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1.
BMC Public Health ; 21(1): 1614, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479524

RESUMO

BACKGROUND: Adolescent multiple risk behaviour (MRB) is associated with negative outcomes such as police arrests, unemployment and premature mortality and morbidity. What is unknown is whether MRB is associated with socioeconomic status (SES) in adulthood. We test whether adolescent MRB is associated with socioeconomic status (SES) in young adulthood and whether it is moderated by early life SES variables. METHODS: Prospective cohort studies; British Cohort Study 1970 (BCS70) and Avon Longitudinal Study of Parents and Children (ALSPAC), born in 1991-1992, were used and two comparable MRB variables were derived. Logistic regression was used to determine the association between MRB and young adult SES. The moderating effect of three early life SES variables was assessed using logistic regression models with and without interaction parameters. Evidence to support the presence of moderation was determined by likelihood ratio tests ≤p = 0.05. Multiple imputation was used to account for missing data. RESULTS: Adolescents had a median of two risk behaviours in BCS70 and three in ALSPAC. Adolescent MRB was negatively associated with young adult SES (university degree attainment) in BCS70 (OR 0.81, 95% CI: 0.76, 0.86) and ALSPAC (OR 0.85, 95% CI: 0.82, 0.88). There was a dose response relationship, with each additional risk behaviour resulting in reduced odds of university degree attainment. MRB was associated occupational status at age 34 in BCS70 (OR 0.86 95% CI: 0.82, 0.90). In BCS70, there was evidence that maternal education (p = 0.03), parental occupational status (p = 0.009) and household income (p = 0.03) moderated the effect of adolescent MRB on young adult SES in that the negative effect of MRB is stronger for those with low socioeconomic backgrounds. No evidence of moderation was found in the ALSPAC cohort. CONCLUSIONS: Adolescence appears to be a critical time in the life course to address risk behaviours, due to the likelihood that behaviours established here may have effects in adulthood. Intervening on adolescent MRB could improve later SES outcomes and thus affect health outcomes later in life. Evidence for a moderation effect in the BCS70 but not ALSPAC suggests that more detailed measures should be investigated to capture the nuance of contemporary young adult SES.


Assuntos
Assunção de Riscos , Classe Social , Adolescente , Adulto , Criança , Estudos de Coortes , Humanos , Estudos Longitudinais , Estudos Prospectivos , Fatores Socioeconômicos , Reino Unido/epidemiologia , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-34444307

RESUMO

The COVID-19 outbreak and related restrictions meant a higher incidence of screen-related risk behaviors in both children and adolescents. Our goal was to assess the perceived importance and extent of school-based preventions related to these risks during the long-term, nation-wide distant schooling period in the Czech Republic. The online survey was responded to by the school-based prevention specialists (N = 1698). For the analysis, within-subject analysis of variance (ANOVA) and binominal logistic regression were used. At-risk internet use and cyber-bullying were perceived as pressing, but other risks, for example, excessive internet use or the use of cyberpornography, received substantially less priority. The differences in all grades were significant and moderate to large (η2G between 0.156 and 0.288). The proportion of schools which conducted prevention interventions of screen-related risks was low (between 0.7% and 27.8%, depending on the grade and the type of the risk). The probability of delivering prevention intervention was in all grades significantly predicted by the presence of screen-related problems in pupils (OR 3.76-4.88) and the perceived importance of the screen-related risks (OR 1.55-1.97). The limited capacity of schools to deliver prevention interventions during distant schooling as well as the low awareness and impaired ability to recognize the importance of some screen-related risks should be addressed.


Assuntos
COVID-19 , Adolescente , Criança , Estudos Transversais , Surtos de Doenças , Humanos , Assunção de Riscos , SARS-CoV-2 , Instituições Acadêmicas , Inquéritos e Questionários
3.
Accid Anal Prev ; 160: 106327, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34371286

