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Rationale and aim Facilitators and barriers to satisfaction after implementation of the electronic medical/health record ( EMR/ EHR) are important to understand as patient satisfaction is linked with improvement in health care and meaningful use of EMR/ EHR. The objectives of this systematic review were to evaluate patient satisfaction after implementation and to synthesize available factors regarding the estimates of the patient satisfaction with EMR/ EHR. These factors may help vendors to better design EMR/ EHR and to assist in providing direction for progression of research in this field. Methods Data sources for the study included reports of studies from the Medline, Ovid, Springerlink, EBSCOhost, Embase and Wiley Online Library, and searching of bibliographies of review and other articles. Our inclusion criteria were the descriptions of patient satisfaction after implementation of EMR/ EHR. Results Searching the online database resulted in 1425 articles and 58 articles from reference lists. After removing duplicates and assessing against the selection criteria, 41 articles were for further full-text review. After careful analysis, 33 articles were excluded. Eventually, a total of eight articles met inclusion criteria and were assessed. Conclusions These studies showed a positive patient satisfaction with EMR/ EHR, but more rigorous studies should be carried out to more precisely quantify and describe the impact of EMR/ EHR on patient satisfaction. Due to many factors influencing patient satisfaction with EMR/ EHR, more research is needed to understand these factors before more concrete measurements of satisfaction can be developed to help researchers develop effective evaluation satisfaction. [ABSTRACT FROM AUTHOR]

Objective: To assess methods, quality and outcomes of systematic reviews (SRs) conducted to evaluate the effectiveness of root coverage (RC) procedures in the treatment of recession-type defects (RTD). Methods: MEDLINE and EMBASE were searched up to and including April 2010 to identify SRs investigating the effectiveness/efficacy of surgical interventions for the treatment of patients with RTD. Searching was conducted independently by two reviewers, and data extraction was based on the methodological criteria applied and on the effects of interventions reported by each SR. The checklist proposed by Glenny and colleagues, the Overview Quality Assessment Questionnaire and the "Assessment of Multiple systematic Reviews", instrument were used to assess the quality of SRs. Additionally, the methodological criteria applied by included reviews were compared with those proposed by the Cochrane Collaboration. Results: Search strategy identified 716 potentially eligible articles, of which 12 papers regarding 10 SRs were included in the study. Results from different SRs showed that subepithelial connective tissue grafts associated or not to coronally advanced flaps can be used to reduce recession depth and improve the width of keratinized tissue. All quality assessment tools showed that most of the SRs were of good methodological quality, but they also highlighted key points that could be improved in future reviews. Only two SRs followed in full the guidelines proposed by the Cochrane Collaboration. Conclusions: All SRs agree that RC may be anticipated by different surgical procedures. However, differences in the methodological quality between reviews were quite evident, and thus making a clear indication that there is a need of standardization of the methods that will be applied by future SRs. As a result, a standardized checklist for reporting SRs was proposed by the authors. [ABSTRACT FROM AUTHOR]

Aim Sarcopenia is a well-recognized geriatric syndrome, which is associated with a variety of adverse outcomes. The present study aimed to evaluate the prevalence of sarcopenia and its associative clinical characteristics in Taiwan. Methods Data of the I- Lan Longitudinal Aging Study ( ILAS) were retrieved for this study. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People criteria, and comparisons of demographic characteristics, physical performance, body composition, cardiometabolic profiles and functionality indicators were carried out. Results Overall, data of 1008 participants (mean age 65.2 ± 9.3 years, male 50.6%) were retrieved for analysis. The cut-off value of relative appendicular skeletal muscle was 7.0 kg/m2 for men and 5.9 kg/m2 for women. Sarcopenia was significantly related to low body mass index, smaller waist circumference, poor nutrition and poor cognition. The mean carotid intima-media thickness and cardiometabolic parameters showed no statistically significant findings. Conclusions The present paper showed the epidemiology of sarcopenia, and the strong connection to functionality indicators. However, sarcopenia was not associated with cardiometabolic risk or carotid intima media thickness in the present study. Geriatr Gerontol Int 2014; 14 (Suppl. 1): 36-45. [ABSTRACT FROM AUTHOR]

Background and Aim Physicians' attitudes towards disease prevention are crucial. The purposes of this study are to examine the prevalence of cardiovascular risk factors and adherence to international preventive screening programmes by a group of physicians. Methods Online and paper format questionnaires were completed by a sample of 650 physicians from November 2010 to March 2011. The collected data included the main components of screening programmes, which are recommended in international guidelines. Results The data show that 30.5% of male physicians currently smoke, 19.4 % are obese, 15.2% have hypertension, 38% are physically inactive and 10.9% have diabetes. Nearly all (95%) of the female participants and most (83%) of the male participants older than 45 years had never had a colonoscopy. Of the male physicians older than 55 years, 36.4% had never had prostate-specific antigen testing, and only 10.9% had undergone a digital rectal examination. Among the female physicians, 27.4% were obese, and 42% had never had a mammogram. Conclusion The prevalence of behavioural risk factors for cardiovascular disease is high among physicians. A substantial percentage of the practising physicians did not adhere to the age-specified preventive screening measures recommended in international guidelines. [ABSTRACT FROM AUTHOR]

This paper examines the prevalence of multiple symptoms and the relationships between future expectations and multiple symptoms in a cross-sectional study of 100 patients with chronic obstructive pulmonary disease. A questionnaire was used to examine the patients' symptoms of breathlessness, anxiety, depression, sleeplessness, fatigue, and pain, and their outlook for the future. All patients reported breathlessness, 64% anxiety, 69% depression, 28% sleeplessness, 72% fatigue, and 45% pain. Those with anxiety reported significant depression ( P < 0.001), and those with fatigue reported significant depression ( P = 0.004). Patients who reported pain also reported significant sleeplessness ( P = 0.022). A negative outlook for the future was reported by 42% of patients who also reported significantly more anxiety, depression, sleeplessness, fatigue, and pain ( P ≤ 0.049). Multiple symptoms are common in chronic obstructive pulmonary disease, and patients with a pessimistic view of the future reported more symptoms. Those with multiple symptoms and a negative outlook toward the future may benefit from interventions to help them achieve a more positive outlook for the future, which may relieve symptom burden. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate whether psychosocial functioning in adulthood (e.g., friends support, cohabitation, community connectedness and work satisfaction) could be predicted by mental health, subjective well-being, social relations and behavior problems in adolescence, and whether gender was a moderator in these associations. Data were obtained from a major population-based Norwegian study, the Nord-Trøndelag Health Study ( HUNT), in which 517 men and 819 women completed an extensive self-report questionnaires at baseline (mean age 14.4 years) and at follow-up (mean age 26.9 years). Community connectedness as well as work satisfaction were predicted by subjective well-being. Cohabitation was predicted by male gender and frequency of meeting friends in adolescence, and friends support was predicted by frequency of meeting friends. Gender had a minor effect as a moderator. Frequency of meeting friends and subjective well-being seemed to be the strongest adolescent predictors of psychosocial functioning in young adulthood. These findings may have implications both for prevention and intervention in adolescence, as well as for future research. [ABSTRACT FROM AUTHOR]

