Low-risk Behavior Research Articles

Validation in Spanish and English of the Transgender Inclusive Behavior Scale.

The Transgender Inclusive Behavior Scale (TIBS) seeks to measure transgender-inclusive behavior, specifically actions and language use that support transgender people. The TIBS was developed in the United States. This study aimed to develop a Spanish version of the TIBS and confirm the structure of the English version to explore the psychometric properties and evaluate the construct validity in new contexts. We examined predictors of transgender-inclusive behavior by conducting a comparative analysis between participants from Spain and the United Kingdom. The study involved 1,110 university students, with 545 participants hailing from Spain (375 women, 162 men, and 8 non-binary individuals) and 565 participants from the United Kingdom (368 women, 178 men, and 19 non-binary individuals). Exploratory and confirmatory factor analysis were conducted to investigate and validate the factorial structure of the TIBS. The factor analysis results for the 15 items on the scale confirmed a three-dimensional structure in both languages. The scale score reliability was excellent with a Cronbach's alpha (α) = .95 in the British sample and with an α = .89 in the Spanish sample. Being a woman, being lesbian, gay, bisexual, trans, queer, intersex, and/or asexual, and being non-religious were the strongest predictors of inclusive behaviors towards transgender people in both countries. The correlations found indicated that people with lower sexual risk behaviors, and lower sexist, homophobic, and transphobic attitudes also presented higher inclusive behaviors towards trans people. These findings support the development of community strategies to increase the social inclusion of transgender people. The TIBS is a useful measure to track their success.

Social and emotional competencies in Portuguese incarcerated males: psychometric properties of the SEC-Q questionnaire and their relation to health risk behaviors

This study departs from the acknowledged absence of validated measures to assess social and emotional competencies in incarcerated individuals. This is a critical gap given that most available programs aimed at fostering prosocial behavior and reducing antisocial behaviors are theoretically based on enhancing these competencies. This study assessed the psychometric properties of the Social and Emotional Competencies Questionnaire (SEC-Q) in a sample of 219 Portuguese incarcerated males (M age = 37.21 years, SD = 10.61), and to explore the impact of the SEC-Q dimensions on health risk behaviors in this population. The study used confirmatory factor analysis (CFA) to examine the factor structure of the SEC-Q. The four-factor model fitted well to the data (SB χ2 = 267.75; df = 120; Robust CFI = 0.99; Robust RMSEA = 0.06), and, as expected, it includes four dimensions: self-awareness, self-management and motivation, social awareness and prosocial behavior, and decision-making. The four dimensions showed appropriate internal consistency (Cronbach’s alpha = 74–81; McDonald’s omega = 75–82). Additionally, social and emotional competencies were related to higher self-control (rs=0.45, p <.01) and lower health risk behaviors (rs = − 0.25, p <.01), supporting convergent and divergent validity. Findings from the negative binomial regression suggest that higher social awareness and prosocial behavior is related to less health risk behaviors among incarcerated males. This study is a pivotal step to promote an affordable and valid measure to assess social and emotional competencies among Portuguese justice-involved males. SEC-Q can be an important complementary measure for evaluating the effectiveness of interventions aimed at preventing criminal recidivism.

Religious development from adolescence to early adulthood among Muslim and Christian youth in Germany: A person-oriented approach.

Religious decline, often observed among North American Christian youth, may not apply universally. We examined this and whether religiosity is associated with well-being, risk behavior, cultural values, and acculturation among 4080 Muslim and Christian adolescents aged 15-22 in Germany. Utilizing seven waves from the CILS4EU project and a person-oriented analytical approach, we identified different religious trajectories for Muslim (58% high, 31% low, 11% increasing), immigrant-origin Christian (68% low, 32% medium), and non-immigrant Christian (74% low, 17% decreasing, 9% medium) youth. High and medium trajectories were associated with greater well-being, lower risk behavior, more conservative attitudes, and less sociocultural integration. To fully understand religious development, we must consider diverse national contexts and groups, employing long-term perspectives and person-centered analyses.