RESUMO

Young driver speeding behaviour remains a large contributor to road trauma worldwide. In order to provide a more-in depth understanding of how to deter young drivers from this behaviour, this study developed and tested a model of the legal and non-legal factors that influence young driver's intentional speeding behaviour (exceeding the speed limit by more than 10 km/hr). A prospective survey design was conducted to measure the impact of perceptions of legal factors (including classical deterrence and reconceptualised deterrence variables) and non-legal factors (including the variables of fear of physical loss, material loss and perceived social sanctions, as well as the perception that it is safe to engage in the behaviour without being involved in a crash) at time 1, on engagement in speeding behaviour at time 2, which occurred 3 months later. A total of 200 participants aged 17-25 years completed both surveys (Mean age = 20.44 years). Using structural equation modelling, a unique model combining classical and extended deterrence theory, as well as prominent non-legal factors was created, and the variables were able to explain 41% of the variance in speeding behaviour. A high perceived severity of the punishment, experiencing direct punishment avoidance and perceiving that it is safe to speed were significant direct predictors. Meanwhile, there were also numerous significant partially mediated relationships found for both legal and non-legal variables. These findings provide important implications for both the application of deterrence-based theories in road safety and for improving countermeasures to deter young drivers more effectively from engagement in speeding.


Assuntos
Condução de Veículo , Acidentes de Trânsito/prevenção & controle , Humanos , Recém-Nascido , Estudos Prospectivos , Assunção de Riscos , Controle Social Formal , Inquéritos e Questionários
4.
Accid Anal Prev ; 160: 106324, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34371287

RESUMO

The COVID-19 pandemic has led to the implementation of unprecedented public health measures. The effect of these lockdown measures on road safety remain to be fully understood, however preliminary data shows reductions in traffic volume and increases in risky driving behaviors. The objective of the present study is to compare self-reported risky driving behaviors (speeding, distracted driving, drinking and driving, and drugged driving) during the pandemic in Canada and the U.S. to determine what differences exist between these two countries. Data was collected using the Road Safety Monitor (RSM), an annual online public opinion survey that investigates key road safety issues, administered to a representative sample of N = 1,500 Canadian drivers and N = 1,501 U.S. drivers. Respondents were asked about the likelihood of engaging in risky driving during the pandemic as compared to before COVID-19. Results show the majority of respondents indicated their behavior did not change, and most positively, a small proportion reported they were less likely to engage in these risky driving behaviors. However, notable proportions indicated they were more likely to engage in risky driving behaviors during the pandemic, as compared to before COVID-19. Of those who indicated this, U.S. drivers had significantly higher percentages compared to their Canadian counterparts. Behaviors most often reported by this sub-section of drivers who admit to being more likely to engage in risky driving during the pandemic were speeding (7.6%) and drinking and driving (7.6%) in the U.S., and speeding (5.5%) and distracted driving (4.2%) in Canada. Logistic regression results confirm that country was a significant factor, as U.S. drivers had greater odds of reporting they were more likely to engage in these risky driving behaviors, with the exception of speeding. Age also had a significant effect, as increasing age was associated with lower odds of reporting that these risky driving behaviors were more likely during the pandemic. Conversely, sex did not have a significant effect. Overall, the current findings suggest that a small proportion of drivers reported being more likely to engage in risky driving behaviors and the pandemic may have led to changes in the profiles of those drivers engaging in risky driving behaviors during lockdown measures. These results have important implications for policies and can inform how to manage road safety during future lockdowns.


Assuntos
Condução de Veículo , COVID-19 , Acidentes de Trânsito/prevenção & controle , Canadá/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pandemias , Assunção de Riscos , SARS-CoV-2 , Estados Unidos/epidemiologia
5.
Accid Anal Prev ; 160: 106328, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34385086

RESUMO

The prediction of traffic crashes is an essential topic in traffic safety research. Most of the previous studies conducted experiments on real-time crash prediction of expressways or freeways, based on traffic flow data. However, the influence of risky driving behavior on traffic crash risk prediction has rarely been considered. Thus, a traffic crash risk prediction model based on risky driving behavior and traffic flow has been developed. The data employed in this research were captured using the in-vehicle AutoNavigator software. A random forest to select variables with strong impacts on crashes and the synthetic minority oversampling technique (SMOTE) to adjust the imbalanced dataset were included in the research. A logistic regression model was developed to predict the risk of traffic crash and to interpret its relationship with traffic flow and risky driving behavior characteristics. This model accurately predicted 84.48% of the crashes, while its false alarm rate remained as low as 9.75%, which indicated that this traffic crash risk prediction model had high accuracy. By analyzing the relationship between traffic flow, risky driving behavior, and crashes through partial dependency plots (PDPs), the impact of traffic flow and risky driving behavior variables on certain traffic crashes in the prediction model were determined. Through this study, the data of traffic flow and risky driving behavior could be used to assess the traffic crash risk on freeways and lay a foundation for traffic safety management.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Humanos , Modelos Logísticos , Assunção de Riscos , Gestão da Segurança
6.
Artigo em Inglês | MEDLINE | ID: mdl-34444149

