In low- and middle-income countries (LMICs), where the majority of children with developmental disorders live, access to early, specialized interventions is highly limited. While studies from high-income countries show that tailored early intervention can be effective in learning new skills, there remains a lack of evidence-based approaches specifically designed for the realities of LMICs. The study included 50 preschoolers, 25 of whom (mean age = 52.4months) participated in an individualized developmental and behavioral program combined with parent education in addition to preschool attendance over a six-month period. The remaining 25 children (mean age = 50.5months) attended only preschool. The intervention averaged 2.9h per week (range: 2.1-4h) and targeted age-appropriate developmental goals. Additionally, parents received an average of 0.6h per week (range: 0.2-0.7h) of education to support the generalization of skills to daily life. Children who received the individualized developmental and behavioral intervention combined with parent education in addition to preschool made statistically significant progress across all developmental areas compared to those who attended only preschool. These findings highlight the potential of locally adapted, evidence-based, low-intensity interventions, combined with parent education, to improve outcomes for children with developmental disorders, including autism, in LMICs.

BACKGROUND Approximately 30% of patients with head and neck cancer experience adverse effects caused by anxiety and depression. Considering the high prevalence, implementing customized interventions to ease adverse emotional states is imperative. AIM To evaluate the efficacy of cognitive behavioral therapy (CBT)-based psychological interventions in improving the psychological well-being and quality of life (QoL) of patients with laryngeal carcinoma. METHODS This study enrolled 120 patients admitted from February 2022 to February 2024. The control group, comprising 50 participants, received standard supportive psychological care, while the research group, consisting 70 participants, underwent CBT-based interventions. Several clinical outcomes were systematically assessed that included postoperative recovery metrics (duration of tracheostomy and nasogastric tube dependence and length of hospitalization), psychological status (Self-Rating Anxiety Scale and Self-Rating Depression Scale), nutritional markers (serum albumin and hemoglobin levels), sleep quality (Self-Rating Scale of Sleep and Athens Insomnia Scale), and QoL (Functional Assessment of Cancer Therapy-Head and Neck). RESULTS The results demonstrated that the research group experienced superior outcomes, with significantly reduced durations of tracheostomy and nasogastric tube dependence, as well as shorter hospital stays, compared with the control group. Additionally, the research group exhibited markedly lower post-intervention Self-Rating Anxiety Scale, Self-Rating Depression Scale, Self-Rating Scale of Sleep, and Athens Insomnia Scale scores, along with minimal but higher change in serum albumin and hemoglobin levels compared with the control group. All five domains of Functional Assessment of Cancer Therapy-Head and Neck showed notable improvements in the research group, exceeding those observed in the control group. CONCLUSION CBT-based psychological support positively affects the mental well-being and QoL of patients with laryngeal carcinoma, highlighting its potential for broader clinical application.

Abstract Aspirations may condition the future-oriented choices of individuals and thus may play a role in the persistence of poverty or the effort to break out of it. We run a randomised control trial in remote, rural Ethiopia to explore this and evaluate an intervention which aims to change how poor people perceive their future opportunities, alter their aspirations and, through that, modify their investment decisions. A treatment group was shown video documentaries featuring individuals from similar communities who escaped poverty through their own efforts and serve as relatable role models. Five years after the screening took place, the treated households had increased future-oriented investments in agriculture, children’s education and assets. The results can be explained by an increase in aspirations in terms of lifetime goals. Overall, this research uniquely provides evidence that a light-touch behavioural intervention can have persistent economic impacts on a poor population.