PARENT COMMUNICATION PATTERNS AND RISK SEXUAL BEHAVIOR IN LATE ADOLESCENT

Background: Risky sexual behaviour in adolescents can have a detrimental impact on adolescent development and health, such as exposure to sexually transmitted diseases including HIV/AIDS, unwanted pregnancy, and abortion. Many factors can cause risky sexual behaviour, family factors, especially parental communication patterns are one of the most important influences, because parents are the environment that has the strongest preventive efforts in keeping adolescents involved in promiscuous activities. This study aims to find the relationship between parental communication patterns and risky sexual behaviour in late adolescents. Method: Observational analytic with cross-sectional research design. The sample size was 300 respondents with consecutive sampling technique. The independent variable is communication pattern. The dependent variable was risky sexual behaviour in late adolescents. The research data used instruments in the form of questionnaires and analysed using the Spearman's rank test with a significance level of p &lt; 0.05. Result: Parental communication patterns in late adolescents were dominated by authoritative communication patterns at 56% and 63% of respondents have low-risk sexual behaviour. Spearman's rank test results p value &lt; α, p = 0.000 and r = -0.239. Conclusion : Parental communication patterns have a relationship with risky sexual behaviour in late adolescents.

Behavior and Knowledge of Outgoing Thai Travelers Related to Medicinal Use

Consultation with a healthcare professional before to travel is the basis of travel medicine. Those who received pre-travel advice from health experts exhibited lower risk behavior. This study aimed to identify outgoing Thai travelers’ behavior and knowledge regarding medicinal use when traveling. A cross-sectional survey of Thai nationals traveling abroad was conducted via a self-administered online questionnaire. The analyzed data was collected from February 2020 to June 2020. A descriptive statistic was used for the data analysis. Seven hundred people agreed to take part in this study. Most of them were female and aged 51-60 years old. The most popular destinations among the respondents were located in Asia, followed by Europe. The top five destination countries were Japan, China, Vietnam, Laos and Germany. A preferred source of information on pre-travel health consultation was the internet (43.51%). Most of the respondents did not have travel vaccinations (82.29%). Over-the-counter drugs were the most common medication carried by the respondents. Many of the outgoing Thai travelers had a good (41.29%) to excellent (46.86%) level of behavior related to medicinal use both before and during their journeys. Many participants reported that they checked the expiration date and the appearance of the medicine. Age exhibited a significant relationship with respondents’ behavior. Numerous respondents had an excellent level of knowledge related to medicinal use in terms of their medicines’ stability and storage, its use and administration, and medical laws. Gender, marital status, income, and immunization before travel had a significant relationship with the respondents' knowledge. Most of respondents obtained health-related information prior to their travels via the internet. Most participants had great level of health behavior and medicinal use knowledge.

A scoping review of the research evidence of the developmental assets model in Europe.

Positive Youth Development (PYD) is a strength-based perspective that focuses on the resources to promote a successful transition to adulthood, derived from the Relational Developmental Systems theory. In this line, the Developmental Assets (DA) model focuses on describing the personal resources (Internal Assets) and contextual resources (External Assets) that help to reach PYD. Most research from this approach has been carried out in United States and, to a lesser extent, in the European continent. The aim of this scoping review was to examine the evidence collected for the DA model in Europe. Web of Science database was used to search for articles published between 2013 and February 2024. Initially, there were 55 possible articles to be included, but after applying the exclusion criteria, this number was reduced to 11. The findings suggested that the evidence for DA in Europe was in line with North American research, so that a higher presence of DA was related to higher well-being, better psychological adjustment, and lower risk behaviors. Internal Assets were the most influential assets, with the Positive Identity category being especially remarkable. Commitment to Learning and Social Competencies were also highlighted in the studies included in the review. Concerning External Assets, Positive Boundaries-expectations and Empowerment were emphasized as protective factors in youth development. These assets were found to present a protective effect against risk behaviors and were positively associated with PYD and socioemotional skills. Thus, these findings support the applicability of the DA framework in promoting PYD in European context, and some intervention strategies are discussed considering cultural diversity.

