At-risk Behaviors Research Articles

Improving Identification of At-Risk Behaviors in Adolescents With Rheumatic Disease.

Many adolescent patients view their rheumatologist as their primary physician, and therefore it is important to screen youth for sexual activity and substance use as recommended by the American Academy of Pediatrics. We implemented an electronic social history questionnaire (SHQ) and alert system to identify at-risk behaviors in adolescents with rheumatic disease. The SHQ was administered to adolescents 14 years and older with a goal to survey patients' sexual activity and alcohol, tobacco, and drug use. The SHQ was given via tablet at each rheumatology outpatient visit. A positive response triggered a best practice advisory (BPA) alert when the chart was opened to remind the clinician to discuss these results privately. A total of 877 unique patients were surveyed. Ninety patients (12%) reported being sexually active, and sexually active patients were significantly older than those who were not (17.2 vs 15 years; P < 0.001). Seventy-two percent of patients were female, and the mean age was 15.8 years. Sexually active patients were more likely to be smokers, to drink alcohol, and to use other drugs (P < 0.001). Strong associations were observed between alcohol use and male sex (P = 0.0227), White race (P = 0.0052), and public insurance (P = 0.0021). Overall, 12% of patients reported being sexually active, underscoring the need to screen adolescents for sexual activity given many rheumatology patients take teratogenic medication. A smaller proportion used substances. Implementing an electronic medical record-based SHQ can help identify patients most at risk, and the BPA serves as a useful tool to remind clinicians to discuss the SHQ privately.

Using latent class analysis to identify Finnish gambler types and potential risk

ABSTRACT The trend of increasing liberalization in gambling markets has been matched by a need for both effective approaches to promote responsible gambling practices and for improved prevention strategies. Given that the majority of players do not experience problematic gambling, it is in the public interest that knowledge is generated which helps identify activities or clusters of activities which are associated with at-risk behaviors. This study uses a representative sample of the Finnish population aged 15–74, to identify distinct types of gamblers based on their behavioral patterns and predictors of class membership via Latent Class Analysis. Cross-sectional random sample data were collected in 2019 (n = 3148). In addition to confirming existing knowledge for gamblers characterized by high engagement and high risk, it offered insights into three further classes: the largest (ME-HR, 45%), was characterized by moderate engagement, but participated in activities associated with higher levels of risk. Additionally, low-risk classes were differentiated by both gambling preferences and demographic characteristics. Given that the largest class was associated with significant potential for the development of problematic behaviors, this work makes several recommendations for preventative actions, including targeted awareness campaigns and psychoeducation addressing erroneous beliefs about gambling.

Abstract B070: Addressing health disparities around breastfeeding: Development of a braided curriculum

Abstract Purpose: Breastfeeding initiation and longer duration are known to reduce risk of breast and ovarian cancer. While racial disparities in breast cancer diagnosis and mortality rates exist in the United States, disparate rates of breastfeeding initiation and duration continue to widen. The positive effects of these community lactation support through peer education programs among Black mothers have been demonstrated, but these programs are limited by the lack of reach to vulnerable families. Integration of lactation education and support within parenting programs targeting complementary maternal behaviors, such as psychosocial stress does not exist. This proof-of-concept study uses novel Systematic Braiding methodology to develop an integrated maternal behavior parenting curriculum. Methods: In line with the systematic braiding technique, key stakeholders of two evidence based programs, Intergen (a culturally competent breastfeeding peer-educator program) and SafeCare® (a widely disseminated evidence-based parenting program), were consulted to identify core program components, shared and unique theoretical constructs, and programmatic targets including: population of interest, behaviors, delivery mode, program content, dose and length, assessment, fidelity monitoring. Results: 10 program developers and content experts identified shared and unique theoretical constructs and programmatic targets including: population of interest – at-risk minority parents, behaviors (parenting, breastfeeding, and cancer prevention), delivery mode (in person and self-guided), program content, dose and length, assessment, and fidelity monitoring. Areas of integration were captured to inform the braiding of the new curriculum based in social cognitive theory and the theory of planned behavior including modules on cancer education, prevention through breastfeeding, and screening were captured to inform the braiding of the new curriculum. Future directions will assess the acceptability and feasibility of the braided curriculum via user-centered feedback across informants from each of four key informant groups: 1) target recipients of the curriculum including Black women, &amp;lt;36 weeks gestation; 2) potential program providers; 3) community health care professionals; and 4) state-level legislative representatives. Interim findings will be presented. Discussion: There is limited exploration on using widely disseminated parenting programs to increase breastfeeding uptake among African American mothers. This study takes first steps towards developing a robust intervention to increase the reach of breastfeeding education to expecting African American mothers through a widely disseminated parenting model. Improving knowledge of cancer prevention through breastfeeding along with behavior (initiation and duration) among this at-risk population may positively impact breast and ovarian cancer risk. Citation Format: Marlo Vernon, Ashwini Tiwari, Elinita Pollard, Biplab Datta, Zach Hoffman, Kate Guastaferro, Shannon Self-Brown. Addressing health disparities around breastfeeding: Development of a braided curriculum [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B070.