To identify diurnal glycemic patterns in adults with type 2 diabetes (T2D) using continuous glucose monitoring (CGM)-based machine learning and examine their association with diabetes distress, a key psychosocial outcome. In this observational study, 137 adults with T2D wore blinded CGM (FreeStyle Libre Pro), yielding 1657 days of data. Glycemic patterns were identified using unsupervised machine learning via Gaussian mixture modeling, validated with Bayesian information criterion and silhouette scores. Diabetes distress was assessed with the 17-item Diabetes Distress Scale and analyzed through analysis of covariance (ANCOVA), adjusting for age, sex, body mass index, diabetes duration, and glucose management indicator. Clustering identified four distinct glycemic profiles: Cluster 1 (suboptimal control, nocturnal hypoglycemia; 15.8%), Cluster 2 (suboptimal control, nocturnal hyperglycemia; 27.1%), Cluster 3 (poorly controlled, prolonged hyperglycemia; 21.1%), and Cluster 4 (well controlled; 36.1%). Diabetes distress scores varied significantly: participants in Cluster 3 reported the highest distress (mean = 2.37, 95% CI = 1.99-2.76), while Cluster 4 reported the lowest (mean = 1.67, 95% CI = 1.48-1.86; P = .03). Effect sizes indicated differences corresponded to clinically meaningful categories of "little or no distress" vs "moderate distress." CGM-based machine learning identified physiologically distinct glycemic phenotypes that were also associated with psychosocial burden. This work demonstrates the added value of integrating CGM-derived profiles with patient-reported outcomes. These findings highlight the potential of CGM phenotyping to support precision diabetes care by enabling early identification of high-risk subgroups, guiding tailored behavioral and psychosocial interventions, and informing technology-enabled decision tools that connect physiological monitoring with emotional well-being in T2D management.

Sarcopenic obesity (SO), characterized by the coexistence of excess adiposity and diminished muscle mass and function, represents an increasing health concern among the older adults. Resistance and aerobic exercises are effective strategies for managing this condition. However, due to low exercise adherence among older adults, the current state of prevention and control of SO remains challenging. Moreover, qualitative insights into the specific exercise experiences of this population, particularly in the Chinese context, are lacking. This study seeks to elucidate the barriers and facilitators to exercise adherence among elderly individuals affected by SO through the application of the Theoretical Domains Framework (TDF) and the Capability, Opportunity, Motivation-Behavior (COM-B) model. This study employed a descriptive qualitative research methodology. From March to September 2024, 21 community-dwelling older adults with SO were recruited in Southwest China to participate in face-to-face, semi-structured interviews. Participants were aged 60 years or older and diagnosed with SO. The interview outline was developed based on the TDF, and interviews were audio-recorded and transcribed verbatim. Data were analyzed using both deductive and inductive approaches, and the identified themes were mapped onto the TDF and the COM-B model. This study analyzed a total of 488 utterances, which comprehensively covered 12 domains of the TDF and the 3 core components of the COM-B model. Six barrier themes and three facilitator themes were identified. The main barriers included inadequate capability (e.g., lack of knowledge, insufficient exercise confidence, poor self-control), limited opportunity (e.g., unsafe environments, body image pressure), and insufficient motivation (e.g., lack of security). The facilitators included motivation (e.g., perceived benefits of exercise, perceived disease threat) and opportunity (e.g., multidimensional social support). This study revealed that exercise adherence among geriatric individuals with SO is influenced by a complex interplay of factors. The key barriers identified were insufficient exercise confidence and lack of security. Future research should incorporate targeted behavioral intervention strategies, such as demonstration of the behavior, verbal persuasion about capability, pros and cons, and restructuring the physical environment, to effectively address the multifaceted challenges associated with SO in older adults. These strategies should be central to the development of effective intervention programs aimed at promoting physical activity among this cohort.

Decentralized clinical trials (DCTs), particularly in the U.S., gained substantial attention during the COVID-19 pandemic, enabling trial activities to be conducted from participants’ homes or local healthcare facilities despite restrictions and lockdowns. Regardless of the growth in interest, many facets of the DCT landscape remain unexplored or nascent in their development. This study aims to explore the key characteristics and development of the U.S.-registered DCT landscape, adoption patterns across various clinical contexts, and the role of digital technologies. We analyzed 1370 decentralized trials from ClinicalTrials.gov, collected using a broad DCT-keyword search. The data were screened and coded manually, and analyzed descriptively for temporal trends, purpose of decentralization, intervention type, geographic representation, and digitalization. Our findings align with previous reports of a growing, heterogeneous landscape of DCTs, with behavioral interventions appearing more suitable for decentralization than other types of interventions. Notably, most DCTs still focus on evaluating decentralized methods rather than merely implementing them in their investigations. Often, studies integrate digital tools either as the interventions themselves or to enable the digital delivery of study activities. Although the trial registry used is U.S.-based, and a U.S. partner is part of more than 50% of the studies identified, many trials are done in multiple countries or countries outside of the U.S. (42%). Among these trials, the data revealed considerable differences, with digitalized DCTs in this sample concentrated in high-income countries. Despite rapid growth in DCTs, our findings suggest the presence of a field in development, very much focused on establishing a methodological foundation. To unlock the potential of DCTs locally and globally, four critical areas demand further attention: digital equity, regulatory frameworks for diverse technologies, establishment of methodological validation processes, and further research on barriers to implementation.

