Faith Cole

Objetivo. Analizar los patrones de intermitencia en el suministro de agua entre 2022 y 2024 a manera de identificar desigualdades regionales y socioeconómicas, y su relación con la disponibilidad de agua renovable y el estrés hídrico. Material y métodos. Se usaron datos de la Encuesta Nacional de Salud y Nutrición Continua 2022, 2023 y 2024. Se estimó la proporción de hogares con acceso continuo (24/7) al agua potable por región, nivel socioeconómico (NSE) y estrato urbano-rural. Además, se compararon niveles de intermitencia según la disponibilidad regional de agua renovable per cápita y niveles de sequía. Resultados. Sólo 36.5% de los hogares tienen suministro continuo. La intermitencia es más alta en hogares rurales del sur y entre los hogares con menor NSE. De forma paradójica, las regiones con mayor sequía presentan mejor abasto. Conclusiones. La intermitencia en México parece responder más a desigualdades en infraestructura y factores socioeconómicos que a condiciones ambientales de escasez hídrica.

Biosocial birth cohort studies are uniquely positioned to be novel sites of interdisciplinary research. Their enduring commitment to specific field sites and populations, recurring grant renewal cycles, ability to ask prospective questions while drawing on long-standing data repositories, and more ensure ongoing collaboration and allow research to remain responsive to the evolving needs and timelines of multiple disciplines. However, it is widely recognised that interdisciplinary work is often easier imagined than achieved, and additional conditions are required to facilitate it beyond assembling teams of varied experts. This piece offers mediating practices as a concept that refers to the practical, multi-directional, and relational processes that attempt to resolve tensions that interdisciplinary teams often confront. Mediating practices bridge gaps among different disciplines’ data and methods, often relying on pragmatic strategies, like re-designing data infrastructures or planning action items after a meeting, to do so. As such, mediating practices are crucial to conducting successful interdisciplinary research. Further, the concept of mediating practices foregrounds the actions of junior team members who often perform these practices, highlighting the need to foster epistemic humility and models of horizontal knowledge production in interdisciplinary teams. Here, the authors discuss their experiences and insights as members of interdisciplinary projects and outline how mediating practices emerged in these projects and enabled interdisciplinary success.

In recent years, there have been increasing calls for the development and growth of the biosocial as a paradigm through which to tackle complex problems. The use of birth cohorts, mixed methods frameworks, and interdisciplinary work are common in biosocial research. However, these practices are also theoretically and practically complex due to epistemic, methodological, and academic challenges – particularly for early career researchers (ECRs) who face time constraints, funding limitations, and disciplinary expectations. This paper draws on lessons from the experiences of ECRs in biosocial research by reflecting on theoretical heterogeneity, the necessity of translation and negotiation across disciplines and methodologies, and the practicalities of funding, collaboration, and dissemination. Throughout, the paper discusses strategies to overcome common challenges and provide suggestions for fellow ECRs and those interested in biosocial ECR training and development. The paper highlights the importance of strong networks with senior biosocial researchers and peers, the value of practical support, and the importance of formal and informal learning opportunities. The authors call for the enthusiasm for biosocial research to be matched with investment in the development and support for ECRs.

Background Alcohol use is a leading cause of disease. Although low- and middle-income countries (LMICs) have lower per capita alcohol consumption, the alcohol-attributable disease burden is high in these settings with consumption increasing. LMICs are also experiencing unprecedented levels of internal migration, potentially increasing mental stress, changing social restrictions on drinking, and increasing alcohol availability. We assessed the relationship between internal migration, opportunity to drink, and the transition from first use to regular alcohol use and alcohol use disorders (AUD) in Nepal, a low-income, South Asian country. Methods A representative sample of 7435 individuals, aged 15–59 from Nepal were interviewed in 2016–2018 (93% response rate) with clinically validated measures of alcohol use and disorders and life history calendar measures of lifetime migration experiences. Discrete-time hazard models assessed associations between migration and alcohol use outcomes. Results Net of individual sociodemographic characteristics, internal migration was associated with increased odds of opportunity to drink (OR 1.32, 95% CI 1.14 to 1.53), onset of regular alcohol use given lifetime use (OR 1.29, 95% CI 1.13 to 1.48) and AUD given lifetime use (OR 1.24, 95% CI 0.99 to 1.57). The statistically significant association between internal migration and opportunity to drink was specific to females, whereas the associations between migration and regular use and disorder were statistically significant for males. Conclusions Despite high rates of internal migration worldwide, most research studying migration and alcohol use focuses on international migrants. Findings suggest that internal migrants are at increased risk to transition into alcohol use and disorders. Support services for internal migrants could prevent problematic alcohol use among this underserved population.