A latent class analysis of multiple health-risk behaviours among Portuguese college students

Traditionally, the prevalence of health-risk behaviours is high among university students. Although these behaviours are often analysed in isolation, there is likely evidence for the co-occurrence of multiple risk behaviours. In this study, a latent class analysis (LCA) was conducted with cross-sectional data from 840 Portuguese students (55.4% female) to explore patterns of multiple risk behaviours across seven behavioural dimensions (alcohol consumption, smoking, unhealthy eating, sedentary behaviour, risky sexual practices, illicit drug use, and self-medication). Additionally, a latent class regression was performed to explore predictors (perceived well-being and sociodemographic and academic characteristics) for each behavioural pattern. A three-class model emerged with different probabilities of risk: Low-risk behaviours (51.4%), Moderate-risk behaviors (14.9%), and High-risk behaviours (33.7%). Students with better perceptions of well-being and health were likelier to be in the healthier class. Students in the low- and moderate-risk classes were more likely to be in their first year of study, not in a romantic relationship and to be full-time students. Students who had not changed residence at the beginning of their studies and were female were more likely to be in the healthiest class. This study provides essential strategies for health promotion among university students, offering crucial insights for the design of effective health promotion interventions, especially targeted at specific groups of students with similar patterns of multiple risk behaviours.

Lifestyle trajectories in middle-aged adults and their relationship with health indicators.

Understanding the impact of different lifestyle trajectories on health preservation and disease risk is crucial for effective interventions. This study analyzed lifestyle engagement over five years in 3,013 healthy adults aged 40-70 from the Barcelona Brain Health Initiative using K-means clustering. Nine modifiable risk factors were considered, including cognitive, physical, and social activity, vital plan, diet, obesity, smoking, alcohol consumption, and sleep. Self-reported diagnoses of new diseases at different time-points after baseline allowed to explore the association between these five profiles and health outcomes. The data-driven analysis classified subjects into five lifestyle profiles, revealing associations with health behaviors and risk factors. Those exhibiting high scores in health-promoting behaviors and low-risk behaviors, demonstrate a reduced likelihood of developing diseases (p < 0.001). In contrast, profiles with risky habits showed distinct risks for psychiatric, neurological, and cardiovascular diseases. Participant's lifestyle trajectories remained relatively stable over time. Our findings have identified risk for distinct diseases associated to specific lifestyle patterns. These results could help in the personalization of interventions based on data-driven observation of behavioral patterns and policies that promote a healthy lifestyle and can lead to better health outcomes for people in an aging society.

Exploring the determinants of risk behavior for transfusion transmissible infections among first-time blood donors in Mandalay General Hospital, Myanmar.