RESUMO

Aversive personality traits have been linked to risk-taking across various domains. Herein, we investigated whether the common core of aversive traits, the Dark Factor of Personality (D), is related to risk-taking. Whereas the conceptualizations of D (common core of aversive traits) and risk-taking (not inherently socially and/or ethically aversive) do not necessarily imply an association, several theoretical considerations do suggest a positive relation between the constructs. In three studies (overall n = 689), we linked D to various self-report measures of risk-taking (Studies 1 and 2), as well as to a behavioral risk-taking task (Study 3). Overall, D was positively (although not always statistically significantly) related to self-reported risk-taking in terms of financial, health-related, and recreational risk-taking, fearlessness, novelty sensation seeking, intensity sensation seeking, and drug use. However, we did not find an association between D and behavioral risk-taking. Our findings provide insights into the relation between aversive personality and risk-taking, but also point to inconsistencies depending on the specific nature of risk-taking studied.


Assuntos
Personalidade , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos da Personalidade , Inventário de Personalidade , Assunção de Riscos
7.
FP Essent ; 507: 11-18, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34410092

RESUMO

Communication is an essential component in providing health care for adolescent patients. A critical part of adolescence is identity development. Affirmation of identity and emphasis on individual strengths are important for this age group. The concept of resilience is at the center of adolescent care and shapes how care is defined and delivered. A primary goal is to protect patients from harm through a combination of promotion of protective factors, including resilience, and risk factor reduction. In adolescents, use of motivational interviewing has been shown to decrease risky sexual behaviors, help prevent unplanned pregnancy, increase physical activity levels, and decrease substance use. Confidentiality is another essential component of care. The American Academy of Pediatrics (AAP) recommends use of the Strengths, School, Home, Activities, Drugs/substance use, Emotions/eating/depression, Sexuality, Safety (SSHADESS) screen for psychosocial assessment. Several other standardized, validated screening tools also may be valuable in guiding discussions and identifying risky behaviors. Sexual orientation, gender identity, religious, racial, and ethnic components of identity development should be addressed. The empowerment of adolescent patients to achieve personal independence in the health care setting is part of the transition from an adolescent approach to health care to an adult approach.


Assuntos
Saúde do Adolescente , Identidade de Gênero , Adolescente , Adulto , Criança , Comunicação , Feminino , Humanos , Masculino , Gravidez , Assunção de Riscos , Comportamento Sexual , Estados Unidos
8.
PLoS One ; 16(8): e0256241, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34388215

RESUMO

The importance of researching public support for preventive policies have been amplified by the COVID-19 pandemic. Using a representative sample of the Hungarian population, we investigated the support for commonly used preventive measures (social distancing, hand hygiene and wearing masks) comparing two different policy tools (nudges and regulations). Because of the high risk and unfamiliarity of the pandemic, the respondents' risk perception and experience with the disease was also assessed. All preventive measures were generally supported and, contrary to the findings of previous nudge research, there was no clear pattern whether regulations or nudges are preferred. People with higher level of risk perception supported both types of policies more but slightly favoured the regulations. Those who had contact with the disease (either themselves or a close friend or family member contracting COVID-19) reported a higher level of risk perception. When the person themselves was afflicted, this higher levels of risk perception did not translate to a higher level of support, moreover, it even decreased support for the regulations according to regression analysis. In case of a loved one contracting the disease, there was an increased support for both types of measures, but that is explained by the higher risk perception.


Assuntos
Atitude , COVID-19/psicologia , Controle de Doenças Transmissíveis/métodos , Opinião Pública , Adolescente , Adulto , COVID-19/epidemiologia , COVID-19/prevenção & controle , Feminino , Humanos , Hungria , Masculino , Pessoa de Meia-Idade , Assunção de Riscos
9.
Proc Natl Acad Sci U S A ; 118(32)2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34341120

