Decision-making under conditions of explicit risk and uncertainty in autistic and typically developing adolescents and young adults.

Adolescence has been characterized as a period of risky and possibly suboptimal decision-making, yet the development of decision-making in autistic adolescents is not well understood. To investigate decision-making in autism, we evaluated performance on 2 computerized tasks capturing decision-making under explicit risk and uncertainty in autistic and non-autistic adolescents/young adults ages 12-22 years. Participants completed the Game of Dice Task (32 IQ-matched participant pairs) to assess decision-making under explicit risk and the modified Iowa Gambling Task (35 IQ-matched pairs) to assess decision-making under uncertainty. Autistic participants overall made riskier decisions than non-autistic participants on the Game of Dice Task, and the odds of making riskier decisions varied by age and IQ. In contrast, the autistic group showed comparable levels of learning over trial blocks to the non-autistic group on the modified Iowa Gambling Task. For both tasks, younger autistic participants performed poorer than their non-autistic counterparts, while group differences diminished in older ages. This age-related pattern suggests positive development during adolescence on risk assessment and decision-making in autism but also implies differential developmental trajectories between groups. These findings also suggest differential performance by the risk type, with additional complex influences of IQ and fluid cognition, which warrants further investigations.

Issues of risky behaviours in university students.

AIM: Risk behaviour is typical of adolescence and young adulthood, but the consequences can persist for the rest of life - in all domains - physical, psychological, and social. Challenging situations, stress, as well as feelings of a lack of stimulation in an individual's life are considered to be triggers for risky behaviours. Prevention therefore plays a crucial role. The aim of the study was to analyse the current situation in addictive and risky sexual behaviours in a group of university students. MATERIAL AND METHODS: Between 2019 and 2022, students of universities in East Bohemia - University of Hradec Králové (UHK), Charles University (UK), University of Defence (UNOB), and University of Pardubice (UPCE) - were approached and asked to complete a questionnaire survey focused on addictive and risky sexual behaviours. Based on the search strategy, research hypotheses were constructed, which were subsequently developed into interview questions. The research hypotheses were tested using Pearson's test. The questionnaire return rate was 84%. After eliminating invalid responses, 157 participants were included in the survey - 64% female, 36% male, age range 19-32 years. RESULTS: In the area of addictive behaviours, the focus was on substance and non-substance addictions. In terms of addictive substances, a question addressed cigarette smoking, which was reported by 14.6% of the survey participants. This is 50% less than what we see in the general population of the same age (by general population we mean the group of people approached for the surveys conducted, chosen by stratified random sampling based on age). In contrast, significantly higher rates of university students reported the use of illicit substances - marijuana, sedatives/tranquilizers without a doctor's prescription, cocaine, or hallucinogens compared to the age-matched general population. In the area of risky sexual behaviours, a question was included       about sexual intercourse with casual acquaintances. It was experienced by one in four respondents. In 83.3%, this behaviour was influenced by the use of an addictive substance. The survey pointed to the high rates of salutoprotective factors (e.g. interest in sports was reported by 87.9% of respondents). Perceived social support from friends (reported by 74.5% of respondents) or family (reported by 72.6% of respondents) is a preventive factor for risky behaviours. CONCLUSIONS: The aim of the survey was to determine the prevalence of high-risk addictive and sexual behaviours among university students and possible prevention measures. Salutoprotective factors during increased stress or awareness of social support seem to be of benefit. We assumed a protective effect of higher education, but this survey did not show it. On the contrary, the stress induced by university studies and the pressure on academic performance appeared to be a risk factor. The results of the survey provide insights into new approaches to the prevention to improve its effectiveness and point to major problems to be addressed in Czech university students.

Exploring risky health behaviors and vulnerability to sexually transmitted diseases among transnational undocumented labor migrants from Bangladesh: a qualitative study.

