Behavioral Barriers Research Articles

The role of pre‐ and post‐mating barriers in reproductive isolation in a dung beetle species complex

AbstractPre‐ and post‐zygotic reproductive barriers are key components of reproductive isolation (RI) between taxa. Their timing of appearance and their strength can tell us about the underlying processes promoting differentiation between taxa in allopatry. Canthon cyanellus LeConte (Coleoptera: Scarabaeidae) represents a species complex that has diversified recently, and the species delimitation is still unclear. In this study, we performed experimental crosses to evaluate pre‐mating reproductive barriers between three subspecies of C. cyanellus: Canthon cyanellus cyanellus, Canthon cyanellus sallei, and Canthon cyanellus violetae. We further estimated post‐mating barriers by measuring fecundity and fertility in F1 and F2 generations in reciprocal crosses between two subspecies, C. c. cyanellus and C. c. sallei, and estimating the relative contribution of each barrier to total RI. Results showed that the subspecies are not strongly isolated overall, but asymmetric isolation was observed, with one cross accounting for 40% RI, whereas the other did not contribute to RI. Pre‐mating behavioral barriers accounted for a small fraction of total RI, whereas post‐mating (mostly post‐zygotic) barriers contributed to a larger extent. Fecundity and fertility in the F1 were higher than in parental populations, but this was strongly reduced in the F2. Our results suggest that diversification time between subspecies has been enough to accumulate genetic incompatibilities and indicate a faster accumulation of post‐ than pre‐zygotic reproductive barriers in this species complex.

The relationship of PrEP beliefs to perceived personal, interpersonal and structural benefits and barriers to PrEP use in women who inject drugs

BackgroundWomen who inject drugs (WWID) have significant biological, behavioral, and gender-based barriers to accessing HIV prevention services, including Pre-Exposure Prophylaxis (PrEP) medication. Little is known about how beliefs about PrEP impact both perceived barriers and benefits of PrEP use and how they may be related to the decision-making process.MethodsSurveys were conducted with 100 female clients of a large syringe services program in Philadelphia, Pennsylvania. The sample was categorized into three groups based on mean PrEP beliefs scores using terciles: accurate beliefs, moderately accurate beliefs, and inaccurate beliefs. Oneway ANOVA tests were used to compare groups by perceived benefits and barriers to PrEP, drug use stigma, healthcare beliefs, patient self-advocacy, and intention to use PrEP.ResultsParticipants had a mean age of 39 years (SD 9.00), 66% reported being White, 74% finished high school, and 80% reported having been homeless within the past 6 months. Those with the most accurate PrEP beliefs reported highest intent to use PrEP and were more likely to agree that benefits of PrEP included it preventing HIV and helping them “feel in charge”. Those with inaccurate beliefs were more likely to strongly agree that barriers, such as fear of reprisal from a partner, potential theft, or feeling they “might get HIV anyway”, were reasons not to use PrEP.ConclusionsResults indicate perceived personal, interpersonal and structural barriers to PrEP use are associated with accuracy of beliefs is, pointing to important intervention targets to increase uptake among WWID.

Barriers of Malaria Control Interventions in African and Asian communities: A Comparative Meta-Synthesis Study

Background: The research about malaria mainly focused on clinical, vector biology, and epidemiology quantitative studies. But the qualitative evidence at the community level remains untouched in high transmission countries. The current paper focuses on the qualitative evidence to explore the behavioral and community health barriers of malaria control interventions at the grassroots level using an inter-continental comparative platform. Therefore, we selected qualitative studies from Asian and African continents which hold major high transmission hotspot areas. Methods: We screened qualitative studies that focused in-depth on the barriers of malaria control measures for meta-synthesis, which were published between 2010 and 2020 in the Asian and African countries. We followed PRISMA guidelines to conduct a literature search on 7 databases and the quality of the articles was assessed by the SRQR guide. We conducted thematic synthesis and quantified the themes to assess the proportion of barriers identified in both continents and highlighted the barriers and recommendations using an explanatory framework. Results: We have selected 8 articles, which studied in-depth perceptions, barriers, and challenges of malaria control interventions in both Asian and African communities. The lack of knowledge on malaria, approaching traditional healers for treatment, and corruption in the distribution of insecticide nets were the major identified barriers in Asian countries, whereas lack of knowledge and noncompliance to drugs due to side effects were the major issues reported in African countries. Conclusion: Meta-synthesis is designed to investigate the common phenomena among diverse settings. In this study, we have attempted to pool the commonalities and contrasts in barriers of malaria control interventions in both countries. The results of the review givefirsthand information to the policymakers for revising strategies and priorities for the malaria elimination goals in both developing countries.

