Risk Perception and Risk-Taking Behaviour during Adolescence: The Influence of Personality and Gender

Exploring the Association between Educational Aspirations and Intentions to Migrate among Youth in Central Mexico by Gender

We assessed the association between educational aspirations and the intention to migrate among 1,446 adolescents aged 11-17 years, living in semi-urban/rural communities in Jalisco, Mexico. Analyses rely on survey data from the Family Migration and Early Life Outcomes study. The outcome variable was the intention to migrate, a three-category variable coded as no intention to migrate, intention to migrate within Mexico, and intention to migrate internationally. The main independent variable was the adolescents' educational aspirations, conceptualized as the intention to achieve higher education. Multinomial logistic regression models were used to examine associations. We found an association between educational aspirations and intentions to migrate, and it was moderated by gender. Girls with the highest educational aspirations intended to migrate internationally, while higher educational aspirations were not a driver for boys' migration intentions. The study findings have implications for education and migration policies and future research.

Does early exercise intolerance effect time to return to play, symptom burden, neurocognition, Vestibular-Ocular-Motor (VOM) function and academic ability in acutely concussed student-athletes?

INTRODUCTION

Early Exercise Intolerance (EEI) is associated with delayed recovery and longer time to Return To Play (RTP), but this has not been established.Participants; (n = 52, male n = 30) UK university-aged rugby-union student-athletes.

METHODS

Student-athletes completed baseline screening (July-October 2021 and 2022). The test battery was repeated within 48 h, 4, 8 and 14 days after a Sports-Related Concussion (SRC) with the Buffalo Concussion Bike or Treadmill Test to set sub-symptom heart rate threshold. Student-athletes then completed a controlled early exercise protocol in-between reassessment (days 3, 5-7 and 9-13). Those with EEI were compared to those with early-exercise tolerance.

OUTCOME MEASURES

Post-Concussion Symptom Scale, Immediate Post-Concussion and Cognitive Test, Vestibular-Ocular Motor Screening Tool and the Revised Perceived Academic Impact Tool.

RESULTS

EEI was seen throughout the initial 14-days post-SRC (23.8%, 22.4%, 25.5%. 25.0%). EEI was associated with a slower reaction time within 48 h (-0.01 (-0.030-0.043) Vs 0.06 (0.033-0.24), p = 0.004) and greater VOMS scores within 48 h; (0.00 (0.00-4.00) Vs 5.50 (2.75-9.00), p = 0.016) and 4 days (0.00 (0.00-2.00) Vs 5.00 (0.00-6.00), p = 0.044). RTP was 12.5 days longer in those with EEI at 14-days post-SRC.

CONCLUSION

EEI is prevalent following an SRC in university-aged student-athletes and was associated with delayed recovery and RTP.

Shyness and risk-taking during peer observation in children and adolescents

Although temperamental shyness is conceptualized as a trait marked by cautiousness, we know relatively little about its relation to risk-taking. We examined how shyness was related to opportunities for risk-taking while considering how social context (i.e., presence of peers) and developmental stage (i.e., children and adolescents) might influence this relation. In the current study, 198 children (Mage = 10.17 years) and 221 adolescents (Mage = 13.46 years) completed the Balloon Analogue Risk Task (BART) alone or during a peer observation manipulation. For children and adolescents, shyness was related to physiological arousal and self-reporting feeling anxious during the peer condition. However, peer observation did not influence the relation between shyness and behavioral responses during the BART. Across both alone and peer conditions, shyness was related to a longer response time for children and adolescents, which may reflect decisional conflict during risk-taking opportunities. Furthermore, shyness in children (but not in adolescents) was related to poorer performance (i.e., fewer points), whereas shyness was unrelated to risk-taking propensity (i.e., number of pumps) for both children and adolescents. Overall, although the presence of peers may induce anxiety during a risk-taking opportunity for children and adolescents higher in shyness, this does not appear to modify their risk-taking behaviors. Instead, shyer children and adolescents in general may take a longer time to decide whether to act in a risky manner, whereas shy children in particular may show poorer performance in obtaining a reward on a risk-taking task.

Bullying at School and Students' Learning Outcomes: International Perspective and Gender Analysis

The present study empirically investigates how school-based bullying victimization affects students' learning outcomes, taking into consideration international and gender perspectives. The main objective of the present research is to provide a better understanding of the consequences of bullying victimization in the learning process of adolescents. We estimate a statistical function that empirically establishes the relationship between the students' outcomes in mathematics, reading, and science (output) and a wide set of explanatory variables (educational factors), one of which is that of being bullied. The present study uses a large sample of 612,004 students between 15 and 16 years old, attending 21,903 schools in 79 countries. The data come from the 2018 round of the Programme for International Student Assessment. The results indicate that bullying victimization is associated with decreases in academic achievement in mathematics, reading, and science. In addition, no relevant differences by gender are observed in reading and science but, other factors being equal, bullied males score less than bullied females in mathematics.

Mapping Risk Judgment and Risk Taking in Mountain Hiking: An Information Integration Approach

Risk analysis is essential for promoting hiking-based tourism. Our objective in the present study was to map 395 mountain hikers' positions on risk judgment and risk taking, according to how they integrated three antecedent factors of confidence (environment, team, and self). For integrating information, people can develop an additive rule whereby they apply the same weight to all information or use interaction rules (i.e., conjunctive or disjunctive), to give different weights to information. In the questionnaire our participants completed, there were eight scenarios that combined the three confidence antecedent factors as information cues. We applied cluster analysis, repeated-measures analyses of variance, chi-square tests, and bivariate correlation analyses to the questionnaire results to identify three participant risk positions. In the first risk position (cluster 1), participants used a disjunctive integration rule for both risk judgment and risk taking. In the second risk position (Clusters 2 and 4), they used an additive integration rule for risk judgment while they used a disjunctive integration rule for risk taking. In the third risk position (cluster 3), they used an additive integration rule for both risk judgment and risk taking. In each risk position, confidence in the three antecedent factors (environment, team, and self) negatively affected risk judgment and positively affected risk taking. We found the compositions of the clusters to be related to the participants' sex, and we discuss various advantages of applying information integration for mountain hiking practitioners and promoters.

Parent-Child Associations in COVID-19-Related Preventive Behaviors and Efficacy Expectations: A One-Year Longitudinal Survey

PURPOSE

It is necessary to identify the variables that explain the variance in preventive behaviors against COVID-19 to increase adolescents' engagement in these behaviors. We focused on efficacy expectations of preventive behaviors and their associations within families. This study examined the associations between efficacy expectations and preventive behaviors, and between adolescents and their parents in terms of efficacy expectations and preventive behaviors.

METHODS

A cross-lagged panel model was employed to analyze 281 parent-child pairs consisting of 245 children (118 girls, mean age = 17.4 years), 277 mothers (median age = 49.3 years), and 211 fathers (median age = 51.5 years). Participants completed the Prevention of COVID-19 Infection Scale at baseline (October 2020 to April 2021) and one-year follow-up to assess efficacy expectations and preventive behaviors for sanitization, contact, and hoarding factors.

RESULTS

Efficacy expectations of preventive behaviors at baseline were positively associated with preventive behaviors at one-year follow-up regarding the sanitization and contact factors. Additionally, for parents, efficacy expectations of preventive behaviors at baseline were positively associated with subsequent preventive behaviors regarding the hoarding factor. Parental efficacy expectation scores for contact at baseline were positively associated with their children's scores at one-year follow-up.

DISCUSSION

The findings highlight the association between parental efficacy expectations at an initial time point and adolescents' efficacy expectations at one-year follow-up toward COVID-19 preventive measures, particularly contact-related behaviors. These insights can inform public health interventions targeting individual expectations and parental involvement to promote effective preventive practices during future health crises.

Risk perception and use of personal protective equipment (PPE) in pesticide use: does risk shape farmers' safety behavior?

Risk perception and use of personal protective equipment (PPE) in pesticide use were studied in 109 farmers of northern Greece. Farmers differed in the levels of pesticide risk perception, with 26.6% showing very low and low levels, 34.9% showing moderate levels, and 38.5% showing high and very high levels. Pesticide risk perception was positively correlated with education and large cultivated area, but negatively with age and non-farming as a main profession. Most farmers (82.6%) showed adequate use of PPE (mostly face mask and gloves). The use of PPE was positively correlated with education and risk perception, but negatively with age and non-farming as a main profession. Farmers with high levels of risk perception used 1.3 and 2.6 times more PPE items than those with moderate and low levels of risk perception, respectively. High education was a positive predictor, whereas main profession other than farming was a negative predictor of PPE use.

