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Herpes zoster (HZ), a common disease in older adults, affects their quality of life. Therefore, this study aimed to examine the blog posts of HZ-related information on social media platforms to analyze the attitudes and behaviors of residents toward the dissemination of health information. This research used content analysis to focus on Weibo, a representative social media in China, to analyze the content of 1866 blog posts related to herpes zoster (HZ) and herpes zoster vaccine (HZV). According to the consistency test by Cohen's Kappa, four themes were identified: (a) sources, (b) tones, (c) epidemiological information, and (d) extended parallel process model elements. The findings showed that most information on Weibo came from non-professionals, with a neutral tone, and showed the invisible pain of HZ and the effectiveness of HZV through the two largest aspects of prevention and aged protection in epidemiological information. However, current blog posts treat the older adult as invisible individuals, failing to acknowledge them as recipients of the information. Additionally, the cost of the vaccine acts as an invisible economic barrier, contributing to the dissemination of incorrect information about folk remedies. This impacts the older adult's acceptance of health information related to HZV. Thus, the way to share health information with the older adult needs to be improved in the future, and attention should be paid to the transmission of incorrect information to improve their vaccination rates and awareness of health management.

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Objective: The purpose of this study was to develop an effective communication approach to encourage lung cancer screening action within rural screening-eligible populations. Methods: An iterative research approach using targeted engagement with the priority population was used. Findings were triangulated through multiple methods, including two surveys and concept testing interviews. The Health Belief Model and the Extended Parallel Process Model served as study frameworks. Results: Initial findings suggest that threat levels are high in the priority population and an emphasis on barrier mitigation messaging may drive action. Health campaign posters integrating these findings were developed and tested with the priority population. The new health campaign posters were tested against examples of previously used health campaign posters. Findings suggest that the new health campaign posters were more effective in spurring lung cancer screening motivation and intention to act in the priority population compared to current health campaign poster examples. Conclusion: Messaging focused on gain-framing, inoculation messaging, and barrier mitigation may be more effective in encouraging lung cancer screening action in rural eligible populations. Innovation: This project outlines a systematic process to developing effective, targeted communication approaches using behavior change and persuasive communication frameworks along with engagement from priority populations.

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Competency-based teasing has been identified as a risk factor for children's depressive symptoms. However, the specific psychological mechanisms mediating this relationship are not well understood, especially in the context of Chinese culture. This study examined the relationship between competency-based teasing, subsequent depressive symptoms, and the possible mediating role of positivity in Chinese children by using parallel process latent growth curve modelling. Gender differences were also explored. A sample of 4376 Chinese children (55.1% boys; age: M = 9.98 years, SD = 0.88) completed measurements of the relevant constructs on five occasions across 2 years, using half-year intervals. The findings revealed that competency-based teasing was significantly positively associated with subsequent depressive symptoms in Chinese children. Furthermore, positivity mediated this relationship in girls, but not in boys. The results suggest that positivity-cultivating and gender-specific interventions may be effective to reduce the risk of depressive symptoms in Chinese children.

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BACKGROUND: The higher prevalence of hookah tobacco smoking (HTS) has become worrisome in women. Thus, it is essential to identify and measure the perceptions associated with this unhealthy behavior as well as the type of response to risk messages to design the effective programs. This study aimed to psychometric evaluation of a new instrument, named the Extended Parallel Process Model-Hookah Tobacco Smoking Questionnaire (EPPM-HTSQ), for female university students. MATERIAL AND METHODS: This methodological study was conducted in 2019-2020 in central and western Iran. The first version of the instrument was developed with 97 items. Face, Content, and construct validity methods were used to assess the EPPM-HTSQ validity. The data viability for factorability was guided through Kaiser-Meyer-Olkin (KMO) measure of sample adequacy (Values >0.7) and Bartlett's test of Sphericity (P < 0.05). The Exploratory Factor Analysis (EFA) method with varimax rotation and SPSS software was performed to identify the main factors of the questionnaire and interpretable factors. The internal consistency and external reliability were determined. The test-retest was used for evaluating the stability of tools. RESULTS: During the assessment of the face and content validity 71 items remained in the questionnaire. EFA led to the extraction of nine dimensions: "Focusing on superior rewards," "Response Efficacy," "Perceived physical threat," "Perceived social threat," "Self-efficacy," "Fear control," "Attitude," "Fear," and "Intention" Kaiser-Meyer-Olkin (KMO) test (0.957) and Bartlett's test (P < 0.001). Cronbach's alpha (0.871-0.951) and ICC (0.985-0.998) were approved for scale dimensions. CONCLUSION: Important findings of the present study were the development and validation of the EPPM-HTSQ for measuring EPPM variables in relation to HTS; introducing a new variable "focusing on superior rewards"; as well as, the new classification of the concept of "perceived threat." The final version of the EPPM-HTSQ is a valid and reliable tool, but it is suggested to be re-evaluated in other studies with different populations and sample sizes.

