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The current research aimed to study the strategies that people employ in order to become more desirable as mates in different cultural settings. More specifically, using a closed-ended questionnaire on a sample of 7181 participants from 14 different countries, we identified 10 different strategies that people employ to become more appealing as mates. Participants indicated that they had more frequently used the "Enhance looks," followed by the "Show off abilities and talents," and the "Demonstrate similarity" strategies. On the other hand, they had less frequently used the "Keep undesirable things hidden," the "Show off and exaggerate wealth and abilities," and the "Drastic appearance changes" strategies. Female participants indicated that they had more extensive used the "Enhance looks" strategy than male participants, while male participants indicated that they had more extensive used the "Increase income and social status" and the "Show off and exaggerate wealth and abilities" strategies than female participants. The sex effects, as well as the extent of use, were generally consistent across the different cultures. The identified strategies were classified further into two main strategies, namely the "Develop and demonstrate desirable traits" and the "Deceive about undesirable traits," which was generally consistent across the different countries. [ABSTRACT FROM AUTHOR]

• The Italian adaptation of the DAX appears to be a reliable and valid instrument to assess individual differences in driving anger expression, supporting the four original factors. • The DAX subscales were associated with measures of trait anger and aggressive driving. • Young drivers reported expressing more aggression while driving. • The DAX factors were associated with crashes and crash-related conditions (i.e., fines). • The associations between the different forms of driving anger expression, aggressive driving, and crash involvement remained significant when controlling for socially desirable responding. This study examined the factor structure and the psychometric properties of the Driving Anger Expression Inventory (DAX) in a large sample of Italian drivers. After removing several items and allowing six error pairs to correlate, Confirmatory Factor Analysis (n = 1007) supported a four-factor solution that broadly confirmed the four original factors, and this was confirmed in a second group (N = 1047) of drivers. The three aggressive factors (physical aggressive expression, use of a vehicle and verbal aggressive expression) were positively related, while the adaptive/constructive subscale was negatively related to measures of trait anger and aggressive driving. In addition, younger drivers reported engaging in the aggressive forms of expression more frequently, while older drivers reported more frequently engaging in the adaptive/constructive form of expression. Finally, those who had crashed in the past three years reported more frequently engaging in the three aggressive forms of expression, while those that had not crashed reported more frequently engaging in the adaptive/constructive form of expression. Although the DAX factors showed moderate correlations with social desirability, the associations between the different forms of driving anger expression, aggressive driving and crash involvement remained significant when controlling for socially desirable responding. [ABSTRACT FROM AUTHOR]

INTRODUCTION There is currently little research on polytobacco use in China. The present study examined cognitions that predicted the use of cigarettes, e-cigarettes and waterpipes in a Chinese sample of students. METHODS A convenience sample of 281 university students, obtained using snowball sampling, completed an online survey during the 2019-2020 academic year in Guangzhou, China. RESULTS Men more strongly agreed, than women, with the possible advantages of using alternative nicotine and tobacco products, including: young people who smoke have more friends, smoking makes young people look cool, smoking makes young people feel more comfortable, smoking helps relieve stress, and it would be easy to quit. Factors significantly associated with regular cigarette use were the cognitions: 'I would smoke if my best friend offered', 'Young people who use these products have more friends', and 'It would be easy to quit these products' (global good classifications= 80.1%). In the case of waterpipes, agreement with the cognition: 'The product helps people relieve stress' was significantly associated with its use (global good classifications=80.1%). In the case of e-cigarettes, agreement with the cognitions: 'I would smoke if my best friend offered' and 'It would be easy to quit using these products' were significantly associated with the use of e-cigarettes (global good classifications=74.7%). CONCLUSIONS The results highlight the need to develop prevention programs that prepare young Chinese people to resist social pressure from friends to use tobacco products. There is also evidence of the need to facilitate and disseminate rigorous scientific information among young people about the possible negative health effects of alternative tobacco products. There were also gender differences in the use of these products and in the cognitions towards their use, so it is important to take the gender perspective into account in the analysis of the results and when writing future questionnaire items. [ABSTRACT FROM AUTHOR]

Adult individuals frequently face difficulties in attracting and keeping mates, which is an important driver of singlehood. In the current research, we investigated the mating performance (i.e., how well people do in attracting and retaining intimate partners) and singlehood status in 14 different countries, namely Austria, Brazil, China, Greece, Hungary, Italy, Japan, Peru, Poland, Russia, Spain, Turkey, the UK, and Ukraine (N = 7,181). We found that poor mating performance was in high occurrence, with about one in four participants scoring low in this dimension, and more than 57% facing difficulties in starting and/or keeping a relationship. Men and women did not differ in their mating performance scores, but there was a small yet significant effect of age, with older participants indicating higher mating performance. Moreover, nearly 13% of the participants indicated that they were involuntarily single, which accounted for about one-third of the singles in the sample. In addition, more than 15% of the participants indicated that they were voluntarily single, and 10% were between-relationships single. We also found that poor mating performance was associated with an increased likelihood of voluntary, involuntary, and between-relationships singlehood. All types of singlehood were in higher occurrence in younger participants. Although there was some cross-cultural variation, the results were generally consistent across samples. [ABSTRACT FROM AUTHOR]

People make friends for a variety of reasons. The current study aimed to explore these reasons and the role of the Dark Triad in predicting them, using self-report questionnaires in a sample drawn from 12 countries. We found that the most important reasons for making friends were having people around with desirable traits such as compatibility, who could provide support and be relied upon in times of need, and with whom one could frequently socialize. Less important reasons included achieving self-serving goals such as career advancement and securing an intimate partner. We found small effects of age, sex, and relationship status. Furthermore, higher scores in Machiavellianism and Narcissism were associated with a greater emphasis on all reasons, particularly on achieving self-serving goals. Conversely, higher Psychopathy scores were associated with a lower importance placed on all reasons except mating, where they were associated with higher importance. • Examined the reasons why people make friends in a sample drawn from 12 countries • Found cross-cultural consistency in the reasons for making friends • Found cross-cultural variations in the reasons for making friends • Found significant effects of Dark Triad on the reasons for making friends [ABSTRACT FROM AUTHOR]

