Low Risk Perception Research Articles

Online Child Sexual Exploitation and Abuse of Children and Adolescents with Disabilities: A Systematic Review

Online child sexual exploitation and abuse (OCSEA) is a rising global problem affecting children and adolescents worldwide. Despite the escalating prevalence of OCSEA, there is limited research specifically focusing on children and adolescents with disabilities. To bridge this gap, this systematic review was conducted to identify the prevalence, nature and associated risk factors of OCSEA of children and adolescents with disabilities. Following the PRISMA Statement, this systematic review included scientific evidence from 12 academic databases and the gray literature published between 1993 and 2023. A total of 13 studies were extracted, and thematic analysis was conducted to analyze the data. The findings of this systematic review reveal the characteristics such as the gender, age and type of disabilities of OCSEA victims. Perpetrators use diverse techniques, including online grooming, manipulation, and cyber-threats, resulting in consequences such as mental health issues and social isolation of victims. The associated risk factors include lack of parental monitoring, social isolation, and low risk perception. The results of this research provide crucial insights into OCSEA of children and adolescents with disabilities, emphasizing the need for targeted interventions and further exploration in this understudied area.

Identifying Barriers to Utilization of Basic Emergency Obstetric and NewBorn Care Services in Jigawa State, North-western Nigeria: A Qualitative Study

Background: Maternal mortality has remained high in northern Nigeria despite decades of effort aimed at reducing it. The number of women who deliver in Emergency Obstetric Care (EmONC) facilities is low. This study explored the barriers to utilizing Basic EmONC services in Jigawa State.
 Methods: A qualitative study was conducted among mothers of children under five years through 12 Focus Group Discussions. A purposive sampling technique was used to select participants who were categorized based on age (below 35 years, 35 years and above) and prior utilization of EmONC services. Content analysis along thematic lines was done and the findings were reported in narrative form.
 Results: The mean age of participants was 31 ± 6 years. The majority of participants had primary education and most were unemployed. Most of the participants identified obstetric danger signs, however, they opine that medical attention should be sought only when complications become serious. Participants in all groups unanimously said decision-making for seeking medical care rests with the husband and occasionally the mother-in-law. Barriers to seeking care identified by participants include lack of money, distance to the nearest health facility, fear of embarrassment by healthcare workers, and insecurity among others.
 Conclusion: Most participants were knowledgeable of obstetric danger signs, but with low risk-perception towards obstetric complications. The Jigawa State government should engage in a robust education campaign on the need for early decision-making to seek care as well as strengthen its women empowerment programs to overcome barriers to seeking care for obstetric complications.

A Socioecological Perspective to Understand Perceived Risks and Benefits of Oral Pre-exposure Prophylaxis Towards the Promotion of Combination HIV Prevention Strategies

ABSTRACT HIV incidence rates remain disproportionately high among adolescent girls and young women in Sub-Saharan Africa, where women are 5–7 times more likely to become HIV-infected than their male peers. Oral pre-exposure prophylaxis (PrEP), a first-generation licenced biomedical innovation, can benefit populations at substantial risk of HIV acquisition, with options for independent product use for women in vulnerable situations. However, adoption of new product innovations bears several complexities with limited product knowledge, product confidence and low perceptions of risk. This study utilizes a socioecological perspective to explore perceptions of HIV risk and perceived barriers or benefits of oral PrEP with a sample of adolescent girls and young women and young men in rural KwaZulu-Natal. A theory-driven data-informed analysis utilizing the Health Belief Model and participatory research was used to engage with both men and women from HIV high-burden districts. The study identified various levels of risk using the socioecological perspective and found a specific association among women of PrEP as assurance of lower risk of HIV infection, whereas men perceived PrEP as insurance for risky behaviour. Revisiting perceptions of risk in terms of risk profiles should be ongoing and this study highlights that strategic health communication is needed to increase understanding of HIV risk in order to promote PrEP as part of HIV combination prevention for those willing to adopt new health innovations.

