The emotional and social concerns of mothers of children with cleft palate: A cross-sectional study.

PROBLEM: Among birth defects, a cleft palate is one of the most common defects globally, with a prevalence rate of 1 in 700 live-born children per annum. Caring for a child with cleft palate is considered a challenge for mothers who provide around clock care for these children. Despite this, there is limited knowledge of their experiences and needs particularly in low resource settings. BACKGROUND: Previous literature emphasized that mothers of children with cleft palate face many challenges involving emotional distress, social isolation, and financial burden. QUESTION: To investigate the emotional and social concerns of mothers of children with Cleft Palate compared to mothers of children without cleft palate. METHODS: A comparative study design was conducted at the Jordanian Royal Medical Services using convenience sample of 312 mothers of children with and without cleft palate in Jordan. FINDINGS: There was a significant difference in the presence of anxious feelings between mothers of children with cleft palate and those mothers without cleft palate children. Within group comparison for mothers of children with cleft palate has shown a significant difference in their social concerns with regards to social support and child's future. DISCUSSION: Mothers of children with cleft palate reported significantly higher levels of sadness feelings. These emotions could be attributed to several factors, including the financial burden associated with medical treatment and interventions, the burden of caring for a child with special needs, the social stigma related to the child's appearance, the lack of public awareness, and the insufficient social support services. CONCLUSION: Mothers of children with Cleft Palate experience a considerable amount of emotional and social concerns which require urgent interventions.

Socio-demographic Predictors of Hospitalization Duration Among Patients with Borderline Personality Disorder.

Borderline personality disorder (BPD) is a complex psychopathology associated with high service utilization rates. In turn, the hospitalization of BPD patients is a controversial challenge for mental health professionals. Prior literature has identified certain socio-demographic factors as linked to an increased risk of BPD. In this study, we examined the possible connection between these socio-demographic factors and hospitalization duration. We analyzed 1077 hospitalization records of 200 BPD-diagnosed patients. Patients' gender, age, education level, employment and marital statuses, and living arrangement were statistically significantly linked with hospitalization duration. Specifically, female gender, age twenty or below, no high-school diploma (or, to a lesser extent, a diploma with no academic education), unemployment status and/or patients who live with parents are strongly associated with longer hospitalizations compared to male gender, older patients, more educated, married/divorced status and/or those who do not live with their parents. Additionally, the results point to a weak, albeit statistically significant, temporal pattern with more advanced hospitalizations generally aligning with the duration of their preceding ones, while being slightly shorter. In order to prevent potentially unnecessary prolonged and regressive hospitalizations, an estimation of the expected hospitalization duration should be explicitly considered when setting hospitalization goals and plans.

Socio-demographic predictors of the time interval between successive hospitalizations among patients with borderline personality disorder.

Background: Borderline personality disorder (BPD) affects 0.7 to 2.7% of the adult population and higher rates are reported in inpatient care. Hospitalizations of BPD patients are a complex and controversial challenge for mental health professionals. Recurrent hospitalizations are common and it is essential to identify risk factors that characterize patients who benefit from their hospitalization and those who return to the ward shortly after discharge. Aim: To investigate the potential link between BPD patients' socio-demographic factors and the expected time interval between their successive hospitalizations. Methods: A retrospective analysis of 1051 hospitalization records from 174 BPD patients. Through univariate, bivariate, and multivariate analyses, we investigated the possible relationship between patients' primary socio-demographic factors and the time between their successive hospitalizations. Results: Patients' age, marital status, and living arrangement were found to be statistically connected with the time interval between successive hospitalizations. Specifically, being older, married and/or patients to live with one's spouse/partner seem to be linked with a longer time interval between successive hospitalizations compared to patients who are young, single/divorced and/or those who live with their parents. Conclusions: The expected time interval between successive hospitalization of BPD patients can be partly explained by their socio-demographic characteristics.

Adherence to UK dietary guidelines in school-aged children from the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort.

