Behavioral Factors Research Articles

Attitude and utilization of ChatGPT among registered nurses: A cross-sectional study.

This study explores the influencing factors of attitudes and behaviors toward use of ChatGPT based on the Technology Acceptance Model among registered nurses in Taiwan. The complexity of medical services and nursing shortages increases workloads. ChatGPT swiftly answers medical questions, provides clinical guidelines, and assists with patient information management, thereby improving nursing efficiency. To facilitate the development of effective ChatGPT training programs, it is essential to examine registered nurses' attitudes toward and utilization of ChatGPT across diverse workplace settings. An anonymous online survey was used to collect data from over 1000 registered nurses recruited through social media platforms between November 2023 and January 2024. Descriptive statistics and multiple linear regression analyses were conducted for data analysis. Among respondents, some were unfamiliar with ChatGPT, while others had used it before, with higher usage among males, higher-educated individuals, experienced nurses, and supervisors. Gender and work settings influenced perceived risks, and those familiar with ChatGPT recognized its social impact. Perceived risk and usefulness significantly influenced its adoption. Nurse attitudes to ChatGPT vary based on gender, education, experience, and role. Positive perceptions emphasize its usefulness, while risk concerns affect adoption. The insignificant role of perceived ease of use highlights ChatGPT's user-friendly nature. Over half of the surveyed nurses had used or were familiar with ChatGPT and showed positive attitudes toward its use. Establishing rigorous guidelines to enhance their interaction with ChatGPT is crucial for future training. Nurse managers should understand registered nurses' attitudes toward ChatGPT and integrate it into in-service education with tailored support and training, including appropriate prompt formulation and advanced decision-making, to prevent misuse.

What is known about cardiovascular diseases among seafarers: A systematic scoping review and quality assessment.

Seafarers are at an increased risk of developing cardiovascular diseases (CVDs), potentially due to a stressful working environment and behavioral risk factors. To develop better prevention strategies, it is important to elucidate the extent of this risk. Therefore, we conducted a systematic literature review on CVD in seafarers. We conducted systematic searches in five databases. All studies investigating CVDs among occupational seafarers, published in articles or conference papers, were eligible for inclusion. The identified records were screened and reviewed by two independent researchers, who also evaluated the methodological quality of the included studies. Three thousand nine hundred and seventeen records qualified for screening, and 55 were eligible for inclusion. Most of the studies were observational, including cohort, frequency, incidence or prevalence studies, and review of case records. Around half were assessed at risk of biased findings. Participants in the studies were primarily from North America or the European continent and work onboard transportation vessels. Many studies investigated CVDs as a cause of death, focusing on conditions such as CVD, ischemic heart disease, and myocardial infarction. Frequency of CVD conditions varied but indicate that seafarers face a greater risk compared to the reference populations or control groups. Environmental factors were mainly investigated as risk factors. Our results indicate a higher risk of CVDs among seafarers compared to reference or control groups. However, due to the variable quality of the evidence, well-designed studies are needed to establish the causes of cardiovascular mortality and morbidity in seafarers and to investigate behavioral aspects of cardiovascular risk.

Social Phenotyping for Cardiovascular Risk Stratification in Electronic Health Registries.

Evaluation of social influences on cardiovascular care requires a comprehensive analysis encompassing economic, societal, and environmental factors. The increased utilization of electronic health registries provides a foundation for social phenotyping, yet standardization in methodology remains lacking. This review aimed to elucidate the primary approaches to social phenotyping for cardiovascular risk stratification through electronic health registries. Social phenotyping in the context of cardiovascular risk stratification within electronic health registries can be separated into four principal approaches: place-based metrics, questionnaires, ICD Z-coding, and natural language processing. These methodologies vary in their complexity, advantages and limitations, and intended outcomes. Place-based metrics often rely on geospatial data to infer socioeconomic influences, while questionnaires may directly gather individual-level behavioral and social factors. Z-coding, a relatively new approach, can capture data directly related to social determinant of health domains in the clinical context. Natural language processing has been increasingly utilized to extract social influences from unstructured clinical narratives-offering nuanced insights for risk prediction models. Each method plays an important role in our understanding and approach to using social determinants data for improving population cardiovascular health. These four principal approaches to social phenotyping contribute to a more structured approach to social determinant of health research via electronic health registries, with a focus on cardiovascular risk stratification. Social phenotyping related research should prioritize refining predictive models for cardiovascular diseases and advancing health equity by integrating applied implementation science into public health strategies.