A generic logic model for physical activity interventions for the cardiac population using intervention mapping

Abstract Introduction Regular physical activity is important in the secondary prevention of cardiovascular disease. But many cardiac patients have difficulty establishing lifelong physical activity habits, even after completion of an exercise-based cardiac rehabilitation programme. There is a need for effective interventions to support cardiac patients' physical activity. Such interventions are often complex behaviour change interventions whose design should be grounded in programme theory, i.e., a description of how the intervention is expected to lead to its effects and under what conditions. A logic model is often used to communicate programme theory [1]. Purpose The purpose of this work was to describe a generic logic model for behaviour change interventions to increase and maintain physical activity among patients who have had an acute cardiac event. Methods We applied the Intervention Mapping approach [2] to develop a generic logic model that is both data- and theory-driven, i.e. informed by research evidence and behaviour change theory. The at-risk behaviour for the individual cardiac patient was defined as "insufficient independent long-term maintenance of heart-healthy physical activity", compounded by the environmental factor "lack of support provision for long-term independent physical activity" from the healthcare providers and people in the patient’s interpersonal environment. We defined performance objectives by asking the questions: "What do people who had an acute cardiac event need to do to increase and maintain their heart-healthy physical activity?" and "What do the healthcare providers and people in the patient’s interpersonal environment need to do to encourage and support the patient in being physically active?" The performance objectives specify what actions are required of the individuals targeted in the intervention. We selected determinants corresponding to performance objectives based on empirical evidence from systematic reviews and based on behaviour change theory such as the Reasoned Action Approach (RAA) and the Health Action Process Approach (HAPA). Results Central elements of the logic model are presented in table 1. The logic model includes 18 performance objectives and 13 determinants, supported by empirical evidence from 40 scientific publications. Conclusion The generic logic model serves as a collection of current knowledge regarding increasing and maintaining physical activity among the cardiac population and can be used for a number of purposes: as a foundation for developing new interventions; as a blueprint against which to compare and/or solidify the programme theory of existing interventions; as a conceptual framework for designing evaluations of interventions; as a current evidence map from which to identify research gaps; and as a point of reference for reflecting on one’s own health behaviour.Table 1.Elements of the logic model.

Principal and Secondary Diagnoses Related to Eye Injury: Characteristics from a tertiary center in Northern Thailand

OBJECTIVE This study aimed to explore the epidemiological characteris-tics of primary and secondary diagnoses of eye injuries requiring hospitali-zation in a tertiary referral center. METHODS The medical records of 726 patients with diagnoses of eye injury who were admitted between January 2016 and December 2019 were reviewed. RESULTS Four hundred and thirty-six of the patients (60.1%) were hospitalized with a principal diagnosis related to eye injury, while 290 patients (39.9%) were admitted with secondary diagnoses. Over the four-year period of study, the proportion of admissions with a principal diagnosis stayed consistently in the range of 54.0% to 63.9%. Most of the patients in the principal diagnosis group were age between 41 and 60 years. Patients in the secondary diagnosis group, however, were mostly between the age of 21 and 40 years. The majority of patients in the principal diagnosis group (267 patients, 61.2%) had eye injuries which had occurred at work, whereas in the secondary diagnosis group most (230 patients, 79.3%) had eye injuries resulting from traffic accidents. CONCLUSIONS Work-related accidents and traffic accidents were the two main types of at-risk behaviors in both the primary and secondary diagnosis categories. Initiatives for public health education related to eye injuries should pay more special attention to these two primary causes of severe eye injuries. KEYWORDS principal diagnosis, secondary diagnosis, eye injury, hos- pitalization

Unveiling Health Inequalities: Exploring Metabolic Dysfunction in Rural Roma Communities.