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BACKGROUND: Perceiving oneself as obese has been associated with weight loss attempts. However, such a perception may not sufficiently drive significant weight reduction in many individuals. Hence, relying solely on the traditionally emphasized perceived risk of behavioral changes in obesity is challenging. This study used an extended parallel process model and a risk perception attitude framework to explore the influence of perceived risk and perceived efficacy on individual obesity knowledge and obesity prevention behaviors. METHODS: Data were obtained from 1,100 Korean adults aged 40-69 years through an online survey conducted in October 2022. Multinomial logistic regression and analysis of variance were employed to assess the relationships among perceived risk, perceived efficacy, obesity knowledge, and obesity prevention behaviors. RESULTS: Sex was associated with being underweight, overweight, and obese. Moreover, perceived severity was associated with obesity, whereas perceived susceptibility was associated with overweight and obese. Response efficacy was related to being overweight alone, whereas self-efficacy was associated with being underweight, overweight, and obese. The main effects of sex and perceived risk, and their interaction effect were statistically significant for obesity knowledge. Additionally, the main effects of sex, perceived risk, and perceived efficacy on obesity prevention behaviors were statistically significant. CONCLUSIONS: The extended parallel process model and risk perception attitude framework proved effective in classifying obesity based on body mass index, obesity knowledge, and obesity prevention behaviors.

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Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30-59 years (n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants' knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy (P < 0·001 for all) and response efficacy (P = 0·029) in comparison with CG. GFM (P = 0·004) and G\FLM (P = 0·034) reduced carbohydrate intake and LFM (P = 0·034) and G\LFM (P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P = 0·046), BMI (P = 0·038), fasting blood sugar (P = 0·030), 2-hour postprandial blood glucose (P = 0·027) and TAG (P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended.

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BACKGROUND: Insomnia symptoms are common following bereavement and may exacerbate severe and protracted grief reactions, such as prolonged grief disorder (PGD). However, typical trajectories of insomnia symptoms and risk factors for having a more chronic insomnia trajectory following bereavement are yet unknown. METHOD: In the current investigation, 220 recently bereaved (≤6 months post-loss) participants, completed questionnaires assessing sociodemographic and loss-related characteristics, rumination, experiential avoidance and symptoms of (prolonged) grief and depression, on three time-points (6 months apart). We applied growth mixture models to investigate the typical trajectories of insomnia symptoms following bereavement. RESULTS: Three insomnia trajectory classes emerged, characterized by a resilient (47 %), recovering (43 %), and a chronic trajectory (10 %). Baseline depression symptoms best predicted the type of insomnia trajectory. At one-year follow-up, 9 %, 27 %, and 60 % of participants met the criteria for probable PGD within the resilient, recovering and chronic trajectory, respectively. A parallel process model showed that temporal changes in insomnia symptoms were strongly related to changes in prolonged grief symptoms. CONCLUSION: The results suggest, that targeting insomnia symptoms in the treatment of PGD, particularly with comorbid depression, may be a viable option.

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There is limited evidence on heterogenous co-developmental trajectories of internalizing (INT) and externalizing (EXT) problems from childhood to adolescence and predictors of these joint trajectories. We utilized longitudinal data from Raine Study participants (n = 2393) to identify these joint trajectories from 5 to 17 years using parallel-process latent class growth analysis and analyze childhood individual and family risk factors predicting these joint trajectories using multinomial logistic regression. Five trajectory classes were identified: Low-problems (Low-INT/Low-EXT, 29%), Moderate Externalizing (Moderate-EXT/Low-INT, 26.5%), Primary Internalizing (Moderate High-INT/Low-EXT, 17.5%), Co-occurring (High-INT/High-EXT, 17%), High Co-occurring (Very High-EXT/High-INT, 10%). Children classified in Co-occurring and High Co-occurring trajectories (27% of the sample) exhibited clinically meaningful co-occurring problem behaviors and experienced more adverse childhood risk-factors than other three trajectories. Compared with Low-problems: parental marital problems, low family income, and absent father predicted Co-occurring and High Co-occurring trajectories; maternal mental health problems commonly predicted Primary Internalizing, Co-occurring, and High Co-occurring trajectories; male sex and parental tobacco-smoking uniquely predicted High Co-occurring membership; other substance smoking uniquely predicted Co-occurring membership; speech difficulty uniquely predicted Primary Internalizing membership; child's temper-tantrums predicted all four trajectories, with increased odds ratios for High Co-occurring (OR = 8.95) and Co-occurring (OR = 6.07). Finding two co-occurring trajectories emphasizes the importance of early childhood interventions addressing comorbidity.

