Despite decades of investment in gender-based violence (GBV) services, a substantial proportion of survivors in humanitarian settings never disclose their experiences or seek formal help. Existing frameworks have largely conceptualized this silence as a product of access barriers, overlooking its social rationality as deliberate, strategic non-disclosure. This paper proposes the Silence-Disclosure Framework, integrating two original constructs: Swallowed Silence (the phenomenological experience of deliberate suppression) and Strategic Silence (the social-rational calculus underlying non-disclosure). The framework is developed through secondary analysis of two qualitative studies: 33 internally displaced women (IDWs) in Douala, Cameroon, and 352 internally displaced persons (IDPs) and 28 service providers in Kaya, Burkina Faso, both employing intersectional analytical frameworks. Silence operates at three interdependent levels: structural (the social conditions that make disclosure costly), analytical (a deliberate cost-benefit calculus, Strategic Silence), and phenomenological (the embodied burden of sustaining that silence over time, Swallowed Silence). The framework reconceptualizes silence as constrained agency rather than a deficit of knowledge or access, with direct implications for programming that targets the social conditions of disclosure rather than solely service availability.
Noise is an important environmental stressor, yet how noise-related stress unfolds across everyday mobility contexts remains insufficiently understood. Existing mobility-based studies have focused largely on intra-city movement and self-reported psychological stress, with less attention to physiological stress in real-life settings and to inter-city mobility under regional integration. This exploratory study examines how weekend mobility contexts are associated with objective noise exposure, subjective noise perception, and physiological and psychological stress responses among inter-city travelers with cross-city work-residence arrangements. Integrating real-time noise sensing, activity-travel diaries, self-reported measures, and wearable physiological data, we analyzed 945 weekend observations nested within 44 participants living in Zhongshan and working in Zhuhai, a specific subgroup of inter-city travelers in the Guangdong-Hong Kong-Macao Greater Bay Area, China. Path analysis with cluster-robust standard errors showed that higher-than-usual objective noise exposure was directly associated with physiological stress, while its association with psychological stress was mediated by perceived noise. Weekend mobility contexts were also important. Travel episodes, especially non-leisure-oriented travel, were more strongly associated with elevated stress-related outcomes than most activity episodes. No statistically significant stress-related association was detected for inter-city leisure activities, whereas inter-city non-leisure activities were linked to stronger perceived noise and higher indirect associations with physiological and psychological stress. These findings provide preliminary evidence that noise-related stress is context-dependent and pathway-specific. By integrating wearable physiological sensing with real-time noise measurement and activity-travel diaries, this study advances a contextualized understanding of how regional integration may reshape everyday environmental stress and health-related outcomes. Public health interventions should address mobile noise exposure and related stress beyond residential environments, particularly in contexts of regional integration.
Research suggests that gene-environment correlation (rGE) is a central mechanism in the causation of depression. In particular, individuals with a higher genetic risk of depression also have a disproportionately high risk of experiencing adversities that may to some extent be attributed to one's own behaviors. However, the specific behaviors implicated in this process remain a black box. In this study, we leverage a real life social interactional setting to investigate the link between the genetic burden of depression and behaviors that may evoke negative evaluations from others. We analyze observations about survey participants made by interviewers who were not privy to participants' genetic risk. Analysis of approximately 18,000 unique participants across two US datasets of older adults shows that a higher polygenic index (PGI) of depressive symptoms increased the probability of being perceived as experiencing cognitive struggle and discomfort, and being unhealthy, but not of being seen as untrustworthy or disengaged. These effects seem to be accounted for by stable differences in average depressive symptoms between individuals rather than elevated depressive symptoms during particular interactions. Specific evaluations were to some degree explained by the genetic correlation of depression with certain other traits, including ADHD, neuroticism, and self-rated health. Our findings suggest that the process of rGE in depression involves micro behaviors that are interpreted by others as signals of low competence and that create awkwardness during social interactions.
The onset of functional disability is a hallmark event of ageing, often provoking a process of adaptation. While resilience, here defined as maintaining a stable level of well-being, is viewed as central to successful ageing, its high prevalence following major health events in later life remains subject to considerable debate, and has been described as an artefact of modelling and measurement choices. This paper examines to what extent different adaptation trajectories can be distinguished following the onset of functional disability across multiple dimensions of well-being and assesses how modelling choices shape their identification. Using the Survey of Health, Ageing and Retirement in Europe (SHARE), individuals who developed persistent limitations in activities of daily living were examined in a growth mixture modelling framework to identify distinct trajectories for three well-being dimensions (life satisfaction, quality of life and depressive symptoms), and compared to matched controls to ensure that trajectories are attributable to the health shock. Three trajectories emerged for life satisfaction and quality of life, with resilience as modal response (86.5% and 78.7%, respectively). For depressive symptoms, four trajectories were identified, with resilient and chronic patterns observed in comparable proportions (43.4% each). Greater disability severity predicted a recovery trajectory, whereas pre-existing functional limitations and socioeconomic disadvantage were associated with chronic and improving pathways, both marked by low pre-onset well-being. These findings indicate that resilience is a common but not uniform reaction to functional health loss, underscoring the need for multidimensional outcomes and careful modelling to understand adaptation to disability in later life.
