Driving behaviour and visual compensation in glaucoma patients: Evaluation on a driving simulator.

BACKGROUND: To assess the driving performance and both the visual scanning and driving compensations of glaucoma patients. METHODS: In this case-control pilot study, the driving behaviour and performance of 14 patients with glaucoma and nine healthy age- and sex-similar control subjects were compared in a fixed-base driving simulator. All subjects performed in four scenarios with one to two hazardous situations on urban streets, for a total of five hazards. Measurements taken during the tests included reaction times, longitudinal regulation, lateral control and eye and head movements. RESULTS: Glaucoma patients showed poor driving performance with longer reaction time to hazardous situations than control subjects: pedestrians crossing the road from the left (p < 0.022) or from the right (p = 0.013), and vehicles coming from the left (p = 0.002). Their mean duration of lateral excursion was longer (p = 0.045), and they showed more lane excursions in a wide left curve (p = 0.045). Glaucoma patients also showed a higher standard deviation of time-headway (p = 0.048) with preceding vehicles. Analyses of driving behavioural compensations on curved roads showed that glaucoma patients stayed closer to the centre line in large (p = 0.006) and small (p = 0.025) left curves and on small right curves (p = 0.041). Additionally, on straight roads, as compared to control subjects, glaucoma patients showed longer mean time-headway (p = 0.032) and lower mean speed (p = 0.04). Finally, the glaucoma group exhibited a larger standard deviation of horizontal gaze (p = 0.034) than the control subjects. CONCLUSIONS: In a virtual driving environment, glaucoma patients exhibited unsafe driving behaviours, despite their driving and eye-scanning compensations.

Risk factors for eating disorders among Chinese and international university students: a comparative cross-sectional study.

OBJECTIVE: The aim of the study was to investigate the prevalence of eating disorders (EDs) and their association with socio-demographic and behavioural factors among university students. METHODS: A cross-sectional study among university students (Chinese and international) in Nanjing, China. We collected the data from 877 students, of which 811 were eligible for this study. They submitted a self-administered questionnaire (Eating Disorder Examination Questionnaire 6 (EDE-Q6) related to socio-demographic, health variables and lifestyle factors. Data were assessed with the help of SPSS software. RESULTS: A total of 401 Chinese and 410 international university students (49.44% vs. 50.55%) participated in this study. Binary logistic regression showed that young female adults of 18~25 years of age had more risk of developing eating disorders. Higher body mass index (BMI), such as overweight and obesity, were more influential risk factors (p < 0.001) for eating disorders. The significant risks (p < 0.001) EDs were found in students who were athletes, physically active, and involved in various extra-curricular activities. Alcohol and smoking were significant risk factors associated with eating disorders. CONCLUSION: The results indicated higher risks of eating disorders followed by objective binge eating and compensatory behaviour. In this scenario, early assessment and treatment are necessary to reduce the burden of eating disorders and to promote good nutritional practices among university students.

The effect of snack consumption on physical activity: A test of the Compensatory Health Beliefs Model.

The Compensatory Health Beliefs Model proposes that individuals may believe that an unhealthy behaviour can be compensated for by subsequent engagement in a healthy behaviour. The present study aimed to test this proposition, specifically by examining the influence of snack consumption (healthy, unhealthy) on type of activity selected (physical, sedentary). A sample of 100 female undergraduate students (Mage = 20.41 years) were randomly assigned to consume either healthy or unhealthy snacks of comparable nutritional value. To assess potential compensatory behaviour, participants were then given the choice to engage in either a physical activity (exercise on a treadmill) or a sedentary activity (a game on an iPad). Results showed that a significantly higher proportion of participants who consumed the unhealthy snacks selected the physical activity as opposed to the sedentary activity. Perceived healthiness of the snacks, but not perceived caloric intake, mediated the relationship between snack type and activity selection. The findings provide empirical evidence for compensation proposed by the Compensatory Health Beliefs Model, whereby an unhealthy behaviour (unhealthy snack consumption) led to subsequent engagement in a healthy behaviour (physical activity).

Male circumcision for HIV prevention: female risk compensatory behaviour in South Africa.