Europe's largest ethnic minority, the Roma, are often confronted with substantial obstacles that result in health disparities. Research indicates that there are elevated rates of both communicable and non-communicable diseases, such as metabolic syndrome (MetS), among Roma communities, often linked to living conditions, limited education, or poverty. This study centers on remote rural Roma settlements in Romania, evaluating the prevalence of metabolic dysfunction, obesity, and liver steatosis while considering socio-economic and lifestyle factors. Over a period of 36 months, local visits to a total of 25 rural Roma communities were conducted, where a medical team gathered information through a standardized questionnaire and conducted a physical exam on every participant. Liver steatosis was also recorded with the help of a portable wireless ultrasound device. Our study included 343 participants, with a predominance of female subjects, representing 72.5% (n = 249) of the patients. The prevalence of obesity, defined by a body mass index (BMI) above 30 kg/m2, was 32.2% (n = 111). Arterial hypertension was found to have a prevalence of 54.1% (n = 185), with de novo hypertension being observed in 19.2% patients (n = 66). Type 2 diabetes mellitus was found in 28.9% patients (n = 99), with 19.5% being de novo cases. The prevalence of hepatic steatosis was 57.2% (n = 111/194). A positive association between metabolic features and at-risk behaviors was found. This study underscores the transition from infectious to metabolic diseases in vulnerable communities and highlights the urgency of targeted public health strategies tailored to the unique needs of rural Roma populations, aiming to mitigate health disparities and promote equitable healthcare access.

STUDENTS’ LEVEL OF RISK FACTORS AFFECTING DELINQUENCY IN QUEZON BUKIDNON COMPREHENSIVE NATIONAL HIGH SCHOOL

This study aimed to assess the levels of risk factors such as alcoholism, bullying, gambling, gang involvement, and truancy. The study explores how these factors impact both delinquent behaviors and academic performance among at-risk students. The research uses a quantitative approach and utilizes a survey methodology with a self-made questionnaire. The questionnaire undergoes rigorous validity and reliability testing. The investigation focuses on 179 at-risk students to understand the dynamics of delinquent behavior. The data-gathering procedure includes obtaining permission, conducting pilot testing, and administering the questionnaire with strict privacy measures. Scoring is done using a 5-point Likert scale. The analysis of the collected data is guided by the statistical tools, such as weighted mean, ANOVA, and Pearson correlation. The findings of the study revealed the significant impact of risk factors on at-risk students behavior, particularly the role of truancy in influencing delinquency. It also establishes correlations between respondents age and alcoholism, gambling, and gang involvement. Additionally, it identifies associations between parents educational attainment and bullying behaviors, as well as the marital status of respondents parents and truancy. The study suggests a collaborative approach involving educators, parents, and stakeholders to develop customized interventions based on the identified risk factors. By customizing strategies based on the challenges elucidated in this study, stakeholders can contribute to creating a safer and more supportive educational environment for at-risk students, addressing juvenile delinquency comprehensively. KEYWORDS: Risk Factors, Juvenile Delinquency, Academic Performance. At-risk students

Assessing gambling disorder using frequency- and time-based response options: A Rasch analysis of the gambling disorder identification test.

The Gambling Disorder Identification Test (GDIT) is a recently developed self-report measure. The GDIT includes items with multiple response options that are either based on frequency or time, and item response theory evaluations of these could yield vital knowledge on its measurement performance. The GDIT was evaluated using Rasch analysis in a study involving 597 Swedish gamblers. In a three-dimensional Rasch model, the item response difficulty range extended from -1.88 to 4.06 and increased with higher time- and frequency-based responses. Differential item functioning showed that some GDIT items displayed age and gender-related differences. Additionally, person-separation reliability indicated the GDIT could reliably be divided into three to four diagnostic levels. The frequency- and time-based item response options of the GDIT offer excellent measurement, allowing for elaborate assessment across both lower and higher gambling severity. The GDIT can be used to detect DSM-5 Gambling Disorder, thereby holding significance from both epidemiological and clinical standpoints. Notably, the 3-item GDIT Gambling Behavior subscale also shows potential as a brief screening tool for identifying at-risk gambling behavior.