Objective The prevalence of metabolic syndrome is high among Chinese residents, and it is crucial to understand the current situation and intervene promptly. In this study, we investigated the current status of metabolic syndrome in some regions of China, analyzed related risk factors, and developed a risk prediction model to guide preventive measures. Methods A multistage stratified cluster random sampling method was used to select 3541 permanent residents aged 18-79 years from a district in Beijing for face-to-face questionnaire surveys, physical examinations, and laboratory tests. All participants were randomly divided into training and validation sets. Correlation analysis and multivariate logistic regression were employed to identify risk factors for metabolic syndrome, and a column-line graph prediction model was developed. The discriminative ability and predictive accuracy of the model were assessed by receiver operating characteristic (ROC) curve and calibration curves. Results The prevalence of metabolic syndrome in this study was 18.4%. The results of multivariate logistic regression analysis showed that increasing age, being male (OR = 1.827), being overweight (OR = 4.865), being obese (OR = 11.482), hazardous alcohol consumption (OR = 1.673), marital/cohabitation history, and specific occupations (agriculture, forestry, fisheries, and water production, and unemployed) were independent risk factors for metabolic syndrome ( P < 0.05). The column-line graph prediction model, constructed accordingly, performed well, and the model indicated that BMI and age were the most significant risk factors for metabolic syndrome. The results of model validation showed that the AUCs of the training and validation sets were 0.815 (95% CI: 0.795-0.836) and 0.787 (95% CI: 0.756-0.818), respectively, indicating that the model performed well in discriminating. The model exhibited a good fit on the training set (with 1000 resamples via the Bootstrap method; calibration slope = 1.002, calibration intercept = 0.005; Hosmer-Lemeshow test, P = 0.127 > 0.05). The initial validation set showed signs of slight overfitting, and after probability calibration using the Platt Scaling method, the model’s calibration performance was significantly improved (calibration slope = 0.92, calibration intercept = -0.03; Hosmer-Lemeshow test, P = 0.082 > 0.05). The Brier scores of the training set and validation set were 0.120 and 0.136, respectively, with mean absolute errors (MAE) of 0.240 and 0.256, indicating that the model had favorable predictive accuracy and stability. Conclusions The metabolic syndrome column-line diagram risk prediction model constructed in this study, based on multivariate logistic regression analysis, has good discriminative ability and high prediction accuracy. The model shows that a large proportion of the current risk factors for metabolic syndrome are modifiable, and that the risk of metabolic syndrome in high-risk groups, such as the elderly, men, people with marital/cohabitation histories, and people with specific occupations, can be reduced through behavioral and lifestyle interventions. This model can provide a scientific basis for the early identification of high-risk groups for metabolic syndrome and has an important guiding value for targeted preventive interventions.