Objetivo. Medir el acceso a través de la intermitencia en el suministro de agua potable en hogares mexicanos. Material y métodos. A través de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022), se recolectó información sobre intermitencia en días por semana y horas por día durante las últimas cuatro semanas y el suministro de agua durante el año para la temporada de mayor escasez. Resultados. 31.5% de los hogares recibieron agua los siete días de la semana, las 24 horas del día. De estos, 17.4% no tuvo escasez en los últimos 12 meses. La intermitencia es más común entre hogares de las regiones en el sur del país y entre los más pobres. El 81% de las familias almacena agua y 16% almacena en contenedores portátiles como cubetas. Conclusión. En este artículo se presentan por primera vez patrones de intermitencia en el suministro de agua a nivel nacional en México. La gran mayoría de las familias no reciben agua de forma continua y tienen que almacenar agua. El almacenamiento podría disminuir la calidad del agua y la falta de confianza para su consumo con consecuencias para la salud. La conexión al sistema potable no refleja el acceso real de las familias al agua.

In the face of water scarcity due to climate change and population growth, cities around the world, especially in the Global South, increasingly provide intermittent, rather than continuous, water supply. Because an intermittent water supply has negative effects on infrastructure and water quality, literature often recommends transition to continuous supply, but that transition may be unfeasible or cost-prohibitive for many cities. There are few policy recommendations for ensuring safe and equitable urban water accesswithinwater-scarce systems. By understanding how households bear the monetary and non-monetary costs of intermittency, we can make urban water safer, more sustainable, and more equitable. This study combines results from open-ended household interviews and ethnographic observations about water management (n = 59 households) with a large-N survey (n = 2,595 individuals) to understand how households experienced water scarcity in Mexico City. We found most residents reported satisfaction with the quantity of intermittent water supply but incurred monetary and non-monetary costs to achieve that satisfaction. We document the ways householdsadapted to scarcity, transforming the intermittent supply they received from the grid by storing, reusing, and conserving water. These adaptations “made scarcity enough,” allowing families to store and preserve sufficient water to meet their needs for waterquantity. However, these same adaptations simultaneously burdened households with financial costs, such as expenditures for storage, pumps, and alternative water sources, and non-monetary costs, such as time-intensive labor spent managing water and noticeable deterioration in drinking waterquality. Because the scarce public water supply is distributed unequally throughout the city, the financial, labor, and water quality impacts of adapting to scarcity were borne privately, primarily by marginalized households. Our findings about intermittency have implications for water justice and equity. We conclude with policy solutions that address the deterioration of water quality during household storage and the inequalities of intermittency.