Parental Education and the Responses to Higher SAT Scores

<h3>Abstract</h3> Using discontinuities within the Swedish SAT system, we study the causal impact of additional admission opportunities on participation in higher education among high-ability students. Students with low-educated parents who marginally pass an SAT score threshold, are more likely to enroll and graduate from programs they could have attended even with a lower score. This suggests that they face behavioral barriers even in a setting where colleges are tuition-free, student grants universal, and application systems simple. In contrast, students with high-educated parents respond to enhanced opportunities in ways that appear rational and informed; particularly by switching to higher-quality, more competitive programs.

Psychological Distance, Construal Level, and Parental Vaccine Hesitancy for COVID-19, HPV, and Monkey Pox Vaccines.

Building on the construal-level theory and the multi-dimensional model of behavioral barriers, this study examined whether psychological distance and construal level explain the association between behavioral intention and behavioral barriers that may lead to parental vaccine hesitancy. Results of multilevel structural equation models show that low vaccination intention, far distance perception, and abstract construal of vaccines led to more global concerns, such as vaccine safety and relevance. Such effects emerged when people considered specific vaccines, such as coronavirus disease 2019 (COVID-19), human papillomavirus (HPV), and monkeypox vaccines, and when they considered multiple vaccines in general.

‘You have to use everything and come to some equilibrium’: a qualitative study on hypoglycemia self-management in users of continuous glucose monitor with diverse hypoglycemia experiences

IntroductionAlthough continuous glucose monitoring systems (CGMs) can help reduce hypoglycemia, about one-quarter of people with type 1 diabetes (T1D) who use CGMs still either spend at least 1% of the...

Implementation Challenges of ICT in the Public Sector in Upazila Region of Bangladesh: An Empirical Study

Information and Communication Technology (ICT) plays a pivotal role in achieving Digital Bangladesh's vision of making the government accountable, transparent and effective in providing services to the citizens. The ICT-based governance (e-governance) in service delivery mechanism has become essential and time worthy. However, the implementation of e-governance is not up to the mark and the government is not getting the full benefits of e-governance due to the structural, organizational, and behavioral barriers. The dilemma between the service providers (agent) with numerous problems and the recipients’ viewpoints (principal) has been analyzed how the problem lies and the principal faces problem to get services. The objective of this study is to analyze the current situation of ICT-enabled Public Service Delivery; implementation challenges of ICT at the Upazila level of Bangladesh and come up with an evidence-based solution. To achieve the objectives, both qualitative and quantitative approaches were employed. Purposive random sampling was used to collect data through offline and online questionnaire surveys. Besides, interview and observation methods were also employed for strengthening the study findings. The study found that strong policy supports of the government i.e. ICT policy, and digital Bangladesh vision enable the e-government services to benefit the citizen. However, it is evident that the dearth of IT physical infrastructure, unstable internet connection, shortage of skilled manpower, and technology fear of public employees create obstacles to provide ITC-enabled services. Sometimes people’s unawareness also serves as barrier to receive e-government services. The study recommends improvement of internet speed, supply of continuous electricity supply, training of public employees, providing upgraded technology, and developing user-friendly softwares to address those problems and enhance ICT-induced public service delivery system. &#x0D; Keywords: E-governance, Readiness, Public Service Delivery, Barriers, Way forward

Using Principles of an Adaptation Framework to Adapt a Transdiagnostic Psychotherapy for People With HIV to Improve Mental Health and HIV Treatment Engagement: Focus Groups and Formative Research Study.

