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\nPRACTICE IMPLICATIONSSeveral studies have suggested a high prevalence of violence in young people’s romantic relationships. A significant gap in knowledge persists, however, regarding how young people in special residential homes for youth (SRHY) in Sweden characterize and communicate about the violence they experience in their relationships, as well as how they describe societal responses to such violence within their networks, including from professionals. Sixteen in-depth interviews were conducted with girls from three different SRHYs using Hydén’s “teller-focused” approach. Responses varied based on the girls’ personal networks and professional connections. A common denominator, however, is that the girls had disclosed the violence, described as exceptionally severe, to any external person to only a limited extent. Many of them shared their experiences of victimization for the first time during the interview, prompting a reconsideration and clarification of the relational aspects of the interview procedure and resulting in the conceptualization of a new interview procedure: the relational interview approach. This approach has implications for the practicalities of engaging in a conversation with a young person who has experienced violence.Youth engaging in risk behaviors may be exposed to IPV, but their vulnerability risks go unnoticed.Social services need to be able to detect IPV exposure among youth at special residential homes.Youth IPV needs to be addressed at special residential homes for youth and staff need more education regarding IPV.Youth engaging in risk behaviors may be exposed to IPV, but their vulnerability risks go unnoticed.Social services need to be able to detect IPV exposure among youth at special residential homes.Youth IPV needs to be addressed at special residential homes for youth and staff need more education regarding IPV. [ABSTRACT FROM AUTHOR]

Disasters are increasing in frequency and intensity due to climate change. Youth are the largest and most vulnerable group exposed to disasters. More evidence is needed regarding how youth mental health and health behaviors vary based on disaster exposure, how mental health influences health behaviors, and how diverse groups of youth may be differentially affected. Using data from the Youth Risk Behavior Survey and Federal Emergency Management Agency, we examined the impact of Hurricane Sandy (2012) on mental health (sadness, suicidality) and health behaviors (substance use, physical activity, screen time, sexual behaviors) of 240,365 youth. Difference-in-differences regression analyses evaluated pre-disaster (2005–2011) and post-disaster (2013–2019) changes. There were 83,442 (34.7 %) adolescents (51.2 % female, 18.1 % non-Hispanic White) located in 6 districts exposed to Hurricane Sandy and 156,923 (65.3 %) adolescents located in 13 non-exposed districts. Exposure was associated with differences in substance use, physical (in)activity, and risky sexual behaviors, but not mental health outcomes. Mental health did not moderate the association between disaster exposure and health behaviors. Hispanic adolescents and those identifying as Other races/ethnicities were most vulnerable to post-disaster negative health outcomes. Study limitations include questionnaire design, cross-sectional data, sampling, and possible response biases. Findings provide critical information about youth mental health and health behaviors following disasters, as well as how youth may differ in their responses. Findings provide guidance for early identification and resource allocation for youth at higher risk for post-disaster health issues. • We evaluated Hurricane Sandy's impact on adolescent health using difference-in-difference logistic regression models. • No association found between Hurricane Sandy exposure and mental health outcomes (depression, suicidality). • Exposure was linked to changes in substance use, physical (in)activity, and risky sexual behaviors. • Mental health did not moderate the link between disaster exposure and adolescent health. • Youth in areas exposed to the hurricane demonstrated smaller decreases in smoking and larger increases in cannabis use. • Adolescents identifying as Hispanic and Other races were at the highest risk for adverse health outcomes. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusions While headache disorders are linked to low physical activity levels, the impact of depression on this relationship is unclear.To assess how single and comorbid diagnoses of migraine and tension‐type headache (TTH) interact with depression and leisure‐time physical activity (LTPA) levels in The Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil).In this cross‐sectional analysis based on the ELSA‐Brasil baseline data, the relationship of migraine, TTH (both assessed with the International Classification of Headache Disorders, Second Edition), and depression (assessed with the Clinical Interview Schedule–Revised) with LTPA levels (International Physical Activity Questionnaire) was investigated by employing linear regression models. Models were adjusted for sociodemographic, lifestyle, and clinical covariates, and interaction terms were created to examine additive effects of comorbid conditions.Among 14,088 participants, 54.4% (7668/14,088) were female, prevalence rates were: TTH = 39.6% (5573/14,088), migraine = 27.0% (3806/14,088), depression = 0.7% (94/14,088), depression + TTH = 1.1% (148/14,088), and depression + migraine = 2.5% (356/14,088). The mean (standard deviation) LTPA levels across the groups were: no headache + no depression = 148.7 (183.0) min/week, TTH = 133.5 (170.1) min/week, migraine = 110.3 (154.8) min/week, depression = 76.5 (146.3) min/week, depression + TTH = 84.5 (127.7) min/week, and depression + migraine = 64.3 (123.2) min/week. Negative associations were found for depression (β = −55.1, 95% confidence interval [CI] −93.6 to −17.0; p = 0.005), migraine (β = −24.7, 95% CI −33.2 to −15.4; p < 0.001), and TTH (β = −15.5, 95% CI −23.1 to −7.6; p < 0.001) with LTPA. No interaction effect was observed for depression + TTH (β = 36.0, 95% CI −12.6 to 84.6; p = 0.147) and depression + migraine (β = 31.7, 95% CI −11.3 to 74.7; p = 0.149), indicating no additive effect of comorbid conditions on LTPA levels. After adjusting for headache attack frequency, only depression + migraine remained negatively associated with LTPA (β = −38.7, 95% CI −71.6 to −5.8; p = 0.021).Headache disorders and depression were independently and inversely associated with LTPA, with the strongest effects seen in depression alone or comorbid with migraine. [ABSTRACT FROM AUTHOR]

Few evidence-based interventions have been widely adopted in common clinical settings, particularly for opioid-dependent people with HIV (PWH) seeking drug treatment. We developed a brief evidence-based intervention, Holistic Health for HIV (3H+), specifically for ease of implementation and integration within drug treatment settings. In this study, we compared 3H+ to the gold standard, Holistic Health Recovery Program (HHRP+) using a non-inferiority trial. Between 2012 and 2017, 106 participants were randomly assigned to either the brief 3H+ intervention or the gold standard HHRP+. HIV treatment (ART adherence, viral suppression) and risk behaviors (sharing injection equipment, condom use) were compared between the two arms at baseline, end-of-intervention (EOI-12 weeks) and at follow-up (24 weeks). Average treatment effect was calculated based on the difference-in-difference (DID) estimator and a non-parametric bootstrap was used to assess non-inferiority. At the 12-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to multiple outcomes: percent sharing syringes and needles (DID:1.4, 95%CI [-18.6,21.5], p<0.01) and attainment of high ART adherence (DID: 9.7, 95%CI: [-13.1, 32.2], p = 0.04). At the 24-week EOI point, 3H+ was found to be non-inferior to HHRP+ with respect to percent sharing syringes and needles (DID: 8.9, [-10.1, 28.30], p = 0.04) and attainment of viral suppression (DID: 18.9, 95% CI:[-7.1, 42.0], p = 0.01). For other indicators, such as consistent condom use, the hypothesis test for non-inferiority was inconclusive at the 12-week EOI (DID: -20.2, 95%CI [-48.9–10.7], p = 0.51). For HIV treatment as prevention to be effective, PWH need to achieve viral suppression. In the absence of this success, they must reduce HIV risk behaviors. The finding that 3H+ was non-inferior to HHRP+ suggests that brief behavioral interventions can be deployed in real world settings to help more efficiently achieve Ending the HIV Epidemic goals. [ABSTRACT FROM AUTHOR]

This study used a structural model to analyze the health beliefs and prevention expectations of consumers in order to better understand their health risk behavior and their experience with restaurant precautionary measures. The findings indicated the perceived severity of COVID-19 during the pandemic led to a significant increase in the consumers’ preventative behaviors. Likewise, the customers’ perceived severity of the COVID-19 threat enhanced their concerns about the safety of restaurant service. Based on the moderating effect, we found that lower trust in restaurant precautionary measures weakened the otherwise positive relationship between the consumers’ perceived severity of the COVID-19 threat and their preventative behavior. Recommendations can help the restaurant prepare for future public health concerns. [ABSTRACT FROM AUTHOR]