IJCM_274A: “Knowledge, attitude, practice regarding preventive measures; stigma and risk perception of covid 19 among the residents in the rural field practice area of a teaching hospital in Mangaluru”

Background: The success of battle against COVID 19 depends on public adherence towards infection control measures, which is greatly affected by their knowledge, attitude, and practices towards the COVID 19 pandemic. Objectives: Among the residents in the rural field practice area of a teaching hospital in Mangaluru:- 1) To assess knowledge, attitude, practice regarding preventive measures of COVID 19. 2) To assess stigma and risk perception of COVID 19. Methodology: A community based cross sectional study, by house-to-house visit was conducted among 323 participants residing in the rural field practice area of A.J. Institute of Medical Sciences & Research Centre, Mangaluru. Multistage sampling was adopted. Details regarding socio-demographic characteristics; knowledge, attitude, practice regarding preventive measures of COVID 19; risk perception and stigmatizing behavior was collected. Analysis was done using SPSS trial version 28. Results: 61% of participants were male; 27% had primary education and 33.1% were unemployed. Mass media was the most common source of COVID 19 related information. The knowledge of preventive measures of COVID 19 was good in 97.5% of the participants. 98.1% had positive attitude towards the preventive measures of COVID 19. The practice of preventive measures of COVID 19 good in 63.5%. 87.6% had taken two dose of COVID 19 vaccine. Low risk perception was seen in 96% and 83.6% had low stigmatizing behavior towards COVID 19. Gender was significant predictor of attitude scores. Age, gender, educational status, occupation status, type of family was the significant predictor of practices scores. Conclusion: Majority of the participants had good knowledge, positive attitude and good practice of preventive measures of COVID 19. As a result of effective IEC effort by different authorities is reaching rural part of India, people are aware of the preventive measures, has positive attitude about it and are practicing them.

Examining the Association Between Psychopathy Clusters and Risk-Taking Behaviors

IntroductionPsychopathy encompasses the sub-dimensions of interpersonal manipulation, callous affect, erratic lifestyle, and criminal tendencies. Most studies investigating this trait have traditionally utilized a variable-centered approach. However, in the current study, we have adopted a person-centered approach.ObjectivesOur objective was to analyze distinct homogeneous subgroups of individuals characterized by specific psychopathy profiles and examine their relationship with risk-taking behavior.MethodsOur sample consisted of 371 participants (26.4% men, aged 18 to 59 years), who completed the 34-item Self-Report Psychopathy Scale-III to assess psychopathy and Risk-taking behaviors were assessed using the Domain-Specific Risk-Taking Scale (DOSPERT-30).ResultsThrough cluster analysis, we identified four distinct groups: Low psychopathy, Low criminal tendencies, High erratic lifestyle, and High psychopathy group. The primary findings revealed that the High psychopathy group, characterized by elevated scores in all sub-dimensions, exhibited higher levels of Risk-Taking Behaviors and a lower Perception of Risk compared to the other groups. Furthermore, the Low criminal tendencies group, marked by high scores in all dimensions and low scores in criminal tendencies, demonstrated greater risk-taking behavior compared to the Low psychopathy and High erratic lifestyle groups.ConclusionsThese results stimulate the debate about whether it is appropriate to incorporate the dimension of criminal tendencies within the concept of psychopathy. Certain clinical implications emerge from this study that are deserving of a comprehensive and thoughtful discussion.Disclosure of InterestNone Declared

Providing medication for opioid use disorder and HIV pre-exposure prophylaxis at syringe services programs via telemedicine: a pilot study

