns of eating have received little attention. METHODS: This article examines a sequence of large-scale, time use surveys in urban Australia stretching from 1974 to 2006. The earliest survey in 1974 (conducted by the Cities Commission) was limited to respondents aged between 18 and 69 years, while the later surveys (by the Australian Bureau of Statistics) included all adult (15 years of age or over) living private dwellings. Since time use surveys capture every activity in a day, they contain much information about mealtimes and the patterns of eating. This includes duration of eating, number of eating occasions and the timing of eating. Inferential statistics were used to test the statistical significance of these changes and the size of the effects. RESULTS: The eating patterns of urban Australian adults have changed significantly over a 32-year period and the magnitude of this change is non-trivial. Total average eating time as main activity has diminished by about a third, as have eating occasions, affecting particularly luncheon and evening meals. However, there is evidence that eating as secondary activity that accompanies another activity is now almost as frequent as eating at mealtimes. Moreover, participants seem not to report it. CONCLUSIONS: Contemporary urban Australians are spending less time in organized shared meals. These changes have occurred the over same period during which there has been a public health concern about the prevalence of unhealthy weight. Preliminary indications are that societies that emphasize eating as a commensal, shared activity through maintaining definite, generous lunch breaks and prioritizing eating at mealtimes, achieve better public health outcomes. This has implications for a strategy of health promotion, but to be sure of this we need to study countries with these more socially organized eating patterns.

Evidence for indirect loss of significance effects on violent extremism: The potential mediating role of anomia.

Psychological research suggests that violent extremism (e.g., terrorism) stems partly from existential motives, such as individuals' need to achieve significance in life after experiencing failure, ostracism, or humiliation (Significance Quest Theory; SQT). Parallel investigations from sociology and criminology established similar findings by linking anomia-a syndrome including feelings of meaninglessness, powerlessness, isolation, self-estrangement, and normlessness-with violent behavior. In line with SQT, this contribution tested if anomia could mediate Loss of Significance effects on violent extremism. Accordingly, three studies conducted in France highlight indirect effects of exposure to discrimination on legitimation of political violence (Study 1, cross-sectional, minority population sample, N = 110), violent behavioral intentions (Study 2, experimental, undergraduate sample, N = 249), and support for ISIS fighters (Study 3, experimental, undergraduate sample, N = 221) through anomia. A subsequent study shows this indirect effect to be robust when controlled for Social Dominance Orientation and Political Extremism (Study 4, cross-sectional, undergraduate sample, N = 279). A final investigation re-analyzing data collected in Turkey highlights a reverse effect when the independent variable tapped into social inclusion (rather than exclusion; Study 5, cross-sectional, undergraduate sample, N = 321). This indirect effect was also robust to Political Extremism and Intolerance as control variables. These results support the usefulness of considering anomia as a proximal predictor of violent extremism in a SQT perspective.

Child delinquency in communal conflict areas in southwestern Nigeria.

This study examines the influence of persistent communal conflicts on child delinquency. Within psychosociological models, the study investigates child delinquency in conflict areas in southwestern Nigeria. Triangulation of sampling techniques and methods of data collection were adopted (questionnaire, focus group discussions, in-depth interview, records, journals, and publications). The records showed that there were more child delinquents in the communal conflict areas and the factors responsible were as follows: a gap in family communication, regulation and control mechanism deficiency, institutional and social lapses, excessive drugs abuse, persistent economic hardship and social disorganization, long communal hatred, and negative social variables. There was a significant relationship between the variables of communal conflicts and child delinquency. The study concludes that social control failed because of children learning violence acts from birth and the environment. There is a need for more cemented social ties among neighboring towns, for perpetrators of conflict to face the wrath of law, and for security agents to not overstay in conflict areas.

Neighborhood health, social structure and family violence.

Within a large field of family violence research, a slowly growing body of literature has examined community-level variables to explain variation in violence. Studies investigating the role of ecological factors have largely been informed by social disorganization theory. This represents considerable progress, but the community context also includes many ecological factors yet to be considered by studies examining family violence, and as such, successful neighborhood interventions have been limited. Furthermore, few community-level studies have explored whether serious family violence is geographically clustered. The current study used police calls for service data to examine how the health context of a community is associated with family violence. Accounting for spatial dependence, a higher prevalence of self-reported mental illness in a neighborhood related to family violence, although a higher prevalence of physical health difficulties was negatively associated with family violence. These results carry implications that can inform community-based efforts, particularly in economically disadvantaged neighborhood, aimed at reducing family violence.

Outlet Type, Access to Alcohol, and Violent Crime.

