High-risk Activities Research Articles

Distinct Hepatitis B and HIV co-infected populations in Canada.

Due to shared modes of exposure, HIV-HBV co-infection is common worldwide. Increased knowledge of the demographic and clinical characteristics of the co-infected population will allow us to optimize our approach to management of both infections in clinical practice. The Canadian Hepatitis B Network Cohort was utilized to conduct a cross-sectional evaluation of the demographic, biochemical, fibrotic and treatment characteristics of HIV-HBV patients and a comparator HBV group. From a total of 5996 HBV-infected patients, 335 HIV-HBV patients were identified. HIV-HBV patients were characterized by older median age, higher male and lower Asian proportion, more advanced fibrosis and higher anti-HBV therapy use (91% vs. 30%) than the HBV-positive / HIV seronegative comparator group. A history of reported high-risk exposure activities (drug use, high-risk sexual contact) was more common in HIV-HBV patients. HIV-HBV patients with reported high-risk exposure activities had higher male proportion, more Caucasian ethnicity and higher prevalence of cirrhosis than HIV-HBV patients born in an endemic country. In the main cohort, age ≥60years, male sex, elevated ALT, the presence of comorbidity and HCV seropositivity were independent predictors of significant fibrosis. HIV seropositivity was not an independent predictor of advanced fibrosis (adj OR 0.75 [95%CI: 0.34-1.67]). In conclusion, Canadian co-infected patients differed considerably from those with mono-infection. Furthermore, HIV-HBV-infected patients who report high-risk behaviours and those born in endemic countries represent two distinct subpopulations, which should be considered when engaging these patients in care.

Capitalizing on Neuroplasticity Across Development to Redirect Pathways from Juvenile Justice Involvement.

Adolescence is an exquisitely sensitive period of development during which pathways branch toward success in school and prosocial pursuits or, conversely, toward behavior problems and involvement in high-risk activities and systems, such as juvenile justice (JJ). Adverse childhood experiences (ACEs) such as poverty, family dysfunction, and child maltreatment, have been strongly and repeatedly associated with JJ involvement. A significant body of research from neuroscience has established that ACEs can alter facets of neurodevelopment that undergird self-regulation throughout childhood and adolescence, thereby increasing susceptibility to behaviors that attract attention of the JJ system. Because the ability to intervene prior to system-entrenchment is crucial to disrupting an adverse developmental pathway, we look toward neuroscience to offer insights into how to do so more effectively. In this chapter, evidence is summarized that informs an understanding of how neurodevelopmental pathways may lead to JJ involvement. Because neurodevelopment is malleable in response to both detrimental and positive experiences, there is potential for well-targeted interventions to normalize brain and cognitive development, especially during sensitive periods of maturation. This discussion is followed by a proposed research agenda to determine how to exploit these critical windows of opportunity to divert youth from persistent antisocial behavior and JJ involvement. Lastly, a review of neuroscience findings regarding the ability of intervention to strengthen brain systems that modulate self-regulation is presented. This research has direct practical significance with potential to be translated into meaningful policy change.

Programmable Implementation and Blockchain Security Scheme Based on Edge Computing Firework Model

In cloud computing, since the program runs in cloud, it can be written in programming language and maintained only in the cloud after compilation. Due to the heterogeneous nature of the edge node platform, many tasks are migrated from the cloud to the edge terminal. It is not easy to realize the programming under the edge computing, and the maintenance cost is also high. At the same time, because the programmable is a high-risk activity, it has high security requirements. In order to solve this problem, this paper designs a programmable and blockchain security scheme based on the edge computing firework model, realizes the programming of the internet of things (IoT) gateway firework node under the edge computing, and appreciates the safe transmission and storage of programmable data through the blockchain system. The experimental results show that this scheme not only facilitates the user's programming, enhances the real-time performance, and saves the data transmission cost, but also ensures the security and reliability of the system.