BACKGROUND: In Bangladesh, remittances constitute a substantial portion of the country's foreign exchange earnings and serve as a primary source of income. However, a considerable number of Bangladeshi citizens reside overseas without proper documentation, exposing them to significant challenges such as limited access to healthcare and socioeconomic opportunities. Moreover, their irregular migration status often results in engaging in risky health behaviors that further exacerbate their vulnerability. Hence, this study aimed to investigate the risky health behavior and HIV/STI susceptibility of Bangladeshi irregular international migrants residing across the globe with undocumented status. METHODS: Using a qualitative Interpretative Phenomenological Approach (IPA), 25 illegal migrants were interviewed who are currently living illegally or returned to their home country. The author used a thematic approach to code and analyze the data, combining an integrated data-driven inductive approach with a deductive approach. Concurrent processing and coding were facilitated by employing the Granheim model in data analysis. RESULTS: The study identified four risky health behaviors among irregular Bangladeshi migrants: hazardous living conditions, risky jobs, suicidal ideation, and tobacco consumption. Additionally, the authors found some HIV/STI risk behavior among them including engaging in unprotected sex, consuming alcohol and drugs during sexual activity, and having limited access to medical facilities. CONCLUSIONS: The findings of this study can be used by health professional, governments, policymakers, NGOs, and concerned agencies to develop welfare strategies and initiatives for vulnerable undocumented migrant workers.

Objective numeracy exacerbates framing effects from decision-making under political risk.

While Prospect Theory helps to explain decision-making under risk, studies often base frames on hypothetical events and fail to acknowledge that many individuals lack the ability and motivation to engage in complex thinking. We use an original survey of US adults (N = 2813) to test Prospect Theory in the context of the May 2023 debt ceiling negotiations in the US Congress and assess whether objective numeracy moderates framing effects. We hypothesize and find evidence to suggest that most respondents are risk-averse to potential gains and risk-accepting to potential losses; however, high numerates are more risk-averse and risk-accepting to gains and losses, respectively, than low numerates. We also find that need for cognition interacts with numeracy to moderate framing effects for prospective losses, such that higher need for cognition attenuates risk-acceptance among low numerates and exacerbates risk-acceptance among high numerates. Our results are robust to a range of other covariates and in models accounting for the interaction between political knowledge and need for cognition, indicating joint moderating effects from two knowledge domains similarly conditioned by the desire to engage in effortful thinking. Our findings demonstrate that those who can understand and use objective information may remain subjectively persuaded by certain policy frames.

Factors related to the low-risk perception of driving after cannabis use.

INTRODUCTION: Modifying risk perceptions related to driving after cannabis use (DACU) could deter individuals from enacting this behavior, as low-risk perception is associated with DACU engagement. This study identified sociodemographic characteristics, substance use, other driving behaviors, peer norms, and psychological characteristics that are associated with lower risk perception regarding DACU. METHODS: Canadian drivers aged 17-35 who have used cannabis in the past year (n = 1,467) completed an online questionnaire. A multivariate linear regression model allowed for identifying variables associated with the low-risk perception of DACU (i.e. believing it to be safe as one's driving ability is not impaired by cannabis or by being high). RESULTS: Lower risk perception of DACU was associated with identifying as male, weekly to daily cannabis use, engagement in DACU, general risky driving behaviors, being a passenger of a driver who engages in DACU, number of friends who engage in DACU, and peer approval of DACU. Having driven under the influence of alcohol, living in urban areas, having received traffic tickets in the past three years, and declaring past-week irritability and cognitive problems were associated with holding a higher risk perception related to DACU. DISCUSSION: Road education and prevention programs should target attitudes and perceptions regarding risks shaped by sociocultural norms and past risky driving experiences. They need to reach out more specifically to drivers with the identified characteristics associated with the low-risk perception of DACU. These interventions can potentially help reduce the rate of individuals who engage in this behavior.

Distracted on duty: A theory-based exploration of influences leading to mobile phone distracted riding among food delivery workers.