Objectives This paper examines the awareness and use of nonoccupational HIV post-exposure prophylaxis ( nPEP) in Spain, and the factors that influence this awareness. Methods Between June 2009 and July 2010, a mobile unit offered free, rapid HIV tests in a number of Spanish cities. A total of 2545 people were passively recruited and tested, and answered a self-administered questionnaire containing sociodemographic, behavioural and nPEP-related questions. Bivariate and multivariate analyses were performed, stratifying by gender/sexual behaviour. Results Some 34% of the responders were men who have sex with men ( MSM), 30% were men who have sex exclusively with women ( MSW), and 35% were women. Approximately 26% were foreigners, 46% had a university degree, and 51% had previously taken an HIV test. Overall, 22% were aware of nPEP. Only 2% had ever used it; 70% of these after high-risk sexual intercourse. Awareness was higher among MSM (34%) than women (16%) and MSW (15%). Multivariate analysis showed a lack of nPEP awareness to be associated with being born in Latin America, while awareness increased with the number of previous HIV tests among women and MSW. In MSM, awareness was also associated with having a university degree, the degree of interaction with gay culture, number of partners, and use of the internet as the main way of meeting partners. Conclusions nPEP awareness in the studied population was unacceptably low. The promotion of its availability should be made a major objective of prevention programmes, as a complementary measure to condom use. [ABSTRACT FROM AUTHOR]

Background A clear policy trend exists towards promoting the use of direct payments (DPs), including those for families with disabled children who use short breaks. However, uptake has been slow and use of DPs has been socially patterned. Recent programmes in England have dramatically increased investment in short break provision including breaks funded through DPs. This research examines the characteristics, circumstances and experiences of families who use DPs to fund short breaks with those who use short breaks funded in other ways. Method The paper draws on surveys totalling 348 parents and carers in families with disabled children using short breaks. We investigate associations between the use of DPs and a range of demographic, socio-economic, well-being, service use and satisfaction indicators. Logistic regression identifies which variables are most strongly associated with use of DPs. We also draw on open-ended survey responses which highlight important aspects of families' experience of using DPs. Results Characteristics significantly associated with increased use of DPs include the presence of main carers who are female, more highly educated and from White British backgrounds, younger children, lower levels of area deprivation, greater access to service and social networks and use of more hours of short breaks. Characteristics not found to be significantly associated with use of DPs include various health and well-being indicators, impairment characteristics of children and service satisfaction. A range of benefits of DPs are described along with problems accessing and using them. Conclusions Direct payments can have a number of benefits for families using short breaks, but access to them is currently problematic and socially patterned. If the uptake of DPs is to be increased and made more equitable, more attention must be paid to promoting and supporting their use in ways which meet the needs of individual families. [ABSTRACT FROM AUTHOR]

Aim: This paper aims to assess the subjective quality of life (SQOL) and its correlates among older adults in rural communities of Vietnam and Indonesia. Methods: The paper uses the data from the INDEPTH/WHO Study on global aging and adult health (SAGE). The study was carried out in the FilaBavi Health and Demographic Surveillance System (HDSS) site in Vietnam and in Purworejo HDSS in Indonesia. All people aged 50 years and over who lived in these two HDSS areas were surveyed. Face-to-face household interviews were carried out by trained surveyors using the standardized summary version of the INDEPTH/WHO SAGE questionnaire. The SQOL was assessed by asking the respondents 'How would you rate your overall quality of life?' The response set was a five-point scale where 1 = Very good, 2 = Good, 3 = Moderate, 4 = Bad, 5 = Very bad. Results: In both countries, the SQOL was reported to be higher among (i) men; (ii) people with higher education; (iii) people who were in a marital partnership; (iv) people who lived with other family members; and (v) those with higher economic status, compared with that in those of other category(ies) of the same characteristic. In Vietnam, people who belonged to the second to fifth economic quintiles and had more than 6 years of education were sevenfold more likely to report very good/good quality of life compared with those who belonged to the first economic quintile (poorest) and had no formal education. The corresponding figure was 2.7 for Indonesia. Conclusions: The patterns of sociodemographic determinants of SQOL show that inequality in quality of life exists among older adults in the two study settings. Geriatr Gerontol Int 2012; 12: 397-404. [ABSTRACT FROM AUTHOR]

Background: There have been limited trend studies examining variations on the patterns of alcohol consumption among Whites, Blacks, and Hispanics in the United States. The current paper reports national trends in drinking patterns, volume of drinking (number of drinks per month), binge drinking, and drinking to intoxication among Blacks, Whites, and Hispanics over a period of 10 years and identifies sociodemographic predictors of these behaviors across the 3 ethnic groups. Methods: Data are from the 1991 to 1992 National Longitudinal Alcohol Epidemiologic Survey (NLAES; n = 42,862) and the 2001 to 2002 National Epidemiologic Study on Alcohol and Related Conditions (NESARC; n = 43,093). Both surveys used multistage cluster sample procedures to select respondents 18 years of age and older from the U.S. household population. Results: Trends varied across different dimensions of drinking and ethnic groups. There were no statistically significant differences in the mean number of drinks consumed per month among men and women in any of the 3 ethnic groups between 1992 and 2002, but there was a significant rise in the proportion of current drinkers in both genders and in all 3 ethnic groups. Multivariate analysis indicated that, compared to Whites in 1992, Blacks and Hispanics did not increase their volume of drinking, but Whites did. Drinking 5 or more drinks in day at all did not increase between 1992 and 2002, but drinking 5 or more drinks at least once a month was more likely for all groups in 2002 compared to Whites in 1992. Drinking to intoxication at all was more likely among Whites in 2002 than 1992, but drinking to intoxication at least once a month was more likely among Whites and Blacks in 2002 than 1992. Conclusion: The only common trend between 1992 and 2002 across both genders and 3 ethnic groups was a rise in the proportion of drinkers. There was also a rise in drinking 5 or more drinks in a day (Whites, Blacks, and Hispanics) and drinking to intoxication (Whites and Blacks), but this was limited to those reporting such drinking at least once a month. The reasons for these changes are many and may involve complex sociodemographic changes in the population. It is important for the field to closely monitor these cross-ethnic trends in alcohol consumption. [ABSTRACT FROM AUTHOR]

ABSTRACT The present study was carried out to determine the dietary habits of patients with schizophrenia and the influence of these habits on the degree of obesity. The study was developed in a sample of 159 patients, who were given a self-reported questionnaire, to ascertain the influence of socio-familiar aspects, pharmacological treatment, and dietary habits. Anthropometric measurements (body mass index (BMI) and waist circumference (WC)) were also taken. Patients with schizophrenia presented unhealthy dietary habits, as indicated by the finding that 51% of the patients took no longer than 15 min to eat, 40.8% did not eat fruit daily, and 63.1% did not eat fish. Women were three times more likely to be obese than men (odds ratio (OR) = 2.91, P = 0.021). Patients classified as having unhealthy dietary habits have a 2.33-fold higher risk of obesity than patients with good dietary habits (OR = 2.33, P = 0.034). In summary, this paper highlights the fact that patients with schizophrenia have a detrimental dietary pattern that is associated with an increase in BMI and WC, with the consequent development of obesity and related metabolic alterations, regardless of the pharmacological treatment being followed. Future research directions will include exploring the need for nutritional education programmes to improve the dietary habits of such patients. [ABSTRACT FROM AUTHOR]