Blood donation is vital to healthcare, but it must be kept safe by mitigating the risk of transfusion transmissible infections (TTIs). The objective of this study was to investigate the factors that influence risk behavior for transfusion transmissible infections among first-time blood donors at Mandalay General Hospital, Myanmar. This study utilized a cross-sectional study design using secondary data. Mandalay city and Mandalay Blood Bank in Mandalay General Hospital were purposely selected and a total of 406 first-time blood donors participated. A structured questionnaire administered by an interviewer was used. The questionnaire contained background characteristics, knowledge on TTIs, attitude toward TTIs, and TTIs risk behaviors. To examine the determinants (background characteristics, knowledge, and attitude) that affect risk behavior, inferential statistics techniques that included the chi-squared test, bivariable logistic regression, and multivariable logistic regression were applied. A p-value of less than 0.05 signified statistical significance. Among 406 first-time blood donors, 52.9% were under 20 years old, and 53.7% were male. Most had undergraduate education (77.6%), were married (84.2%), and were students (55.7%). Additionally, 76.8% hadn't received the hepatitis B vaccine. Blood groups were distributed as follows: B (40.0%), O (33.8%), A (23.4%), AB (8.9%). About 15.8% showed high knowledge level, and 63.6% had high attitude. Notably, 29.3% exhibited high-risk behavior for TTIs. Age was associated with lower risk behavior (OR = 1.54, 95% CI: 0.99, 2.38, p = 0.049), but lost significance in multivariable regression (p = 0.214). Knowledge on TTIs didn't show significance. However, high attitudes were significantly associated with lower risk behavior (OR = 11.4, 95% CI: 1.25, 103.83, p = 0.017, retained in multivariable regression, p = 0.012). Findings of this study contribute in the development of programs that ensure a safe and reliable blood supply chain. To improve blood safety standards among first-time blood donors, this study highlights the value of targeted education and screening processes, placing particular emphasis on acquiring knowledge and positive attitude toward blood donation and risk behavior.

Reducing delivery insurance costs through risk score model for food delivery company

In this paper, we propose a novel pricing model for delivery insurance in a food delivery company in Latin America, with the aim of reducing the high costs associated with the premium paid to the insurer. To achieve this goal, a thorough analysis was conducted to estimate the probability of losses based on delivery routes, transportation modes, and delivery drivers’ profiles. A large amount of data was collected and used as a database, and various statistical models and machine learning techniques were employed to construct a comprehensive risk profile and perform risk classification. Based on the risk classification and the estimated probability associated with it, a new pricing model for delivery insurance was developed using advanced mathematical algorithms and machine learning techniques. This new pricing model took into account the pattern of loss occurrence and high and low-risk behaviors, resulting in a significant reduction of insurance costs for both the contracting company and the insurer. The proposed pricing model also allowed for greater flexibility in insurance contracting, making it more accessible and appealing to delivery drivers. The use of estimated loss probabilities and a risk score for the pricing of delivery insurance proved to be a highly effective and efficient alternative for reducing the high costs associated with insurance, while also improving the profitability and competitiveness of the food delivery company in Latin America.

Factors associated with the use of annual health checkups in Thailand: evidence from a national cross-sectional health and welfare survey.

Thailand has provided free annual health checkups (AHC) since universal health coverage began in 2002. However, evidence regarding the equitable use of AHC is scarce. Thus, this study explored factors associated with the use of AHC in Thailand. A cross-sectional study was conducted using data from the national 2015 Health and Welfare Survey. Respondents aged 15 years or above (n = 57,343) were selected as the study sample. Descriptive statistical analysis and multivariable binary logistic regression were conducted to examine the association between the use of AHC and factors selected on the basis on Andersen's Behavioral Model of Access to Medical Care. Among the study sample, approximately 4.9% (n = 2,815) had used AHC during the past year. Regarding predisposing factors, the use of AHC was positively related to age (e.g., over 61 vs. 15-30: AOR = 2.90 [95% CI = 2.40-3.52], p < 0.001) and female sex (AOR = 1.23 [95% CI = 1.12-1.35] p < 0.001). For enabling factors, the AHC use was positively associated with income (e.g., Q4 vs. Q1: AOR = 1.98 [95% CI = 1.75-2.25], p < 0.001), education (e.g., high vs. low: AOR = 3.11 [95% CI = 2.75-3.51], p < 0.001), being married (e.g., vs. single: AOR = 1.27 [95% CI = 1.11-1.46], p < 0.001), and urban residency (AOR = 1.12 [95% CI = 1.04-1.22], p = 0.006). For need-for-care factors, the AHC use was positively related to chronic disease (AOR = 1.26 [95% CI = 1.15-1.38], p < 0.001), non-smoking (e.g., vs. daily: AOR = 1.18 [95% CI = 1.03-1.36], p = 0.015), non-drinking (e.g., vs. 3-4 times per week: AOR = 1.26 [95% CI = 1.04-1.53], p = 0.016), and vegetable consumption (e.g., over 5 ladles vs. below 1 ladle: AOR = 1.86 [95% CI = 1.50-2.31], p < 0.001). The results indicate that health awareness could play a significant role in the use of AHC. Individuals with high socioeconomic status (e.g., high-income people) and those with low-risk health behaviors (e.g., non-smokers) generally have a high interest in health and well-being. This may have been the primary reason for the high use of AHC among these groups. Thus, the government should continue to promote the public's health awareness through various public campaigns and education programs to increase the use of AHC.