Using mobile phones while riding is a form of distracted riding that significantly elevates crash risk. Regrettably, the factors contributing to mobile phone use while riding (MPUWR) among food delivery riders remain under-researched. Addressing this literature gap, the current study employs the Job Demands-Resources (JD-R) model and various socio-economic factors to examine the determinants of MPUWR. The research incorporates data from 558 delivery workers in Hanoi and Ho Chi Minh City, Vietnam. The study utilizes two analytical methods to empirically test the hypotheses, considering non-linear relationships between variables: Partial Least Square Structural Equation Modelling (PLS-SEM) and Artificial Neural Network (ANN). The results reveal mixed impacts of factors connected to job resources. Although social support appears to deter MPUWR, work autonomy and rewards seemingly encourage it. Furthermore, a predisposition towards risk-taking behaviour significantly impacts the frequency of mobile phone usage among delivery riders. Interestingly, riders with higher incomes and those who have previously been fined by the police exhibit more frequent mobile phone use. The findings of this study present valuable insights into the crucial factors to be addressed when designing interventions aimed at reducing phone use among food delivery riders.

Prevalence of sexually risky behaviors among Mexican medical students.

University students are at high risk of sexually transmitted infections due to the lack of adequate sexual education, as well as multiple associated factors, which lead to risky sexual practices. It is important to update data about sexual behaviors to identify the main factors associated with sexually risky behaviors. The present study aimed to evaluate the current prevalence of sexually risky practices in medical students. A cross-sectional study was conducted among medical students through an anonymous self-administered online questionnaire including demographic characteristics and sexual behaviors. We used descriptive statistics and multivariable regression to analyze the data collected. A total of 1520 undergraduate medical students aged between 18 and 28 years old were included in the study. Sixty percent of the students were sexually active with a higher proportion in men (70%), likewise, they had an earlier sexual debut (16.5 vs 16.9 years old), and a greater number of lifetime sexual partners than women (3.8 vs 2.2). The main sexual activity in both groups was vaginal sex with high use of condoms (75%), however, most of them (67%) reported having unprotected oral sex. Logistic regression analysis showed that condomless sex was associated with having oral sex, anal sex, and being female. The findings of this study showed that medical university students are involved in risky sexual behaviors, the major risk factor was unprotected oral sex. Based on these results, we recommended designing interventions to improve sexual education and preventive approaches from early stages such as in middle school students to mitigate sexually transmitted infections among medical university students.

Can platform use patterns be an indicator of HIV-related risk and sub-group heterogeneity among men who have sex with men in Singapore: a latent class analysis.

Introduction: Low-level HIV epidemic settings like Singapore face the challenge of reaching men at-risk who have less contact with programmes. We investigated patterns of meeting platform use by men seeking male sexual partners (MSM) as potential marker of risk to differentiate sub-groups for interventions. Methods: Latent Class Analysis (LCA) was applied to a survey sample of MSM recruited from bars/clubs, saunas and a smartphone application, using purposive sampling. The best-fit LCA model which identified homogeneous sub-groups with similar patterns of meeting platform was factored in multivariable regression to identify associations with risk behaviors on the pathway to HIV infection. Results: Overall 1,141 MSM were recruited from bars/clubs (n = 426), saunas (n = 531), and online (n = 184). Five patterns emerged, reflecting salient platform use characteristics: Sauna-centric (SC; n = 413), App-centric (AC; n = 276), Multiple-platforms (MP; n = 123), Platform-inactive (PI; n = 257), and "Do not hook up" (DNH; n = 72) classes. Men in the SC and MP classes had high probabilities of using saunas to meet partners; SC were older and less likely to have disclosed their sexual orientation. The MP class had high probabilities of connecting across all platforms in addition to saunas and more likely to have disclosed their sexual orientation, than the PI class. Men in the SC and MP classes had twice the odds of reporting multiple sex partners (aORSC = 2.1; 95%CI: 1.33.2; aORMP = 2.2; 95%CI: 1.14.6). Single/non-partnered MSM and those using alcohol/drugs during sex had 1.7 (95%CI: 1.22.5) and 3.2 (95%CI: 2.05.1) the odds respectively, of reporting multiple sex partners. The SC and MP classes had higher odds of engaging in group sex while MSM using alcohol/drugs during sex had twice the odds of reporting group sex. Alcohol/drugs and group sex were independently associated with condomless sex (as was lower education). Group sex, alcohol/drugs during sex, disclosure of sexual orientation or being Singaporean/permanent resident were associated with recent testing for HIV. Discussion: The five distinct risk profiles identified can help tailor differentiated HIV interventions-combined with field knowledge and other prevention-to expand HIV self-testing, Pre-Exposure Prophylaxis and other services (e.g., Mpox vaccination) to sub-groups at risk.