An integrative framework for mapping the psychological landscape of risk perception

We vary greatly in our perception of risk, not just because of differences between risks themselves, but also because of individual, contextual and cultural differences too. To better understand and predict responses to risk, we need to (a) integrate these components, combining approaches from different psychological disciplines and (b) also consider risk tolerance - how individuals trade-off between risks and benefits. We therefore developed an ICONS (individual, contextual, cognitive, social) framework; using it across two empirical studies (n = 4228) to examine how individuals perceive and respond to the quotidian risks associated with consumer products. Three dimensions underlined risk perceptions: benefits, dread and individual responsibility. Risk tolerance was typically predicted by interactions between individual (demographic, cultural worldview, personality) and contextual (product type/category, harm information) factors. In turn, perceived dread, benefits and individual differences shaped how likely participants were to communicate risk information. Our results demonstrate for the first time how the interaction between individual, cognitive (risk tolerance, intensity), contextual, and social (risk communication) factors is key to understanding and predicting risk perceptions. Together, our findings help explain why societal responses to risks are often difficult to predict and have implications for the spread, and amplification, of risk information.

Associations of Impulsivity and Risky Decision-Making with E-Cigarette-Related Outcomes Among Adolescents with Congenital Heart Disease: Variable- and Person-Oriented Approaches

Adolescents with congenital heart disease (CHD) have elevated risk for acquired cardiovascular complications, increasing their vulnerability to e-cigarette-related health harms. Impulsivity and risky decision-making have been associated with adolescent substance use, but the relationships between these factors and e-cigarette-related outcomes among cardiovascular at-risk adolescents with CHD are unknown. This cross-sectional study aimed to (a) determine the associations of impulsivity and risky decision-making with e-cigarette-related outcomes (i.e. susceptibility, ever use, perceptions of harm and addictiveness) via variable-oriented analysis (logistic regression), (b) identify groups of adolescents with similar profiles of impulsivity and risky decision-making via exploratory person-oriented analysis (latent profile analysis; LPA), and (c) examine differences on e-cigarette-related outcomes between profile groups. Adolescents aged 12 to 18 years with CHD (N = 98) completed a survey assessing impulsivity facets (Short UPPS-P) and e-cigarette-related outcomes and were administered a risky decision-making task (Iowa Gambling Task, Version 2; IGT2). In variable-oriented analyses, impulsivity facets (negative urgency, positive urgency, lack of premeditation) but not risky decision-making were associated with e-cigarette susceptibility and ever use. The exploratory LPA identified two groups with similar patterns of responding on the Short UPPS-P and IGT2 labeled "Low Impulsivity" and "High Impulsivity," which were primarily characterized by significant differences in negative and positive urgency. Adolescents in the High Impulsivity group had increased odds of e-cigarette susceptibility but not ever use compared to the Low Impulsivity group. This work indicates that strategies to prevent e-cigarette use among adolescents with CHD may be enhanced by addressing impulsivity, particularly negative and positive urgency.

"Absolutely No One Else, Other Than Yourself": Experiences of Adolescents and Young Adults with Cancer During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic caused widespread disruption to the provision of health care in the United Kingdom. It posed two risks to AYACs: disruption of care and long-term adverse consequences compounding late effects. This study sought to better understand the experiences of AYACs receiving care during the pandemic and identify areas where greater support is needed. Methods: In-depth semistructured interviews with AYACs (n = 6), 16-22 years at diagnosis. Interviews were transcribed verbatim and analyzed using the principles of Giorgi's phenomenological analysis. Results: Four major themes and an interconnected theme were identified. Changes to health care meant AYACs were isolated and loss of in-person follow-up caused anxiety (theme 1). AYACs had to adapt to life with COVID-19 restrictions (theme 2). Support during the pandemic came from a variety of sources (theme 3). AYACs reported poor mental health due to a fear of relapse and contracting COVID-19 (theme 4). An additional burden for AYACs was the loss of the third person (e.g., parent) in consultations (interconnected theme). Conclusion: This study has wider implications for delivery of AYAC care, despite being set during the COVID-19 pandemic. The mental health implications will impact long-term care of these patients, and health care professionals must be aware of these to meet AYACs' holistic care needs.

Individual differences in legal and illicit cannabis purchasing behaviour in British Columbia, Canada: Findings from a 2021 cross-sectional survey

BACKGROUND

Despite thousands of licensed cannabis retail stores operating across Canada, there remains a significant illicit cannabis market. Some cannabis users continue to buy cannabis from dealers, illicit stores, and/or illicit online retailers.

METHODS

Data are from the 2021 British Columbia Cannabis Use Survey. Respondents (n = 8473) were 19 years or older, lived in British Columbia at the time of the survey, and reported using cannabis in the past 12 months.

RESULTS

Buying cannabis from all types of illicit sources was more common among younger cannabis users, those who use cannabis more frequently and started using cannabis before the age of 17 (vs. 19 or older), and among those who co-use cannabis with other drugs. Specifically, buying cannabis from a dealer was more common among men, those with lower educational attainment, and those who seek the lowest prices when buying cannabis. In contrast, those using cannabis for medical (vs. non-medical) purposes were more likely to report getting cannabis from illicit retail stores, while buying cannabis from illicit websites was more common among people who use edible cannabis products.

CONCLUSION

Consistent with other studies, younger and more frequent cannabis users were more likely to report buying cannabis from illicit sources. However, these findings suggest there is significant heterogeneity among those who buy cannabis from different types of illicit sources, which should be carefully considered when developing policies and strategies aimed at encouraging consumers to transition to legal sources.

Sex Differences in Mountain Bike Accidents in Austria from 2006 to 2018: A Retrospective Analysis

Woyke, Simon, Anja Hütter, Christopher Rugg, Willi Tröger, Bernd Wallner, Mathias Ströhle, and Peter Paal. Sex differences in mountain bike accidents in Austria from 2006 to 2018: a retrospective analysis. High Alt Med Biol. 25:89-93, 2024. Introduction: Mountain biking is becoming increasingly popular, and mountain bike (MTB) accidents are on the rise. The aim of this study was to assess sex differences in mountain biking accidents in the Austrian Alps. Methods: This retrospective study includes all MTB accidents in Austria from 2006 to 2018. Data were collected by Alpine Police officers and recorded in a national digital registry. Results: The accidents involved 5,095 mountain bikers (81% men and 19% women). The number of MTB accidents rose markedly from 208 in 2006 to 725 in 2018. Men wore a helmet more often than did women (95% vs. 92%; p = 0.001). The most common injury category was "wound/bleeding" for both sexes (men 40% and women 41%). Women were more frequently transported by helicopter or terrestrially (p > 0.001). Conclusion: In the Austrian Alps, the number of MTB accidents more than tripled between 2006 and 2018. Women were involved in only one fifth of all accidents. Sex differences in MTB accidents include (1) women wearing helmets less often, (2) women being less frequently injured, (3) women suffering fewer serious injuries, and (4) women being more frequently transported by helicopter or terrestrially, while men more often did not require transportation.

State-Level Recreational Cannabis Legalization Is Not Differentially Associated with Cannabis Risk Perception Among Children: A Multilevel Regression Analysis

Introduction: As more states pass recreational cannabis laws (RCLs) for adults, there is concern that increasing (and state-sanctioned) cannabis acceptance will result in a reduced perception of risk of harm from cannabis among children. We aimed to discover whether children in states with RCLs had decreased perception of risk from cannabis compared with children in states with illicit cannabis. Methods: We analyzed data from the multisite multistate Adolescent Brain and Cognitive Development Study to determine how the perception of cannabis harm among children (age at baseline: 9-10; N=10,395) changes over time in states with and without RCLs. Using multilevel modeling, we assessed survey responses from children longitudinally across 3 years, adjusting for state-, family-, and participant-level clustering and child-level factors, including demographics (sex, race, and socioeconomic status), religiosity, and trait impulsivity. Results: There was no significant main effect of state RCLs on perceived risk of cannabis use, and no differences in change over time by state RCLs, even after controlling for demographic factors and other risk (e.g., impulsivity) and protective (e.g., religiosity) factors. Conclusions: This analysis indicates that state-level RCLs are not associated with differential perception of cannabis risk among children, even after controlling for demographics, trait impulsivity, and religiosity. Future studies could assess how perception of risk from cannabis changes as children and adolescents continue to mature in states with and without RCLs.

Tobacco use and oral health related quality of life among Indian adolescents

OBJECTIVES

The present study was conducted to assess tobacco use and its effect on Oral Health-Related Quality of Life (OHRQoL) in Indian adolescents.

METHODS

The present study was conducted on 1,600 13-14 year old adolescents from the schools of Modinagar, western Uttar Pradesh, India selected using stratified random sampling technique. OHRQoL was assessed using Hindi version of Child Perceptions Questionnaire (CPQ). Information regarding demographic, socioeconomic and oral health measures was also collected from the study participants. Tobacco use was assessed through questions derived from Global Youth Tobacco Survey (GYTS) questionnaire. Influence of predictor variables on tobacco use was evaluated using multilevel Poisson regression model.

