High-risk Behaviors Research Articles

Effectiveness of Peer-Led Education in Reducing HIV Transmission among Youths in Urban Areas: A Comprehensive Review

HIV transmission among urban youths remains a significant public health concern, driven by factors such as risky sexual behaviors, limited access to healthcare, and high social connectivity. Peer-led education has emerged as a promising intervention to reduce HIV transmission by utilizing the influence of social networks and delivering relatable, accessible information on HIV prevention. This review assessed the effectiveness of peer-led education programs in urban areas by examining their impact on HIV-related knowledge, behavior change, and HIV testing rates. Studies revealed that peer-led education significantly improves HIV knowledge, promotes condom use, and encourages HIV testing among urban youths, contributing to a reduction in high-risk behaviors. Additionally, the social and emotional benefits of peer-led education create supportive environments for discussing sexual health, reducing stigma, and fostering empowerment among participants. However, challenges such as variability in program quality, sociocultural barriers, and sustainability issues limit the long-term success of these interventions. To address these challenges, future strategies should focus on integrating digital health platforms, personalizing peer education, and employing rigorous program evaluation methods. The methodology for this review included a comprehensive analysis of existing literature, including randomized controlled trials, systematic reviews, and observational studies, to provide a holistic understanding of peer-led education’s effectiveness in reducing HIV transmission among urban youths. Keywords: Peer-led education, HIV prevention, Urban youths, Behavioral change, HIV transmission.

Pre-Exposure Prophylaxis for the Prevention of HIV-1: An Assessment of Oral Pre-Exposure Prophylaxis Usage Patterns, First Evidence of HIV-1, and HIV-1 Risk Factors in the United States.

In clinical trials, once-daily oral tenofovir-based pre-exposure prophylaxis (PrEP) significantly reduced HIV-1 acquisition risk; however, this was highly dependent on medication adherence and persistence. We report clinical characteristics, PrEP usage patterns, first evidence of HIV-1, and associated risk factors among adults with commercial insurance using oral PrEP in the United States using health plan claims from the IQVIA PharMetrics® Plus database between January 1, 2015, and March 31, 2020, from individuals who newly initiated emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) or FTC/tenofovir alafenamide (TAF) for daily PrEP. Overall, 25,419 individuals were included (FTC/TDF, n = 24,232; FTC/TAF, n = 1187), with generally similar characteristics reported during the 6-month baseline period across cohorts. Mean follow-up length was 504 and 77 days for FTC/TDF and FTC/TAF, respectively, corresponding with the 2019 approval of FTC/TAF for PrEP. Similarly, mean PrEP use duration was 354 and 68 days for FTC/TDF and FTC/TAF, respectively. PrEP breaks (>90-day gap) were observed in 11.1% of individuals using FTC/TDF, with a mean break duration of 249 days; 20.0% of individuals using FTC/TDF and 7.3% using FTC/TAF had ≥1 sexually transmitted infection diagnosis during follow-up. From 6 to 12 months of follow-up, mean FTC/TDF proportion of days covered (PDC; 0.74 vs. 0.67) and persistence (70.2% vs. 57.4%) decreased; real-world PDC and persistence were lower than reported in globally conducted clinical trials. First evidence of HIV-1 was infrequent among individuals using FTC/TDF (0.6%), though 60.3% had PrEP on hand when HIV-1 definition was met; high-risk sexual behavior, syphilis, and gonorrhea were the most important risk factors.

Contraceptive Choice and Sexual Behaviors in Both-Sex Attracted Adolescents: A Retrospective Cohort Study

Study ObjectiveBisexual adolescents have higher rates of unintended pregnancy than their heterosexual peers and increased rates of high-risk sexual behaviors. They may be less likely to use effective contraception, though limited data is available. This study sought to compare contraceptive choice and sexual risk behaviors of both-sex attracted and opposite-sex attracted adolescents and young adults (AYA) presenting to a contraception clinic. MethodsA retrospective chart review of AYA aged 14-24 years who presented for an initial visit to a contraception clinic from 2014 to 2020. The primary outcome was contraceptive choice (long-acting reversible contraception (LARC), non-LARC, or nothing). Secondary outcomes included sexual behaviors. Results were analyzed using Pearson's chi-square and Wilcoxon tests. Results2369 AYA were included in this study. Both-sex attracted and opposite-sex attracted patients were similar in age, race, and ethnicity. There was no difference between groups in percent selecting LARC (71% vs 66.1%, p=0.11). Both-sex attracted patients reported a younger age at first sex (14.6 years vs 15.5 years, p < .001), more lifetime sexual partners (4.1 vs 2.8, p < .001), and a higher prevalence of forced intercourse (21.9% vs 8.8%, p < .001). ConclusionsBoth-sex attracted and opposite-sex attracted AYA patients chose LARCs at similar rates in a setting with standardized contraceptive counseling. Both-sex attracted patients had more sexual risk behaviors. Healthcare providers should be inclusive in their approach to obtaining sexual health histories and providing contraceptive counseling and be cognizant that adolescents with both-sex attraction may be at higher risk of forced intercourse.