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PURPOSE: Identify how early COVID-19 public health messages incorporated in the tenets of the extended parallel process model (EPPM). SETTING: YouTube videos developed by governmental departments, medical institutions, news organizations, and non-profit organizations in the United States were aggregated. METHOD: This qualitative study conducted a keyword search to identify public service announcements (PSAs). The sample was further refined after searching PSAs that contained fear appeals. A thematic analysis was performed by using the constant comparative method. SAMPLE: A total of forty-three videos was included in the final analysis. RESULT: Two themes emerged regarding messages aimed at arousing the perceived severity of threat. These themes include emphasizing the consequences of being infected and utilizing personal narratives. Perceived susceptibility of threat was aroused by emphasizing that some groups have higher risks than others. Two themes emerged around arousing perceived response efficacy: (1) the authority of professionals; and (2) altruism and personal responsibility. One way was identified to arouse perceived self-efficacy, which is informing the protective measures. CONCLUSION: Multiple strategies were used in PSAs about COVID-19 to arouse fear during the early stages of the pandemic. The utilization of self-efficacy was oversimplified, by not providing details about the rationale for the recommended behavior.

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Teacher-student relationships (TSR) have been a key focus of study for developmental and educational psychology researchers interested in improving proximal and distal academic outcomes for children and youth. Although prior empirical work suggests some degree of association between TSR and achievement, the co-development of TSR and achievement during elementary grades remains unclear with most findings limited to reading and mathematics achievement. The current study used parallel process growth curve models (PPGCMs) to examine the longitudinal growth trajectories of teacher-student closeness and conflict, and science, reading, and mathematics achievement simultaneously for children followed from kindergarten to third grade in the Early Childhood Longitudinal Study, Kindergarten Class of 2010-2011 (N = 13,490). Findings from the final PPGCM showed teacher-student closeness in kindergarten was positively associated with science, reading and mathematics achievement in kindergarten (r = 0.234 to 0.277) and the linear growth of achievement through third grade (r = 0.068 to 0.156). Teacher-student conflict in kindergarten was negatively associated with science, reading, and mathematics achievement in kindergarten (r = -0.099 to -0.203) and the linear growth of achievement through third grade (r = -0.081 to -0.135). Child biological sex, family socioeconomic status, and child racial and ethnic identity predicted TSR and achievement developmental trends. Implications of the findings and future directions for research are discussed.

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This research aimed to inform the development of a health communication campaign to increase the uptake of COVID-19 prevention behaviors among university students. Twenty-eight students attending a mid-sized public university in the southeastern United States and 84 parents or guardians of university students were recruited. The study included an online survey assessing COVID-19 prevention behaviors, perceived susceptibility to COVID-19, perceived severity of COVID-19, and semi-structured interviews to elicit beliefs on COVID-19 prevention behaviors. Students and parents/guardians reported that getting COVID-19 was possible but not necessarily likely. COVID-19 was seen as serious and at least somewhat severe. Dominant interview themes for benefits, barriers, response efficacy, and self-efficacy related to prevention behaviors are reported. Overall, perceptions of behavioral benefits, barriers, and response efficacy were often shared by parents and students but varied across behaviors. These data provide insights for future campaign development for the control of infectious diseases among college students.

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Prescription drug misuse (PDM) is a mounting public health concern in the U.S., particularly among college students. The field's reliance on cross-sectional designs and limited controls for other substance use has failed to capture the specific role of misuse for longer-term health. Therefore, the present study tested associations between trajectories of PDM problems and college students' mental health and subjective happiness over time. Participants were 300 students who completed a baseline assessment (T1) and follow-ups every 6 months for two years (T2-T5). Participants self-reported problems associated with PDM and mental health. Results from univariate latent growth models indicated that problems with PDM were initially on an increasing trajectory. Based on parallel process models, problems with PDM were concurrently associated with higher levels of depressive symptoms, disinhibition, callousness/aggression, and lower levels of subjective happiness at T1. Further, we found support for parallel trajectories between PDM problems and both depressive symptoms and general disinhibition. Participants whose PDM problems were on an increasing (worsening) trajectory at baseline showed an increase in depressive symptoms and general disinhibition over the next two years. Participants whose PDM problems accelerated over time (got worse at a faster and faster rate over time) also showed a significant increase in their depressive symptoms over time. Most findings, however, were no longer statistically significant in sensitivity analyses that controlled for alcohol and other drug problems. Findings highlight college as an important time for interventions to prevent substance use and its associated negative consequence on later young adult mental health.