The relationship between cumulative ecological risk and health risk behaviors among Chinese adolescents

ObjectivesTo explore the relationship between cumulative ecological risk and individual risky behavior and multiple forms of aggregated behaviors among adolescents, and examine the gender differences.MethodsA large-scale, nationally representative, and students-based investigation was conducted in rural and urban areas of eight provinces in China from October to December 2021. A total of 22 868 adolescents with an average age of 14.64 years completely standardized questionnaire in which the sociodemographic characteristics, socio-ecological risk factors and risky behaviors were used to analyze.ResultsOf included students, 48.4% encountered the high level of social-ecological risk. The prevalence of breakfast intake not daily, alcohol use (AU), smoking, physical inactivity, prolonged screen time (ST) on weekdays and weekends, suicidal ideation, suicidal plan, suicidal attempt, and non-suicidal self-injury (NSSI) was 41.0%, 11.9%, 3.4%, 61.9%, 15.1%, 51.1%, 27.7%, 13.9%, 6.5% and 27.0% respectively. 22.2% of participants engaged in high-risk behaviors. All were significantly influences of increased cumulative ecological risk on individual behavior and low-risk clustering behaviors separately. The odds ratio of breakfast intake not daily, AU, smoking, physical inactivity, prolonged ST in weekday and weekend, suicidal ideation, suicidal plan, suicidal attempt, and NSSI for the adjusted model in low versus high level of cumulative ecological risk was respectively significant in both boy and girls, and the ratio of odds ratios (ROR) was separately 0.95 (p = 0.228), 0.67 (p < 0.001), 0.44 (p < 0.001), 0.60 (p < 0.001), 0.78 (p = 0.001), 0.83 (p = 0.001), 0.80 (p = 0.001), 0.83 (p = 0.022), 0.71 (p = 0.005), 0.75 (p = 0.001). Girls encountering a high level of cumulative ecological risk were more likely to engage in multiple forms of clustering risky behaviors than boys (RORs: 0.77, p = 0.001).ConclusionsResearch and effective inventions at the social-ecological environment, based on the view of cumulative risk, are needed to promote the healthy development of behaviors in adolescence, and pay more attention to decreasing the occurrence of risky behaviours in girls than boys.

Health behavior profiles and association with mental health status among US active-duty service members.

