Individual Characteristics Research Articles

Reference-dependence in multi-destination choice: A heterogeneous reference point perspective

Destination choice in multi-destination trips is crucial for understanding tourists' preferences, predicting tourism demand and flow, and fostering collaborative opportunities between destinations. This study utilises prospect theory to examine how tourists select a stop within a multi-destination trip and to explore the role of other chosen stops' attributes as a reference point when tourists plan their itinerary. The results reveal dynamic perceptions of gains and losses relative to reference points that vary across individual characteristics and destination attributes. Additionally, heterogeneity is revealed in tourists' reference-dependent patterns, which can be categorised as immediate- and delayed-gratification reference dependencies. These findings contribute to the destination choice discourse by proposing new directions for comprehending tourists' heterogeneous reference dependencies and attitudes in sequential destination choices.

Pain and development: interacting phenomena

Abstract For decades, clinicians and researchers have observed bidirectional relationships between child development and the pain experience in childhood. Pain in childhood is an inherently developmental phenomenon, embedded in an iterative, time-dependent process that reflects individual biological, behavioral, social, psychological, and environmental characteristics that unfold across the early life span. Childhood pain can have wide ranging effects on brain development in ways that contribute—for better and worse—to social, emotional, and cognitive well-being in childhood and on into adulthood. Atypical trajectories of development in the context of disorders such as autism, cerebral palsy, ADHD, and mood/anxiety disorders also contribute to unique childhood pain experiences. In this paper, pain will be considered as a determinant of development, and conversely development will be considered as a key determinant of a child's pain experience. We will discuss how intersectional identities (eg, gender, race, socioeconomic status) and associated social, structural, systemic, and physical environments influence the relationship between development and pain. Finally, we will identify what might be needed to think “developmentally” in ways that extend from the “bench side” in the lab to the “curb side” in the community, integrating a developmental perspective into research and clinical practice to achieve health accessibility and equity in pain care for all children across the developmental spectrum.

Identifying momentary suicidal ideation using machine learning in patients at high-risk for suicide.

Strategies to detect the presence of suicidal ideation (SI) or characteristics of ideation that indicate marked suicide risk are critically needed to guide interventions and improve care during care transition periods. Some studies indicate that machine learning can be applied to momentary data to improve classification of SI. This study examined whether the classification accuracy of these models varies as a function of type of training data or characteristics of ideation. A total of 257 psychiatric inpatients completed a 3-week battery of ecological momentary assessment and measures of suicide risk factors. The accuracy of machine learning models in classifying the presence, duration, or intensity of ideation was compared across models trained on baseline and/or momentary suicide risk data. Relative feature importance metrics were examined to identify the risk factors that were most important for outcome classification. Models including both baseline and momentary features outperformed models with only one feature type, providing important information in both correctly classifying and differentiating individual characteristics of SI. Models classifying SI presence, duration, and intensity performed similarly. Results of this study may not generalize beyond a high-risk, psychiatric inpatient sample, and additional work is needed to examine temporal ordering of the relationships identified. Our results support using machine learning approaches for accurate identification of SI characteristics and underscore the importance of understanding the factors that differentiate and drive different characteristics of SI. Expansion of this work can support use of these models to guide intervention strategies.

Investigating pedestrians’ red light running intentions at urban intersections in different traffic Environments: A scenario-based analysis guided by theoretical frameworks