HIV treatment engagement is critical for people with HIV; however, behavioral health comorbidities and HIV-related stigma are key barriers to engagement. Treatments that address these barriers and can be readily implemented in HIV care settings are needed. We presented the process for adapting transdiagnostic cognitive behavioral psychotherapy, the Common Elements Treatment Approach (CETA), for people with HIV receiving HIV treatment at a Southern US HIV clinic. Behavioral health targets included posttraumatic stress, depression, anxiety, substance use, and safety concerns (eg, suicidality). The adaptation also included ways to address HIV-related stigma and a component based on Life-Steps, a brief cognitive behavioral intervention to support patient HIV treatment engagement. We applied principles of the Assessment, Decision, Administration, Production, Topical Experts, Integration, Training, Testing model, a framework for adapting evidence-based HIV interventions, and described our adaptation process, which included adapting the CETA manual based on expert input; conducting 3 focus groups, one with clinic social workers (n=3) and 2 with male (n=3) and female (n=4) patients to obtain stakeholder input for the adapted therapy; revising the manual according to this input; and training 2 counselors on the adapted protocol, including a workshop held over the internet followed by implementing the therapy with 3 clinic patients and receiving case-based consultation for them. For the focus groups, all clinic social workers were invited to participate, and patients were referred by clinic social workers if they were adults receiving services at the clinic and willing to provide written informed consent. Social worker focus group questions elicited reactions to the adapted therapy manual and content. Patient focus group questions elicited experiences with behavioral health conditions and HIV-related stigma and their impacts on HIV treatment engagement. Transcripts were reviewed by 3 team members to catalog participant commentary according to themes relevant to adapting CETA for people with HIV. Coauthors independently identified themes and met to discuss and reach a consensus on them. We successfully used principles of the Assessment, Decision, Administration, Production, Topical Experts, Integration, Training, Testing framework to adapt CETA for people with HIV. The focus group with social workers indicated that the adapted therapy made conceptual sense and addressed common behavioral health concerns and practical and cognitive behavioral barriers to HIV treatment engagement. Key considerations for CETA for people with HIV obtained from social worker and patient focus groups were related to stigma, socioeconomic stress, and instability experienced by the clinic population and some patients' substance use, which can thwart the stability needed to engage in care. The resulting brief, manualized therapy is designed to help patients build skills that promote HIV treatment engagement and reduce symptoms of common behavioral health conditions that are known to thwart HIV treatment engagement.

Assessing Barriers and Adherence to Insulin Injection Technique in People With Diabetes: Development and Validation of New Assessment Tools.

The correct injection technique is crucial for people with insulin therapy. However, barriers to insulin injections exist, which can lead to problems with injections. In addition, injection behavior may deviate from recommendations leading to lower adherence to the correct injection technique. We developed two scales to assess barriers and adherence to the correct technique. Two item pools were created to assess barriers to insulin injections (barriers scale) and adherence to the correct technique (adherence scale). In an evaluation study, participants completed the two newly created scales, as well as other questionnaires used for criterion validity. Exploratory factor analysis, correlational analysis, and receiver operating characteristics analysis were computed to analyze the validity of the scales. A total of 313 people with type 1 and type 2 diabetes using an insulin pen for insulin injections participated. For the barriers scale, 12 items were selected achieving a reliability of 0.74. The factor analysis revealed three factors namely emotional, cognitive, and behavioral barriers. For the adherence scale, nine items were selected achieving a reliability of 0.78. Both scales showed significant associations with diabetes self-management, diabetes distress, diabetes acceptance, and diabetes empowerment. Receiver operating characteristics analysis showed significant area under the curves for both scales in classifying people with current skin irritations. Reliability and validity of the two scales assessing barriers and adherence to insulin injection technique were demonstrated. The two scales can be used in clinical practice to identify persons in need of education in insulin injection technique.