Introduction Effective management of municipal solid waste (MSW)is a persistent challenge in India, where rapid urbanization and limited infrastructure contribute to unscientific disposal practices. Household (HH) waste constitutes the largest share of MSW, yet reliable data on its generation and composition remain scarce. This study presents a baseline assessment conducted in Ujjain, Madhya Pradesh, as part of the I-MISS intervention on HH waste segregation. Methodology A cross-sectional survey was undertaken among 215 HHs across slum and non-slum areas. Waste was collected daily for seven consecutive days, sorted into 23 predefined fractions, and analyzed for per capita and per HH-level generation, composition, and mis-sorting. Results Findings reveal an average daily per capita generation of 141.0 g and 146.7 g,and per HH generation of 651.4 g. Organic waste formed the largest fraction (69.1%), followed by plastics, paper, and textiles. Nearly half (48.1%) of the dry waste stream was mis-sorted, mainly due to organic and sanitary fractions being placed incorrectly. Mis-sorting was more pronounced in slum HHs, particularly for sanitary and hazardous sharp waste. Statistical analysis highlighted that family size, house type, and socio-economic status (SES) significantly influenced waste generation patterns, with smaller HHs and middle-income groups producing more waste. Discussion The study underscores the urgent need to strengthen HH-level segregation through targeted behavioral interventions and improved infrastructure. Emphasizing composting, recycling, and the safe disposal of sanitary and hazardous waste can enhance resource recovery and reduce environmental risks. These findings provide crucial evidence to inform urban waste management policies and design locally appropriate, sustainable strategies for Indian cities.

Background and objective Childhood, adolescence, and emerging adulthood represent critical transitional periods characterized by rapid biological, psychological, and social development, each of which may distinctly influence diet–mood interactions. To date, no study has concurrently examined the association between dietary diversity and depressive symptoms across the full developmental spectrum spanning these life stages. As a result, age-specific vulnerabilities and potential windows for intervention remain poorly understood. Using a large and diverse sample of Chinese children, adolescents, and university students, this cross-sectional study aimed to explore the relationship between dietary diversity and depressive symptoms across these key developmental periods. The findings may help inform the design of targeted, developmentally appropriate nutritional strategies for depression prevention. Materials and methods In this cross-sectional investigation, a total of 11,856 Chinese college students and 1,281 children and adolescents were enrolled. All participants completed self-administered questionnaires assessing demographic characteristics, lifestyle behaviors, dietary diversity, and depressive symptoms [evaluated with the Patient Health Questionnaire-9 (PHQ-9) and the 20-item Zung Self-Rating Depression Scale (SDS)]. Multivariable logistic regression analyses were employed to examine the associations between dietary diversity and depressive symptoms, with adjustment for relevant confounding factors. Results The prevalence of depressive symptoms was 18.9% (2,245/11,856) among college students and 4.7% (60/1,281) among children and adolescents. Among college students, a significant inverse relationship was observed between dietary diversity scores and depressive symptoms. Compared to participants with a score of 0, the adjusted odds ratios decreased progressively with higher scores, ranging from OR = 0.94 (95% CI: 0.39, 2.30) for a score of 1 to OR = 0.33 (95% CI: 0.13, 0.81) for a score of 9. Similarly, among children and adolescents, higher dietary diversity was associated with markedly lower odds of depressive symptoms, with ORs declining from 0.164 (95% CI: 0.007, 3.837) for one food score to 0.026 (95% CI: 0.002, 0.390) for seven food scores, relative to the zero-score reference group. In analyses of specific food groups, college students showed significant inverse associations between depressive symptoms and consumption of vegetables (OR = 0.67, 95% CI: 0.55, 0.81), fruits (OR = 0.78, 95% CI: 0.70, 0.88), red meat (OR = 0.85, 95% CI: 0.75, 0.95), and soy products (OR = 0.89, 95% CI: 0.80, 0.99). Among children and adolescents, significant associations were observed for multiple dietary factors, with inverse associations for fruit intake ( P = 0.019) and breakfast consumption ( P < 0.001), and positive associations for sugar-sweetened beverages ( P = 0.025), fried foods ( P < 0.001), fast food ( P < 0.001), and processed foods ( P = 0.033). Conclusions This study establishes a significant inverse relationship between dietary diversity and depressive symptoms. The results support the integration of dietary diversity into public health recommendations and behavioral interventions. Specifically, fostering diverse and healthy eating patterns emerges as a promising, practical strategy for the prevention of depressive symptoms, underscoring the role of nutrition in mental well-being.