Compliance to UK dietary recommendations was assessed in school-aged children from a population-based cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). A Children's Eatwell Guide (C-EWG) score was developed to assess socio-demographic predictors of meeting dietary recommendations. ALSPAC children with plausible diet diary data at 7 years (n 5373), 10 years (n 4450) and 13 years (n 2223) were included in the study. Their dietary intakes (recorded between 1998 and 2006) were compared with dietary guidelines for total and saturated fats, free sugars, salt, fibre, protein, carbohydrates, fruit and vegetables, non-oily and oily fish and red/processed meat. The C-EWG score (0-9 points) indicated the number of recommendations met at each age. Cross-sectional associations between socio-demographic characteristics and C-EWG scores were assessed using multivariable regression. The lowest adherence to guidelines at 7 years was for sugar (0·1 % meeting recommendations), followed by fibre (7·7 %), oily fish (9·5 %), saturated fat (9·7 %) and fruit and vegetables (15·2 %). Highest adherence was for limiting red/processed meat (67·3 %) and meeting carbohydrate recommendations (77·3 %). At 7 years, 12·1 % of participants failed to meet any of the nine recommendations, 26·9 % met one and 28·2 % met two. Similar patterns were seen at 10 and 13 years. A lower social class and maternal educational attainment and higher maternal BMI were associated with meeting fewer recommendations. Most school-aged children in this cohort did not meet UK dietary recommendations, particularly children from lower socio-economic backgrounds. Additional public health initiatives are needed to improve the quality of UK children's diets, particularly targeting lower socio-economic groups.

Socio-demographic predictors of obesity among women in Mukono Central Division in Central Uganda: a cross-sectional study.

BACKGROUND: There is a steadily increasing trend in obesity globally and in Sub-Saharan Africa that disproportionately affects women in most places. This is not different in Uganda, where the Uganda Demographic and Health Survey indicated an increase in obesity among women of reproductive age as measured by the body mass index (BMI). However, studies on the predictors of obesity in women are still limited. Particularly, studies using specific indicators of body fat are scant. This study explored the socio-demographic predictors of obesity as indicated by total body fat percentage among women in the age range of 18 to 69 years old living in Mukono Central Division in Central Uganda. METHODS: A cross sectional study design using quantitative methods was employed. A total of 384 women between 18 and 69 years old from Mukono Central Division in Central Uganda were randomly recruited. A structured questionnaire was used to collect socio-demographic data including age, level of education, marital status, childbearing status, household expenditure, household size and employment status. Total body fat percentage, the indicator for obesity was measured using the body composition meter from TANITA. The data was analyzed using multinomial logistic regression analysis using SPSS version 20. RESULTS: 155 women, nearly two fifths (40.4% CI 95% 38.4-42.4) were classified as obese. Age, marital status, childbearing status, and employment status were the factors that were associated with obesity among these women. Employment status was the only variable that remained significantly associated with obesity among the women after adjusting for other factors. Unemployed women were nearly two times more likely to be obese than the employed women (AOR 1.9; 95% CI 1.1-3.1). The prevalence of obesity among the unemployed and employed women was 48.2% and 34.4% respectively. CONCLUSIONS: Obesity in women was predicted by employment status. An in-depth study on factors that predispose unemployed women to obesity, will be instrumental in guiding interventions to curb the emerging obesity epidemic in Uganda. In the same vein, strategies to reduce levels of unemployment among women living in urban Uganda are essential for protecting public health from the dimension of reducing obesity levels.

HIV infections averted at PEPFAR-APIN clinics in Nigeria: a ten-year retrospective evaluation of the clinical outcomes of post-exposure prophylaxis services.

Introduction: Nigeria contributes a high fraction to the global burden of HIV infections. Post-exposure prophylaxis (PEP) is a proven strategy to prevent transmission of the virus. The aim of this study was to determine the clinical outcomes of PEP in Nigeria at four clinics funded by United States President's Emergency Plan for AIDS Relief and AIDS Prevention Initiative in Nigeria (PEPFAR-APIN): Ahmadu Bello University Teaching Hospital (ABUTH), Jos University Teaching Hospital (JUTH), University of Maiduguri Teaching Hospital (UMTH) and University College Hospital (UCH).Methods: This study adopted a multisite retrospective design using the site's databases (2006-2016). Retrieved data was exported into SPSS version 25 for statistical analysis. Outcomes were measured as a proportion of HIV infections averted after PEP. Frequencies and percentages were used to describe the findings, while binary logistic regression was used to determine the sociodemographic predictors of clinical outcomes.Results: The average age of the 575 PEP patients whose data were retrieved was 30.45 (SD ±9.50 years), with 344 (59.8%) being females. Out of 545 patients,157 (28.8%) indicated their job status as students. Out of 273 patients, 198 (72.5%) reported their exposure type was non-occupational. The HIV status of 129 (22.4%) patients was negative after completing PEP. Prescribed regimen (ß = -0.048, 95% CI -0.095 to -0.001, p = 0.045) and type of exposure (ß = 0.351, 95% CI 0.042-0.660, p = 0.027) were predictors of post-PEP HIV status in JUTH and ABUTH respectively.Conclusion: There was a high rate of lost-to-follow-up among the PEP patients, but the incidence of seroconversion was low in those who were tested after PEP. The right choice of regimen and presenting with non-occupational exposure affected the outcome of the service.