Introduction: Adolescence is a key developmental period characterized by increased maladaptive risky behaviors. Two related but distinct constructs, urgency (the tendency to act rashly in response to strong negative or positive emotions) and emotion dysregulation, are important risk factors for engaging in maladaptive risky behaviors. Thus far, research has largely agreed that these two risk factors are highly correlated. However, the causal direction between these constructs is less understood. The goal of the current study is to determine whether urgency predicts emotion dysregulation change among adolescents. Method: This project is an analysis of 544 youth (49.8% female, Mage=14.22, SD=0.52). We tested whether urgency at baseline predicts change in emotion dysregulation over a nine-week period, and whether that relationship differs across boys and girls. Results: Two multigroup latent change score path analyses found that negative, but not positive, urgency significantly predicted emotion dysregulation change (negative urgency: b = -0.57, p =0.001; positive urgency: b =0.22, p =0.06). There was no evidence of moderation by gender. Discussion: This work provides initial evidence of a temporal relationship between higher negative urgency and increased emotion dysregulation. The next step is to determine whether negative urgency imparts risk for maladaptive behaviors through its effect on emotion dysregulation. The long-term goal of this program of research is to design and test interventions to reduce the impact of negative urgency for adolescent risk-taking. [ABSTRACT FROM AUTHOR]

AbstractAimsMethodsResultsConclusionsAging is an inevitable stage in which in addition to physiological and mental changes, perception and awareness decline, and memory functions gradually deteriorate. The aim of this study was to examine the effects of body awareness on fall-related behaviors and fall risk in geriatric individuals.This cross-sectional study was conducted with 176 individuals over 65 years of age who presented to family health centers. Body awareness (BAQ), fall-related behaviors (FaB) and fall risk (Morse) were examined. Statistical significance was accepted as p < 0.05 in the analyzes.There was a moderate, negative, and statistically significant relationship between the Morse and BAQ scores of the participants (r=-0.576) (p < 0.05). There was a moderate, positive, and statistically significant relationship between the BAQ and FaB scores of the participants (r = 0.235) (p < 0.05).The results showed a significant relationship between body awareness levels and fall-related behaviors and fall risk in geriatric individuals. [ABSTRACT FROM AUTHOR]

Adolescence is a time when important changes occur in behavioral development, and previous studies have confirmed the relationship between excessive Internet use and decreased oral health behavior. Our purpose is to identify the indirect effects and behavioral factors of smartphone screen time on the caries symptom experience of adolescents. Using data from the 16–17th Korea youth risk behavior web based survey (2020–2021), we investigated the smartphone screen time of 109,796 students in middle school 1st to high school 3rd. Adolescents who used smartphones more than 6 h per week were 28% more likely to experience caries symptoms than those who used smartphones less than 2 h (odds ratio = 1.28; 95% confidence interval, 1.22–1.35). Those who consumed cariogenic drinks more than once a day were 25% more likely to experience caries symptoms, and those who brushed their teeth less than once a day were 26% more likely to experience caries symptoms (odds ratio = 1.25, 1.26; 95% confidence interval, 1.07–1.46, 1.06–1.51). Excessive smartphone screen time is associated with addictive eating habits and reduced physical activity that increase cariogenic dietary behaviors, and decrease oral health behaviors. It suggests that excessive smartphone use indirectly related to the experience of caries symptoms. [ABSTRACT FROM AUTHOR]

Purpose: College students' academic achievement has crucial implications for their future success. Students' health may be a key determinant of academic performance, but more research is needed to understand this relationship. Design/Setting/Subjects: Secondary analysis of the American College Health Association-National College Health Assessment III pre-COVID-19 Spring 2020 dataset. N = 39 146 undergraduates at 75 higher education institutions (14% mean response rate, comparable with other large-scale national college health surveys). Measures: Self-reported grade point average (GPA) and 33 health behaviors in the categories of dietary behavior, physical activity, sedentary behavior, substance use, sexual risk behavior, violence-related behavior, mental health, and sleep behavior. Analysis: Weighted cross-tabulations examining the association between GPA and health behaviors; multinomial logistic regressions assessing if behaviors predicted GPA, controlling for year, sex/gender, and race/ethnicity. Individual GPA categories were also compared to a D/F referent group. Results: There were gradient trends across GPA categories for A through D/F (18 behaviors) or A through C (12 behaviors) (P <.001). Each health behavior predicted GPA differences (P <.001), except heroin use (P =.052). The A GPA group was significantly different from the D/F GPA group for 27 behaviors (P <.001). In general, protective behaviors corresponded with higher GPAs and most risk behaviors were associated with lower GPAs. Conclusions: There is a link between numerous health behaviors and academic performance. Stakeholders invested in college students' health and academics should engage in mutually beneficial strategies to safeguard students' current and future well-being and success. [ABSTRACT FROM AUTHOR]

Alcohol dependence, influenced by physical activity (PA) and sedentary behavior, lacks clear causal clarity. This study aims to clarify causal relationships by estimating these effects using bidirectional two-sample Mendelian randomization (MR). A bidirectional multivariable two-sample MR framework was employed to assess the causal effects of PA and sedentary behavior on alcohol dependence. Summarized genetic association data were analyzed for four PA-related activity patterns—moderate to vigorous physical activity (MVPA), vigorous physical activity (VPA), accelerometer-based physical activity with average acceleration (AccAve), and accelerometer-based physical activity with accelerations greater than 425 milli-gravities (Acc425)—and three sedentary behavior patterns—sedentary, TV watching, and computer use. The study was expanded to include the examination of the relationship between sedentary behavior or PA and general drinking behavior, quantified as drinks per week (DPW). We obtained summarized data on genetic associations with four PA related activity patterns (MVPA, VPA, AccAve and Acc425) and three sedentary behavior related behavior patterns (sedentary, TV watching and computer use). MR analysis found AccAve inversely associated with alcohol dependence risk (OR: 0.87; 95% CI: 0.80–0.95; p < 0.001), MVPA positively associated (OR: 2.86; 95%CI: 1.45–5.66; p = 0.002). For sedentary behavior and alcohol dependence, only TV watching was positively associated with the risk of alcohol dependence (OR: 1.43; 95%CI: 1.09–1.88; p = 0.009). No causal links found for other physical or sedentary activities. Reverse analysis and sensitivity tests showed consistent findings without pleiotropy or heterogeneity. Multivariate MR analyses indicated that while MVPA, AccAve and TV watching are independently associated with alcohol dependence, DPW did not show a significant causal relationship. Our results suggest that AccAve is considered a protective factor against alcohol dependence, while MVPA and TV watching are considered risk factors for alcohol dependence. Conversely, alcohol dependence serves as a protective factor against TV watching. Only TV watching and alcohol dependence might mutually have a significant causal effect on each other. • Expanded analysis of genetic data links activity patterns to drinking behaviors. • AccAve reduces alcohol dependence risk; MVPA and TV watching increases it. • Lifestyle changes could reduce alcohol dependence risk. [ABSTRACT FROM AUTHOR]

The growing frequency and size of wildfires across the US necessitates accurate quantitative assessment of evolving wildfire behavior to predict risk from future extreme wildfires. We build a joint model of wildfire counts and burned areas, regressing key model parameters on climate and demographic covariates. We use extended generalized Pareto distributions to model the full distribution of burned areas, capturing both moderate and extreme sizes, while leveraging extreme value theory to focus particularly on the right tail. We model wildfire counts with a zero‐inflated negative binomial model, and join the wildfire counts and burned areas sub‐models using a temporally‐varying shared random effect. Our model successfully captures the trends of wildfire counts and burned areas. By investigating the predictive power of different sets of covariates, we find that fire indices are better predictors of wildfire burned area behavior than individual climate covariates, whereas climate covariates are influential drivers of wildfire occurrence behavior. [ABSTRACT FROM AUTHOR]

Introduction: Homelessness is associated with an increased risk of syphilis, HIV, and other STIs and disproportionately impacts sexual and gender minorities. Method: Data for this analysis came from a longitudinal cohort study of 285 urban gay, bisexual, and other men who have sex with men (MSM). The study aimed to (1) describe the prevalence of homelessness over time (2) identify characteristics associated with homelessness, and (3) measure associations between recent homelessness and substance use and STI/HIV risk behaviors three months later. Participants were recruited from clinical and non-clinical settings and attended a baseline visit and study visits every three months for up to 18-months. Data was collected between July 2018 and September 2020. Descriptive analyses and mixed-effects logistic regression models were utilized. Results: One-third of participants (94) reported experiencing homelessness throughout the study. Homelessness was significantly and independently associated with increased risk for future drug/alcohol use before/during sex (aOR: 3.8, 95% CI: 1.7, 8.6), methamphetamine use (aOR: 6.3 95% CI: 2.6, 15.2), injection drug use (adjusted odds ratio (aOR): 3.7, 95% CI: 1.0, 13.1), and sex exchange (aOR: 12.7; 95% CI: 5.5, 29.4). Conclusion: Interventions to reduce homelessness are necessary to lower risk of substance use and STI/HIV risk behaviors. [ABSTRACT FROM AUTHOR]