Survey on Interaction Between Nutrient Status and Selected Polymorphisms in Association with Weight Loss of Patients with Severe Obesity Underwent Bariatric Surgery.

There is little information about the effect of single nucleotide polymorphisms (SNP) and nutritional status and weight loss after bariatric surgery. This study investigated the interactive effect of eight obesity-related SNPs and nutritional status on weight loss after Roux-en-Y gastric bypass (RYGB). This is a case-control study. After 1-year follow-up, the patients who underwent RYGB were dividing into two groups. The case group consisted of patients who lost more than 50% of their excess body weight (EBW%) 1year after the surgery. The control group included patients who lost < 50% of EBW at same time frame. Then, the relationship between eight SNPs related to UCP2, FTO, LEPR, GHRL, and NPY genes with weight loss were checked. In this study, 160 patients were recruited. The median of age for case and control group were 43 and 42 respectively. The presence of mutant variant NPYrs16147 had a significant relationship in terms of weight loss between the two groups (P > 0.05). In dominant model, two SNPs, UCP2 rs659366 and UCP2 rs660339, showed protective effect of the vitamin D deficiency. In conclusion, the presence mutant variant of NPYrs16147 is directly related to the incidence of weight loss greater than 50% of EBW. However, it is apparent individual behavioral, dietary, and other factors may have more influence on weight loss among patients underwent RYGB.

HIV and gender identity expression among transfeminine people in the Western Cape, South Africa – a thematic analysis of data from the HPTN 071 (PopART) trial

IntroductionTransfeminine people in South Africa have a high HIV risk due to structural, behavioural, and psychosocial factors. Transfeminine people and feminine identifying men who have sex with men (MSM) are often conflated or grouped with transgender or MSM categories in HIV service programming, although they don’t necessarily identify as either. We aimed to investigate gender expression among feminine identifying people who were assigned male at birth. We examined how local conceptualizations of sexuality and gender intersect with the key population label of ‘transgender’ imported into local HIV programming.MethodsA qualitative cohort nested within the HPTN 071 (PopART) trial included longitudinal, in-depth interviews with eight transfeminine people (four who disclosed as living with HIV). Data were collected approximately every six weeks between January 2016 and October 2017. We used a combination of thematic analysis and case study descriptions to explore gender identification among participants.ResultsOf the eight participants, only one accepted ‘transgender’ as a label, and even she used varying terms at different times to describe her identity. For participants, a feminine identity included dressing in normatively feminine clothes; using feminine terms, pronouns and names; and adopting stereotypically feminine mannerisms. Participants would switch between typically feminine and masculine norms in response to contextual cues and audience. For example, some participants accepted identification as masculine gay men amongst their family members. Among peers, they expressed their identity through typically more effeminate gender characteristics, for example self-identifying as “femgay”. With partners they often also took on a feminine identity role, for example identifying as women in sexual and romantic relationships (meaning they viewed and expressed themselves as the feminine partner in the relationship).ConclusionsOur findings are amongst the first exploratory and descriptive data of transfeminine people in South Africa. We show how transfeminine people navigate fluid gender identities that could pose a challenge for accessing and utilizing HIV services that are currently set up for transgender individuals or MSM. More work needs to be done to understand and respond to the diverse and shifting ways people experience their gender identities in this high HIV burden context.