The Effect of Preconception Counseling According to the Theory of Planned Behavior with the Presence of the Spouse on Preconception Health Behaviors – A Training Trial Study

Background and Objective: Preconception care consists of biomedical, behavioral, and social services, along with health interventions, for women and couples before conception to improve their health status and reduce individual and environmental high-risk behaviors. This study aimed to assess to preconception counseling according to the theory of planned behavior with the presence of the spouse on preconception care behaviors. Materials and Methods: This study was an educational trial. The researcher randomly divided women into two intervention and control groups. The control group only received routine preconception care in the presence of the spouse. The intervention group, according to the theory of planned behavior, received 60-minute face-to-face counseling weekly sessions. The main outcomes of behavior were divided into two categories: screening tests and vaccinations and individual lifestyle (exercise, nutrition, and smoking). The questions also focused on men’s check-up tests. The data normality was analyzed by group, variable type, and measurement stage using the Shapiro-Wilk test and the skewness and kurtosis results. Levene's and Mochli's tests were used to check the homogeneity of variances and assumption of sphericity, respectively. Data were analyzed using independent t-tests, chi-square, repeated measures test, and SPSS 26 software. Result: The previous lifestyle behaviors were respectively 15.22 + 2.836, 15.49 + 2.769, and 16.84 + 1.894 before, immediately, and 4 weeks after the intervention in control, and 12.70 + 3.69, 15.53 + 3.02, and 16.60 + 2.73 in the intervention group, indicating no significant differences (p=0.08). However, the two groups significantly increased healthy lifestyles over time(p=0.001). The results also showed that the mean of test and vaccination was respectively 4.44 ± 2.99, 2.75 ± 6.42, and 2.49 ± 8.31 before, immediately, and 4 weeks after the intervention in control, and 4.09 + 3, 6.74 + 2.87, and 8.35 + 2.37 in the intervention group, indicating no significant differences(p=0.99). Conclusion: Since the presence of the husband during the training of women's pre-pregnancy care can affect their health behaviors regardless of the type of intervention, men are suggested to attend prepregnancy training and consultations for at least one session.

Congenital Syphilis in the United States: A Narrative Review.

Congenital syphilis (CS) continues to pose a significant global challenge. There has been a marked increase in reported cases in the US, with 102.5 cases per 100,000 live births in 2022 compared to 11.6 cases per 100,000 live births in 2014. CS can lead to a range of severe complications, including premature birth, intrauterine growth restriction, miscarriage, perinatal death, stillbirth, and postnatal complications that may persist into later life. Maternal/parental factors such as age, race/ethnicity, occupation, income level, access to healthcare services, and incarceration have been linked to higher rates of CS. Additionally, pregnant individuals who engage in high-risk behaviors such as sex work, having multiple sexual partners, or substance use are at a higher risk of exposure and subsequent infection. Routine screening for syphilis during pregnancy is crucial for its detection, timely management, and prevention of CS. The asymptomatic nature of the latent stage of syphilis further underscores the importance of prenatal syphilis screening. Studies in various countries have shown that early or first antenatal care visit screening for CS is cost-effective. This review article critically evaluates the current knowledge of CS in the US, including its prevalence, social determinants of health, prevention efforts, challenges, the significance of screening, and the call to action to address the rising trend.