Most theories of decision making under risk assume that payoffs and probabilities are separable. In the context of a lottery, the subjective value of a prospective outcome (the payoff) is assumed to be independent of the likelihood that the outcome will occur (the probability). In violation of this assumption, we present eight experiments showing that people anticipate less utility from uncertain outcomes than from certain outcomes, even conditional on their realization. The devaluation of uncertain outcomes is observed across different measures of utility (willingness to spend money or time; choice between different options), different populations (student and online samples), and different manipulations of uncertainty. We show that this result does not simply reflect a misunderstanding of the instructions or people's aversion toward a "weird" transaction with unexplained features. We highlight the implications of this phenomenon for empirical investigations of risk preferences and conclude with a discussion of the psychological mechanisms that might drive the devaluation of probabilistic outcomes. This paper was accepted by Yuval Rottenstreich, behavioral economics and decision analysis. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2021.02284. [ABSTRACT FROM AUTHOR]

Some theories in economics and psychology propose that background uncertainty, which is uncertainty that is independent of a person's actual decision, can alter people's risk-taking behavior with respect to that decision. However, previous empirical research mostly relying on single experiments is inconclusive regarding the existence of this effect. Here, we systematically investigate the effect of background uncertainty on decision-making. After reviewing the literature, we argue that two types of background uncertainty should be distinguished: (a) background ambiguity, where the decision maker does not know the probability of the outcomes of the background event, and (b) background risk, where the outcome probabilities are known. We tested the hypotheses (i) that background uncertainty does affect risk-taking in the decision at hand, and (ii) the type of background uncertainty moderates that effect. In four experiments (total N =863), we induced background uncertainty (ambiguity or risk) using different methods and measured risk-taking with multiple behavioral tasks. We did not find a significant effect of background uncertainty on risk-taking behavior. [ABSTRACT FROM AUTHOR]

Background: In the United States (US), incidence of early age of onset colorectal cancer (EOCRC, diagnosed <50 years of age) has been increasing. Using a Bayesian analytic approach, we evaluated the association between county-level ecological factors and survival among individuals with EOCRC and identified hotspot and coldspot counties with unexplained low and high survival, respectively. Methods: Principal component (PC) analysis was used to reduce dimensionality of 36 county-level social, behavioral, and preventive factors from the Centers for Disease Control and Prevention data. Survival information was derived from the Surveillance, Epidemiology, and End Results Program data from January 1, 2000 to December 31, 2019. The association between the identified PCs and survival was evaluated using multivariable spatial generalized linear mixed models. Counties with residual low and high survival (i.e., unexplained by the PCs) were classified as hotspots and coldspots, respectively. Results: Four PCs were used to explain the spatial variability in 5-year survival among 75,215 individuals with EOCRC: PC1) poverty, chronic disease, health risk behaviors (β = -0.03, 95% credible interval (CrI): -0.04, -0.03); PC2) younger age, chronic disease-free, minority status (β = -0.01, 95% CrI: -0.02, 0.00); PC3) urban environment, preventive services (β = 0.02, 95% CrI: 0.00, 0.03); and PC4) older age (-0.04, 95% CrI: -0.06, -0.02). Among individuals with distant malignancies, the residual spatial variability remained high for two US counties: 1) Salt Lake County, UT residents experiencing 26.5% (95% CrI: 1.5%, 47.8%) lower odds of survival [hotspot], and 2) Riverside County, CA residents experiencing 37% (95% CrI: 7.97%, 78.8%) higher odds survival [coldspot] after adjustment for county-level factors. Conclusions: County-level ecological factors are strongly associated with survival among individuals with EOCRC. Yet there is some evidence of survival disparities among individuals with distant malignancies that remain unexplained by the included factors. [ABSTRACT FROM AUTHOR]

With the development of the Shanghai International Shipping Center, the diversity of vehicle types on the highways and arterial roads near Yangshan port is continually increasing. Within such a container port corridor, large container trucks are primarily utilized for mainline transportation. Their larger size and significant inertia would increase psychological pressure on sedan drivers, and elevate their behavior risk. To investigate the effects of container trucks on drivers' visual characteristics and driving behavior as well as to predict driving risk, firstly, this research conducted field tests in four scenarios surrounding the port. Visual characteristics and behavior data of sedan drivers were collected. Secondly, a "Visual‐behavior" chain model was established. The relationship between drivers' visual characteristics, driving behavior, and driving risk was illustrated from the perspective of time‐series behavior patterns. Thirdly, three driving risk prediction models were built with Autoregressive Integrated Moving Average (ARIMA), Long Short‐Term Memory (LSTM), and ARIMA‐LSTM. The results indicate that the ARIMA‐LSTM model shows the most effective prediction performance. This research provides a field‐data comparative analysis of the driving risks influenced by a high proportion of container trucks. The findings contribute to understanding the unique mixed traffic visual environment around large‐scale container ports. [ABSTRACT FROM AUTHOR]

Background: Cyberbullying and health risk behaviors are pervasive issues for secondary vocational students that not only detrimentally impact their academic achievement but also pose a significant threat to overall health. The purpose of this study was to understand the current situation of cyberbullying and health risk behaviors among secondary vocational students in China and to explore the relationships among cyberbullying, self-control, self-control over internet usage, and health risk behaviors through a mediation model. Methods: This was a cross-sectional study. From March to April 2023, a self-administered questionnaire was completed by a cluster sample of 1184 students from grades 1 to 3 at three secondary vocational schools in Jilin Province. The researchers utilized a sociodemographic questionnaire, the Cyberbullying and Cybervictimization Scale (CAV), the Adolescent Health Related Risky Behavior Inventory (AHRBI), the Self-Control Scale (SCS), and the Internet Usage Self-Control Scale (IUSCS-CS) to assess the prevalence and impact of cyberbullying and health risk behaviors. Descriptive statistics, spearman correlation analyses. Finally, the Process plug-in V2.16.3 was used to analyze a mediation model for the data. Results: Among secondary vocational students, 839 individuals (70.86%) experienced cyberbullying and 1036 individuals (87.50%) had one or more health risk behaviors. A chi-square test showed that the differences in cyberbullying incidence were statistically significant (P < 0.05) for being children, type of accommodation, residence, ethnicity, purpose of using the internet, and family composition. Statistically significant differences in health risk behaviors were observed based on gender, type of accommodation, residence, ethnicity, academic achievement, classmate relationships, purpose of using the internet, and family composition (P < 0.05). Health risk behaviors and cyberbullying were correlated (r = 0.60), health risk behaviors and self-control and internet usage self-control were negatively correlated (r = -0.42, -0.50). Mediation analysis indicated that self-control (0.02, 0.08) and internet usage self-control (0.08, 0.17) partially mediated the association between cyberbullying and health risk behaviors. Conclusions: Secondary vocational students exhibit a high prevalence of cyberbullying and health risk behaviors. The study confirmed that self-control and internet usage self-control has an important role in mediating cybeibullying and health risk behaviors. Adolescent health promoters should develop targeted strategies to enhance the self-control of secondary vocational school students to mitigate their engagement in health risk behaviors. [ABSTRACT FROM AUTHOR]

Background and Objectives Methods Results Discussion and Conclusions Scientific Significance Limited evidence guides the efficacy and safety of cannabis for therapeutic purposes (CTP). Healthcare providers lack requisite knowledge to advise and support patients. This study aimed to describe and compare several aspects of initial CTP interactions across different provider types.Adult cannabis consumers (N = 507) from the United States completed an anonymous online survey about their initial CTP interaction with their healthcare provider. Providers were categorized into four groups (Mental Health [MH], Family Medicine [FM], Medical Clinics [MC], and Other Specialty [OS]). Analyses compared several aspects of the interaction (e.g., risk mitigation, recommendations, satisfaction/confidence) across groups.Less than half of the sample reported discussion of cannabis risks (44.0%) or follow‐ups at subsequent visits (46.7%). Recommendations (where to obtain, consumption method, dose, frequency, and authorization) were uncommon (9.7%–25.2%). While the MH group reported the highest rates of risk mitigation behaviors, regression models adjusted for sociodemographic and cannabis characteristics were largely nonsignificant. For recommendations, the MC group was more likely than the MH group to report receiving all recommendations (p < .05). Younger age and greater cannabis‐related problems increased likelihood of risk mitigation and recommendations.CTP interactions focused on risk but generally lacked comprehensive recommendations that could potentially promote safe use. Data from provider perspectives could support the need for CTP guidelines and develop training for healthcare providers to promote safe CTP practices.For the first time, this study explored several aspects of CTP interactions and compared experiences across a variety of providers. [ABSTRACT FROM AUTHOR]