Medicare Eligibility and Changes in Coverage, Access to Care, and Health by Sexual Orientation and Gender Identity

Medicare provides nearly universal insurance coverage at age 65 years. However, how Medicare eligibility affects disparities in health insurance coverage, access to care, and health status among individuals by sexual orientation and gender identity is poorly understood. To assess the association of Medicare eligibility with disparities in health insurance coverage, access to care, and self-reported health status among individuals by sexual orientation and by gender identity. This cross-sectional study used the age discontinuity for Medicare eligibility at age 65 years to isolate the association of Medicare with health insurance coverage, access to care, and self-reported health status, by their sexual orientation and by their gender identity. Data were collected from the Behavioral Risk Factor Surveillance System for respondents from 51 to 79 years old from 2014 to 2021. Data analysis was performed from September 2022 to April 2023. Medicare eligibility at age 65 years. Proportions of respondents with health insurance coverage, usual source of care, cost barriers to care, influenza vaccination, and self-reported health status. The study population included 927 952 individuals (mean [SD] age, 64.4 [7.7] years; 524 972 [56.6%] females and 402 670 [43.4%] males), of whom 28 077 (3.03%) identified as a sexual minority-lesbian, gay, bisexual, or another sexual minority identity (LGB+) and 3286 (0.35%) as transgender or gender diverse. Respondents who identified as heterosexual had greater improvements at age 65 years in insurance coverage (4.2 percentage points [pp]; 95% CI, 4.0-4.4 pp) than those who identified as LGB+ (3.6 pp; 95% CI, 2.3-4.8 pp), except when the analysis was limited to a subsample of married respondents. For access to care, improvements in usual source of care, cost barriers to care, and influenza vaccination were larger at age 65 years for heterosexual respondents compared with LGB+ respondents, although confidence intervals were overlapping and less precise for LGB+ individuals. For self-reported health status, the analyses found larger improvements at age 65 years for LGB+ respondents compared with heterosexual respondents. There was considerable heterogeneity by state in disparities by sexual orientation among individuals who were nearly eligible for Medicare (close to 65 years old), with the US South and Central states demonstrating the highest disparities. Among the top-10 highest-disparities states, Medicare eligibility was associated with greater increases in coverage (6.7 pp vs 5.0 pp) and access to a usual source of care (1.4 pp vs 0.6 pp) for LGB+ respondents compared with heterosexual respondents. The findings of this cross-sectional study indicate that Medicare eligibility was not associated with consistently greater improvements in health insurance coverage and access to care among LGBTQI+ individuals compared with heterosexual and/or cisgender individuals. However, among sexual minority individuals, Medicare may be associated with closing gaps in self-reported health status, and among states with the highest disparities, it may improve health insurance coverage, access to care, and self-reported health status.

Awareness of cancer and its associated factors for parents of adolescents and young adults: A cross-sectional study.

Cancer is a common health problem worldwide. Early cancer education for adolescents and young adults (AYAs) is important for the prevention or early detection of cancer. In this questionnaire-based cross-sectional study, we examined the cancer awareness among parents of AYAs. Japanese adults with junior or senior high school children were included in this study. The cancer awareness measure (CAM) was used to assess cancer awareness, and the survey was conducted in December 2021. Warning signs, barriers to seeking help, and risk factors were surveyed using an online anonymous questionnaire. In addition, personal information, the presence of other cancer survivors, attendance at cancer seminars, conversations with children about cancer, interest in cancer education for children, and previous cancer screening were surveyed. A t-test or Spearman correlation coefficient was used to compare the total CAM scores for the individual factors. The relationship between cancer-screening behavior and individual factors was analyzed using the χ2 test. In addition, multiple regression analysis or logistic regression analysis was used to identify the factors influencing cancer awareness or cancer-screening behavior. Responses were obtained from the 612 participants. The mean CAM score was 3.7 for cancer warning signs, 4.3 for barriers to seeking help, and 6.5 for risk factors. Cancer warning signs were associated with gender and the presence of a spouse, family member, or friend who had experienced cancer. Barriers to seeking help were associated with age, gender, and education, while risk factors were associated with gender, education, and conversations about cancer with children. Moreover, these scores were associated with each cancer screening behavior. Cancer awareness among Japanese adults with AYAs was influenced by gender, academic background, occupation, the presence of cancer survivors around them, and whether they had conversations about cancer with their children, as well as their cancer screening behavior.