Objective: To investigate the controlled direct effect (CDE) of common mental disorders (CMD) on xerostomia which is not mediated by psychoactive medication intake. Methods: A population‐based cross‐sectional study was conducted with 1720 individuals aged 20‐59 years from Florianópolis, Brazil, in 2009. A two‐stage cluster sample design was adopted, with a systematic selection of census tracts, followed by a random selection of households. All inhabitants of the selected households belonging to the age group of interest were considered eligible to participate. CMD were assessed using the Self‐Reporting Questionnaire (SRQ > 7). Xerostomia was the outcome assessed by asking: "How often do you feel dry mouth?" with responses "often" and "always" taken as indicating xerostomia. Psychoactive medication intake was set as the mediator. Confounding factors included sex, age, per capita family income, educational attainment and smoking status. Marginal structural models were performed to quantify the CDE of CMD on xerostomia. Missing data were handled by multiple imputation by chained equations, and sensitivity analysis for unmeasured confounding was carried out. Results: The overall prevalence of xerostomia was 8.8% and 15.3% of the individuals presented with CMD. After adjustment, the prevalence of xerostomia among individuals with CMD was 3.2 times higher than that among individuals without CMD (PR = 3.2 [95% CI: 2.3; 4.5]). The CDE of CMD on xerostomia which is not mediated by the medication intake resulted in a three times greater prevalence of xerostomia (PR = 3.0 95% CI: 2.0; 4.5) among those individuals with CMD. Conclusions: Common mental disorders is directly and negatively associated with xerostomia. Clinicians should bear in mind the emotional state when investigating the underlying factors and managing patients with xerostomia. [ABSTRACT FROM AUTHOR]

Background and Objective Various studies have reported the relationship between alcohol consumption and gingival condition. However, they focus on the direct effects of alcohol consumption or alcohol sensitivity on gingival condition, and it is unclear how oral health behaviors relate these relationships. The aims of this study were to assess the inter-relationships between gingival condition, tooth-brushing behavior after drinking alcohol and alcohol sensitivity in university students who drink more than once per week on average. Material and Methods A total of 808 students (541 males, 267 females) that habitually consume alcohol were analyzed. The disease activity of gingival condition was assessed as the percentage of bleeding on probing (% BOP). Additional information regarding alcohol sensitivity and oral health behaviors, including tooth-brushing behavior after drinking, were also collected. Results Thirteen percent of the current participants reported neglecting tooth-brushing after drinking, and their alcohol consumption was higher than those who did not neglect tooth-brushing. Logistic regression analysis showed that high % BOP (% BOP ≥ 20) was associated with male ( OR = 1.53; 95% CI, 1.01-2.33), neglect of tooth-brushing after drinking ( OR = 2.60; 95% CI, 1.20-5.61) and debris index ( OR = 8.38; 95% CI, 4.24-16.60) in participants with low alcohol sensitivity. In participants with high alcohol sensitivity, high % BOP was associated with debris index ( OR = 7.60; 95% CI, 3.12-18.51), but not with any oral health behaviors. Conclusions The study revealed that alcohol consumption was indirectly related to gingival disease activity through the neglect of tooth-brushing after drinking alcohol in university students with low alcohol sensitivity. [ABSTRACT FROM AUTHOR]

Presenteeism or attending work while ill is a growing organizational problem. This study examined the association between job demands, presenteeism, and absenteeism. We tested a moderated mediation model of the effects of job demands on absenteeism with the key objective of exploring the mediation effects of presenteeism and the moderating effects of organizational justice on this relationship. Based on a sample of emergency services call centre workers ( N = 227), the research revealed that high job demands were associated with presenteeism, which in turn predicted longer absence spells. Furthermore, employee perceptions of distributive justice acted as an important mechanism through which presenteeism mediated the relationship between job demands and absenteeism. Practitioner points Organizations should be aware that work overload and strict attendance management practices can stimulate presenteeism., Managers should recognize that presenteeism can subsequently lead to longer spells of absence., Employee perceptions of fair outcomes minimize the deleterious effects of presenteeism on absenteeism. [ABSTRACT FROM AUTHOR]

Aims To assess whether associations between maternal smoking during pregnancy and offspring smoking initiation are due to intrauterine mechanisms. Design Comparison of associations of maternal and partner smoking behaviour during pregnancy with offspring smoking initiation using partner smoking as a negative control ( n = 6484) and a Mendelian randomization analysis ( n = 1020), using a genetic variant in the mothers as a proxy for smoking cessation during pregnancy. Setting A longitudinal birth cohort in South West England. Participants Participants of the Avon Longitudinal Study of Parents and Children ( ALSPAC). Measurements Smoking status during pregnancy was self-reported by mother and partner in questionnaires administered at pregnancy. Latent classes of offspring smoking initiation (non-smokers, experimenters, late-onset regular smokers and early-onset regular smokers) were previously developed from questionnaires administered at 14-16 years. A genetic variant, rs1051730, was genotyped in the mothers. Findings Both mother and partner smoking were similarly positively associated with offspring smoking initiation classes, even after adjustment for confounders. Odds ratios (OR) [95% confidence interval ( CI)] for class membership compared with non-smokers were: experimenters: mother OR = 1.33 (95% CI = 1.06, 1.67), partner OR = 1.28 (95% CI = 1.06, 1.55), late-onset regular smokers: mother OR = 1.80 (95% CI = 1.43, 2.26), partner OR = 1.86 (95% CI = 1.52, 2.28) and early-onset regular smokers: mother OR = 2.89 (95% CI = 2.12, 3.94), partner OR = 2.50 (95% CI = 1.85, 3.37). There was no clear evidence for a dose-response effect of either mother or partner smoking heaviness on class membership. Maternal rs1051730 genotype was not clearly associated with offspring smoking initiation class in pre-pregnancy smokers ( P = 0.35). Conclusion The association between smoking during pregnancy and offspring smoking initiation does not appear to operate through intrauterine mechanisms. [ABSTRACT FROM AUTHOR]

Background To examine the social determinants of infant smoke exposure and whether these associations vary by mothers' smoking status and number of children in the household. Methods There were 135 278 mothers from 28 states who participated in the Pregnancy Risk Assessment Monitoring System from 2000 to 2003. Results Overall 9.9% of mothers reported that her infant was in the same room as someone smoking for 1 or more hours per day. Among smoking households, infants with 1 or 2+ siblings were 25% and 59% more likely to be exposed to 1+ hours of second-hand smoke daily, respectively, than infants with no siblings. Conclusion Infants only a few months old are being exposed to second-hand smoke, particularly infants whose mother smokes and infants with siblings, indicating the importance of surveillance even for this young age group. [ABSTRACT FROM AUTHOR]