Background: Transport-related injuries (TIs) are a substantial public health concern for all regions of the world. The present study quantified the burden of TIs and deaths in the Eastern Mediterranean region (EMR) in 2017 by sex and age. Methods: TIs and deaths were estimated by age, sex, country, and year using Cause of Death Ensemble modelling (CODEm) and DisMod-MR 2.1. Disability-adjusted life years (DALYs), which quantify the total burden of years lost due to premature death or disability, were also estimated per 100 000 population. All estimates were reported along with their corresponding 95% uncertainty intervals (UIs). Results: In 2017, there were 5.5 million (UI 4.9-6.2) transport-related incident cases in the EMR -- a substantial increase from 1990 (2.8 million; UI 2.5-3.1). The age-standardized incidence rate for the EMR in 2017 was 787 (UI 705.5-876.2) per 100 000, which has not changed significantly since 1990 (-0.9%; UI -4.7 to 3). These rates differed remarkably between countries, such that Oman (1303.9; UI 1167.3-1441.5) and Palestine (486.5; UI 434.5-545.9) had the highest and lowest age-standardized incidence rates per 100 000, respectively. In 2017, there were 185.3 thousand (UI 170.8-200.6) transport-related fatalities in the EMR -- a substantial increase since 1990 (140.4 thousand; UI 118.7-156.9). The age-standardized death rate for the EMR in 2017 was 29.5 (UI 27.1-31.9) per 100 000, which was 30.5% lower than that found in 1990 (42.5; UI 36.8-47.3). In 2017, Somalia (54; UI 30-77.4) and Lebanon (7.1; UI 4.8-8.6) had the highest and lowest age-standardized death rates per 100,000, respectively. The age-standardised DALY rate for the EMR in 2017 was 1,528.8 (UI 1412.5-1651.3) per 100 000, which was 34.4% lower than that found in 1990 (2,331.3; UI 1,993.1-2,589.9). In 2017, the highest DALY rate was found in Pakistan (3 454 121; UI 2 297 890-4 342 908) and the lowest was found in Bahrain (8616; UI 7670-9751). Conclusion: The present study shows that while road traffic has become relatively safer (measured by deaths and DALYs per 100 000 population), the number of transport-related fatalities in the EMR is growing and needs to be addressed urgently. [ABSTRACT FROM AUTHOR]

• The Driver Behaviour Questionnaire was administered in two independent samples. • The four factor solution was confirmed using exploratory factor analysis in the first sample. • Confirmatory factor analysis confirmed the four factors in the second independent sample. • All four DBQ factors were significantly related to crashes in the first sample. • In the second sample the number of crashes reported was very low. The Driver Behaviour Questionnaire (DBQ) is the most commonly used framework for investigating the relationship between self-reported driving behaviour and crash involvement. However, in spite of the fact that the scale is almost 30 years old, the factor structure of the scale and relationship to crashes in New Zealand remains under-researched. The present study set out to establish the factor structure of the DBQ in a sample of New Zealand private vehicle drivers and to examine the adequacy of this factor structure in an independent second sample of New Zealand drivers. Using exploratory factor analysis, the first sample (n = 860, M age = 39.3, 44% females) produced a factor structure that broadly supported the four hypothetical factors of errors, violations, aggressive violations and lapses. This factor structure was supported in a second sample from the New Zealand electoral roll (n = 441, M age = 53.4, 55% females), using confirmatory factor analysis. There were a number of differences in the relationships that the DBQ factors had with the demographic and descriptive variables. In the first sample, all four of the DBQ factors were significantly related to crash involvement. In contrast, none of the DBQ factors were related to crash involvement in the second sample, possibly due to the very small number of crashes reported. However, these differences are likely due to differences in the demographic composition of the two samples. The present study suggests that the DBQ is a valid measure of aberrant driving behaviour in New Zealand and this consists of errors, violations, aggressive violations and lapses. [ABSTRACT FROM AUTHOR]

An extensive body of research has found that angry and aggressive driving are both significantly related to crash involvement. There has also been a large body of research investigating the situational factors related to angry and aggressive driving, but one interesting question that has not yet been answered is whether the enforcement of traffic laws causes or reduces angry and aggressive driving. The independent region of Northern Kosovo represents a unique opportunity to investigate the impact of a lack of traffic enforcement on driving behaviour. Therefore, the present study set out to investigate whether the presence of traffic enforcement has a significant impact on the level of driver anger and aggressive driving. Registered owners of motor vehicles in Northern Kosovo and Serbia were both sent a questionnaire which contained the 28-item Dula Dangerous Driving Index (DDDI) and the 21-item UK Driving Anger Scale (UKDAS). This found that anger was higher in two of the four driving anger factors (direct hostility and progress impeded) and two of the three DDDI factors (risky driving & aggressive driving). Furthermore, the present study found that the lack of police enforcement was a significant predictor of both aggressive and risky driving, even after the driving anger and demographic variables had been partialled out. Therefore, it appears that introducing or increasing traffic enforcement may be one method of reducing aggressive and risky driving behaviour. [ABSTRACT FROM AUTHOR]

The drive to reduce fuel consumption and greenhouse gas emissions is one shared by both businesses and governments. Although many businesses in the European Union undertake interventions, such as driver training, there is relatively little research which has tested the efficacy of this approach and that which does exist has methodological limitations. One emerging technology employed to deliver eco-driving training is driver training using a simulator. The present study investigated whether bus drivers trained in eco-driving techniques were able to implement this learning in a simulator and whether this training would also transfer into the workplace. A total of 29 bus drivers attended an all-day eco-driving course and their driving was tested using a simulator both before and after the course. A further 18 bus drivers comprised the control group, and they attended first aid courses as well as completing the same simulator drives (before-after training). The bus drivers who were given the eco-driving training significantly improved fuel economy figures in the simulator, while there was no change in fuel economy for the control group. Actual fuel economy figures were also provided by the bus companies immediately before the training, immediately after the training and six months after the training. As expected there were no significant changes in fuel economy for the control group. However, fuel economy for the treatment group improved significantly immediately after the eco-driving training (11.6%) and this improvement was even larger six months after the training (16.9%). This study shows that simulator-based training in eco-driving techniques has the potential to significantly reduce fuel consumption and greenhouse gas emissions in the road transport sector. [ABSTRACT FROM AUTHOR]