RESUMO

The COVID-19 pandemic reached staggering new peaks during a global resurgence more than a year after the crisis began. Although public health guidelines initially helped to slow the spread of disease, widespread pandemic fatigue and prolonged harm to financial stability and mental well-being contributed to this resurgence. In the late stage of the pandemic, it became clear that new interventions were needed to support long-term behavior change. Here, we examined subjective perceived risk about COVID-19 and the relationship between perceived risk and engagement in risky behaviors. In study 1 (n = 303), we found that subjective perceived risk was likely inaccurate but predicted compliance with public health guidelines. In study 2 (n = 735), we developed a multifaceted intervention designed to realign perceived risk with actual risk. Participants completed an episodic simulation task; we expected that imagining a COVID-related scenario would increase the salience of risk information and enhance behavior change. Immediately following the episodic simulation, participants completed a risk estimation task with individualized feedback about local viral prevalence. We found that information prediction error, a measure of surprise, drove beneficial change in perceived risk and willingness to engage in risky activities. Imagining a COVID-related scenario beforehand enhanced the effect of prediction error on learning. Importantly, our intervention produced lasting effects that persisted after a 1- to 3-wk delay. Overall, we describe a fast and feasible online intervention that effectively changed beliefs and intentions about risky behaviors.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Pandemias/prevenção & controle , Assunção de Riscos , Adulto , COVID-19/virologia , Humanos , Masculino , Saúde Mental , Percepção/fisiologia , Saúde Pública , SARS-CoV-2/patogenicidade , Inquéritos e Questionários , Adulto Jovem
10.
J Int AIDS Soc ; 24(8): e25741, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34338417

RESUMO

INTRODUCTION: Adolescents and young people comprise a growing proportion of new HIV infections globally, yet current approaches do not effectively engage this group, and adolescent HIV-related outcomes are the poorest among all age groups. Providing psychosocial interventions incorporating psychological, social, and/or behavioural approaches offer a potential pathway to improve engagement in care and health and behavioural outcomes among adolescents and young people living with HIV (AYPLHIV). METHODS: A systematic search of all peer-reviewed papers published between January 2000 and July 2020 was conducted through four electronic databases (Cochrane Library, PsycINFO, PubMed and Scopus). We included randomized controlled trials evaluating psychosocial interventions aimed at improving engagement in care and health and behavioural outcomes of AYPLHIV aged 10 to 24 years. RESULTS AND DISCUSSION: Thirty relevant studies were identified. Studies took place in the United States (n = 18, 60%), sub-Saharan Africa (Nigeria, South Africa, Uganda, Zambia, Zimbabwe) and Southeast Asia (Thailand). Outcomes of interest included adherence to antiretroviral therapy (ART), ART knowledge, viral load data, sexual risk behaviours, sexual risk knowledge, retention in care and linkage to care. Overall, psychosocial interventions for AYPLHIV showed important, small-to-moderate effects on adherence to ART (SMD = 0.3907, 95% CI: 0.1059 to 0.6754, 21 studies, n = 2647) and viral load (SMD = -0.2607, 95% CI -04518 to -0.0696, 12 studies, n = 1566). The psychosocial interventions reviewed did not demonstrate significant impacts on retention in care (n = 8), sexual risk behaviours and knowledge (n = 13), viral suppression (n = 4), undetectable viral load (n = 5) or linkage to care (n = 1) among AYPLHIV. No studies measured transition to adult services. Effective interventions employed various approaches, including digital and lay health worker delivery, which hold promise for scaling interventions in the context of COVID-19. CONCLUSIONS: This review highlights the potential of psychosocial interventions in improving health outcomes in AYPLHIV. However, more research needs to be conducted on interventions that can effectively reduce sexual risk behaviours of AYPLHIV, as well as those that can strengthen engagement in care. Further investment is needed to ensure that these interventions are cost-effective, sustainable and resilient in the face of resource constraints and global challenges such as the COVID-19 pandemic.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/psicologia , Participação do Paciente/psicologia , Intervenção Psicossocial , Cooperação e Adesão ao Tratamento/psicologia , Adolescente , Terapia Antirretroviral de Alta Atividade , COVID-19 , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pandemias , Assunção de Riscos , SARS-CoV-2 , Comportamento Sexual , África do Sul , Carga Viral , Adulto Jovem
11.
BMC Public Health ; 21(1): 1549, 2021 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-34391389