Pedestrian risky behaviors are one of the contributing factors to crashes involving pedestrians. Therefore, it is crucial to comprehend the mechanisms by which pedestrians interact with many influential components in the traffic environment. This study aimed to evaluate pedestrians’ red light running intentions and related factors under different traffic flow scenarios, including straight traffic flow, right-turning traffic flow, and left-turning traffic flow. A theoretical approach based on the theory of planned behavior (TPB) and the prototype willingness model (PWM) was employed. Data were collected from an online survey of 2250 participants in Tehran, Iran. Structural equation modeling (SEM) was used to identify the significant factors that explain intentions. All models successfully explained the behavioral intention for red light running violation; however, the findings revealed that the integrated model was the best-performing model to represent violation and, thus, was selected for interpreting the results and drawing relevant conclusions. Different traffic flow scenarios had varied effects on violation intentions for individual characteristics and model constructs. Previous crash experiences and driving-related background variables emerged to impact pedestrian violation intention across three scenarios. The findings also suggested that the rational constructs (attitude, perceived behavioral control, and facilitating conditions) had a more robust impact on violation intention compared to reactive constructs (prototype similarity, prototype favorability), with facilitating conditions being the strongest predictor of the model, followed by attitudes toward violation as a significant predictor of intention for red light violation. According to the results, the mechanism of risk-taking varies depending on the direction of the traffic flow. Higher risk was associated with the violation at the intersections with straight traffic flow compared to the intersections with turning traffic flow. Based on the findings of this study, several implications, including interventions focusing on individuals’ transportation safety attitudes, countermeasures to increase the risk perception of pedestrians toward turning vehicles, and countermeasures regarding the use of mobile phones while walking for the context of this study were proposed.

PENGEMBANGAN USAHA PADA UMKM YU MIN BATIK & BUTIK DESA SIDOREJO KECAMATAN COMAL KABUPATEN PEMALANG

<table width="576" border="1" cellspacing="0" cellpadding="0"><tbody><tr><td width="402"><p>The Micro, Small and Medium Enterprises that are the object are the UMKM Yu Min Batik & Boutique owned by Mrs. Siti Aminah which is located in Sidorejo Village, Comal District, Pemalang Regency. This MSME operates in the field of clothing and modified batik cloth in Pemalang. The aim of implementing this activity is to develop business, good financial management and production performance. The business assistance provided includes marketing aspects. The efforts made by the accompanying team aim to promote Yu Min Batik & Boutique products through MSME activities such as bazaars and catalog content on online social media. This is due to increasingly sophisticated technological developments and seeing many entrepreneurs, especially MSMEs, promoting their businesses through online social media. The aim is to introduce and attract the interest of potential customers by understanding the individual characteristics of consumers so that the products sold will match their wishes.</p><p>The assistance method used is carrying out several programs such as making banners, making simple bookkeeping, Google maps, participating in MSME bazaar activities, making direction boards, making organizational structures, business profiles, and creating social media (Instagram). After analyzing and applying the program to Yu Min Batik products, it produced a positive impact on MSME owners. Such as introducing products through promotions on social media and placing banners, organizational structures, understanding simple bookkeeping, business profiles, and installing direction boards to fulfill product requirements to support promotions so that people have more confidence in the products they want to buy.<strong></strong></p></td></tr></tbody></table>

ВЛИЯНИЕ ЭКОНОМИЧЕСКИХ ФАКТОРОВ (ДЕТЕРМИНАНТ) НА СУБЪЕКТИВНЫЕ ОЦЕНКИ УРОВНЯ ФИЗИЧЕСКОЙ АКТИВНОСТИ НАСЕЛЕНИЯ ТРУДОСПОСОБНОГО ВОЗРАСТА

Despite the importance of physical activity indicators and their decisive influence on public health indicators, no studies have been conducted on the impact of health determinants, including economic ones, on physical activity indicators. The purpose of the study is to analyze the fact and degree of influence of economic factors as a component of lifestyle on physical activity indicators. Materials and methods of research. The individual economic characteristics of patients were considered as the object of the study. Since the normality of the distribution for quantitative features, as a rule, was not observed, a nonparametric criterion was used to assess the differences 2 and the nonparametric analogue of the correlation coefficient is the association coefficient. Approaches to the identification and measurement of the economic determinant of public health were described in detail earlier [24, 25]. The size of the real random sample was 1400 respondents. The average age of respondents of working age in the general sample was 39.7 years. As criteria of physical activity, subjective characteristics of physical activity given by the respondents themselves, the fact of performing physical exercises, and attitude to active recreation were used. Results. The use of complex (composite) features characterizing a person's financial situation and economic well-being makes it possible to identify differences in behavioral patterns regarding subjective perceptions of the level of physical activity among the working-age population. The influence of economic factors (determinants) is manifested in a decrease in the level of physical activity and a greater proportion of those who have low and very low levels of physical activity according to their own ideas, a more frequent negative attitude towards physical exercise among respondents with a low level of material security. However, the subjective attitude towards active recreation was positive for the majority of respondents, regardless of their level of material well-being.