Efficacy and clinical predictors of response to rTMS treatment in pharmacoresistant obsessive-compulsive disorder (OCD): a retrospective study.

BACKGROUND: Application of repetitive transcranial magnetic stimulation (rTMS) for treating obsessive-compulsive disorder (OCD) has been promising and approved by the Food and Drug Administration in 2018, but effects differ between patients. Knowledge about clinical predictors of rTMS response may help to increase clinical efficacy but is not available so far. METHODS: In a retrospective study, we investigated the efficacy of rTMS over the dorsolateral prefrontal cortex (DLPFC) or supplementary motor area (SMA) in 65 pharmaco-resistant OCD outpatients recruited for rTMS treatment from July 2015 to May 2017. Patients received either SMA rTMS (n = 38) or bilateral DLPFC rTMS (n = 27) in case of reporting higher affective and depressive symptoms in addition to the primary OCD symptoms. OCD symptoms and depression/anxiety states were measured at baseline (before the 1st session) and after the 20th session of rTMS. Additionally, we performed a binary logistic regression analysis on the demographic and clinical variables based on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) 3-factor and 2-factor models and individual items to investigate potential predictors of rTMS response. RESULTS: Patients' scores in Y-BOCS and Beck anxiety/depression inventories were significantly decreased following rTMS treatment. 46.2% of all patients responded to rTMS, based on the criterion of at least a 30% reduction in Y-BOCS scores. There was no significant difference between response rates of patients in DLPFC and SMA groups. No significant demographic predictors of rTMS efficacy were identified. The factors "obsession severity", "resistance" and "disturbance" and the "interference due to obsessions" and "resistance against compulsions" items of the Y-BOCS significantly predicted response to rTMS. CONCLUSIONS: In patients with less intrusive/interfering thoughts, and low scores in the "obsession severity", "disturbance", and "resistance" factors, rTMS might have superior effects. Identifying clinical and non-clinical predictors of response is relevant to personalize and adapt rTMS protocols in pharmaco-resistant OCD patients. Interpretation of rTMS efficacy should be done with caution due to the lack of a sham intervention condition.

Health-related quality of life and its socio-economic and cultural predictors among advanced cancer patients: evidence from the APPROACH cross-sectional survey in Hyderabad-India.

BACKGROUND: Patients with advanced cancer often experience poor health-related quality-of-life (HRQoL) due to cancer and treatment-related side-effects. With India's palliative care landscape in its infancy, there is a concern that advanced cancer patients, especially individuals who are from disadvantaged populations experience poor HRQoL outcomes. We aim to assess HRQoL of advanced cancer patients in terms of general well-being (physical, functional, emotional, and social/family well-being), pain experiences, psychological state, and spiritual well-being, and determine the relationship between belonging to a disadvantaged group and HRQoL outcomes. We hypothesize that patients from disadvantaged or minority backgrounds, identified in this paper as financially distressed, female, lower years of education, lower social/family support, minority religions, and Non-General Castes, would be associated with worse HRQoL outcomes compared to those who are not from a disadvantaged group. METHODS: We administered a cross-sectional survey to 210 advanced cancer patients in a regional cancer center in India. The questionnaire included standardized instruments for general well-being (FACT-G), pain experiences (BPI), psychological state (HADS), spiritual well-being (FACT-SP); socio-economic and demographic characteristics. RESULTS: Participants reported significantly lower general well-being (mean ± SD) (FACT-G = 62.4 ± 10.0) and spiritual well-being (FACT-SP = 32.7 ± 5.5) compared to a reference population of cancer patients in the U.S. Patients reported mild to moderate pain severity (3.2 ± 1.8) and interference (4.0 ± 1.6), normal anxiety (5.6 ± 3.1) and borderline depressive symptoms (9.7 ± 3.3). Higher financial difficulty scores predicted most of the HRQoL domains (p ≤ 0.01), and being from a minority religion predicted lower physical well-being (p ≤ 0.05) and higher pain severity (p ≤ 0.05). Married women reported lower social/family well-being (p ≤ 0.05). Pain severity and interference were significant predictors of most HRQoL domains. CONCLUSIONS: Advanced cancer patients, especially those with lower financial well-being and belonging to minority religions, reported low physical, functional, emotional, social/family, and spiritual well-being, and borderline depressive symptoms. Future studies should be directed at developing effective interventions supporting vulnerable groups such as those with financial distress, and those belonging to minority religions.