First report on human T-lymphotropic virus 1 infection in a group of transgender women

IntroductionThere is a lack of data on human T-lymphotropic virus 1 (HTLV-1) infection among transgender women (TGW). Therefore, this study estimated the prevalence of HTLV-1 infection in a group of TGW in Brazil.MethodsA cross-sectional study was conducted with 235 TGW in Goiânia City, Central Brazil. Respondent-driven sampling was used for recruitment. All participants were interviewed, and serum samples were tested for anti-HTLV-1/2 using an enzyme-linked immunosorbent assay (ELISA; Murex HTLV-I + II, DiaSorin, Dartford, United Kingdom). Seropositive samples were submitted for confirmation by Western blot (WB; MP Diagnostics HTLV BLOT 2.4 test, MP Biomedicals, Germany).ResultsThe majority of participants were young (≤ 25 years old), self-declared mixed or brown ethnicity, single, had attended high school, and had a monthly income above US$ 255 (R$ 1,000,00; nearly the minimum wage in Brazil at the time). Most reported earlier age at first sex and various risk behaviors for sexually transmitted infections (STIs). Three TGW were anti-HTLV-1/2 positive by ELISA and were subsequently positive for HTLV-1 by WB, giving a crude HTLV-1 seroprevalence of 1.3%; 1.0% (95% CI: 0.0–1.9) after being weighted by RDS Analysis Tool (RDSAT). The HTLV-1 seropositive TGW reported high-risk sexual behaviors. In addition, one of them also engaged in injecting drug use.ConclusionThese data indicate the circulation of HTLV-1 in TGW in Goiânia City, Central Brazil. Given the alarming estimates of high-risk sexual behaviors, there is an urgent need to intensify health programs targeting this population to control and prevent HTLV-1 and other STIs effectively.

Young North African migrants in Europe: exploring their health and the adequacy of health services

Abstract Background Over five million people from North Africa (NA) lived in Europe in 2019, including youth characterized by intense trans-border mobility, precarious living conditions and high-risk behaviours such as prostitution and illegal activities. This population challenges health professionals and institutions ability to deliver medical care and health information remains scarce. This scoping review aims to better understand NA adolescents and young adult (aged 12-25) health status, access to and use of healthcare. Methods Following the Arksey and ÓMalley process and based on the Population-Concept-Context framework, we searched the CINAHL, Cochrane, Embase, PubMed, PsycINFO and Web of Science databases for peer-reviewed articles and non-index reports. We systematically tracked references. Results Initial search returned 5319 articles of which we included 13 (2 Spanish, 2 French, 3 German). All reported about observational studies. Nine of 13 papers included males only and 11 focused exclusively on unaccompanied minors. They reported about physical health conditions related to poverty such as dental caries, iron deficiency and dermatological conditions (n = 5) or infectious diseases, notably tuberculosis (n = 7). Trauma-related mental health conditions were frequently reported (n = 7), including post-traumatic stress disorder and alcohol, cannabis or benzodiazepines harmful use with frequent overlapping presentations. Three studies discussed multi-pronged barriers to healthcare, emphasizing the importance of transcultural approaches and attention to social factors. Conclusions Embedded into multiple factors of vulnerability, poor physical and mental health is commonly associated with young NA migrants. Evidence is limited in scope and quality notably about females and young adults. There is an important gap about optimal strategies to deliver tailored health services, notably to respond to complex mental health needs. Key messages • The complex health needs and barriers to care of young NA migrants in Europe are not adequately documented, understood, and addressed. • Particular attention should be paid to trauma-related mental health conditions.

Lake shape and the characteristics of migration behavior modify Atlantic salmon smolt migration success through lakes.

Migration is a high-risk behavior. For the Atlantic salmon, Salmo salar, migrating from its river nursery area to marine feeding grounds, the magnitude of risk varies with habitat type. Passage through lakes, in particular, is associated with low rates of migration success. Downstream migrating salmon smolts are rheotactic when migrating in rivers, but lakes typically provide poorer directional currents for migrating salmon. In this study we tested if, in the absence of clear navigational cues in lakes, Atlantic salmon smolts switch to a random search strategy to find the outflowing river. We constructed random search simulations to test if lake basin shape has an effect on migration success. We also compared simulated migration characteristics with migrations of salmon smolts through five real lakes for which there are telemetry data for migrating salmon. Correlated random walk simulations showed that a random search strategy could be successful for all lake shapes tested but was more successful in curved (round and elliptical) than rectangular basin shapes. Rectangular basins with the migration start and stoppoints at the ends of the lake had a higher success than those where these points were perpendicular to the axis of the lake. In general, a random walk model predicted the migration success rate of fish tracked through real lakes. However, for two lakes the simulated migration success exceeded that of actual success, suggesting that fish passing through these lakes were not adopting a random search strategy. We speculate that this is the result of either conflicting navigational cues which inhibit smolts from finding the lake outlet or that they temporarily suspend migration (e.g., to feed). Modelling predicted that for small lakes, directional swimming in short steps (ca. 100 m) followed by turns with very low variation from the direction of travel resulted in the highest migration success. For larger lakes, longer step lengths but also with low turn variation (simulated turning angle drawn from distributions of standard deviation 2° and 5° around a mean of 0°) resulted in the highest migration success. We conclude that navigation in downstream migrating salmon smolts switches from rheotaxis in rivers to a random search tactic in lakes except where residual flow cues in some lakes prevent this, at times resulting in suboptimal navigation outcomes.