This study investigated the clustering of health behaviors among US active duty servicemembers (ADSM) into risk profiles and explored the association between these profiles with ADSM sociodemographic characteristics and mental health status. This study utilized secondary data from the 2018 Health Related Behaviors Survey (HRBS), a Department of Defense (DoD) self-administered online survey. Health behaviors included physical activity, screen use, sleep habits, tobacco/substance use, alcohol drinking, preventive health care seeking and condom use at last sex/having multiple sexual partners. Past-year mental health status was measured using the Kessler Screening Scale for Psychological Distress (K6). Latent class analysis (LCA) on health behaviors was used to cluster ADSMs into risk profiles. Multivariable logistic model was used to examine whether ADSM characteristics and mental health status were associated with ADSMs' risk profiles. The LCA identified a four-class model that clustered ADSMs into the following sub-groups: (1) Risk Inclined (14.4%), (2) High Screen Users (51.1%), (3) Poor Sleepers (23.9%) and (4) Risk Averse (10.6). Over a tenth (16.4%) of ADSMs were categorized as having serious psychological distress. Being male, younger, less educated, in the Army, Marine Corps or Navy were associated with higher odds of being Risk Inclined (AOR ranging from 1.26 to 2.42). Compared to the reference group of Risk Adverse ADSMs, those categorized as Risk Inclined (AOR: 8.30; 95% CI: 5.16-13.36), High Screen Users (AOR: 2.44; 95% CI: 1.56-3.82) and Poor Sleepers (AOR: 5.26; 95% CI: 3.38-8.19) had significantly higher odds of having serious psychological distress. Study findings suggest opportunities to tailor behavioral and health promotion interventions for each of the distinct risk profiles. For example, ADSM described as Risk Inclined may benefit from preventive mental health services. Solutions for ADSM described as Poor Sleepers may include education on sleep hygiene; instituting duty schedules; and shifting military cultural norms to promote sleep hygiene as a pathway to optimal performance and thus military readiness. ADSM with low-risk behavior profiles such as those described as Risk Averse may prove beneficial in the roll-out of interventions as they act as peer-educators or mentors.

Facilitators and Barriers to PrEP Acceptability and Initiation Among Opioid Treatment Program Patients and Staff.

The Centers for Disease Control and Prevention recommends PrEP (pre-exposure prophylaxis) for people who use drugs, yet uptake remains low. This study explores the acceptability and potential uptake of PrEP among participants in an opioid treatment program (OTP). We conducted 26 in-depth, semistructured interviews with staff and patients at an OTP in Baltimore, Maryland. Overall, participants felt that providing PrEP within the program would be beneficial, but they noted competing priorities among populations engaging in high-risk behaviors and lack of willingness among groups with lower risk behaviors. Participants reported several barriers to PrEP use among people who use drugs and who use medications for opioid use, including cost, competing priorities, stigma, and misconceptions about who should use PrEP. Facilitators to PrEP use were described as health benefits, trusted relationships with providers, and existing resources in the opioid treatment program. Practitioners should consider addressing barriers to access and stigma within an OTP setting for HIV prevention tools.

Maternal healthy lifestyle score and offspring birth outcomes: secondary analyses of the PEARS RCT

Abstract Background The influence of maternal lifestyle behaviours during pregnancy on offspring outcomes has been investigated individually. A composite Healthy Lifestyle Score (HLS) comprising low-risk protective lifestyle behaviours can be useful for studying links between overall lifestyle and health outcomes. We aimed to study links between HLS and its components in early and late pregnancy with birth outcomes among women with overweight and obesity (OWOB), as their offspring may be at increased risk for adverse birth outcomes. Methods Secondary analyses were conducted with data from the PEARS (Pregnancy Exercise And nutrition Research Study) trial, a RCT of a diet and exercise lifestyle intervention to prevent gestational diabetes. HLSs (scored 0-5) based on information about maternal diet (AHEI-P), exercise (MET-minutes), alcohol consumption, smoking, and sleep habits were created for 334 and 289 mothers in early (14-16 weeks gestation) and late pregnancy (28 weeks gestation), respectively. Higher HLSs indicate a healthier overall lifestyle. Regression analyses examined associations of HLSs and individual lifestyle factors with adverse birth outcomes; low birthweight (BW), macrosomia and being born small or large for gestational age (SGA or LGA). Results Mean HLS was 3.38 in early, and 3.19 in late pregnancy. Only 12% and 10% of mothers had the maximum HLS in early and late pregnancy. Preliminary results indicated no strong links between composite HLSs and birth outcomes. Examination of the individual factors revealed that not smoking in early and late pregnancy was linked to a decreased risk for SGA (OR: 0.23, 95% CI: 0.07-0.74, p &amp;lt; 0.01; OR: 0.12, 95% CI: 0.04-0.35, p &amp;lt; 0.01) and low BW (OR: 0.11, 95% CI: 0.02-0.62, p = 0.01; OR: 0.10, 95% CI: 0.02-0.57, p = 0.01) (unadjusted results). Conclusions Adherence to a healthy lifestyle among pregnant women with OWOB can be improved. Our results highlight the importance of smoking cessation in pregnancy to avoid adverse birth outcomes. Key messages • Many pregnant women with OWOB do not adhere to a healthy lifestyle. • Smoking cessation in pregnancy is important to reduce the risk of adverse birth outcomes.