Factors associated with encounter-specific police procedural justice perceptions among Dutch detainees

ABSTRACT Previous research on police procedural justice shows that observed assessments of police behaviour, for example through systematic social observation, are not strongly correlated with citizen perceptions of the same police behaviour. There is a growing body of knowledge about how people form their perceptions of police behaviour and how personal and situational characteristics are associated with specific judgements about procedural justice. However, we know little about how this works for people who most frequently interact with the police and criminal justice system, such as offenders or arrestees. The present study uses data from the Prison Project to examine to what extent individual and situational characteristics relate to perceptions of encounter-specific police procedural justice among Dutch detainees. Male adults in pre-trial detention (N = 1380) were surveyed on how they perceived procedural justice during their arrest, which occurred approximately three weeks prior. In addition to individual characteristics (demographics, attitudes, psychosocial characteristics and criminal history), we measured characteristics that reflect the situation during arrest, such as location, police verbal abuse and unnecessary use of force. This allowed us to examine the relationship between situational factors and detainee perceptions, net of individual characteristics. Regression analyses show that next to pre-existing general attitudes towards the police, several situational characteristics (i.e. perceptions of use of force and verbal abuse, anger and outcome fairness) were strongly associated with encounter-specific procedural justice perceptions. Our results indicate that, beyond (pre-existing) individual characteristics, situational factors of the arrest play an important role in forming specific procedural justice perceptions of the police.

Prevalence of immunoglobulin E sensitisation to mites and pollens in 25,451 French dogs from 2016 to 2022.

Canine atopic dermatitis (cAD) is a common skin disorder in dogs, wherein allergens are presumed to exert a significant influence. The prevalence of allergen sensitisation in dogs with suspected cAD remains inadequately investigated in France. This study aimed to analyse allergen-specific immunoglobulin (Ig)E test results from French dogs with suspected cAD, exploring potential risk factors influencing sensitisation. The study included 25,451 client-owned dogs presented with clinical signs of cAD between January 2016 and December 2022. The study population consisted of 226 pure breeds and 915 cross-bred dogs of both sexes, with a mean age of 4.4 (±2.8) years. Data collection involved the compilation of results from canine serological allergen-specific IgE ELISA tests, using a 23 allergen composite panel. The influence of breed, sex, age, geographical area and sampling season on IgE test outcomes subsequently was analysed. Of the 25,451 analysed samples, 75.6% exhibited significant serum IgE concentrations in response to at least one of the tested allergens, with 67.9% testing positive for mites and 39.8% for pollens. Breed, sex, age, geographical area and sampling season were identified as significant risk factors influencing sensitisation patterns. This study provides insights into the prevalence and risk factors associated with allergen sensitisation in dogs with suspected cAD. Understanding these factors is crucial for effective diagnosis and tailored management strategies in veterinary practice. The findings underscore the need for personalised approaches in addressing cAD, considering individual patient characteristics.

Sexuality and Gender Diversity Among Adolescents in Australia, 2019-2021.