This study tested the four factor structure of the Driving Anger Expression Inventory (DAX) in a sample of young Malaysian drivers and the relationship these factors had with several other variables. Confirmatory Factor Analysis broadly supported the four factor solution of the DAX, being: Personal Physical Aggressive Expression, Use of a Vehicle to Express Anger, Verbal Aggressive Expression and Adaptive/Constructive expression. The short version of the Driving Anger Scale was positively correlated with the three types of aggressive responses and not surprisingly with a variable comprised of all three types of aggressive responses (Total Aggressive Expression). Total Aggressive Expression was higher for males and negatively related to age, years licensed and slower preferred driving speed. All three of the aggressive forms of expression had significant relationships with crash-related conditions, such as: loss of concentration, losing control of their vehicle, having received a ticket and involvement in near-misses. In particular, all three of the aggressive forms of expression had significant relationships with losing control of the vehicle and Total Aggressive Expression was correlated with all crash-related conditions. In addition, Personal Physical Aggressive Expression and Total Aggressive Expression were both significantly related to crash involvement. [ABSTRACT FROM AUTHOR]

This research used the Driving Anger Expression Inventory (DAX) to investigate the expression of driving anger amongst a sample of New Zealand drivers. Confirmatory Factor Analysis found that the data fitted a three factor solution, which consisted of: Verbal Aggressive Expression; Use of a Vehicle to express anger, and an Adaptive/Constructive factor. The Personal Physical Aggressive Expression factor was not supported in the present sample. However, in line with previous findings, the present research found that the two aggressive types of anger expression were significantly related to potentially crash related conditions, such as: losing control of the vehicle, loss of concentration and near-misses. The two aggressive types of driving anger were also positively related to trait anger and driving anger, while the Adaptive/Constructive factor was negatively related to both these variables. The present study also confirmed that those drivers who expressed their anger in an aggressive manner are more likely to be male and younger, while those who deal with their anger in a constructive manner were more likely to be older and female. [ABSTRACT FROM AUTHOR]

The present study developed a revised version of the driving anger expression inventory (25-items) and a short (15-item) version using data from 551 drivers. Split half factor analyses on both versions confirmed the original four factors; personal physical aggressive expression, use of a vehicle to express anger, verbal aggressive expression and adaptive/constructive expression. The two DAX versions were strongly correlated, demonstrating the suitability of both forms of the scale and the aggressive forms of expression were higher for drivers who reported initiating road rage interactions. Total aggressive expression was also higher for drivers who reported recent crash-related conditions, such as: loss of concentration, losing control of their vehicle, moving violations, near-misses and major crashes. The revised DAX and DAX-short provide shorter versions of the 49-item DAX that can more easily be combined with other questionnaires and require smaller sample sizes to analyse. Further research is required to validate these tools among different samples and populations. [ABSTRACT FROM AUTHOR]

The present study examined the types of situations that cause Malaysian drivers to become angry. The 33-item version of the driver anger scale (Deffenbacher et al., 1994) was used to investigate driver anger amongst a sample of 339 drivers. Confirmatory factor analysis showed that the fit of the original six-factor model (discourtesy, traffic obstructions, hostile gestures, slow driving, illegal driving and police presence), after removing one item and allowing three error pairs to covary, was satisfactory. Female drivers reported more anger, than males, caused by traffic obstruction and hostile gestures. Age was also negatively related to five (discourtesy, traffic obstructions, hostile gestures, slow driving and police presence) of the six factors and also to the total DAS score. Furthermore, although they were not directly related to crash involvement, several of the six forms of driving anger were significantly related to the crash-related conditions of: near misses, loss of concentration, having lost control of a vehicle and being ticketed. Overall the pattern of findings made in the present research were broadly similar to those from Western countries, indicating that the DAS is a valid measure of driving anger even among non-European based cultures. [ABSTRACT FROM AUTHOR]

Highlights: [•] CFA supported the unidimensional nature of both the DAS and PADS. [•] The PADS was a significant predictor of violations. [•] The DAS was a significant predictor of near-misses. [•] Neither of the scales were significant predictors of crash-involvement. [ABSTRACT FROM AUTHOR]

Highlights: [•] CFA supported the original four factors, which all had good internal reliability. [•] Licence tenure was negatively related to the three types of aggressive expression. [•] The aggressive types of expression were related to crash related conditions. [•] None of the DAX factors was related to either minor or major crash involvement. [•] The DAX can be used with both professional and private vehicle drivers. [ABSTRACT FROM AUTHOR]

Abstract: The present study aimed to investigate both the on road behaviour of Belgian school students and the validity of the Adolescent Road User Behaviour Questionnaire (ARBQ) in a sample of students attending school in Belgium. In total, 294 adolescents completed the ARBQ along with measures of their self-reported accident involvement and sensation seeking behaviour. Confirmatory Factor Analysis supported the original factor structure of: “unsafe road crossing”, “playing on the road” and “planned protective behaviour” for the 21-item version of the questionnaire, but not for the full scale. Males were found to engage more often in unsafe crossing behaviour and playing on the roads. There were also age differences, with unsafe road crossing increasing with age and engagement in planned protective behaviours improving with age. Those who reported being involved in an accident also reported more frequent engagement in unsafe crossing, playing on the roads, thrill seeking behaviour and lower levels of behaviour inhibition. Therefore, this study confirms that the ARBQ is a useful tool for investigating safety-related behaviours that contribute to accident involvement. [Copyright &y& Elsevier]

Abstract: This study set out to investigate the proportion of UK drivers who engage in some form of distracting behaviour whilst driving. Data were collected by roadside observation in six urban centres in the South of England. The observations took place on randomly selected roads at three different time periods during two consecutive Tuesdays. The data revealed that 14.4% of the 7168 drivers observed were found to be engaged in a distracting activity. The most frequently observed distraction was talking to a passenger, followed by smoking and using a mobile phone. Younger drivers were significantly more likely to be distracted in general and by talking to passengers, while older drivers were less likely to be distracted by adjusting controls or using a mobile phone. [Copyright &y& Elsevier]