Background Rates of suicide attempts and nonsuicidal self-injury [( NSSI); e.g., cutting, burning] peak in adolescence and early adulthood; females and individuals with psychiatric symptoms and diagnoses appear to be at particular risk. Hinshaw et al. [ Journal of Consulting and Clinical Psychology, (), 80, 1041] reported that young women with histories of childhood ADHD diagnoses reported higher rates of suicide attempts and NSSI than nondiagnosed, comparison women. Methods Via analyses of an ongoing longitudinal investigation, our aims are to examine, with respect to both aspects of self-harmful behavior, (a) ADHD subtype differences and effects of diagnostic persistence (vs. transient and nondiagnosed classifications) and (b) potential mediating effects of impulsivity and comorbid psychopathology, ascertained during adolescence. Results Young adult women with a childhood diagnosis of ADHD-Combined type were at highest risk for suicide attempts as well as the most varied and severe forms of NSSI compared with those with ADHD-Inattentive type and those in the comparison group; participants with a persistent ADHD diagnosis were at higher risk than those with a transient diagnosis or those never meeting criteria for ADHD. Mediator analyses revealed that, during adolescence, an objective measure of impulsivity plus comorbid externalizing symptoms were simultaneous, partial mediators of the childhood ADHD-young adult NSSI linkage. Adolescent internalizing symptoms emerged as a partial mediator of the childhood ADHD-young adult suicide attempt linkage. Conclusions ADHD in females, especially when featuring childhood impulsivity and especially with persistent symptomatology, carries high risk for self-harm. Psychiatric comorbidity and response inhibition are important mediators of this clinically important longitudinal association. We discuss limitations and implications for prevention and intervention. [ABSTRACT FROM AUTHOR]

Background This study reports findings from the International Alcohol Control ( IAC) study that assesses the impact of alcohol control policy on consumption and policy-related behaviors. Modeled on the International Tobacco Control study that uses longitudinal surveys with comparison between countries, the baseline survey was carried out in New Zealand. This study reports analysis of the purchasing behavior respondents report separately for on- and off-premise outlets, providing validation data for both alcohol consumption and reported prices. Methods New Zealand is a high-income country with an adult per capita alcohol consumption (as of 2011) of 9.5 l. The survey was carried out among a nationally representative sample of drinkers. Interview data on place and time of purchase, amounts purchased, price paid, and consumption (beverage and location specific) was collected. Relationships between policy relevant variables and consumption were modeled taking into account demographic variables. Validation was provided by government data on alcohol available for consumption, aggregate expenditure and prices from the Consumer Price Index. Results Drinkers paying low prices at on- or off-licensed premises had higher odds of consuming 6+ drinks on a typical occasion, as did drinkers purchasing alcohol at later times. Regarding frequency, drinkers purchasing at later times were more likely to be daily drinkers. Lower price in off licenses but not on licenses predicted daily drinking. The data collected accounted for approximately 96% of alcohol available for consumption and the prices accounted for 98% of aggregate expenditure. Conclusions Valid survey data were collected to give an accurate picture of alcohol consumption and prices paid by drinkers. Heavy drinkers were more likely to buy cheaper alcohol and purchase at later times; 2 policy issues under discussion in many settings. This analysis suggests the IAC study that has the potential to provide data to contribute to the debate on appropriate policy responses to reduce alcohol-related harm. [ABSTRACT FROM AUTHOR]

Background This article examines age at first drink and adult drinking, binge drinking and DSM-5 alcohol use disorder ( AUD) among U.S. Hispanic national groups. Methods Respondents come from 2 independent studies. The Hispanic Americans Baseline Alcohol Survey used a multistage cluster sample design to interview 5,224 individuals 18 years of age and older selected from the household population in Miami, New York, Philadelphia, Houston, and Los Angeles. Respondents in the border area ( N = 1,307) constituted a household probability sample of Mexican Americans living on U. S. counties that border Mexico. In both surveys, data were collected during computer-assisted interviews conducted in respondents' homes. The Hispanic American Baseline Alcohol Survey and the border sample response rates were 76 and 67%, respectively. Results U. S.-born Hispanics begin drinking at a younger age than those who are foreign-born, independent of national group. Among foreign-born Hispanics, age of arrival in the United States is not associated with age at first drink. Results support the hypothesis that a younger age at first drink is associated with a higher mean volume of drinking, a higher probability of bingeing, and a higher probability of DSM-5 AUD. But the results do not show a clear pattern by which a particular national group would consistently show no associations or stronger associations between age at first drink and the alcohol-related outcomes under consideration. Conclusions An earlier age at first drinking is positively associated with heavier drinking patterns among U. S. Hispanics. However, as in other areas of alcohol epidemiology, here too there is considerable variation in age at first drink and drinking across Hispanic national groups. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Hookah tobacco smoking has increased in prevalence among Florida adolescents and is often viewed as a safer alternative to cigarette smoking by young adults. Asthmatic adolescents are at increased risk of the negative health effects of hookah smoking. The purpose of this study is to examine if hookah use and harm perception vary by asthma status. METHODS The Florida Youth Tobacco Survey was conducted in 2012 among 36,578 high school students. Secondary data analysis was conducted to compare the rates of hookah use among asthmatic youth to their nonasthmatic counterparts. Risk perception of hookah use compared to cigarette smoking was also assessed among asthmatic and nonasthmatic adolescents. RESULTS One in 5 high school students reported lifetime asthma. These asthmatic students have a significantly higher prevalence of hookah smoking and greater perception of hookah use as being less harmful than cigarette smoking, than their nonasthmatic counterparts. Among asthmatics, 12th graders and Hispanic students had the highest prevalence of hookah smoking. CONCLUSION Common misperceptions of hookah smoking as being less harmful than cigarette smoking are prominent among high school students in Florida and are greater among students with asthma than those students who do not have asthma. Efforts to increase education to dispel the myths surrounding hookah smoking as a safer alternative to cigarette smoking needs to exist at the high school level for both students with and without asthma. [ABSTRACT FROM AUTHOR]

Aims To test the effectiveness of tailored quitline (telephone) counselling among smoking parents recruited into cessation support through their children's primary schools. Design Two-arm randomized controlled trial with 3- and 12-month follow-up. Setting Proactive telephone counselling was administered by the Dutch national quitline. Participants Smoking parents were recruited through their children's primary schools and received either intensive quitline support in combination with tailored supplementary materials ( n = 256) or a standard self-help brochure ( n = 256). Measurements The primary outcome was 7-day point-prevalence abstinence at 12-month follow-up. Also measured were baseline characteristics, use of and adherence to nicotine replacement therapy and pharmacotherapy, smoking characteristics and implementation of a home smoking ban. Findings Parents who received quitline counselling were more likely to report 7-day point-prevalence abstinence at 12-month assessment [34.0 versus 18.0%, odds ratio ( OR) = 2.35, confidence interval ( CI) = 1.56-3.54] than those who received a standard self-help brochure. Parents who received quitline counselling were more likely to use nicotine replacement therapy ( P < 0.001) than those who received a standard self-help brochure. Among parents who did not achieve abstinence, those who received quitline counselling smoked fewer cigarettes at 3-month ( P < 0.001) and 12-month assessment ( P < 0.001), were more likely to make a quit attempt ( P < 0.001), to achieve 24 hours' abstinence ( P < 0.001) and to implement a complete home smoking ban ( P < 0.01). Conclusions Intensive quitline support tailored to smoking parents is an effective method for helping parents quit smoking and promoting parenting practices that protect their children from adverse effects of smoking. [ABSTRACT FROM AUTHOR]