Background: Systematic counseling on behavioral health risk factors (HRFs) may be suitable to promote health among general hospital patients. This study aimed to investigate the openness of patients towards systematic screening and intervention of HRFs, its relation to actual participation in a multi-behavioral intervention, and whether socio-economic characteristics, HRFs and health indicators are related to approval. Methods: All 18- to 64-year-old patients hospitalized in five medical departments at the University Medicine Hospital Greifswald in Germany were asked between May and July 2022 to participate in a survey and in a subsequent pre-post intervention study. Among all eligible patients, 225 (78.9%) participated in the survey. Patients' approval of systematic screening and intervention of HRFs was assessed using five statements with a total sum score of 0–20 (i.e., scores of 0–6, 7–13, 14–20 referring to low, medium and high approval). Associations with intervention participation, socio-economic, behavioral and health-related patient characteristics were analyzed using logistic and multivariable linear regression analyses. Results: The mean total approval of screening and intervention was 13.8 (SD = 4.8). Of the 125/ 73/ 16 patients with high/ medium/ low approval, 88.0%/ 78.1%/ 50.0% participated in the subsequent intervention, respectively. Approval was independent of socio-demographic and -economic characteristics and self-rated general health. Current tobacco smoking was the only HRF negatively (p = 0.02) and diabetes mellitus was the only disease positively (p = 0.01) associated with approval. Conclusion: High approval of HRF screening, which was rather independent of socio-economic characteristics and worse self-rated general health, speaks in favor of proactively approaching and motivating all general hospital patients to participate in health behavior change intervention. Tobacco smokers might need higher efforts to motivate participation than non-smokers. Trial registration: ClinicalTrials.gov Identifier NCT05365269 on May 9, 2022. [ABSTRACT FROM AUTHOR]

Objectives: Examine the prevalence of risk behaviors for the development of eating disorders in academy footballers of the Liga MX, compare sociodemographic data and highlight the participants' perceptions regarding the influence of the sports environment and external pressure on their relationship with food and their bodies. Methods: A cross-sectional study was carried out with 536 footballers (331 men and 205 women) in the categories U14, U16, U18 men and U15, U19 women of Liga MX with prior consent from their clubs and strict confidentiality measures. The data were collected via Google Forms using the Eating Attitudes Test (EAT-26). Results: Of the participants, 13.4% met or exceeded the cut-off point on the EAT-26. The highest prevalence was observed in the Female U19 category. The reflections indicated that the sports environment and external pressure affect the relationship with food and bodies in a significant proportion of participants. Conclusions: The study highlights a high prevalence of risk behaviors for eating disorders in Liga MX football players, with a higher incidence in the female categories, also evidencing a multifactorial etiology. [ABSTRACT FROM AUTHOR]

Background: Understanding the impact of natural disasters on the HIV epidemic in populations with high HIV burden is critical for the effective delivery of HIV control efforts. We assessed HIV risk behaviors, seroprevalence, and viral suppression in a high HIV prevalence Lake Victoria fishing community before and after COVID-19 emergence and lockdown and a severe lake flooding event, both of which occurred in 2020. Methods: We used data from the largest Lake Victoria fishing community in the Rakai Community Cohort Study, an open population-based HIV surveillance cohort in south-central Uganda. The data were collected both prior to (September-December 2018) and after (October-December 2021) COVID-19 emergence and a severe flooding event. Households impacted by flooding were identified via drone data and through consulting village community health workers. The entire study population was subject to extensive COVID-19-related lockdowns in the first half of 2020. Differences in HIV-related outcomes before and after COVID, and between residents of flooded and non-flooded households, were assessed using a difference-in-differences statistical modeling approach. Findings: A total of 1,226 people participated in the pre- and post-COVID surveys, of whom 506 (41%) were affected by flooding. HIV seroprevalence in the initial period was 37% in flooded and 36.8% in non-flooded households. After the COVID-19 pandemic and lockdown, we observed a decline in HIV-associated risk behaviors: transactional sex declined from 29.4% to 24.8% (p = 0.011), and inconsistent condom use with non-marital partners declined from 41.6% to 37% (p = 0.021). ART coverage increased from 91.6% to 97.2% (p<0.001). There was 17% decline in transactional sex (aPR = 0.83, 95% CI: 0.75–0.92) and 28% decline in the overall HIV risk score (aPR = 0.83, 95% CI: 0.75–0.92) among HIV-seronegative participants. We observed no statistically significant differences in changes of HIV risk behavior, seroprevalence, or viral suppression outcomes when comparing those affected by floods to those not affected by floods, in the periods before and after COVID-19, based on difference-in-differences analyses. Interpretation: Despite a high background burden of HIV, the COVID-19 pandemic, and severe flooding, we observed no adverse impact on HIV risk behaviors, seroprevalence, or virologic outcomes. This may be attributed to innovative HIV programming during the period and/or population resilience. Understanding exactly what HIV programs and personal or community-level strategies worked to maintain good public health outcomes despite extreme environmental and pandemic conditions may help improve HIV epidemic control during future natural disaster events. [ABSTRACT FROM AUTHOR]

Background: Studies investigating the association between cannabis use and physical activity have had mixed results. This study provided a population-based assessment while determining how the relationship is affected by variables such as cannabis legalization status and chronic medical conditions. Methods: Behavior Risk Factor Surveillance System (BRFSS) data were used to evaluate the association between cannabis use and physical activity among adults ages 18 years and older in several states and territories of the U.S. during 2016–2022. Adjusted odds ratios (ORs) measuring the relationship between physical activity in the past 30 days (yes vs. no) and cannabis use in the past 30 days (yes vs. no) based on legalization and health status were estimated using logistic regression. Results: Physical activity increased from 73.16% in 2016 to 75.72% in 2022 (3.5% increase) and current cannabis use increased from 7.48% in 2016 to 14.71% in 2022 (96.7% increase). Current cannabis use was 6.5% higher in areas of legalized recreational cannabis (vs. not legal) and 0.7% higher in areas of legalized medical cannabis (vs. not legal). For the combined years, the OR measuring the association between cannabis use and physical activity was 1.24 (95% CI 1.10–1.41), after adjusting for age, sex, race/ethnicity, marital status, employment status, education, smoking status, weight classification, legal status, and chronic medical condition. The adjusted OR was 1.47 (95% CI 1.34–1.62) in areas with legalized recreational and medical cannabis (vs. illegal) and 1.05 (95% CI 0.98–1.12) in areas with legalized medical cannabis only (vs. illegal). Having a medical condition was significantly associated with lower prevalence of physical activity in the adjusted models (overall adjusted OR = 0.79, 95% CI 0.73–0.85). However, this significantly lower odds ratio was insignificant for current cannabis users. Conclusions: Public policy and personal health behaviors may improve with the findings that legal medical cannabis promotes greater physical activity in those experiencing chronic medical conditions and legal recreational cannabis promotes (even more so) greater physical activity in those not experiencing chronic medical conditions. [ABSTRACT FROM AUTHOR]

This study departs from the acknowledged absence of validated measures to assess social and emotional competencies in incarcerated individuals. This is a critical gap given that most available programs aimed at fostering prosocial behavior and reducing antisocial behaviors are theoretically based on enhancing these competencies. This study assessed the psychometric properties of the Social and Emotional Competencies Questionnaire (SEC-Q) in a sample of 219 Portuguese incarcerated males (M age = 37.21 years, SD = 10.61), and to explore the impact of the SEC-Q dimensions on health risk behaviors in this population. The study used confirmatory factor analysis (CFA) to examine the factor structure of the SEC-Q. The four-factor model fitted well to the data (SB χ2 = 267.75; df = 120; Robust CFI = 0.99; Robust RMSEA = 0.06), and, as expected, it includes four dimensions: self-awareness, self-management and motivation, social awareness and prosocial behavior, and decision-making. The four dimensions showed appropriate internal consistency (Cronbach's alpha = 74–81; McDonald's omega = 75–82). Additionally, social and emotional competencies were related to higher self-control (rs=0.45, p <.01) and lower health risk behaviors (rs = − 0.25, p <.01), supporting convergent and divergent validity. Findings from the negative binomial regression suggest that higher social awareness and prosocial behavior is related to less health risk behaviors among incarcerated males. This study is a pivotal step to promote an affordable and valid measure to assess social and emotional competencies among Portuguese justice-involved males. SEC-Q can be an important complementary measure for evaluating the effectiveness of interventions aimed at preventing criminal recidivism. [ABSTRACT FROM AUTHOR]