Effects of a behavior-based safety observation program: Promoting safe behaviors and safety climate at work.

Behavior-based safety (BBS) programs promote coworkers observing and correcting each other's at-risk behaviors on site; the idea behind BBS programs is to create a cultural shift in a company where it is acceptable for coworkers to stop anyone, at any time, from working in an unsafe manner. The main objective of this study is to examine the impacts of a BBS observation program in the construction industry. The subject, an electrical contracting company, implemented the BBS program in January 2019. This study utilized multiple data sources: the company's incident data, BBS program report data, and surveys, including the Safety Climate Assessment Tool for Small Contractors. A total of 3,891 at-risk behaviors from the BBS reports, including 600 comments, and 141 survey responses were analyzed. The most frequently reported at-risk behavior was the line of fire, and the at-risk behaviors were often observed when workers conducted tasks, such as running or pulling wires, installing devices, and installing lights. The overall perception of safety climate was high, and the respondents reported that the safety climate had improved since the adoption of the BBS program. Overall, implementing the BBS program benefited in cultivating the company's collective safety climate. As a result of the BBS program, the company implemented better communication strategies for their safety meetings on the most frequently reported at-risk behaviors, replacing safety gears with higher quality ones, and redesigning online safety training to better reflect the identified tasks that were associated with more at-risk behaviors.

The effectiveness of electronic screening and brief intervention for alcohol-related maxillofacial trauma: a randomized controlled trial

ObjectivesThis study aims to deliver a novel web-app-based electronic Screening and Brief Intervention to patients with alcohol-related facial trauma and assess changes in at-risk drinking behaviors and attitudes towards their drinking and alcohol-related trauma. Study design, setting, and sampleThis was a two-arm parallel randomized controlled trial. Participants who had sustained alcohol-related facial injuries were recruited from three Australian hospitals. Results56 participants were enrolled and randomized initially with 45 participants completing the questionnaire at baseline and 3-month follow-up. Most of the participants were male (71.1%), aged between 18 and 29 (40%), and presented to the ED for the first time (68.9%). The study revealed that the intervention group participants found the information provided via the e-SBI helpful in changing their drinking habits and seek help. The e-SBI intervention had a moderate effect on ASSIST Scores (d=-.59; 95% CI, -.03, 1.18). The effect sizes of the e-SBI on the secondary outcomes also ranged between small and moderate. ConclusionsThe novel app-based e-SBI can effectively deliver information on harmful drinking and provide brief intervention and other venues for help and subsequently improve awareness and willingness to seek help and reduce the risk of injury recurrence. Statement of Clinical RelevanceElectronic Screening and Brief Intervention may provide a means of bypassing clinician based limitations of training and time constraints for tertiary prevention for patients who have sustained alcohol related facial trauma, this project encourages further larger studies in the future to assess the effectiveness of this modality of prevention.

Electronic performance monitoring framework to quantify unhealthy and unsafe on-site behaviours

Health and Safety (H&S) should be a significant concern in construction projects. The quantification of the work injury accidents started with work A. W. Heinrich (1931), passing per Frank E. Bird Jr. (1969) to a study by ConocoPhillips Marine (2003). These theories, also known as the Accident triangle, Heinrich's triangle, or Bird's triangle, are a base for industrial accident prevention applied in practice by the Dupont STOPTM methodology. Over this methodology, the number of unhealthy and unsafe behaviours is classified and accounted for to diagnose the potential workers' recordable injuries, lost workdays, and fatalities. The At-risk behaviours and the Near Misses are the most challenging safety measurement approach as they depend on the human-observation notes usually conducted in a safety audit. Electronic Performance Monitoring (EPM) concerns the use of innovative hardware and software to assess on-site safety and productivity. The electronic monitoring of construction workers can contribute to evaluating unsafe behaviours. At-risk behaviours could be measured based on location, trajectory, and motions. Also, with the monitoring of the equipment and vehicles, it is possible to measure Near Misses. The Information Technologies integration allows for collecting information about Recordable Injuries, Lost workdays, and Fatalities. This work discusses and presents a framework connecting EPM deployment to data acquisition of unhealthy and unsafe on-site behaviours. The contributions in the theoretical and practical fields concern the opportunities of using new technological assumptions to increase data acquisition and improve the accuracy and effectiveness of quantitative safety analysis.