Building cover crop expertise with citizen science in the upper Midwest: supporting farmer innovation in a time of change

The use of cover cropping, as one element in a continuous living cover approach, has the potential to protect water quality and promote soil health, but overall U.S. acreage in cover crops as well as adoption rates remain low. Research on behavioral barriers to cover crop use indicates a lack of information about locally suitable practices and cover crop varieties, as well as the additional management complexity of cover cropping and a high degree of uncertainty in outcomes, especially in areas with shorter growing seasons. This paper describes the development of a citizen science project on cover cropping in Wisconsin designed to (i) generate more geographically distributed data on cover crop performance in the state; and (ii) build understanding of farmer decision-making around growing practices, barriers, and motivations for cover cropping. Citizen science, as it relies on physically distributed members of the public in data generation, is well established as an avenue for generating environmental data. We engage the approach as a tool for also researching influences on individual behavior and identifying potential leverage points for change, especially on-farm innovation and experimentation. I share project findings regarding cover cropping practices and biomass production, results on motivations and influences for cover cropping, as well as participatory approaches to share those results with farmers. This project also offers more general insights into how the citizen science model can be used to expand understanding of decision-making contexts, and to develop responsive outreach efforts that support participants in taking action.

Mapping of the Bioeconomy Ecosystem in Latvia

Bioeconomy is no longer limited to being a concept in research papers and policy strategies; it presents real opportunities for regional development, i.e., by improving local employment, socio-economic development, economy and sustainable local bioresource use. But the obtaining of these opportunities is challenged by various barriers. It is proposed that analogously with other widely research fields (energy efficiency, industrial sustainability), the implementation of novel bioeconomy ideas, even when they are scientifically based, encounters the so-called ‘implementation gap’ (similarly to, e.g., the ‘energy efficiency gap’). This implementation gap is related to national, but also regional challenges, i.e., technical, economic, organizational, behavior and other barriers that hinder the most successful bioeconomy deployment. The technical obstacles can be, e.g., lack of processing or production technologies, capacity problems, while organizational barriers can manifest as logistics chain problems due to the availability of bioresources or internal organization problems of the company, lack of time, reluctance to take on new responsibilities or lack of awareness of opportunities provided by the bioeconomy. This significance of the regional analysis level for barrier assessment calls for more precise information. The first step for in-depth investigation of the bioeconomy implementation gap in Latvian context is the research of the bioeconomy ecosystem. In fact, as required by the National industrial policy guidelines, the Strategy for knowledge based bioeconomy development for Latvia was developed in 2022 by the Latvian bioeconomy ecosystem stakeholders. The current research focuses on the identification and more detailed characterization of the stakeholders of Latvian bioeconomy ecosystem, their interactions, as well as the identification of current challenges and barriers for knowledge-based bioeconomy and innovations development. In order to further elaborate the structure of the bioeconomy ecosystem, the mapping of ecosystem stakeholders was implemented.

Using Behavior Change Theory to Identify Drivers and Barriers for Antifungal Treatment Decisions: A CaseStudy in a Large Teaching Hospital in the East of England, UK.

Antifungal stewardship (AFS) programs are recognized to contribute to optimizing antifungal prescribing for treatment and prophylaxis. However, only a small number of such programs are implemented. Consequently, evidence on behavioral drivers and barriers of such programs and learnings from existing successful AFS programs is limited. This study aimed to leverage a large AFS program in the UK and derive learnings from it. The objective was to (a) investigate the impact of the AFS program on prescribing habits, (a) use a Theoretical Domains Framework (TDF) based on the COM-B (Capability, Opportunity, and Motivation for Behavior) to qualitatively identify drivers and barriers for antifungal prescribing behaviors across multiple specialties, and (c) semiquantitatively investigate trends in antifungal prescribing habits over the last 5years. Qualitative interviews and a semiquantitative online survey were conducted across hematology, intensive care, respiratory, and solid organ transplant clinicians at Cambridge University Hospital. The discussion guide and survey used were developed to identify drivers of prescribing behavior, based on the TDF. Responses were received from 21/25 clinicians. Qualitative outcomes demonstrated that the AFS program was effective in supporting optimal antifungal prescribing practices. We found seven TDF domains influencing antifungal prescribing decisions-five drivers and two barriers. The key driver was collective decision-making among the multidisciplinary team (MDT) while key barriers were lack of access to certain therapies and fungal diagnostic capabilities. Furthermore, over the last 5years and across specialties, we observed an increasing tendency for prescribing to focus on more targeted rather than broad-spectrum antifungals. Understanding the basis for linked clinicians' prescribing behaviors for identified drivers and barriers may inform interventions on AFS programs and contribute to consistently improving antifungal prescribing. Collective decision-making among the MDT may be leveraged to improve clinicians' antifungal prescribing. These findings may be generalized across specialty care settings.

