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ObjectiveIn March 2020, several countries banned unnecessary outdoor activities during COVID-19, commonly called ‘lockdowns. These lockdowns have the potential to impact associated levels of physical activity and sedentary behaviour. Given the numerous health outcomes associated with physical activity and sedentary behaviour, the aim of this review was to summarise literature that investigated differences in physical activity and sedentary behaviour before vs during the COVID-19 lockdown.Design, data sources and eligibility criteriaElectronic databases were searched from November 2019 to October 2020 using terms and synonyms relating to physical activity, sedentary behaviour and COVID-19. The coprimary outcomes were changes in physical activity and/or sedentary behaviour captured via device-based measures or self-report tools. Risk of bias was measured using the Newcastle-Ottawa Scale.ResultsSixty six articles met the inclusion criteria and were included in the review (total n=86 981). Changes in physical activity were reported in 64 studies, with the majority of studies reporting decreases in physical activity and increases in sedentary behaviours during their respective lockdowns across several populations, including children and patients with a variety of medical conditions.ConclusionGiven the numerous physical and mental benefits of increased physical activity and decreased sedentary behaviour, public health strategies should include the creation and implementation of interventions that promote safe physical activity and reduce sedentary behaviour should other lockdowns occur.

The existing empirical research exploring the impact of threat appeals on driver behavior has reported inconsistent findings. In an effort to provide an up-to-date synthesis of the experimental findings, meta-analytic techniques were employed to examine the impact of threat-based messages on fear arousal and on lab-based indices of driving behavior. Experimental studies (k = 13, N = 3044), conducted between 1990 and 2011, were included in the analyses. The aims of the current analysis were (a) to examine whether or not the experimental manipulations had a significant impact on evoked fear, (b) to examine the impact of threat appeals on three distinct indices of driving, and (c) to identify moderators and mediators of the relationship between fear and driving outcomes. Large effects emerged for the level of fear evoked, with experimental groups reporting increased fear arousal in comparison to control groups (r = .64, n = 619, p<.01). The effect of threat appeals on driving outcomes, however, was not significant (r = .03, p = .17). This analysis of the experimental literature indicates that threat appeals can lead to increased fear arousal, but do not appear to have the desired impact on driving behavior. We discuss these findings in the context of threat-based road safety campaigns and future directions for experimental research in this area.

Non-heterosexual individuals are at high risk for a variety of factors associated with the emergence of psychotic experiences (PEs) (e.g. common mental disorders, substance use, and stress). However, there is a scarcity of data on the association between sexual orientation and PEs. Therefore, the aim of this study was to examine the sexual orientation-PE relationship, and to identify potential mediators in this relationship. This study used nationally representative cross-sectional data from the 2007 Adult Psychiatric Morbidity Survey. Sexual orientation was dichotomized into heterosexual and non-heterosexual. Past 12-month PE was assessed with the Psychosis Screening Questionnaire. Regression and mediation analyses were conducted to analyze the association between sexual orientation and PEs, and to identify potential mediators involved in this relationship. The final sample consisted of 7275 individuals aged ⩾16 years. The prevalence of non-heterosexual orientation and any PE was 7.1% and 5.5%, respectively. After adjusting for sex, age, and ethnicity, non-heterosexual orientation was positively associated with any PE (odds ratio 1.99, 95% confidence interval 1.34-2.93). The strongest mediators involved in this relationship were borderline personality disorder (BPD) traits (mediated percentage = 33.5%), loneliness (29.1%), and stressful life events (25.4%). These findings suggest that there is a positive relationship between sexual orientation and PEs in the general population in England, and that underlying mechanisms may involve BPD traits, loneliness, and stressful life events. Future studies with a longitudinal design are warranted to shed more light on how these factors are implicated in the association between sexual orientation and PEs.