HIV pre-exposure prophylaxis services, provision, and delivery in the European treatment network of HIV, hepatitis and global emerging infectious diseases (NEAT ID).

We conducted a survey to evaluate HIV pre-exposure prophylaxis (PrEP) practices in a European clinical research network on HIV, hepatitis, and global infectious diseases (NEAT ID). An online survey comprising 22 questions was sent via a secure electronic tool to the investigating physician of each of the 342 NEAT ID study centres across 15 European countries in November 2020. In total, 50 sites from 12 countries responded (15% response rate). Most sites were in Western Europe, two were in Poland, and one was in Hungary. Of the responding sites, 45 provided PrEP services for a total of 27 416 PrEP users, with 1361 new PrEP initiators each month. These centres supplied PrEP for men who have sex with men (100%), people who inject drugs (84%), sex workers (84%), women (62%), and transgender women (31%). PrEP persistence after 1 year was >90%, 75%-90%, and 40%-75% in 17, 24, and 4 centres, respectively. In total, 32/45 (71%) centres reported strong community-based organization commitment at their site, and 15/45 (33%) centres developed task-shifting processes to deliver PrEP through nurses (11/15), pharmacists (5/15), and key-population peers (2/15). The biggest barriers to implementation of PrEP were low awareness of and knowledge about PrEP (47%), unwillingness to disclose sexual identity or at-risk behaviour (36%), and lack of administrative support (29%). Of the 45 centres, 32 (71%) have already been involved in PrEP research and 43 (96%) were interested in participating in such studies. The few NEAT ID centres that responded to the survey showed disparities in PrEP deployment and practices despite a common interest in participating in research in this field.

A Portrait of Gambling Behaviors and Associated Cognitive Beliefs Among Young Adolescents in Italy

AbstractGambling disorder is a highly prevalent behavioral addiction in young adults. Accordingly, data on the prevalence of gambling as experience and problem gambling as at-risk behavior among adolescents are necessary, due to the increase in gambling behavior and its implications in recent years. This study aimed to assess the prevalence and characteristics (i.e., cognitive beliefs and knowledge of risk) of gambling among Italian adolescents.A cross-sectional survey analyzed gambling behavior, related cognitive beliefs, and knowledge of the gambling context in a large sample of Italian adolescents, differentiating gambling activities per se and problem gambling as a risk for addiction. Data from 4825 Italian 15-year-olds showed that the prevalence of regular gamblers (i.e., experiencing frequent gambling experience in the last 12 months) was 6.4%, and that of adolescents who played at least once in the last 12 months was 52%. The regular and at-risk gamblers who reported critical scores in the Gambling Related Cognitions Scale declared higher knowledge of gambling and worse cognitive beliefs than both non-gamblers and occasional gamblers.Prevalence data and descriptive outcomes of this study suggest the importance of further analyzing the gambling phenomenon among adolescents. The increasing intensity of gambling engagement and compulsive gambling highlights the clinical need to address youth addiction through structured primary and secondary prevention programs.

Sharpen the focus on chemsex

Chemsex is the intentional use of substances in sexualized settings among men who have sex with men. An increasing public health issue, chemsex has estimated prevalence rates of 3% to 29% in men who have sex with men. Known risks of chemsex include higher exposure to HIV and other STIs, addiction, and cardiovascular problems. Recent research has also shown that chemsexers are prone to depression, anxiety, psychotic experiences, and cognitive impairment. Our commentary highlights the discrepancy between the public health burden associated with risky chemsex practices and the research gap in this domain. We warn against the simplistic application to chemsex of existing theoretical concepts or therapeutic strategies that work for addictions and at-risk sexual behaviours. Such an approach neglects the unique features of this emerging phenomenon, which mainly affects stigmatized minorities.