Sexuality- and gender-diverse (SGD) young people experience substantial health disparities relative to cisgender heterosexual peers. Little is known about SGD adolescents younger than 15 years. To describe SGD prevalence and associated factors in a population-representative cohort of younger adolescents in Australia. This prospective cohort study was part of the Future Proofing Study, with enrollment of year 8 students at 134 Australian secondary schools from 2019 to 2021 and annual follow-ups for 5 years. Data were analyzed from June 20, 2023, to June 6, 2024. Outcomes of interest were baseline self-reported gender and sexuality identities, individual characteristics, and mental health and disability diagnoses, as well as school characteristics. Among 6388 participants, median (IQR) age was 13.9 (13.6-15.8), with a range of 10.7 to 17.5 years. Most participants attended school in a major city (76.0%), were born in Australia (91.4%), and spoke English at home (93.7%). Approximately half (3122 participants; 48.9% [95% CI, 45.2%-59.0%]) identified as female or girls, and 46.5% (2973 participants; 95% CI, 39.8%-53.4%) identified as male or boys. The overall proportion of transgender identity was 3.3% (95% CI, 2.7%-3.9%), with 23 participants (0.4%) identifying as transgender boys, 10 participants (0.2%) identifying as transgender girls, 117 participants (1.8%) identifying as transgender nonbinary, and 59 participants (0.9%) identifying as another transgender identity. The overall proportion of sexuality diversity was 12.0% (95% CI, 10.4%-13.8%). The proportion of cisgender participants who were sexuality-diverse (13.0% [95% CI, 11.4%-14.8%] of girls and 4.7% [95% CI, 3.7%-5.9%] of boys) was lower than the proportion among gender-diverse participants, which ranged from 30.0% (95% CI, 9.3%-64.1%) of transgender girls to 91.5% (95% CI, 81.3%-96.4%) of those with another diverse gender identity. Gender diversity and sexuality diversity were strongly associated (odds ratio [OR], 66.24; 95% CI, 38.23-114.80), and both were negatively associated with age (gender diversity: OR per 1-year older, 0.61; 95% CI, 0.49-0.76; sexuality diversity: OR per 1-year older, 0.78; 95% CI, 0.65-0.93) and positively with mental health diagnosis (gender diversity: OR, 2.41; 95% CI, 1.79-3.24; sexuality diversity: OR, 2.50; 95% CI, 2.10-2.98), and disability diagnosis (gender diversity: OR, 2.39; 95% CI, 1.68-3.40; sexuality diversity: OR, 1.96; 95% CI, 1.64-2.36). While there were significant associations between individual and school characteristics and responses to gender and sexuality identity items, patterns of association differed, with no consistent association with economic disadvantage. This cohort study of young adolescents found higher rates of SGD than among samples of older adolescents. The significant associations with younger age, poorer mental health, and disability underscored the urgent need for inclusive programs to promote a safe and welcoming environment in schools, health care settings, and communities.

Sickness absence patterns during the COVID-19 pandemic among Finnish public sector employees

Abstract Background The patterns of sickness absence (SA), that is, the clustering of differing lengths of episodes and total number of days absent, have not been examined. We examined these SA patterns and factors associated with the patterns during the COVID-19 pandemic. Methods We used survey data from employees of four large Finnish cities in 2020 linked with SA data in 2021 retrieved from employer registers (n = 39 791). SA patterns were defined through cluster analysis (K-means) including number of SA days, short (1-9 days), and long (10-365 days) SA episodes within one year. The associations of employee and work characteristics in 2020 with SA clusters in 2021 were analysed with multinomial regression. Results Four SA patterns (=clusters) were identified: 1) Optimal SA pattern (n = 31 320, 79%), 2) Recurring short SA episodes (n = 5149, 13%), 3) Recurring long SA episodes (n = 2964, 7%), and 4) Very high levels of SA with long episodes (n = 358, 1%). Compared to optimal SA pattern, female gender, higher body mass index, former smoking, abstinence from alcohol, not being in high occupational socioeconomic position, on-site work during COVID-19, and COVID-19 infection were associated with all suboptimal SA patterns. Recurring short SA episodes were more likely in younger employees (odds ratio=0.98, 95% confidence interval 0.97-0.98), those with a temporary job (1.10, 1.00-1.20), current smokers (1.34, 1.21-1.48), those using passive commute modes (1.03, 1.01-1.05 [car]; 1.02, 1.00-1.04 [public transport]), and those who had experienced a team reorganization due to COVID-19 (1.27, 1.10-1.46). The two most adverse SA patterns were more likely among older employees, and less likely among those cycling to work (0.91, 0.84-0.98; 0.97, 0.95-0.99). Conclusions We identified three differential suboptimal SA patterns. Compared to the optimal SA pattern, several individual-level risk factors, but also some COVID-19 related factors were found to associate with suboptimal SA patterns. Key messages • We identified three suboptimal sickness absence patterns during COVID-19 pandemic. • Individual characteristics, but also COVID-19 related factors were associated with the observed sickness absence patterns.