Background: Traveling to meet sexual partners and substance use are associated with increased risk of infectious disease. It is important to understand what factors may increase substances use or increased infection transmission risk (IITR) sexual behaviors among rural LGBTQ+ individuals.Objective: This study investigates substance use and sexual behaviors associated with increased infection transmission risk among rural LGBTQ+ individuals, and how these are associated with relationship type (friends or romantic partners) and travel distance.Methods: Participants (18 years+, identify as LGBTQ+, and provided a $25 gift card) were recruited from Illinois (25 counties), in 2021. Data included demographics, sexual and drug use behaviors, and assessed how these behaviors varied by relationship type and distance traveled (e.g. when meeting friends out-of-state).Results: The 398 participants were 79.1% White and 12.3% Black. By orientation, 29% heterosexual, 36% gay/lesbian, and 35% bisexual/other. By identity, 43% cisgender male, 51% cisgender female, and 6% genderqueer/other. Alcohol use while visiting out-of-state friends was more frequent among transgender (vs cisgender men; OR = 9.686, 95% confidence interval = 2.123-44.19), and individuals traveling > 1/month (all p < .050). Infection-related sexual behaviors while visiting out-of-state romantic partners was more frequent among prescription medication misuse (all p < .050) and traveling > 1/week (vs < 1/month; OR = 3.399, 95% CI = 1.037-11.144).Conclusion: This study of rural LGBTQ+ identified that alcohol use was associated with travel to visit out-of-state romantic partners, and prescription medication misuse increased infection-related sexual behavior during out-of-state travel. Health professionals can develop substance use and increased infection transmission risk sexual behavior interventions on gender minority groups in rural areas and target those who are traveling. [ABSTRACT FROM AUTHOR]

Introduction: In the early days of the COVID-19 pandemic, individuals were asked to perform costly actions to reduce harm to strangers, even while the general population, including authorities and experts, grappled with the uncertainty surrounding thenovel virus. Many studies have examined health decision-making by experts, but the study of lay, non-expert, individual decisionmaking on a stranger's health has been left to the wayside, as ordinary citizens are usually not tasked with such decisions. Methods: We sought to capture a snapshot of this specific choice behavior by administering two surveys to the general population in the spring of 2020, when much of the global community was subject to COVID-19-related restrictions, as well as uncertainty surrounding the virus. We presented study participants with fictitious diseases varying in severity that threatened oneself, a loved one or a stranger. Participants were asked to choose between treatment options that could either provide a sure, but mild improvement (sure option) or cure the affected person at a given probability of success (risky option). Results: Respondents preferred gambles overall, but risk-seeking decreased progressively with higher expected severity of disease. This pattern was observed regardless of the recipient's identity. Distinctions between targets emerged however whendecisions were conditioned on a treatment's monetary cost, with participants preferring cheaper options for strangers. Discussion: Overall, these findings provide a descriptive model of individual decision-making under risk for others; and inform on the limits of what can be asked of an individual in service to a stranger. [ABSTRACT FROM AUTHOR]

Children from disadvantaged families are at greater risk of developing regulation difficulties. Research suggests that family-level resources such as parental education or income are related to self-regulation development. However, most studies looking at the role of family resources have used single estimators of socioeconomic status or applied a composite score, neglecting that an interplay of resources may affect self-regulation outcomes. In N = 248 at-risk children (Mage: 65.7 months, 51% female), we examined the effect of economic, cultural, and social family resources on behavioral self-regulation in kindergarten. Results showed that family income, maternal education, and available help in child-rearing predicted the Head-Toes-Knees-Shoulders task performance. The results indicate that behavioral self-regulation is associated with different family resources beyond socioeconomic status. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore how the relationship between information-seeking and infection-prevention behaviors through risk perception changes according to the level of trust in the media and government. Methods: The study is a secondary data analysis of data from a cross-sectional national survey of 700 adults living in the community, representing different age groups, genders, and geographic regions. A validated questionnaire was used to assess information-seeking behaviors, trust in media and government, and risk perception to explain infection-prevention behaviors in response to the COVID-19 pandemic. A conditional analysis was conducted using SPSS and PROCESS macro (Model 7) to identify the effect of moderated mediation. Results: The participants were fairly balanced by gender and age group. Most participants learned about COVID-19 through major broadcasts and television (56.7%) followed by internet media (21.7%). Information-seeking and risk perception together explained 17% of the variance in infection-prevention behaviors (F=63.95, p< 0.01). The standardized indirect effect (β=0.04, BootCI 0.02, 0.06) was significant at 95% CI. The moderated mediation index (M=− 0.04, CI − 0.05, − 0.01) indicates that trust in media and government influences the effect of information-seeking on risk perception and infection-prevention behavior even after controlling for age and gender. Conclusion: Information-seeking behaviors affect infection-prevention behaviors directly and indirectly through risk perception. Trust in media and government modulates this relationship, emphasizing the importance of establishing trust to promote effective risk communication and long-term public compliance with infection-prevention practices. Health authorities should focus on building trust through transparent risk communication and integrating diverse media perspectives. Further research is needed to explore the psychological and social mechanisms underlying trust in media and government through qualitative, cross-cultural comparisons. [ABSTRACT FROM AUTHOR]

Background: Artificial light at night (ALAN) is a common phenomenon and contributes to the severe light pollution suffered by more than 80% of the world's population. This study aimed to evaluate the relationship between outdoor ALAN exposure and cardiovascular health (CVH) in patients with diabetes and the influence of various modifiable factors. Methods: A survey method based on the China Diabetes and Risk Factor Monitoring System was adopted. Study data were extracted for 1765 individuals with diabetes in Anhui Province. Outdoor ALAN exposure (nW/cm2/sr) within 1000 m of each participant's residential address was obtained from satellite imagery data, with a resolution of ~1000 m. Health risk behaviors (HRBs) were measured via a standardized questionnaire. A linear regression model was employed to estimate the relationship between outdoor ALAN, HRBs, and CVH. Results: Participants' mean age was 59.10 ± 10.0 years. An association was observed between ALAN and CVH in patients with diabetes (β = 0.205) and exercise (β = −1.557), moderated by HRBs, or metabolic metrics. There was an association between ALAN, ALAN, vegetable intake, and CVH. Conclusions: Exploring the relationship between ALAN exposure and cardiovascular and metabolic health provides policy data for improving light pollution strategies and reducing the risk of cardiovascular and metabolic disease in patients with diabetes. [ABSTRACT FROM AUTHOR]

Families are key in the healthy development of Latinx sexual minority youth (Latinx SMY), a group that experiences behavioral, mental, and sexual health disparities. Despite this, there are no family-based interventions for Latinx SMY and their families to prevent drug use, sexual risk behaviors, and depressive symptoms. The purpose of this pilot study was to evaluate the preliminary impact (i.e., estimated effect sizes) of Familias con Orgullo (FcO) and examine its feasibility and acceptability among 30 Latinx SMY and their parents. Parents and adolescents were randomized to FcO or a control condition and assessed pre/post-intervention. Feasibility was measured based on session completion and effect sizes. Focus groups were conducted to evaluate intervention acceptability. Findings showed promising effects favoring FcO on parent-adolescent communication (d = 0.46) and parental involvement (d = 0.34). There were also promising effects favoring FcO on suicidal thoughts (OR = 0.75) and depression symptoms (OR = 0.69). Finally, 100% of the adolescents in FcO either continued to remain drug-free or transitioned from current use to no use (from baseline to post-intervention) compared to 74% in the control. Effect sizes for condomless sex, parental monitoring, and positive parenting were small. Session completion (above 80%) and focus group findings indicated strong feasibility and acceptability. FcO holds promise for reducing drug use and depressive symptoms and improving family functioning among Latinx SMY. [ABSTRACT FROM AUTHOR]

Objectives: Psychiatric symptoms occur frequently in people living with human immunodeficiency virus (PLWH), which may affect quality of life, sexual risk behavior, and adherence to antiretroviral therapy (ART). Data from large cohorts are limited, and symptoms are often analyzed in isolation. Therefore, we applied a network analysis to assess the interrelatedness of mental health indicators in a large cohort of PLWH. Methods: We included 1615 PLWH on ART. Participants reported on the severity of depression, anxiety, impulsivity, substance use, quality of life, sexual risk behavior, and ART adherence. An Ising network model was constructed to analyze interrelations between mental health indicators and connections with clinical consequences. Results: Our network analysis revealed that symptoms of depression, anxiety, and indicators of impulsivity were interrelated. Substance use was prevalent and strongly connected with sexual risk behavior. Quality of life was most strongly connected with symptoms of depression. Unexpectedly, ART adherence did not display connections with any of the mental health indicators. Conclusion: In PLWH, the interrelatedness between symptoms of depression and anxiety and indicators of impulsivity is high. Mainly, depressive symptoms seem to impact quality of life, which warrants attention for depression in PLWH. We did not observe evidence for the common assumption that patients suffering from psychiatric symptoms are less adherent to HIV treatment. [ABSTRACT FROM AUTHOR]