Background The use of psychoactive substances is a key public health issue due to its impact on mental, physical, and social health. Integrated drug checking is a well-known harm reduction and addiction prevention measure and is currently implemented in four federal states in Austria. The aim of this study is to investigate the prevalence of drug checking use among a web-survey sample of people who use drugs (PWUD) in Austria and to examine differences in socio-demographic and substance use characteristics between individuals with and without drug checking experience. In addition, reasons for not using these services are explored. Methods A secondary data analysis of the Austrian data from the European Web Survey on Drugs (EWSD), a targeted survey conducted between March and May 2021 was performed. Based on reported drug checking experience, the data set was divided into two groups - those with and without drug checking experience – and compared. Results In this web-survey sample of PWUD ( n  = 1113), 20.1% reported prior use of a drug checking service in Austria. The groups with drug checking experience ( n  = 224) and those without ( n  = 889) differed significantly in both univariate and multivariate analyses. Univariate analysis revealed significant differences in terms of age, household composition, highest level of education, employment status, region of residence, substance use prevalences and treatment experience. Participants who used cannabis only had significantly less experience with drug checking. No significant differences were found regarding gender and income. While logistic regression analysis showed a significant relationship between sociodemographic predictors and drug checking experience, this relationship was relatively weak. The main reasons for not having used the services yet included a high level of trust in the source of supply (68%), confidence in receiving high quality of substances (64%), and a lack of service availability near the place of residence (62%). Conclusions The results indicate that drug checking services are well-accepted and trusted but not equally accessed by and accessible to all PWUD. Specifically, people who use only cannabis and those residing with parents or in rural or small-town areas access services less. In conclusion, there is considerable potential for expanding the availability and accessibility of drug checking services in Austria, particularly to reach underserved groups of PWUD who could benefit from this intervention.

Growing evidence reports that chronic kidney diseases (CKD) might play a role in erectile dysfunction (ED), but limited knowledge is available. Therefore, we performed a systematic review up to 21/08/2019 to investigate the associations between CKD and ED. The main analysis reported the prevalence of ED as absolute estimates (in %) with their 95% confidence intervals (CIs) and across CKD stages (when specified), hemodialysis and transplant, calculating the p for interaction across strata. Among 291 studies, we included 34 articles with 5986 men. We found an overall prevalence of 76% (95%CI: 72–79) with a high degree of heterogeneity (I2 = 84.2%; p < 0.0001). Analyzing the data by CKD stage, we found a significant higher prevalence of ED in CKD (78%; 95%CI: 75–81%; I2 = not possible) compared with hemodialysis stage (prevalence = 77%; 95%CI: 73–80%; I2 = 84.5) or to patients undergoing transplant (prevalence = 64%; 95%CI: 54–74%; I2 = 54%) (p across strata = 0.036). Considering the high prevalence of ED in men with CKD, health care practitioners should focus on issues of sexual health in men with CKD. Given the advancements in dialysis and therapy and the associated advancements in survival and life expectancy, maintaining the patients’ sexual function is important for their well-being and quality of life.

Global health and social research have advocated a requirement for community-engaged research methods to better address the needs of minoritised groups. However, conventional research practices, often influenced by positivist traditions, tend to prioritise convergence, overlooking critical tensions within and across data sets. Resultantly, changes within healthcare and policy have not been matched with parallel benefits for minoritised groups. These disparities underscore the need for research methods that can adequately give voice to multiple stakeholder groups and understand these discrepancies. In response to these issues, the present study introduces the novel development of the Qualitative Triangulation Framework (QTF). Extending previous triangulation methodologies, the QTF provides a framework for exploring both agreement and disagreement within and across qualitative data sets from multiple stakeholder groups. Developed in the context of research with trans and gender diverse (TGD) youth, the QTF was valuable for revealing both inter- and intra-group differences in what they deemed as health-enhancing. Thus, the QTF enhances the actionability of qualitative findings, allowing for the development of more effective policy recommendations that can better address these overlooked tensions. Beyond its application to TGD healthcare, the QTF provides a replicable model for amplifying minoritised voices in research with other underserved populations, advancing equity in healthcare research and practice. Extension of the QTF for systematically exploring competing perspectives beyond minoritised groups are also discussed. Overall, the QTF represents a significant advancement in qualitative methodologies, offering a powerful tool for researchers seeking to navigate complexity, reconcile conflicting viewpoints, and drive meaningful change.

Medical care of transgender and non-binary (TNB) patients if often a complex interdisciplinary effort involving a variety of healthcare workers (HCWs) and services. Physicians not only act as gatekeepers to routine or transitioning therapies but are also HCWs with the most intimate and time-intensive patient interaction, which influences TNB patients’ experiences and health behaviors and healthcare utilization. The aim of this study was to investigate the physician–patient relationship in a sample of TNB individuals within the Austrian healthcare system, and explore its associations with sociodemographic, health-, and identity-related characteristics. A cross-sectional study utilizing an 56-item online questionnaire, including the Patient-Doctor Relationship Questionnaire 9 (PDRQ-9), was carried out between June and October 2020. The study involved TNB individuals 18 or older, residing in Austria, and previously or currently undergoing medical transition. In total, 91 participants took part, of whom 33.0% and 25.3% self-identified as trans men and trans women, respectively, and 41.8% as non-binary. Among participants, 82.7% reported being in the process of medical transitioning, 58.1% perceived physicians as the most problematic HCWs, and 60.5% stated having never or rarely been taken seriously in medical settings. Non-binary participants showed significantly lower PDRQ-9 scores, reflecting a worse patient–physician relationship compared to trans male participants. TNB patients in Austria often report negative experiences based on their gender identity. Physicians should be aware of these interactions and reflect potentially harmful behavioral patterns in order to establish unbiased and trustful relations.