Abstract: There is widespread use of self-report measures of driving behaviour in the traffic psychology literature, despite the frequent criticism that such measures are subject to social desirability bias. However, no research has yet investigated the more recently developed measures of driving anxiety and avoidance behaviour for socially desirable responding. Furthermore, relatively little research has investigated the issue of socially desirable responding on self-reported driver behaviour in general, and that which does exist has several shortcomings. The present study used a repeated measures design to assess the effect of social desirability on a measure of driving avoidance, the Driving and Riding Avoidance Scale (DRAS), and the Driver Behaviour Questionnaire (DBQ). A sample of 228 undergraduate students completed the DRAS, DBQ and a measure of socially desirable responding in class, which constituted a public place, and then again 2months later in the privacy of their homes. None of the DBQ items were significantly different across the two locations. However, two of the DRAS general avoidance items were higher in the public setting, perhaps demonstrating the effect of socially desirable responding on driving avoidance due to environmental or practical concern. Nevertheless, overall it appears as though the DRAS and DBQ are not particularly vulnerable to socially desirable responding, although further well-designed research on the effects of such bias on these and other self-report measures of driving behaviour should be undertaken. [Copyright &y& Elsevier]

Abstract: The present study aimed to describe the road user behaviour of New Zealand adolescents and to investigate the applicability of the Adolescent Road user Behaviour Questionnaire (ARBQ) to New Zealand adolescents. In total 944 adolescents were surveyed in the North and South islands of New Zealand. Factor analysis of the scale produced three factors which had acceptable internal reliability and were very similar to those found in the original research. The three factors were “unsafe crossing behaviour”, “playing on the road” and “planned protective behaviour”. This research also found that males and those who were at least part Maori were more likely to put themselves at risk by playing on the road. Furthermore, those who identified themselves as being part Maori also engaged in unsafe road crossing behaviour more often than Caucasian and Asian adolescents. Interestingly, only the interaction effect between age and sex was significantly related to engagement in planned protective behaviour. However, despite differences between New Zealand and England, and differences in the sample characteristics, the scale appeared to be measuring the same latent variables. Therefore, this research confirmed that the ARBQ is a useful tool for investigating the behaviour of adolescents on the road. [Copyright &y& Elsevier]

Abstract: Driving anxiety can have a significant impact on everyday functioning and usually results in some kind of avoidance behaviour. The Driving and Riding Avoidance Scale (DRAS; Stewart, A. E., & St. Peter, C. C. (2004). Driving and riding avoidance following motor vehicle crashes in a non-clinical sample: psychometric properties of a new measure. Behaviour Research and Therapy, 42, 859–879) shows promise in the self-report assessment of the degree of such avoidance. The present study investigated the psychometric properties of the DRAS in a sample of 301 university students. Internal consistency for the DRAS was 0.89 and temporal stability over two months was 0.71. The factor structure of the DRAS supported the use of the general and traffic avoidance subscales but not the weather and riding avoidance subscales in the present non-clinical sample. However, a significant limitation of the DRAS is that it does not assess the reasons for driving avoidance, and is therefore not a measure of avoidance that is due to driving anxiety. Some items may be rated highly for practical reasons, such as avoidance because of increasing fuel and other costs associated with driving. Modified instructions for the DRAS should ensure that it measures anxiety-related avoidance behaviour. [Copyright &y& Elsevier]

Abstract: The present study examined the types of situations that cause Spanish drivers to become angry. The 33-item version of the Driver Anger Scale () was used to investigate driver anger amongst a sample of 371 drivers. Confirmatory factor analysis showed the fit of the original six-factor model was satisfactory. In most of the subscales Spanish drivers reported similar levels of anger to that reported by drivers from other nations. Female drivers reported more anger overall and on three of the six types of driving anger (discourtesy, traffic obstructions and illegal driving). Individually, police presence, slow driving and overall anger were significant predictors of crash involvement (p <0.05), even after the contributions of the background variables had been partialled out. [Copyright &y& Elsevier]

Abstract: This research investigated the types of situations that cause drivers to become angry while driving. The Driver Anger Scale [Deffenbacher, J. L., Oetting, E. R., & Lynch, R. S. (1994). Development of a driver anger scale. Psychological Reports, 74, 83–91] was used to investigate driver anger amongst 861 drivers. The resultant data were factor analysed, producing four categories of anger provoking situations; progress impeded, risky driving, hostile gestures and discourteous driving. Overall levels of driver anger were higher than equivalent research in the UK, but appeared to be lower than that found in America. In line with overseas research, female drivers reported more anger overall and in two of the four categories of driver anger (risky driving and hostile gestures). There were also regional differences, with the drivers from the main urban areas reporting more anger than those from the secondary urban areas. Reported anger declined with age for all categories of anger provoking situations. Those drivers reporting a higher level of driving anger across all potential anger inducing situations tended to be; female, younger, from a main urban area, report a higher annual mileage, be less experienced (in terms of years driving) and prefer a higher speed. The overall level of driver anger was not related to crash involvement, and neither were any of the four categories of driver anger. [Copyright &y& Elsevier]

Abstract: One of the most commonly used frameworks for investigating the relationship between self-reported driving behaviour and crash involvement is the Manchester Driver Behaviour Questionnaire (DBQ). However, in spite of the fact that Spain has a relatively large road safety problem (annually more than 5000 people die and over 150,000 are injured in traffic accidents), only one study could be found using the DBQ to measure aberrant driving behaviour in this country. In addition that research solely reported the frequencies of the different driving behaviours they measured. The current research attempted to fill this gap by administering a translated Spanish version of the DBQ to a sample of drivers in Spain. Although factor analysis produced a four factor solution, there were a number of departures from the expected factor structure. The most unusual finding was that the first factor contained a mixture of lapses and errors. This may indicate that either some of the meaning was lost in the translation into Spanish, or that the distinction between these two factors may not apply to Spanish drivers. The second factor was a strong violations factor and was constructed of violations and aggressive violations to do with getting somewhere in a hurry. The third factor once again confirmed that interpersonal violations are a separate entity from the other aggressive violations, meaning that this research did not support the “aggressive violations” factor. The fourth factor had very low internal reliability and contained only three lapses. However, in agreement with previous research, it was the violations factor which was predictive of crash involvement after the contributions of the demographic and descriptive variables had been partialled out. [Copyright &y& Elsevier]