We examined the associations between the use of different types of media and COVID-19 vaccine hesitancy, as well as risk behaviors of COVID-19 infection, in Japan in late 2021. Cross-sectional surveys were conducted using rapid online surveys of residents in Iwate Prefecture from February 5 to 7, 2021, and from October 1 to 3, 2021. Each individual's risk of acquiring SARS-CoV-2 infection was calculated using a quantitative assessment tool (the microCOVID). Intention to get vaccinated for COVID-19 was assessed by self-report. Usage of five types of media for obtaining COVID-related information was assessed: (1) newspapers, (2) television or radio, (3) internet or news apps, (4) social network services (SNS) (excluding LINE, a popular messaging app), and (5) other. Reliance on SNS did not show significant associations with either intention to get vaccinated or engaging in risky behavior for acquiring COVID-19. Although users of the internet or news apps were marginally significantly less likely to engage in high-risk behavior, significant associations between vaccine hesitancy and the usage of the internet or news apps were found in the middle age and elderly groups (OR [95% confidence interval (CI)] in middle age: 1.55 [1.07–2.23]; in elderly; 9.24 [3.28–26.02]). The differential associations between different types of media use and COVID-19 prevention behaviors may assist in preparing for future pandemic outbreaks. One implication for public health risk communication is audience segmentation, such as emphasizing vaccine safety and effectiveness for older audiences. [ABSTRACT FROM AUTHOR]

There is a need for well-described treatments targeting individuals at risk for suicidal behaviors. The present study aims to investigate the effectiveness of MBCT adapted to individuals who are suicidal (MBCT-S) in a randomized controlled trial, comparing an intervention group receiving MBCT-S and treatment as usual (TAU) with a control group receiving TAU only. Participants who were 18 years or older and experienced suicidal ideation were included. Assessments on suicidal ideation and symptoms associated with suicidal behavior were carried out at baseline, post-treatment, and 12 weeks after the end of the training. When comparing the intervention group with the control group, a significant reduction was found at follow-up in suicidal ideation and depressive symptoms. When focusing on the intervention group only, a significant reduction was found in suicidal ideation, depressive symptoms, hopelessness, worrying, defeat, and entrapment, and a significant increase in mindfulness both at post-treatment and at follow-up. The findings suggest that MBCT-S is a promising suicide-specific intervention as it may have the potential to reduce suicidal ideation and suicide-related components. [ABSTRACT FROM AUTHOR]

Background: Combining pathogen reduction technology (PRT) with blood screening may alleviate concerns over the risk of transfusion‐transmitted infections (TTI) and support changes in blood donor selection to potentially increase blood availability. This study aimed to estimate the residual risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) transfusion‐transmission in Canada after implementing PRT, while eliminating deferrals for sexual risk behaviors. Study Design and Methods: A probabilistic approach that combined Bayesian networks with Monte Carlo simulations was used to estimate the risk of transfusing HIV‐, HBV‐, or HCV‐contaminated blood components. Different scenarios were considered to compare the current residual risk after PRT implementation, with and without donor deferral criteria for sexual risk behaviors. Donor profiles and blood component outcomes were simulated based on a literature review including the prevalence and incidence of HIV, HBV, and HCV in the Canadian blood donor population; the use of current blood screening assays; and HIV, HBV, and HCV blood donor viral loads. Results: In the universal PRT scenario (i.e., with PRT/without deferral criteria), the estimated risks of HIV, HBV, and HCV transmission were significantly lower than those in the currently observed scenario (i.e., without PRT/with deferral criteria). Conclusions: This risk model suggests that PRT for platelets and plasma (and eventually for RBCs when available) significantly reduces the residual risks of HIV, HBV and HCV transfusion‐transmission and could enable the removal of blood donor deferral criteria for sexual risk behaviors. [ABSTRACT FROM AUTHOR]

Background/Objectives: Despite the importance of resistance exercise in older adults, factors associated with participation remain unclear, especially regarding sex differences. This study investigated sociodemographic, behavioral, and comorbidity factors associated with insufficient resistance exercise participation among community-dwelling older adults in Korea, with analyses stratified by sex. Methods: Nationally representative cross-sectional data from 8671 participants aged ≥65 years (3758 men and 4913 women; mean age 72.8) were analyzed using the 6th-8th Korea National Health and Nutrition Examination Surveys (2014–2019). Complex-sample multivariable logistic regression identified factors associated with insufficient resistance exercise overall and by sex. Results: Women had a higher prevalence of insufficient resistance exercise than men (91.27% vs. 71.04%, p < 0.001). Older age groups, particularly those aged ≥80 years (OR: 2.39; 95% CI: 1.86–3.07), and those with lower education (OR: 1.56; 95% CI: 1.33–1.82), rural residence (OR: 1.89; 95% CI: 1.49–2.38), low household income, (OR: 1.45; 95% CI: 1.13–1.88), insufficient aerobic exercise (OR: 1.68; 95% CI: 1.46–1.94), current smoking (OR: 1.70; 95% CI: 1.26–2.29), and diabetes (OR: 1.28; 95% CI: 1.09–1.51) were independently associated with a higher likelihood of insufficient resistance exercise. The association of household income, current smoking, hypertension, and diabetes with resistance exercise adherence showed differences in sex-stratified analyses. Conclusions: Multiple sociodemographic, behavioral, and comorbid factors are linked to resistance exercise adherence among older Koreans. Tailored, sex-specific interventions are needed to promote resistance exercise in this population, informing public health strategies and further research on effective approaches for diverse older adults. [ABSTRACT FROM AUTHOR]

Justice-involved people with substance use disorders are an at-risk population for health risk behaviors, particularly those related to Human Immunodeficiency Virus (HIV) and other sexually transmitted infections. Risk-reduction programs provide correctional agencies with a practical solution in to reducing HIV-related health risks in justice-involved populations. This study compared two interventions (in-prison, group-based WaySafe with self-adminstered, tablet-based StaySafe for people on probation) to determine whether one intervention was more effective than the other in terms of common outcomes. Multi-level analyses compared effect sizes from outcome studies testing WaySafe and StaySafe. Results showed the interventions had similar effects with regard to measures of HIV Knowledge, HIV Services and Testing, and Risk Reduction Skills. Collectively, this study suggests the StaySafe intervention can be used in situations where the more intensive WaySafe intervention is not feasible and affords correctional agencies the flexibility to implement the curriculum that best meets their organization's goals and needs. [ABSTRACT FROM AUTHOR]

• Real-time trust estimation model is proposed, which is dynamic and quantitative, considering the evolution pattern of driver's trust and the perceived risk; • Mathematical modeling and machine learning methods are combined; • A trust-based reminder strategy that aims to enhance the safety of human–machine co-driving is designed; • Driver-in-loop experiment validates the effectiveness in enhancing the safety, maintaining driver's trust and reducing trust biases in human–machine co-driving. The development of automated vehicles (AVs) will remain in the stage of human–machine co-driving for a long time. Trust is considered as an effective foundation of the interaction between the driver and the automated driving system (ADS). Driver's trust miscalibration, represented by under-trust and over-trust, is considered to be the potential cause of disuse and misuse of ADS, or even serious accidents. The estimation and calibration of trust are crucial to improve the safety of the driving process. This paper mainly consists of the following two aspects. Firstly, a dynamic and quantitative trust estimation model is established. A framework for trust estimation is constructed. Driver's perceived risk and behavior features were monitored and a Kalman filter was used to dynamically and quantitatively estimate the driver's trust. We conducted a driver-in-the-loop experiment and generated model parameters through a data-driven approach. The results demonstrated that the model exhibited precision in trust estimation, with the highest accuracy reaching 74.1%. Secondly, a reminder strategy to calibrate the over-trust of the driver is proposed based on the model from the first part. A scenario with four risky events was designed and the ADS would provide voice reminders to the driver when over-trust was detected. The results demonstrated that the reminder strategy proved to be beneficial for safety enhancement and moderate trust maintenance during the driving process. When the driver is over-trusting, the accident rates of the reminder group and the non-reminder group were 60.6% and 13.0%, respectively. Our contribution in this paper can be concluded by four points: (1) A real-time trust estimation model is proposed, which is dynamic and quantitative, considering the evolution pattern of driver's trust and the perceived risk; (2) Mathematical modeling and machine learning methods are combined; (3) A trust-based reminder strategy that aims to enhance the safety of human–machine co-driving is designed; (4) Driver-in-loop experiment validates the effectiveness in enhancing the safety, maintaining driver's trust and reducing trust biases in human–machine co-driving. [ABSTRACT FROM AUTHOR]