La protection de l’environnement dans la Zone internationale des fonds marins : réflexions sur le droit à venir

The prospect of the development of resource exploitation activities in the Area, particularly of its mineral resources, increases the worrying pressure on the deep sea as never before. The environment of the Area is however reputed to be as remarkable as it is fragile ; it is also largely unknown. In this context, the question of the development of a law adapted to the emerging threats is urgent. Two parallel normative processes are underway that are expected to be completed in the near future. The first one is hosted by the International Seabed Authority (ISBA), the second is taking place in the framework of an intergovernmental conference mandated by the UN General Assembly. These parallel processes initially raise the question of the sources of environmental protection law in the deep sea. The present contribution explores the rationale for this fragmented and differentiated production of law, which itself raises the question of the articulation of future rules. In law and in fact, it appears that the law in gestation under the ISBA will occupy a central place. Thus, the second part of this contribution is devoted to questioning the environmental ambition of the future law on deep-sea mining. Since these are high-risk activities in a context of total scientific and technical uncertainty, it is understandable that the precautionary approach should be the basis of the law. The analysis of the rules being finalized then questions the way in which the law concretely declines this approach and attempts to highlight the strengths and limits of an infinitely complex normative exercise.

Abortion and its correlates among female fisherfolk along Lake Victoria in Uganda.

Introduction:In Uganda, people living in fishing communities tend to engage in high-risk sexual activity which leads to unintended pregnancies that may end in abortions. Abortion has negative social, psychological, and medical impacts. We determined the frequency of abortion and its correlates among female fisher-folk along Lake Victoria in Uganda.Methods:A cross-sectional survey was conducted among women aged 15– 49 years from Kigungu and Nsazi fishing communities. Data were collected on socio-demographic characteristics, abortion, and family planning use. Associations between abortion and participant characteristics were assessed using logistic regression models.Results:Of the 713 women interviewed, 36, 5% were pregnant and 247, 34.6 % were using contraception. Majority (600, 84.2%) of those interviewed reported ever being pregnant. Approximately 45% of the pregnancies were un-intended while a third of those who had ever been pregnant (195, 32.5%) reported having aborted before. Slightly over a third (247, 34.6%) reported currently using or ever using family planning. Women aged 30+ years were more likely to abort compared to those aged 15-29 years (aOR: 2.7; 95% CI: 1.23-5.91). Women who had living children were less likely to abort compared to those who didn’t have any living child (aOR: 0.06; 95% CI: 0.01 – 0.17).Conclusion:The rate of abortion among female fisher-folk in Uganda is substantial. Family planning use is still low and unintended pregnancies are common. Abortion risk increased with the age of the mother. Continuous behavioral change communication and optimization of family planning use are recommended to reduce abortions.

Epidemiology and Risk Factors for Hepatitis C Infection in Malaysia: A Narrative Review

Hepatitis C infection is a growing public health issue in Malaysia. A large number of people living with hepatitis C virus (HCV) are unaware of the infection. The treatment complexity warrants a comprehensive understanding of this infectious disease to support planning for strategies to reduce the burden of disease associated with hepatitis C. This study aimed to summarise the epidemiology and risk factors attributable to hepatitis C acquisition in Malaysia based on local published articles. Published articles related to epidemiology and risk factors for hepatitis C infection in Malaysia between 2005 and 2017 were searched through several online databases. Related information from the Ministry of Health official website was also compiled. An increasing trend in the incidence and mortality rate of hepatitis C infection is noted over the last decades. In 2009, the national prevalence of people infected with HCV was approximately 2.5%, with the prevalence rate varying according to different high-risk groups. The most common genotypes reported are genotypes 3 and 1. Frequently reported risk factor for HCV acquisition is injection drug use. Other identified risk factors are being a blood product recipient, haemodialysis patient or participant in high-risk sexual activity. Nevertheless, a considerable number of patients had no known risk factors. The prevalence and burden of HCV-related disease are substantial and can be attributed to many factors. High-quality design studies are needed to provide stronger evidence of the risk factors for hepatitis C infection in local populations for future public health planning.

Livelihood security of small holder farmers in eastern Himalayas, India: Pond based integrated farming system a sustainable approach

