The Influence of Stakeholder Interests on Safety Outcome Reporting in Psychedelic Research and Implications for Science Communication.

Psychedelics are a group of psychoactive substances which produce complex and subjective changes to consciousness and carry unique safety considerations. There is a growing body of work investigating the use of psychedelics for mental health treatment alongside increasing socio-cultural and political acceptance. This rapid evolution has prompted corporations to fund psychedelic clinical trials, leading to a potential rise in conflicts of interest in relevant studies and publications. However, the body of evidence for the safety and efficacy of psychedelic-assisted psychotherapy for psychiatric illnesses is early. There is concern regarding the introduction of bias in psychedelic clinical trials and the selective reporting of results amidst and beyond corporate involvement. At a crucial time in psychedelic drug reform, this paper explores the safety concerns associated with psychedelics, the potential influences of financial stakeholders on safety outcome reporting and the importance of balanced science communication in maintaining public health and safety.

Environmental Factors Affecting Spatio-Temporal Distribution of Crop-Exploiting Species: Implications for Coexistence Between Agricultural Production and Avifauna Conservation in Wetlands.

Bird communities in agroecosystems bring both ecosystem services (e.g., pollination) and disservices (e.g., crop exploitation) to farmers. However, in the proximity of wetland reserves, farmers disproportionately experience harvest yield loss due to large aggregation of bird species that can utilize various agricultural resources. This often results in negative human-wildlife interactions which lower conservation support among farmers. Knowledge about the distribution of avian species that negatively influence yields, and its environmental drivers is thus fundamental to reconcile crop production and bird conservation. This study aims to examine the spatio-temporal patterns in richness and abundance of bird species known to cause agricultural yield loss as well as species-specific distribution patterns for the six bird species that are most challenging for local farmers. In combination with interview surveys of local farmers (n = 367) and seasonal bird surveys (n = 720), we investigated distribution of crop-exploiting avian species in the Indawgyi wetland ecosystem in Myanmar. Our results showed high richness and abundance of crop-exploiting species in the water habitat across all seasons, with most challenging species exhibiting higher presence closer to these water sources. The crop phenology had positive effect on species richness and abundance during the growing season. The agricultural use of crop-exploiting species was season- and species-specific, where the presence probability in the agricultural habitat was higher in habitat generalists than wetland specialists. Therefore, we suggest improved management of natural wetland habitats (e.g., habitat restoration), sustainable coexistence mechanisms in farms close to water (e.g., bird-friendly rice farming and Ecolabel certification) to reduce avian impacts on the farming communities and, at the same time, to promote bird conservation in wetlands of international importance.

How international conflicts and global crises can intertwine and affect the sources and levels of air pollution in urban areas.

This paper analyses the intertwined impacts of the 2018 US sanctions on Iran and the COVID-19 pandemic (as examples of unplanned international conflicts and global crises) on the source and extent of air pollution in Tehran, the capital of Iran. The impacts are parametrized using the levels of criteria air pollutants (CAP) for 5 years (2015-2020), which were previously deweathered using the promising machine learning technique of Random Forest (RF). The absolute principal component scores-multiple linear regression (APCS-MLR) method and the bivariate polar plot (BPP) technique are used here to analyze the source apportionment profile of the city for the business as usual (BAU; 2015 to 2018), sanctions (2019), and COVID-19 and sanctions (2020) intervals. The results show the severe impact of the 2018 US sanctions on Tehran's air quality (AQ); O3, NO2, CO, PM2.5, and PM10 levels increased by 117%, 55%, 20%, 35%, and 10%, respectively, while SO2 levels decreased by 30%. The sanctions also triggered a number of events, such as the disruption of the high-grade fuel supply chain and the Mazut crisis, which directly or indirectly accelerated the photochemical production of local tropospheric ozone to some extent. Sanctions also disrupted Tehran's AQ response to the pandemic, with CAP levels decreasing by only 2-7% during the pandemic. The ozone and PM10 BPPs show that the source apportionment profile of the city is dominated by local anthropogenic emission sources, especially urban transport, after the sanctions and the pandemic. Results also show that the impact of soft wars, such as the US sanctions against Iran, on urban air quality degradation is much stronger than that of hard wars, such as the Russia-Ukraine war.