RESUMO

BACKGROUND: A Cross-sectional Rapid Situational Assessment of People Who Inject Drug (PWIDs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injecting drug users in Nairobi and Coastal regions of Kenya. There is paucity of data and information on injecting drug use in sub-Saharan Africa and there is sufficient evidence of existence of the environment for development and growth of injecting drug use. Past studies on PWID and its association to HIV and AIDS that have been conducted in Kenya do not provide sufficient information to support effective planning and comprehensive national response to the HIV and AIDS epidemic. METHODS: A cross-sectional study design was adopted in which a set of initial subjects referred to as 'seeds' were first identified from which an expanding chain of referrals were obtained, with subjects from each wave referring subjects of subsequent waves. The seeds were drawn randomly from the population and interviewed to pick the one with the largest network and other unique characteristics. A maximum of twelve seeds were recruited. The second stage involved conducting assessment visits to the sites to identify potential collaborators that included non-governmental organizations (NGOs), drug treatment centres, health facilities, community based organizations (CBO's) among others. Three NGOs located in the coast region and one in Nairobi region were identified to assist in identifying drug injection locations and potential participants. Key informant interviews (KIIs) and Focus Group Discussions (FGDs) were also conducted using interview guides. RESULTS: A total of 646 individuals (344 in Nairobi and 302 at the coast) were recruited for the study between January and March 2010. Of these 590 (91%) were male and 56 (9%) were female. Findings showed that most PWIDs initiated injecting drug use between the ages of 20-29 years, with the youngest age of initiation being 11 years and oldest age being 53 years. Most commonly injected drug was heroin (98%), with a small (2%) percentage injecting cocaine. Other non-injecting methods such as smoking or combining these two drugs with other drugs such as cannabis or Rohypnol were also common. Most PWIDs used other substances (cigarettes, alcohol, and cannabis) before initiating injecting drug use. The adjusted national HIV prevalence of PWIDs was 18.3% (19.62% unadjusted) with PWIDs in Nairobi region registering 18.33% (20.58% unadjusted) compared PWIDs for Coastal region indicating 18.27% (18.59% - unadjusted). The gender based HIV prevalence showed that women were more at risk of acquiring HIV (44.51%-adjusted) compared to men (15.97%-adjusted). The age specific HIV prevalence showed that PWIDs who initiated injecting at 11-19 years (44.7% adjusted) were most at risk in Nairobi compared to those who initiated injecting at age 20-24 years (23.2% - adjusted) in the coastal region. While all PWIDs continue to be at risk in the two regions, those from the Western parts of Nairobi, Kenya were at a relatively higher risk given their increased propensity for sharing injecting equipment and solutions. CONCLUSIONS: Compared to the national HIV prevalence of (4.9%), the results show that People Who Inject Drugs (PWIDs) are at particularly high risk of infection in Kenya and there is urgent need for intervention (KenPHIA, 2018). This study also showed clear evidence that 70% of PWIDs are primary school educated, engage in high risk injecting and sexual behaviors comprising sharing of injecting equipment, unprotected heterosexual and homosexual sex. Given that initiation of injecting drug use begins early and peaks after formal school years (20-29 years), prevention programmes should be targeted at primary and secondary school students, college and out of school youth. Further, to protect People who inject drugs (PWIDs) from HIV infection, the country should introduce free Needle Syringe Programs (NSP) with provision of condoms and Methadone Assisted Therapy (MAT) as a substitute for drug use.


Assuntos
Infecções por HIV , Preparações Farmacêuticas , Abuso de Substâncias por Via Intravenosa , Adolescente , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Quênia/epidemiologia , Masculino , Prevalência , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Inquéritos e Questionários , Adulto Jovem
12.
Artigo em Inglês | MEDLINE | ID: mdl-34360215

RESUMO

The objective of this study was to investigate the association between first sexual intercourse and sexual violence victimization, symptoms of depression, and suicidal ideation among sexually active adolescents in the United States. Data for this study came from the U.S. 2017 and 2019 iterations of the National Youth Risk Behavior Survey. An analytic sample of 6252 adolescents aged 14-18 years old (49.5% female) who reported ever having sexual intercourse was analyzed using Poisson regression. The outcome variables investigated in this study were sexual violence victimization, symptoms of depression, suicidal ideation, a suicide plan, and suicide attempts, and the main explanatory variables were age at first sexual intercourse and forced sexual intercourse. We also analyzed differences by gender and race. Of the 6252 adolescents who reported ever having sexual intercourse, 7.1% had their first sexual intercourse before age 13, and 14.8% experienced forced sexual intercourse. About 16% of adolescents experienced sexual violence during the past year, 42.6% reported symptoms of depression, 23.9% experienced suicidal ideation, 19.3% made a suicide plan, and 11.1% attempted suicide during the past year. In the regression analysis, early sexual intercourse was significantly and positively associated with suicidal ideation (relative risk (RR) = 1.15, 95% Confidence Interval (CI) = 1.02-1.30), suicide plan (RR = 1.18, 95% CI = 1.00-1.38), and suicide attempts (RR = 1.36, 95% CI = 1.15-1.61). Controlling for the effects of covariates, history of forced sexual intercourse was positively associated with the five outcomes examined with the relative risk ranging between 1.59 and 6.01. Findings of this study suggest that history of early or forced sexual intercourse is associated with poor mental health outcomes among adolescents and underscores the importance of developing interventions that offer psychological support in reducing the adverse impact of early sexual intercourse and forced sexual intercourse on adolescent health.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Delitos Sexuais , Adolescente , Coito , Depressão/epidemiologia , Feminino , Humanos , Masculino , Assunção de Riscos , Comportamento Sexual , Ideação Suicida , Estados Unidos/epidemiologia
13.
PLoS One ; 16(8): e0256806, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34437629