This study examined the teachers’ strategies, challenges, and levels of discipline among modern-day learners at Sinunuc National High School in Zamboanga City. Using a mixed-method design, the quantitative phase involved thirty (30) Senior High School students who assessed the extent of teachers’ strategies and student discipline through a structured survey. The qualitative phase consisted of interviews with five (5) Senior High School teachers to explore the challenges encountered in maintaining classroom order. Descriptive statistics and regression analysis were utilized for quantitative data, while thematic analysis was employed for qualitative responses. Results revealed that teachers consistently used effective communication strategies, behavioral interventions, and collaborative problem-solving techniques to promote discipline. Students demonstrated a high level of discipline characterized by respect, compliance, and responsibility. Regression results showed that teachers’ strategies significantly predicted 68% of the variance in students’ discipline, indicating a strong relationship between teacher practices and student behavior. Findings highlight the importance of positive reinforcement, participatory rule-setting, restorative approaches, and consistent communication. Recommendations include strengthening student-centered strategies, enhancing teacher training, and sustaining collaborative discipline practices to improve classroom management and learner engagement.

Prioritizing Psychosocial Interventions for Disruptive Behaviors.

Background Drug use is inversely related with the availability of alternative, non-drug reinforcers. We recently demonstrated that brief single-item measures of past month non-drug reinforcement were associated with return to drug use and life satisfaction among people in substance use treatment. This study sought to extend the utility of these brief-to-collect measures to a general population and to determine associations with behavioral economic demand. Method Participants reporting current alcohol use were recruited using crowdsourcing methods (n = 380) and completed brief measures of non-drug enjoyability, availability, and relative frequency for their period of heaviest alcohol use and their current alcohol use. Alcohol demand was collected using hypothetical purchase tasks. Results Demand was significantly associated with relative frequency of drug use such that more proportional drug reinforcement was associated with higher demand intensity (Q 0) and reduced price sensitivity (p’s < 0.001). Non-drug availability was associated with demand intensity during both time periods, but only with price sensitivity during the heaviest use period. Non-drug enjoyability only had a significant relationship with demand intensity during the heaviest use period. Conclusions These findings further emphasize the inverse relationship between drug use and the availability, enjoyment, and engagement with non-drug activities. These data also highlight the validity of brief, easy to collect measures of non-drug reward making them ideal for use in the context of developing novel behavioral or pharmacological interventions for substance use disorder.

Interest is growing in whether healthcare professionals from a range of backgrounds can deliver complex behaviour-change interventions effectively. Thus, as part of a wider evaluation of 'REDUCE,' a novel, person-centred, cognitive behavioural intervention targeting the self-care behaviours of individuals with a history of diabetic foot ulcers, we explored whether, how, and why, a diverse group of healthcare professionals developed a sense of competence and confidence as facilitators of behaviour change. Our aim was to generate insights to support the recruitment, training, development and retention of appropriately skilled personnel for this and similar behaviour change-oriented interventions going forward. We interviewed 15 healthcare professionals who had been appointed and trained to deliver the REDUCE intervention in the context of a randomised controlled trial. We analysed the resulting data thematically. Our interviewees described diverse backgrounds, routes into the programme, and motivations, and similarly variegated journeys towards competence and confidence as facilitators. They observed how training provided a solid foundation on which to build, but that subsequent learning - substantially self-directed - also played an important part in their development. Interviewees emphasised the particular contributions of experiential learning and reflective practice, noting the key roles that supervision and group support played in the latter, and highlighting how such arrangements helped them to learn from, rather than be derailed by, challenging cases and interactions. Finally, interviewees talked of the returns and rewards of engaging with the REDUCE programme, and how they had benefited both professionally and personally from investing in their own development as facilitators of behaviour change. Healthcare professionals involved with this behaviour-change intervention were not passive recipients of training and support. Instead, they were self-directed learners who invested actively in their own development. To enable facilitators to reach their full potential, their agency needs to be recognised and interventions organised in ways which enable them to access appropriate experience and support. Not applicable (the manuscript reports on a qualitative study).