RESULTS

The tobacco use among the study population was 8.1 % and CPQ scores were 9.15±0.32. Adolescents who used tobacco had worse OHRQoL scores. Low socioeconomic status, presence of dental caries, absence of regular dental visits (last 6 months) were associated with increased regular consumption of tobacco products.

CONCLUSIONS

The findings of the present study play an important role in planning public health strategies to improve adolescent OHRQoL and reduce tobacco use.

The impact of public health lockdown measures during the COVID-19 pandemic on the epidemiology of children's orthopedic injuries requiring operative intervention

BACKGROUND

In March 2020, Ontario instituted a lockdown to reduce spread of the SARS-CoV-2 virus. Schools, recreational facilities, and nonessential businesses were closed. Restrictions were eased through 3 distinct stages over a 6-month period (March to September 2020). We aimed to determine the impact of each stage of the COVID-19 public health lockdown on the epidemiology of operative pediatric orthopedic trauma.

METHODS

A retrospective cohort study was performed comparing emergency department (ED) visits for orthopedic injuries and operatively treated orthopedic injuries at a level 1 pediatric trauma centre during each lockdown stage of the pandemic with caseloads during the same date ranges in 2019 (prepandemic). Further analyses were based on patients' demographic characteristics, injury severity, mechanism of injury, and anatomic location of injury.

RESULTS

Compared with the prepandemic period, ED visits decreased by 20% (1356 v. 1698, p < 0.001) and operative cases by 29% (262 v. 371, p < 0.001). There was a significant decrease in the number of operative cases per day in stage 1 of the lockdown (1.3 v. 2.0, p < 0.001) and in stage 2 (1.7 v. 3.0; p < 0.001), but there was no significant difference in stage 3 (2.4 v. 2.2, p = 0.35). A significant reduction in the number of playground injuries was seen in stage 1 (1 v. 62, p < 0.001) and stage 2 (6 v. 35, p < 0.001), and there was an increase in the number of self-propelled transit injuries (31 v. 10, p = 0.002) during stage 1. In stage 3, all patient demographic characteristics and all characteristics of operatively treated injuries resumed their prepandemic distributions.

CONCLUSION

Provincial lockdown measures designed to limit the spread of SARS-CoV-2 significantly altered the volume and demographic characteristics of pediatric orthopedic injuries that required operative management. The findings from this study will serve to inform health system planning for future emergency lockdowns.

Parents' and adolescents' perspectives and understanding of information about childhood cancer precision medicine

BACKGROUND

Precision medicine is projected to become integral to childhood cancer care. As such, it is essential to support families to understand what precision medicine entails.

METHODS

A total of 182 parents and 23 adolescent patients participating in Precision Medicine for Children with Cancer (PRISM), an Australian precision medicine clinical trial for high-risk childhood cancer, completed questionnaires after study enrollment (time 0 [T0]). Of the parents, 108 completed a questionnaire and 45 completed an interview following return of precision medicine results (time 1 [T1]). We analyzed the mixed-methods data comprising measures exploring families' perceptions and understanding of PRISM's participant information sheet and consent form (PISCF), and factors associated with understanding.

RESULTS

Most parents were satisfied with the PISCF, rating it as at least "somewhat" clearly presented (n = 160/175; 91%) and informative (n = 158/175; 90%). Many suggested improvements including the use of clearer language and a more visually engaging format. Parents' actual understanding of precision medicine was low on average, but scores improved between T0 and T1 (55.8/100-60.0/100; p = .012). Parents from culturally and/or linguistically diverse backgrounds (n = 42/177; 25%) had lower actual understanding scores than those from a Western/European background whose first language was English (p = .010). There was little correlation between parents' perceived and actual understanding scores (p = .794; Pearson correlation -0.020; 95% CI, -0.169 to 0.116). Most adolescent patients read the PISCF either "briefly" or "not at all" (70%) and had a perceived understanding score of 63.6/100 on average.

CONCLUSIONS

Our study revealed gaps in families' understanding of childhood cancer precision medicine. We highlighted areas for potential intervention such as through targeted information resources.

PLAIN LANGUAGE SUMMARY

Precision medicine is projected to become part of the standard of care for children with cancer. Precision medicine aims to give the right treatment to the right patient and involves several complex techniques, many of which may be challenging to understand. Our study analyzed questionnaire and interview data from parents and adolescent patients enrolled in an Australian precision medicine trial. Findings revealed gaps in families' understanding of childhood cancer precision medicine. Drawing on parents' suggestions and the literature, we make brief recommendations about improving information provision to families, such as through targeted information resources.

Impulsivity and sensitivity to reward as mediating factors of the negative relationship between emotional intelligence and health-related risk-taking: evidence from a sample of university students

BACKGROUND

Better abilities in emotional intelligence (EI) have been linked to a decreased tendency to engage in health-related risk behaviour. However, the processes underlying this relationship are still unclear. The aim of this research was to examine the role of impulsivity and sensitivity to reward as mediating factors in the relationship between EI and health risk-taking.

METHODS

Two hundred and fifty participants (Mage = 23.60, age range = 18-59; SD = 6.67; 71.60% women) were assessed on ability EI levels, risk-taking in health contexts, impulsivity, and sensitivity to reward. Unlike previous studies in the literature, we employed a performance-based ability measure to assess EI (Mayer-Salovey-Caruso Emotional Intelligence Test, MSCEIT).

RESULTS

The results confirmed the negative relationship between EI and health risk-taking and revealed the existence of a significant negative indirect effect of EI on health-risk taking through various dimensions of impulsivity and sensitivity to reward. EI abilities -particularly the ability to manage emotions- were associated with lower levels of impulsivity under positive and negative emotional states, a better management of the tendency towards sensation seeking, and a decreased emotional reactivity to rewards.

CONCLUSIONS

The present research provides a better understanding of the processes underlying the negative relationship between EI and health risk-taking. Our findings suggest that having higher levels of EI abilities would allow for a more objective evaluation of risk scenarios and a more appropriate and safer decision making through its influence on the levels of impulsivity and emotional reactivity to rewards. Practical implications, limitations, and future lines of research are discussed.

Examining Gender Differences in the Relationship Between School Bonding and Opioid Misuse Among Justice-Involved Adolescents

Justice-involved adolescents (JIAs) have an increased risk for opioid use disorder and overdose related to opioid misuse (OM). Consequences of untreated OM include recidivism and poor educational outcomes, which can be harsher for female JIA. Therefore, identifying relevant factors and settings that reduce the risk for OM is critical. Schools are a central institution in adolescent development. Drawing on social control theory, JIA with higher levels of school bonding was hypothesized to attenuate risk for OM. Cross-sectional data on 79,960 JIA from the Florida Department of Juvenile Justice were examined. Multivariate and stratified logistic regression analyses were employed. On average, for every one-unit increase in school bonding, JIA had 22%, female JIA had 23%, and male JIA had 22% lower odds of OM. Results suggest school bonding and the school context should be considered in treatment and how this setting may impact OM intervention outcomes among JIA.

Gender differences in teenager bullying dynamics and predictors of peer-to-peer intimidation

Thanks to several previous efforts, school peer-to-peer bullying is nowadays considered a major issue for educational dynamics, research, and policy. Specifically in the field of research, bullying assessment tools have been gaining ground in recent years. Among them, the School Bullying Questionnaire (CIE-A) stands out. This is a teenager-targeted scale assessing bullying dynamics from a three-factor approach (i.e., victimization, symptomatology, and intimidation). However, to date, no previous study using similar tools has followed a gender perspective, and this shortcoming may hinder the effectiveness of policies and actions to face school bullying. The core aim of this study was to examine the effect of gender on teenagers' bullying-related factors and intimidation outcomes. This cross-sectional study analyzed the data provided by a gender-weighted sample of 770 Spanish teenagers with a mean age of M = 14.25 (SD = 1.53) years. They responded to a questionnaire that included the CIE-A together with other variables theoretically related to bullying dynamics, such as risk perception, sensation seeking, life satisfaction, and family conflict. Apart from typical inter-group comparisons, data were analyzed through a multi-group structural equation modeling (MGSEM) approach. Regarding bullying experiences, male teenagers have shown greater involvement in both victimization (passive bullying) and intimidation (active harassment) behaviors. On the other hand, females self-reported greater symptomatology in passive bullying scenarios, despite being less frequently involved in them. Further, the MGSEM showed good fit values (RMSEA <.08; all incremental coefficients >0.90) and theoretical plausibility, also depicting a set of structural mechanisms differentially explaining active peer-to-peer intimidation behaviors across genders. For instance, while risk perception is a significant predictor of intimidation only among females, sensation seeking plays a predictive role among male teenagers, but not for their female counterparts. The results of this study suggest that teenagers' engagement in active bullying may be substantially different when approached from a gender perspective, finding key divergences in the variables that predict bullying-related behavioral outcomes. The outcomes of this research highlight the need to take into account gender differences, as well as extracurricular issues that influence intimidation dynamics, in potential bullying-related interventions.