RESUMO

Scientific evidence plays an important role in the therapeutic decision-making process. What happens when physicians are forced to make therapeutic decisions under uncertainty? The absence of scientific guidelines at the beginning of a pandemic due to an unknown virus, such as COVID-19, could influence the perceived legitimacy of the application of non-evidence-based therapeutic approaches. This paper reports on a test of this hypothesis, in which we administered an ad hoc questionnaire to a sample of 64 Italian physicians during the first wave of the COVID-19 pandemic in Italy (April 2020). The questionnaire statements regarding the legitimacy of off-label or experimental drugs were framed according to three different scenarios (Normality, Emergency and COVID-19). Furthermore, as the perception of internal bodily sensations (i.e., interoception) modulates the decision-making process, we tested participants' interoceptive sensibility using the Multidimensional Assessment of Interoceptive Awareness (MAIA). The results showed that participants were more inclined to legitimate non-evidence-based therapeutic approaches in the COVID-19 and Emergency scenarios than the Normality scenario. We also found that scores on the MAIA Trusting subscale positively predicted this difference. Our findings demonstrate that uncertain medical scenarios, involving a dramatic increase in patient volume and acuity, can increase risk-taking in therapeutic decision-making. Furthermore, individual characteristics of health care providers, such as interoceptive ability, should be taken into account when constructing models to prevent the breakdown of healthcare systems in cases of severe emergency.


Assuntos
COVID-19/epidemiologia , Médicos/psicologia , Adulto , Idoso , COVID-19/virologia , Tomada de Decisões , Prescrições de Medicamentos , Tratamento de Emergência , Feminino , Humanos , Interocepção , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Preparações Farmacêuticas/administração & dosagem , Assunção de Riscos , SARS-CoV-2 , Inquéritos e Questionários
14.
AIDS Behav ; 25(9): 2767-2778, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34389891

RESUMO

Between 2010 and 2015, Eswatini conducted mass media health behavior campaigns (HBCs) designed to avert new HIV infections. Using longitudinal data from the nationally representative Swaziland HIV Incidence Measurement Survey of 2011, we describe the impact of exposure to HBCs on selected HIV risk behaviors and HIV incidence among sexually active, HIV-negative adults (n = 11,232). Exposure to partner reduction HBCs was significantly associated with reporting fewer (i.e., 1 versus 2, or 2 versus ≥ 3) sexual partners in the prior 6 months at baseline among women (aOR = 3.02; 95% CI 1.38, 6.62); and at both baseline and at 6-months follow-up for men (aOR = 2.26; 95% CI 1.49, 3.44; aOR = 1.95, 95% CI [1.26-3.00], respectively). Despite these reported partner reductions, there was no association between HBC exposure and prospectively observed HIV seroconversions (n = 121). This analysis strengthens the evidence that HIV prevention at the population level requires integrated strategies.


Assuntos
Infecções por HIV , Adulto , Essuatíni , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Comportamentos Relacionados com a Saúde , Humanos , Incidência , Masculino , Assunção de Riscos , Comportamento Sexual , Parceiros Sexuais
15.
Artigo em Inglês | MEDLINE | ID: mdl-34360342

RESUMO

Adolescents frequently engage in noisy leisure activities which can result in hearing-related problems. However, the effect of leisure noise exposure is liable to an individual's risk-taking behavior. Identifying leisure noise activities and relevant factors related to risk-taking behavior in adolescents, are important to optimize hearing conservation programs targeting youngsters. The purpose of the study was to explore the presence of hearing-related symptoms, as well as noise exposure during various activities, and the use of hearing protector devices (HPDs) in adolescents in two educational programs in Flanders. In addition, their attitudes and beliefs towards noise, hearing loss, and HPDs were investigated. The final sample consisted of 247 adolescents. The most important hearing-related symptoms after noise exposure were tinnitus and noise sensitivity. With regard to leisure noise exposure, listening to PMPs was most frequently reported. The use of HPDs during most noisy activities was limited, in accordance with the presence of hearing-related symptoms, considering noise as unproblematic, and having worse scores on subscales of the beliefs about hearing protection and hearing loss scale. In the future, hearing conservation programs should target adolescents specifically for a more health-orientated behavior towards noise exposure, hearing loss, and HPDs.