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Introduction: Recent research has emphasized that achievement motivation is context-sensitive and varies within individual students. Ubiquitous temporal landmarks such as exams or deadlines are evident contextual factors that could systematically explain variation in motivation. Indeed, research has consistently found that university students increase their study efforts as exams come closer in time, indicating increasing study motivation. However, changes in study motivation for a specific exam as it comes closer have rarely been investigated. Instead, research on developmental changes in expectancy and value beliefs has consistently founds that achievement motivation declines over a semester. Surprisingly, declining motivation thus apparently coincides with increasing study efforts for end-of-semester exams. Methods: The present research investigates this apparent contradiction by assessing how exam-specific motivation and study behavior change under equal methodological conditions as an exam draws closer. Using parallel growth curve models, we examine changes in expectancy-value beliefs, performance approach and avoidance motivation and study behavior as well as motivational want- and should-conflicts among 96 students over eight weekly measurement points. Results and discussion: Results show that students study more for their exam as it comes closer and increase their use of surface learning strategies more rapidly than their use of deep learning strategies. However, even exam-specific expectancy and attainment value beliefs decline while performance-avoidance motivation increases over time, indicating that students increasingly study out of fear to fail as exams come closer. Consistent with these findings, students' experience of should conflicts decreases while their want conflicts increase over time. We discuss several possible mechanisms underlying our findings in addition to potential theoretical consequences and suggest future research opportunities to better understand students' changes in situative motivation and study behavior in the context of temporal landmarks.

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Background and Aims: Preventive behaviors against coronavirus disease 2019 (COVID-19) are important, and messages that create a sense of danger are necessary to create these behaviors. One of the widely used models for designing risk messages is the Extended Parallel Process Model (EPPM). The present study was conducted to investigate the factors related to protective behaviors against COVID-19 in the personnel of the health department based on EPPM. Methods: In this cross-sectional study, 699 personnel of the deputy health department of Chaharmahal and Bakhtiari province were included in the study by census method. Data were collected online using valid questionnaires, including demographic questions and history of contracting COVID-19 and the questionnaire of EPPM constructs. Data were analyzed in SPSS24 software, using descriptive and analytical statistics. Results: The results showed that there were positive correlations between the protective behaviors and the constructs of perceived severity (p < 0.001, r = 0.542), perceived susceptibility (p < 0.001, r = 0.260), self-efficacy (p < 0.001, r = 0.594), response efficiency (p > 0.001, r = 0.522), and risk control (p > 0.001, r = 0.501). There was a negative correlation between protective behaviors and fear control (p < 0.001, r = 0.329). The results of multiple linear regression showed that these six constructs explained 49.8% of protective behaviors against COVID-19, among which the role of the perceived severity construct was stronger than other constructs. Conclusion: Regarding the results, it is suggested that the results of this research be used in the development of training programs to improve protective behaviors in high-traffic offices, and by focusing on fear and risk control.

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BACKGROUND: A theory-guided Tailored Counseling and Navigation (TCN) intervention successfully increased cancer genetic risk assessment (CGRA) uptake among cancer survivors at increased risk of hereditary breast and ovarian cancer (HBOC). Understanding the pathways by which interventions motivate behavior change is important for identifying the intervention's active components. PURPOSE: We examined whether the TCN intervention exerted effects on CGRA uptake through hypothesized theoretical mediators. METHODS: Cancer survivors at elevated risk for HBOC were recruited from three statewide cancer registries and were randomly assigned to three arms: TCN (n = 212), Targeted Print (TP, n = 216), and Usual Care (UC, n = 213). Theoretical mediators from the Extended Parallel Process Model, Health Action Planning Approach, and Ottawa Decision Support Framework were assessed at baseline and 1-month follow-up; CGRA uptake was assessed at 6 months. Generalized structural equation modeling was used for mediation analysis. RESULTS: The TCN effects were most strongly mediated by behavioral intention alone (ß = 0.49 and 0.31) and by serial mediation through self-efficacy and intention (ß = 0.041 and 0.10) when compared with UC and TP, respectively. In addition, compared with UC, the TCN also increased CGRA through increased perceived susceptibility, knowledge of HBOC, and response efficacy. CONCLUSIONS: Risk communication and behavioral change interventions for hereditary cancer should stress a person's increased genetic risk and the potential benefits of genetic counseling and testing, as well as bolster efficacy beliefs by helping remove barriers to CGRA. System-level and policy interventions are needed to further expand access.

