What May Be Associated with Young Adult E-Cigarette Use? Examination of Key Correlates

Given increasing rates of e-cigarette use among young adults, research is needed on the attitudes and beliefs that drive use among this age group. Tobacco control approaches used to prevent cigarette smoking may not work as effectively for preventing e-cigarette use. To address this research gap, the present study applied the Integrated Behavior Model (IBM) encompassing the affect heuristic theory to examine the individual-level determinants (i.e., attitude, perceived norm, personal agency, intention, and e-cigarette risk perception) of young adults\u27 e-cigarette use. The 2013-2014 Population Assessment of Tobacco and Health (PATH) Study Wave 1 baseline adult dataset consisted of 9,112 young adults (ages 18-24). A total of 3,887 (42.7%) reported ever having used an e-cigarette even one or two times, and reported now using e-cigarettes every day (n=160), some days (n=947), or not at all/non-users (2,780). Structural equation modeling (SEM) indicated that both the affect heuristic theory and constructs adapted from the IBM were significant drivers of e-cigarette use among young adults. The final structural model demonstrated acceptable fit (CFI = 0.935; TLI = 0.925; RMSEA = 0.024, 90% CI: 0.022-0.026). As expected for the IBM, as young adults’ positive feelings, perceived benefits, and normative beliefs of e-cigarettes increased, their intention to quit e-cigarettes decreased; which increased the likelihood of currently using e-cigarettes. As perceived benefit and positive feelings increased, young adults\u27 risk perceptions decreased resulting in a higher likelihood of using the device. These findings suggest that future communication, educational, and policy strategies to prevent e-cigarette use among young adults should highlight the health risk of e-cigarettes to address the high perceived benefits and low risk perceptions reported by young adults in this study

Designing Effective Tsunami Messages: Examining the Role of Short Messages and Fear in Warning Response

Although tsunamis have the potential to be extremely destructive, relatively little research on tsunami messaging has taken place. Discovering whether tsunami warning messages can be written in a way that leads to increased protective response is crucial, particularly given the increased use of mobile message services and the role they play in notifying the public of imminent threats such as tsunami and other hazards. The purpose of this study was to examine the possibility of designing warning messages for tsunamis that improve upon message style and content used by public alerting agencies to date and to gain insight that can be applied to other hazards. This study tested the impact of tsunami messages that varied in length and content on six message outcomes—understanding, believing, personalizing, deciding, milling, and fear. Relative to the short message, revised messages resulted in significantly more understanding and deciding, known precursors to taking protective action under threat. The revised message also resulted in significantly more fear, which is believed to influence behavioral intentions. Findings suggest that shorter messages may not deliver enough content to inform message receivers about the threat they face and the protective actions they should perform. Longer messages delivered with more specific information about the location of impact, threat-associated risks, and recommended protective actions were associated with better message outcomes, including quicker intended response. Recommendations for future tsunami warnings are provided

Social Media and Sexual Behavior Among Adolescents: Is there a link?

Background: Adolescent sexual risk taking and its consequences remain a global public health concern. Empirical evidence on the impact that social media has on sexual health behaviors among youth is sparse. Objective: The study aimed to examine the relationship between social media and the change in sexual risk over time and whether parental monitoring moderates this relationship. Methods: This study comprised a sample of 555 Latino youth aged 13-19 years from Maryland, United States completing baseline and follow-up surveys. Mixed-effects linear regression was used to examine the relationship between social media and the change in sexual risk over time and whether parental monitoring moderated the relationship. Results: Sexual risk behaviors significantly increased between baseline (T1) and follow up (T2) (mean=0.432 vs mean=0.734, P\u3c.001). Youth sending more than 100 text messages per day had significantly higher sexual risk scores (beta=1.008, P\u3c.001) but significantly larger declines in sexual risk scores for higher levels of parental monitoring (beta=−.237, P=.009). Conclusions: Although adolescents exchange SMS at high rates, parental monitoring remains vital to parent-child relationships and can moderate SMS frequency and sexual risk behaviors, despite parental influence diminishing and peer pressure and social influences increasing during adolescence

Legal space for syringe exchange programs in hot spots of injection drug use-related crime.