Research has shown that using a mobile phone whilst driving may increase the risk of being crash involved by as much as nine times. As around 65% of New Zealand''s population own mobile phones, this represents a potentially very significant hazard. In order to effectively target interventions towards those drivers who use mobile phones while driving, information is needed about the characteristics of these drivers. The present study investigated the frequency of mobile phone use on New Zealand''s roads and the characteristics of drivers who use mobile phones while driving. The research found that more than half (57.3%) of the participants used a mobile phone at least occasionally while driving. Those who reported using a mobile phone more often whilst driving tended to; be male, reside in a main urban area, report a higher annual mileage, drive a later model car with a larger engine, prefer a higher driving speed, have less driving experience (in years) and to be younger. In line with previous research, there was also a significant relationship between crash involvement and use of a mobile phone whilst driving. However, once the contributions of the demographic and descriptive variables had been partialled out, using hierarchical logistic regression, the relationship between crash involvement and mobile phone use was no longer significant. [Copyright &y& Elsevier]

Research using the driver behaviour questionnaire (DBQ) has found that aberrant driving behaviours can be categorised into: errors, lapses and violations (and aggressive violations, depending on the version of the DBQ used). There is also extensive evidence that it is only the `violations'' score which is significantly correlated with, and predictive of, crash involvement. This consistency has been found both across different samples and different countries. However, recent research conducted on those driving cars in a work-related context has found a different factor structure and a different pattern of correlations with crash involvement. The present study extends this research by investigating the factor structure of the DBQ and the relationship between aberrant driving behaviour and crash involvement for a sample of truck drivers. Factor analysis yielded a four factor solution, that broadly replicated the four hypothetical factors (errors, lapses, violations and aggressive violations) found in the general driving population. Only the violations factor was found to be significantly predictive of crash involvement. This research provides evidence of the robust nature of the DBQ findings in populations other than the drivers of private motor vehicles. [Copyright &y& Elsevier]

This study examined the physical strain experienced by cable hauler choker setters, and the applicability of heart rate indices for measuring physical strain in commercial forest harvesting operations in New Zealand. The heart rate of four choker setters were recorded continuously throughout the working day and applied to heart rate indices. Based on the relative heart rate at work (%HRR), ratio of working heart rate to resting heart rate and 50% level indices, the mean working heart rate (HRw) of 106 bt. min(-1) +/- 6.9 (mean +/- SD) placed choker setting in the moderate workload category. The specific tasks of line shifts (120.3 +/- 4.8 bt. min(-1)), hooking up drags (118.8 +/- 6.6 bt. min(-1)) and uphill travel (126.1 +/- 12.9 bt. min(-1)), imposed the most severe workloads on the choker setters. This research also demonstrated that heart rate indices could be used as an effective means of determining the physiological strain of subjects working in New Zealand's commercial forest harvesting operations. [ABSTRACT FROM AUTHOR]

• The present research used the Theory of Planned Behaviour. • The intentions to use a mobile phone (to text) while driving were investigated. • The psychological reasons underpinning this behaviour were also explored. There is clear research evidence that using a mobile phone while driving is dangerous. However, although drivers generally know this is a risky behaviour, many continue to use a handheld mobile phone while driving. The present research used the Theory of Planned Behaviour (TPB) to explore the psychological reasons underpinning intentions to use a mobile phone while driving in general, as well as to send and read text messages while driving across four different scenarios. Convenience sampling was used to obtain data from 314 participants who held a valid licence to drive in the UK, had driven at least once in the last six months and owned a mobile phone. General intentions to use a mobile phone while driving were predicted by positive Attitudes towards the behaviour and higher Perceived Behavioural Control. Moreover, when predicting intentions to send and read text messages, it was positive Attitudes that was the most consistent and significant predictor. Surprisingly, neither Perceived Behavioural Control nor Subjective Norms were significant predictors of intentions to send or read text messages. Furthermore, perceptions of risk (crashing and being apprehended by the police) were significant predictors of intentions to send and read texts over and above that provided by the TPB variables. The present research highlights the need for interventions to target attitudinal change and to increase risk perceptions in order to reduce the prevalence of these risky behaviours. [ABSTRACT FROM AUTHOR]

Describes how a voluntary accident reporting scheme has been used to identify the requirements for, and monitor the effectiveness of interventions within the New Zealand logging industry. Development of chainsaw cut-resistant legwear; Determination of the most appropriate color for high visibility clothing; Underlying rationale for each intervention.

Kidney cancer, a type of urogenital cancer, imposes a high burden on patients. Despite this, no recent research has evaluated the burden of this type of cancer in the Middle East and North Africa (MENA) region. This study explored the burden of kidney cancer from 1990 to 2019 according to age, sex and socio-demographic index (SDI). The Global Burden of Disease (GBD) 2019 data was utilized to estimate the incidence, death, and disability-adjusted life-years (DALYs) caused by kidney cancer. These estimates were reported as counts and as age-standardised rates with 95% uncertainty intervals (UIs). The estimated age-standardised incidence, mortality, and DALY rates of kidney cancer in 2019 were 3.2 (2.8–3.6), 1.4 (1.2–1.6), and 37.2 (32.0–42.6) per 100,000, respectively. Over the period from 1990 to 2019, these rates have increased by 98.0%, 48.9%, and 37.7%, respectively. In 2019, the United Arab Emirates, Qatar, and Lebanon had the largest age-standardised incidence, mortality, and DALY rates. The smallest age-standardised incidence rates were seen in Yemen, Afghanistan, and the Syrian Arab Republic. Additionally, the smallest age-standardised mortality and DALY rates were observed in the Syrian Arab Republic, Yemen, and Morocco. The highest incidence rates were found among individuals aged 75–79 in both males and females. In 2019, the MENA/Global DALY ratio exceeded one for females aged 5–19 age and males aged 5–14, compared to 1990age groups in males. The burden of kidney cancer consistently rose with increasing SDI levels from 1990 to 2019. The increasing burden of kidney cancer highlights the urgent need for interventions aimed at improving early diagnosis and treatment in the region. [ABSTRACT FROM AUTHOR]