High ambient temperatures associations with children and young adult injury emergency department visits in NYC

Injury is a significant health burden for children and young adult and may be an increasing concern in a warming climate. Research reveals many impacts to children's health associated with hot weather and heatwave events, including a growing literature on the association between high ambient temperature and injury, which may vary by intent such as injury resulting from violence. However, little is known about how this association varies across different types of injury and subgroups of young people. We examined relationships between warm season ambient temperature and intentional and unintentional injury among children and young adults in New York City (NYC). Within a case-crossover design, our study observed injury-related emergency department (ED) visits from the New York Statewide Planning and Research Cooperative System administrative dataset. Injuries were categorized as unintentional or intentional injuries during the warm season (May through September) in NYC from 2005 to 2011 among patients (0, 1-4, 5-9, 10-14, 15-19, 20-25 years old (y.o.)). Conditional logistic regression models with distributed lag non-linear functions were used to model the cumulative odds ratio (OR) injury-related ED visit over 0-5 lag days. Analyses were stratified by age group and sex to understand how associations vary across young people of different age and sex. There were a total of 572 535 injury-related ED visits. The largest effect of elevated temperature (daily minimum 77°F vs 48°F) was for unintentional injury among 5-9 y.o. (OR 1.32, 95% CI 1.23, 1.42) and for intentional injury among 20-25 y.o. (OR 1.54, 95% CI 1.28, 1.85). Further stratified analyses revealed that the highest risk of unintentional injury was among 5-9 y.o. males and 20-25 y.o. males for intentional injury. Our results suggest that high ambient temperatures are associated with higher odds of unintentional and intentional injuries among children. This work adds to a growing body of literature demonstrating the adverse impacts of heat on children, and suggests the need for messaging to parents and children about adopting adaptive strategies to prevent injuries when it is hot outside.

Acceptability of restrictions in the COVID-19 pandemic: a population-based survey in Denmark and Sweden

Introduction

Denmark and Sweden initially adopted different responses to the COVID-19 pandemic although the two countries share many characteristics. Denmark responded swiftly with many mandatory restrictions. In contrast, Sweden relied on voluntary restrictions and a more "relaxed" response during the first wave of the pandemic. However, increased rates of COVID-19 cases led to a new approach that involved many more mandatory restrictions, thus making Sweden's response similar to Denmark's in the second wave of the pandemic.

Aim

The aim was to investigate and compare the extent to which the populations in Denmark and Sweden considered the COVID-19 restrictions to be acceptable during the first two waves of the pandemic. The study also aimed to identify the characteristics of those who were least accepting of the restrictions in the two countries.

Materials and methods

Cross-sectional surveys were conducted in Denmark and Sweden in 2021. The study population was sampled from nationally representative web panels in the two countries, consisting of 2,619 individuals from Denmark and 2,633 from Sweden. The questionnaire captured key socio-demographic characteristics. Acceptability was operationalized based on a theoretical framework consisting of seven constructs and one overarching construct.

Results

The respondents' age and gender patterns were similar in the two countries. The proportion of respondents in Denmark who agreed with the statements ("agree" alternative) that captured various acceptability constructs was generally higher for the first wave than the second wave of the pandemic. The opposite pattern was seen for Sweden. In Denmark, 66% in the first wave and 50% in the second wave were accepting of the restrictions. The corresponding figures for Sweden was 42% (first wave) and 47% (second wave). Low acceptance of the restrictions, defined as the 25% with the lowest total score on the seven acceptability statements, was associated with younger age, male gender and lower education levels.

Conclusion

Respondents in Sweden were more accepting of the restrictions in the second wave, when the country used many mandatory restrictions. In contrast, respondents in Denmark were more accepting of the restrictions in the first wave than in the second wave, implying an increased weariness to comply with the restrictions over time. There were considerable socio-demographic differences between those who expressed low acceptance of the restrictions and the others in both countries, suggesting the importance of tailoring communication about the pandemic to different segments of the population.

Impulsivity and Risk-Taking Behavior in School-Going Adolescents

Introduction Impulsivity (or impulsiveness) and risk-taking behavior are significant concerns as the adolescent population is at a higher risk of injuries and violence, unhealthy sexual behaviors, and drug- and alcohol-related problems. The early identification of these traits in adolescents can prove beneficial through timely interventions. This study was conducted to assess impulsive behavior and risk-taking behavior among school-going adolescents in New Delhi, India, and to study the association, if any, between the two. Methodology A cross-sectional study was conducted among 571 students of classes 9th-10th in three randomly selected schools in a part of Delhi, India. Barratt Impulsiveness Scale - Brief (BIS-Brief) was used to evaluate impulsivity, and risk-taking behavior was assessed using the RT-18 tool. Results The majority (72.3%) of the 571 students were aged 14-15 years. Among the students, 56.0% were males. The impulsivity score obtained ranged from 8 to 30, with a mean score of 15.7 (SD ±4.1). The risk-taking score ranged from 2 to 18, with a mean score of 9.9 (SD ±2.9). Impulsivity was seen to be significantly higher among the female students (p=0.004). The risk-taking behavior was significantly higher among the students from government schools, among the females, and among those who used the internet more. There was a significant direct association between impulsivity and risk-taking behavior among the students (correlation coefficient 0.301, p<0.001). Conclusion The study results showed that the mean impulsivity and risk-taking scores were comparable to other studies in adolescent age groups done internationally using the same tools. Impulsivity and risk-taking behavior were both found to be higher among females. There was a significant direct association between impulsivity and risk-taking.

Offence-specific scripts among juvenile deliberate firesetters: a possible explanation for fire proclivity

The study employed inductive-thematic analysis to identify dynamic cognitive-emotional processes occurring in proximity to deliberate firesetting among a sample of N = 35 adjudicated juvenile firesetters. Six fire-specific themes were determined. Three of these themes are akin to an implicit theory (i.e. a belief system informed by previous experiences): Fire Interest, Fire is Controllable, and Fire Denial/Accidental. Three of these themes are consistent with a cognitive script (i.e. a behavioural guide for how and when to use fire): (a) fire is destructive; (b) fire conceals evidence; and (c) fire creates calm. When reviewed more closely, the theme 'fire is destructive' is composed of two separate subcategories: 'fire creates destructive fun' and 'fire is a destructive tool for revenge'. The findings have risk assessment and treatment implications for juvenile firesetters.

Risk Factors Associated With Driving After Marijuana Use Among US College Students During the COVID-19 Pandemic

PURPOSE

To assess the sociodemographic and behavioral risk factors associated with driving after marijuana use among US college students.

METHODS

A secondary analysis used the fall 2020 and spring 2021 American College Health Association- National College Health Assessment III and the dataset was restricted to college students ≥18 years of age who reported recent driving and marijuana use. Associations between risk factors and driving after marijuana use were estimated using multivariable logistic regression.

RESULTS

A total of 29.9% (n = 4,947) of the respondents reported driving after marijuana use. Males (adjusted odds ratio [AOR]: 1.64, 95% confidence interval [CI]: 1.48-1.82), non-Hispanic Black (AOR: 1.32, 95% CI: 1.02-1.71), sexual minorities (AOR: 1.19, 95% CI: 1.07-1.31), individuals with an alcohol or substance use disorder (AOR: 1.44, 95% CI: 1.08-1.91), anxiety (AOR: 1.20, 95% CI: 1.06-1.36), higher suicidality (AOR: 1.18, 95% CI: 1.07-1.31), and those who also drank and drove (AOR: 3.18, 95% CI: 2.84-3.57) had a higher risk of driving after marijuana use.

DISCUSSION

Future research should focus on increasing awareness of driving after marijuana use and prevention programs and/or strategies on college campuses regarding driving after marijuana use for these groups to reduce this risky behavior.

The effects of moral norms and anticipated guilt on COVID19 prevention behaviors

Studies have shown that older adolescents have a low perceived personal risk of COVID-19, and yet their ability and willingness to engage in COVID-19 prevention behaviors is imperative for community health. Thus, health communication scholars need to consider alternative psycho-social predictors of prevention behaviors that will assist in protecting others in a pandemic. Based on Schwartz's Norms Activation Model (NAM; Schwartz, 1977), we examined the relationship between moral norms and COVID-19 prevention behaviors (mask wearing and physical distancing). We predicted that anticipated guilt would mediate the relationship between moral norms and intention to engage in prevention behaviors, and that collective orientation would strengthen the association between moral norms and anticipated guilt. We tested predictions with data from a cross-sectional survey with a probability-based sample of college students at a large land grant university. These data indicated that moral norms were associated with behavioral intention, and this relationship was mediated by anticipated guilt. Collective orientation was found to moderate the relationship between moral norms and anticipated guilt in the context of physical distancing but not mask wearing. These findings suggest that making moral norms salient when designing an intervention is an effective strategy for older adolescents.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04477-5.