Assuntos
Dispositivos de Proteção das Orelhas , Perda Auditiva Provocada por Ruído , Adolescente , Perda Auditiva Provocada por Ruído/prevenção & controle , Humanos , Atividades de Lazer , Assunção de Riscos , Inquéritos e Questionários
16.
Reprod Health ; 18(1): 172, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407856

RESUMO

BACKGROUND: This study aimed to identify factors associated with risk sexual behaviours and target high-risk groups at risk of HIV/STDs infection among university students. METHODS: The cross-sectional study was conducted from 1 November to 31 December 2020 in one university, located in Henan Province. A total of 1602 individuals who reported having ever had sex were analyzed as the subjects of this study. Descriptive analysis and multivariable logistic regression analysis were applied for this study to assess factors associated with risk sexual behaviours among university students. RESULTS: University students who reported having ever had sex accounted for about 9%, with an average age of 19.37 ± 1.03. Of them, having multiple sexual partners and inconsistent condom use during the last 6 months were 37.3% and 35%, respectively. Over 50% of participants had their sexual debut before the age of 18. Bisexual students (AOR = 0.27; 95% CI 0.16, 0.44) and those who lived on over 3000 Yuan per month (AOR = 0.50; 95% CI 0.28, 0.91) were consistently less likely to engage in condom use during the last 6 months. University students who were from high-grade (AOR = 1.56; 95% CI 1.12, 2.18 for sophomore; AOR = 1.84; 95% CI 1.28, 2.65 for junior; AOR = 2.07; 95% CI 1.38, 3.11 for senior), who lived on over 3,000 Yuan per month (AOR = 4.19; 95% CI 2.17, 8.11) or who reported being homosexual (AOR = 3.92; 95% CI 2.17, 7.06) and bisexual (AOR = 33.22; 95% CI 13.11, 84.15) were more likely to have multiple sexual relationships. University students who had sexual debut before the age of 18 were more likely to engage in risk sexual behaviours. CONCLUSIONS: The prevalence of sexual activity among Chinese university students is generally low, but risk sexual behaviours are of considerable concern. University students with higher living expenses, who are not heterosexual and who are younger at first sexual intercourse tend to engage in risk sexual behaviours. The scale-up of intervention is the need to prevent the expansion of the HIV epidemic among young students.


Assuntos
Infecções por HIV , Doenças Sexualmente Transmissíveis , Adolescente , Adulto , China/epidemiologia , Preservativos , Estudos Transversais , Infecções por HIV/epidemiologia , Humanos , Fatores de Risco , Assunção de Riscos , Comportamento Sexual , Estudantes , Universidades , Adulto Jovem
17.
BMC Public Health ; 21(1): 1506, 2021 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-34348701

RESUMO

BACKGROUND: Psychoactive substance use is a public health challenge among young people in informal settlements. Though rarely examined, psychoactive substance use is linked to sexual expectancies and inhibitions, and consequently high-risk sexual behaviours. This study examined the association between sexual expectancies and inhibitions, and high-risk sexual behaviours among young psychoactive substance users (PSUs) in informal settlements in Kampala, Uganda. METHODS: This cross-sectional study recruited 744 young PSUs from informal settlements in Kampala. Respondent driven sampling was used to recruit respondents. A 'modified' Poisson regression model was used for inferential statistics. Data were analysed using the Stata 14 software. RESULTS: Of the 744 study participants, 45.6% believed that psychoactive substance use improves sexual performance; 43.3% believed that psychoactive substances make sex more pleasurable, and 53.3% believed that psychoactive substances give courage or confidence to approach a partner for sex. The belief that psychoactive substance use improves sexual performance (PR 1.14, 95% CI: 1.01-1.30), increases the likelihood of engaging in sex (PR 1.20, 95% CI: 1.04-1.40) or gives courage or confidence to approach a sexual partner (PR 1.21, 95% CI: 1.05-1.39) were associated with having sex while under the influence of psychoactive substances. The belief that a psychoactive substance user under the influence of psychoactive substances is more likely to engage in sex (PR 1.48, 95% CI: 1.15-1.90), and likely to find it difficult to refuse sex (PR 1.28, 95% CI: 1.06-1.55) were positively associated with engaging in multiple sexual partnerships. The belief that one easily forgets to use a condom when under the influence of psychoactive substances was positively associated with inconsistent condom use (PR 1.26, 95% CI: 1.09-1.45). CONCLUSION: Psychoactive substance use expectancies associated with high-risk sexual behaviours included the belief that psychoactive substances improve sexual performance and improve confidence in approaching a sexual partner. Psychoactive substance use inhibitions associated with high-risk sexual behaviours included an increased likelihood of engaging in sexual intercourse, difficulties in refusing to engage in sexual intercourse, and forgetting to use condoms while intoxicated. Interventions targeting a reduction in high-risk sexual behaviour should integrate the impact of psychoactive substance use on sexual behaviour.