Vaccine Hesitancy and COVID-19 Risk Behaviors Associated with Social Media Use in Japan

ABSTRACT We examined the associations between the use of different types of media and COVID-19 vaccine hesitancy, as well as risk behaviors of COVID-19 infection, in Japan in late 2021. Cross-sectional surveys were conducted using rapid online surveys of residents in Iwate Prefecture from February 5 to 7, 2021, and from October 1 to 3, 2021. Each individual’s risk of acquiring SARS-CoV-2 infection was calculated using a quantitative assessment tool (the microCOVID). Intention to get vaccinated for COVID-19 was assessed by self-report. Usage of five types of media for obtaining COVID-related information was assessed: (1) newspapers, (2) television or radio, (3) internet or news apps, (4) social network services (SNS) (excluding LINE, a popular messaging app), and (5) other. Reliance on SNS did not show significant associations with either intention to get vaccinated or engaging in risky behavior for acquiring COVID-19. Although users of the internet or news apps were marginally significantly less likely to engage in high-risk behavior, significant associations between vaccine hesitancy and the usage of the internet or news apps were found in the middle age and elderly groups (OR [95% confidence interval (CI)] in middle age: 1.55 [1.07–2.23]; in elderly; 9.24 [3.28–26.02]). The differential associations between different types of media use and COVID-19 prevention behaviors may assist in preparing for future pandemic outbreaks. One implication for public health risk communication is audience segmentation, such as emphasizing vaccine safety and effectiveness for older audiences.

Dysmenorrhea in Polish Adolescent Girls: Impact on Physical, Mental, and Social Well-Being—Results from POLKA 18 Study

Background: Dysmenorrhea, characterised by painful menstrual cramps, is a pressing issue among adolescent girls globally. It significantly impacts their quality of life and has been associated with increased mental health issues and engagement in risky behaviours like smoking. In Poland, there is limited research on menstrual health, emphasising the need for a study to understand dysmenorrhea experiences and their impact on young menstruating individuals. Methods: This research project investigated the effects of dysmenorrhea on quality of life and school attendance, as well as its associations with non-communicable diseases, including mental health among adolescent girls in Poland. Additionally, the study examined risk factors for non-communicable disease development, including high-risk health behaviours and exposure to violence. The study utilised a cross-sectional design, administering self-reported questionnaires in high schools and vocational schools in six voivodeships (regions) in Poland. The analysis was performed using the R language in the Rstudio environment. p-value &lt; 0.05 was considered significant. Results: A significant percentage of respondents experienced heavy menstruation, irregularity, and pain. Adolescents with dysmenorrhea reported higher rates of school absenteeism, mental health issues (such as anxiety and panic attacks), and a higher likelihood of engagement in risk behaviours like smoking and illicit drug use. The study also identified associations between dysmenorrhea and experiences of violence, including sexual abuse and intimate partner violence, as well as links to self-harm and suicidal ideation. Conclusions: These findings contribute to understanding dysmenorrhea among Polish adolescent girls, emphasising the need for tailored interventions and support services. The study underscores the necessity of addressing menstrual health comprehensively, considering its impact on various aspects of young women’s lives and promoting their overall well-being.

Programmatic and Organizational Barriers and Facilitators to Addressing High-Risk Issues in Supportive Housing and Housing First Programs.