Relationships between work-family conflict and family structure in the lives of working mothers in Hungary - a pilot study.

BACKGROUND: The family, as the basic socialization environment, is a complex dynamic system that - as a whole and through its subsystems - is in relationships with other social systems (Bagdy in Family socialization and personality disorders. Nemzeti Tankönyvkiadó, Budapest, 2002; Lakatos et al. in Mentálhigiéné és Pszichoszomatika 21(1):56-85, 2020). The system with which the family system has long-term relationships is the work system/environment. Creating and maintaining a work-life balance has become a central issue in our societies, as they are two of the most organising forces, and reconciling them is a very difficult task due to the demands and expectations coming from both directions, often simultaneously (Makra et al. in Magyar Pszichológiai Szemle 67(3):491-518, 2012). This kind of "double burden" primarily affects women, but their increasing role in the labour market is not necessarily followed by an equal sharing of work within family life (Engler et al. in Work-life balance in women's careers. In: Tardos K, Paksi V, Fábri Gy (eds) Scientific careers in the early 21st century. Belvedere Meridionale, Szeged, pp 114-126, 2021). We hypothesise that involvement in work negatively correlates with work-life balance, making it more difficult to integrate into the family. It was expected that the relationship between the number of children and mothers' professional involvement would be negative. A positive correlation was expected between the age of the youngest child and the mothers' work involvement. On the other hand, a family united by cohesion and resilience leads to higher job satisfaction. METHODS: For the present analysis, we analysed the relationships between work-family conflict and family structure in working mothers with children in a sample of 273 participants. The self-reported questionnaire included demographic data and 2 standard questionnaires: the Work-Family Conflict Questionnaire and the Olson-Family Test (FACES-IV.). The study was conducted in Hungary. RESULTS: No significant relationship was found between work involvement and work-family conflict. A negative relationship was observed between work involvement and family involvement. Similiarily, no significant relationship was found between the number of children, the age of the youngest child and work involvement, contrary to expectations. The findings indicate a positive relationship between good family cohesion, flexibility and job satisfaction. CONCLUSION: Striking a work-family balance is a challenging process for families with young children, especially working mothers. A mutually negative relationship between work and family involvement has been shown. The importance of a well-functioning family, with adequate cohesion and flexibility, is reflected in family and job satisfaction. The relationship between work-to-family conflict and job involvement is moderated significantly only when family flexibility is low. The results from the present pilot study indicate important relationships between variables and point to further research directions worth investigating in a larger sample in the future.

"It's normal to be afraid": attacks on healthcare in Ouaka, Haute-Kotto, and Vakaga prefectures of the Central African Republic, 2016-2020.