Farming in eastern Himalayan region of India is a high risk activity due to climatic uncertainty, lack of resources with small and marginal farmers and non-adoption of improved technologies. Pond based integrated farming system (IFS) is a whole farm approach aims at increasing production, employment and income through integration of various farming enterprises (rice, vegetables, fruits, fish, pigs, poultry, goat and others) as per climate, social acceptability and market demand. Eleven farm pond based IFS models were evaluated in 150 farmers' field covering 22.5 ha area in South Garo Hills district of Meghalaya, India during 2009–14 in a participatory approach. The individual farming system unit considered in present study was 0.15 ha. The study revealed that productivity and income of farmers under pond based IFS improved substantially over farmers' practice. The maximum rice equivalent yield (REY) was obtained under model 6 (pond + rice + vegetables + pig integration, 4.04 Mg) followed by model 8 (pond + vegetable + pig + fruit integration, 4.02 Mg) and the lowest was recorded under farmers' practice (rice + vegetables, 0.53 Mg). IFS model 6 (74.3 kg unit−1 year−1) followed by 8 (60.2 kg unit−1 year−1) had noticeably higher protein equivalent yields over rest of the models. The IFS model 6 emerged as the best model because of high net return (INR. 23,900 unit−1 year−1, 1$ = INR 67), employment generation (81 man-days unit−1 year−1) as well as higher productivity in terms of REY (4.04 Mg unit−1 year−1) whereas, farmers' practice registered low net return (INR. 4120 unit−1 year−1), employment (42 man-days unit−1 year−1) and productivity (0.61 Mg unit−1 year−1). The Sustainable Value Index and System Economic Efficiency of IFS models 6 and 8 were much higher than other models. The overall results revealed that pond based IFS has the potential to provide year round food, nutrition, employment opportunities and substantially increase income of resource poor rural house-holds of the study region in Eastern Himalayas, India.

Understanding the Motives of High-Risk Leisure Participants: A Case of Mt. Everest Mountaineers

Participation in high-risk leisure activities has increased dramatically over the years despite the number of risks and dangers the activities present during participation. Mountaineering is considered as one of the most popular activities of high-risk leisure activities. However, there is a lack of research investigating the motives of mountaineers who trek/ climb difficult mountain ranges risking their health. Therefore, the purpose of this study was to investigate the motives of mountaineers who trek/climb the Mt. Everest Base Camp for leisure. The total number of 4 participants who completed ‘Mt. Everest Base Camp and Kala Pattar’ program was recruited in Kathmandu, Nepal, and an in-depth interview was conducted to collect data. To analyze the data, a line-by-line analysis was performed to establish emergent themes. Then, a thematic analysis was conducted using these themes as the basis. The findings indicated that the reasons the participants engage in mountaineering in difficult mountain ranges were generally to feel an accomplishment. On the other hand, the primary motive for joining the Mt. Everest Base Camp program was affect regulation, which is an escape strategy from emotional difficulties and/or stresses from daily life.

626. Tackling the HIV Epidemic in South Florida: Patient Insights on Approaches for HIV Counseling, Testing, and Access to Prevention or Treatment

BackgroundThe South Florida Metropolitan Statistical Area has for several years recorded the highest HIV incidence in the nation, and prevalence in the top three of all counties. To address the alarming disparity in HIV impact, we developed a survey study to learn about the beliefs, attitudes, and perspectives of persons who accessed services at an HIV community-based organization in South Florida.MethodsSurveys were administered in English and Spanish to 109 persons who visited a community-based HIV service provider (Latinos Salud) at any of its three South Florida sites in April 2019. The survey evaluated the participants’ perspectives on different avenues for HIV counseling, screening, and accessing HIV medications for prevention or treatment.ResultsThe majority of survey participants were male (90%), homosexual/gay/queer (75%), and Hispanic/Latino (56%; Table 1). Participants’ self-reported their HIV status as negative (64%), positive (30%), or unknown (6%; Table 1). Of those not currently living with HIV, 77% reported having been tested within the past 6 months, and 81% reported recent engagement in high-risk activities (Table 1).Most participants considered using social media to promote awareness of HIV and related services a good idea (Table 2). Large proportions of participants endorsed receiving HIV counseling through in-person conversations with clinicians (91%), staff at community-based organizations (83%), friends (83%), telehealth visits (69%), conversations with teachers (63%), or church members (56%; Table 2). Most participants endorsed a range of both clinical (e.g. local health clinic) and non-clinical (e.g. mobile van) locations as acceptable settings for HIV testing (Table 2). Large proportions of participants endorsed receiving medications to prevent or treat HIV immediately after testing (82%), by home delivery (78%), or through telehealth (60%; Table 2). Meaningful associations were found between certain patient demographics (race/ethnicity, testing history, or insurance status) and the participants’ perspectives on specific strategies (Table 3).Table 1. Participant Characteristics Table 2. Participants’ Views on Strategies for HIV Counseling, Testing, and Access to Medications Table 3. Participants’ Views on Strategies for HIV Counseling, Testing, and Access to Medications Stratified by Patient Characteristics ConclusionThese real-world findings can be used to inform clinic- and community-based interventions tailored to individual patient characteristics.Disclosures Tamar Sapir, PhD, Gilead Sciences, Inc. (Other Financial or Material Support, Independent medical education grant)

Extreme traveler.