Behavioral and neural network characterizations of the reinforcement of voluntary physical activity in heterogenous mice

Maintaining healthy and consistent levels of physical activity (PA) is a cost-effective means of reducing the onset of &gt;40-chronic diseases; however, these benefits go largely unrealized by the ~97% of adult Americans who fail to meet activity guidelines. Our prior work suggests that acute activity engages aversion-related brain regions, which may act as a barrier to PA adherence. Chronic PA is reinforcing and creates neural remodeling a across a network of brain regions belonging to the mesocorticolimbic system - comprising of stress and aversion-related brain regions [such as the basolateral amygdala (BLA)] and important reinforcement brain regions [i.e., the ventral tegmental area (VTA)]. A primary focus of this study is to determine how neural inputs to the nucleus accumbens (NAc) -the central point of convergence for this system– are engaged during acute and chronic PA. Objectives: Here we tested whether sex differences in the reinforcing value of wheel-running exist in a genetically diverse population of mice, the Heterogeneous Stock/Northport (HS/Npt). Moreover, we sought to identify the neural circuits engaged during acute and chronic voluntary wheel-running in these mice. Hypothesis: Given established findings that female rodents run more than males, we hypothesized that female HS/Npt mice would find wheel-running less aversive than males. We further hypothesized that 1-week of voluntary wheel-running would increase cFos expression (compared to mice with 1-week of wheel-lock) in brain regions associated with stress and aversion, whereas 4-weeks of wheel-running would increase neural engagement in brain regions associated with reinforcement, including the NAc, insular cortex, VTA and the medial preoptic area (a sexually dimorphic brain region critical for the estrogenic control of wheel-running in female rodents). Methods: As a proxy for their hedonic state, mice were provided a two-bottle choice saccharin preference test following acute or chronic PA. To better define the mesocorticolimbic system, we used an established retrograde tracer (rAAV-retro) to label the neural inputs to the NAc, which helped to identify important brain region involvement at two distinct stages of PA reinforcement. Results: There were no differences in running distance between female and male mice at 1- or 4-weeks and no differences in saccharin preference at 1-week. In contrast, male HS/Npt showed lower saccharin preference compared to females at 4-weeks of voluntary wheel running, suggesting a potential sex difference in the reinforcement value of chronic PA. Whole brain cFOS imaging is currently underway. Conclusions: It appears that chronic voluntary activity may confer lower hedonic states in male mice. Moreover, an improved understanding of how neural circuits across the mesocorticolimbic system are engaged during crtical stages of PA (in males and females) may prove important for determining neural and behavioral barriers to exercise adherence in humans. American College of Sports Medicine This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Population Segmentation for COVID-19 Vaccine Outreach: A Clustering Analysis and Implementation in Missouri.

The purpose of this work was to segment the Missouri population into unique groups related to COVID-19 vaccine acceptance using data science and behavioral science methods to develop tailored vaccine outreach strategies. Cluster analysis techniques were applied to a large data set that aggregated vaccination data with behavioral and demographic data from the American Community Survey and Deloitte's HealthPrism™ data set. Outreach recommendations were developed for each cluster, specific to each group's practical and motivational barriers to vaccination. Following selection procedures, 10 clusters-or segments-of census tracts across Missouri were identified on the basis of k -means clustering analysis of 18 different variables. Each cluster exhibited unique geographic, demographic, socioeconomic, and behavioral patterns, and outreach strategies were developed on the basis of each cluster's practical and motivational barriers. The segmentation analysis served as the foundation for "working groups" comprising the 115 local public health agencies (LPHAs) across the state. LPHAs with similar community segments in their service area were grouped together to discuss their communities' specific challenges, share lessons learned, and brainstorm new approaches. The working groups provided a novel way for public health to organize and collaborate across the state. Widening the aperture beyond Missouri, population segmentation via cluster analysis is a promising approach for public health practitioners interested in developing a richer understanding of the types of populations they serve. By pairing segmentation with behavioral science, practitioners can develop outreach programs and communications campaigns that are personalized to the specific behavioral barriers and needs of the population in focus. While our work focused on COVID-19, this approach has broad applicability to enhance the way public health practitioners understand the populations they serve to deliver more tailored services.