BackgroundPeople who inject drugs (PWID) are at high risk for opioid overdose and infectious diseases including HIV. We piloted PARTNER UP, a telemedicine-based program to provide PWID with medication for opioid use disorder (MOUD) with buprenorphine/naloxone (bup/nx) and oral pre-exposure prophylaxis (PrEP) with tenofovir disoproxil fumarate/emtricitabine through two syringe services programs (SSP) in North Carolina. We present overall results from this project, including participant retention rates and self-reported medication adherence.MethodsStudy participants met with a provider for an initial in-person visit at the SSP, followed by weekly telemedicine visits in month 1 and then monthly until program end at month 6. Participants were asked to start both MOUD and PrEP at initiation but could choose to discontinue either at any point during the study. Demographics and health history including substance use, sexual behaviors, and prior use of MOUD/PrEP were collected at baseline. Follow-up surveys were conducted at 3- and 6-months to assess attitudes towards MOUD and PrEP, change in opioid use and sexual behaviors, and for self-reported medication adherence. Participant retention was measured by completion of visits; provider notes were used to assess whether the participant reported continuation of medication.ResultsOverall, 17 persons were enrolled and started on both bup/nx and PrEP; the majority self-identified as white and male. At 3 months, 13 (76%) remained on study; 10 (77%) reported continuing with both MOUD and PrEP, 2 (15%) with bup/nx only, and 1 (8%) with PrEP only. At 6 months, 12 (71%) remained on study; 8 (67%) reported taking both bup/nx and PrEP, and 4 (33%) bup/nx only. Among survey participants, opioid use and HIV risk behaviors decreased. Nearly all reported taking bup/nx daily; however, self-reported daily adherence to PrEP was lower and declined over time. The most common reason for not continuing PrEP was feeling not at risk for acquiring HIV.ConclusionsOur study results show that MOUD and PrEP can be successfully administered via telemedicine in SSPs. PrEP appears to be a lower priority for participants with decreased continuation and adherence. Low perception of HIV risk was a reason for not continuing PrEP, possibly mitigated by MOUD use. Future studies including helping identify PWID at highest need for PrEP are needed.Trial registrationProviding Suboxone and PrEP Using Telemedicine, NCT04521920. Registered 18 August 2020. https://clinicaltrials.gov/study/NCT04521920?term=mehri%20mckellar&rank=2.

Effect of Fitness-To-Drive and Metacognition on Road Traffic Injury Among Older Taxi Drivers: Hierarchical Modeling.

Age-related cognitive and somatic motor skills changes have been linked to impaired driving abilities. Taxi drivers play an important role in providing public transportation services and security. This study aimed to examine the level of fitness-to-drive (FTD) and identify the predictors of self-reported traffic injury among the older taxi drivers. Taxi drivers 60years and older in Bangkok and the metropolitan area were enrolled. Hierarchical regression models were carried out to examine the effects of demographics, FTD, and metacognition towards self-reported road traffic injury. Totally, 46.1% of the respondents were classified as at-risk drivers. Drivers with alcohol consumption and low risk perception toward road safety were more likely to experience road traffic injury. Regular assessment of physical and psychometric capacity among older taxi drivers could provide another empirical basis to improve public safety transport.

Cigarette and E-Cigarette Harm Perceptions During Pregnancy.

Research suggests that pregnancy status (prior, current, and future intention) is associated with differences in perceived harm of electronic cigarette (e-cigarette) use during pregnancy. However, perceptions of health outcomes attributed to cigarette and e-cigarette use during pregnancy have not been explored among a sample of pregnant women who smoke. The purpose of this study was to explore differences in perceived harms of cigarette and e-cigarette use and perceived birth and health outcomes associated with cigarette and e-cigarette use during pregnancy among a sample of pregnant women who currently smoked. Using a cross-sectional online survey, we examined perceptions about cigarette and e-cigarette use during pregnancy among a sample of U.S. pregnant women ( n = 267) who smoked in the past 30 days. Participants were grouped into categories based on e-cigarette use status (current, past, and never e-cigarette users). Differences between e-cigarette use status and perceived harm (absolute of cigarettes, e-cigarettes, and relative of e-cigarettes) and perceived health outcomes attributed to smoking/e-cigarette use were examined. Among our sample, 45.7%, 39.7%, and 14.6% were current, ever, and never e-cigarette users, respectively. Associations existed between e-cigarette use status and absolute perceived harm of cigarettes, relative perceived harm of e-cigarettes, and perceived health outcomes. Current e-cigarette users believed pregnant women who smoked cigarettes were more likely to lose a child because of miscarriage or sudden infant death syndrome or give birth to a child with low birth weight, reduced lung function, cleft lip, reduced brain function, or attention-deficit/hyperactivity disorder than never e-cigarette users. No associations were found between perceived birth and health outcomes of e-cigarette use by e-cigarette user status. Pregnant women who smoked and used e-cigarettes had lower risk perceptions about e-cigarette use during pregnancy than those who only smoked. Health messages and research about the harms of nicotine exposure during pregnancy should address the risks of dual-use versus only e-cigarette use. In addition, messages about the relative harm of e-cigarettes compared to cigarettes are needed for pregnant women who smoke and have trouble quitting.