BackgroundDespite national recommendations, adult respiratory vaccination rates in the U.S. remain suboptimal, contributing to preventable morbidity and mortality. Co-administering influenza and COVID-19 vaccines is a practical, yet underutilized strategy to improve uptake.MethodsThis project assessed the impact of a team-based behavioral and educational intervention program on influenza and COVID-19 vaccine co-administration. Twenty U.S.-based outpatient clinics serving diverse adult populations were selected for the intervention group and matched to control clinics by vaccination history and demographics. All clinics operated within a technology-enabled vaccine administration ecosystem. Clinic staff (healthcare providers [HCPs] and non-HCPs) at intervention sites participated in the program, consisting of expert-led educational and behavioral interventions. Their perceptions and recommendation behaviors were assessed pre- and post-intervention using a modified Vaccine Confidence Index survey. Adult vaccination data were collected from August 2024 to February 2025. Co-administration rates (receipt of both vaccines within 24 hours) were compared between groups. Chi-square testing and relative risk (RR) estimates with 95% confidence intervals (CI) were calculated.Results23,430 and 91,924 adults (≥18 years) received an influenza vaccine in the intervention and control groups, respectively. Of these, 31.4% in intervention clinics and 21.4% in control clinics received a COVID-19 vaccine at the same visit (RR, 1.47; 95% CI, 1.43–1.50; p< 0.001). Among adults ≥65 years, 11,694 and 47,816 received an influenza vaccine in the intervention and control groups, respectively; co-administration rates were 32.1% versus 22.8% (RR, 1.41; 95% CI, 1.37–1.45; p< 0.001). Survey findings showed increased vaccine confidence and recommendation behaviors among intervention clinic staff.ConclusionA targeted seasonal program for clinic teams can significantly improve co-administration. These findings underscore the importance of staff behavioral and educational interventions. Further, it highlights their role in reducing missed opportunities for COVID-19 vaccination and strengthening adult immunization efforts.DisclosuresTiffany A. Dickey, PharmD, BCIDP, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds (Public Company) Ruth Carrico, PhD, DNP, APRN, VaxCare: Advisor/Consultant Colm Smart, MBA, VaXcare: Stocks/Bonds (Private Company) Laura Hendrix, MS, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds (Public Company) Kathryn Lang, MD, PhD, VaxCare: Advisor/Consultant Hagit Kopel, PhD, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds (Public Company) James A. Mansi, PhD, Moderna, Inc.: Employee|Moderna, Inc.: Stocks/Bonds (Public Company)

An Integrated antimicrobial stewardship approach in tertiary care hospitals in developing countries using a multi-domain framework ('PRESCRIBES' checkpoint) - A call for action.

PurposeSchistosomiasis (SCH) japonica remains a persistent public health concern in the Philippines despite continuing control efforts. This study aims to examine the transmission dynamics of SCH japonica and evaluate different intervention strategies using a One Health modeling approach, with the goal of supporting feasible control and elimination targets.MethodsWe developed a compartmental mathematical model calibrated using field survey data collected in 2022 from eight endemic barangays in Agusan del Sur and Surigao del Norte. The dataset included SCH prevalence, egg excretion levels in humans and animals quantified through Kato-Katz, modified McMaster, and sedimentation techniques, and household distance to potential transmission sites. Multiple intervention strategies were examined, including human and animal chemotherapy, WaSH (water access, sanitation, and hygiene) adoption, pasture prohibition, vegetation clearing, and snail control. Sensitivity analysis using Partial Rank Correlation Coefficients (PRCC) was performed to identify influential transmission drivers.ResultsThe model estimates baseline prevalence at approximately 20% in humans across the study areas. Under medium WaSH adoption, human prevalence is projected to decline to approximately 1.01% by 2030, whereas high WaSH coverage further reduces prevalence to 0.64%. Combining WaSH and pasture prohibition alongside chemotherapy is projected to reduce human prevalence to 0.09% and animal prevalence to 0.10% by 2030. Sensitivity analysis identified snail-to-human transmission rate (PRCC = 0.612) and snail shedding rate (PRCC = 0.607) as the most influential parameters.ConclusionIntegrated strategies focusing on WaSH, reduced animal exposure, and targeted chemotherapy offer the most effective pathway toward achieving World Health Organization’s (WHO’s) 2030 SCH targets. Implementation should be strengthened through health education, behavioral interventions, mechanization support, and active Local Government Unit (LGU) participation.Graphical Supplementary InformationThe online version contains supplementary material available at 10.1186/s40249-025-01404-7.