Representativeness of disadvantaged pupils in a trial to improve beverage consumption in Belgium

Abstract Background The cluster-randomized controlled trial DRINK was implemented in 2021 to evaluate the effect of interventions aimed at reducing sweetened beverages and increasing tap water consumption among children in French-speaking primary schools in Belgium. Multiple participation issues related to the implementation in the school setting were encountered. Our aim was to describe the individual characteristics of pupils at baseline and their participation in the data collection. Methods In 2021, out of a sample of 168 schools stratified by region and socioeconomic index (SEI), 46 were included. Children in grades 3 to 5 were asked to complete a 4-day diary to record all beverages consumed. Questionnaires were completed by children and parents, from which individual characteristics were summarised, such as the Family Affluence Scale (FAS; in three groups). Results School participation (overall: 29.0%) was higher in Wallonia (33.0%) than in Brussels (22.0%), and in schools with an intermediate SEI (33.0%). At baseline, a total of 3,631 children participated in the data collection, either through the 4-day diary, the child questionnaire, or the parent questionnaire; 2,013 completed all three instruments. Participating children were more likely to be girls, to have an intermediate FAS, to be born in Belgium, and to have two working parents. The proportion of children attending schools in the Brussels region was 27.9% of the total participating children and dropped to 11.5% for those who returned three valid questionnaires. The proportions of low FAS (14.4% to 11.8%), birth outside Belgium (11.8% to 8.7%), and low parents’ schooling (35.3% to 33.8%) were lower among children who completed the three instruments. Conclusions The low participation of Brussels schools, possibly exacerbated by the Covid-19 impact, may explain why disadvantaged children were less represented in the baseline sample. Such knowledge is valuable for interpreting the findings of such a trial. Key messages • Participation issues may have affected the representativeness of less advantaged children. • Documenting such disparities is key to understanding the context in which interventions were implemented.

Health coaching: the node of health literacy & health promotion

Abstract Introduction To achieve sustainable health behaviors and outcomes to move from a precarious health situation to good health, people need to be supported in health literacy in behavior change that ensure interventions’ success. As a non-clinical approach, health coaching aims to increase a person’s levels of self-efficacy, confidence and resilience, by promoting the sense of coherence. This communication aims to identify the benefits that health coaching as a salutogenic approach can trigger. Methods The work is structured in a narrative review of literature and the lived experience of the authors in health coaching. Results The published research on health coaching and the systematic professional experience of the authors highlight: (1) the anchoring of health coaching in the salutogenic model and in the person-centered approach focused on individual characteristics and needs in driving healthy behaviors; (2) health coaching as a collaborative relationship with chronically ill people and people at risk of developing illness; (3) the role of health coaching as a sense of coherence (SOC) promoter; (4) health coaching as a new profession in the healthcare ecosystem (e.g. NHS, UK), cooperating with multidisciplinary teams. Discussion From A.Antonovsky’s model approach to health, the SOC stands out and constitutes one of the basic theories in health coaching interventions, by strengthening the person’s capabilities of comprehensibility, manageability, and meaningfulness. As an emerging profession, with ethical and a growing research foundation, it is facilitated by trained professionals in managing and monitoring health behavior change. Conclusions Health coaching aims to bring relevance, meaning and strategy to a person’s behavioral change. Health coaching demonstrates positive effects on several health parameters by supporting the implementation of health literacy development and empowering people to trigger sustainable changes that lead to healthier lifestyles.

Risk factors for COVID-19 among healthcare workers: a hospital-based cohort study in Portugal