South Africa promotes male circumcision (MC) as an HIV prevention method and implemented a national plan to scale-up MC in the country from 2012 to 2016. Literature has suggested that female risk compensatory behaviours (RCBs) are occurring in countries where these programmes have been implemented. Behaviours such as decreased condom use, concurrent sexual partners and sexual activity during the circumcision wound-healing period have the potential to jeopardise the campaigns' objectives. Literature has shown that directly providing women with MC information results in correct knowledge however, previous studies have not directly sought women's views and ideas on engagement with the information. This study aims to identify and explore female RCBs in relation to MC campaigns in South Africa, and to identify interventions that would result in greater female involvement in the campaigns. Snowball sampling was used to conduct twelve qualitative vignette-facilitated semi-structured interviews with women residing in a municipal housing estate in Durban, Kwa-Zulu Natal, South Africa. Interviews were audio-recorded, verbatim transcribed and analysed using framework analysis. MC knowledge and understanding varied, with some participants mistaking MC as direct HIV protection for females. Despite a lack in knowledge, the majority of women did not report signs of RCBs. Even with a lack of evidence of RCBs, misinterpretation of the MC protective effect has the potential to lead to RCBs; a concept acknowledged in the literature. Several women expressed that MC campaigns are directed to males only and expressed a keenness to be more involved. Suggested interventions include couple counselling and female information sessions in community clinics. Exploring women's attitude towards involvement in MC campaigns fills in a research knowledge gap that is important to international health, as women have a vital role to play in reducing the transmission of HIV.

'Real-world' compensatory behaviour with low nicotine concentration e-liquid: subjective effects and nicotine, acrolein and formaldehyde exposure.

AIMS: To compare the effects of (i) high versus low nicotine concentration e-liquid, (ii) fixed versus adjustable power and (iii) the interaction between the two on: (a) vaping behaviour, (b) subjective effects, (c) nicotine intake and (d) exposure to acrolein and formaldehyde in e-cigarette users vaping in their everyday setting. DESIGN: Counterbalanced, repeated measures with four conditions: (i) low nicotine (6 mg/ml)/fixed power; (ii) low nicotine/adjustable power; (iii) high nicotine (18 mg/ml)/fixed power; and (iv) high nicotine/adjustable power. SETTING: London and the South East, England. PARTICIPANTS: Twenty experienced e-cigarette users (recruited between September 2016 and February 2017) vaped ad libitum using an eVic Supreme™ with a 'Nautilus Aspire' tank over 4 weeks (1 week per condition). MEASUREMENTS: Puffing patterns [daily puff number (PN), puff duration (PD), interpuff interval (IPI)], ml of e-liquid consumed, changes to power (where permitted) and subjective effects (urge to vape, nicotine withdrawal symptoms) were measured in each condition. Nicotine intake was measured via salivary cotinine. 3-Hydroxypropylmercapturic acid (3-HPMA), a metabolite of the toxicant acrolein, and formate, a metabolite of the carcinogen formaldehyde, were measured in urine. FINDINGS: There was a significant nicotine concentration × power interaction for PD (P < 0.01). PD was longer with low nicotine/fixed power compared with (i) high nicotine/fixed power (P < 0.001) and (ii) low nicotine/adjustable power (P < 0.01). PN and liquid consumed were higher in the low versus high nicotine condition (main effect of nicotine, P < 0.05). Urge to vape and withdrawal symptoms were lower, and nicotine intake was higher, in the high nicotine condition (main effects of nicotine: P < 0.01). While acrolein levels did not differ, there was a significant nicotine × power interaction for formaldehyde (P < 0.05). CONCLUSIONS: Use of a lower nicotine concentration e-liquid may be associated with compensatory behaviour (e.g. higher number and duration of puffs) and increases in negative affect, urge to vape and formaldehyde exposure.

Mobile phone use during driving: Effects on speed and effectiveness of driver compensatory behaviour.

This study analysed and modelled the effects of conversation and texting (each with two difficulty levels) on driving performance of Indian drivers in terms of their mean speed and accident avoiding abilities; and further explored the relationship between speed reduction strategy of the drivers and their corresponding accident frequency. 100 drivers of three different age groups (young, mid-age and old-age) participated in the simulator study. Two sudden events of Indian context: unexpected crossing of pedestrians and joining of parked vehicles from road side, were simulated for estimating the accident probabilities. Generalized linear mixed models approach was used for developing linear regression models for mean speed and binary logistic regression models for accident probability. The results of the models showed that the drivers significantly compensated the increased workload by reducing their mean speed by 2.62m/s and 5.29m/s in the presence of conversation and texting tasks respectively. The logistic models for accident probabilities showed that the accident probabilities increased by 3 and 4 times respectively when the drivers were conversing or texting on a phone during driving. Further, the relationship between the speed reduction patterns and their corresponding accident frequencies showed that all the drivers compensated differently; but, among all the drivers, only few drivers, who compensated by reducing the speed by 30% or more, were able to fully offset the increased accident risk associated with the phone use.