INTRODUCTION: Attacks on healthcare have further weakened the already fragile health system in the Central African Republic. We investigated attacks on healthcare in three conflict-affected prefectures-Ouaka, Haute-Kotto, and Vakaga-from 2016 to 2020. The study aim was to gain an in-depth understanding of the immediate and long-term effects of attacks on healthcare workers, facilities, supply chain, quality of care, and other components of the health system. We provide a qualitative description of the incidents, assess their impacts, identify mitigation efforts, and discuss challenges to recovery. METHODS: We used purposive and snowball sampling to identify participants in the study. Semi-structured key informant interviews were conducted with administrative and health authorities, front-line personnel, and staff of non-governmental organizations. Interviews were done in Sango, French, or English. Recorded interviews were transcribed and notes taken for non-recorded interviews. Transcripts and notes were analyzed using inductive coding, allowing participant responses to guide findings. RESULTS: Of 126 attacks identified over the study period, 36 key informants discussed 39 attacks. Attacks included killings, physical and sexual assault, abductions, arson, shelling with grenades, pillage, occupations, and verbal threats. The violence led to extended closures and debilitating shortages in healthcare services, disproportionately affecting vulnerable populations, such as children under five, or people who are elderly, chronically ill, or displaced. Healthcare workers faced psychological trauma and moral injury from repeated attacks and the inability to provide adequate care. Personnel and communities made enormous efforts to mitigate impacts, and advocate for assistance. They were limited by failed reporting mechanisms, ongoing insecurity, persistent lack of resources and external support. CONCLUSION: Effective strategies to safeguard healthcare from violence exist but better support for communities and health workers is essential, including measures to assess needs, enhance security, and facilitate recovery by quickly rebuilding, resupplying, and re-staffing facilities. CAR's government, international organizations, and donors should make concerted efforts to improve reporting mechanisms and end impunity for perpetrators. Their investment in community organizations and long-term health system support, especially for health worker training, salaries, and psychosocial care, are vital steps towards building resilience against and mitigating the impacts of attacks on healthcare.

The ethical dimension of personal health monitoring in the armed forces: a scoping review.

BACKGROUND: Personal Health Monitoring (PHM) has the potential to enhance soldier health outcomes. To promote morally responsible development, implementation, and use of PHM in the armed forces, it is important to be aware of the inherent ethical dimension of PHM. In order to improve the understanding of the ethical dimension, a scoping review of the existing academic literature on the ethical dimension of PHM was conducted. METHODS: Four bibliographical databases (Ovid/Medline, Embase.com, Clarivate Analytics/Web of Science Core Collection, and Elsevier/SCOPUS) were searched for relevant literature from their inception to June 1, 2023. Studies were included if they sufficiently addressed the ethical dimension of PHM and were related to or claimed relevance for the military. After selection and extraction, the data was analysed using a qualitative thematic approach. RESULTS: A total of 9,071 references were screened. After eligibility screening, 19 articles were included for this review. The review identifies and describes three categories reflecting the ethical dimension of PHM in the military: (1) utilitarian considerations, (2) value-based considerations, and (3) regulatory responsibilities. The four main values that have been identified as being of concern are those of privacy, security, trust, and autonomy. CONCLUSIONS: This review demonstrates that PHM in the armed forces is primarily approached from a utilitarian perspective, with a focus on its benefits, without explicit critical deliberation on PHM's potential moral downsides. Also, the review highlights a significant research gap with a specific lack of empirical studies focussing specifically on the ethical dimension of PHM. Awareness of the inherent ethical dimension of PHM in the military, including value conflicts and how to balance them, can help to contribute to a morally responsible development, implementation, and use of PHM in the armed forces.

A Randomized Controlled Trial of Two Parent-Child Parallel Interventions to Enhance Positive Adaptation of Immigrant Families in Hong Kong: The Moderating Role of Depressive Symptoms.

Parents and children who have recently immigrated from the Chinese mainland to Hong Kong face various challenges, including psychological and sociocultural adaptation difficulties. In collaboration with community partners, our research team has developed and implemented culturally sensitive and preventive parent-child parallel interventions to enhance positive adaptation among immigrant parents and children. Two interventions were conducted in this randomized controlled trial: an emotion regulation (ER) arm, which addressed psychological adaptation by reducing parent-child conflicts and improving emotions, and an information provision (IP) arm targeting sociocultural adaptation by increasing participants' knowledge about Hong Kong. The study randomly assigned 113 and 73 parent-child pairs (allocation ratio 3:2) into the ER and IP arms, respectively. Parents and children attended four two-hour weekly sessions of their assigned intervention and completed assessments before, immediately after, and one month following the intervention. The results showed that in the ER arm, parents showed improved positive affect, and children reported decreases in parent-child conflicts more than their counterparts in the IP arm. In the IP arm, parents and children increased their knowledge, and parents decreased sociocultural adaptation difficulties more than their counterparts in the ER arm. In addition, the moderation analyses showed that in both interventions, parents and children with elevated baseline depressive symptoms obtained greater benefits relative to their counterparts with fewer symptoms. Such marked improvements were seen among parents in negative affect and adaptation difficulties and among children in parent-child conflict, positive and negative affect in the ER arm. More improvements were noted among parents in negative affect and sociocultural adaptation difficulties and among children in negative affect in the IP arm. Future studies are suggested to develop and provide parent-child parallel interventions targeting both psychological and sociocultural adaptations to parents and children with heightened baseline depressive symptoms to facilitate their positive adaptation in Hong Kong.