In cross-sectional studies from the United States, single indicators of structural racism have been associated with adverse birth outcomes. Yet little is known about multidimensional measures of structural racism and birth outcomes, or about the impact of such measurement across generations. We constructed a multidimensional measure of structural racism and linked it to a multigenerational birth outcomes dataset of Black women from South Carolina who gave birth between 1989 and 2020. Each family tree had information on grandmothers' (Generation 1, G1) and mothers' (Generation 2, G2) structural racism measures and mothers' (G2) and infants' (Generation 3, G3) birth outcomes (N = 37,544 family trees). We used confirmatory factor analysis to create four latent dimensions of structural racism: Criminal Justice, Economic Opportunity, Educational Resources, and Residential Segregation and Housing. We used multilevel logistic regression to examine the relationship between grandmothers' (G1) exposure to the four dimensions and mothers' (G2) and infants' (G3) preterm birth and low birthweight, and the relationship between mothers' exposure to the four dimensions and the infants' preterm birth and low birthweight. When both grandmothers' and mothers' exposures were accounted for in the same model, we found that greater exposure to structural racism in the Residential Segregation and Housing dimension among grandmothers was associated with a higher odds of poor birth outcomes for infants, while more exposure to structural racism in the Criminal Justice dimension was associated with better birth outcomes for infants. Mothers' structural racism exposure had no statistically significant association with their infants' birth outcomes in these models. This study highlights the importance of grandmothers' exposure to structural racism on infants' birth outcomes.
OBJECTIVES:This paper examined how momentary negative affect (NA) and positive affect (PA) are linked to ambulatory cognitive performance and whether these associations vary by age. Although prior research has identified between-person associations linking affect and cognitive performance, few ecological momentary assessment studies have investigated within-person relationships across adulthood. METHODS:Data were drawn from the Effects of Stress on Cognitive Aging, Physiology, and Emotion (ESCAPE) study. Participants were 260 racially and economically diverse adults aged 25-65 (Mage = 46.5) who completed five daily assessments over 14 days. At each assessment, participants reported their current affect and completed brief, standardized cognitive tasks via smartphone. Multilevel models examined within-person associations between NA, PA and ambulatory cognitive performance (processing speed, working memory, spatial memory) and tested age as a moderator. RESULTS:Across all ages, moments of heightened NA (compared to individuals' averages) were related to worse working memory (γNA = -0.0004, SE = 0.0002, p = .02). Moments of heightened NA were related to decreases in processing speed (γNA = -0.0001, SE = 0.0000, p = .02) but only among adults around the sample mean age (46 years) and older. In contrast, moments of heightened PA were associated with decreases in working memory (γPA = -0.0003, SE = 0.0002, p = .04) only among adults under the sample mean age. No significant associations were observed between momentary affect and spatial memory. CONCLUSION:These results indicate that within-person associations between affect and cognition in daily life vary as a function of age-related contextual and behavioral factors. These findings suggest potential clinical implications for cognition, particularly during periods of elevated NA in later midlife.
BACKGROUND:Dementia prevention is increasingly conceptualised as an exposome issue, reflecting life course eco-psychosocial exposures. For Aboriginal and Torres Strait Islander peoples in Australia, these exposures can be articulated through the Social and Emotional Wellbeing (SEWB) framework and Indigenous conceptualisations of Place. However, dementia research and policy often rely on spatial and socioeconomic proxies that overlook Place-based opportunities for brain health. We employed research yarning to examine how Place influences brain health and inform strengths-based, locally-tailored dementia prevention policy. METHODS:Data were collected via research yarning across eight urban, regional, and rural/remote Australian sites. Data were analysed using reflexive thematic analysis, combining deductive coding guided by the SEWB framework with inductive analysis centring Aboriginal perspectives. RESULTS:Thirteen yarns were held with 88 participants from 6 ACCHOs and 7 communities across 8 sites, with 33 additional participants attending feedback yarns. Participants described brain health as supported through everyday relational and cultural exposures accumulating from birth. Connection to Country, Culture, spirituality, family, and Community reinforced brain health through intergenerational continuity and relationship to ancestral lands. Structural factors - educational access, socioeconomic conditions, health system design, and cultural governance - could enhance or disrupt these relationships. Geographic remoteness did not uniformly predict vulnerability; its effects were mediated by kinship and community structures. CONCLUSION:For Aboriginal and Torres Strait Islander peoples, Place represents a nexus of structural and cultural determinants relevant to brain health. Community-led examination of Place-based exposures extends exposomic frameworks, offering an ethically-grounded foundation for dementia prevention policy with potential relevance for Indigenous populations globally.
While previous research has examined sociocultural influences on women's motivations for FGCS, less attention has been paid to how clinical encounters are experienced and interpreted in relation to genital concerns and decisions about surgery. Data collection was conducted in 2024-2025 in Belgium and the Netherlands and consisted of in-depth interviews with eleven women who had undergone FGCS and twelve clinicians who perform these procedures, supplemented by focus group discussions with 44 women from the general population. Using reflexive thematic analysis, we identified four interrelated patterns: unsolicited clinical remarks that participants experienced as drawing attention to previously unproblematic aspects of their genital appearance; validation of pre-existing concerns that some women seeking FGCS experienced as reinforcing perceptions of abnormality; recommendations that extended existing concerns to additional anatomical features or procedures women had not previously considered; and reassurance about genital diversity and surgical risks that some women described as creating greater space for reflection. The findings suggest that clinical encounters can constitute an important relational context in which meanings of genital normality and abnormality, and, among women seeking FGCS, possible surgical intervention are negotiated. By foregrounding how women experience and interpret these interactions, the paper contributes to debates on autonomy and FGCS and highlights the value of considering the relational conditions in which decisions about surgery are made.