Association between life’s essential 8 and metabolic dysfunction-associated steatotic liver disease among US adults

BackgroundMetabolic dysfunction-associated steatotic liver disease(MASLD) is the most common cause of chronic liver disease. Clinical evidences have demonstrated the link between MASLD and the increased risk of cardiovascular disease (CVD) development. We aimed to investigate the relationship between Life’s Essential 8 (LE8), an enhanced approach to assessing cardiovascular health(CVH), and MASLD.MethodsData were extracted from the National Health and Nutrition Examination Survey (NHANES) in 2017–2020 cycles. MASLD was assessed by the latest diagnostic criteria. LE8 scores (range 0–100) were obtained from measurements based on American Heart Association definitions, divided into health factor and health behavior scores. Multivariable logistic and restricted cubic spline models were used to assess the associations.Results5646 participants were included based on the inclusion and exclusion criteria, 2616 (46.33%) participants were diagnosed with MASLD. After adjusting for confounding variables, higher LE8 scores were associated with a lower risk of MASLD (OR = 0.19, 95%CI 0.17–0.21; P < 0.001), similar associations were also observed between health behavior and health factor scores with MASLD. Subgroup analyses illustrated that the negative association between LE8 score and MASLD was stronger among younger, non − Hispanic White, and never married participants.ConclusionsIn this nationally representative sample of U.S. adults, LE8 scores, health behavior scores, and health factor scores were negatively associated with the prevalence of MASLD in non-linear fashions. Subjects maintaining ideal health factors and health behaviors are less likely to develop MASLD. Public health policies are needed to advocate healthy behaviors and factors.

A biobehavioral observational study to understand the multilevel determinants of cardiovascular health in Black women: the BLOOM Study protocol

BackgroundThe racial/ethnic and gender disparities in cardiovascular disease (CVD) morbidity and mortality in the United States are evident. Across nearly every metric, non-Hispanic Black women have poorer overall cardiovascular health. Emerging evidence shows a disproportionately high burden of increased CVD risk factors in Black women of childbearing age, which has a far-reaching impact on both maternal and child outcomes, resulting in premature onset of CVD and further widens the racial disparities in CVD. There is growing recognition that the fundamental driver of persistent racial/ethnic disparities in CVD, as well as disparities in behavioral risk factors such as physical activity and sleep, is structural racism. Further, the lived personal experience of racial discrimination not only has a negative impact on health behaviors, but also links to various physiological pathways to CVD risks, such as internalized stress resulting in a pro-inflammatory state. Limited research, however, has examined the interaction between daily experience and health behaviors, which are influenced by upstream social determinants of health, and the downstream effect on biological/physiological indicators of cardiovascular health in non-pregnant Black women of childbearing age.Methods/DesignThe BLOOM Study is an observational study that combines real-time ambulatory assessments over a 10-day monitoring period with in-depth cross-sectional lab-based physiological and biological assessments. We will use a wrist-worn actigraphy device to capture 24-h movement behaviors and electronic ecological momentary assessment to capture perceived discrimination, microaggression, and stress. Blood pressure will be captured continuously through a wristband. Saliva samples will be self-collected to assess cortisol level as a biomarker of psychological stress. Lab assessments include a fasting venous blood sample, and assessment of various indices of peripheral and cerebral vascular function/health. Participants’ address or primary residence will be used to obtain neighborhood-level built environmental and social environmental characteristics. We plan to enroll 80 healthy Black women who are between 18 and 49 years old for this study.DiscussionResults from this study will inform the development of multilevel (i.e., individual, interpersonal, and social-environmental levels) lifestyle interventions tailored to Black women based on their lived experiences with the goal of reducing CVD risk.ClinicalTrials.gov IdentifierNCT06150989.