BACKGROUND: Copious evidence indicates that syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs (PWID). The efficacy of SEPs in supporting the public health needs of PWID populations is partially dependent on their accessibility and consistent utilization among injectors. Research has shown that SEP access is an important predictor of PWID retention at SEPs, yet policies exist that may limit the geographic areas where SEP operations may legally occur. Since 2000 in the District of Columbia (DC), SEP operations have been subject to the 1000 Foot Rule (§48-1121), a policy that prohibits the distribution of any needle or syringe for the hypodermic injection of any illegal drug in any area of the District of Columbia which is within 1000 feet of a public or private elementary or secondary school (including a public charter school). The 1000 Foot Rule may impede SEP services in areas that are in urgent need for harm reduction services, such as locations where injections are happening in real time or where drugs are purchased or exchanged. We examined the effects of the 1000 Foot Rule on SEP operational space in injection drug use (IDU)-related crime (i.e., heroin possession or distribution) hot spots from 2000 to 2010. METHODS: Data from the DC Metropolitan Police Department were used to identify IDU-related crime hot spots. School operation data were matched to a dataset that described the approximate physical property boundaries of land parcels. A 1000-ft buffer was applied to all school property boundaries. The overlap between the IDU-related crime hot spots and the school buffer zones was calculated by academic year. RESULTS: When overlaying the land space associated with IDU-related crime hot spots on the maps of school boundaries per the 1000-ft buffer zone stipulation, we found that the majority of land space in these locations was ineligible for legal SEP operations. More specifically, the ineligible space in the identified hot spots in each academic year ranged from 51.93 to 88.29 % of the total hot spot area. CONCLUSIONS: The removal of the 1000 Foot Rule could significantly improve the public health of PWID via increased access to harm reduction services. Buffer zone policies that restrict SEP operational space negatively affect the provision of harm reduction services to PWID

Do COVID-19 related primary emotions affect risk perceptions, efficacy beliefs, and information seeking and behavior? Examining emotions as audience segments

Introduction Primary emotions among the populace during global health crises, such as the COVID-19 pandemic, provide valuable insights. Guided by appraisal theories of emotions, this study explores emotional segmentation by mapping primary emotions related to COVID-19 and investigating their impact on cognitive and behavioral outcomes, including risk perceptions, efficacy beliefs, behavioral intentions, prevention behaviors, and information seeking/avoidance. Methods Study 1 surveyed young adults (N = 1,368) to investigate their emotions about COVID-19 and examine the effect of these emotions on risk perceptions, efficacy beliefs, and behavioral intentions regarding mask-wearing and physical distancing. Study 2 replicated Study 1 with a quota-based national sample of U.S. adults (N = 8,454) and further tested the effect of primary emotions on preventive behaviors and information seeking/avoidance. Results Results indicated that most people experienced negative emotions, such as sadness, anger, and anxiety. These emotions were associated with varying levels of risk perceptions, efficacy beliefs, behavioral intentions, actual behaviors, and information seeking/avoidance. Notably, across both studies, anxious individuals demonstrated more favorable health-related perceptions and behavioral outcomes compared to those experiencing anger. Discussion These findings offer insights into the emotional experiences of individuals during the COVID-19 pandemic and highlight the significant impact of these emotions on risk perceptions and health-related behaviors. Understanding these emotional responses can inform public health strategies and communication efforts during health crises

The Microanatomic Location of Metastatic Breast Cancer in Sentinel Lymph Nodes Predicts Nonsentinel Lymph Node Involvement

Background: The majority of sentinel node (SN) positive breast cancer patients do not have additional non-SN involvement and may not benefit from axillary lymph node dissection (ALND). Previous studies in melanoma have suggested that microanatomic localization of SN metastases may predict non-SN involvement. The present study was designed to assess whether these criteria might also be used to be more restrictive in selecting breast cancer patients who would benefit from an ALND. Methods: A consecutive series of 357 patients with invasive breast cancer and a tumorpositive axillary SN, followed by an ALND, was reviewed. Microanatomic SN tumor features (subcapsular, combined subcapsular and parenchymal, parenchymal, extensive localization, multifocality, and the penetrative depth from the SN capsule) were evaluated for their predictive value for non-SN involvement. Results: Non-SN metastases were found in 136/357 cases (38%). Microanatomic location and penetrative depth of SN metastases were significant predictors for non-SN involvement (<0.001); limited penetrative depth was associated with a low frequency of non-SN involvement with a minimal of 10%. Conclusions: Microanatomic location and penetrative depth of breast cancer SN metastases predict non-SN involvement. However, based on these features no subgroup of patients could be selected with less than 10% non-SN involvement

Nonfatal Injuries 1 Week After Hurricane Sandy — New York City Metropolitan Area, October 2012

On October 29, 2012, Hurricane Sandy (Sandy) made landfall in densely populated areas of New York, New Jersey, and Connecticut. Flooding affected 51 square miles (132 square kilometers) of New York City (NYC) and resulted in 43 deaths, many caused by drowning in the home, along with numerous storm-related injuries. Thousands of those affected were survivors of the World Trade Center (WTC) disaster of September 11, 2001 (9/11) who had previously enrolled in the WTC Health Registry (Registry) cohort study. To assess Sandy-related injuries and associated risk factors among those who lived in Hurricane Sandy-flooded areas and elsewhere, the NYC Department of Health and Mental Hygiene surveyed 8,870 WTC survivors, who had provided physical and mental health updates 8 to 16 months before Sandy. Approximately 10% of the respondents in flooded areas reported injuries in the first week after Sandy; nearly 75% of those had more than one injury. Injuries occurred during evacuation and clean-up/repair of damaged or destroyed homes. Hurricane preparation and precautionary messages emphasizing potential for injury hazards during both evacuation and clean-up or repair of damaged residences might help mitigate the occurrence and severity of injury after a hurricane