Abstract Background Healthcare workers (HCWs) have an increased risk of transmitting SARS-CoV-2 infection to frail patients and are also at higher risk of exposure. Hence, it is essential to understand the risk factors for infection of HCWs to limit adverse events occurring in healthcare facilities. This study aimed to identify risk factors for symptomatic COVID-19 infection among HCWs in the hospital context. Methods We used data from a hospital-based cohort study followed between December 2020 and January 2022 in three central Portuguese hospitals. Following the study protocol, RT-PCR testing was performed whenever an HCW reported any symptom compatible with COVID-19. Characteristics of infected (at least one positive RT-PCR with symptoms) versus non-infected HCW were compared using the Chi-square test. Results A total of 3034 HCWs were followed during 13 months and 533 had a positive test for SARS-CoV-2. A higher percentage (> 40 %) of infections were in individuals without a primary vaccination scheme. Other than age, no differences were found regarding individual characteristics: infected HCWs had a higher percentage of individuals aged 18 to 50 years old compared to the non-infected HCWs (74.7 % versus 66.2 %, p < 0.001). Regarding work functions, no differences were found for self-report of working in direct contact with COVID-19 patients. Additionally, the percentage of HCWs who declared to perform tracheal intubation procedures was similar in infected versus non-infected HCWs (6.2 % versus 8.9 %, p = 0.080). Conclusions Infected HCWs were younger than the non-infected. HCWs working in direct contact with patients or performing tracheal intubations didn’t exhibits increased rates of infection suggesting the success of preventive measures and other standard procedures in limiting infection transmission in healthcare facilities. Key messages • HCWs working in direct contact with COVID-19 patients or performing tracheal intubations were not the most infected personnel. • Preventive measures and other standard procedures were successful in limiting COVID-19 infection transmission in healthcare facilities.

Habitat and density effects on the demography of an expanding wolf population in Central Europe

Demographic parameters are key to understanding population dynamics. Here, we analyse the survival and reproduction of the German wolf population in the 20 years following recolonization. Specifically, we analysed the effects of environmental, ecological and individual characteristics on 1) survival probability of the population; 2) annual survival rates of age classes; 3) reproduction probability; and 4) reproductive output, measured as the number of detected pups/juveniles. Using Cox proportional hazards model, we estimated a median survival time of circa three years for wolves. Annual survival probabilities were found to be 0.75 for juveniles, 0.75 for subadults and 0.88 for adults. Survival was lower for juveniles in winter and for subadult males in summer, probably associated with dispersal events. Low habitat suitability was clearly associated with lower survival in juveniles and subadults, but not in adults. Local territory density was related to increased survival. Reproduction probability within a territory was 0.88, but explanatory variables had no effect. Reproductive output was four pups/juveniles on average, positively related to habitat suitability and female experience, but negatively related to territory density. Survival values were very high for the species when compared to other regions. We hypothesize that carrying capacity has not been reached in the study area, thus the survival may decrease in the future if the landscape becomes saturated. Furthermore, our results highlight a spatial pattern in survival and reproduction, with area of better habitat suitability favouring faster population growth. Thus, targeting conservation measures to low habitat suitability areas will have a strong population effect on the short term by boosting survival and reproduction of the individuals, while long‐term viability should be carefully planned with high suitability areas in mind, as those contain the territories with higher survival and reproduction potential.

Consumers’ attitudes towards healthy eating: a qualitative comparison between older and younger Chinese consumers

PurposeUnhealthy diets are associated with an increased risk of non-communicable diseases and present a significant public health challenge. When developing effective interventions and policies, consideration must be given to the unique social culture in which food choice is embedded. Health vulnerabilities to poor nutrition exist throughout life but may be influenced by socio-cultural factors such as age. This study aimed to assess the attitudes of older or younger Chinese consumers towards healthy eating and explore the factors influencing their food choices.Design/methodology/approachSemi-structured interviews were conducted in Wuhan, China, with 20 consumers aged 18–25 (Group A) and 20 consumers aged 65 and over (Group B).FindingsThematic analysis revealed that the two groups had positive attitudes towards healthy eating, although Group A participants were more knowledgeable. Time pressure, food prices and social networks differentially influence healthy eating practices across age groups.Originality/valueGiven China’s economic and cultural context, healthy eating interventions should consider the individual characteristics and food preferences of the different age groups. This approach can optimize targeted healthy eating interventions, and media communications related to healthy eating.