It is recommended that cancer survivors at increased risk for heredity seek cancer genetic risk assessment (CGRA), which includes cancer genetic counseling and genetic testing. A Tailored Counseling and Navigation (TCN) intervention successfully increased CGRA uptake among women with a history of cancer who enrolled in a randomized controlled trial. Understanding reasons for TCN's effectiveness can guide future interventions that use risk messages and behavior change techniques. We conducted mediation analyses, which enabled identification of the TCN's active components. Eligible breast and ovarian cancer survivors (n = 641) were recruited from three statewide cancer registries and were assigned to three groups: TCN, Targeted Print, and Usual Care. Mediator variables drawn from behavioral and risk communication theories were assessed at baseline and 1-month follow-up; CGRA uptake was assessed at 6 months. The strongest mediator was intention to obtain a CGRA, followed by self-efficacy, perceived risk, knowledge of hereditary breast and ovarian cancer, and perceived CGRA benefits. Risk communication and behavioral change interventions for hereditary cancer should stress a person's increased genetic risk and the potential benefits of genetic counseling and testing, as well as bolster efficacy beliefs by helping remove CGRA barriers. System-level and policy interventions are needed to further expand access.

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OBJECTIVE: Optimizing health care workers' (HCWs) willingness to respond (WTR) is critical in low-and-middle-income countries (LMICs) for proper health system functioning during extreme weather events. Pakistan frequently experiences weather-related disasters, but limited evidence is available to examine HCW willingness. Our study examined the association between WTR and behavioral factors among emergency department HCWs. METHODS: A cross-sectional survey was conducted from August to September 2022 among HCWs from 2 hospitals in Karachi, Pakistan. Non-probability purposive sampling was used to recruit participants. A survey tool was informed by Witte's Extended Parallel Process Model (EPPM). Multivariate logistic regression analyses were performed to examine the association between WTR and attitudes/beliefs as well as EPPM profiles. RESULTS: Twenty-nine percent of HCWs indicated a low WTR. HCWs using public transportation had a higher WTR. Perceived knowledge and skills, self-efficacy, and perceived impact of one's response showed positive associations with WTR if required. Perception that one's colleagues would report to work positively predicted WTR if asked. Consistent with the EPPM, HCWs with high efficacy and perceived threat were willing to respond to weather disasters. CONCLUSIONS: Our findings highlight the need of strengthening WTR by promoting self-efficacy and enhancing accurate risk perception as a response motivator, among emergency department HCWs in Pakistan.

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Previous research suggested that during the COVID-19 pandemic, mental distress did not affect all people equally. This longitudinal study aims to examine joint trajectories of depressive, anxiety, and stress symptoms in a sample of Italian adults during the pandemic, and to identify psychosocial predictors of distress states. We analyzed four-wave panel data from 3,931 adults who had received assessments of depressive, anxiety and stress symptoms between April 2020 and May 2021. Trajectories of individual psychological distress were identified by Latent Class Growth Analysis (LCGA) with parallel processes, and multinomial regression models were conducted to identify baseline predictors. Parallel process LCGA identified three joint trajectory classes for depression, anxiety and stress symptoms. Most individuals (54%) showed a resilient trajectory. However, two subgroups showed vulnerable joint trajectories for depression, anxiety and stress. Expressive suppression, intolerance to uncertainty, and fear of COVID-19 were risk characteristics associated with vulnerable trajectories for mental health distress. Moreover, vulnerability to mental health distress was higher in females, younger age groups and those unemployed during the first lockdown. Findings support the fact that group heterogeneity could be detected in the trajectories of mental health distress during the pandemic and it may help to identify subgroups at risk of worsening states.