Outrunning a bad diet: interactions between exercise and a Western-style diet for adolescent mental health, metabolism and microbes

Adolescence is a period of biological, psychological and social changes, and the peak time for the emergence of mental health problems. During this life stage, brain plasticity including hippocampal neurogenesis is increased, which is crucial for cognitive functions and regulation of emotional responses. The hippocampus is especially susceptible to environmental and lifestyle influences, mediated by changes in physiological systems, resulting in enhanced brain plasticity but also an elevated risk for developing mental health problems. Indeed, adolescence is accompanied by increased activation of the maturing hypothalamic-pituitary-adrenal axis, sensitivity to metabolic changes due to increased nutritional needs and hormonal changes, and gut microbiota maturation. Importantly, dietary habits and levels of physical activity significantly impact these systems. In this review, the interactions between exercise and Western-style diets, which are high in fat and sugar, on adolescent stress susceptibility, metabolism and the gut microbiota are explored. We provide an overview of current knowledge on implications of these interactions for hippocampal function and adolescent mental health, and speculate on potential mechanisms which require further investigation.

Predicting individual differences in behavioral activation and behavioral inhibition from functional networks in the resting EEG

The behavioral activation system (BAS) and behavioral inhibition system (BIS) are thought to underly affective dispositions and self-regulatory processes. The BAS is sensitive to reward and involved in approach behaviors, and the BIS is sensitive to punishment and involved in avoidance behaviors. Trait BAS and BIS relate to distinct behavioral profiles and neural activity, but little is known about how trait BAS and BIS relate to functional networks in EEG. We applied a data-driven method called connectome predictive modeling (CPM) to identify networks relating to trait BAS and BIS and tested whether the strength of those networks predicted trait BAS and BIS in novel subjects using a leave-one-out cross-validation procedure. Adult participants (N = 107) completed a resting state task with eyes closed and eyes open, and trait BAS and BIS were measured via Carver and White's (1994) BIS and BAS scales. We hypothesized distinct positive (more synchronization) and negative (less synchronization) networks would relate to trait BAS and BIS. For eyes closed, we identified two negative networks, one in theta and one in alpha predicted BIS. We identified three positive networks, one in theta and one in beta predicted Fun Seeking and one in theta predicted Drive. For eyes open, negative theta and alpha networks predicted BIS, a positive theta network predicted Fun Seeking, and a negative gamma network predicted mean BAS. Visualization of the networks are presented. Discussion centers on the observed networks and how to advance application of CPM to EEG, including with clinical implications.

Prevalence and Factors Associated with Risky Sexual Behaviors Among Sexually Active Female Adolescents in Zambia

Despite decades long commitment to women's reproductive health rights, sexually transmitted diseases and unintended pregnancies continue to be major public health concerns in sub-Saharan Africa. In order to provide an evidence base for future policy and services, this study aims to explore the prevalence and factors associated with risky sexual behaviors (RSB) among sexually active Zambian female adolescents using a nationally representative sample. Data on females, aged 15-19 (n = 3000), were obtained from the 2018 Zambia Demographic and Health Survey, an interviewer-administered, nationally representative survey that used multistage sampling. The study conducted multiple logistic regression to explore the correlates of RSB. Of the 3000 respondents, 49.7% (1490) reported ever having sexual intercourse of which 71.1% reported engaging in RSB. Among sexually active female adolescents, the following RSB percentage were reported: intercourse before age 16 (50.6%), nonuse of condoms at last intercourse (37.8%), engaging in transactional sex (6.2%), alcohol use at last intercourse (4.6%), and multiple sexual partners (1.9%). Educational attainment and household wealth showed strong inverse trends with RSB risk and there were notably large geographic differences in RSB within Zambia (22.1% in Lusaka region vs. 62.4% in Western province). The multiple logistic regression results revealed that those who were younger, unmarried, with less than secondary education, without access to Internet, and residents of Western Zambia were significantly more likely to have engaged in RSB (AOR: 1.74-7.69, p < 0.05). Given the negative health outcomes associated with RSB, Zambian adolescent health care programs may strategically target limited resources to the identified risk groups.

The Role of Emotional Dysregulation, Impulsivity Traits and Aggressive Behaviors in Adolescents Who Sustain Multiple Motor-Vehicle Crashes

Adolescents tend to experience multiple motor-vehicle crashes (MVCs). Recent literature has thoroughly explored the psychological consequences following an MVC, but prior psychological functioning, the ability to regulate one's emotions and tendencies to impulsivity and aggressive behaviors have been far less explored. This study aims to explore the emotional-behavioral functioning, measured with the Youth Self-Report (YSR); emotional dysregulation, measured with the Difficulties in Emotional Regulation Scale (DERS); impulsivity traits, measured with the Barratt Impulsiveness Scale (BIS-11); and the capacity to be mindful, measured with the Mindful Attention Awareness Scale (MAAS), in adolescents that have experienced one or more MVCs in a year. N = 295 adolescents who visited an emergency department for MVCs were divided in two groups based on the number of MVCs they had sustained over the course of a year. The adolescents in Group 1 sustained more than three MVCs, and adolescents in Group 2 sustained only one. Participants were assessed through self-report questionnaires. Adolescents showed difficulties in emotional regulation, impulsivity traits, aggressive behaviors and a low capacity to be mindful. These results may be useful in the creation of intervention and prevention programs focused on emotional awareness targets for adolescents.

Intervention initiatives to raise young people’s interest and participation in STEM

For nearly a decade, two science interventions anchored in project-based learning (PBL) principles have been shown to increase student science learning in 3rd grade and high school physical science classes. Both interventions employed a randomized control trial of several thousand students (N = 3,271 in 3rd grade and N = 4,238 in 10th, 11th, and 12th grades). Incorporating a rich background of research studies and reports, the two interventions are based on the ideas of PBL as well as the National Academies of Science’s publications, including how children learn; how science learning and instruction can be transformed; and the performance expectations for science learning articulated in the Next Generation of Science Standards. Results show significant positive increases in student academic, social, and emotional learning in both elementary and secondary school. These findings can be traced, in part, to carefully crafted experiential participatory activities and high-quality instructional materials which act as strong facilitators for knowledge acquisition and use. Reviewing the innovations undertaken by these two interventions, this article describes the importance of studying social and emotional factors ‘in situ’, using the Experience Sampling Method (ESM), that can motivate and engage students in science learning in both elementary and secondary school. Using these ‘in situ’ data collection (N = 596 students in 3rd and N = 1412 students in 10th, 11th, and 12th grades) along with case studies and repeated measures analysis gave deep insights into emotional and social development for young children and adolescents. These methods should continue to be considered when trying to understand key factors of improving engagement in science.

Perceptions of and adherence to early COVID-19-related restrictions and associations with substance use among youth in Canada

INTRODUCTION

As a largely social behaviour, substance use may have decreased for some youth overall in Canada during the COVID-19 pandemic; however, continued use may indicate nonadherence to pandemic-related restrictions and social distancing measures. In a sample of Canadian adolescents (aged 12-19 years), our objective was to examine how substance use (cannabis, binge drinking, cigarettes, vaping) is associated with perceptions of, and adherence to, early COVID-19-related public health measures, taking into consideration sociodemographic factors.

METHODS

Cross-sectional data were retrieved from online data collected during Year 8 of the COMPASS school-based study, during the early months of the COVID-19 pandemic (May-July 2020) in British Columbia, Ontario and Quebec. We fitted two models using generalized estimating equations to examine how substance use was associated with separate measures of (1) perceptions of, and (2) adherence to early COVID-19 restrictions.

RESULTS

In our sample, 10% of adolescents perceived COVID-19 restrictions as too weak and 14% perceived them as too strict. Nearly half (46%) reported taking restrictions very seriously, and 5% did not take them seriously at all. Binge drinking, cigarette use and vaping were associated with perceptions that restrictions were too strict and with nonadherence. However, adolescents who used cannabis were less likely to perceive COVID-19-related restrictions as too strict.

CONCLUSION

This study highlights the association of adolescent substance use with perceptions of, and adherence to, COVID-19-related public health restrictions in Canada. Our findings emphasize a need for continual monitoring of substance use behaviours during the COVID-19 pandemic to better characterize adolescent risk and further inform targeted public health strategies accordingly.

Risk Factors for Accidents and Close Calls in Junior Freeriders, Adolescent Alpine Skiers and Adult Freeriders-A Comparison

Understanding factors associated with risk-taking behavior, accidents and close calls could enhance prevention strategies and thus contribute to preventing serious injury or death in the long term. The following study aims to assess these factors in junior freeride athletes in comparison with competitive alpine skiers of similar age and adult freeriders. A cross-sectional questionnaire design was used to assess risk-related variables and potential associated factors. Accident and close call involvement did not significantly differ between the groups (p > 0.080). No significant relationships between gender and risk-related variables were found (|r| < 0.26). Precautionary behavior was higher in freeride adults and freeride juniors compared to alpine skiers (p < 0.001) and deliberate risk-taking was lower in freeride adults compared to junior freeriders and alpine skiers (p < 0.001). Regression analyses revealed that the association between self-objectification and accidents was stronger in freeride juniors compared to alpine skiers of similar age and freeride adults (p < 0.049). Although accidents and close calls were similar between groups, age seems to be an associated variable to deliberate risk-taking and precautionary behavior. The relationship between accidents and self-objectification in freeride juniors implicates a need for risk education in freeriders in the sensitive phase of adolescence beyond the mere presentation of environmental dangers.