During a normal pregnancy, the body undergoes several physiological adaptations, and a woman's body weight and size change rapidly over a short period of time. Pregnancy may be associated with increased susceptibility to developing body image dissatisfaction, which can have negative consequences for the mother (e.g., depression, eating disorders) and the child (e.g., childhood obesity). Women who were already overweight/obese pre-pregnancy appear to be particularly at risk, as they are often dissatisfied with their body image already before pregnancy. This study aims to investigate the relationship between pre-pregnancy overweight/obesity, gestational weight gain (GWG), and body image as assessed immediately after birth. Body image was assessed in healthy pregnant women (N=197) using the German version of the Body Image in Pregnancy Scale (BIPS-G). Univariate analyses of variance and hierarchical linear regression analyses were conducted to examine the association between pre-pregnancy weight, GWG and the subscales of the BIPS-G. Additionally, a latent profile analysis (LPA) was conducted. Overall, women with pre-pregnancy obesity and GWG above recommendations were more dissatisfied with certain aspects of their body image during pregnancy. The strongest association was found between pre-pregnancy obesity and the subscale preoccupation with appearance. The LPA revealed three distinct profiles. Women with obesity and overweight and with GWG above recommendations were more likely to have a profile characterized by increased body image problems during pregnancy. It is important to implement psychological, behavioral, and weight-related interventions in women who are already overweight and obese prior to pregnancy.

Although support for tobacco smoking cessation provided by general practitioners (GP) has proven effective, such an approach remains quite rare. We designed a behavioural science-based intervention to improve GP support for patients to quit smoking. The present study aimed to evaluate the effectiveness of this in-office paper-based intervention by comparing it with a no-intervention control group. We conducted an online randomised controlled trial between January and May 2024 among GPs in France. The intervention consisted in sending a kit containing an information sheet for GPs outlining the main stages of brief advice for smoking cessation, questionnaires for patients asking them about their smoking status and, for those who smoked, their motivation to quit, as well as a poster to be displayed in each GP's waiting room to encourage people who smoke tobacco to complete the questionnaire. The primary outcome was the proportion of people who smoke with whom GPs had discussed smoking cessation on their last full working day five weeks after the kit had been sent out. The secondary outcome was the likelihood that GPs provided cessation support (e.g., prescribed nicotine replacement therapy (NRT), proposed a follow-up consultation, and/or referred patients to other professionals) on the same day. Of the 800 GPs recruited, 641 fully completed the final survey (333 in the intervention group and 308 in the control group). The proportion of people who smoke with whom GPs had discussed cessation was significantly higher in the intervention group (59.0% vs. 52.3%, p < 0.05). The likelihood of a follow-up consultation being offered to patients who smoke was also significantly higher in the intervention group (73.8% vs. 60.3%, p < 0.05). The likelihood of NRT prescription or referral were not significantly different between groups (82.4% vs. 77.9%, and 23.3% vs. 21.5%, respectively). Providing simple paper-based tools was associated with a greater likelihood of GPs discussing smoking cessation with their patients. This kind of intervention could usefully complement other primary care interventions, for example training, remuneration and financial incentives or care pathway reorganisation, with a view to significantly decreasing smoking prevalence. The study was retrospectively registered on 25 November 2024 (ISRCTN10207960).

ABSTRACT This study integrates the Norm Activation Model (NAM) and the Theory of Planned Behavior (TPB), along with two additional constructs – Multitasking While Driving (MWD) and Ego-Driven Driving Perception (EDDP) – to examine the psychological mechanisms underlying aggressive driving behaviors (ADB). A cross-sectional online survey was conducted among urban drivers in Tehran, Iran, using a convenience sampling strategy. The survey was distributed via social media platforms, and participation was voluntary, yielding 510 valid responses. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Results indicate that personal norms, influenced by awareness of consequences and ascription of responsibility, reduce ADB, while attitudes, perceived behavioral control, and subjective norms intensify it. Notably, EDDP, influenced by MWD, weakens ethical norms and increases aggression, highlighting the interplay between personal morality and self-perceived expertise in shaping driving behaviors, while offering useful insights for urban traffic safety policies and driver behavior interventions.

Sensory profiles and a teacher-mediated classroom intervention for preschool skin-picking behaviours.