The association between sedentary behavior and depression in older adults has been reported in several studies; however, study results on the relationship between the different types of sedentary behavior and depression are not uniform. The purpose of this study was to quantitatively review the association between depression and total sedentary behavior, mentally active sedentary behavior, and passive sedentary behavior. We systematically searched for observational studies on the association between sedentary behavior and depression in older adults using PubMed, Embase, and Web of Science databases. A random effects model was used to combine odds ratios (ORs) and 95 % confidence intervals (CIs). In addition, we performed subgroup and sensitivity analyses to explore potential sources of heterogeneity. Five longitudinal and 10 cross-sectional studies with a total of 144,161 participants were included in the meta-analysis. The OR of total sedentary behavior associated with depression was 1.49 (95 % CI 1.24–1.79). The combined OR value of mentally active sedentary behavior and depression was 0.82 (95 % CI 0.69–0.97), and no association was found between passive sedentary behavior and the risk of depression. We were unable to find dose-response relationships between the different types of sedentary behavior and depression because there were too few studies with raw data to analyze. Total sedentary behavior may increase the risk of depression in older adults, whereas mentally active sedentary behavior is associated with a lower risk of depression. Differentiating between the types of sedentary behavior can inform interventions to prevent or ameliorate depression in older adults. • Total sedentary behavior in older adults was positively associated with depression. • Mentally active sedentary behavior was associated with a decrease in depression. • Passive sedentary behavior was not associated with the occurrence of depression. [ABSTRACT FROM AUTHOR]

Context: Globally, around 17.9 million people annually die due to CVDs, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (2 million).The cause of heart attacks and strokes are due to combination of risk factors- tobacco use, unhealthy diet, obesity, physical inactivity, alcohol use, hypertension, diabetes and hyperlipidaemia. Most cardiovascular diseases can be prevented by addressing these behavioural risk factors. Objectives: 1) To know the life style approach of doctors working in various departments in the institute. 2) To assess cardiovascular risk behaviour of these subjects and to make them alert in preserving their health. Material and Methods: A cross-sectional study was carried out amongst teaching staff of Government Medical College & General Hospital, Ongole, Prakasam district, Andhra Pradesh during the period of August to October 2023. The study was performed 91 teaching staff. A pre – designed, pretested, semi structured questionnaire was used for collecting details on socio-demographic profile, lifestyle related details like diet and physical activity, habits and existing co-morbidities. Results: Majority participants were female 50 (54.9%). The mean age of mean age of female was 37.4 ± 10.22 and male was 42.61 ± 9.54 years. The mean weight (78.90 ± 10.81) and Mean BMI (28.22±4.24) were above the normal range among the male participants. History of hypertension was more common in the 45-54 age group which signifies that age is one of the most important risk factors. History of diabetes mellitus was more in the 45-54 age group followed by 35-44 age group. In the 35-44 age group the high prevalence of diabetes is due to family history of diabetes. Conclusions: This study showed a high prevalence of cardiovascular risk factors and signifies the importance of health awareness among the staff members regarding the various cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background and Aims: Healthcare students are expected to lead healthy lives yet they may engage in health risk behaviors (HRBs) like physical inactivity, poor diet, and substance use. These behaviors can have negative consequences for both the individual's health and well‐being, as well as their ability to perform their future roles as healthcare providers. This study aimed to assess the prevalence of HRBs and associated factors among medical and nursing students at Lumbini Medical College, Nepal. Methods: A cross‐sectional study was conducted among 412 undergraduate healthcare students using a self‐administered questionnaire. HRBs across various domains were assessed. Validated scales screened for anxiety and depression. Regression analyses determined associations between mental health and HRBs. Results: Low physical activity was prevalent, with only 10.7% exercising ≥5 times/week. Inadequate fruit/vegetable intake (1–2 servings/day) was reported by 79.9% students. Short sleep duration (5–6 h) on weeknights (51.2%) was common. More than three quarter (76.5%) of students met the screening cutoff score for HRBs. The study highlighted that students with addiction, depression and anxiety are more likely to exhibit HRBs (p < 0.01). Conclusion: Multiple HRBs were highly prevalent among the students. A considerable proportion demonstrated a clustering of risky lifestyle factors, which were linked to poor mental health. Interventions should address academic burden, promote positive health behaviors, and target mental well‐being in this vulnerable group. [ABSTRACT FROM AUTHOR]

Understanding tourist profiles and behaviors during health pandemics is key to better preparedness for unforeseen future outbreaks, particularly for tourism and hospitality businesses. This study develops and applies a novel data analytics methodology to gain insights into the health risk reduction behavior of restaurant diners/patrons during their dining out experiences in a pandemic. The methodology builds on data relating to four constructs (question categories) and measurements (questions and attributes), with the constructs being worry, health risk prevention behavior, health risk reduction behavior, and demographic characteristics. As a unique contribution, the methodology generates a behavioral typology by identifying risk profiles, which are expressed as one- and two-level decision rules. For example, the results highlighted the significance of restaurants' adherence to cautionary measures and diners' perception of seclusion. These and other factors enable a multifaceted analysis, typology, and understanding of diners' risk profiles, offering valuable guidance for developing managerial strategies and skill development programs to promote safer dining experiences during pandemics. Besides yielding novel types of insights through rules, another practical contribution of the research is the development of a public web-based analytics dashboard for interactive insight discovery and decision support. [ABSTRACT FROM AUTHOR]

An estimated 761,000 children have been orphaned primarily due to HIV/AIDs in Zimbabwe. Being an orphan is one of the adverse childhood experiences (ACEs) that can lead to poor mental health outcomes, including higher levels of mental distress and suicide risk behaviors for vulnerable adolescents and young adults. This study examines the prevalence of orphanhood and its association with mental distress and suicide risk behaviors among adolescents and young adults in Zimbabwe. Data for this study was derived from the Zimbabwe Violence Against Children and Youth Survey (ZVACS). The sample size included 8,715 participants aged 13 to 18 years old. The prevalence of orphanhood was determined using chi-square tests. Four logistic regression models were employed to examine significant association between orphanhood and two outcomes (i.e., mental distress as measured by the Kesler 6 and lifetime suicide risk behaviors). The results showed that the prevalence of being an orphan was higher for adolescents and young adults with primary education or lower (48.4%), experienced moderate/severe mental distress in the past 30 days (45.3%), reported lifetime suicide thoughts/attempted suicide/self-harm (45%), were females (38.5%), and aged 18-24 years old (44.6%), respectively. Additionally, regression results showed that being an orphan was associated with higher odds of reporting moderate/severe mental distress in the past 30 days, and lifetime suicidal thoughts, attempted suicide or self-harming behaviors among adolescents and young adults. This study underscores the need to prioritize mental health interventions, including screenings for mental distress and suicide risk behaviors, as well as providing robust social support to orphans and their families with limited resources. Further research is needed to understand protective and risk factors associated with longitudinal effects of mental distress and suicidal tendencies for vulnerable orphans in Zimbabwe. [ABSTRACT FROM AUTHOR]

Context: Globally, around 17.9 million people annually die due to CVDs, followed by cancers (9.3 million), respiratory diseases (4.1 million), and diabetes (2 million).The cause of heart attacks and strokes are due to combination of risk factors- tobacco use, unhealthy diet, obesity, physical inactivity, alcohol use, hypertension, diabetes and hyperlipidaemia. Most cardiovascular diseases can be prevented by addressing these behavioural risk factors. Objectives: 1) To know the life style approach of doctors working in various departments in the institute. 2) To assess cardiovascular risk behaviour of these subjects and to make them alert in preserving their health. Material and Methods: A cross-sectional study was carried out amongst teaching staff of Government Medical College & General Hospital, Ongole, Prakasam district, Andhra Pradesh during the period of August to October 2023. The study was performed 91 teaching staff. A pre – designed, pretested, semi structured questionnaire was used for collecting details on socio-demographic profile, lifestyle related details like diet and physical activity, habits and existing co-morbidities. Results: Majority participants were female 50 (54.9%). The mean age of mean age of female was 37.4 ± 10.22 and male was 42.61 ± 9.54 years. The mean weight (78.90 ± 10.81) and Mean BMI (28.22±4.24) were above the normal range among the male participants. History of hypertension was more common in the 45-54 age group which signifies that age is one of the most important risk factors. History of diabetes mellitus was more in the 45-54 age group followed by 35-44 age group. In the 35-44 age group the high prevalence of diabetes is due to family history of diabetes. Conclusions: This study showed a high prevalence of cardiovascular risk factors and signifies the importance of health awareness among the staff members regarding the various cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

We develop a methodology to decompose the conditional market risk premium and risk premia on higher-order moments of excess market returns into risk premia related to contingent claims on down, up, and moderate market returns. The decomposition exploits information about the risk-neutral market return distribution embedded in option prices, but does not depend on assumptions about the functional form of investor preferences or about the market return distribution. The total market risk premium is highly time-varying, as are the contributions from downside, upside, and central risk. Time-series variation in risk premia associated with each region is primarily driven by variation in risk prices associated with the probability of entering each region at short horizons, but it is primarily driven by variation in risk quantities at longer horizons. Analogous decompositions implied by prominent representative agent models generally fail to match the dynamic risk premium behavior implied by the data. Our results provide a set of new empirical facts regarding the drivers of conditional risk premia and identify new challenges for representative agent models. This paper was accepted by Lukas Schmid, finance. Supplemental Material: The internet appendix and data files are available at https://doi.org/10.1287/mnsc.2022.01663. [ABSTRACT FROM AUTHOR]