Although they may pose a serious health risk or may even turn out to be life-threatening, extreme sports, i.e. high-risk physical activities of varied difficulty, are growing in popularity among international travelers in recent years. Extreme sports encompass a wide range of activities such as scuba diving, rafting, surfing, bungee jumping and mountaineering. It is not unusual for travelers to engage in extreme sports far off the beaten path, in destinations where environmental conditions are difficult and specialist healthcare is not easily available. Therefore, before taking the decision to engage in any form of adventurous activity, travelers should be encouraged to take certain precautionary measures. The most important are: identification of potential health risk factors related to travel or the activity itself, physical conditioning and fitness training prior to travel (depending on the type of activity) and prophylaxis (a travel health kit, mandatory and recommended vaccinations, a pre-travel consultation to assess a person's fitness to travel and identify any potential contraindications for certain types of adventure sports, a comprehensive travel insurance policy). The article focuses on popular extreme sports, common risk factors associated with extreme activities as well as the recommended prophylaxis and precautionary measures.

Green Innovation Risk Identification of the Manufacturing Industry under Global Value Chain Based on Grounded Theory

Green innovation in the manufacturing industry has been widely recognized. Although green innovation can create economic, social, and ecological value, it is also a high-risk activity. We must facilitate and protect the value of green innovation through scientific and systematic management of the risks generated in the process of innovation. The primary task of risk management is risk identification. Therefore, based on the perspective of the global value chain, this paper identifies the risk of green innovation in the manufacturing industry using the research method of grounded theory. By examining the interview records of 25 manufacturing enterprise executives, we summarize and identify the four major risks and 31 risk factors of green innovation. The empirical results of this paper are as follows: (1) the green innovation risks of the manufacturing industry under the global value chain include green R&D risks under the global value chain; manufacturing risks under the global value chain; marketing risks under the global value chain; service risks under the global value chain. (2) Green R&D risks under the global value chain include seven risk factors; green manufacturing risks under the global value chain include 10 risk factors; green marketing risks under the global value chain include nine risk factors; green service risks under the global value chain include five risk factors.

Using habitat risk assessment to assess disturbance from maritime activities to inform seabird conservation in a coastal marine ecosystem

Habitat prioritization is a powerful tool for identifying critical wildlife areas for conservation. This study evaluates the risk of disturbance from maritime activities to seabirds in order to prioritize critical seabird foraging habitat for conservation thereby providing a much-needed methodological contribution demonstrating how to transparently incorporate metrics of “cost” based on risk to support ocean zoning. We standardized and combined predicted seabird distributions for six nonresident species foraging in the non-coastal “offshore” waters in the Greater Farallones National Marine Sanctuary and Cordell Bank National Marine Sanctuary, which we predicted using ten years of Applied California Current Ecosystem Studies (ACCESS) at-sea data for the month of July. We obtained maritime activity data from the California Ocean Use Atlas, whale-watching data, expert consultation, and primary literature. Activities included benthic fishing with fixed and mobile gear, military operations, oil spill, shipping, and whale-watching. Risk calculations were based on management effectiveness, spatial and temporal overlap of activities with seabird distributions, changes in area, and severity of negative impacts. Of those activities evaluated with the InVEST Habitat Risk Assessment (HRA) model, higher risk activities were oil spill, benthic fishing with fixed or mobile gear, and military activities. Looking at all risks spatially, highest cumulative risk areas concentrated to the north and northeast of Cordell Bank, along segments of the shelf break, and along areas of the shipping lanes. We demonstrated the use of the HRA tool to quantify costs for use in Marxan habitat prioritization software. The HRA model provided a transparent and replicable cost metric that partitioned risk into exposure and consequence. This approach provided two options for meeting high priority seabird foraging protection goals in the Sanctuaries: 1) protecting the low cost Marxan-prioritized areas or 2) managing high risk maritime activities highlighted by the HRA model. Waters around the Farallon Islands, nearby and northeast of Cordell Bank, and to the southwest of the continental shelf break in the southern region of Greater Farallones National Marine Sanctuary were identified as areas where seabirds would benefit from a combination of adding protections to some low cost Marxan-prioritized areas and enhancing management of the primary disturbance resulting from higher risk activities of oil spill, benthic fishing with mobile or fixed gear, and military activities, each of which have spatial footprints contributing to high cost Marxan prioritized areas. Either approach could be scaled up to include a larger habitat area, multiple habitat types, and different maritime activities. Our methods can be applied globally to improve ocean zoning where critical wildlife areas are threatened by human activities.