The impact of comorbidities and sociodemographic predictors on pneumococcal vaccination coverage in adults with coronary heart disease.

Aim: Coronary heart disease (CHD) increases the risk of adverse outcomes from invasive pneumococcal disease. Methods: Using the 2020 and 2021 data from the national health interview survey, we identified adults with CHD. Chi-square analysis and logistic regression were used to examine factors that influence vaccination status. Results: There were 2675 participants aged 41 and above with CHD. Participants were predominantly white people (82.5%) and males (60.1%). The odds of receiving the pneumococcal vaccine increased with stepwise increase in comorbidities from 1 to 2 and from 2 to 3. Among individuals with ≥2 comorbidities, black people were less likely to be vaccinated compared with white people. Conclusion: Pneumococcal vaccine uptake among adults with CHD is determined by cumulative comorbidities and ethnicity.

Geographic disparities and predictors of vaccination exemptions in Florida: a retrospective study.

BACKGROUND: In the United States, state-level policies requiring vaccination of school-going children constitute a critical strategy for improving vaccination coverage. However, policies allowing vaccination exemptions have also been implemented and contribute to reductions in vaccination coverage and potential increases in the burden of vaccine-preventable diseases. Understanding the geographic disparities in the distribution of vaccination exemptions and identifying high risk areas is necessary for guiding resource allocation and public health control strategies. This study investigated geographic disparities in vaccination exemptions as well as socioeconomic and demographic predictors of vaccination exemptions in Florida. METHODS: Vaccination exemption data were obtained from the Florida Department of Health's Florida HealthCHARTS web interface. Spatial patterns in geographic distribution of total and non-medical vaccination exemptions were assessed using county-level choropleth maps. Negative binomial models were used to identify significant predictors of county-level risks of both total and non-medical vaccination exemptions. RESULTS: Total exemptions varied from 0 to 30.2 per 10,000 people. Nine counties had exemption risks in the top two classes (10.4-15.9 and 15.9-30.2 exemptions per 10,000 people). These counties were distributed in five distinct areas: Western Panhandle, central northern area, central, South-eastern coastal area, and the southern coastal border of the state. Non-medical exemptions varied from 0 to 10.4 per 10,000 people. Fifteen counties had exemption risks in the top two classes (3.7-5.6 and 5.6-10.4 exemptions per 10,000 people), and were located in six distinct areas: Western and Central Panhandle, Northeastern, Central-eastern coastal area, Central-western coastal area, and the South-western coastal border of the state. Predictors of high risk of total vaccination exemptions were high density of primary care providers (p < 0.001), high median income (p = 0.001), high percentage of Hispanic population (p = 0.046), and low percentage of population with a college education (p = 0.013). A predictor of high risk of non-medical vaccination exemptions was high percentage of White population (p = 0.045). However, predictors of low risks of non-medical exemptions were high percentages of population: living in rural areas (p = 0.023), with college education (p = 0.013), with high school education (p = 0.009), and with less than high school education (p < 0.001). CONCLUSIONS: There is evidence of county-level geographic disparities in both total and non-medical vaccination exemption risks in Florida. These disparities are explained by differences in county-level socioeconomic and demographic factors. Study findings are important in guiding resource allocation for health planning aimed at improving vaccination rates and reducing incidence of vaccine-preventable diseases.

Demographic and COVID Experience Predictors of COVID-19 Risk Perception among Chinese Residents in Canada.