Activity of the Tobacco Industry in Research and Scientific Literature.

Introduction: Tobacco companies conduct and fund research. They are not always interested in open-ended research. They promote their interests through public relations campaigns. It's a proven fact that they influence the scientific community by impairing scientific reputation, especially in the case of health-related research. Methods: To obtain a comprehensive picture of research and funding activities of the tobacco industry as well as studies about the tobacco industry, respective scientific articles were analyzed in terms of temporal aspects, research areas, networking, and funding sources using established and advanced bibliometric methods. Results: We found the foci of publications with tobacco industry involvement or funding were mainly in chemistry, toxicology, pharmacology, and agricultural sciences. Health-related scopes occurred much less frequently. In contrast, health and medical sciences were the main focus of publications on the tobacco industry. The Chinese state-owned CNTC was the most research-involved tobacco company and often networked with Chinese academic institutions. Whereas, Western universities, on the other hand, collaborated with tobacco companies to a much lesser extent. Conclusion: Conflicts of interest of researchers or academic institutions with the tobacco industry occur repeatedly. That is highly problematic and should not be ignored by the scientific community. The science and the public should be skeptical about tobacco industry-supported research.

Khartoum War's echoes in oil and energy sectors: Economic and environmental implications for Sudan and South Sudan.

The energy sector is a main driver of African growth, particularly in regions with geopolitical conflicts like Sudan and South Sudan. The oil and gas industry notably influences these regions' economy, politics, humanitarian situation, and social stability. This study seeks to investigate how the Khartoum War affected the energy sector of both Sudan and South Sudan, particularly looking at the disruptions caused by recent conflicts and their impact on oil production, economic stability, and environmental conditions. The study employs a multi-disciplinary approach, utilising different sources such as regional legal agreements, government reports, academic articles, and press releases from international organisations. The key methodology includes qualitative analysis of several documents and quantitative assessment of production data and economic reports. The study's key findings show a significant decline in oil production and transportation due to the shutdown of key oilfields and pipelines, intensifying economic and humanitarian crises. Additionally, the damage to oil infrastructure has presented serious environmental risks, highlighting the delicate balance between resource management and regional stability. In conclusion, the study's findings underscore the intense impact of the Khartoum War on the energy sector of Sudan and South Sudan, and the urgent need for policy recommendations to mitigate these effects and foster sustainable development.

Associations of mothers' decisional conflicts and satisfaction with governmental health promotion materials with their daughters' HPV vaccination uptake in China: A cross-sectional survey.