Beyond Intuition: The Role of Financial Knowledge in Navigating Investments in Emerging Markets

Over the last century, global stock markets have crashed multiple times, leading to bankruptcy and unemployment and making individuals highly cautious about investing. Hence, individual investors in developing markets are highly prone to behavioural biases in their investment decisions, which influence their investment experience. The objective of this study is to examine the relationships between behavioural factors and investment experience, as well as the moderating effect of financial knowledge on individual investors in Bangladesh. Data was analysed using the partial least squares structural equation modelling (PLS-SEM) technique. The results revealed that behavioural factors such as anchoring, gambler’s fallacy, social interaction, and locus of control significantly influenced individual investors’ investment experiences. Moreover, financial knowledge had a moderating effect on these relationships. The study has important implications for investors, as it highlights the potential pitfalls of behavioural factors and the importance of financial knowledge in investors’ investment experience. The study’s findings imply that the government should develop new market opportunities through innovative products and take the necessary steps to incorporate regulations that will offer investors a better market experience.

O-223 Can the theory of planned behavior predict parents’ disclosure of donor conception to their children within 5-9 years?

Abstract Study question Does application of the theory of planned behavior (TPB) help predict heterosexual-couple parents’ disclosure of donor conception (DC) to their children? Summary answer According to TPB, parents with a stronger will to act in accordance with social norms favoring disclosure were more likely to start the disclosure process. What is known already In contrast to same-sex couples and single mothers by choice, heterosexual couples need to make an active decision to disclose, or not disclose, their use of DC to their child. While disclosure at an early age is encouraged by international and national guidelines, many heterosexual-couple parents struggle with this. A previous study has found an association between parental scores of TPB factors and disclosure intention, but so far, no study has applied the TPB to predict parents’ de facto disclosure behavior. Study design, size, duration The present study is based on the fourth (2014-2017) and fifth (2022-2023) waves of data collection in the prospective, longitudinal Swedish Study on Gamete Donation (SSGD). The project collects survey data at five timepoints from acceptance to be donor-recipient, to the children were adolescents. Participating parents had conceived through identity-release oocyte donation (OD; n = 68, response rate 65%) and sperm donation (SD; n = 62, response rate 56%) as part of a heterosexual couple. Participants/materials, setting, methods The SSGD includes all parents seeking gamete donation treatment at Swedish university hospitals between 2005-2008, the present study including parents’ data when the children were 7-8 years (T4), and 13-17 years (T5). Parents completed the TPB Disclosure Questionnaire (TPB-DQ) at T4, and disclosure behavior was assessed at both T4 and T5. Data from the participants who had not yet disclosed at T4 were analyzed using survival analysis with Cox regressions. Main results and the role of chance Forty participants (31%) had not disclosed the DC to their children at T4 and out of these, 13 had still not disclosed at T5. The TPB-DQ consists of four factors affecting intent to disclose; Attitudes, Subjective norms, Perceived behavioral control and Behavioral intent. The use of Cox regression enabled us to estimate how the parents disclosing to their children related to TPB-DQ, as well as the effect of adjusting for possible confounders. We found a significant association between scores on the TPB-DQ factor Subjective norms at T4 and the subsequent disclosure behavior at T5 (HR = 2.019; 95% CI: 1.36 to 3.01). None of the other factors were significantly associated with disclosure behavior. Adjusting for potential confounders did not affect the outcomes. Our results show that parents with a stronger will to act in accordance with social norms favoring disclosure were more likely to start the disclosure process within the next 5-9 years. In particular, the co-parent’s opinion about disclosure was found to be an important motivating factor in disclosure behavior. Limitations, reasons for caution The present study concerns heterosexual-couple parents with children conceived following treatment with gametes from open-identity donors, which limits the generalizability of our findings to other groups and contexts. Other limitations include the risk of systematic attrition due to the longitudinal study design and decreased statistical power due to few participants. Wider implications of the findings Our findings highlight the importance of perceived subjective norms for parents’ disclosure behavior and indicate that the co-parent’s opinion about disclosure is particularly relevant. Counselors should focus on supporting prospective parents to initiate and maintain a healthy and open dialogue about concerns around family building with DC. Trial registration number Not applicable

Exposure to structural racism-related state laws is associated with worse cardiovascular health among US adults, BRFSS 2011 and 2013.