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Background: Efforts to increase the availability of Medication Assisted Treatment for alcohol use disorder (AUD) and opioid use disorder (OUD) may be futile if patients lack motivation for recovery and are unwilling to seek treatment. Objectives: In this cross-sectional, online survey, we used the Extended Parallel Process Model (EPPM) to assess how participants at risk of AUD or OUD react to their perceived threat and assess their response to pharmacotherapy as a potential treatment. EPPM constructs were assessed using the Risk Based Diagnosis Scale. Descriptive statistics measure the proportion of treated vs untreated participants. Untreated participants were sorted into one of three groups categorizing perceived threat - low threat appraisal, and danger or fear control. Results: Of 411 total responses, most (n = 293[71.29%]) sorted into the AUD cohort and 118(28.71%) into the OUD cohort. Overall, 104(25.30%) had received treatment and 307(74.70%) didn't. Within the OUD cohort, there were 67 untreated participants - 16(23.88%) exhibited low threat appraisal, 13(19.40%) were likely to undergo fear control, and 38(56.72%) were likely to undergo danger control. Within the AUD cohort, there were 240 untreated participants - 75(31.25%) exhibited low threat appraisal, 100(41.67%) were likely to experience fear control, and 65(27.08%) were likely to experience danger control. Participants in the OUD cohort were more likely to undergo danger control than those in the AUD cohort (χ2 = 19.26, p < 0.05). Conclusions: This study identified perceived threat and efficacy when an individual was at risk of a SUD, but more insight into potential early interventions is needed - particularly in those individuals with polysubstance use disorder.

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The present study examines the association between gray matter volume and cognition. Studies that have examined this issue have focused primarily on older adults, whereas the present study examines the issue across the entire adult lifespan. A total of 463 adults, ages 20-88 at first assessment, were followed longitudinally across three assessments over 8-10years. Significant individual differences in a general cognition measure comprised of measures of speed of processing, working memory, and episodic memory were observed, as well as in measures of cortical and subcortical gray matter. Parallel process latent growth curve modeling showed a reliable relationship between decreases in cortical matter and cognitive decline across the entire adult lifespan, which persisted after controlling for age effects. Implications of these findings in relation to progression toward dementia, risk assessment, cognitive intervention, and environmental factors are discussed, as well as implications for theories of cognitive aging.

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Background: Trachoma is an eye disease caused by bacteria called Chlamydia trachomatis. This infection causes papillary and/or follicular inflammation of the tarsal conjunctiva referred to as active trachoma. Active trachoma prevalence among 1 to 9 years old children is 27.2% in Fogera district (study area). Many people still require the implementation of the face cleanliness components of the SAFE strategy. Even if face cleanness is an important component to prevent trachoma, there is limited research done on this area. Therefore, the purpose of this study is to assess behavioral responses to face cleanliness messages to prevent trachoma among mothers having children aged 1 to 9 years old. Methods: A community-based cross-sectional study was conducted with the guidance of an extended parallel process model in Fogera District from December 01 to December 30, 2022. A multi-stage sampling technique was used to select 611 study participants. Interviewer administered questionnaire was used to collect the data. Bivariable and multivariable logistic regression analysis was done to identify predictors of behavioral responses using SPSS V.23 significant variables were declared by AOR at a 95% confidence interval and a p-value <0.05. Result: Among the total participants, 292 (47.8%) were in danger control. Residence [AOR = 2.91; 95% CI: (1.44-3.86)], marital status [AOR = 0.79; 95% CI: (0.667-0.939)], level of education [AOR = 2.74; 95% CI: (1.546-3.65)], family size [AOR = 0.57; 95% CI: (0.453-0.867)], round trip to collect water [AOR = 0.79; 95% CI: (0.423-0.878)], having information about face washing [AOR = 3.79; 95% CI: (2.661-5.952)], Source of an information health facility [AOR = 2.76; 95% CI: (1.645-4.965)], school [AOR = 3.68; 95% CI: (1.648-7.530)], health extension workers [AOR = 3.96; 95% CI: (2.928-6.752)], Women development army [AOR = 2.809; 95% CI: (1.681-4.962)], knowledge [AOR = 2.065; 95% CI: (1.325-4.427)] self-esteem [AOR = 1.013; 95% CI: (1.001-1.025)], self-control [AOR = 1.132; 95%CI: (1.04-1.24)], and future orientation [AOR = 2.16; 95% CI: (1.345-4.524)] were found to be statistically significant predictors of behavioral response. Conclusion: Less than half of the participants were in the danger control response. Residence, marital status, level of education, family size, face-washing information, source of information, knowledge, self-esteem, self-control, and future orientation were independent predictors of face cleanliness. Strategies of face cleanliness messages should give high attention to perceived efficacy with consideration of perceived threat.