Background: China started to implement the HPV vaccination program for females in 2016. This study investigated associations between mothers' decisional conflicts, satisfaction with governmental health promotion materials, and their daughters' HPV vaccination uptake. Methods: A cross-sectional online survey was conducted between July and October 2023 among mothers of girls aged 9-17 years in Shenzhen, China. Participants were mothers having a daughter aged 9-17 years at the survey date and a smartphone with internet access. About 3 % of all primary and secondary schools in Shenzhen were randomly selected by the research team (11 primary schools and 13 secondary schools). Teachers at the selected schools invited mothers of female students aged 9-17 years to complete an anonymous online questionnaire. Multivariate logistic regression was fitted. Results: Among 11,728 mothers who completed the survey, 18.9% of their index daughters received at least one dose of HPV vaccination. In multivariate analysis, less decisional conflict about the choice of HPV vaccines for their daughters (AOR: 1.07, 95%CI: 1.05, 1.10), more satisfaction with the government's health promotional materials related to HPV vaccines (AOR: 1.15, 95%CI: 1.12, 1.19), receiving more cue to action from significant others (AOR: 1.23, 95%CI: 1.19, 1.27), and perceived higher self-efficacy related to HPV vaccines (AOR: 1.79, 95%CI: 1.67, 1.92) were associated with a higher uptake of HPV vaccines. Perceived susceptibility to HPV (AOR: 0.79, 95%CI: 0.74, 0.85), perceived barriers to having the index daughter receive HPV vaccines (AOR: 0.82, 95%CI: 0.80, 0.84), and mothers who were hesitant to receive HPV vaccination (AOR: 0.75, 95%CI: 0.68, 0.84) were associated with a lower uptake. Conclusion: HPV vaccination uptake was low among girls in China. Future health promotion should address mothers' decisional conflicts about the choice of HPV vaccines for their daughters and improve the health promotional materials. School-based HPV vaccination programs might be useful.

Decision-making conflicts regarding hematopoietic stem cell transplantation in patients with hematological neoplasms: A descriptive qualitative study.

PURPOSE: To explore and understand the conflict in decision-making of hematopoietic stem cell transplantation in patients with hematological neoplasms. METHODS: A descriptive qualitative study of 16 patients with hematologic neoplasms in the hematology department was conducted between February 2022 and May 2022. Purposive sampling was used to select participants. Face-to-face in-depth personal interviews were performed. Interviews were recorded, transcribed, and coded. This descriptive qualitative study adhered to the COREQ checklist. RESULTS: All patients indicated difficulties in making decisions regarding hematopoietic stem cell transplantation. Five themes were identified: (1) weighing the pros and cons of HSCT, (2) financial burden versus desire for rebirth, (3) treatment urgency versus being unprepared, (4) saving oneself versus damaging loved ones, and (5) family companionship versus emotional isolation. These themes reflect the contradictions, entanglements, and realistic conflicts in decision-making regarding hematopoietic stem cell transplantation for patients with hematological neoplasms. CONCLUSIONS: This study identified multiple conflicts of decision-making in patients with hematologic neoplasms regarding decisions on hematopoietic stem cell transplantations. Healthcare workers should provide patients with disease knowledge, doctor-patient and intra-family communication, and access to financial support in order to resolve their conflicts and ultimately help them make the decision that is most optimum for them.

Experiences of workplace conflicts by midwives and implications for their wellbeing in selected hospitals in the Northern Region of Ghana.

AIM: Conflicts are ubiquitous in human societies and manifest in varied forms and scales within societies, communities and organisations. While many studies have investigated workplace conflicts, least attention has been paid to how midwives differently experience these conflicts and the impacts of these conflicts on their wellbeing. This study fills this gap by investigating the multifaceted impact of workplace conflicts on the wellbeing of midwives. METHOD: The study employed a purely qualitative approach within the analytical framework of the Stress Theory of organisational conflicts. Thirty-five participants were selected for the study through an expert purposive sampling technique. Interviews and Focus Group Discussions were used to collect primary data for the study. Collected data were analysed using an inductive thematic analytical technique. RESULTS: The findings highlight the multifaceted impact of conflict on both the professional and personal well-being of midwives. Conflicts induce severe physical and psychological strains on midwives, generate fears, angst, and anxieties, and disrupt social harmony prompting exclusion and discrimination among midwives in the hospital. CONCLUSION: We argue that apart from task-demand generated stress, workplace conflicts prompt both physical and psychological stress on midwives which culminate into a myriad of physical, emotional, and mental health issues. IMPLICATION FOR PRACTICE: Initiation of conflict resolution and mediation training programs for midwives so as to equip them with essential skills for effectively managing and resolving workplace conflicts. Setting up internal grievance mechanisms for midwives in their work places and training of midwives on social skills, and stress management skills.