Perception and Correlates of Opioid Overdose Risk Among Overdose Survivors Who Use Nonprescribed Opioids in San Francisco and Boston.

Understanding opioid overdose risk perception may inform overdose prevention strategies. We used baseline data from a randomized overdose prevention trial, in San Francisco, CA, and Boston, MA, among people who used nonprescribed opioids, survived an overdose in the past 3 years, and had received naloxone. Participants were asked how likely they were to overdose in the next 4 months. We combined "extremely likely" and "likely" (higher risk perception) and "neutral," "unlikely," and "extremely unlikely" (lower risk perception). We performed bivariate analyses and separate multivariable logistic regression models of risk perception across (1) sociodemographic, (2) substance use, and (3) overdose risk behavior measures. Covariates were selected a priori or significant in bivariate analyses. Among 268 participants, 88% reported at least 1 overdose risk behavior; however, only 21% reported higher risk perception. The adjusted odds ratio (AOR) of higher risk perception was 2.41 (95% confidence interval [CI]: 1.10-5.30) among those unhoused in the past 4 months, 2.06 (95% CI: 1.05-4.05) among those using opioids in a new place, and 5.61 (95% CI: 2.82-11.16) among those who had overdosed in the past 4 months. Living in Boston was associated with higher risk perception in all 3 models (AOR = 2.00-2.46, 95% CI: 1.04-4.88). Despite prevalent risk behaviors, a minority of participants perceived themselves to be at higher risk of overdose. Nonetheless, some known risk factors for overdose were appropriately associated with risk perception. Fentanyl has been prevalent in Boston for longer than San Francisco, which may explain the higher risk perception there.

Public knowledge, sentiments, and perceptions of low dose radiation (LDR) and power production, with special reference to reactor accidents

Abstract People’s perceptions concerning radiation inform decision making in relation to nuclear power production. There have been extensive studies of people’s perceptions of radiation including in relation to the Fukushima and Chernobyl nuclear events. This paper reports on a social science literature review study and is concerned with public responses to low dose radiation (LDR) and nuclear facilities, particularly in the marine environment. This review confirms that people with little knowledge about radiation have the highest risk perceptions in relation to nuclear power; conversely people with a broader knowledge have lower risk perceptions and are more favourable to nuclear power. Education can increase positive perceptions, but the influence of underlying experience of feeling, emotion, attachment, or mood may dampen this effect. This paper reports studies which document anxiety within the Japanese community in relation to the Fukushima nuclear accident. Literature concerning specific radionuclides released is described. While there are uncertainties about the presence of health impacts following LDR exposures, public attitudes are not in line. There is a need for better dialogue between nuclear professionals and scientists to achieve better nuclear education and public communication outcomes; more specific communication surrounding multi-isotopes, and multi-elements of nuclear power plant disaster releases is warranted. Trusted communicators should include nuclear and social scientists as well as regulators. Given the importance of decarbonization in the context of climate change, this is increasingly important.

IDF23-0504 Low Diabetes Risk Perception in University Students-A Barrier in the Prevention of Diabetes

IDF23-0504 Low Diabetes Risk Perception in University Students-A Barrier in the Prevention of Diabetes

Socio-ecological factors that influence youth vaping: perspectives from Western Australian school professionals, parents and young people

ABSTRACT Purpose To understand from the perspectives of school professionals, parents and young people the socio-ecological factors that may facilitate and prevent e-cigarette use among young people in Perth, Western Australia. Methods Purposive sampling was used to recruit school professionals, parents and young people for one-on-one (n = 35) or joint (n = 3) interviews (in-person n = 11 or online n = 27). Data were analysed using thematic analysis and classified into four domains based on the socio-ecological model: i) individual, ii) interpersonal, iii) organizational/community and iv) societal/policy. Results Factors that were found to support vaping among young people included sensation-seeking and risk-taking behaviour; a low-risk perception of vapes; attractive characteristics of vapes; ease of access; perception vaping is a social activity; and lack of knowledge about vaping among parents and school professionals. Vaping prevention messages originating from the familial, educational and community spheres are lacking but wanted by adults and young people. Conclusions The pervasiveness of the e-cigarette trade and persistent challenges related to surveillance and enforcement need to be addressed to reduce exposure and access to e-cigarettes. A mixture of “hard” and “soft” public policy tools involving key stakeholders in a range of settings is needed to prevent e-cigarette access and uptake by young people.