Maternal healthy lifestyle score and psychological well-being: secondary analyses of the PEARS RCT

Abstract Background The associations between lifestyle behaviours and well-being are still poorly understood, particularly in the antenatal period when women are potentially exposed to increased stress and anxiety. Moreover, lifestyle behaviours have often been investigated individually, while a Healthy Lifestyle Score (HLS) comprising low-risk protective lifestyle behaviours can be useful for studying links between overall lifestyle and health and psychosocial outcomes. Therefore, our aim was to study associations between maternal HLS in early and late pregnancy and psychological well-being. We focused on women with overweight and obesity (OWOB), as they may be at higher risk of psychosocial vulnerability. Methods Secondary analyses were conducted with data from the PEARS (Pregnancy Exercise And nutrition Research Study) trial, a randomized controlled trial of a diet and exercise lifestyle intervention with smartphone application support to prevent gestational diabetes. HLSs (scored 0-5) based on information about maternal diet (AHEI-P), exercise (MET-minutes), alcohol consumption, smoking, and sleep habits were created for 334 and 289 mothers in early (14-16 weeks gestation) and late pregnancy (28 weeks gestation), respectively. Higher HLSs indicate a healthier overall lifestyle. Correlations and regression analyses examined HLS associations with well-being (WHO-5, scored 0-100) in early and late pregnancy. Results Mean pregravid BMI was 29.2. Mean well-being score was 56.3 in early and 60.7 in late pregnancy. In early pregnancy, 18% of mothers scored 0-2 on HLS, 35% scored 3, and 47% scored 4-5. In late pregnancy, this was 27%, 34% and 39% respectively. Preliminary results show significant positive associations between HLSs and well-being at both time points (r's ranging between 0.16 and 0.29, all p &amp;lt; 0.05). Conclusions Higher adherence to healthy lifestyle behaviours in mothers with OWOB was linked with higher well-being throughout pregnancy. Key messages • Many pregnant women with OWOB do not adhere to a healthy lifestyle. • Well-being and a healthy lifestyle are related throughout pregnancy.

Whose fault? Defendant perceptions of their own blameworthiness and guilty plea decisions

ABSTRACT With the present paper, we seek to understand how defendants form of perceptions blameworthiness and to assess how these perceptions affect willingness to accept a plea offer. With an online vignette survey (N = 659), we randomized 1) guilt and 2) riskiness of victim behavior in a vehicular manslaughter case. We also asked respondents to rate the blameworthiness of themselves and their victims. First, results indicate that guilty respondents were more likely to accept a plea than those who were innocent. Second, those in the low-risk victim behavior condition viewed themselves as more blameworthy. Third, people who view themselves as more blameworthy, or their victims as less blameworthy, are more likely to take a plea offer. Lastly, the effects of guilt, victim behavior, and perceptions of victim blameworthiness are also at least partially mediated by perceptions of self-blame. Overall, victim behavior was a key predictor of self-blameworthiness, which was then a critical predictor of WTAP. Results also suggest that respondents viewed blame as a zero-sum game and made decisions about whether to accept a plea based on whether they think they were at fault in the situation.

Heterogeneity in Adolescents' Non-Suicidal Self-Injury Behaviour Trajectories Based on the Group-Based Trajectory Model and a Decision Tree Analysis of Family-Related Determinants.