Navigating sexual minority identity in sport: a qualitative exploration of sexual minority student-athletes in China.

BACKGROUND: Sexual minority student-athletes (SMSAs) face discrimination and identity conflicts in intercollegiate sport, impacting their participation and mental health. This study explores the perceptions of Chinese SMSAs regarding their sexual minority identities, aiming to fill the current gap in research related to non-Western countries. METHODS: A qualitative methodology was adopted, utilising the Interpretive Phenomenological Analysis (IPA) approach with self-categorization theory as the theoretical framework. Participants were recruited through purposive and snowball sampling, and data were collected via semi-structured interviews, documents, and field notes. Sixteen former and current Chinese SMSAs participated in this study. RESULTS: The study reveals four themes: hidden truths, prioritisation of athlete identity, self-stereotyping, and attempt. The results revealed that while SMSAs were common in intercollegiate sport, their identities were often concealed and not openly discussed. The predominant focus on athlete identity in sport overshadowed their sexual minority identities. Additionally, SMSAs developed self-stereotypes that influenced their thoughts and behaviours. The non-heterosexual team atmosphere in women's teams led to the development of intimate relationships among teammates. CONCLUSIONS: The findings from this study could be incorporated into existing sport policies to ensure the safe participation of SMSAs in Chinese intercollegiate sports. This research offers valuable insights for the development and implementation of inclusive policies. Future research in China could investigate the attitudes of coaches and heterosexual student-athletes toward sexual minority identities to inform targeted interventions.

Conflicts of Interest in Nutrition: Categorical Thinking and the Stigma of Commercial Collaboration.

There is a high level of concern about the possible influence of commercial organizations on food-related research and professional bodies, including regulatory and advisory panels. This has contributed to an increased emphasis on the declaration and management of conflicts of interest (CoI) in the reporting, evaluation, and application of research in nutrition science. However, common perceptions of CoI in nutrition, and procedures for declaring and managing these, often lack intellectual rigor and consistency. This commentary highlights 3 main issues related to CoI in nutrition, particularly the emphasis on industry-related CoI relative to other sources of conflict and bias. 1) Considerations of CoI in nutrition are largely limited to financial or collaborative links to the food industry, disregarding other important sources of influence such as intellectual allegiances or nonindustry financial and professional incentives. 2) Associations with industry incur ad hominem, often punitive stigmatization of individuals and their research, and inappropriate downgrading or exclusion of evidence. This disproportionately affects expertise in the food and agricultural sciences, in which commercial collaborations are widely encouraged. 3) These practices and related approaches to managing CoI are applied without due consideration of the nature of the conflicts and activities involved, the qualifications of individuals, or the availability of other, objective methods and guidance for assessing research quality and risks of bias. Overall, recognition of the nature and range of CoI in nutrition and approaches to their identification and management lack consistency and balance. A singular and strict focus specifically on industry-related CoI may paradoxically exacerbate rather than mitigate imbalance and bias in the field. This commentary outlines the underlying issues and the need for more comprehensive and nuanced approaches to the assessment, reporting, and management of CoI in nutrition.

Profiles of suicide attempted in children and adolescents

Abstract Objective: Suicide attempt (SA) is the strongest predictive variable for completed suicide. The Department of Cauca in Colombia has an SA rate higher than the national average, but the factors are unknown. The objective was to identify the profiles of SA in children and adolescents of Cauca. Methods: Cross-sectional study, which included all SA (Event-356) records from the SIVIGILA platform in children under 18 years of age between 2016 and 2019. The authors described the variables and multiple correspondence analysis (MCA) with the Burt method, according to the completeness of the data to establish the possible SA profiles using STATA 15.1, and R. The Ethics Committee at Universidad del Cauca approved it. Results: The study found 977 SA during this period, 72.4% female, 97.1% adolescent, 74.4% mestizo, 19.3% indigenous, 45.3% resided in municipalities exposed to the armed conflict, 32.3% expressed ideation and previous attempts, and 15.5% prior attempts. The MCA included 810 SA and identified three profiles: "Classic", which had mestizo adolescents with a history of prior SA, mental illness, or psychoactive substance use problems; "Related to the armed conflict", which included female adolescents with a first SA and residents in municipalities exposed to the armed conflict; "Ethnic" represented by male indigenous, with housing in a rural area. Conclusion: The SA profiles found in Cauca were "Classic", "Related to the armed conflict", and "Ethnic"; these can be considered to implement prevention strategies from a cross-cultural, mental health, and gender perspective, with the presence of the state in the territories.