Examination of multidimensional geographic mobility and sexual behaviour among Black cisgender sexually minoritized men in Chicago.

Black sexually minoritized men (BSMM) are the most likely to acquire HIV in Chicago- a racially segregated city where their daily travel may confer different HIV-related risks. From survey and GPS data among participants of the Neighbourhoods and Networks Cohort Study, we examined spatial (proportion of total activity space away from home), temporal (proportion of total GPS points away from home), and motivation-specific (discordance between residential and frequented sex or socializing neighbourhoods) dimensions of mobility. To identify potential drivers of BSMM's risk, we then examined associations between mobility and sexual behaviours known to cause HIV transmission: condomless anal sex, condomless anal sex with a casual partner, transactional sex, group sex, and sex-drug use. Multivariable logistic regression models assessed associations. Of 269 cisgender BSMM, most were 20-29 years old, identified as gay, and lowincome. On average, 96.9% (Standard Deviation: 3.7%) of participants' activity space and 53.9% (Standard Deviation: 38.1%) of participants' GPS points occurred outside their 800m home network buffer. After covariate adjustment, those who reported sex away from home were twice as likely to report condomless sex (Odds Ratio: 2.02, [95% Confidence Interval (CI): 1.08, 3.78]). Those who reported socializing away from home were four times more likely to have condomless sex with a casual partner (Odds Ratio: 4.16 [CI: 0.99, 29.0]). BSMM are on the move in Chicago, but only motivation-specific mobility may increase HIV transmission risk. Multidimensional investigations of mobility can inform place-based strategies for HIV service delivery.

Association between school context and occurrence of multiple sexual partners: cross-sectional study with multilevel analysis. / Associação entre o contexto escolar e a ocorrência de múltiplos parceiros sexuais: um estudo transversal com análise multinível.

The objective was to investigate the association between the school context and the occurrence of multiple partners among adolescents, considering individual variables (age, gender, Bolsa Família, LGB, early sexual initiation and use of alcohol or drugs in the last sex). Cross-sectional study with multilevel analysis carried out in 2018 with adolescent students from Olinda, Brazil. The variable (multiple partners) was collected based on the 'Youth Risk Behavior Survey' questionnaire. School context variables were time in school (regular school vs. full/semi-full school) and the Social Vulnerability Index of the school district. Of 2,500 participants, 1,044 were analyzed for being sexually active and most had two or more partners (63.89%). Regular school students were more likely (OR 1.47, CI 1.10-1.97) to have multiple sexual partners compared to those in full-day schools/half-day schools. However, no association was found in relation to the SVI of the schools' neighborhoods (OR 1.18, IC 0.82-1.70). More time spent at school was associated with fewer chances of multiple sexual partners, while studying in schools located in highly vulnerable neighborhoods was not associated with the occurrence of multiple sexual partners among adolescents.