The objective of this study was to determine whether exposure to structural racism-related state laws is associated with cardiovascular health among a racially and ethnically diverse sample of US adults. Data were from the Database of Structural Racism-Related State Laws and the Behavioral Risk Factor Surveillance System (BRFSS). The sample included 958,019 BRFSS 2011 and 2013 respondents aged 18+ from all 50 US states. The exposure was a summary index of 22 state laws related to the criminal legal system, economics and labor, education, healthcare, housing, immigration, and political participation. The outcome was the American Heart Association's Life's Simple 7 (LS7), a summary index of seven cardiovascular health indicators. Linear regression models included fixed effects for year and state to control for time trends and unmeasured time-invariant state-level contextual factors. In the full sample, a one standard deviation increase in the structural racism state legal index was associated with a 0.06-unit decrease in the LS7 (b=-0.06; 95% CI:-0.09, 0.02; p=0.001), controlling for individual- and state-level covariates. Contrary to expectations, stratified models revealed no statistically significant differences by race and ethnicity in the association between the structural racism state legal index and the LS7.

Integration of Sensor-Based Technology in Mental Healthcare: A Systematic Scoping Review

AbstractSensor-based technologies can collect objective and real-time data on physiological, behavioral, and contextual factors related to mental disorders. This not only holds potential for mental healthcare but also comes with challenges, such as handling large amounts of data and supporting the integration of sensors in clinical practice. This systematic scoping review aims to provide an overview of studies explicitly addressing the integration of sensor-based technology in mental healthcare by reporting on the way that therapists and patients work with sensors. In addition, we explore barriers and facilitators for the integration of sensor-based technology in clinical practice. Four databases were searched on April 5, 2023. Studies on sensor-based technology integrated in mental healthcare were included. A total of 14 studies were included. In these studies, a variety of sensor-based technologies were used. All studies were conducted between 2016 and 2022. Most studies showed that sensor-based technologies are accepted by patients and that their use is associated with symptom reduction. However, most studies did not systematically report on barriers and facilitators and mainly focused on the technology itself rather than on the broader context of its intended use. Also, sensor-based technologies are not yet embedded in clinical protocols. From the current review, we can conclude that sensor-based technologies are sufficiently accepted and feasible, and that sensors are promising for enhancing clinical outcomes. However, sensors are not properly integrated in treatment protocols yet. Therefore, we propose a next phase in research on sensor-based technology in mental healthcare treatment. This next phase asks for a multifaceted approach consisting of (1) embedding sensor-based technology in treatment protocols in co-creation with patients and clinicians, (2) examining the feasibility of these interventions together with small-scale evidence studies, and (3) systematically examining the implementation of sensor-based technology in clinical practice using existing frameworks for technology implementation. Open Science Framework: https://doi.org/10.17605/OSF.IO/XQHSY.

Microscopic simulation of bicycle traffic flow incorporating cyclists’ heterogeneous dynamics and non-lane-based movement strategies

Cycling as a mode of transport is on an upward trend as a low-emission alternative to driving in urbanized areas nowadays. With the increasing number of cyclists, it is of great importance to assess the capacity of cycling infrastructure in practice. Simulation models are useful tools to investigate bicycle flow performance considering cyclists’ distinct moving behaviors. However, existing bicycle simulation models are restricted by either space discretization, lane-based setup, adaptation from models for car traffic, or complicated calibration requirement in a force-based environment. In addition, cyclists’ decision-making ability in the operational-level cycling behavior are not well-captured in these models. This paper proposes a comprehensible microscopic bicycle simulation model which includes a detailed decision-making process and the ability to simulate continuous-space lateral movement. The model consists of three levels, maneuver decision, movement planning, and physical acceleration. It is able to simulate bicycle flow dynamics in undersaturated traffic conditions on an exclusive bike path. As we do not intend to show the empirical validity of the proposed model, the simulation experiment aims at verifying the model and exploring bicycle flow performance in various scenarios by estimating the fundamental diagrams (FDs). The effect of different path widths on bicycle flow capacity is first explored. Other behavioral factors, including desired speed heterogeneity, overtaking incentive, and safety region size perceived by cyclists, which can potentially influence the shape of the FD are also tested. The model can be further extended to simulate relatively complex cycling behavior with cooperative and anticipative strategies and investigate bicycle flow characteristics in congested traffic conditions.