Aims To investigate the prevalence of awareness of the online illicit drug marketplace Silk Road ( SR), consumption of drugs purchased from SR and reasons for use and non-use of SR. Design and setting Global Drug Survey: purposive sample collected in late 2012. Participants The base sample ( n = 9470) reported recent drug purchase and resided in the United Kingdom ( n = 4315, median age 24, 76% male), Australia ( n = 2761, median age 32, 76% male) or the United States ( n = 2394, median age 21, 80% male). Measurements Online questionnaire. Findings A total of 65% of US, 53% of Australian and 40% of UK respondents had heard of SR; 18% of US, 10% of UK and 7% of Australian respondents had consumed drugs purchased through SR. Across the three countries, 3,4-methylenedioxy-N-methylamphetamine (MDMA) was the most commonly purchased drug (53-60%), followed by cannabis (34-51%), lysergic acid diethylamide (LSD) (29-45%) and the 2C family (16%-27%). The most common reasons for purchasing from SR were wider range (75-89%), better quality (72-77%), greater convenience (67-69%) and the use of vendor rating systems (60-65%). The most common reasons for avoiding SR purchase were adequate drug access (63-68%) and fear of being caught (41-53%). Logistic regressions found that, compared with people from the UK, Australians [odds ratio ( OR) = 3.37; 95% confidence interval ( CI) = 2.29, 4.97) and Americans (OR = 1.46; 95% CI = 1.10, 1.94) were more likely to use SR due to lower prices; and to avoid SR purchase due to fear of being caught ( Australia: OR = 1.65; 95% CI = 1.39, 1.96; USA: OR = 1.62; 95% CI = 1.37, 1.92). Conclusions While reasons for Silk Road use accord with broader online commerce trends (range, quality, convenience, ratings), its appeal to drug purchasers is moderated by country-specific deterrents and market characteristics. [ABSTRACT FROM AUTHOR]

Background and Aims Alcohol and nicotine dependence are associated with considerable morbidity and mortality, especially when cases are persistent. The risk for alcohol and nicotine dependence is increased by childhood maltreatment. However, the influence of childhood maltreatment on dependence course is unknown, and is evaluated in the current study. Design Physical, sexual and emotional abuse, and physical and emotional neglect, were evaluated as predictors of persistent alcohol and nicotine dependence over 3 years of follow-up, with and without control for other childhood adversities. Setting National Epidemiologic Survey on Alcohol and Related Conditions ( NESARC). Participants NESARC participants completing baseline and follow-up who met criteria at baseline for past-year alcohol dependence ( n = 1172) and nicotine dependence ( n = 4017). Measurements Alcohol Use Disorder and Associated Disabilities Interview Schedule ( AUDADIS) measures of alcohol/nicotine dependence, childhood maltreatment and other adverse childhood experiences (e.g. parental divorce). Findings Controlling for demographics only, physical, sexual and emotional abuse and physical neglect predicted 3-year persistence of alcohol dependence [adjusted odds ratio ( AOR) = 1.50-2.99; 95% CI = 1.04-4.68] and nicotine dependence ( AOR = 1.37-1.74; 95% CI = 1.13-2.11). With other childhood adversities also controlled, maltreatment types remained predictive for alcohol persistence ( AOR = 1.53-3.02; 95% CI = 1.07-4.71) and nicotine persistence ( AOR = 1.35-1.72; 95% CI = 1.11-2.09). Further, a greater number of maltreatment types incrementally influenced persistence risk ( AOR = 1.19-1.36; 95% CI = 1.11-1.56). Conclusions A history of childhood maltreatment predicts persistent adult alcohol and nicotine dependence. This association, robust to control for other childhood adversities, suggests that maltreatment (rather than a generally difficult childhood) affects the course of dependence. [ABSTRACT FROM AUTHOR]

Background Knowledge is scarce on what contributes to whether children with early language delay (LD) show persistent, recovering or sometimes late-onset LD without a prior history of early LD in subsequent preschool years. Aims To explore whether an integrative model of vital risk factors, including poor early communication skills, family history of language-related difficulties and male gender, predicts the development of persistent, recovering or late-onset LD trajectories from 3 to 5 years quantitatively and qualitatively differently. Methods & Procedures LD was assessed by maternal reports on the Ages and Stages Questionnaire at 3 and 5 years for 10 587 children in The Norwegian Mother and Child Cohort Study. Children were classified across time as having no, late onset, transient or persistent LD. Multinomial logistic regression analyses included the integrative model of vital risk factors and covariates. Outcome & Results Across time, 3%, 5% and 6.5% of the children displayed persistent, transient and late-onset LD, respectively. The odds for persistent LD were doubled for boys and children with low language comprehension at 1.5 years; and tripled by late-talking familial risk. These same odds decreased for transient LD, and even further for late-onset LD. Familial risk for writing and reading difficulties especially increased the odds for late-onset and persistent LD, while familial risk of unintelligible speech increased the odds for transient LD. Although girls had on average far better language comprehension than boys, low language comprehension was a stronger risk factor for persistent LD in girls. Conclusions & Implications Preschool LD trajectories were uniquely predicted from the integrative risk model of poor early communicative skills, family history and male gender. This might benefit identification of different LD trajectories by supporting broader severe vulnerability for persistent LD, milder vulnerability for transient LD, and possibly a specific risk for reading and learning difficulties for children with late-onset LD. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Purging Disorder (PD), an Other Specified Feeding or Eating Disorder (APA, 2013), is characterized by recurrent purging in the absence of binge eating. Though objectively large binge episodes are not present, individuals with PD may experience a loss of control (LOC) while eating a normal or small amounts of food. The present study sought to examine the role of LOC eating in PD using archival data from 101 women with PD. Method Participants completed diagnostic interviews and self-report questionnaires. Analyses examined the relationship between LOC eating and eating disorder features, psychopathology, personality traits, and impairment in bivariate models and then in multivariate models controlling for purging frequency, age, and body mass index. Results Across bivariate and multivariate models, LOC eating frequency was associated with greater disinhibition around food, hunger, depressive symptoms, negative urgency, distress, and impairment. Discussion LOC eating is a clinically significant feature of PD and should be considered in future definitions of PD. Future research should examine whether LOC eating better represents a dimension of severity in PD or a specifier that may impact treatment response or course. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:244-251) [ABSTRACT FROM AUTHOR]