Environmental risk issues pose a threat to human life and well-being. In order to reduce environmental risks, environmental risk response strategies have become increasingly vital. As the group most affected by environmental risks, the public environmental risk coping behaviors affect the effectiveness of environmental risk management. However, the public adoption of such behaviors mainly depends on their willingness. Therefore, the key to effective governance lies in guiding the public to voluntarily adopt appropriate environmental risk coping behaviors. The theory of environmental psychology provides relevant references for this. The internal psychological motivations of the public (including attitudes and subjective norms etc.) affect their choices of environmental risk behavior. The main purpose of this research is to explore the determinants underlying environmental risk coping behaviors using extending the theory of planned behavior by additional constructs (trust, risk perception, interaction satisfaction). The research applies a questionnaire survey method to collect data from the public living in the vicinity of two locations in China—an industrial area and a waste incineration plant in a Chinese city. The result of SEM shows that the public's trust in governments has a positive influence on the intention to collaborate, while the public's trust in the government and enterprises is negatively correlated with their intention to engage in confrontational behavior. Also, there is a positive correlation between confrontational intention and confrontational behavior, while the intention to cooperate may not necessarily result in collaborative behavior. Risk perception is not related to trust and the intention to collaborate, but it positively affects the intention to confront. The reason for the public to willingly take collaborative actions is not because they have perceived a high level of risk, and the public's high trust in the government can enhance their intention to take collaborative actions. It is thus clear that government credibility plays an important guiding role in public risk responsive behavior. The research findings provide policy recommendations for guiding public environmental risk coping behavior. [ABSTRACT FROM AUTHOR]

Understanding risk tolerance is crucial for predicting and changing behavior across various domains, including health and safety, finance, and ethics. This remains true during a crisis, such as the COVID‐19 pandemic, and leads to a key question: Do current risk measures reliably predict risk‐taking in the drastically different context of a pandemic? The Domain Specific Risk‐Taking (DOSPERT) scale, one of the most widely used risk‐taking measures, assesses self‐reported risk‐taking in response to 30 risky situations across five domains. With the hypothetical risks of the DOSPERT being based on prepandemic circumstances, we estimate that three out of four of its risk‐taking situations were not possible due to preventive measures or did not reflect risk‐taking in times of COVID‐19. In addition, COVID‐19 brought forth new behaviors deemed risky. With an aim to better predict risk‐taking in times of a pandemic, we introduce the Pandemic DOSPERT (PDOSPERT). We summarize three preregistered online studies with 1254 UK participants to validate the scale against the original DOSPERT and three other common risk‐taking measures. We also test its ability to predict pandemic risk‐related behaviors at three points in time over 2 years. Overall, we find that the PDOSPERT scale significantly improves predictions for pandemic‐related risk behavior as compared to the original DOSPERT. In particular, the health/safety subscale is significantly and strongly associated with pandemic‐related risk behavior. We not only validate a pandemic‐specific risk task but also introduce a template for developing context‐ and domain‐sensitive measures for risk‐taking in the future. [ABSTRACT FROM AUTHOR]

Risk behaviors frequently co-occur in adolescence and may share the same risk and protective factors, including parental factors. However, few longitudinal studies analyze this relationship with an approach that considers that adolescents may engage in more than one risk behavior simultaneously, especially in low-and-middle-income countries. Therefore, the present study aimed to extend existing knowledge by (1) identifying different latent patterns of risk behaviors; (2) evaluating whether parental factors (such as parenting styles, parental alcohol use, and parental living status) predicted these patterns of risk behaviors in a sample of Brazilian students. Seventy-two public schools with 6,391 seventh and eighth grade students participated in this longitudinal study. Measures used were collected at baseline and 21 months later. Four latent classes of adolescent risk behaviors (drug use, bullying, and unprotected sex) were identified through latent class analyses: "low-risk behaviors," "high bullying," "high alcohol use and bullying," and "high-risk behaviors." We found that authoritative parenting style is a protective factor for all risk behavior classes, and an indulgent parenting style seems to protect against the "high bullying" group. In addition, maternal drunkenness is a risk factor for adolescents' likelihood of belonging to the "high alcohol use and bullying" and "high-risk behavior" classes. Thus, prevention programs should focus on building positive parenting skills and raising awareness of the parental alcohol abuse effects once they seem to act as a protective factor to different types of risk behaviors simultaneously. [ABSTRACT FROM AUTHOR]

With the wide application of hydrogen, the research related to 70 MPa pressure level hydrogen storage tank is very important. This paper takes the 70 MPa hydrogen storage tank in the hydrogen refueling station as the research object, and analyses the diffusion characteristics of hydrogen after leakage from the tank under different wind conditions by FLUENT. Studies find that after hydrogen ejects to the obstacle by the effect of high-pressure, it transforms to be dominated by the simple diffusion and the wind condition. The ambient wind helps to reduce the volume fraction of hydrogen. This paper proposes risk mitigation measures based on the distribution of the flammable clouds — installing nitrogen outlets and reducing the height of the enclosure. The volume of flammable clouds is reduced from about 2.72 m3 to less than 0.045 m3 after adding measures, which proves the feasibility of the measures. • A hydrogenation station model is established to simulate the leakage of a 70 MPa hydrogen storage tank. • The diffusion of hydrogen under different wind conditions is compared. • Risk mitigation measures based on the distribution of flammable clouds are proposed and validated. [ABSTRACT FROM AUTHOR]

We present the findings from a pilot study to evaluate the effects of a six-week adapted folk-dance intervention on physical and mental health for at-risk adolescents conducted in schools. At-risk adolescents are at particular risk for sedentary behavior, poor mental health, and lower quality of life, and are likely to benefit from motivating and health-promoting activities such as dance. However, it can be challenging to conduct and evaluate evidence-based interventions with this population. We conducted a convergent parallel mixedmethod design using pre-post measures of mental well-being, as well as prepost measures using inertial measurement units to assess physical activity during a 6-week adapted folk-dance intervention. At the completion of the study, we conducted semi-structured interviews with all stakeholder groups. We observed significant improvements in mental well-being, as indicated by increased WEMWBS and MHC-SF scores, while the UCLA score showed no significant change, with these outcomes independent of age and gender. Furthermore, at-risk adolescents reduced the time spent in stationary/resting position, while their heart rates were also reduced by ~15% in such conditions. Our results suggest that at-risk youth who participated in adapted folk-dance became more enthusiastic and showed more willingness to move over the course of the intervention. Quantitative results were supported by interviews, which found that participants responded positively to the adapted folk-dance classes, and reported both elevated physical exertion and high levels of enjoyment. The mixed-method research design also provided insights into the suitability of data collection methods for this hard-to-reach population. We report on these outcomes, including best practices for working within schools on health-promoting physical activities. [ABSTRACT FROM AUTHOR]

Background: The prevalence of clinically diagnosed depressive disorders (DD) in Chinese left-behind children (LBC) remains unknown. We aim to estimate the prevalence of DD, discuss the associations between DD and self-harm (SH) behaviors in a large representative sample of Chinese LBCs chosen from Yunnan province. Methods: A total of 5462 LBCs were selected from the most recent datasets of the Mental Health Survey for Children and Adolescents in Yunnan (MHSCAY), a mega population-based two-phase cross-sectional survey. Weighted prevalence rates and designed Logistic regression were adopted to estimate the prevalence of DD and the association between DD and SH. Results: The weighted prevalence of lifetime and current DD were 4.22% (95% CI: 3.13-6.00%) and 3.84% (95% CI: 2.85-5.00%) in Chinese LBCs. Higher lifetime and current DD prevalence rates were observed in girls and those reported adverse parental marital status and SH behaviors. The absence of DD was associated with significantly decreased odds of SH behavior (OR = 0.06), repetitive SH (OR = 0.09), using multiple SH methods (OR = 0.09), and severe SH (OR = 0.15). Subsequently performed stratified analyses identified prominent effect modification by sex and age, as a stronger association between DD and SH was found in girls (OR = 0.02 versus OR = 0.07 in boys) and younger adolescents (OR = 0.08 versus OR = 0.22 in older adolescents). Conclusion: The prevalence of DD was high in Chinese LBCs. DD was associated with prominently increased risk of SH behaviors in LBCs. Attention and intervention are needed in this vulnerable population. [ABSTRACT FROM AUTHOR]