Using machine learning-based analytics of daily activities to identify modifiable risk factors for falling in Parkinson’s disease

BackgroundAlthough risk factors that lead to falling in Parkinson's disease (PD) have been previously studied, the established predictors are mostly non-modifiable. A novel method for fall risk assessment may provide more insight into preventable high-risk activities to reduce future falls. ObjectivesTo explore the prediction of falling in PD patients using a machine learning-based approach. Method305 PD patients, with or without a history of falls within the past month, were recruited. Data including clinical demographics, medications, and balance confidence, scaled by the 16-item Activities-Specific Balance Confidence Scale (ABC-16), were entered into the supervised machine learning models using XGBoost to explore the prediction of fallers/recurrent fallers in two separate models. Results99 (32%) patients were fallers and 58 (19%) were recurrent fallers. The accuracy of the model to predict falls was 72% (p = 0.001). The most important factors were item 7 (sweeping the floor), item 5 (reaching on tiptoes), and item 12 (walking in a crowded mall) in the ABC-16 scale, followed by disease stage and duration. When recurrent falls were analysed, the models had higher accuracy (81%, p = 0.02). The strongest predictors of recurrent falls were item 12, 5, and 10 (walking across parking lot), followed by disease stage and current age. ConclusionOur machine learning-based study demonstrated that predictors of falling combined demographics of PD with environmental factors, including high-risk activities that require cognitive attention and changes in vertical and lateral orientations. This enables physicians to focus on modifiable factors and appropriately implement fall prevention strategies for individual patients.

Assisted bathing of older people with dementia: a mixed methods systematic review protocol.

The objective of this review update is to determine the best strategies for assisted bathing or showering of older people with dementia. Bathing is a high-risk activity that can worsen agitated behavior in people with dementia, becoming a source of stress or burden for nurses and caregivers. Since a review was originally published in 2013, new studies have been conducted reporting on various interventions related to assisted bathing and showering. The review will consider people older than 60 years with dementia, their families, nurses, and formal caregivers. The quantitative component will consider studies that examine interventions aiming to reduce agitated behaviors during assisted bathing. The qualitative component will include studies reporting on experiences of assisted bathing of older people with dementia. This review update will follow the JBI mixed methods review approach. Published and unpublished studies will be identified from searches of the major international databases and relevant databases for gray literature. Two independent reviewers will carry out screening, critical appraisal, and data extraction. The extracted data will include details about the study characteristics, quantitative results, and qualitative findings relevant to the review. Where possible, quantitative data will be statistically pooled. Qualitative results will be synthesized using the meta-aggregation approach developed by JBI. Finally, the findings from both quantitative and qualitative components will be organized into a line of argument to produce an overall configured analysis. Where configuration is not possible, the findings will be presented in narrative form. PROSPERO CRD42020208048.

Assessing the relation of chemical and non-chemical stressors with risk-taking related behavior and adaptive individual attributes among adolescents living near the New Bedford Harbor Superfund site