Role of Social Media in Adolescent-Parent Relationships Among At-Risk Youths

This study aimed to understand the role of adolescent and parent social media use on adolescents reported at-risk behaviors, as well as the role of social media among at-risk youths and their parents. Semi-structured interviews, based on interpretive phenomenological analysis, were utilized with six pairs of individuals resulting in 12 total participants. Each pair consisted of an adolescent between the ages of 13 and 17 along with their parent. Data analysis resulted in three themes: encountering negativity on social media did not refrain the adolescent from social media usage, misunderstanding of the parent regarding social media and technology caused challenges in parental monitoring, and the quality of time spent together differed in the perception of the adolescent participants and parent participants. The findings of this study suggest that even though participant pairs reported encountering negativity on social media, they continue to use social media, and parent participants are unaware of the amount of time their adolescent spends on social media, which could be contributed to the lack of quality time they spend with one another. The findings of this research add to the current literature regarding social media and the impact it has on the parent-adolescent relationship among at-risk youth.

Secondary risk reduction service acceptability amongst Irish breast cancer survivors and clinicians

Abstract Background Many patients (&amp;gt;75%) diagnosed with breast cancer in Ireland today will be cured and are at risk of dying from other cancers and non-communicable diseases. Breast cancer diagnosis provides a pivotal time point for education on modifiable risk factors and engagement with secondary risk reduction services. Our study set out to establish the level of awareness and acceptability of these areas, respectively. Methods A survey was developed for breast cancer survivors and oncology clinicians using previously validated questionnaires; the ‘Mitchelstown Cohort Survey’ and the ‘International Physical Activity Questionnaire'. IBM SPSS software (Version 28.0) was used for data analysis. Results Between September and December 2021, 322 patients and 29 clinicians attending the South Infirmary Victoria and Cork University Hospitals, completed the survey. Over 80% of patients and clinicians were aware of modifiable cancer risk factors. Only 1 in 5 clinicians had training in secondary risk reduction however 90% were willing to refer to services. Education had an impact on the likelihood of patient engagement with weight management, dietary, and exercise education (Pearson chi-squared test; p = 0.009, 0.039, 0.139 respectively). Patients who smoked, had increased alcohol intake, or gained weight since diagnosis were more likely to engage with services (p = &amp;lt;0.001, p = &amp;lt;0.001, p = 0.015 respectively). Patients who made changes to activity levels since diagnosis were more likely to engage with exercise education (p = 0.015). Conclusions This study identified that over 4 in 5 breast cancer survivors and oncology clinicians were aware of the importance of modifiable lifestyle risk factors. While 9 in 10 clinicians were willing to refer to secondary prevention services if available, the likelihood of patient engagement was associated with their at-risk behaviours and education level. Our study highlights the challenges of implementing health promotion programs in this cohort. Key messages • High level of intended engagement with secondary risk reduction services amongst breast cancer survivors and oncology clinicians. • Likelihood of patient engagement was associated with their at-risk behaviours and education level.

Examining the factors that influence medication administration errors and the reporting of these among mental health nurses in the hospital setting: a systematic review

Background/Aims A medication administration error is defined as ‘any difference between what the patient received or was supposed to receive and what the prescriber intended in the original order’. Medication administration errors are associated with increased morbidity and mortality. They occur frequently in the mental health setting and pose a serious risk of patient harm. The factors leading to medication administration errors in the mental health care setting is under researched and the potential for mental health services to prevent harm from medication administration error is unknown. The aim of this study was to understand factors that influence medication administration errors, and the reporting of these, among mental health nurses in the mental health hospital setting. Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (2015) checklist. A total of 3625 studies were identified, nine of which were included for final review. The CINAHL, Cochrane, EMBASE, Medline, Medline Ovid, Psych Info and PubMed databases were searched, as well as grey literature. Results Medication administration errors and their reporting are complex, multifaceted and show organisational and individual overlap. Heavy workload, staffing shortages, differing levels of experience, ward dynamics, lack of knowledge, interruptions, communication and patient interaction contributed to the occurrence of medication administration errors. Key factors included rationale on why not to report an error, lack of knowledge regarding how to report, what to report, as well as fear and stigma. Conclusions Many factors lead to the occurrence of a medication administration error or why they are not reported. More education is needed to help reduce medication administration errors. Further research may understand the behavioural patterns of mental health nurses and at-risk behaviour. This may help identify adequate interventions to reduce the risk of medication administration errors in this setting.

Medium to long term follow up study of the efficacy of cessation of eye-rubbing to halt progression of keratoconus.