Health disparities among in multicultural and non-multicultural families in South Korea

Abstract South Korea has experienced significant immigrant growth, with international marriages playing a key role in this demographic change. In 2019, international marriages accounted for 10.3% of all marriages, increasing the number of multicultural households. Multicultural families in Korea faced controversies over accepting new members in a society traditionally considered racially and ethnically homogenous. In rural areas, where patriarchal and conservative values prevail, there is greater discrimination and negative perception towards foreigners compared to urban areas, impacting access to healthcare. This potentially adversely affects the health of married immigrants. However, research on this issue is limited. This study aims to examine the differences in health behaviors, access to care, and health status between multicultural and non-multicultural families in rural and urban areas. Using a cross-sectional study design based on the 2023 Community Health Survey, the sample included 228,216 adults from non-multicultural families and 3,373 adults from multicultural families. Adjusted differences in outcome were estimated using regression models, including linear probability and logistic models. Overall, there were minimal or no differences in health behaviors and health status between adults from multicultural and non-multicultural families. However, significant differences were observed in access to care, such as annual health check-ups (0.72 [0.64, 0.81]) and vaccinations (0.84 [0.76, 0.94]). Non-multicultural families showed regional differences in all outcomes, whereas multicultural families exhibited minimal or no regional differences. These findings suggest that multicultural families may face barriers beyond regional environments, limiting their access to care and potentially leading to long-term negative health outcomes. Targeted policy development for multicultural families in Korea is necessary to address this issue. Key messages • Access to health care may vary for individual and local factors, especially for people with different ethnicities or cultures. • Multicultural families may encounter greater barriers than individual and regional characteristics, requiring the development of tailored policies for immigrants and multicultural families.

Labour migration and mental health of left-behind children in Georgia: a mixed methods study

Abstract Background Global migration is on the rise, and as a result, millions of children are left in their home countries while their parents migrate abroad. Little is known about the mental health of left-behind children (LBC) in Eastern Europe. The study addresses this research gap in Georgia, a leading migrant-sending country in the region. Methods Applying convergent parallel design, this mixed methods research integrates a qualitative study with schoolteachers from six public schools in Samegrelo and Guria regions (6 focus group discussions and 6 in-depth interviews) (i); a school survey with 933 adolescents (ii) from 18 public schools, (12-18 age group, internalizing and externalizing problems assessed with Aschenbach’s “Youth Self-Report” questionnaire), and a qualitative study using life-narrative interviews with 39 adolescents (iii). We analysed qualitative data using reflexive thematic analyses and applied multiple linear regression to analyse quantitative data. Results The Quantitative and qualitative findings converge in some respects while diverging in others. Schoolteachers perceive migratory separation as a traumatizing life event, making children vulnerable to mental health issues. Similarly, schoolchildren perceive separation from parents as a stressful life event; however, they also acknowledge positive aspects of migrant labour, such as material benefits. From the perception of LBC, close family ties, friendships, school support, and optimism help with coping. This study also revealed a gender disparity, with boys exhibiting more rule-breaking behaviour and girls performing worse on most Youth Self- Reported syndrome scales. Regression analysis showed associations between adolescents’ problem behaviours and relationships with family members, friendships, and school environment. Conclusions This research found that parental migration effects on children are complex and depend on individual and transnational family characteristics. Key messages • Left-behind children may need emotional and academic support. • Strengthening family ties, supportive school environment and friendships contribute to adolescents’ coping with parental migration.

4.F. Scientific session: Progress in assessing climate change risks to health and implementation in UK and Europe

Abstract Climate change poses one of the greatest threats to health security. Climate change is increasing the frequency and intensity of environmental health threats like flooding and heatwaves and is creating conditions which heighten the risks from infectious diseases. Whilst everyone will be at some risk from adverse health impacts from climate change, the impacts will vary at individual level and the most disadvantaged both here in the UK and around the world will be disproportionately affected. Many of the anticipated adverse health impacts of climate change in the UK are still avoidable through mitigation and adaptation and that there are other benefits to health to be gained, therefore rapid action is critical to avoid the most severe potential scenarios. The Health Protection Research Unit in Environmental Change and Health, funded by the National Institute of Health Research, provides multi-disciplinary research to support decision-making relating to the impacts and responses to environmental changes that affect human health and well-being in the UK and beyond. In this workshop we present the results of recent research on the progress in assessing climate change risk factors on health in the UK and review the evidence on implementation of mitigation and adaptation measures in Europe. The workshop aims to support evidence translation for climate action that prioritises health protection and equity. The workshop will include presentations on reviewing risk assessment methods for quantifying health impacts across Europe as well as analysing the effects of fuel poverty on cold-related mortality. We present results from an analysis of primary care data to identify individual level characteristics associated with increased risk of mortality during heatwaves. Furthermore, we review national food-based dietary guidelines across Europe and South America to determine how environmental sustainability is being integrated to benefit health. The workshop will comprise 4 -5 oral presentations and we will then open the floor to have a wider facilitated discussion about what are the evidence needs for UK and European policy to further address climate risks to health. Key messages • The progress in assessment and understanding of risks from climate change on health is improving. • The health risks we face from climate change will not be distributed equally across the UK and Europe.