Objectives To identify social and structural barriers to timely utilisation of qualified providers among children under five years in a high‐mortality setting, rural Mali and to analyse how utilisation varies by symptom manifestation. Methods Using baseline household survey data from a cluster‐randomised trial, we assessed symptom patterns and healthcare trajectories of 5117 children whose mothers reported fever, diarrhoea, bloody stools, cough and/or fast breathing in the preceding two weeks. We examine associations between socio‐demographic factors, symptoms and utilisation outcomes in mixed‐effect logistic regressions. Results Almost half of recently ill children reported multiple symptoms (46.2%). Over half (55.9%) received any treatment, while less than one‐quarter (21.7%) received care from a doctor, nurse, midwife, trained community health worker or pharmacist within 24 h of symptom onset. Distance to primary health facility, household wealth and maternal education were consistently associated with better utilisation outcomes. While children with potentially more severe symptoms such as fever and cough with fast breathing or diarrhoea with bloody stools were more likely to receive any care, they were no more likely than children with fever to receive timely care with a qualified provider. Conclusions Even distances as short as 2–5 km significantly reduced children’s likelihood of utilising healthcare relative to those within 2 km of a facility. While children with symptoms indicative of pneumonia and malaria were more likely to receive any care, suggesting mothers and caregivers recognised potentially severe illness, multiple barriers to care contributed to delays and low utilisation of qualified providers, illustrating the need for improved consideration of barriers.

Although important advances have been made in our understanding of the underpinnings of major depressive disorder (MDD) at the individual level (eg, genes, temperament, and direct experiences of traumatic events), less is understood about wider contextual risk factors, such as those at the neighborhood level.¹ A large body of research has demonstrated that direct exposure to community violence (as either a victim or a witness) is associated with depressive symptoms and MDD,^2,3 but fewer studies have evaluated the potential risks of living in a more violent neighborhood, independently of personal exposure to violence.^4,5 Living in a neighborhood with greater levels of violence may be associated with the development of depression through Beck’s proposed triad of cognitions,⁶ specifically perceiving the world as dangerous or without meaning, the self as worthless, and the future as hopeless. Other mechanisms might include greater daily stress, disruption of social networks, loss of social capital,^7,8 and in the case of children, the impact of neighborhood violence on caregivers.^9,10

Aims: To disaggregate associations with alcohol use disorder relative to those with early alcohol use stages in an adult population. We estimated prevalence rates and socio‐demographic correlates for the opportunity to drink and transitions into life‐time alcohol use, regular use and alcohol use disorder.Design: A retrospective, cross‐sectional population survey within a family panel study.Setting: Chitwan in Nepal, an ethnically diverse setting with heterogeneous ethnic restrictions regarding alcohol.Participants: A total of 10 714 individuals aged 15–59 years (response rate = 93%).Measurements: The Nepal‐specific Composite International Diagnostic Interview assessed life‐time alcohol use opportunity, any use, regular use, disorder and socio‐demographic characteristics.Findings: Seventy per cent [95% confidence interval (CI) = 69.08–70.82%] of the population had the opportunity to drink, 38.06% (95% CI = 37.14–38.99%) had life‐time alcohol use, 32.37% (95% CI = 31.48–33.27%) had regular alcohol use and 6.04% (95% CI = 5.60–6.50%) developed an alcohol use disorder. Compared with high‐caste Hindus, all other ethnicities had greater odds of early stage transitions [odds ratios (OR) ranged from 1.31, 95% CI = 1.16–1.47 to 1.98, 95% CI = 1.81–2.18)], but not of development of disorder. Male sex was associated with greater odds of all transitions, from opportunity (OR = 5.71, 95% CI = 5.41–6.03) to development of disorder (OR = 1.95, 95% CI = 1.35–2.81). The youngest cohort had higher odds of all transitions, from opportunity (OR = 4.86, 95% CI = 4.47–5.29) to development of disorder (OR = 9.34, 95% CI = 6.88–12.70). Higher education was associated with lower odds of all transitions except opportunity [from use (OR = 0.77, 95% CI = 0.71–0.83) to the development of disorder (OR = 0.73, 95% CI = 0.59–0.89)].Conclusions: The prevalence of life‐time alcohol use among adults in Nepal appears to be low, but the overall prevalence of disorder is similar to other countries. Socio‐demographic correlates of early alcohol use transitions differ from those associated with later transitions; while sex and age cohort were associated with all transitions, ethnicity was associated with early transitions (opportunity, life‐time use, regular use), but not later transitions (use and regular use to disorder).