Risk management is an important component of service delivery in supportive housing and Housing First programs. However, there is no evidence on the implementation of risk management approaches in these settings. This qualitative study examined what service providers working in supportive housing and Housing First programs in Canada identify as the programmatic and organizational factors that affect the prevention and management of high-risk behaviours and challenges (e.g., overdose, suicide attempts, non-suicidal self-injury, falls and fall-related injuries, fire-setting, hoarding, apartment takeovers, violence, property damage, drug selling) in their programs. In-depth interviews were completed with a purposive sample of 32 service providers. Data were analyzed using an integrative approach that incorporated techniques from qualitative description and thematic analysis. Four thematic factors, which were comprised of various barriers and facilitators, that affected management of high-risk issues in supportive housing and Housing First programs were identified: [1] flexibility in addressing risk issues; [2] early identification of risk issues; [3] built environment and housing location; and [4] resource availability. Overall, the findings underscore how service providers aim to identify high-risk issues promptly, beginning as early as referral, and that their capacity to effectively do this and intervene accordingly is dynamically shaped by various aspects of the program model, environment, and availability of internal and external resources. Yet, the findings also highlight how risk management approaches may conflict with other programmatic goals and values, and the importance of considering these collectively. Systems-level changes to strengthen programs' capacity to prevent risk and implications for future research are discussed.

Research on the Detection Algorithm of Elderly Falling Behavior Based on AlphaPose Model

This study aims to address the challenge of quickly and accurately detecting high-risk behaviors such as falls in elderly people in hardware environments with limited power consumption and cost. Therefore, this article proposes an optimized behavior anomaly detection algorithm based on the AlphaPose model. The algorithm first improved the human target detection and pose estimation models to achieve faster pedestrian detection and pose joint point inference; Then, using the adjusted AlphaPose model, efficiently obtain the image coordinate data of each joint point in the human body; Finally, by analyzing the relationship between the linear velocities of the human head and hip joints, as well as the changes in the angle between the vertical line of the human center and the X-axis of the image, it is determined whether a fall event has occurred. This study deployed the proposed algorithm on the JetsonNano embedded development board and compared its performance with mainstream fall detection algorithms based on human posture, including YOLOv3+Pose, YOLOv4+Pose, YOLOv5+Pose, trtpose, and NanoDet+Pose. The experimental results show that on the set embedded platform, when the image resolution is 320×240, this algorithm achieves a detection rate of 8.83 frames per second and an accuracy of 0.913, both of which are superior to the compared algorithms. In summary, this algorithm has high real-time performance and accuracy, and can effectively identify the falling behavior of elderly people in a timely manner.

Evaluation of the Effects of Educational Interventions on the Modification of High-Risk Job Behaviors in Patients with Brucellosis in Rural Areas of Arak County based on the Family-Centered Empowerment Model (FCEM)

Background and Objectives: Brucellosis is a common disease worldwide. Family-centered empowerment model is a model for empowering patients to modify high-risk behaviors. Given the wide range of health and economic complications caused by the prevalence of brucellosis in society, we sought to evaluate the effect of this model in modifying the high-risk behaviors of patients with brucellosis. Methods: The present study was a quasi-experimental interventional study that examined 88 patients with Brucellosis in Arak County in 2021. Data were collected using a standardized questionnaire based on the family-centered empowerment model in six constructs, namely knowledge, attitude, perceived severity, self-esteem, self-efficacy, and behavior at two stages before and two months after the educational intervention. Independent t-test, paired t-test, and chi-square test at a significance level of 0.05 were used to analyze the data. Results: The mean of patients' age was 42.19±19.79. The results of the paired t-test indicated that the mean scores of knowledge (P&lt;0.001), attitude (P&lt;0.001), perceived severity (P&lt;0.001), self-esteem (P&lt;0.001), self-efficacy (P&lt;0.001), and behavior (P&lt;0.001) significantly increased in the intervention group after education. but changes in mean scores of knowledge (P=0.71), attitude (P= 0.53), perceived severity (P=0.26), self-esteem (P=0.18), self-efficacy (P=0.21), and behavior (P=0.41) were not significant in the control group. Conclusion: The results indicated that educational intervention based on the family-centered empowerment model could be effective in increasing knowledge, thereby improving Brucellosis prevention behaviors.

The Hidden Impact of War on Children’s Identity and Attachment: „The Magician’s Elephant”

Significant advances in neurology, cognition, and sociopsychology occur during adolescence. Teenagers usually spend less time with their parents as they get older, but they tend to spend a lot more time with their peers let it be their friends or siblings. However, parents still have a significant impact on their adolescent’s growth. The bond between a teen and their parent has a significant impact on emotional, social, and cognitive development. Less high-risk behavior, fewer mental health issues, and improved social skills and strategies for coping are all linked to secure attachment. “The Magician’s Elephant” is a 2023 computer-animated fantasy action film that Wendy Rogers directed, Martin Hynes wrote the screenplay for, and Julia Pistor acted as producer. This paper questions the hidden impact of war on Children’s identity and attachment with the help of the narrative.