High systolic blood pressure (HSBP) is associated with several metabolic and non-metabolic disorders. This research aimed to document the deaths and disability-adjusted life-years (DALYs) attributable to HSBP in the Middle East and North Africa (MENA) region between 1990 and 2019, by age, sex, underlying cause and socio-demographic index (SDI). We used the methodological framework and data drawn from the Global Burden of Disease study 2019 to identify the burden of diseases attributable to HSBP, from 1990 to 2019, in the MENA region. The estimates reported were presented as counts, population-attributable fractions, and age-standardised rates (per 100,000), along with 95% uncertainty intervals. In 2019, 803.6 thousand (687.1 to 923.8) deaths were attributed to HSBP in MENA, which accounted for 25.9% (22.9–28.6%) of all deaths. The number of regional DALYs caused by HSBP in 2019 was 19.0 million (16.3–21.9 million), which accounted for 11.6% (10.1–13.3%) of all DALYs, and was 23.4% (15.9–31.5%) lower than in 1990. The highest age-standardised DALY rate for 2019 was observed in Afghanistan, with the lowest in Kuwait. Additionally, the DALY rate in MENA rose with age for both sexs. Furthermore, a negative linear relationship was found between SDI and the age-standardised DALY rates. The region has a substantial HSBP-related burden. Policymakers and healthcare professionals should prioritize interventions that effectively promote the early detection of HSBP, access to quality healthcare, and lifestyle modifications to mitigate the HSBP burden in the MENA countries. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is one of the leading causes of disability. We aimed to report the MDD-attributable prevalence, incidence and years lived with disability (YLDs) in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex and socio-demographic index (SDI). Methods: Publicly available data on the burden of MDD were retrieved from the Global Burden of Disease (GBD) study 2019 for the 21 countries in MENA. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. Results: In 2019, MDD had an age-standardised point prevalence of 3322.1 and an incidence rate of 4921.7 per 100,000 population in MENA. Furthermore, there were 4.1 million YLDs in 2019. However, there were no substantial changes in the MDD burden over the period 1990–2019. In 2019, Palestine had the highest burden of MDD. The highest prevalence, incidence and YLDs attributable to MDD were found in the 35–39 age group. In 2019, the YLD rate in MENA was higher than the global rate for almost all age groups. Furthermore, there was a broadly negative association between the YLD rate and SDI. Conclusion: The study highlights the need to prevent the disorder using a multidisciplinary approach and for the provision of cost-effective treatments for those affected, in order to increase their quality of life. [ABSTRACT FROM AUTHOR]

Schizophrenia ranks as the third-most common cause of disability among mental disorders globally. This study presents findings on the prevalence, incidence and years lived with disability (YLDs) as a result of schizophrenia in the Middle East and North Africa (MENA), stratified by age, sex and sociodemographic index (SDI). We collected publicly accessible data from the Global Burden of Disease (GBD) study 2019. This study reports the burden of schizophrenia, from 1990 to 2019, for the 21 countries that comprise MENA. In 2019, MENA exhibited an age-standardised point prevalence of 248.2, an incidence rate of 14.7 and an YLD rate of 158.7 per 100,000, which have not changed substantially between 1990 and 2019. In 2019, the age-standardised YLD rate was highest in Qatar and lowest in Afghanistan. No MENA countries demonstrated noteworthy changes in the burden of schizophrenia from 1990 to 2019. Furthermore, in 2019, the highest number of prevalent cases and the point prevalence were observed among those aged 35–39, with a higher prevalence among males in almost all age categories. Additionally, in 2019, the age-standardised YLD rates in MENA were below the worldwide average. Finally, there was a positive correlation between the burden of schizophrenia and the SDI from 1990 to 2019. The disease burden of schizophrenia has remained relatively stable over the past thirty years. Nevertheless, as the regional life-expectancy continues to increase, the burden of schizophrenia is also expected to rise. Therefore, early planning for the increase in the burden of the disease is urgently needed in the region. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a catastrophic contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Electrolyte disturbances are common complications of COVID-19. The present article examined the potential mechanisms of hypokalemia and hyperkalemia in patients suffering from COVID-19, in order to raise awareness of potassium disorders in SARS-CoV-2 infections. PubMed, Scopus, and Google Scholar were searched with keywords, such as "COVID-19", "SARS-CoV-2", "2019-nCoV", "Hypokalemia", "Hyperkalemia", "Serum potassium", and "Etiology", "Pathophysiology" up to April 20, 2021 without any search filters. We included articles that proposed potential mechanisms for potassium abnormalities in COVID-19 patients. Furthermore, we used backward and forward citation searching. Potassium abnormalities are considered to be important electrolyte disturbances, with reported incidences ranging from < 5% to > 50% in patients affected by SARS-CoV-2. Therefore, understanding the etiologies of potassium abnormalities could help to improve disease outcome. Utilization of ACE2 by SARS-CoV-2 in the renal cells, viral-induced tubular injury, and gastrointestinal abnormalities, such as anorexia, diarrhea, and vomiting may predispose COVID-19 patients to developing hypokalemia. Furthermore, depleted magnesium levels make hypokalemia refractory to treatments. In addition, hyperkalemia may occur because of reduced urinary output, as a consequence of renal failure. Changes in blood pH and medication-induced side-effects are other possible reasons for the deviation of potassium levels from the normal range. The etiology of potassium abnormalities in COVID-19 patients is multifactorial. Therefore, the early detection and management of potassium disorders is vital and would improve the outcome of patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background: There are several types of dermatitis, each capable of causing enduring changes that extend beyond physical discomfort. In severe cases, dermatitis can significantly affect mental health, social interactions, and the overall quality of life. This study reports the burden of dermatitis in the Middle East and North Africa (MENA) region from 1990 to 2019, according to sex, age category, and socio-demographic index (SDI). Methods: Publicly available data regarding the point prevalence, incidence, and years lived with disability (YLDs) were collected from the Global Burden of Disease 2019 study for both the MENA region and its constituent countries. The point prevalence, incidence, and YLDs of dermatitis were represented as counts and age-standardised rates with 95% uncertainty intervals (UIs). Results: In 2019, the age-standardised point prevalence of dermatitis was 2744.6 (2517.8–3003.1) per 100,000 population, which was 2.3% lower than in 1990. The YLD rate was 92.3 (55.6–143.4) per 100,000 population, which was 3.1% lower than in 1990. The largest point prevalence rates were observed among those aged 70–74, for both sexes. The 2019 MENA/Global DALY ratio was not above one in any age group for either sex. During the period 1990 to 2019, there was no clear correlation between the burden of dermatitis and the SDI level. Conclusion: The dermatitis burden in the MENA region remained relatively stable from 1990 to 2019. Future prevention efforts should focus on improving healthcare access, health education, and workplace safety regulations. [ABSTRACT FROM AUTHOR]