"Will you need this health at all? Will you be alive?": using the bioecological model of mass trauma to understand HIV care experiences during the war in Ukraine.

INTRODUCTION: Russia's invasion of Ukraine in February 2022 has severely impacted the healthcare system, including the provision of HIV care. The ongoing war is a human-caused mass trauma, a severe ecological and psychosocial disruption that greatly exceeds the coping capacity of the community. The bioecological model of mass trauma builds on Bronfenbrenner's concept of interaction between nested systems to argue that social context determines the impact of life events on the individual and how an individual responds. This paper uses the bioecological model of mass trauma to explore the impact of Russia's aggression against Ukraine and the ongoing war on HIV-positive people who use drugs in Ukraine, a particularly vulnerable population that may be negatively affected by disruptions to social networks, healthcare infrastructure and economic conditions caused by mass trauma. METHODS: Data were collected between September and November 2022. A convenience sample of 18 HIV-positive people who use drugs were recruited from community organizations that work with people living with HIV, drug treatment programmes, and HIV clinics through direct recruitment and participant referral. A total of nine men and nine women were recruited; the age ranged from 33 to 62 years old (mean = 46.44). Participants completed a single interview that explored how the war had affected their daily lives and access to HIV care and other medical services; their relationships with healthcare providers and social workers; and medication access, supply and adherence. Data were analysed using the Framework Method for thematic analysis. RESULTS: The war had a profound impact on the social, emotional and financial support networks of participants. Changes in social networks, coupled with limited job opportunities and rising prices, intensified financial difficulties for participants. Relocating to different regions of Ukraine, staying at somebody else's home, and losing connections with social workers impacted medication adherence and created lengthy treatment gaps. Participants also experienced a decreased supply of antiretroviral therapy, concerns about accessing medication for opioid use disorder, and overwhelming fears associated with the war, which overshadowed their HIV-related health concerns and negatively impacted medication adherence. CONCLUSIONS: Our analysis reveals the complex impact of war on social networks and healthcare access. Maintaining support networks and competent healthcare providers will be essential amid the ongoing war.

Exploring the impact of right-turn safety measures on E-bike-heavy vehicle conflicts at signalized intersections.

A major safety hazard for e-bike riders crossing an intersection is encountering heavy vehicles turning right in the same direction, which often results in severe casualties. Recently, some cities in China have implemented right-turn safety improvement treatments (i.e., right-turn yielding rules and right-turn warning facilities) at intersections to reduce the occurrence of such accidents. However, the risk perception and behavior of e-bike riders and heavy vehicle drivers dynamically change during the right-turn interaction process, and the safety effects of different right-turn safety measures remain unclear. This study aims to investigate the safety effect of right-turn safety measures on E-Bike-Heavy Vehicle (EB-HV) right-turn conflicts at signalized intersections. The right-turn conflicts and potential influencing factors are extracted from aerial video data, including characteristics of right-turn warning facilities, characteristics and behavior of e-bike riders and heavy vehicle drivers, environmental factors, and traffic-related factors. Moreover, traffic conflict indicators such as the Time to Collision (TTC), Post Encroachment Time (PET), and Jerk are selected and calculated. Multinomial and binary logit models are used to estimate and analyze the EB-HV right-turn conflict severity and drivers yielding behavior. The results reveal that: (a) right-turn warning facilities can decrease the probability of slight and severe EB-HV right-turn conflicts, while the presence of law enforcement cameras could prompt heavy vehicle drivers to comply with the yielding rules and adopt more cautious behavior; (b) increased heavy vehicle speed and acceleration before turning right have strong correlation to illegitimate yielding behavior of the driver and higher EB-HV right-turn conflict severity; and (c) aggressive behavior of e-bike rider increases the severe conflict probability, especially at intersections without right-turn warning facilities. Based on the study findings, several practical implications are suggested to reduce the risk of EB-HV right-turn conflicts, enhance the effectiveness of right-turn safety measures, and improve crossing safety for e-bike riders.