Analyzing road user risk perception among Indian drivers on varying curve geometry: A structural equation modeling approach

Driver risk perception ability depends on how they perceive and interpret information from different sources to safely and comfortably operate their vehicles based on the highway features ahead. The present study is divided into two parts to review these aspects: (a) identifying the factors that influence driver risk-taking behavior, and (b) evaluating the soundness of the identified factors by comparing them with quantitative risk perception. For that, 1075 user perception data were collected using a developed questionnaire form through face-to-face interviews. A questionnaire form consists of a total of 33 questions/variables. After applying the factor reduction techniques, namely principal component analysis, the most significant variables (19 questions/variables) influencing the user’s perception are identified. Then, considering these significant variables, five separate risk perception models were developed using the Structural Equation Modeling technique for five varying curve geometries. The results revealed that the user’s risk perception changes for the same user for varying curve geometry. It is also identified that male drivers have more risky behavior (lower risk perception) than female drivers. Besides, Garrett’s ranking technique is also adopted to rank the user risk perception for the varying curve geometry to identify the dangerous curves by assigning the rank. Lastly, to check the feasibility of the results, the risk perception score is also compared with the quantitative risk score. Based on the study results, it is concluded that the study findings will be helpful for highway planners and authorities to introduce some safety measures to alert users of the potential hazards on the roadside and increase their capacity for taking risks on complex curves; hence, the likelihood of crashes can be minimized.

Association of personal and systemic factors on intrapartum risk perception and obstetric intervention rates: a cross-sectional study

BackgroundRisk perception is fundamental to decision-making; therefore its exploration is essential to gaining a comprehensive understanding of the decision-making process for peripartum interventions. The aim of this study was to investigate associations between personal and systemic factors of the work setting and the risk perception of obstetric healthcare professionals, and in turn how this might influence decisions regarding obstetric interventions.MethodsCase vignettes were used to measure risk perception. A quantitative cross-sectional online survey was performed within an exploratory sequential mixed-methods design, and an intervention readiness score created. Associations were calculated using location and dispersion measures, t-tests and correlations in addition to multiple linear regression.ResultsRisk perception, as measured by the risk assessment score, was significantly lower (average 0.8 points) for midwives than for obstetricians (95%-CI [-0.673; -0.317], p < .001). Statistically significant correlations were found for: years of experience and annual number of births in the current workplace, but this was not clinically relevant; hours worked, with the groups of participants working ≥ 30,5 h showing a statistically significant higher risk perception than participants working 20,5–30 h (p = .005); and level of care of the current workplace, with the groups of participants working in a birth clinic (Level IV) showing a statistically significant lower risk perception than participants working in Level I hospital (highly specialised obstetric and neonatal care; p = .016). The option of midwife-led birthing care showed no correlation with risk perception. The survey identified that risk perception, occupation, years in the profession and number of hours worked (i.e. full or part time) represent significant influences on obstetric healthcare professionals’ willingness to intervene.ConclusionsThe results of the survey give rise to the hypothesis that the personal and systemic factors of professional qualification, occupation, number of hours worked and level of acuity of the workplace are related to the risk perception of obstetric healthcare professionals. In turn, risk perception itself made a significant contribution to explaining differences in willingness to intervene, suggesting that it influences obstetricians’ and midwives’ decision-making. Overall, however, the correlations were weak and should be interpreted cautiously. The significant variations in the use of interventions must be addressed in order to provide the highest quality and best possible care for childbearing women and their families. To this end, developing strategies to improve interdisciplinary relationships and collaboration is of great importance.Trial registrationGerman Clinical Trials Register DRKS00017172 (18.06.2019).

Personal factors influencing female students' condom use at a higher education institution.