The current study aimed to identify demographic and COVID experience predictors for COVID-19 risk perception among Chinese residents in Canada. A final sample of 653 participants aged 18 and up completed an online survey in simplified Chinese during the peak of the first wave of COVID-19 (25 April-10 June 2020). After removing those with missing data on demographic covariates, as missing data cannot be imputed, 444 were included in the structural equation model, and COVID-19 risk perception was indexed by three outcome variables: self-infection risk perception (i.e., likelihood of personal infection of COVID-19); threat perception (i.e., whether the pandemic is a real threat); and future infection rate prediction (i.e., a latent variable for community, Ontario, Canada, and World infection rate predictions). Predictors included demographic (i.e., income, gender, education, age, household size, employment status, and life satisfaction) and COVID experience variables (i.e., personal connection with confirmed or suspected COVID-19 cases, self-isolation experience, perceived anti-Chinese discrimination, and confusion over COVID-19 information). In the structural equation model, we found increased risk perception for the following demographic and COVID experience predictors; women, relatively higher education, living alone, working in a medical field, lower in life satisfaction, having personal connection with confirmed or suspected COVID-19 cases, with perceived anti-Chinese discrimination, or showing high confusion over COVID-19 information.

Logistic Regression Model of Demographic Predictors and Confounders of Binge Alcohol Use Among Adults with Major Depression.

Identifying sociodemographic populations with a major depressive episode (MDE) who are at increased risk for binge alcohol use (BAU) is critical for developing focused prevention programs to meet the needs of each population. Thus, the goal of the current exploratory retrospective study is to examine if sex, race, age, education, marital status, and income can significantly predict the risk for BAU among adults with MDE and if the association between MDE and BAU changes after adjusting for demographic variables in question while holding sex, race, and age as constant variables. Data from the Substance Abuse and Mental Health Services Administration's 2018 National Survey for Drug Use and Health were extracted and analyzed to achieve the study goal. The unweighted sample included 6,999 adults representing a weighted population size of 33,900,452.122 in the USA. Results revealed that age and marital status significantly predicted BAU in the past month among adults with MDE. Adults under the age of 50, with a college degree, never married, divorced/separated, and with a high-middle income level or higher were at higher risk for BAU. The study's clinical implications are that understanding demographics of individuals with MDE at increased risk for BAU can inform improved tailored assessment and treatment of alcohol abuse and MDE among at-risk populations. Future research should consider examining additional potential risk factors for BAU among adults with MDE.

Demographic predictors of resilience among nurses during the COVID-19 pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is mostly transmitted through respiratory droplets. One of the exposure methods pf this disease is through occupational exposures and, thereby, a large number of people are prone to catching this disease due to their occupations. Nurses during the COVID-19 pandemic are at the forefront of healthcare. There is no information about the level of resilience and the demographic and job factors predicting resilience in the critical conditions of this occupational group. OBJECTIVE: The present study aims to determine the resilience score and its predictive demographic factors among the nurses working at the hospitals involved with COVID-19 in Ahvaz, Iran. METHODS: 387 nurses from Ahvaz hospitals participated in this study. The Connor-Davidson Resilience Scale (CD-RISC) was used to assess resilience. Demographic information was also collected using a designed questionnaire. Since the present study was conducted during the COVID-19 pandemic, the questionnaires were sent online. Data were entered into software SPSS (version 23) and T-test, ANOVA and regression methods were used for data analysis. RESULTS: The mean score of 61.18 (±14.8) was obtained for CD-RISC. The results of this study showed that age (r = 0.610, P = 0.003), work experience (r = 0.572, P = 0.030), and level of education (r = 0.514, P = 0.044) had a significant positive correlation with nurses' resilience score during the COVID-19 pandemic. Multiple regression analysis indicated that work experience and level of education were the predictors of nurses' resilience (R2 = 0.15). CONCLUSION: The score of nurses' resilience was low. Based on the results, education and work experience were determined as the contributing factors for resilience. The findings can help to better understand effective and predictive demographic factors to achieve higher resilience in stressful situations.

Does driver seatbelt use increase usage among front seat passengers? An exploratory analysis.

INTRODUCTION AND METHOD: Observational data collected during the Wisconsin 2017, 2018, and 2019 National Occupant Protection Use Survey (NOPUS) were analyzed for this study to explore the influence of drivers' seatbelt use on front seat passengers' usage in the same vehicle. The analyses include comparing seatbelt usage rates for drivers and front passenger(s) based on their gender and based on geographical area as well as analyses of the aggregated data. RESULTS: The descriptive analyses strongly suggest that seatbelt usage rates of passengers differ considerably depending on whether the driver uses the seatbelt. When female drivers wear seatbelts, seatbelt usage rates for female front seat passengers for the three years 2017, 2018, and 2019 are 97.8%, 96.3%, and 97.1% respectively, with corresponding usage rates for male passengers being 95.5%, 93.0%, and 96.0% respectively. When male drivers wear seatbelts, the seatbelt usage rates for male front seat passengers for the three years 2017, 2018, and 2019, are 93.4%, 95.5%, and 94.3%, respectively, with the corresponding usage rates for female passengers being 97.7%, 96.0%, and 97.7%, respectively. The evidence suggests that drivers' use of seatbelts significantly improves the seatbelt usage of front seat passengers. Seatbelt usage rates of male passengers as well as female passengers are higher while traveling with female drivers who use seatbelts than while traveling with male drivers who use seatbelts. Conclusions and Practical Applications: Future seatbelt use campaigns should target males.