BACKGROUND: While there are overwhelming data supporting the association between alcohol outlet density and violent crime, there remain conflicting findings about whether on- or off-premise outlets have a stronger association. This inconsistency may be in part a result of the methods used to calculate alcohol outlet density and violent crime. This analysis uses routine activity theory and spatial access methods to study the association between access to alcohol outlets and violent crime, including type of outlet and type of crime in Baltimore, MD. METHODS: The data in this analysis include alcohol outlets from 2016 (n = 1,204), violent crimes from 2012 to 2016 (n = 51,006), and markers of social disorganization, including owner-occupied housing, median annual household income, drug arrests, and population density. The analysis used linear regression to determine the association between access to alcohol outlets and violent crime exposure. RESULTS: Each 10% increase in alcohol outlet access was associated with a 4.2% increase in violent crime exposure (ß = 0.43, 95% CI 0.33, 0.52, p < 0.001). A 10% increase in access to off-premise outlets (4.4%, ß = 0.45, 95% CI 0.33, 0.57, p < 0.001) and LBD-7 outlets (combined off- and on-premise outlets; 4.2%, ß = 0.43, 95% CI 0.33, 0.52, p < 0.001) had a greater association with violent crime than on-premise outlets (3.0%, ß = 0.31, 95% CI 0.20, 0.41, p < 0.001). CONCLUSIONS: Access to outlets that allow for off-site consumption had a greater association with violent crime than outlets that only permit on-site consumption. The lack of effective measures to keep order in and around off-premise outlets could attract or multiply violent crime.

'Broken hospital windows': debating the theory of spreading disorder and its application to healthcare organizations.

BACKGROUND: Research in criminology and social-psychology supports the idea that visible signs of disorder, both physical and social, may perpetuate further disorder, leading to neighborhood incivilities, petty violations, and potentially criminal behavior. This theory of 'broken windows' has now also been applied to more enclosed environments, such as organizations. MAIN TEXT: This paper debates whether the premise of broken windows theory, and the concept of 'disorder', might also have utility in the context of health services. There is already a body of work on system migration, which suggests a role for violations and workarounds in normalizing unwarranted deviations from safe practices in healthcare organizations. Studies of visible disorder may be needed in healthcare, where the risks of norm violations and disorderly environments, and potential for harm to patients, are considerable. Everyday adjustments and flexibility is mostly beneficial, but in this paper, we ask: how might deviations from the norm escalate from necessary workarounds to risky violations in care settings? Does physical or social disorder in healthcare contexts perpetuate further disorder, leading to downstream effects, including increased risk of harm to patients? CONCLUSIONS: We advance a model of broken windows in healthcare, and a proposal to study this phenomenon.

Neighborhood Concentrated Disadvantage and Dating Violence among Urban Adolescents: The Mediating Role of Neighborhood Social Processes.

The link between relationship violence and aspects of neighborhood concentrated disadvantage (e.g., percent of unemployed adults, percent of families below poverty level), has been established. However, the literature examining neighborhood social processes, including informal social control and social cohesion, in relation to adolescent dating violence has shown mixed results with a limited theoretical foundation and methodology. Using a social disorganization theoretical framework, this study examined the mediating role of these neighborhood social processes in the relation between concentrated disadvantage and adolescent dating violence within an urban context. Participants included 605 adult residents in 30 census tracts and 203 adolescents from neighborhoods on the West and South sides of Chicago. Neighborhood-level concentrated disadvantage was measured via Census data, adult residents reported on neighborhood social processes, and youth reported on dating violence. Informal social control was negatively associated with dating violence, and social cohesion was positively associated with dating violence. A multilevel mediation model showed that concentrated disadvantage was related to higher levels of dating violence via lower levels of informal social control. These results extend social disorganization theory to dating violence within an urban context, while also highlighting the important role of neighborhood processes on relationship violence. Implications for research and intervention programming are discussed.

The university campus environment as a protective factor for intimate partner violence against women: An exploratory study.

Some neighborhood characteristics linked to social disorganization theory have been related to intimate partner violence against women (IPVAW). The study of other neighborhood-level factors that may influence IPVAW risk, however, has received less attention. The aim of this study is to analyze the influence of university campuses on IPVAW risk. To conduct the study, IPVAW cases from 2011 to 2013 in the city of Valencia, Spain, were geocoded (n = 1,623). Census block groups were used as the neighborhood analysis unit. Distance between each census block group and the nearest university campus was measured. A Bayesian spatial model adjusted for census block group-level characteristics was performed. Results showed that the distance from a university campus was associated with an approximate 7% increase in IPVAW risk per kilometer. These results suggest that university campuses integrated in the city are related to IPVAW risk. Further research is needed to explain the mechanisms involved.