Bayesian hybrid gamma-GPD model for extreme traffic conflict threshold determination in the peak over threshold approach.

Extreme value theory (EVT) models have been frequently utilized to estimate crash risk from traffic conflicts with the peak over threshold commonly used to identify conflict extremes. However, a common problem for the peak over threshold method is the selection of a suitable threshold to distinguish general and extreme conflicts. Subjective and arbitrary selection of the threshold in peak over threshold method can result in bias and unstable estimation results. The primary objective of the study is to propose a hybrid modelling approach for the threshold determination in peak over threshold method. The hybrid model consists of a joint gamma distribution and generalized Pareto distribution (GPD). The gamma distribution is used to fit general conflicts while the GPD is used to fit extreme conflicts. Specially, discontinued, continued and differentiable gamma-GPD models are developed with the threshold being treated as a model parameter. Traffic conflict data collected from three signalized intersections in the city of Surrey, British Columbia were used for the study. The modified time to collision (MTTC) was employed as conflict indicator. The Bayesian approach was employed to estimate the threshold as well as other hybrid gamma-GPD model parameters. The results show that the discontinued gamma-GPD model is superior to the continued and differentiable gamma-GPD models for determining the threshold in terms of crash estimation accuracy and model fit. The crash estimates using the threshold determined by the hybrid gamma-GPD model outperform those estimated based on the traditional quantile plots method, indicating that the superiority of the proposed threshold determination approach based on gamma-GPD hybrid model. The proposed hybrid gamma-GPD model could determine the threshold parameter in peak over threshold method for traffic conflicts extremes automatically in an objective and quantitative way. It contributes to existing peak over threshold method for producing reliable crash estimation.

Analysis of pedestrian-two-wheeler conflicts at green light digital countdown signals: A random parameter ordered logit model approach.

The rising prevalence of e-bikes and shared bikes in transportation modes adds complexity to pedestrian movement at intersections. The conflict technique is a substitute for collisions in analyzing pedestrian safety at digital countdown signal intersections. Pedestrian and two-wheeler trajectories were obtained using Unmanned Aerial Vehicle (UAV) and T-Analyst software. The severity of pedestrian-two-vehicle conflicts was assessed using indicators such as Time to Collision (TTC), Post Encroachment Time (PET), and Yaw Rate Ratio (YRR), along with the fuzzy C-mean clustering method. An analysis of the impact of pedestrian characteristics, cyclist characteristics, and road conflict factors on severity was conducted using a random parameter ordered logit model. A total of 630 valid conflicts were identified, comprising 105 potential conflicts, 242 minor conflicts, and 283 serious conflicts. More minor and serious conflicts occurred in Signal 1 and Signal 2. Serious conflicts mainly occurred in road Zone 2, Zone 3, and Zone 5, while minor conflicts were more frequent in Zone 4 and Zone 5. Pedestrian crossing at Signal 2 increased the conflict severity, and the refuge island had a similar effect. Cyclists passing the conflict point first reduced the probability of serious conflicts. Older adults are safer at countdown signal intersections than young people. It is essential to enhance the awareness of digital countdown signals among youth. Managers should consider diverting two-wheelers during peak hours and encourage cyclists to walk through crosswalks.