Clinical and demographic predictors of response to anodal tDCS treatment in major depression disorder (MDD).

Transcranial direct current stimulation (tDCS) of the prefrontal cortex is known as a promising intervention in major depression disorder (MDD). However, limited information on predictors of therapeutic response to tDCS are available. This study aimed to investigate clinical and demographic predictors of therapeutic response in patients taking no medications. For this purpose, the required data were collected from 2 independent tDCS trials on 116 MDD patients. Accordingly, 84 patients underwent 10 sessions of 2 mA tDCS daily each one lasted for 20 min and 32 patients received 10 twice sessions of 2 mA tDCS daily each one lasted for 20 min. Anodal electrode was located over the left dorsolateral prefrontal cortex (DLPFC), and cathode was over the right supraorbital region. Depression symptoms and the underlying clinical dimensions were assessed using the Beck Depression Inventory (BDI-II) at baseline and after the tDCS treatment. Of the included 116 patients, 47.4% showed an antidepressant response. Results of logistic regression analysis showed that the reduction in BDI-II scores after tDCS was associated with the baseline values of cognitive-affective symptoms factor, loss of pleasure, loss of interest, and sleep problems. Pronounced sleep disturbances and cognitive-affective symptoms were identified as the potential clinical predictors of response to tDCS. However, more prospective tDCS studies are necessary to validate the predictive value of the derived model.

Analysis of real-time crash risk for expressway ramps using traffic, geometric, trip generation, and socio-demographic predictors.

There have been numerous studies on real-time crash prediction seeking to link real-time crash likelihood with traffic and environmental predictors. Nevertheless, none has explored the impact of socio-demographic and trip generation parameters on real-time crash risk. This study analyzed the real-time crash risk for expressway ramps using traffic, geometric, socio-demographic, and trip generation predictors. Two Bayesian logistic regression models were utilized to identify crash precursors and their impact on ramp crash risk. Meanwhile, four Support Vector Machines (SVM) were applied to predict crash occurrence. Bayesian logistic regression models and SVMs commonly showed that the models with the socio-demographic and trip generation variables outperform their counterparts without those parameters. It indicates that the socio-demographic and trip generation parameters have significant impact on the real-time crash risk. The Bayesian logistic regression model results showed that the logarithm of vehicle count, speed, and percentage of home-based-work production had positive impact on crash risk. Meanwhile, off-ramps or non-diamond-ramps experienced higher crash potential than on-ramps or diamond-ramps, respectively. Though the SVMs provided good model performance, the SVM model with all variables (i.e., all traffic, geometric, socio-demographic, and trip generation variables) had an overfitting problem. Therefore, it is recommended to build SVM models based on significant variables identified by other models, such as logistic regression.

Complementary and alternative medicine (CAM) among Australian hospital-based nurses: knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users.

OBJECTIVE: This study was intended to examine CAM among Australian hospital-based nurses, identifying their knowledge, attitude, personal and professional use, reasons for use, CAM referrals, and socio-demographic predictors of CAM users. METHODS AND MATERIALS: Nurses holding a qualification in nursing and working in surgical wards were included using a convenience sampling technique. A self-complete questionnaire was developed to achieve the aims of the study. Descriptive and non-parametric statistics were calculated to describe and analyse data. RESULTS: Overall, 95.7% and 49.7% of nurses reported personal and professional use of CAM, respectively. The most popular CAM/CAM domain personally and professionally used by nurses was massage therapy and mind-body therapies. The primary reason for personal use of CAM was "[it] fits into my way of life/philosophy". Furthermore, massage therapists were the most commonly recommended CAM practitioners to patients. Only 15.8% of nurses would always ask patients about use of herbal medicines as part of nursing history taking. Over one-fifth (22.4%) of nurses rated their attitude as having a very positive, and 60.3% rated themselves as having very little or no knowledge of CAM. A positive correlation was also found between knowledge and attitude about CAM. Positive attitude and higher knowledge about CAM were positively correlated to CAM referrals. Several socio-demographic factors predicted personal and professional use of CAM. CONCLUSION: This study revealed that nurses generally believe not to have sufficient knowledge of CAM but are open to use CAM with patients. Nurses' positive attitude toward and personal use of CAM could be an indication that they are poised for further integration of evidence-based CAM into nursing practice to treat whole person.