Objective Social capital incorporates neighbourhood and individual levels of interactions and influences health. The objective of this was to assess the association of neighbourhood and individual social capital with oral health-related quality of life ( OHRQo L) in pregnant and postpartum women. Methods This was a follow-up prevalence multilevel study on a representative sample of 1248 women grouped into 55 neighbourhoods. OHRQo L was assessed in the postpartum period using the Oral Health Impact Profile questionnaire ( OHIP-14). Exploratory variables were gathered during the first trimester of pregnancy and included neighbourhood social capital (neighbourhood-level measure), individual social capital (social support and social networks), demographic and socio-economic variables, oral health measures, and health-related behaviours. Results The multilevel ordered multinomial logistic regression showed that neighbourhood social capital did not significantly affect women's OHRQo L during pregnancy and postpartum period. Individual social capital measures were independently associated with high OHRQoL. Lack of family social network increased the odds for high OHRQoL ( OR = 1.44, 95% CI: 1.08-1.92). Individuals with high levels of positive social interaction were less likely to report high scores of OHRQoL ( OR = 0.90, 95% CI: 0.82-0.98). Conclusion Individual social capital was of greater relevance to women's OHRQo L in and after pregnancy than neighbourhood social capital. These findings suggest that quality of personal and social resources of pregnant women are more important for OHRQo L than the neighbourhoods where the women live. [ABSTRACT FROM AUTHOR]

Context Medical school curricula remain one of the key levers in increasing the future supply of rural doctors. Data from Australia and overseas have suggested exposure to rural practice via rural placements during basic medical training is positively associated with graduates becoming rural doctors. However, previous studies have suffered from serious methodological limitations. Objectives This study sought to determine whether rural clinical placements are associated with a higher proportion of graduating students planning rural careers and to explore associations with timing, duration and location of placements. Methods Data were obtained from the Medical Schools Outcomes Database and Longitudinal Tracking Project, which is a longitudinal study with a high response rate that prospectively collects data, including practice location intention, from all Australian medical schools. Using logistic regression analysis, the association between placements and rural career intention was assessed, controlling for a number of demographic and contextual variables. Results The association between rural/remote placements later in the programme and rural practice intention was strongly positive whether viewed as simple occurrence or as duration, in contrast to later urban placements, which were strongly negative. A longer duration of placement enhanced the associations reported. Non-metropolitan medical schools were also associated with higher odds of intention to take up rural practice. However, the association with rural placements was overshadowed by the strong positive associations with rural background of students and their stated intention to become a rural doctor at the start of their studies. Conclusions Exposure to rural practice during basic medical training, and the location and curriculum focus of a medical school are confirmed as factors that are positively associated with students' intention to become rural doctors after graduation. However, rural origin and the early intentions at the start of their medical training are better predictors of expressed intention to take up rural practice than rural clinical placements. [ABSTRACT FROM AUTHOR]

Objectives To investigate the prevalence and associated psychosocial factors of occasional and repetitive direct self-injurious behavior (D- SIB), such as self-cutting, -burning, -biting, -hitting, and skin damage by other methods, in representative adolescent samples from 11 European countries. Methods Cross-sectional assessment of adolescents was performed within the European Union funded project, Saving and Empowering Young Lives in Europe ( SEYLE), which was conducted in 11 European countries. The representative sample comprised 12,068 adolescents (F/M: 6,717/5,351; mean age: 14.9 ± 0.89) recruited from randomly selected schools. Frequency of D- SIB was assessed by a modified 6-item questionnaire based on previously used versions of the Deliberate Self-Harm Inventory ( DSHI). In addition, a broad range of demographic, social, and psychological factors was assessed. Results Overall lifetime prevalence of D- SIB was 27.6%; 19.7% reported occasional D- SIB and 7.8% repetitive D- SIB. Lifetime prevalence ranged from 17.1% to 38.6% across countries. Estonia, France, Germany, and Israel had the highest lifetime rates of D- SIB, while students from Hungary, Ireland, and Italy reported low rates. Suicidality as well as anxiety and depressive symptoms had the highest odds ratios for both occasional and repetitive D- SIB. There was a strong association of D- SIB with both psychopathology and risk-behaviors, including family related neglect and peer-related rejection/victimization. Associations between psychosocial variables and D- SIB were strongly influenced by both gender and country. Only a minor proportion of the adolescents who reported D- SIB ever received medical treatment. Conclusion These results suggest high lifetime prevalence of D- SIB in European adolescents. Prevalence as well as psychosocial correlates seems to be significantly influenced by both gender and country. These results support the need for a multidimensional approach to better understand the development of SIB and facilitate culturally adapted prevention/intervention. [ABSTRACT FROM AUTHOR]

Sexual risk behavior and illicit drug use among people living with HIV/AIDS (PLWHA) contribute to poor health and onward transmission of HIV. The aim of this collaborative multi-site nursing research study was to explore the association between self-compassion and risk behaviors in PLWHA. As part of a larger project, nurse researchers in Canada, China, Namibia, Puerto Rico, Thailand and the US enrolled 1211 sexually active PLWHA using convenience sampling. The majority of the sample was male, middle-aged, and from the US. Illicit drug use was strongly associated with sexual risk behavior, but participants with higher self-compassion were less likely to report sexual risk behavior, even in the presence of illicit drug use. Self-compassion may be a novel area for behavioral intervention development for PLWHA. © 2014 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

A case-control study was conducted to determine the association between maternal height and infant length-for-age, and to evaluate how this association is modified by either maternal or infant nutritional status. We hypothesised that maternal excess caloric intake [measured as body mass index (BMI)] would increase the association, while infant nutrition (measured in main meals consumed in addition to breastfeeding) will diminish the effect. Mother and infant pairs in Chimaltenango, Guatemala, were measured for anthropometric values and nutritional status, and mothers were interviewed to elicit nutritional and socio-economic information. Infant length was converted into z-scores based on the World Health Organization's (WHO) standards. Odds ratios (ORs), associated 95% confidence intervals (CIs) and the relative excess risk due to interaction (RERI) were calculated. Cases were infants below 2 z-scores of the WHO's length-for-age, while controls were infants within the −2 to 2 z-score range. Cases ( n = 84) had an increased odds (OR: 3.00, 95% CI: 1.57-5.74) of being born to a stunted mother (below 145 cm) when compared with controls ( n = 85). When adjusted for potential confounders, the OR decreased to 2.55 (95% CI: 1.30-5.02). Negative RERI values were produced for the joint exposure of maternal BMI ≥ 25 and maternal stuntedness (RERI: −0.96), as well as for the joint exposure of maternal stuntedness and infant nutrition (RERI: −2.27). Our results confirm that maternal stuntedness is a significant contributor to infant stuntedness; however, this association is modified negligibly by maternal nutritional status and significantly by infant nutritional status, each in a protective manner. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency may be a risk factor for negative outcome in pregnancy, such as pre-term labour, low birthweight, intrauterine growth retardation and gestational diabetes. This study aimed to evaluate the relationship between vitamin D and pre-eclampsia. This was a case-control study of 59 pre-eclamptic women and 59 healthy pregnant women selected in two hospitals in Ahvaz, Iran. Women with term singleton pregnancy, nulliparous and of reproductive age were selected. Venous blood samples (2 mL) were taken and the level of 25-dihydroxy vitamin D (25- OH- D) was measured. If the levels of 25- OH- D were less than 10 ng mL−1, between 10 ng mL−1 and 29 ng mL−1 and more than 30 ng mL−1, they were considered as indicating deficient, insufficient and normal 25- OH- D concentrations, respectively. The independent t-test, Mann- Whitney U-test, chi-square and logistic regression were used for analysing the data. Vitamin D deficiency was significantly higher in the pre-eclampsia group [odds ratio ( OR) = 24.04, confidence interval ( CI) = 2.10-274.8, P = 0.01]. Older women (30-35 years) were more likely to develop pre-eclampsia compared with the control group ( OR = 10.36, CI = 2.18-49.09, P = 0.003). The results showed that women with body mass index ( BMI) <20 were more likely to develop pre-eclampsia. The ages between 20 years and 30 years and normal BMI were not the risk factors for pre-eclampsia. Vitamin D deficiency has a statistically significant relationship with pre-eclampsia. It seems that the serum vitamin D levels are low in Iranian women because of their particular lifestyle and they may need more than 400 IU day−1 vitamin D supplement during pregnancy. [ABSTRACT FROM AUTHOR]