O estudo investiga a associação entre o contexto escolar e a ocorrência de múltiplos parceiros entre adolescentes, considerando as variáveis individuais. Estudo transversal com análise multinível, realizado no período de fevereiro a junho de 2018 com estudantes de 14 a 19 anos. A variável desfecho (múltiplos parceiros sexuais) foi coletada com base no questionário Youth Risk Behavior Survey (YRBS). As variáveis do contexto escolar foram tempo na escola (escola regular vs escola integral/semi-integral) e índice de vulnerabilidade social (IVS) do bairro onde a escola está localizada. De 2.500 participantes, 1.044 foram analisados por serem sexualmente ativos. A maioria dos adolescentes (63,89%) teve dois ou mais parceiros. Estudantes de escola regular (mínimo de 4h diárias) tiveram mais chances (OR 1.47, IC 1.10-1.97) de terem múltiplos parceiros sexuais quando comparados àqueles de escola integral/semi-integral (mínimo de 7h diárias). Porém, não houve associação em relação ao IVS dos bairros das escolas (OR 1.18, IC 0.82-1.70). Maior tempo na escola esteve associado a menor chance de múltiplos parceiros sexuais, enquanto estudar em escolas localizadas em bairro de alta vulnerabilidade não esteve associado à ocorrência de múltiplos parceiros sexuais entre adolescentes.

Determinants factors in the recognition of a usual source of care by Brazilian adolescents. / Fatores determinantes no reconhecimento de uma fonte usual de cuidado por adolescentes brasileiros.

The present study aimed to analyze the demographic, socioeconomic, and health factors and risk behaviors associated with the recognition of a Usual Source of Care (USC), according to gender. This work was a cross-sectional study, based on the National Survey of School Health (2015), conducted with 100,464 Brazilian adolescents. Descriptive analyses were performed based on Pearson's χ2, and the prevalence ratio (PR) through logistic regression models in Stata 14 for each type of USC (Primary Health Care (PHC), Private Practice, Hospital, and Emergency), stratified by sex. Recognition of a USC was reported by 55.5% of the adolescents, 58.6% of whom were female. In the multivariate analysis, the variables that present social, economic, and risk behavior inequalities showed positive associations for USC PHC for both genders. For the other types of USC, the demographic and socioeconomic characteristics showed negative associations. The results of this study showed that PHC is the service with the highest recognition among adolescents in conditions of social vulnerability. This reinforces the need to consolidate the PHC in order to favor the health care of adolescents, establishing bonds and improving access to health actions.

Objetivou-se analisar os fatores demográficos, socioeconômicos, de saúde e comportamentos de risco associados ao reconhecimento de uma Fonte Usual de Cuidados (FUC). Estudo transversal, a partir da Pesquisa Nacional de Saúde do Escolar (2015) realizado com 100.464 adolescentes brasileiros. Realizou-se análises descritivas através do χ2 de Pearson, e a razão de prevalência (RP) através dos modelos de regressão logística no Stata 14 para cada tipo de FUC (APS, Consultório Particular, Hospital e Emergência), estratificado por sexo. O reconhecimento de uma FUC foi referido por 55,5% dos adolescentes, sendo 58,6% do sexo feminino. Na análise multivariada, as variáveis que apresentam desigualdades sociais, econômicas e de comportamento de risco demonstraram associações positivas para a FUC APS, para ambos os sexos. Para os demais tipos de FUC, as características demográficas e socioeconômicas quando associadas apresentaram associações foram negativas. Os resultados deste estudo mostraram que a APS é o serviço com maior reconhecimento dos adolescentes em condições de vulnerabilidade social. O que reforça a necessidade de consolidação da APS a fim de favorecer a atenção à saúde dos adolescentes, no estabelecimento de vínculo e na melhoria do acesso às ações de saúde.

[Usual source of care and Brazilian adolescent access to Primary Health Care (PHC) services]. / Fonte usual de cuidado e o acesso de adolescentes brasileiros a serviços de Atenção Primária à Saúde (APS).