South African female students' consistent condom use is low, possibly due to personal factors, such as knowledge about sexual reproductive health, attitudes towards safe sex, risk perceptions and condom use, self-efficacy. This study aimed to investigate the personal factors that influence condom utilisation among female students. This study was conducted at a higher education institution in the Northern Cape province in South Africa. A quantitative, descriptive survey design was used. Three hundred and eighty five participants were selected using convenience sampling. The research instrument was a self-administered questionnaire, and the data were analysed using the Statistical Package for the Social Sciences, version 28. Almost two-thirds (250, 64.9%) of participants used condoms to prevent pregnancy, sexually transmitted infections (STIs), and human immunodeficiency virus (HIV). Although attitudes towards safe sex were generally positive, low risk perceptions were reported. Consistent use of condoms was found in 32.2% (124) of participants, while 45.3% (174) participants used condoms inconsistently or never. A significant finding was that consistent use increased the likelihood of negotiating for a condom with partners by 9.14 times and confidence in putting one on for a partner by 8.05 times. The findings depict average levels of the use of condoms among female students. Prevention efforts should concentrate on educating female students to strengthen condom use and self-efficacy.Contribution:This study, supporting existing literature, suggests that preventative efforts should focus on educating young women about condom use, self-efficacy and encouraging STI conversations with sexual partners.

Coping and risk perception during the COVID-19 pandemic in type 2 diabetes: Does it influence metabolic control?

Diabetes and poor glycemic control are significant predictors of severity and death in the COVID-19 disease. The perception of this risk in individuals with type 2 diabetes (T2D) could modify coping styles, leading to behaviors associated with better self-care and metabolic control. Theoretically, active coping is associated with better glycemic control in patients with T2D. Nonetheless, information during extreme risk like the COVID-19 pandemic is still limited. Our objective was to evaluate the association between coping styles and risk perception in the COVID-19 pandemic and the change in metabolic parameters. This is a prospective study that included individuals with T2D treated in a tertiary care center during the COVID-19 outbreak who returned to follow-up one year later. We assessed coping styles and risk perception with the Extreme Risk Coping Scale and the risk perception questionnaire. Clinical characteristics and metabolic parameters were registered in both visits. Groups were compared using Kruskal Wallis tests, and changes in metabolic parameters were assessed with Wilcoxon rank sum tests. Our sample included 177 participants at baseline, and 118 concluded the study. Passive coping was more frequent in women. Low-risk perception was associated with higher age, lower psychiatric comorbidities, and lower frequency of psychiatric treatment compared with other risk perception groups. Patients with active coping plus high-risk perception did not have a change in metabolic parameters at follow-up, whereas patients with other coping styles and lower risk perception had an increase in total cholesterol, LDL-cholesterol, and triglycerides. There were no differences by coping group or by risk perception in glycemic control.

Human Papillomavirus (HPV) Vaccine Coverage and Confidence in Italy: A Nationwide Cross-Sectional Study, the OBVIOUS Project.

Human Papillomavirus (HPV) vaccination rates are still below the target due to vaccine refusal or delay, lack of knowledge, and logistical challenges. Understanding these barriers is crucial for developing strategies to improve HPV vaccination rates. This cross-sectional study used a questionnaire to investigate social and behavioral factors influencing decision making about the HPV vaccine. The survey was conducted from 11 April to 29 May 2022 and involved 10,000 Italian citizens aged ≥ 18 years. The sample was stratified based on region of residence, gender, and age group. 3160 participants were surveyed about themselves, while 1266 respondents were surveyed about their children's vaccine uptake. Among females aged ≥ 26 years, the national average HPV vaccine uptake was 21.7%, with variations across different regions. In the 18-25 age group, females had a vaccine uptake (80.8%) twice as much as males (38.1%), while vaccine uptake among male and female children aged 9-11 was similar. The OBVIOUS study in Italy reveals factors influencing low HPV vaccine uptake, suggesting targeted approaches, tailored information campaigns, heightened awareness of eligibility, promoting early vaccination, addressing low-risk perception among males, addressing safety concerns, and enhancing perceived accessibility to improve vaccine uptake and mitigate health risks.

Risk perception about communicable and vector borne diseases among international travellers to Pakistan: A cross sectional study.