Planning a digital intervention for adolescents with asthma (BREATHE4T): A theory-, evidence- and Person-Based Approach to identify key behavioural issues

OBJECTIVES

To describe a transparent approach to planning a digital intervention for adolescents to self-manage their asthma using breathing retraining (BRT), based on an existing, effective adult intervention (BREATHE).

METHODS

A theory-, evidence-, and Person-Based Approach was used to maximise the effectiveness and persuasiveness of the intervention. A scoping review and semistructured interviews with target intervention users (N = 18, adolescents aged 12-17 years with asthma and parents) were carried out to explore user perspectives, barriers, and facilitators towards the intended behaviours and potential intervention features. The combined evidence was used alongside and to inform theory-based activities and enabled iterative planning of the intervention.

RESULTS

The scoping review identified themes relating to user-specific self-management issues, content, education, training needs, and features for a digital intervention. Interviews elicited potential barriers to intended behaviours such as the anticipated embarrassment of using BRT and concerns around remaining calm. Facilitators included BRT delivered by adolescents who share experiences of asthma and information for performing exercises discreetly. Relevant theoretical frameworks ensured that appropriate psychological constructs were targeted. A behavioural analysis identified six intervention functions and thirty behaviour change techniques. Logic modelling mapped the programme theory and mechanisms, which aims to improve adolescent asthma-related quality of life.

CONCLUSIONS

This study gives a transparent insight into the approach followed to plan a self-guided BRT intervention for adolescents and has led to identification of key behavioural issues, enabling relevant intervention content to be chosen. Insight has been given into adolescent perceptions of BRT, which facilitated development of the prototype intervention.

Behavioral problems in anxious youth: Cross-sectional and prospective associations with reinforcement sensitivity and parental rejection

A subsample of children and young people (CYP) with anxiety disorders presents with comorbid behavioral problems. These CYP have greater impairment in daily life, profit less from current treatments, and have an increased risk for continued mental problems. We investigated two potential explanations for these comorbid behavioral problems. First, high punishment sensitivity (PS) may lead to a strong inclination to experience threat, which may not only elicit anxiety but also defensive behavioral problems. Second, behavioral problems may arise from high reward sensitivity (RS), when rewards are not obtained. Behavioral problems may subsequently elicit parental rejection, thereby fueling anxiety. We used a cross-sectional (age = 16.1, N = 61) and prospective (age = 22.2, N = 91) approach to test the relationship between PS/RS and comorbid behavioral problems. Participants were a subsample of highly anxious CYP from a large prospective cohort study. PS/RS were indexed by a spatial orientation task. We also investigated the prospective association between behavioral problems and anxiety at 6-year follow-up, and the proposed mediation by parental rejection. PS and RS showed no cross-sectional or prospective relationships with comorbid behavioral problems in highly anxious CYP. Yet, behavioral problems in adolescence showed a small prospective relationship with anxiety in young adulthood, but this was not mediated nor moderated by parental rejection. No evidence was found for PS/RS being involved in comorbid behavioral problems in anxious CYP. Findings point to comorbid behavioral problems as potential factor contributing to the further increase of anxiety.

COVID-19 vaccine hesitancy and its determinants among sub-Saharan African adolescents

COVID-19 vaccine hesitancy among adolescents poses a challenge to the global effort to control the pandemic. This multi-country survey aimed to assess the prevalence and determinants of COVID-19 vaccine hesitancy among adolescents in sub-Saharan Africa between July and December 2021. The survey was conducted using computer-assisted telephone interviewing among adolescents in five sub-Saharan African countries, Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania. A rural area and an urban area were included in each country (except Ghana, which only had a rural area), with approximately 300 adolescents in each area and 2662 in total. Sociodemographic characteristics and perceptions and attitudes on COVID-19 vaccines were measured. Vaccine hesitancy was defined as definitely not getting vaccinated or being undecided on whether to get vaccinated if a COVID-19 vaccine were available. Log-binomial models were used to calculate the adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for associations between potential determinants and COVID-19 vaccine hesitancy. The percentage of COVID-19 vaccine hesitancy was 14% in rural Kersa, 23% in rural Ibadan, 31% in rural Nouna, 32% in urban Ouagadougou, 37% in urban Addis Ababa, 48% in rural Kintampo, 65% in urban Lagos, 76% in urban Dar es Salaam, and 88% in rural Dodoma. Perceived low necessity, concerns about vaccine safety, and concerns about vaccine effectiveness were the leading reasons for hesitancy. Healthcare workers, parents or family members, and schoolteachers had the greatest impacts on vaccine willingness. Perceived lack of safety (aPR: 3.52; 95% CI: 3.00, 4.13) and lack of effectiveness (aPR: 3.46; 95% CI: 2.97, 4.03) were associated with greater vaccine hesitancy. The prevalence of COVID-19 vaccine hesitancy among adolescents is alarmingly high across the five sub-Saharan African countries, especially in Tanzania. COVID-19 vaccination campaigns among sub-Saharan African adolescents should address their concerns and misconceptions about vaccine safety and effectiveness.

Energy Drinks and Sleep among Adolescents

Many adolescents worldwide have the problem of meeting recommended nightly sleep hours. The causes of sleep disturbance are multifactorial, but interest in food’s effect on sleep has dramatically increased lately. In this study, we investigated the association between regular energy drink (ED) intake (weekly or more frequent) and sufficient sleep (SS) (≥8 h) in adolescents. Additional objectives were to examine the relationship between health-related behaviors and SS, stratified by gender. A population-based cross-sectional study was conducted during the 2019/2020 school year from 12 schools in Belgrade. There were 1287 students aged 15 to 19 who participated (37.4% male). We used a modified version of the food frequency questionnaire adapted for Serbian adolescents. Logistic regression revealed that regular ED consumption was an independent risk factor negatively related to SS in both sexes. Additionally, daily vegetable and water intake (≥2 L) showed a positive correlation with SS in boys, while in girls, the odds of realizing SS decreased with statements of sedative use. In conclusion, we show that ED intake is negatively associated with SS in both sexes; daily vegetable and water intake (≥2 L) may raise the odds of SS in boys, while sedative use may decrease the chances of SS in girls.

The personality and cognitive traits associated with adolescents' sensitivity to social norms

Little is known about the personality and cognitive traits that shape adolescents' sensitivity to social norms. Further, few studies have harnessed novel empirical tools to elicit sensitivity to social norms among adolescent populations. This paper examines the association between sensitivity to norms and various personality and cognitive traits using an incentivised rule-following task grounded in Game Theory. Cross-sectional data were obtained from 1274 adolescents. Self-administered questionnaires were used to measure personality traits as well as other psychosocial characteristics. Incentivised rule-following experiments gauged sensitivity to social norms. A series of multilevel mixed effects ordered logistic regression models were employed to assess the association between sensitivity to norms and the personality and cognitive traits. The results highlighted statistically significant univariate associations between the personality and cognitive traits and sensitivity to norms. However, in the multivariate adjusted model, the only factor associated with sensitivity to norms was gender. The gender-stratified analyses revealed differences in the personality and cognitive traits associated with sensitivity to norms across genders. For males need to belong was significantly negatively associated with sensitivity to norms in the multivariate model. By comparison, emotional stability was negatively associated with sensitivity to norms for females. This study reinforced the findings from an earlier study and suggested female adolescents had higher levels of sensitivity to norms. The results indicated no consistent pattern between sensitivity to norms and the personality and cognitive traits. Our findings provide a basis for further empirical research on a relatively nascent construct, and bring a fresh perspective to the question of norm-following preferences among this age group.

The relationship between self-reported ability emotional intelligence and risky driving behaviour: Consequences for accident and traffic ticket rate

Road safety represents one of the main public health issues worldwide, and risky driving behaviour is one of the most predominant factors in traffic road accidents. The primary objective of this research was to clarify the relationship between emotional intelligence (EI) abilities and the probability of engaging in risky behaviour during driving. Previous literature linking these constructs is limited, and research has yielded mixed findings. In the present study, 555 drivers from a Spanish community sample (M_age = 39.34, ranging from 18 to 79 years old; 49.19% women) were assessed on risky driving behaviour using the Dula Dangerous Driving Index while self-reported ability EI was measured using the Wong and Law Emotional Intelligence Scale. Gender, age, and driving experience were controlled. The results of this study revealed that a higher self-reported ability EI, particularly the ability to regulate emotions, was related to a lower tendency to engage in risky driving behaviours. In turn, self-reported ability EI was negatively and indirectly related to the number of road accidents and traffic tickets through the mediating effect of risky driving. The regulation of emotions (via direct and indirect effect) and the appraisal of the emotions of others (via direct effect) were the EI abilities that better predicted the number of accidents and traffic tickets. We discuss the practical implications of these findings, along with suggested future lines of research.