To study the progression of keratoconus after cessation of eye rubbing with a minimum follow up of three-years. Retrospective, monocentric, longitudinal cohort study of keratoconus patients with a minimum of 3 years follow-up. One hundred fifty three eyes of seventy-seven consecutive patients with keratoconus were included. Initial examination consisted of anterior and posterior segment evaluation using slit-lamp biomicroscopy. At the initial visit, patients were thoroughly informed of their pathology and instructed to stop rubbing their eyes. Eye rubbing cessation was assessed at all the follow-up visits at 6 months, 1 year, 2 years, 3 years, and yearly afterward. Corneal topography using the Pentacam® (Oculus®, Wetzlar, Germany) was used to obtain maximum and average anterior keratometry readings (Kmax and Kmean), as well as thinnest pachymetry (Pachymin, μm) in both eyes. The main outcomes measured were maximum keratometry (Kmax), mean keratometry (Kmean), and thinnest pachymetry (Pachymin) values at various time points to assess for keratoconus progression. Keratoconus progression was defined as a significant augmentation of Kmax (>1D), Kmean (>1D), or significant diminution of Pachymin (>5%) throughout the total follow-up duration. One hundred fifty three eyes of seventy-seven patients (75.3% males) aged 26.4 years old, were followed for an average of 53 months. Over the course of the follow-up, there was no statistically significant variation of ∆Kmax (+0.04 ± 0.87; p = 0.34), ∆ Kmean (+0.30 ± 0.67; p = 0.27) nor ∆Pachymin (-4.36 ± 11.88; p = 0.64). Among the 26 of the 153 eyes which had at least one criterion of KC progression, 25 admitted continuing eye rubbing, or other at-risk behaviors. This study suggests that a significant proportion of keratoconus patients are likely to remain stable if close monitoring and strict ARB cessation are achieved, without the need for further intervention.

Sleep Deprivation and Insomnia in Adolescence: Implications for Mental Health.

Sleep changes significantly throughout the human lifespan. Physiological modifications in sleep regulation, in common with many mammals (especially in the circadian rhythms), predispose adolescents to sleep loss until early adulthood. Adolescents are one-sixth of all human beings and are at high risk for mental diseases (particularly mood disorders) and self-injury. This has been attributed to the incredible number of changes occurring in a limited time window that encompasses rapid biological and psychosocial modifications, which predispose teens to at-risk behaviors. Adolescents' sleep patterns have been investigated as a biunivocal cause for potential damaging conditions, in which insufficient sleep may be both a cause and a consequence of mental health problems. The recent COVID-19 pandemic in particular has made a detrimental contribution to many adolescents' mental health and sleep quality. In this review, we aim to summarize the knowledge in the field and to explore implications for adolescents' (and future adults') mental and physical health, as well as to outline potential strategies of prevention.

Sexting Behaviors Before and During COVID-19 in Italian and Colombian Young Adults

IntroductionRecent research highlight increasing at-risk online sexual activities and behaviors during the COVID-19 pandemic among young adults. Specifically, sexting refers to exchanging sexually suggestive messages, photos, and videos through technological devices, and it can be placed on a continuum from safer to riskier behavior. This study aims to improve our knowledge about sexting behaviors in Italian and Colombian young adults before and during the COVID-19 pandemic.MethodsA survey online was filled in by all recruited participants through a snowball sampling procedure (from December 2019 to June 2021) both in Italy and Colombia, resulting in a total of 2931 participants (2051 from Italy and 880 from Colombia) aged 18 to 35 years old (Mage = 23.85; SDage = 3.63; 67.6% girls).ResultsItalian youth were more engaged in risky sexting than Colombian participants, while Colombians indicated being more engaged in non-consensual sexting than Italians. Sexual minority people reported more sharing their own sexts, higher levels of sexting under pressure, and 3.2 times more risky sexting than exclusively heterosexual counterparts. During the pandemic period, participants sent their own sexts 1.5 times more and were less involved in non-consensual sexting than in the pre-pandemic era.ConclusionsThe present research could help understand better the cultural dynamics underlying the differences in sexting behaviors, suggesting the relevance of investigating how sexting behaviors and online at-risk activities have changed since the pandemic started.Policy ImplicationsResults provide implications for educational and prevention programs to improve young people's awareness of sexting behaviors.