Falling Short in Bariatric Surgery: An Exploration of Key Barriers and Motivators of Attrition

BackgroundIn the United States, obesity-related diseases pose significant healthcare challenges, with bariatric surgery offering a potential solution. However, bariatric surgery completion rates, particularly among Black and Hispanic populations, remain low. ObjectiveThis study applied the Theoretical Domains Framework (TDF) to explore behavioral factors influencing bariatric surgery program attrition among a majority Black participant population to inform interventions for improving attrition. MethodsWe conducted semi-structured interviews with 40 surgical and non-surgical participants and conducted deductive content analysis informed by six TDF constructs to explore factors influencing bariatric surgery program attrition. ResultsParticipants’ decision-making regarding bariatric surgery is influenced by behavioral factors, including knowledge, skills, social roles, beliefs about capabilities, optimism, and beliefs about consequences. ConclusionUnderstanding multifaceted factors influencing bariatric surgery attrition will inform the development of tailored interventions that address knowledge gaps, enhance skills, and consider social role conflicts to improve patient engagement and decision-making in managing obesity, especially for Black populations.

Adverse Childhood Experiences, Substance Use, and Poor Mental Health Among the U.S. Adult Population

Adverse childhood experiences (ACEs) are linked to various lifelong negative outcomes. However, there is little counseling literature on the effects of ACEs on adult mental health. Utilizing the 2021 Behavioral Risk Factor Surveillance System dataset, we examined individual ACEs and cumulative ACEs scores to quantify the relationship between ACEs and behavioral and mental health outcomes. Findings showed that 60.9% of the participants experienced at least one ACE, with nearly 1 in 6 participants reporting four or more ACEs. Childhood emotional abuse was the most prevalent form of ACE reported. Multiple logistic regression analyses adjusting for sociodemographic covariates showed that reporting any of the ACEs was significantly associated with heavy alcohol use, marijuana use, and poor mental health. Furthermore, a graded dose-response relationship was found between cumulative ACEs scores and outcome variables. The findings highlight the importance of consciously screening and considering ACEs to better assist clients with presenting behavioral and mental health issues.

A Brief Report of Lung Cancer Screening Utilization Prior to, During, and in the Later Stages of the COVID-19 Pandemic in the United States

IntroductionWhile COVID-19 has impacted healthcare and screening utilization, its impact on lung cancer screening (LCS) uptake remains unclear. Our study investigated LCS utilization and associated predictors among LCS-eligible adults before (2019), during (2020-2021), and at a later stage (2022) of COVID-19. MethodsWe used cross-sectional, nationally representative, population-based data from the Behavioral Risk Factor Surveillance System over four consecutive years: 2019 (n=4,484; weighted n=1,559,137), 2020 (n=1,239; weighted n=200,301), 2021 (n=1,673; weighted n=668,359), and 2022 (n=20,804; weighted n=9,458,907). The outcome was self-reported LCS uptake (0= did not have LCS in the past 12 months and 1=underwent LCS in the past 12 months). We conducted weighted statistics and multivariable logistic regression. ResultsOverall, out of 11,886,704 million LCS-eligible individuals, 2,129,900 received LCS in four years (2019-2022). National rates of LCS among screening-eligible individuals were 16.3% (95%CI:14.4-18.5), 19.4% (95%CI:15.3-24.3), 18.3% (95%CI:15.6-21.3) and 18.1% (95%CI:17.1-19.2) in 2019, 2020, 2021 and 2022, respectively. Respondents reporting lung disease and cancer (other than lung cancer) history were more likely to receive LCS across all four years. During the pandemic (2020), Hispanic (vs. White), and rural (vs. urban) residents have lower odds of LCS utilization. In 2022, men had increased odds of reporting LCS use relative to women. No sex differences in LCS use were observed in previous years. ConclusionOur findings indicate consistently low LCS utilization (<20%) over four years. Nationwide efforts to boost LCS awareness and utilization are essential for mitigating the lung cancer burden in the US.

