Gang membership and sexual violence: associations with childhood maltreatment and psychiatric morbidity.

BACKGROUND: Gang members engage in many high-risk sexual activities that may be associated with psychiatric morbidity. Victim-focused research finds high prevalence of sexual violence towards women affiliated with gangs. AIMS: To investigate associations between childhood maltreatment and psychiatric morbidity on coercive and high-risk sexual behaviour among gang members. METHOD: Cross-sectional survey of 4665 men 18-34 years in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang membership. Participants completed questionnaires covering violent and sexual behaviours, experiences of childhood disadvantage and trauma, and psychiatric diagnoses using standardised instruments. RESULTS: Antisocial men and gang members had high levels of sexual violence and multiple risk behaviours for sexually transmitted infections, childhood maltreatment and mental disorders, including addictions. Physical, sexual and emotional trauma were strongly associated with adult sexual behaviour and more prevalent among gang members. Other violent behaviour, psychiatric morbidity and addictions accounted for high-risk and compulsive sexual behaviours among gang members but not antisocial men. Gang members showed precursors before age 15 years of adult preference for coercive rather than consenting sexual behaviour. CONCLUSIONS: Gang members show inordinately high levels of childhood trauma and disadvantage, sexual and non-sexual violence, and psychiatric disorders, which are interrelated. The public health problem of sexual victimisation of affiliated women is explained by these findings. Healthcare professionals may have difficulties promoting desistance from adverse health-related behaviours among gang members whose multiple high-risk and violent sexual behaviours are associated with psychiatric morbidity, particularly addictions

Ethnic disparities in psychotic experiences explained by area-level syndemic effects

Background Ethnic inequalities in health outcomes are often explained by socioeconomic status and concentrated poverty. However, ethnic disparities in psychotic experiences are not completely attenuated by these factors. Aims We investigated whether disparities are better explained by interactions between individual risk factors and place-based clustering of disadvantage, termed a syndemic. Method We performed a cross-sectional survey of 3750 UK men, aged 18–34 years, oversampling Black and minority ethnic (BME) men nationally, together with men residing in London Borough of Hackney. Participants completed questionnaires covering psychiatric symptoms, substance misuse, crime and violence, and risky sexual health behaviours. We included five psychotic experiences and a categorical measure of psychosis based on the Psychosis Screening Questionnaire. Results At national level, more Black men reported psychotic experiences but disparities disappeared following statistical adjustment for social position. However, large disparities for psychotic experiences in Hackney were not attenuated by adjustment for social factors in Black men (adjusted odds ratio, 3.24; 95% CI 2.14–4.91; P < 0.002), but were for South Asian men. A syndemic model of joint effects, adducing a four-component latent variable (psychotic experiences and anxiety, substance dependence, high-risk sexual behaviour and violence and criminality) showed synergy between components and explained persistent disparities in psychotic experiences. A further interaction confirmed area-level effects (Black ethnicity × Hackney residence, 0.834; P < 0.001). Conclusions Syndemic effects result in higher rates of non-affective psychosis among BME persons in certain inner-urban settings. Further research should investigate how syndemics raise levels of psychotic experiences and related health conditions in Black men in specific places with multiple deprivations. Declaration of interest K.B. is Editor in Chief of the British Journal of Psychiatry but played no part in the review and decision proces

Ethnic disparities in psychotic experiences explained by area-level syndemic effects.

BACKGROUND: Ethnic inequalities in health outcomes are often explained by socioeconomic status and concentrated poverty. However, ethnic disparities in psychotic experiences are not completely attenuated by these factors. AIMS: We investigated whether disparities are better explained by interactions between individual risk factors and place-based clustering of disadvantage, termed a syndemic. METHOD: We performed a cross-sectional survey of 3750 UK men, aged 18-34 years, oversampling Black and minority ethnic (BME) men nationally, together with men residing in London Borough of Hackney. Participants completed questionnaires covering psychiatric symptoms, substance misuse, crime and violence, and risky sexual health behaviours. We included five psychotic experiences and a categorical measure of psychosis based on the Psychosis Screening Questionnaire. RESULTS: At national level, more Black men reported psychotic experiences but disparities disappeared following statistical adjustment for social position. However, large disparities for psychotic experiences in Hackney were not attenuated by adjustment for social factors in Black men (adjusted odds ratio, 3.24; 95% CI 2.14-4.91; P < 0.002), but were for South Asian men. A syndemic model of joint effects, adducing a four-component latent variable (psychotic experiences and anxiety, substance dependence, high-risk sexual behaviour and violence and criminality) showed synergy between components and explained persistent disparities in psychotic experiences. A further interaction confirmed area-level effects (Black ethnicity × Hackney residence, 0.834; P < 0.001). CONCLUSIONS: Syndemic effects result in higher rates of non-affective psychosis among BME persons in certain inner-urban settings. Further research should investigate how syndemics raise levels of psychotic experiences and related health conditions in Black men in specific places with multiple deprivations