BackgroundEarly life exposure to neurotoxicants and non-chemical psychosocial stressors can impede development of prefrontal cortical functions that promote behavioral regulation and thereby may predispose to adolescent risk-taking related behaviors (e.g., substance use or high-risk sexual activity). This is particularly concerning for communities exposed to multiple stressors. MethodsThis study examined the relation of exposure to mixtures of chemical stressors, non-chemical psychosocial stressors, and other risk factors with neuropsychological correlates of risk-taking. Specifically, we assessed psychometric measures of both adverse behavioral regulation and adaptive attributes among adolescents (age ∼ 15 years) in the New Bedford Cohort (NBC), a sociodemographically diverse cohort of 788 children born 1993–1998 to mothers residing near the New Bedford Harbor Superfund site. The NBC includes biomarkers of prenatal exposure to organochlorines and metals; sociodemographic, parental and home characteristics; and periodic neurodevelopmental assessments. We modelled exposure mixtures using multi-dimensional smooths within generalized additive models. ResultsChildren of younger mothers with lower IQ who were exposed prenatally to higher polychlorinated biphenyls and lead had poorer anger control. This pattern was not apparent for children of older mothers with higher IQs. Direction of associations between increased hyperactivity and prenatal levels of organochlorine mixtures differed by maternal age and depression symptoms. Higher cord blood Pb levels, in conjunction with poorer HOME scores, were associated with poorer self-esteem when mothers had fewer depression symptoms. ConclusionsAnalyses suggest that prenatal chemical exposures and non-chemical factors interact to contribute to neuropsychological correlates of risk-taking behaviors in adolescence. By simultaneously considering multiple factors associated with adverse behavioral regulation, we identified potential high-risk combinations that reflect both chemical and psychosocial stressors amenable to intervention.

Targeted gown and glove use to prevent Staphylococcus aureus acquisition in community-based nursing homes: A pilot study.

To test the feasibility of targeted gown and glove use by healthcare personnel caring for high-risk nursing-home residents to prevent Staphylococcus aureus acquisition in short-stay residents. Uncontrolled clinical trial. This study was conducted in 2 community-based nursing homes in Maryland. The study included 322 residents on mixed short- and long-stay units. During a 2-month baseline period, all residents had nose and inguinal fold swabs taken to estimate S. aureus acquisition. The intervention was iteratively developed using a participatory human factors engineering approach. During a 2-month intervention period, healthcare personnel wore gowns and gloves for high-risk care activities while caring for residents with wounds or medical devices, and S. aureus acquisition was measured again. Whole-genome sequencing was used to assess whether the acquisition represented resident-to-resident transmission. Among short-stay residents, the methicillin-resistant S. aureus acquisition rate decreased from 11.9% during the baseline period to 3.6% during the intervention period (odds ratio [OR], 0.28; 95% CI, 0.08-0.92; P = .026). The methicillin-susceptible S. aureus acquisition rate went from 9.1% during the baseline period to 4.0% during the intervention period (OR, 0.41; 95% CI, 0.12-1.42; P = .15). The S. aureus resident-to-resident transmission rate decreased from 5.9% during the baseline period to 0.8% during the intervention period. Targeted gown and glove use by healthcare personnel for high-risk care activities while caring for residents with wounds or medical devices, regardless of their S. aureus colonization status, is feasible and potentially decreases S. aureus acquisition and transmission in short-stay community-based nursing-home residents.

“Workarounds and Roadblocks”: Risk and Resistance among Food Movement Activists

This article examines how activists involved in the food movement use different tactics intended to challenge and subvert the agrifood structures they encounter. We use data from interviews and participant observations with 57 food movement activists operating in less robust alternative food systems throughout the Southern Plains states of Texas, Arkansas, Oklahoma, and Kansas. Our respondents describe how they interpret their regional food systems as deliberately restrictive to the food movement and explain some of the tactical choices they make to maneuver around various constraints they claim hinder their food movement activism. In actively resisting the agricultural status quo, we find that some activists knowingly engage in forms of high-risk activism. We then examine the different framing devices food movement activists use to explain the risks generated by their tactical workarounds. Our findings contribute to the social movements and food system literature by showing how activists interpret and justify the risks generated by their resistance and by emphasizing the contextual nature of tactical choices and risk in social movement activism.

23.5 SEXTING IN LGBT YOUTH

In 2016, the CDC published data confirming that youth and adults who are LGBT remain socially marginalized, with high rates of victimization, bullying, and cyberbullying. They suffer from overt discrimination and higher rates of depression, suicide, and high-risk activities. Social marginalization has helped fuel the LGBT community’s use of the internet for connection and support. Individuals who are LGBT establish meaningful sexual and romantic relationships online, and these may help form protective family relationships as adulthood progresses. On the other hand, some types of internet use, particularly sexting, can lead to problems, particularly anxiety or depression. Recent research has pointed out that sexting can also have positive outcomes, which may explain why sexting is not rare. The objective of this study was to better understand the differences between youth who are LGBT or heterosexual in sexting activities.