Assuntos
Infecções por HIV , Comportamento Sexual , Adolescente , Preservativos , Estudos Transversais , Humanos , Assunção de Riscos , Parceiros Sexuais , Uganda/epidemiologia
18.
Accid Anal Prev ; 160: 106312, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34339913

RESUMO

Powered two-wheelers (PTW) constitute the most vulnerable type of road user, primarily due to their lack of protection compared to other motorized vehicles, which can lead to a severe accident in the event of crashes. A notable increase in the percentage of PTW accidents resulting in fatalities has raised a serious need for further research in understanding riding behavior. The Motorcycle rider behavior questionnaire (MRBQ) based studies have shown promising results by using MRBQ to relate riding behavior with crash risk. Despite numerous studies using the MRBQ technique and inconsistency in derived inferences across the studies highlighted the need to revise MRBQ and carry out predictive validity for capturing the correct riding behavior of Indian riders. Therefore, this research modified the previously available questionnaire by considering the focus group's opinion, consisting of twenty professional riders, two transportation experts, and two traffic police officers. Additionally, the predictive validity check of MRBQ was carried out using a sample of Indian riders consisting of 392 participants. The exploratory factor analysis of the MRBQ revealed a 32 item version of the questionnaire divided into a four-factor structure (traffic errors, control errors, speed violations, and stunts). The present research highlighted some critical dissimilarities between PTW riders of India and other countries. The low mean score (based on the Likert scale) of the items under the four-factor structure indicated overall a safe PTW rider behavior of Indian riders. Among the four factors, speed violation showed the highest mean score and stunts showed the least mean score indicating frequent and infrequent aberrant ridding behaviors, respectively. A known group construct validity check revealed that gender had a significant and age an insignificant effect on the reporting of aberrant riding behaviors. Furthermore, a negative binomial regression analysis revealed that traffic error had the highest incidence rate ratio, confirming it to be the most significant predictor of crash risk for Indian riders. Finally, the study briefly discussed counter-measure strategies targeting specific riding behavior.


Assuntos
Acidentes de Trânsito , Motocicletas , Humanos , Índia/epidemiologia , Assunção de Riscos , Inquéritos e Questionários
19.
Neuropsychologia ; 160: 107965, 2021 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-34303719

RESUMO

Risk-taking behaviour is an essential aspect of our interactions with the environment. Here we investigated whether vestibular inputs influence behavioural measurement of risk-taking propensity. We have combined bipolar Galvanic Vestibular Stimulation (GVS) with a well-known and established risk-taking behaviour task, namely the Balloon Analogue Risk Task (BART). A sham stimulation was used to control for non-specific effects. Left-anodal and right-cathodal GVS (L-GVS), which preferentially activates the vestibular projections in the right hemisphere, decreased the willingness to take risk during the BART compared with right-anodal and left-cathodal GVS (R-GVS), which activates the left hemisphere. This proved a specific vestibular effect which depends on GVS polarity. Conversely, no generic vestibular effect, defined as the adjusted average of L-GVS and R-GVS conditions compared to sham, emerged, excluding non-specific vestibular effects. Our results confirmed recent findings of a vestibular contribution to decision-making and strategy control behaviour. We suggest that the vestibular-mediated balancing of risk seeking behaviour is an important element of the brain's capacity to adapt to the environment.


Assuntos
Lateralidade Funcional , Vestíbulo do Labirinto , Estimulação Elétrica , Humanos , Assunção de Riscos , Sensação
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