Use of Nudges for Promotion of Sustainable Energy Consumption in Households

Sustainable energy consumption in household is linked to energy saving and the use of renewable energy sources. These are also the main measures of GHG emission reduction linked to energy consumption. There is a huge GHG emission reduction potential linked to energy consumption in households as climate change mitigation policies and measures aiming at sustainable energy consumption are mainly targeting energy supply sector. Climate change mitigation policies in households linked to promote of energy savings and use of renewable energy sources were not able to overcome behavioural barriers of sustainable energy consumption in households, as they were targeting economic barriers mainly. Therefore, new policies and measures targeting behavioural barriers of sustainable energy consumption inn households are necessary. The paper analyses behavioural barriers of sustainable energy consumption in households and provides analysis of policies and measures set to overcome behavioural barriers of sustainable energy consumption. The analysis of advantages and disadvantages of nudges is provided policy recommendations were developed based on analysis conducted.

Effect of Whole-Body Vibration During Chemotherapy in Improving Functional Outcomes of Patients with Malignancies

The use of functional outcome scales to see the effect of whole-body vibration on the patients having malignancies and going through chemotherapy. Objective: To perform a systematic review to see the effects of whole-body vibration on patients having chemotherapy. Methods: Using the specified keywords, a search was conducted in the TRIP, PEDro and PubMed databases. The studies were picked based on their eligibility for evaluation. The articles having full length were included which specified the effect of whole-body vibration technique in the patients having malignancies and going through chemotherapy. Results: According to the exclusion criteria, three publications were included, all related to patients having chemotherapy. Reported were the effects of WBV both in sensory and motor symptoms. Conclusions: It was concluded that by using the whole-body vibrator the debilitating effects of the chemotherapy can be controlled or minimized such as fatigue, weakness and bone loss. It is comparative to high intensity exercises which account behavioral barriers and certain risks

Barriers to HIV Testing among Clients of Female Sex Workers an Assessment of Ogoja Local Government Area

Frequent engagement of men in sexual encounters with female sex workers (FSWs) while not using condoms places them at high risk for Human Immunodeficiency Virus (HIV) infection. HIV testing has been noted to be among the necessary methods to stop HIV transmission and acquisition. However, it’s illustrious that not all men voluntarily test for Human Immunodeficiency Virus (HIV), take a look at how to stop Human immunodeficiency virus (HIV) transmission and/or acquisition. This study aimed to spot barriers to accessing Human immunodeficiency virus (HIV) testing services among men. World Health Organization square measure shoppers of female sex workers (clients) in Ogoja Cross River North, South-South Nigeria. A comprehensive search of recent literature uncovered a fancy array of social, Personal, and behavioural barriers, as well as knowledge/awareness of the Human immunodeficiency virus (HIV) infection’s existence, perception of human immunodeficiency (HIV) risk, stigma from care suppliers or family/partners/friends, distrust of care providers/systems. The purpose of this study is to explore possible barriers to HIV counseling and testing uptake among clients of Female Sex Workers in the Ogoja Local Government area of Cross River State, Nigeria, and to see possible ways of mitigating the barriers to epidemic control. This study was conducted in Ogoja Cross River State, Nigeria, with a sample size of 100 male clients of female sex workers, via random sampling technique through an online survey system known as Mwater for data collection. Frequency counts and percentages were used for data analysis. Vital findings of the study conclude: stigma and trust impact uptake of HIV test among male clients of female sex workers. Keywords: Acquired immunodeficiency syndromes, Barriers, Female sex workers, Human immunodeficiency virus, Human immunodeficiency virus testing, Male.