Objective To determine if the financial costs of teaching GP registrars differs between rural and urban practices. Design Cost-benefit analysis of teaching activities in private GP for GP vocational training. Data were obtained from a survey of general practitioners in South Australia and Western Australia. Setting and participants General practitioners and practices teaching in association with the Adelaide to Outback General Practice Training Program or the Western Australian General Practice Training. Main outcome measures Net financial effect per week per practice. Results At all the training levels, rural practices experienced a financial loss for teaching GP registrars, while urban practices made a small financial gain. The differences in net benefit between rural and urban teaching practices was significant at the GPT2/ PRRT2 (−$515 per week 95% CI −$1578, −$266) and GPT3/ PRRT3 training levels (−$396 per week, 95% CI (−$2568, −$175). The variables contributing greatest to the difference were the higher infrastructure costs for a rural practice and higher income to the practice from the GP registrars in urban practices. Conclusion There were significant differences in the financial costs and benefits for a teaching rural practice compared with an urban teaching practice. With infrastructure costs which include accommodation, being a key contributor to the difference found, it might be time to review the level of incentives paid to practices in this area. If not addressed, this cost difference might be a disincentive for rural practices to participate in teaching. [ABSTRACT FROM AUTHOR]

Recent research has questioned the traditional assumption that populations inevitably rally round their national leaders in times of war and suggested instead that whether this occurs depends upon political communication and mass media coverage. In this study, we provide systematic analysis of the debate in Scotland over the invasion of Iraq in 2003. We examine how the conflict was construed as either for or against the national interest, and how the way this is done is linked to different dimensions of context. First, we provide a mixed-methods analysis of debates in the Scottish Parliament. We show that anti-war speakers from Scottish separatist parties map opposition to the war onto a series of collectively consistent and temporarily flexible categorical oppositions, starting with a familiar antinomy between Scottish people and British rulers (before the invasion), and then shifting to broader oppositions between subjugated people and imperial powers (after the invasion). By contrast, speakers from other parties appear less consistent and less flexible in the nature of their arguments. Second, we examine the opinions of a population sample on the war, how these opinions relate to understandings of Scottish identity and how the media context is pivotal in the translation of anti-war opinions into votes for separatist/anti-war political parties. [ABSTRACT FROM AUTHOR]

Socio-cognitive conflict has been defined as a situation of confrontation with a disagreeing other. Previous research suggests that individuals can regulate conflict in a relational way, namely by focusing on social comparison between relative levels of competences. Relational conflict regulation has been described as yielding particularly negative effects on social interactions and learning, but has been understudied. The present research addresses the question of the origin of relational conflict regulation by introducing a fundamental distinction between two types of regulation, one based on the affirmation of one's own point of view and the invalidation of the other's (i.e., 'competitive' regulation), the other corresponding to the protection of self-competence via compliance (i.e., 'protective' regulation). Three studies show that these modes of relational conflict regulation result from the endorsement of distinct performance goals, respectively, performance-approach goals (trying to outperform others) and performance-avoidance goals (avoiding performing more poorly than others). Theoretical implications for the literature on both conflict regulation and achievement goals are discussed. [ABSTRACT FROM AUTHOR]

Background Neonatal Follow-Up ( NFU) programmes provide health services for families of infants at high risk of developmental problems following difficult or extremely premature birth: yet, up to 30% of families do not attend these programmes with their infants. Methods The study objective was to determine maternal and infant factors that predicted attendance at NFU programmes. Utilizing Andersen's Behavioural Model of Health Services Use, a prospective two-phase multi-site descriptive cohort study was conducted in three Canadian Neonatal Intensive Care Units ( NICU) that refer to two affiliated NFU programmes. In Phase 1, 357 mothers completed standardized questionnaires that addressed maternal and infant factors, prior to their infants' NICU discharge. In Phase 2, attendance at NFU was followed at three time points over a 12-month period. Factors of interest included predisposing factors (e.g. demographic characteristics and social context); enabling factors (e.g. social support, travel distance, and income); and infant illness severity (i.e. needs factors). Multivariate logistic regression was used to estimate the odds ratio for each independent factor. Results Mothers parenting alone, experiencing higher levels of worry about maternal alcohol or drug use, or at greater distances from NFU were less likely to attend. Mothers experiencing higher maternal stress at the time of the infant's NICU hospitalization were more likely to attend NFU. No infant factors were predictive of NFU attendance. Conclusions Mothers at risk of not attending NFU programmes with their infants require better identification, triage, referral and additional support to promote engagement with NFU programmes and improved quality of life for their high-risk infants. [ABSTRACT FROM AUTHOR]

Background Suicide-related ideation and behaviors ( SRIB) are associated with both alcohol disorders and major depressive disorder ( MDD). The objective of this study was to evaluate the relationship of alcohol dependence ( AD) and major depression to the risk for lifetime SRIB. Methods Data from a community-based sample of 1,237 adult Israeli lifetime drinkers assessed with reliable diagnostic measures were analyzed using logistic regression. Results Lifetime SRIB was reported in 4.7% and was more prevalent among participants with AD (9.0%) than among those without AD (4.1%); p-value = 0.01. Although both AD and major depression were associated with SRIB ( AD: OR 2.2, 95% CI 1.1 to 4.4; MDD: OR 11.4, 95% CI = 6.4 to 20.4), joint analysis showed that AD without MDD increased risk for SRIB as compared to those without AD or MDD ( OR 3.1, 95% CI 1.1 to 9.1), but AD did not increase risk among those with MDD ( OR 1.1, 95% CI 0.4 to 2.7). Among those with AD, the severity of subclinical depressive symptoms was associated with increased SRIB. Conclusions These findings show that AD increases risk for SRIB among individuals without a history of major depression. Suicidal tendencies may be undetected and underdiagnosed in this group because of the absence of major depression and therefore left untreated. These findings should be considered when adopting suicide prevention or treatment strategies for this high-risk subpopulation. [ABSTRACT FROM AUTHOR]