Long Covid-19 syndrome (LCS) manifests with a wide range of clinical symptoms, yet the factors associated with LCS remain poorly understood. The current study aimed to investigate the relationships that demographic characteristics, clinical history, laboratory indicators, and the frequency of HLA-I alleles have with the likelihood of developing LCS. We extracted the demographic characteristics and clinical histories from the medical records of 88 LCS cases (LCS+ group) and 96 individuals without LCS (LCS− group). Furthermore, we evaluated the clinical symptoms, serum levels of interleukin (IL)-6 and tumor necrosis factor-α, laboratory parameters, and the frequencies of HLA-I alleles. Following this we used multiple logistic regression to investigate the association these variables had with LCS. Subjects in the LCS+ group were more likely to have experienced severe Covid-19 symptoms and had higher body mass index (BMI), white blood cell, lymphocyte counts, C-reactive protein (CRP), and IL-6 levels than those in the LCS− group (for all: P < 0.05). Moreover, the frequencies of the HLA-A*11, -B*14, -B*38, -B*50, and -C*07 alleles were higher in the LCS+ group (for all: P < 0.05). After adjusting for the most important variables, the likelihood of suffering from LCS was significantly associated with BMI, CRP, IL-6, the HLA-A*11, and -C*07 alleles, as well as a positive history of severe Covid-19 (for all: P < 0.05). Our study showed that a history of severe Covid-19 during the acute phase of the disease, the HLA-A*11, and -C*07 alleles, higher BMI, as well as elevated serum CRP and IL-6 levels, were all associated with an increased likelihood of LCS. [ABSTRACT FROM AUTHOR]

Despite the fact that mobile phones have been transformed over the last decade into information and communication hubs that are fundamental to modern life, there is little information on how this has impacted on mobile phone use while driving. The present study was conducted in Ukraine, where this risky behaviour remains a common driving practice, despite legislative bans. A total of 220 (male = 82%; mean age = 35.53; SD = 10.54) drivers completed an online survey assessing frequency of engaging in a range of mobile phone applications while driving. Four variables of the theory of planned behaviour (general attitude and intention towards phone use while driving, social norms towards mobile phone use, perceived behavioural control, the specific beliefs about being able to engage in distracting activities and drive safely), and type A behaviour pattern were also collected. The results showed that, during the last year, 65% of drivers had read a text message and 49% had written a text using mobile phone applications. Likewise, a substantial proportion of the sample reported using social media while driving, by checking (34%), sending or typing a post (25%) on social network applications. Hierarchical stepwise regressions showed that a positive attitude towards mobile phone use while driving and beliefs about being able to drive safely and write or read a text message were significantly associated with the mobile phone applications use while driving. No associations were found between the type A behaviour pattern and mobile phone applications use. [ABSTRACT FROM AUTHOR]

• Three measures of different aspects of driving anxiety are examined. • The Driving Cognitions Questionnaire measures driving anxiety-related cognitions. • The Driving Situations Questionnaire measures anxiety and avoidance in driving situations. • The Driving Behavior Survey measures anxious driving behaviour. • The measures are promising for use in supporting research and clinical practice. Driving anxiety is a common experience that can have a significant impact on everyday functioning, especially avoidance of driving and travelling in a car. The heterogeneity of driving anxiety means that treatment often needs to address multiple areas of anxiety, cognition, and behaviour, and psychometric measures are an important part of individualised treatment and outcome measurement. There are several measures of driving anxiety, but their psychometric properties in non-clinical samples have not been adequately researched. The present study investigated the psychometric properties of three measures of driving anxiety, the Driving Cognitions Questionnaire (DCQ), Driving Situations Questionnaire (DSQ), and Driving Behavior Survey (DBS). In total, 420 participants from the New Zealand electoral roll completed a survey containing the three measures of driving anxiety, a measure of aberrant driving behaviour (the Driver Behaviour Questionnaire) and demographic and descriptive variables. The three driving anxiety scales demonstrated strong concurrent validity and the DSQ had strong discriminant validity. However, the discriminant validity findings for the DCQ and DBS were mixed. Further research is needed to evidence the psychometric properties of these measures of driving anxiety, so they can be of maximum benefit in designing tailored psychological treatment approaches. [ABSTRACT FROM AUTHOR]

The immune system is tightly regulated to prevent immune reactions to self-antigens and to avoid excessive immune responses during and after challenges from non-self-antigens. Inhibitory immune checkpoints (IICPs), as the major regulators of immune system responses, are extremely important for maintaining the homeostasis of cells and tissues. However, the high and sustained co-expression of IICPs in chronic infections, under persistent antigenic stimulations, results in reduced immune cell functioning and more severe and prolonged disease complications. Furthermore, IICPs-mediated interactions can be hijacked by pathogens in order to evade immune induction or effector mechanisms. Therefore, IICPs can be potential targets for the prognosis and treatment of chronic infectious diseases. This is especially the case with regards to the most challenging infectious disease of recent times, coronavirus disease-2019 (COVID-19), whose long-term complications can persist long after recovery. This article reviews the current knowledge about the kinetics and functioning of the IICPs during and post-COVID-19. [ABSTRACT FROM AUTHOR]

Background: As a poly-ADP ribose polymerase (PARP) inhibitor, veliparib has been identified as a potential therapeutic agent for lung cancer. The present study aimed to conduct a systematic review of clinical trials investigating the efficacy and safety of veliparib for treating lung cancer. Methods: PubMed, Scopus, the Web of Science, and Google Scholar were systematically searched up to October 30, 2022. Only randomized controlled trials (RCTs) evaluating the efficacy or safety of veliparib in the treatment of lung cancer patients were included. Studies were excluded if they were not RCTs, enrolled healthy participants or patients with conditions other than lung cancer, or investigated therapeutic approaches other than veliparib. The Cochrane risk-of-bias tool was used for quality assessment. Results: The seven RCTs (n = 2188) showed that patients treated with a combination of veliparib and chemotherapy had a significantly higher risk of adverse events, when compared to the control arm. There was no statistically significant difference in overall survival (OS) between those treated with veliparib plus chemotherapy and those receiving the standard therapies. Only two trials demonstrated an improvement in progression-free survival (PFS), and only one study found an increase in objective response rate (ORR). Furthermore, adding veliparib to standard chemotherapy showed no benefit in extending the duration of response (DoR) in any of the studies. Conclusions: Only a small number of studies have found veliparib to be effective, in terms of improved OS, PFS, and ORR, while the majority of studies found no benefit for veliparib over standard treatment. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), can manifest itself in several ways, including coagulopathy and thrombosis. These complications can be the first and sometimes only manifestations of SARS‐CoV‐2 infection and can occur early or late in the course of the disease. However, these symptoms are more prevalent in hospitalized patients with venous thromboembolism, particularly those admitted to intensive care units. Moreover, various forms of arterial and venous thrombosis, or micro‐ or macro‐vasculature embolisms, have been reported during the current pandemic. They have led to harmful consequences, such as neurological and cardiac events, nearly all resulting from the hypercoagulable state caused by this viral infection. The severe hypercoagulability observed in patients with COVID‐19 accounts for most cases of the disease that become critical. Therefore, anticoagulants seem to be one of the most vital therapeutics for treating this potentially life‐threatening condition. In the current paper, we present a thorough review of the pathophysiology of COVID‐19‐induced hypercoagulable state and the use of anticoagulants to treat SARS‐CoV‐2 infections in different patient groups, as well as their pros and cons. [ABSTRACT FROM AUTHOR]