We analyzed the association between the recognition of a usual source of care (USC) of Primary Health Care (PHC) and access to services among Brazilian adolescents. This is a cross-sectional study using data from the National Adolescent School-based Health Survey with 68,968 Brazilian adolescents and cluster sampling. Descriptive analyses were carried out with Pearson's χ2 and prevalence ratios (PR) using logistic regression models between access and recognition of USC. It was observed that 74.6% reported access, and this was higher among females (79.3%). In the multivariate analysis, there was a positive association (PR: 1.25; 95%CI: 1.24-1.26); and, when stratified by sex, positive associations for both sexes, (PR: 1.30; 95%CI: 1.28-1.31) male and (PR: 1.21; 95%CI: 1.20-1.23) female. The majority of Brazilian adolescents demonstrated PHC as a USC and were able to access services, but lack of access was more frequent among the most economically vulnerable and those with risk behaviors, indicating potentially avoidable inequities with more equitable and longitudinal PHC services.

Objetivou-se analisar a associação entre o reconhecimento de uma fonte usual do cuidado de Atenção Primária à Saúde (APS) e o acesso aos serviços de APS, entre adolescentes brasileiros. Estudo transversal, a partir da Pesquisa Nacional de Saúde do Escolar realizada com 68.968 adolescentes brasileiros, através de amostragem por conglomerados. Foram realizadas análises descritivas através do χ2 de Pearson e a razão de prevalência (RP) através dos modelos de regressão logística entre acesso aos serviços de APS e o reconhecimento da FUC APS. Dos adolescentes que procuraram os serviços de APS, 74,6% referiram acesso, sendo a maior do sexo feminino (79,3%). Na análise multivariada, observa-se associação positiva (RP: 1,25; IC95%: 1,24-1,26), e na estratificado por sexo, observou-se associações positivas para ambos os sexos, (RP: 1,30; IC95%: 1,28-1,31) masculino e (RP: 1,21; IC95%: 1,20-1,23) feminino. Verifica-se que a maioria dos adolescentes brasileiros que têm a APS como sua FUC conseguiram acessar os serviços de APS, apesar de que, a falta de acesso foram mais frequentes entre os mais vulneráveis economicamente e devido a comportamentos de risco, indicando iniquidades potencialmente evitáveis por meio de uma APS mais efetiva e longitudinal.

Foraging in a non-foraging task: Fitness maximization explains human risk preference dynamics under changing environment.

Changes in risk preference have been reported when making a series of independent risky choices or non-foraging economic decisions. Behavioral economics has put forward various explanations for specific changes in risk preference in non-foraging tasks, but a consensus regarding the general principle underlying these effects has not been reached. In contrast, recent studies have investigated human economic risky choices using tasks adapted from foraging theory, which require consideration of past choices and future opportunities to make optimal decisions. In these foraging tasks, human economic risky choices are explained by the ethological principle of fitness maximization, which naturally leads to dynamic risk preference. Here, we conducted two online experiments to investigate whether the principle of fitness maximization can explain risk preference dynamics in a non-foraging task. Participants were asked to make a series of independent risky economic decisions while the environmental richness changed. We found that participants' risk preferences were influenced by the current and past environments, making them more risk-averse during and after the rich environment compared to the poor environment. These changes in risk preference align with fitness maximization. Our findings suggest that the ethological principle of fitness maximization might serve as a generalizable principle for explaining dynamic preferences, including risk preference, in human economic decision-making.

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

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

Risk and time preferences in individuals with lifestyle-related and non-lifestyle-related cardiovascular diseases: a pilot study.