Urban Birth, Urban Living, and Work Migrancy: Differential Effects on Psychotic Experiences Among Young Chinese Men

BACKGROUND: Urban birth and urban living are associated with increased risk of schizophrenia but less is known about effects on more common psychotic experiences (PEs). China has undergone the most rapid urbanization of any country which may have affected the population-level expression of psychosis. We therefore investigated effects of urbanicity, work migrancy, and residential stability on prevalence and severity of PEs. METHODS: Population-based, 2-wave household survey of psychiatric morbidity and health-related behavior among 4132 men, 18-34 years of age living in urban and rural Greater Chengdu, Sichuan Province, China. PEs were measured using the Psychosis Screening Questionnaire. RESULTS: 1261 (31%) of young men experienced at least 1 PE. Lower levels of PEs were not associated with urbanicity, work migrancy or residential stability. Urban birth was associated with reporting 3 or more PEs (OR: 1.63; 95% CI: 1.25-2.11), after multivariable adjustment, with further evidence (P = .01) this effect was restricted to those currently living in urban environments (OR: 1.78; 95% CI: 1.16-2.72). Men experiencing a maximum of 5 PEs were over 8 times more likely to have been born in an urban area (adjusted odds ratio [AOR] 8.81; 95% CI 1.50-51.79). CONCLUSIONS: Men in Chengdu, China, experience a high prevalence of PEs. This may be explained by rapid urbanization and residential instability. Urban birth was specifically associated with high, but not lower, severity levels of PEs, particularly amongst those currently living in urban environments. This suggests that early and sustained environmental exposures may be associated with more severe phenotypes

Assessing the conservation value of waterbodies: the example of the Loire floodplain (France)

In recent decades, two of the main management tools used to stem biodiversity erosion have been biodiversity monitoring and the conservation of natural areas. However, socio-economic pressure means that it is not usually possible to preserve the entire landscape, and so the rational prioritisation of sites has become a crucial issue. In this context, and because floodplains are one of the most threatened ecosystems, we propose a statistical strategy for evaluating conservation value, and used it to prioritise 46 waterbodies in the Loire floodplain (France). We began by determining a synthetic conservation index of fish communities (Q) for each waterbody. This synthetic index includes a conservation status index, an origin index, a rarity index and a richness index. We divided the waterbodies into 6 clusters with distinct structures of the basic indices. One of these clusters, with high Q median value, indicated that 4 waterbodies are important for fish biodiversity conservation. Conversely, two clusters with low Q median values included 11 waterbodies where restoration is called for. The results picked out high connectivity levels and low abundance of aquatic vegetation as the two main environmental characteristics of waterbodies with high conservation value. In addition, assessing the biodiversity and conservation value of territories using our multi-index approach plus an a posteriori hierarchical classification methodology reveals two major interests: (i) a possible geographical extension and (ii) a multi-taxa adaptation

Exploring new visions for a sustainable bioeconomy

The Bioeconomy is both an enabler and an end for the European Green Deal transformation: achieving the EGD transformation entails transforming the very meaning of sustainable bioeconomy. Among the deepest and most effective leverage points to transform a system are the worldviews driving our behaviours: they yield an enormous power to influence the framings which determine the solution space we explore. Transforming the bioeconomy, thus, requiresreflecting on the stories we tell about ourselves, our place in nature, and our relationship with others. Scholars have highlighted how narratives surrounding the EU Bioeconomy have predominantly embraced a “Green Growth” perspective, centred around economic growth, technological innovation, and anthropocentric values, largely ignoring the social and justice dimensions, as well as not questioning the role, relations, and responsibilities of humans in the web of life. These dominant framings are increasingly contested, though, because they have failed to produce the social and ecological outcomes desired. This report introduces perspectives which have been under-represented in the Bioeconomy discourse and integrates them into an alternative vision for a “green, just and sufficient bioeconomy”. This vision places environmental sustainability and social equity at its core, regardless of economic growth; has an inclusive and participatory perspective; care, respect, and reciprocity for and with other humans and non-humans are core values; technology is important to deliver on the green and just objectives, but ethical considerations for new technologies are openly debated