“The Six Moments:” A Novel Educational Tool to Promote Infection Prevention Practices in Patients Injecting Drugs

Background: The opioid epidemic has led to a dramatic increase in the rate of invasive bacterial infections, including a 4-fold increase in sepsis and a 12-fold increase in endocarditis. The increase has been demonstrated in both veteran and nonveteran populations (Fig. 1). Thus, an urgent need exists to develop novel tools to educate patients and providers regarding (1) at-risk moments among intravenous drug users and (2) methods for preventing transmission of bacterial and viral infections associated with injection drug use. Methods: We conducted a survey among medical trainees and staff and collected information about knowledge and attitudes about harm-reduction services. To address gaps in knowledge, we developed an educational tool for promoting better infection prevention practices among patients who inject drugs by adapting the WHO Five Moments of Hand Hygiene. Results: In total, 43 medical trainees and staff responded to the survey. All respondents regarded infections as a serious risk among patients who inject drugs, although there was variation in perception about which types of pathogens were the most likely to be acquired through this pathway (ie, bacterial vs viral). Among survey respondents, 15 of 39 (38%) reported that they have counseled patients who inject drugs about infection prevention, whereas 24 (58%) reported that they had never provided counseling. The reason for the lack of counseling was primarily a lack of knowledge and a lack of resources (10 of 24, 42%). One-quarter (6 of 24, 25%) reported that they did perceive infection prevention counseling to be part of their role. To solve this knowledge and resource gap, we developed an educational tool designed to promote understanding of the risk of bacterial, viral, and fungal infections and how to prevent them (Fig. 2, A and B). The “Six Moments” model highlights important high-risk moments and activities, such as skin cleaning, use of clean needles, and avoiding oral contamination of needles, as well as the corresponding pathogens that can be transmitted at each stage. Infection prevention strategies are them applied to demonstrate how these infections can be averted. The tool focuses on simple infection prevention interventions that can be taught to patients and providers not trained in infection control to limit transmission of infections associated with IV drug use and addresses the knowledge gap identified through the provider survey. Conclusions: This novel tool can be part of a comprehensive educational program that translates infection prevention principles and applies them to reduce infectious morbidity and mortality related to injection drug use.Funding: NoneDisclosures: None

MONITORING MECHANISM OF RESILIENCE OF THE ANTI-CRISIS POTENTIAL SYSTEM OF THE CONSTRUCTION ENTERPRISE IN THE LONG-TERM PERIOD

The anti-crisis potential of enterprises belonging to industries with a long production cycle is unstable, as the time interval between incoming cash flows is much longer than between outgoing ones. This problem is especially actual for construction companies, whose income largely depends on the state of investment demand. Therefore, there is a need to develop an effective mechanism to control the resilience of the anti-crisis system of the construction company to environmental conditions. According to many scientists, anti-crisis potential is associated with the financial sanation. Given the undeniable usefulness of the analyzed developments, there has been noted that they are unsuitable for managing the financial sanation capacity and anti-crisis potential of construction companies. After all, most of them are suggested for agricultural or industrial ones. Given the definition of "financial sanation", the implementation of measures aimed at restoring business is impossible without investment. Investing funds in any business project, including those aimed at strengthening the financial condition of the enterprise, will be efficient only when they provide an economic effect. Thus, the requirement of return on investment is indisputable, but for high-risk activities, including construction, there is an additional condition, to get a return on investment as soon as possible: from 3 to 10 years. After all, this is the duration period of different types of macroeconomic cycles, during which the vast majority of construction companies go through all stages of economic development: from growth to decline. The dependence of the payback period of equity capital on other factors of the internal and external environment of business systems has been studied in order to manage the rehabilitation and anti-crisis potential of a construction company. General scientific methods such as analysis, synthesis, deduction, induction, analogy as means of studying and generalizing theoretical approaches to providing anti-crisis potential; Васkwаrd Stерwisе method (construction of multifactor linear regressions Stаtistіса 8.0), providing the sequential construction of equations in which the set of input factors decreases by removing the least significant to explain the variation of the independent variate. In order to increase the efficiency of decision-making on the feasibility of additional equity attraction by construction companies there has been developed a methodological approach to forecasting the level of financial sanation capacity of the construction company. It is a complex; a multifactor model - a linguistic scale, allows to identify changes in the payback period of equity in the medium term using quantitative and linguistic estimates and can be used as a functional module of digitized economic management of the enterprise.