Screening behaviors and related factors among the first-degree relatives of Chinese patients with gastric cancer

ObjectiveThis study was aimed at investigating the screening behaviors of the first-degree relatives (FDRs) of Chinese patients with gastric cancer as well as the factors influencing screening behaviors. MethodsIn a cross-sectional design, 197 FDRs of patients with gastric cancer were enrolled at the Peking University Cancer Hospital. Four questionnaires were used: a demographic questionnaire, a knowledge questionnaire of risk factors and warning symptoms for gastric cancer, the Gastric Cancer Health Belief Scale, and a questionnaire screening for behavioral motivators and barriers. Logistic regression analysis was performed to determine the factors influencing screening behaviors. ResultsAmong the 197 FDRs of patients with gastric cancer, 30.96% (61/197) of patients had undergone gastric cancer screening. Among those who participated in gastric cancer screening, the most common screening methods were gastroscopy and the Helicobacter pylori testing, both of which were applied in 63.93% (39/61) of participants, followed by serum tumor marker testing (55.74%, 34/61) and barium meal examination of the upper digestive tract (29.51%, 18/61). The gastric cancer risk factor knowledge score was 9.02 ​± ​3.95, and the gastric cancer warning symptom knowledge score was 4.39 ​± ​1.85. The participants’ knowledge score was moderate, at 13.41 ​± ​5.16. The total health beliefs score was low, at 88.91 ​± ​12.66. Factors independently associated with the screening behaviors of FDRs included educational background, knowledge of gastric cancer risk factors, and health motivation (P ​< ​0.05). ConclusionsThe participation rate in gastric cancer screening of FDRs of patients with gastric cancer was relatively low and was affected by multiple factors. Our results highlighted the urgent need for educational campaigns and precision interventions to raise gastric cancer awareness.

Downstream fish passage at small-scale hydropower plants: Turbine or bypass?

Introduction: Hydropower plants are frequently equipped with physical and behavioral fish protection barriers to prevent downstream moving fish from harmful turbine passage and to guide them to alternative bypasses. As not only diadromous but also potamodromous fish species migrate and inevitably have to pass hydropower plants, knowledge on corridor usage for a wide range of species is important to identify potential deficits and to improve bypass efficiency.Methods: In this study, the corridor usage of downstream moving fish (6,646 individuals from 42 species) was investigated at four small-scale hydropower plants with different concepts to prevent turbine entrainment and to bypass fish.Results: Despite existing bypasses and fine screens with 15 mm and 20 mm bar spacing to prevent turbine entrainment, a large proportion of fish (35%–88%) still passed the turbines. The mainly poor efficiency of the investigated bypasses was probably due to low discharge and unfavorable bypass location or detectability. The various bypass types were used by a different range of fish species and sizes due to species-specific behavior and differing fish communities between sites. The effectiveness of the investigated downstream corridors was positively correlated with the share of discharge.Discussion: To reduce the negative ecological impacts of hydropower plants on downstream moving fish, well-performing bypasses are required that consider not only current requirements regarding design, dimensioning and location, but also the site-specific fish community. Thus, bypasses should function for the widest possible range of species, which can be achieved through less selective bypass types such as full-depth bypasses, or a combination of different bypass systems. Moreover, less harmful turbine technologies and more effective fish protection systems need to be implemented, since fine screens with 15 mm and 20 mm bar spacing cannot prevent small-bodied fish species and juvenile fish &amp;lt;20 cm from turbine entrainment.

Facilitators and barriers of preventive behaviors against COVID-19 during Ramadan: A phenomenology of Indonesian adults.

Intercity mobility restriction, physical distancing, and mask-wearing are preventive behaviors to reduce the transmission of COVID-19. However, strong cultural and religious traditions become particular challenges in Indonesia. This study uses the Behavior Change Wheel to explore barriers and facilitators for intercity mobility restriction, physical distancing, and mask-wearing during Ramadan. Semi-structured in-depth interviews with 50 Indonesian adults were conducted between 10 April and 4 June 2020. Having mapped codes into the Capacity, Opportunity, Motivation - Behavior (COM-B), and Theoretical Domain Framework (TDF) model, we conducted summative content analysis to analyze the most identified factors to preventive behaviors and proposed interventions to address those factors. Belief about the consequence of preventive behaviors was the most mentioned facilitator to all preventive behaviors among compliers. However, optimism as a TDF factor was commonly mentioned as a barrier to preventive behaviors among non-compliers, while environmental context and resources were the most commonly mentioned factors for intercity mobility restriction. Public health intervention should be implemented considering the persuasion and involvement of religious and local leaders. Concerning job and economic context, policy related to the intercity mobility restriction should be reconsidered to prevent a counterproductive effect.