OBJECTIVES: To (1) pilot a study of behavioural characterisation based on risk and time preferences in clinically well-characterised individuals, (2) assess the distribution of preferences in this population and (3) explore differences in preferences between individuals with 'lifestyle-related' (LS) and 'non-lifestyle-related' (NLS) cardiovascular diseases. DESIGN: Cross-sectional study with an economic online experiment to collect risk and time preferences, a detailed clinical characterisation and a sociodemographic and lifestyle survey. A definition of LS and NLS groups was developed. SETTING: Specialist outpatient clinics of the clinic for cardiology and pneumology of the University Hospital Düsseldorf and patients from a cardiology practice in Düsseldorf. PARTICIPANTS: A total of 74 individuals with cardiovascular diseases. OUTCOMES: Risk and time preferences. RESULTS: The implementation of the study process, including participant recruitment and data collection, ran smoothly. The medical checklist, the survey and the time preference instrument were well received. However, the conceptual understanding of the risk preference instrument resulted in inconsistent choices for many participants (47%). The remaining individuals were more risk averse (27%) than risk seeking (16%) and risk neutral (10%). Individuals in our sample were also more impatient (49%) than patient (42%). The participant classification showed that 65% belonged to the LS group, 19% to the NLS group and 16% could not be assigned (unclear allocation to lifestyle (ULS) group). Excluding the ULS group, we show that individuals in the LS group were more risk seeking, and unexpectedly, more patient than those in the NLS group. CONCLUSIONS: The process of the pilot study and its results can be used as a basis for the design of the main study. The differences in risk and time preferences between the LS and NLS groups provide us with a novel hypothesis for unhealthy behaviours: individuals never give up a bad habit, they simply postpone the latter, which can be tested alongside other additional research questions.

Heuristics in risky decision-making relate to preferential representation of information.

When making choices, individuals differ from one another, as well as from normativity, in how they weigh different types of information. One explanation for this relates to idiosyncratic preferences in what information individuals represent when evaluating choice options. Here, we test this explanation with a simple risky-decision making task, combined with magnetoencephalography (MEG). We examine the relationship between individual differences in behavioral markers of information weighting and neural representation of stimuli pertinent to incorporating that information. We find that the extent to which individuals (N = 19) behaviorally weight probability versus reward information is related to how preferentially they neurally represent stimuli most informative for making probability and reward comparisons. These results are further validated in an additional behavioral experiment (N = 88) that measures stimulus representation as the latency of perceptual detection following priming. Overall, the results suggest that differences in the information individuals consider during choice relate to their risk-taking tendencies.

Disparities in behaviors and experiences among transgender and cisgender high school students - 18 U.S. states, 2021.

PURPOSE: Transgender youth (those whose gender identity differs from their sex assigned at birth) experience stigma and discrimination that can place them at increased risk for poor health outcomes compared with cisgender youth (those whose gender identity aligns with their sex assigned at birth). Limited population-based data exist on disparities among transgender and cisgender youth. METHODS: We examined differences in experiences of violence, substance use, mental health, suicide, sexual behavior, unstable housing, parental monitoring, and school connectedness among 98,174 transgender and cisgender high school students using data from 18 states that included an item to assess transgender identity on their 2021 Youth Risk Behavior Survey. RESULTS: Overall, 2.9% of students identified as transgender and 2.6% questioned whether they were transgender. Among transgender students, 71.5% reported that their mental health was not good, 32.3% had attempted suicide, and 29.0% experienced sexual violence. Transgender students were more likely than cisgender students to report experiences of violence, substance use, poor mental health, suicide risk, some sexual risk behaviors, and unstable housing, and were less likely to report feeling connected to others at school. CONCLUSIONS: Interventions that can address the causes of these adverse outcomes and promote the health and wellbeing of transgender youths are warranted.

Machine Learning-Based Prediction of Suicidal Thinking in Adolescents by Derivation and Validation in 3 Independent Worldwide Cohorts: Algorithm Development and Validation Study.