People experiencing homelessness (PEH) face a disproportionately high prevalence of adverse mental health outcomes compared with the non-homeless population and are known to utilize primary healthcare services less frequently while seeking help in emergency care facilities. Given that primary health services are more efficient and cost-saving, services with a focus on mental health that are co-designed with the participation of users can tackle this problem. Hence, we aimed to synthesize the current evidence of such interventions to assess and summarize the characteristics and effectiveness of co-designed primary mental healthcare services geared towards adult PEH. Out of a total of 10,428 identified records, four articles were found to be eligible to be included in this review. Our findings show that co-designed interventions positively impacted PEH’s mental health and housing situation or reduced hospital and emergency department admissions and increased primary care utilization. Therefore, co-designed mental health interventions appear a promising way of providing PEH with continued access to primary mental healthcare. However, as co-designed mental health interventions for PEH can improve overall mental health, quality of life, housing, and acute service utilization, more research is needed.

Purpose Body dysmorphic disorder (BDD) has been consistently linked with eating disorders, however studies that stratify associations between BDD in subjects with and without eating disorder symptomology are sparse. It was, therefore, the aim of this study to assess correlates of BDD (including social media use, motivations for exercise, exercise addiction, and sexuality) stratified by eating disorder symptomology. Methods Cross-sectional study of 1665 health club users recruited online completed a battery of surveys. BDD prevalence rates were calculated and logistic regression models were created in two sub-samples: indicated or no-indicated eating disorder symptomology. Results The key findings showed the prevalence of BDD in participants with indicated-eating disorder symptomology was significantly higher than in participants without indicated-eating disorder symptomology, yielding an odds ratio of 12.23. Furthermore, several correlates were associated with BDD only participants with an absence of eating disorder symptomology (gender, BMI, exercise addiction, exercising for mood improvement, attractiveness and tone), with others being significantly associated with BDD in participants in the presence of indicated eating disorders symptomology (exercising for health and enjoyment, relationship status, and ethnicity). Conclusions This study provides more evidence of the complex relationship that exists between BDD and eating disorders. Furthermore, it is recommended that practitioners working with BDD subjects should screen for eating disorders due to the high morbidity associated with eating disorders. Level of evidence Level III: case-control analytic study.

Despite the availability of pre-exposure prophylaxis (PrEP) in the United Kingdom (UK), uptake among men who have sex with men (MSM) remains inconsistent, signalling a persistent ‘PrEP Gap’. Empirical studies show the important role of psychosocial factors (e.g., stigma, identity, trust in science, and sexual behaviours) in PrEP acceptability and uptake. This study aimed to identify subgroups of MSM in the UK based on psychosocial predictors of PrEP acceptability. A cross-sectional survey of MSM (N = 500) was conducted between June and September 2023. Participants completed validated measures assessing identity resilience, internalised homonegativity, LGBTQ+ connectedness, trust in science, NHS perceptions, HIV stigma, PrEP self-efficacy, condom self-efficacy, sociosexual orientation, perceived HIV risk, and PrEP acceptability. Latent Profile Analysis (LPA) was used to identify distinct subgroups based on these psychosocial dimensions. Four psychosocial profiles were defined: (1) PrEP Ambivalent (15%); (2) PrEP Accepting (36.2%); (3) PrEP Hesitant (37%); and (4) PrEP Rejecting (11.8%). These profiles provide evidence for varied combinations of personal and structural factors influencing PrEP acceptability. PrEP acceptability among MSM in the UK is shaped by distinct psychosocial configurations, influenced by identity, stigma, trust, and perceived risk. These findings highlight the need for differentiated and targeted interventions for enhancing PrEP acceptability based on psychosocial profile. Audience segmentation strategies offer a promising pathway to bridge the awareness-to-engagement gap and address the nuanced barriers facing diverse subgroups within the MSM community.