Prospective associations between Sleep, Sensation-Seeking and Mature Screen Usage in Early Adolescents: Findings from the Adolescent Brain Cognitive Development (ABCD) Study.

Early exposure to mature content is linked to high-risk behaviors. This study aims to prospectively investigate how sleep and sensation-seeking behaviors influence the consumption of mature video games and R-rated movies in early adolescents. A secondary analysis examines the bidirectional relationships between sleep patterns and mature screen usage. Data were obtained from a subsample of 3,687 early adolescents (49.2% female; mean age: 11.96 years) participating in the Adolescent Brain and Cognitive Development study. At Year 2 follow-up, participants wore Fitbit wearables for up to 21 nights to assess objective sleep measures and completed a scale about sensation-seeking traits. At Year 3 follow-up, they answered questions about mature screen usage. Of the sample, 41.8% of the sample reported playing mature-rated video games and 49% reported watching R-rated movies. Sensation-seeking traits were associated with R-rated movie watching one year later. Shorter sleep duration, later bedtime, more bedtime variability, and more social jetlag (discrepancy between the mid-sleep on weekdays and weekends) were associated with mature-rated video gaming and R-rated movie watching one year later. Sleep duration variability was associated with mature-rated video gaming. There was also an interaction effect: those with higher sensation-seeking scores and shorter sleep duration reported more frequent R-rated movie usage than those with longer sleep duration. Secondary analyses showed bidirectional associations between later bedtimes, more variability in bedtimes, and more social jetlag with mature screen usage. Early adolescents with sensation-seeking traits and poorer sleep health were more likely to engage in mature screen usage.

Substance use and psychiatric phenotypes of youth experiencing homelessness: A cluster analysis.

Due to the complex interactions of psychopathology, psychosocial stressors, and risk behaviors, characterizing high-risk phenotypic groups of transitional-age youth experiencing homelessness (TAY-EH) for targeted interventions remains difficult. We aimed to uncover specific phenotypes of TAY-EH based upon psychiatric and substance use disorder (SUD) diagnoses, and to assess relationships between these phenotypes and negative outcomes including suicidality and high-risk behaviors. Participants (N = 140; 57% male, 54% Black) were individuals aged 16-25 years accessing support at a psychosocial agency in the U.S. Northeast. Data were gathered via structured assessment. Cluster analysis identified sub-groups of TAY-EH with differing diagnostic patterns. Bivariate analyses examined associations between cluster membership and target outcomes. A four-cluster solution was identified. Cluster 1 (Co-occurring; N = 33) was characterized by high levels of comorbidity (i.e., major depressive disorder (MDD), SUD, and notable levels of other diagnoses). Clusters 2 (MDD alone; N = 47) and 3 (SUD alone; N = 18) were characterized by single diagnoses. Cluster 4 (None; N = 42) was characterized by low levels of psychopathology. Clusters differed significantly on several variables including suicidality, adverse childhood experiences, and social connectedness. Comorbid MDD and SUD were most strongly associated with high-risk behaviors and suicidality. These results highlight the importance of diagnosis and targeted interventions for co-occurring MDD and SUD to address the crisis of early mortality and other negative outcomes among TAY-EH. This study is the first to identify specific high-risk psychiatric and psychosocial phenotypes among the highly complex group of TAY-EH based upon structured diagnostic assessments.

Risky online behaviors and cybercrime awareness among undergraduate students at Al Quds University: a cross sectional study