Unveiling the influence of reproductive health on poverty: a cross-sectional study in Magwi County, South Sudan

Objective: To understand the relationship between household poverty and reproductive health characteristics in Magwi County, South Sudan. Background: Household poverty is a significant issue in many countries, including South Sudan. Poverty has been identified as a major obstacle to international development, affecting various aspects of development goals such as food security and health. Despite interventions by organizations like the World Bank, poverty rates in beneficiary countries like South Sudan have not seen significant reductions, suggesting the presence of predictors of poverty from behavioral, structural, and political origins. Methods: The study was conducted using an analytical cross-sectional survey design. The study targeted female and male spouses in households and employed a multistage sampling approach to select participants. Result: The results of the study revealed that the level of household poverty in Magwi County was 42%. The prevalence of household poverty was found to be influenced by reproductive health characteristics. The use of short-acting contraception by women was associated with a higher prevalence of poverty, whereas women who had ever aborted a pregnancy had a lower prevalence of poverty. Unintended pregnancy and inconsistent condom use by men were also associated with higher poverty rates, whereas men with only one sexual partner had lower poverty rates. Conclusion: This study provides valuable insights into the relationship between household reproductive health characteristics and poverty in Magwi County, South Sudan. It emphasizes the need for comprehensive approaches that address both behavioral and structural factors to effectively reduce poverty and improve development outcomes.

Evaluation of the prevalence of giardiasis and associated factors in Wardak province, center of Afghanistan

Introduction: Giardia intestinalis is a causative agent of gastrointestinal infections worldwide. Contaminated food, feces, drinking water (orofecal route), and factors like economic conditions, culture, and behavioral factors contribute to its transmission. Wardak province is located in the central region of Afghanistan, divided into eight districts, with a population of 656,720. Methods: A total of 274 patients with diarrhea referred to Wardak Hospital were studied, and among them, 17 individuals (10 males (58.8%) and 7 females (41.2%) tested positive for Giardia spp. by microscopy during 2023. In this cross-sectional study, socioeconomic, cultural, and symptomatology information were collected. The association between risk factors and intestinal parasitic infections was analyzed using Chi-Square and Fisher's exact tests with SPSS 26 and GraphPad Prism 8 software at a significance level of P ≤ 0.05. Results: More than half of the patients were under 30 years old. Most cases of the disease were observed in hot seasons (spring and summer). A significant correlation was found between the prevalence of giardiasis and factors such as close contact with animals, the use of unfiltered water, soil contact, and warmer seasons. No significant correlation was observed between economic status and travel history. 85% of patients had watery diarrhea, and 15% had bloody diarrhea. Conclusion: This is the first epidemiological study conducted in Wardak province, central Afghanistan. The findings reveal the prevalence of giardiasis and its interaction with multiple risk factors. This study suggests that giardiasis is an important causative factor for gastrointestinal diseases in the study region.

Analyzing Party Identification Dynamics Using SmartPLS in the Peshawar Valley, Khyber Pakhtunkhwa Province of Pakistan

The political landscape in Khyber Pakhtunkhwa (KP), Pakistan, has seen a significant transformation since the 2013 elections, marked by the unprecedented dominance of Pakistan Tehreek-e-Insaf (PTI) across three consecutive elections. This study explores the dynamics of party identification with specific relevance to the Peshawar Valley of KP, focusing on the role of family socialization, peer group interactions, political party performance, leadership, and political campaigns. Data from 1196 respondents in the Peshawar Valley were analyzed using multiple regression with SmartPLS. The findings indicate that traditional familial and peer influences on party identification are weakening, while instrumental factors like political leadership and campaigns have a substantial impact. PTI's success is attributed to its effective use of social media and charismatic leadership, emphasizing the shift towards leader-centric and campaign-driven party support. This shift reflects a weakening of traditional partisan alignments and a growing reliance on dynamic political factors in shaping voter behavior.