BACKGROUND: Suicide is the second-leading cause of death among adolescents and is associated with clusters of suicides. Despite numerous studies on this preventable cause of death, the focus has primarily been on single nations and traditional statistical methods. OBJECTIVE: This study aims to develop a predictive model for adolescent suicidal thinking using multinational data sets and machine learning (ML). METHODS: We used data from the Korea Youth Risk Behavior Web-based Survey with 566,875 adolescents aged between 13 and 18 years and conducted external validation using the Youth Risk Behavior Survey with 103,874 adolescents and Norway's University National General Survey with 19,574 adolescents. Several tree-based ML models were developed, and feature importance and Shapley additive explanations values were analyzed to identify risk factors for adolescent suicidal thinking. RESULTS: When trained on the Korea Youth Risk Behavior Web-based Survey data from South Korea with a 95% CI, the XGBoost model reported an area under the receiver operating characteristic (AUROC) curve of 90.06% (95% CI 89.97-90.16), displaying superior performance compared to other models. For external validation using the Youth Risk Behavior Survey data from the United States and the University National General Survey from Norway, the XGBoost model achieved AUROCs of 83.09% and 81.27%, respectively. Across all data sets, XGBoost consistently outperformed the other models with the highest AUROC score, and was selected as the optimal model. In terms of predictors of suicidal thinking, feelings of sadness and despair were the most influential, accounting for 57.4% of the impact, followed by stress status at 19.8%. This was followed by age (5.7%), household income (4%), academic achievement (3.4%), sex (2.1%), and others, which contributed less than 2% each. CONCLUSIONS: This study used ML by integrating diverse data sets from 3 countries to address adolescent suicide. The findings highlight the important role of emotional health indicators in predicting suicidal thinking among adolescents. Specifically, sadness and despair were identified as the most significant predictors, followed by stressful conditions and age. These findings emphasize the critical need for early diagnosis and prevention of mental health issues during adolescence.

Is badger culling associated with risk compensation behaviour among cattle farmers?

BACKGROUND: Risk compensation theory suggests that behaviours are modified in response to interventions that remove risks by substituting them with other risky behaviours to maintain a 'risk equilibrium'. Alternatively, risk reduction interventions may result in spill-over behaviours that seek to minimise risks further. This paper assessed evidence for these behavioural risk responses among farmers in response to badger culling that seeks to remove the risk of bovine tuberculosis in cattle. METHODS: Data from the UK's randomised badger culling trial were re-analysed, comparing farmers' cattle movement practices in proactive and reactive culling areas and control areas. Analysis compared cattle movements during and after the trial using zero-inflated negative binomial regression. RESULTS: The analysis found no strong evidence of risk compensation behaviours among farmers who experienced proactive culling. However, strong evidence for a reduction in cattle movements in reactive culling areas was found. The results indicate high levels of inertia within farming systems in relation to cattle purchasing. LIMITATIONS: Data do not account for the risk of cattle purchases and reflect previous policy regimens. Evidence from recent badger culling interventions should be analysed. CONCLUSION: Proactive badger culling was not associated with risk compensation behaviours, while reactive badger culling was associated with decreased risk taking among farmers.

Rank, stress, and risk: A conjecture.

A perception at the core of studies that consider the link between social rank and stress (typically measured by the so-called stress hormone cortisol) is that the link is direct. Examples of such studies are Bartolomucci (2007), Beery and Kaufer (2015), and Koolhaas et al. (2017). A recent and stark representation of this body of work is a study by Smith-Osborne et al. (2023), who state that "social hierarchies directly influence stress status" (Smith-Osborne et al. p. 1537, italics added). In the present paper, we reflect on this "direct" perspective. We conjecture that the link between social rank and stress involves an intervening variable: an indirect relationship arises when the loss of rank triggers a behavioral response in the form of risk taking aimed at regaining rank, and it is the engagement in risk-taking behavior that is the cause of an elevated level of cortisol. Smith-Osborne et al., as well as others whose papers are cited by Smith-Osborne et al. and who, like Creel (2001) and Avitsur et al. (2006), conducted comprehensive research on the association between rank (social standing) and stress, do not refer to risk taking at all. We present four strands of research that lend support to our conjecture: evidence that in response to losing rank, individuals are stressed; evidence that in response to losing rank, individuals resort to risk-taking behavior aimed at regaining their lost rank; evidence that there exists a link between engagement in risky activities or exposure to risk and elevated levels of cortisol; and an analytical perspective on incidence and intensity, namely a perspective that shows how the willingness to take risks responds to a change in rank, specifically, how a loss of rank triggers a greater willingness to take risks and how this trigger is stronger for individuals whose rank is higher.