Legal space for syringe exchange programs in hot spots of injection drug use-related crime

BACKGROUND: Copious evidence indicates that syringe exchange programs (SEPs) are effective structural interventions for HIV prevention among persons who inject drugs (PWID). The efficacy of SEPs in supporting the public health needs of PWID populations is partially dependent on their accessibility and consistent utilization among injectors. Research has shown that SEP access is an important predictor of PWID retention at SEPs, yet policies exist that may limit the geographic areas where SEP operations may legally occur. Since 2000 in the District of Columbia (DC), SEP operations have been subject to the 1000 Foot Rule (§48–1121), a policy that prohibits the distribution of “any needle or syringe for the hypodermic injection of any illegal drug in any area of the District of Columbia which is within 1000 feet of a public or private elementary or secondary school (including a public charter school).” The 1000 Foot Rule may impede SEP services in areas that are in urgent need for harm reduction services, such as locations where injections are happening in “real time” or where drugs are purchased or exchanged. We examined the effects of the 1000 Foot Rule on SEP operational space in injection drug use (IDU)-related crime (i.e., heroin possession or distribution) hot spots from 2000 to 2010. METHODS: Data from the DC Metropolitan Police Department were used to identify IDU-related crime hot spots. School operation data were matched to a dataset that described the approximate physical property boundaries of land parcels. A 1000-ft buffer was applied to all school property boundaries. The overlap between the IDU-related crime hot spots and the school buffer zones was calculated by academic year. RESULTS: When overlaying the land space associated with IDU-related crime hot spots on the maps of school boundaries per the 1000-ft buffer zone stipulation, we found that the majority of land space in these locations was ineligible for legal SEP operations. More specifically, the ineligible space in the identified hot spots in each academic year ranged from 51.93 to 88.29 % of the total hot spot area. CONCLUSIONS: The removal of the 1000 Foot Rule could significantly improve the public health of PWID via increased access to harm reduction services. Buffer zone policies that restrict SEP operational space negatively affect the provision of harm reduction services to PWID

A multicomponent intervention for the management of chronic pain in older adults: study protocol for a randomized controlled trial

Background: Studies have shown that physical interventions and psychological methods based on the cognitive behavioral approach are efficacious in alleviating pain and that combining both tends to yield more benefits than either intervention alone. In view of the aging population with chronic pain and the lack of evidence-based pain management programs locally, we developed a multicomponent intervention incorporating physical exercise and cognitive behavioral techniques and examined its long-term effects against treatment as usual (i.e., pain education) in older adults with chronic musculoskeletal pain in Hong Kong. Methods/design: We are conducting a double-blind, cluster-randomized controlled trial. A sample of 160 participants aged ≥ 60 years will be recruited from social centers or outpatient clinics and will be randomized on the basis of center/clinic to either the multicomponent intervention or the pain education program. Both interventions consist of ten weekly sessions of 90 minutes each. The primary outcome is pain intensity, and the secondary outcomes include pain interference, pain persistence, pain self-efficacy, pain coping, pain catastrophizing cognitions, health-related quality of life, depressive symptoms, and hip and knee muscle strength. All outcome measures will be collected at baseline, postintervention, and at 3 and 6 months follow-up. Intention-to-treat analysis will be performed using mixed-effects regression to see whether the multicomponent intervention alleviates pain intensity and associated outcomes over and above the effects of pain education (i.e., a treatment × time intervention effect). Discussion: Because the activities included in the multicomponent intervention were carefully selected for ready implementation by allied health professionals in general, the results of this study, if positive, will make available an efficacious, nonpharmacological pain management program that can be widely adopted in clinical and social service settings and will hence improve older people’s access to pain management services

Examination of Late Palaeolithic archaeological sites in northern Europe for the preservation of cryptotephra layers

We report the first major study of cryptotephra (non-visible volcanic ash layers) on Late Palaeolithic archaeological sites in northern Europe. Examination of 34 sites dating from the Last Termination reveals seven with identifiable cryptotephra layers. Preservation is observed in minerogenic and organic deposits, although tephra is more common in organic sediments. Cryptotephra layers normally occur stratigraphically above or below the archaeology. Nearby off-site palaeoclimate archives (peat bogs and lakes &lt;0.3 km distant) were better locations for detecting tephra. However in most cases the archaeology can only be correlated indirectly with such cryptotephras. Patterns affecting the presence/absence of cryptotephra include geographic position of sites relative to the emitting volcanic centre; the influence of past atmospherics on the quantity, direction and patterns of cryptotephra transport; the nature and timing of local site sedimentation; sampling considerations and subsequent taphonomic processes. Overall, while tephrostratigraphy has the potential to improve significantly the chronology of such sites many limiting factors currently impacts the successful application