The rate of cybercrime among Palestinian university students is unknown. This study is the first to examine cybercrime awareness among Palestinian undergraduate students. A cross-sectional design was used to investigate cybercrime awareness, risky online behaviors, and the prevalence of cybercrime among these students. Participants were selected using convenience sampling. Invitations were sent via Google Forms to complete an online questionnaire. The findings revealed that a sizable proportion of participants (52.4%) had either been victims of cybercrime or knew someone who had. High-risk online behaviors included using social media for social interaction, using mobile apps, engaging in excessive social media use, and failing to report criminal activity to law enforcement authorities. The study found a lack of awareness about cybercrime, particularly regarding knowledge, perceived causes, cybersecurity measures, and emotional responses. Multivariate logistic regression analysis identified significant relationships between cybercrime exposure and factors such as students' knowledge of cyberstalking and cybercrime harassment, perceptions of being threatened by cybercrime, the need for university cybercrime awareness programs, and experiences with sextortion, social media harassment, and cyberstalking. Accepting friend requests only from known individuals could reduce their vulnerability to cybercrime. Fear and indifference decreased the likelihood of being exposed to cybercrime, while anger increased the risk. Thus, incorporating cybercrime awareness program, which includes information security awareness, education, and training, into universities' overall security management strategies is critical. This will effectively reduce the risks associated with cyberattacks for students.

Methodology for assessing health risk behaviours among undergraduates in Sri Lanka: a literature review

It is imperative to learn more about the distinctive Health-Risk-Behaviours (HRB) that are culturally acceptable in the lower-resource settings. Therefore, the objective of this review is to identify tools measuring HRBs among undergraduates in Sri Lankan context. A literature review was conducted both manually and electronically through Google Scholar and Hinari and PubMed databases. Self-administered Questionnaires were used in National Surveys and individual studies. Youth-Risk Behaviour-Surveillance-System was the most commonly used comprehensive HRB assessment tool. The National College Health Risk Behaviour Survey, National College Health Assessment were other widely used instruments. There are few validated tools and multiple short scales or items combined like Health-Promotion-Lifestyle[1]Profile, Health-Behaviour-Questionnaire or Inventory, DOSPERT scale, Adolescent-Health-Attitude and Behaviour[1]Survey, Healthy-Lifestyle-Scale, Health-Behaviour-Scale and Health-Behaviour-Checklist. Objective methods for assessing high-risk behaviors (HRBs) include measures of personality and aggression, which have been used to critically quantify violence and accidental injury, as well as biochemical tests for alcohol, nicotine, and other drug use, mechanical or computer sensors, and biological tests such as urinary cultures for sexual risk behaviours. These tools had focused only on specific aspects of HRBs among undergraduates in Western countries and were not comprehensive assessments of HRBs of undergraduates in lower-resource settings. It was evident that there has been a deficit of choices for the adaptation of an HRB tool for undergraduates in lower-resource-settings and a new tool to be developed for Sri Lankan context.

Secondary Syphilis Can Simultaneously Mimic Cholestatic Liver Injury and Glomerular Nephropathy

ABSTRACT Syphilis, a disease affecting millions, still poses challenges for men who have sex with men in high-income countries and often presents in varying ways. It is exceedingly rare for syphilis to simultaneously cause an acute liver injury and nephropathy. This case describes the concomitant clinical presentation of these abnormalities and also describes a liver injury that mimicked cholestatic disease. Treatment of syphilis led to complete resolution of the liver and kidney injury. This case demonstrates a need to exclude syphilis in patients with high-risk behaviors who present with cholestatic liver injury in atypical fashions.

Protective Factors Associated With Lower Likelihood of Injection Drug Use and Experiencing Overdose Among Incarcerated Women

PurposePrior studies evaluated protective factors individually as they relate to fewer drug use risk behaviors and related consequences. This is the first study to examine protective factors as part of a multilevel framework along a risk continuum among women involved in the criminal legal system who use drugs. This study describes factors within the socio-ecological framework that are protective against engaging in injection drug use and experiencing nonfatal overdose. MethodData were collected from 900 women with a history of opioid use disorder who were incarcerated and enrolled in the National Institutes of Health/National Institute on Drug Abuse–funded Justice Community Opioid Innovation Network cooperative. Analysis focused on the relationship among individual, interpersonal, and community- or institutional-level protective factors associated with not injecting drugs and not experiencing an overdose in the 90 days before incarceration using multinomial logistic regression. FindingsFindings from this study suggest that, even among a sample of women who use drugs, there are a number of factors associated with being less likely to report higher-risk injection behavior and/or overdose experiences at the individual level (age, religiosity, and less polysubstance use), interpersonal level (not having a partner who injects drugs), and community or institutional level (fewer months incarcerated, less treatment utilization, and less enacted stigma by health care workers). ConclusionsFindings from this study underscore the importance of being able to target prevention interventions to women at different stages of substance use severity and to capitalize on protective factors for those at lower-risk levels to reduce the trajectory of risk to injection practices and overdose experiences.