Short-term outcomes of da Vinci SP versus Xi for rectal cancer surgery: a propensity score matching analysis of two tertiary center cohorts.

This study compares the perioperative outcomes of robotic rectal cancer surgery between da Vinci single-port (SP) system, the most recent system allowing minimally invasive surgery with reduced ports, and the da Vinci Xi system. Patients who underwent robotic surgery for rectal adenocarcinoma from January 2016 to September 2023 at two tertiary referral centers were included. A retrospective analysis was conducted to compare key parameters between patient cohorts before and after propensity score matching. A total of 378 patients (SP, 65 vs. Xi, 313) were analyzed. The SP group comprised a higher proportion of females (44.6% vs. 28.4%; p = 0.016) and a higher tumor location (8.25cm vs. 6.71cm from the anal verge; p < 0.001) than did the Xi group. SP surgery promoted a shorter total incision length (4.9 cm vs. 9.2 cm; p < 0.001), lower maximum pain scores (5 vs. 7; p < 0.001), and shorter hospital stay (6 vs. 7days; p < 0.001) than did Xi surgery. Operation time (175 vs. 182min; p = 0.829) and postoperative complications (9.2% vs. 12.1%; p = 0.650) did not significantly differ between the groups. Lower lying rectal tumors were more frequently treated using the Xi system than the SP system, promoting a higher diverting stoma rate (13.8% vs. 45.4%; p < 0.001) and a lower anastomosis level (4.6cm vs. 3.3cm; p < 0.001). After 1:1 matching, SP maintained its advantages over Xi in terms of incision length (p < 0.001), maximum pain scores (p = 0.001), and hospital stay (p < 0.001). Overall postoperative complication rates were similar between both groups (10.8% vs. 12.3%; p = 0.777). The da Vinci SP system continues to offer minimal invasive benefits in rectal cancer surgery. However, the Xi system's instrument diversity provides a certain advantage, particularly in cases involving low-lying rectal tumors. Tailoring robotic approaches based on individual patient characteristics remains pivotal for optimizing outcomes of rectal cancer surgery.

Individual level risk factors associated with episodes of heat as recorded within primary care records: a time-stratified case-cross over study

Abstract Background A key recommended action outlined in Heat-Health Action Plans is to identify individuals at risk and deploy targeted interventions, however this is not routinely undertaken. A major contributing factor is a lack of understanding of individual-level risk factors to support an evidence-based approach to targeted prevention. Aim To use electronic health data to identify individual level characteristics associated with increased risk of mortality during heatwaves in England. Methods A time-stratified case-crossover analysis was undertaken of individual-level clinical and socio-environmental (SE) risk factors. Conditional logistic regression was used to characterise associations between temperature and the risk of death on hot days, with analysis stratified by potential risk modifying factors. Results Heat mortality risk was modified by a large range of chronic conditions, with cardio-respiratory, mental health and cognitive function conditions, diabetes and Parkinson’s, all increasing risk. Prescribed medications also increased odds of death during heatwaves. Heat mortality risk was modified by a range of SE determinants of health investigated, with ORs increasing with age; OR differences by sex, ethnicity and living arrangement; an increasing trend in ORs by alcohol intake and body mass index, excluding the obese-3 group. Results suggest the least deprived have the lowest OR and the most deprived have the highest. Conclusions This study has important implications for patient medication management during heat events, incorporating heat-risk considerations into other health policies. The results also provide important evidence on the role of disadvantage in driving the inequitable distribution of climate impacts, and the need for better socio-economic data sets linked to health records. The findings highlight the importance of incorporating an assessment of individual SE circumstances when prioritising patients at highest risk during heat events.