Non-suicidal self-injury (NSSI) is a global public health problem. While some studies have noted the importance of behavioural development patterns in NSSI, most NSSI research is based on cross-sectional survey data. Few studies explore the time-series heterogeneity of trajectories of NSSI symptoms and family-related influencing factors of NSSI. The purpose of the study was to identify the heterogeneity in trajectories of adolescents' NSSI behaviour and their family-related influencing factors. The group-based trajectory model (GBTM) was used to identify the heterogeneity in the NSSI behaviour trajectories of 208 adolescents in China. Next, the decision tree model (DTM) was used to analyse which family related factors influence the trajectory type. The GBTM revealed two heterogeneous trajectories of NSSI behaviour: the high-risk and low-risk NSSI behaviour groups. Next, DTM's average accuracy was 83.2%. A total of seven independent variables were used for the DTM: gender, number of NSSIs in the past month, and family economic, family structure, family conflict, parental psychological control, parental behavior control and family intimacy risks. Family conflict risk was located at the root node and was the most important factor. Heterogeneity within the population should be considered in the management of adolescents' NSSI behaviours. Further, from the perspective of family system theory and cumulative risk, focusing on the adverse effect of multiple risk factors on adolescents' NSSI addiction is more meaningful rather than the impact of single risk factors. Studies that use time series data should focus on the trend of dynamic changes in NSSI addiction characteristics over time.

Men who have sex with men and risk for transfusion-transmissible infections in blood donors in Western countries: A systematic review update.

This systematic review update summarizes evidence concerning transfusion-transmissible infections (TTIs) in male blood donors reporting sex with another man (MSM) or after easing the MSM deferral period. We searched five databases, including studies comparing MSM versus non-MSM donors (Type I), MSM deferral periods (Type II) or infected versus non-infected donors (Type III) in Western countries, and used GRADE to determine evidence certainty. Twenty-five observational studies were included. Four Type I studies suggest that there may be an increased risk for overall TTIs, human immunodeficiency virus (HIV), hepatitis B virus (HBV) and syphilis in MSM donors, but the evidence is very uncertain. There was insufficient evidence of MSM with low-risk sexual behaviour. A Type II study indicates that easing the MSM deferral period to 1 year may have little to no effect on TTI risk. TTI prevalence in blood donors under 5-year, 1-year, 3-month or risk-based deferral in eight other Type II studies was too low to provide clear conclusions on the effect of easing the deferral. Three Type III studies reported that MSM may be a risk factor for HIV. Increased risk of HBV, hepatitis C virus and HTLV-I/II could not be shown. The evidence from Type III studies is very uncertain. There may be an increased risk of HIV in MSM blood donors. Shortening the deferral from permanent to 1 year may have little to no effect on TTI risk. However, there is limited, unclear evidence from observational studies concerning the impact of introducing 3-month or risk-based deferrals.

A Lifestyle Risk Reduction Model for Preventing High-Risk Substance Use Across the Lifespan.

While effective models of alcohol and drug prevention exist, they often focus solely on youth or young adults. This article describes the Lifestyle Risk Reduction Model (LRRM), an approach applicable across the lifespan. The intent behind the LRRM is to guide the development of prevention and treatment programs provided to individuals and small groups. The LRRM authors' goals are to help individuals reduce risk for impairment, addiction, and substance use's negative consequences. The LRRM identifies six key principles that conceptualize the development of substance-related problems by drawing parallels with health conditions, such as heart disease and diabetes, which often result from combined effects of biological risk and behavioral choices. The model also proposes five conditions that describe important steps for individuals as they progress toward greater perception of risk and lower risk behavior. One LRRM-based indicated prevention program (Prime For Life) shows positive results in cognitive outcomes and in impaired driving recidivism for people across the lifespan. The model emphasizes common elements across the lifespan, responds to contexts and challenges that change across the life course, complements other models, and is usable for universal, selective, and indicated prevention programs.