Background and Aim: Globally, pancreatic cancer is recognized as one of the most lethal types of cancers. We report the burden of pancreatic cancer and its attributable risk factors in the Middle East and North Africa (MENA) region, from 1990 to 2019, by age, sex, and socio‐demographic index. Methods: Publicly available data from the Global Burden of Disease 2019 study were used to report the incidence, deaths, and disability‐adjusted life years (DALYs) attributable to pancreatic cancer, as counts and age‐standardized rates with 95% uncertainty intervals. Results: In 2019, pancreatic cancer had an age‐standardized incidence rate of 5.3 and a death rate of 5.5 (per 100 000) in MENA, which have increased by 97.5% and 93.4%, respectively, since 1990. There were 563.6 thousand DALYs attributable to pancreatic cancer in 2019, with an age‐standardized DALY rate of 123.0, which has increased by 84.9% since 1990. The highest number of incident cases was found in the 60–64 and 65–69 age groups, among male and female, respectively. In addition, the MENA/global DALY ratios were higher in all age groups for both sexes in 2019, than they were in 1990. There was a positive association between socio‐demographic index and the burden of pancreatic cancer. Smoking, high fasting plasma glucose, and high body mass index were responsible for 19.2%, 9.3%, and 9.3% of the attributable DALYs in 2019, respectively. Conclusions: There was a clear and substantial increase in the burden of pancreatic cancer in the MENA region. Prevention programs should be implemented in the region that target these three risk factors. [ABSTRACT FROM AUTHOR]

Previous research has found that using a mobile phone while driving has a detrimental effect on driver safety and performance. The present study used the Theory of Planned Behaviour (TPB) to examine a number of factors thought to be related to intentions to send or read text messages while driving. A total of 298 Polish drivers completed a survey that included measures of the TPB components related to intentions to send or read text messages in four different scenarios. The scenarios differed according to whether or not the drivers were waiting at traffic lights or travelling at 100 km/h and according to whether or not they were under time pressure. The research found that Attitudes and Perceived Behavioural Control were positive predictors of general intentions to use a mobile phone while driving. Similarly, Attitudes consistently predicted intentions to send and read text messages across the four scenarios. The findings of this study could be utilised for developing an educational campaign aimed at promoting more positive attitudes toward road safety and at reducing intentions to use mobile phones while driving. [ABSTRACT FROM AUTHOR]

This study aimed to further understand the relationships between sex, gender identity, trait and state driving anger and situational appraisals made while driving, and to validate the 33-item Driving Anger Scale (DAS) in a sample of drivers from France. In total, 378 drivers (males = 38%) aged from 18 to 79 years completed a survey containing the 33-item DAS, the Bem Sex-Role Inventory (BSRI) and eight questions regarding self-reported state anger and appraisals in relation to a recalled recent anger provoking situation experienced while driving. Confirmatory Factor Analysis supported the original six-factor structure of the 33-item DAS. Moreover, Structural Equation Modelling of the factors associated with the recalled anger event showed that trait anger influenced state anger through negative appraisal tendencies, and this was influenced by both sex and gender roles. Females and those reporting more masculine traits tended to have higher levels of trait driving anger. Conversely, drivers with feminine traits had low state anger except if they negatively appraised the situation. This new model could be taken into consideration for developing interventions to reduce anger and “road rage” incidents. [ABSTRACT FROM AUTHOR]

Background: The present study reported the cancer deaths and disability‐adjusted life years (DALYs) that were attributable to high fasting plasma glucose (HFPG) in the Middle East and North Africa (MENA) region by country, age, sex, cancer type and Socio‐demographic Index (SDI), from 1990 to 2019. Methods: Global Burden of Disease (GBD) 2019 data were used to report the cancer‐related deaths and DALYs that were attributable to HFPG, for all MENA countries over the period 1990–2019. The results were presented as numbers, population attributable fractions (PAFs) and rates (per 100,000) with 95% uncertainty intervals. Results: In 2019, there were an estimated 19.8 thousand (5.5–40.2) cancer deaths attributable to HFPG in MENA, which represents 4.7% (1.3–9.3) of all cancer‐related deaths. The number of regional DALYs due to HFPG‐related cancers was 462.2 thousand (127.3–959.5), which represents 3.8% (1.1–7.6) of all cancer‐related DALYs in 2019. From 1990 to 2019, the age‐standardized DALY rate of cancers attributable to HFPG (per 100,000) grew from 56.3 (14.6–121.1) to 107.0 (29.8–220.8), which was a 90.1% (64.4–127.8) increase. In 2019, the highest age‐standardized DALY rate of cancers attributable to HFPG was in Qatar (270.4) and the lowest was in Sudan (75.3). The DALY rate of cancers attributable to HFPG increased with age, peaking for males in the 70–74 age group and for females in the 75–79 age group, and then decreased for both sexes. A broadly positive relationship was found between the national SDI and the national age‐standardized DALY rate of all cancers attributable to FPG over the measurement period. Conclusions: The burden of HFPG‐related cancers has increased over the past three decades in MENA, and was higher than the global average in multiple age groups. Implementing a battery of preventive measures and therapeutic interventions is suggested to address the adverse effects of this modifiable risk factor. [ABSTRACT FROM AUTHOR]