Differences between risk perception and risk-taking are related to impulsivity levels

Background

Although there is broad agreement that perceived risks determine risk-taking behavior, previous research has shown that this association may not be as straightforward as expected. The main objective of this study was to investigate if the levels of impulsivity can explain part of these controversial findings.

Method

A total of 1579 participants (M_age = 23.06, from 18 to 60 years; 69.4% women) were assessed for levels of risk perception, risk-taking avoidance, and impulsivity.

Results

The results showed that while impulsivity was significantly and negatively related to both risk perception and risk-taking avoidance, the relationship with risk-taking avoidance was significantly stronger than with risk perception. The levels of impulsivity predicted risk-taking avoidance even when controlling for risk perception.

Conclusions

These findings indicate that impulsivity can differentially affect risk perception and risk-taking. We propose that the stronger influence of impulsivity on risk-taking is due to the greater reliance of risk-taking, compared with risk perception, on automatic processes guided by impulses and emotions.

COVID-19 vaccination: patient uptake and attitudes in a multi-ethnic North London maternity unit

PURPOSE

COVID-19 vaccine uptake among pregnant women has been low, particularly in younger and ethnic minority mothers. We performed a 'snapshot' survey to explore vaccine uptake and factors which influence this, as well as underlying beliefs regarding COVID-19 vaccination among pregnant women in a North London hospital.

STUDY DESIGN

Pregnant women were invited to complete an anonymised survey, where data were collected on demographics, personal and household vaccination status, and beliefs about the vaccine. Free-text comments were analysed thematically.

RESULTS

Two hundred and two women completed the survey, of whom 56.9% (n=115) were unvaccinated and 43.1% (n=87) had received at least one dose of COVID-19 vaccine, with 35.6% (n=72) having received two doses. Factors associated with acceptance of vaccination included: (a) age over 25 years (57.6% vaccinated vs 17.2% under 25 years); (b) Asian ethnicity (69.4% vaccinated vs 41.2% white ethnicity, 27.5% black/Caribbean/African/black-British ethnicity and 12.5% mixed ethnicity) and (c) living in a vaccinated household (63.7% vaccinated vs 9.7% living in an unvaccinated household) (all p<0.001). Vaccine uptake was higher in women who had relied on formal medical advice as their main source of information compared with other sources (59.0% vs 37.5% friends and family, 30.4% news and 21.4% social media). Qualitative data revealed concerns about a lack of information regarding the safety of COVID-19 vaccination in pregnancy.

CONCLUSION

Age, ethnicity, household vaccination status and information source influenced vaccination status in our pregnant population. These findings highlight the urgent need to tackle vaccine mistrust and disseminate pregnancy-specific vaccine safety data to pregnant women.

TRIAL REGISTRATION NUMBER

5467.

Why take the risk? Exploring the psychosocial determinants of floodwater driving

As anthropogenic climate change progresses, there is an increasing need for individuals to make appropriate decisions regarding their approach to extreme weather events. Natural hazards are involuntary risk environments (e.g., flooded roads); interaction with them cannot be avoided (i.e., a decision must be made about how to engage). While the psychological and sociocultural predictors of engagement with voluntary risks (i.e., risk situations that are sought out) are well-documented, less is known about the factors that predict engagement with involuntary risk environments. This exploratory study assessed whether mental health (depression, anxiety, and stress symptoms), personality traits, and cultural worldviews combine to predict engagement with involuntary risk, using the situation of floodwater driving. An Australian sample (N = 235) was assessed via questionnaire and scenario measures. Results were analyzed in a binomial logistic regression assessing which individual factors predicted decision-making in a proxy floodwater driving scenario. Agreeableness and gender were individually significant predictors of floodwater driving intention, and four factors (named “affect,” “progressiveness,” “insightfulness,” and “purposefulness”) were derived from an exploratory factor analysis using the variables of interest, though only two (“progressiveness” and “insightfulness”) predicted floodwater driving intention in an exploratory binomial logistic regression. The findings highlight the need for further research into the differences between voluntary and involuntary risk. The implication of cultural worldviews and personality traits in interaction with mental health indicators on risk situations is discussed.

Impact of the COVID-19 pandemic on psychological distress and biological rhythm in China’s general population: A path analysis model

Objective

When facing major emergency public accidents, men and women may react differently. Our research aimed to assess the influence of gender difference on social support, information preference, biological rhythm, psychological distress, and the possible interaction among these factors during the COVID-19 pandemic.

Methods

In this cross-sectional study, 3,237 respondents aged 12 years and older finished the online survey. Levels of social support, information preference, biological rhythm, and psychological distress were assessed using validated scales. A path analysis was conducted to explore possible associations among these variables.

Results

The path analysis indicated that women with high levels of social support had a lower possibility of biological rhythm disorders and lower levels of somatization symptoms of psychological distress during the COVID-19 pandemic. The influence of social support on somatization symptoms was exerted via biological rhythm. Women tended to believe both negative and positive information, while men preferred more extreme information.

Conclusion

Our results highlighted gender difference in study variables during the COVID-19 pandemic and the importance of social support in alleviating psychological distress and biological rhythm disorders. Moreover, we confirmed that information preference differed significantly by somatization symptoms of psychological distress, suggesting extra efforts to provide more individualized epidemic information. Longitudinal research is required to further explore casual inferences.

Collisions with another person while skiing and snowboarding: A 13-year national registry analysis

INTRODUCTION

Interindividual collisions while skiing or snowboarding occur regularly, they can be associated with severe injuries.

OBJECTIVE

To elucidate causes of accidents, injury patterns and potential risk factors for injury severity in interindividual collisions of skiers and snowboarders.

MATERIAL AND METHODS

Retrospective analysis of the Austrian Registry for Mountain Accidents within a 13-year timeframe (2005-2018) with regard to on- or off-piste collisions of skiers and snowboarders.

RESULTS

A total of 30,503 collisions, involving 52,430 (85.9%) skiers and 8,576 (14.1%) snowboarders were analysed. Denominators are lacking, since total numbers of skiers and snowboarders were not available. Compared to skiers, snowboarders were younger (23 vs. 42 years; p<0.001), predominantly male (77.4% vs. 61.0%; p<0.001) and less often severely injured (46.8% vs. 26.2%; p<0.001). Most accidents occurred on slopes (>95%). Collisions involving two snowboarders occurred proportionally more often in terrain parks (4.1% of 1,664 injured snowboarders; p<0.001) and while one victim was standing or sitting (9.7%; p<0.001). Contusions/strains/sprains were most prevalent (>23%), as were head injuries (>12%). In skiers, chest, shoulder, hip, thigh and knee injuries occurred more often, leading to fractures, dislocations, concussions and internal injuries more frequently. In snowboarders, spine/back, elbow, forearm, wrist and lower leg injuries were more prevalent. Female gender and standing or sitting prior to the accident was a risk factor for being more severely injured in collisions involving i) two skiers (OR: 4.02 (3.79-4.26) and 3.91 (3.26-4.68)), ii) a skier and a snowboarder (OR: 4.50 (3.95-5.14) and 11.49 (8.04-16.41)) or iii) two snowboarders (OR: 2.85 (2.12-3.84) and 12.47 (6.17-25.20)). Wearing a helmet increased the risk when two skiers collided (OR: 1.10 (1.03-1.17)). In skier vs. snowboarder collisions, the skier had a higher risk of being injured more severely (OR: 7.93 (6.98-9.01)).

CONCLUSIONS

In interindividual collisions of skiers and snowboarders, injury patterns and preceding causes differ substantially. Skiers are more likely to be severely injured. Awareness of an increased risk of injury should be raised particularly while standing or sitting on the slope.