Antenatal psychological and socioeconomic predictors of breastfeeding in a large community sample.

BACKGROUND: Despite much work to publicise the benefits of breastfeeding most women do not persist for the first 6months, as recommended by the WHO. Successful breastfeeding for 6months may depend on several factors, including perinatal mental health. We aimed to investigate the impact of antenatal depressive symptoms, attitudes towards breastfeeding and socio-demographic factors in predicting breastfeeding for 6months in a large community sample. METHODS: The sample was based on the Avon Longitudinal Study of Parents and Children (n=9479), a large-scale birth cohort. Breastfeeding was assessed at multiple time-points, from postnatal day 1 until 6months postnatal. Self-reported symptoms of maternal depression were assessed at 18 and 32weeks gestation and at 8weeks postnatal. Antenatal attitudes towards breastfeeding were assessed at 32weeks gestation. Antenatal, obstetric, psychosocial and socio-demographic variables were also assessed. RESULTS: Antenatal depressive symptoms at both 18 and 32weeks gestation were associated with decreased breastfeeding initiation and duration. However, the prediction of breastfeeding by these symptoms was confounded by socio-demographic and psychosocial covariates. A positive antenatal attitude towards breastfeeding was the strongest predictor and was associated with a 20-30% increase in breastfeeding initiation and maintenance at all time points. CONCLUSION: This study highlights the wide range of factors that independently predict breastfeeding, and suggests that an intervention program to improve antenatal attitudes especially warrants investigation.

Clinical and demographic predictors of response to rTMS treatment in unipolar and bipolar depressive disorders.

OBJECTIVE: Previous studies investigated predictors of repetitive transcranial magnetic stimulation (rTMS) response in depressive disorders but there is still limited knowledge about clinical predictors. Moreover, predictors of rTMS response in bipolar depression (BDD) are less studied than unipolar depression (UDD). METHODS: We performed a binary logistic regression analysis in 248 patients with depressive disorders (unipolar N=102, bipolar N=146) who received 20 sessions of DLPFC rTMS (High-frequency rTMS, low-frequency rTMS, bilateral rTMS) to investigate significant clinical and demographic predictors of rTMS response. We also investigated effects of depression type, response (yes, no) and time on reducing somatic and cognitive-affective symptoms of patients. RESULTS: Depression type (unipolar vs. bipolar) did not have a significant effect on rTMS response. 45% of all patients, 51.5% of UDD patients and 41% of BDD patients, responded to rTMS treatment. Age was the only significant demographic predictor of treatment response in all patients. Cognitive-affective symptoms, compared to somatic symptoms were significant predictors for treatment response to rTMS. Common and unique clinical predictor for UDD and BDD were identified. CONCLUSIONS: Younger patients and those with cognitive-affective rather than somatic symptoms benefit more from DLPFC rTMS treatment. rTMS is effective in UDD and BDD patients. Patients should be selected based on clinical and demographic profile. SIGNIFICANCE: Findings are based on the largest thus far reported sample of patients with depressive disorders that received DLPFC rTMS.

Demographic and mental history-related data predicted occurrence of psychosis in metamphetamine users.

Methamphetamine use is increasing worldwide, and the occurrence of psychosis further complicates treatment. This holds also true for Iran. The aim of the present study was to investigate possible predictors of metamphetamine-induced psychosis. 237 methamphetamine users (70.9% with psychosis; mean age: M=33.41 years) took part in the study. A psychiatric interview was performed covering socio-demographic and illness-related information. Male gender, low education, unemployment, being single, a history of mental disorders, and a higher number of previous hospitalizations predicted the occurrence of psychosis, while age and duration of metamphetamine use were excluded from the equation. Socio-demographic and mental illness-related dimension seemed suitable to predict occurrence of psychosis among metamphetamine abusers.