With the rise in air travel, the risk of diseases travelling from one geographical area to another has also increased. Relatively little is known about how travellers know and perceive the health risks associated with travel and how they adopt preventive measures before and while travelling abroad. The objective of this study is to determine the risk perception about communicable and vector-borne diseases among international travellers arriving from different countries and to find any association between the level of risk perception and independent variables. A cross-sectional study was conducted with 426 participants enrolled through convenient sampling technique. An already validated questionnaire was used to collect information. Chi square test was applied to ascertain any significant association between dependent and independent variables. Out of 426 respondents, only 226 (53%) had a high risk perception, whereas 220 (47%) had a low risk perception. A significant association was noted between the level of risk perception and gender (x2=20.9, p=0.000), level of education (x2=42.9, p=0.000), nationality (x2=7.5, p= 0.006) and region of arrival of the passengers (x2=26.2, p= 0.000). The results of the study revealed that 220 (47%) of the travellers had a low risk perception that may lead to an increase in the burden on healthcare system in Pakistan as well as exporting any new disease from Pakistan to other parts of the world where it does not already exist.

Why Are Adolescent Cannabis Use Disorder Treatment Admissions Declining in the US? The Mediated Pathway of State Treatment Admissions Rates before and after Recreational Cannabis Legalization

Purpose: State-level prevalence data are used to investigate whether recreational cannabis legalization moderates the mediated pathway from the perception of low risk of harm, to cannabis use, to cannabis use disorder (CUD) treatment admissions, among adolescents (age 12–17) in the US. Methods: Annual state prevalence measures of perception of low risk, cannabis use, and CUD treatment admissions between 2008 and 2019 (N = 542 state-year observations) were collected from the National Survey on Drug Use and Health (NSDUH) and the Treatment Episode Dataset – Admissions (TEDS-A). A two-way fixed effects (state and year) moderated mediation model was used to test whether recreational legalization moderated the indirect effect of perception of low risk on treatment admissions via cannabis use. Results: A positive indirect effect of perceiving cannabis as low risk on CUD treatment admissions via cannabis use was observed prior to legalization but not afterwards. After legalization, the positive association of perceiving cannabis as low risk with cannabis use was strengthened, and the positive association of cannabis use with treatment admissions was suppressed, as compared to before legalization. Discussion: Recreational legalization may alter the social acceptability and medical self-administration of cannabis, potentially leading to CUD treatment utilization decline among adolescents even as risk factors for CUD increase. Linking recreational cannabis legalization to advancing awareness of the health risks associated with adolescent cannabis use and promoting adolescent CUD treatment engagement through mHealth approaches and primary care providers are key to addressing potential adolescent health challenges brought about by expanding cannabis legalization.

Covid-19 vaccine compliance among residents of Kathmandu Valley

Background: The Coronavirus disease 2019 (COVID-19) pandemic is a public health threat. Equitable access to safe and effective vaccines is critical to end the COVID-19 pandemic. Promoting the uptake of vaccines (particularly those against COVID-19) require the understanding whether people are willing to be vaccinated, and the reasons behind their decision. Objectives: This study aimed to assess COVID-19 vaccine compliance and factors associated with it among residents of Kathmandu valley. Methods: A cross-sectional analytical study was conducted among residents of Kathmandu valley through a pre-tested web-based self-administered questionnaire. A total of 390 respondents were selected to carry out this study. The collected data were entered into MS-excel and analyzed using SPSS IBM v. 25. Multivariable analysis was performed. Results: Vaccine compliance was found in 94.1% of 390 respondents. Among the respondents, 91.5% had low risk perception of COVID-19; 85.4% had complete prior vaccination history; 61.3% perceived COVID-19 vaccine as effective; 65.6% perceived. COVID-19 vaccine as necessary whereas only 24.6 % believed the COVID-19 vaccine to be safe. Regarding COVID-19 vaccine compliance, females demonstrated a 3-fold higher likelihood than males (AOR= 3.0, 95%CI: 1.01-9.21). Complete vaccination history which had 31.9 times higher odds than no vaccination history (AOR=31.96, 95%CI: 9.72-105.14), perceived vaccine effectiveness which had 7.7 times higher odds than perceived ineffective (AOR= 7.75, 95%CI: 2.37-25.38), and high social influence which had 7.7 times higher odds compared to low social influence (AOR= 7.72, 95%CI: 2.19-27.12) were the associated factors with increased compliance. Conclusion: This study revealed significantly high vaccine compliance rate in Kathmandu valley. Sex, complete vaccination history, perceived vaccine effectiveness and high social influence were the determinants for vaccine compliance which indicated the importance of ensuring people trust the vaccine's safety, utilizing social influence to encourage vaccination, and tailoring strategies to suit different demographics.