Prenatal Morphine Exposure Differentially Alters Addictive and Emotional Behavior in Adolescent and Adult Rats in a Sex-Specific Manner

The effects of prenatal opioid exposure in adult animals has been widely studied, but little is known about the effects of prenatal opioid on adolescents. Most of the risk behaviors associated with drug abuse are initiated during adolescence. The developmental state of the adolescent brain makes it vulnerable to initiate drug use and susceptible to drug-induced brain changes. In this study, pregnant rats were subcutaneously injected with an increasing dose of morphine (5 mg/kg, 7 mg/kg, 10 mg/kg) for 9 days since the gestation day 11. The effects of prenatal morphine (PNM) on learning and memory, anxiety- and depressive- like behavior, morphine induced conditioned place preference (CPP) as well as locomotor sensitization were tested in both adolescent and adult rats. The results showed that: (1) PNM decreased anxiety-like behavior in both adolescent and adult female rats, but not males; (2) PNM decreased depressive-like behavior in adolescent but increased depressive -like behavior in adult females; (3) PNM increased low dose morphine induced locomotor sensitization in females; (4) PNM decreased tyrosine hydroxylase (TH) expression in the prefrontal cortex but decreased dopamine D1 receptor expression in the nucleus-accumbens (NAc) in female rats. These results suggested that PNM altered the emotional and addictive behavior mainly in female rats, with female rats being less anxiety and depressive during adolescence, but more depressive in adult, and more sensitive to low dose morphine induced locomotor activity sensitization, which might be mediated in part by the differential expression of the TH, dopamine D1 receptors in the female brain.

Enabling successful transition-Evaluation of a transition to adult care program for pediatric liver transplant recipients

BACKGROUND

This study aimed to evaluate the transition to adult care program instituted for liver transplant recipients (LTRs) at a large tertiary pediatric hospital in Melbourne, Australia. Evaluation included the change in a Global Assessment Measure (GAM) before and after the transition program, satisfaction with the program, and measures of transition success including rejection rates and attendance at appointments post-transfer. We hypothesized that the introduction of our structured transition program would improve disease understanding, health system understanding, and self-care. We also hypothesized that those who had undergone the transition program would have lower failure to attend rates and lower rates of rejection than historical controls.

METHODS

A LTR transition program was instituted at our service from 2013 to 2015. The program involved initial assessment of competencies with a Global Assessment Measure (GAM), followed by the introduction of a personalized goal setting program addressing issues identified in dedicated transition clinics. Assessment of competencies was compared between the commencement of the program and immediately prior to transfer. Patient satisfaction with the transition process was assessed at an interview 6-12 months after transfer to the adult service. Rejection rates and failure to attend rates were compared between the intervention group and a group of LTRs who did not receive the intervention.

RESULTS

Twenty-eight LTRs participated in the study; 20 received the transition intervention and 8 served as controls. Within the intervention group, all domains of transition competency and reported anxiety regarding transferring had significantly improved at the conclusion of the intervention and all reported satisfaction with the transition program with most (81%) reporting readiness to transfer. There were no significant differences in rejection rates or failure to attend rates between those who did and did not receive the transition intervention.

CONCLUSION

A longitudinal holistic transition program has the potential to positively impact the competencies and readiness of LTRs to successful transition and transfer to adult care.

HIGH RATE OF HCV REINFECTION AMONG RECENTLY INJECTING DRUG USERS: RESULTS FROM THE TRAP HEP C PROGRAM - A PROSPECTIVE NATIONWIDE, POPULATION-BASED STUDY

BACKGROUND

The Treatment as Prevention for Hepatitis C program started in 2016 in Iceland, offering treatment with direct-acting antivirals to hepatitis C virus (HCV)-infected individuals. Reinfections through injection drug use (IDU) can hamper elimination efforts. We determined reinfection rates (RIR) of HCV among patients in the program.

METHODS

Clinical data were gathered prospectively. The study cohort consisted of HCV-cured patients with an estimated sustained virologic response between February 1st 2016 and November 20th 2018, with follow-up until November 20th 2019. The observation period and time until reinfection was estimated using a single random point imputation method coupled with Monte Carlo simulation. The RIR was expressed as reinfections/100 person-years (PYs).

RESULTS

640 treatments of 614 patients (417 males, mean age 44.3 years) resulted in cure, with 52 reinfections subsequently confirmed in 50 patients (37 males). Follow-up was 672.1 PYs with median time to reinfection of 231.7 days. History of IDU was reported by 523 patients (84.8%) and recent IDU with 220 (34.4%) treatments. Stimulants were the preferred injected drug in 85.5% of patients with history of IDU. The RIR was 7.7/100 PYs. Using multivariate Cox proportional hazards models for interval-censored data, age (HR 0.96, 95% CI 0.94-0.99) and recent IDU (HR 2.91, 95% CI 1.48-5.76) were significantly associated with reinfection risk.

CONCLUSIONS

The RIR is high in a setting of widespread stimulant use, particularly in young people with recent IDU. Regular follow up is important among high-risk populations to diagnose reinfections early and reduce transmission.

Investigating COVID-19 risk perception and preventive behaviours in third-level students in Ireland

Objectives

The novel coronavirus outbreak required the population's compliance with public health measures yet young adults have been identified as having low risk perceptions and relatively low adherence with preventive measures. This study investigated third-level students' COVID-19 risk perception, knowledge and attitudes, and preventive behaviours between February and June 2021 to further understand young adults' beliefs and behavioural response to the COVID-19 pandemic in Ireland.

Design

Cross-sectional quantitative online survey design.

Methods

Three hundred and sixty-four university students completed an online survey which measured risk perception, preventive behaviours, knowledge of COVID-19, vaccination attitude and source of COVID-19 information.

Results

University students in Ireland reported high levels of knowledge of COVID-19 and high adherence to preventive behaviours. While risk perception levels were moderately high, students displayed higher concern for others than for themselves. High levels of risk perception significantly predicted preventive behaviours while general knowledge of the virus increased the likelihood of vaccine uptake. Over two-thirds of participants were willing to take the COVID-19 vaccine if available.

Conclusions

Vaccination hesitancy remains a concern among the young adult population requiring urgent attention from public health officials. The implication for health policymakers is that positive behavioural responses of the young population can be reinforced by targeting risk perceptions and by increasing the public's knowledge and understanding of COVID-19.

Personality as a Possible Intervention Target to Prevent Traumatic Events in Adolescence

Traumatic events (severe injury, violence, threatened death) are commonly experienced by children. Such events are associated with a dose-response increasing risk of subsequent substance use, mental illness, chronic disease, and premature mortality. Preventing the accumulation of traumatic events is thus an urgent public health priority. Substance use risk personality profiles (impulsivity, sensation seeking, hopelessness, and anxiety sensitivity) may be an important target for preventing trauma exposure, given associations between these personality traits and risky behaviour, substance misuse, and injuries across adolescence. The current study aimed to investigate associations between personality at age 13 and the number of traumatic events experienced by age 18. It also examined associations between traumas before age 13 and personality at age 13. Participants were the control group of a cluster-randomised controlled trial examining prevention of adolescent alcohol misuse. Baseline data were collected at ages 12–13 (2012). Participants were followed-up at ages 18–19 (2017–2018). Personality profiles of hopelessness, anxiety sensitivity, impulsivity, and sensation seeking were measured at baseline using the Substance Use Risk Profile Scale. Traumatic events and age of exposure were measured at age 18–19 using the Life Events Checklist for DSM-5. Mixed-effect regression was conducted on 287 participants in Stata 17, controlling for sex. High scores on hopelessness, impulsivity, and sensation seeking at age 13 were associated with a greater number of traumatic events by age 18. Impulsivity and sensation seeking predicted the number of new traumatic events from age 13 to 18. Prior trauma exposure was associated with high hopelessness at age 13. Adolescents exhibiting high impulsivity or sensation seeking may be at greater risk of experiencing traumatic events. Additionally, early trauma exposure may contribute to the development of a hopelessness personality trait.

Stability of Risk Perception Across Pandemic and Non-pandemic Situations Among Young Adults: Evaluating the Impact of Individual Differences

Previous research suggests a higher perceived risk associated with a risky behavior predicts a lower likelihood of involvement in that behavior; however, this relationship can vary based on personality characteristics such as impulsivity and behavioral activation. During the COVID-19 pandemic, individuals began to re-evaluate the level of risk associated with everyday behaviors. But what about risks associated with “typical” risk-taking behaviors? In the present study, 248 undergraduate student participants completed measures of impulsivity, behavioral activation and inhibition, propensity to take risks, numeracy, and perceptions of and involvement in both risk-taking behavior and health promoting behavior (e.g., blood donation, registering as an organ donor, vaccination). Our study revealed that higher behavioral inhibition and greater propensity to take risks predicted greater likelihood of involvement in COVID-19-related risk behaviors, even after accounting for perceived risks and benefits of the behavior. Greater likelihood of involvement in social risk behaviors was predicted by greater numeracy and risk-taking propensity. Identifying as male, a greater propensity to take risks, and greater impulsivity predicted increased health/safety risk behaviors. Younger age, lower risk-taking propensity, and lower impulsivity were associated with a greater likelihood of donating blood. For the likelihood of registering to become an organ donor, increasing risk perception, both before and during the pandemic, was associated with greater likelihood of registering, but greater risk-taking propensity was associated with a decreased likelihood of organ donation registration. For flu vaccination, a greater propensity to take risks was associated with a greater likelihood of flu vaccination during the 2020–2021 flu season. Both cognitive and personality factors can predict involvement in risk-taking and health-promotion behaviors, warranting their continued examination.