Purpose Hispanic women living on the United States-México border experience health disparities, are less likely to access cervical cancer screening services, and have a higher rate of cervical cancer incidence compared to women living in nonborder areas. Here we investigate the effects of an intervention delivered by community health workers (CHWs, known as lay health educators or Promotores de Salud in Spanish) on rates of cervical cancer screening in Hispanic women who were out of compliance with recommended screening guidelines. Methods Hispanic women out of compliance with screening guidelines, attending clinics in southern New Mexico, were identified using medical record review. All eligible women were offered the intervention. The study was conducted between 2009 and 2011, and data were analyzed in 2012. Setting/participants-162 Hispanic women, resident in New Mexico border counties, aged 29-80 years, who had not had a Pap test within the past 3 years. Intervention-A CHW -led, culturally appropriate, computerized education intervention. Main outcome measures-The percentage of women who underwent cervical cancer screening within 12 months of receiving the intervention. Change in knowledge of, and attitudes toward cervical cancer and screening as assessed by a baseline and follow-up questionnaire. Results 76.5% of women had a Pap test after the intervention. Women displayed increased knowledge about cervical cancer screening and about HPV. Conclusions A culturally appropriate promotora-led intervention is successful in increasing cervical cancer screening in at-risk Hispanic women on the United States-México border. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Little is known regarding youth perceptions of tap water and school water fountains and how these relate to water and sugar-sweetened beverage ( SSB) intake. METHODS We used national 2010 YouthStyles data to assess perceptions of tap water and school water fountains and associations with water and SSB intake. RESULTS Nearly 1 in 5 participants disagreed their tap water was safe and nearly 2 in 5 disagreed school water fountains were clean and safe. Perceived tap water risk was more prevalent among non-Hispanic ( NH) Blacks (26.4%) and Hispanics (28.3%) compared with NH Whites (14.7%, p < .001) and more prevalent among lower-income youth. Negative water fountain perceptions were more common among high school-aged youth. Perceived tap water risk was not associated with SSB intake (odds ratio [ OR] = 1.0, 95% confidence interval [ CI]: 0.6, 1.5) or water intake ( OR = 1.4, 95% CI: 0.9, 2.1). Negative water fountain perceptions were associated with SSB intake only among Hispanics (race/ethnicity interaction p < .001; OR = 2.9, 95% CI: 1.3, 6.6) but were not associated with water intake. CONCLUSION Negative perceptions of tap water and water fountains among youth are common and should be considered in efforts to provide water in schools. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND Sugar-sweetened beverages ( SSBs) may play a role in increased rates of obesity. This study examined patterns and frequencies of beverage consumption among youth in 3 distinct regions in Canada, and examined associations between beverage consumption and age, sex, body mass index ( BMI), physical activity and dieting behavior, as well as beverage displacement. METHODS The study included data from 10,188 youth (ages 13-18) from Hamilton and Thunder Bay, Ontario, and Prince Edward Island ( PEI) in 2009 to 2010. The study used in-school self-reported surveys with 12 questions regarding beverage consumption during the previous day, along with self-reported height, weight, physical activity levels, and demographic information. Logistic regression analyses were conducted to examine variables associated with SSB intake. RESULTS Overall, 80% of youth consumed at least 1 SSB in the previous day, with 44% consuming 3 or more SSBs. Youth in Thunder Bay consumed significantly more SSBs than Hamilton and PEI, and youth in Hamilton consumed more SSBs than PEI. Boys consumed significantly more SSBs than girls. Older and more physically active youth consumed significantly fewer SSBs. No significant association between BMI and SSB consumption was observed in any model. A modest positive correlation was identified between SSB consumption and milk (r = .06, p < .001) and 100% fruit juice (r = .10, p < .001). CONCLUSIONS A large proportion of youth consumed SSBs, many at high levels. Research evaluating SSB policy and interventions should be considered a priority. [ABSTRACT FROM AUTHOR]

Background The management of the occiput posterior ( OP) position has been controversial for many years. Manual rotation can be performed by midwives and could reduce cesarean sections and instrumental births. We aimed to determine current midwifery views, knowledge, and practice of manual rotation. Method A de-identified, self-reported questionnaire was e-mailed to all Australian College of Midwives full members ( n = 3,997). Results Of 3,182 surveyed, 57 percent (1,817) responded, of whom 51 percent (920) were currently practicing midwifery. Seventy-seven percent of midwives thought that manual rotation at full dilatation was a valid intervention. Sixty-four percent stated the procedure was acceptable before instrumental delivery, but 30 percent were unsure. Most practicing midwives (93%) had heard of manual rotation, but only 18 percent had performed one in the last year. Midwives would support the routine performance of manual rotation for OP position if it reduced operative births from 68 to 50 percent and would support manual rotation for occiput transverse ( OT) position if it reduced operative births from 39 to 25 percent. Conclusion This study indicates that manual rotation is considered acceptable by most midwives in Australia, yet is only performed by a minority. Midwives would be willing to perform prophylactic manual rotation if it was known to facilitate normal vaginal births suggesting a scope to introduce this procedure into widespread clinical practice. [ABSTRACT FROM AUTHOR]

Background Sexual violence ( SV) is being used widely as a weapon of war. However, few studies have investigated its health effects. The objective of the present study is to investigate the relationship between sexual violence and several serious reproductive health conditions including fistula. Methods We conducted a cross-sectional study among 320 women living in Goma, the Democratic Republic of Congo. We assessed the association of four outcomes: fistula, chronic pelvic pain, desire for sex, and desire for children, with SV in two contexts: conflict-related and nonconflict-related. Two groups of women: those who experienced conflict-related sexual violence ( CRSV) and those who experienced nonconflict-related sexual violence ( NCRSV), were compared with women who had not experienced SV. Data were collected by trained interviewers using a standard questionnaire. Results Compared with women who did not experience SV, after adjustment for potential confounders, women who experienced CRSV were significantly more likely to have fistula ( OR = 11.1, 95% CI [3.1-39.3]), chronic pelvic pain ( OR = 5.1, 95% CI [2.4-10.9]), and absence of desire for sex ( OR = 3.5, 95% CI [1.7-6.9]) and children ( OR = 3.5, 95% CI [1.6-7.8]). Women who experienced NCRSV were more likely to report absence of desire for children ( OR = 2.7, 95% CI [1.1-6.5]), and seemed more likely to report chronic pelvic pain ( OR = 2.3, 95% CI [0.95-5.8]), although the difference was not statistically significant. Women who experienced NCRSV did not have higher odds for fistula and absence of sexual desire. Conclusion Conflict-related sexual violence can contribute to women's adverse reproductive health outcomes. Its impact is more devastating than that of NCRSV. [ABSTRACT FROM AUTHOR]

Aim To identify the extent to which homes and neighbourhoods of older community-dwelling people are 'supportive'. Method Cross-sectional survey, in-home observation and interviews involving 202 participants (75-79 years). Measures included SF-36 health-related quality of life and Late Life Function and Disability Instrument ( LLFDI) scores, and self-reported home usability, access, safety and neighbourhood. Associations between home and neighbourhood characteristics were assessed using χ2-tests, t-tests and Pearson correlations. Results Older people rated neighbourhood satisfaction highly (3.0 men, 3.2 women; 4 being the highest score). Many homes failed objective adaptability and safety ratings, particularly bathrooms (80% did not have a shower grab rail, 77% did not have non-slip floors); 27% of homes scored ≥8 of 25 possible hazards. There were significant correlations between perceptions of housing and neighbourhood and SF-36 and disability scores. Conclusion Many homes and neighbourhoods may not accommodate increased frailty or disability of older people into the future. [ABSTRACT FROM AUTHOR]

Aims To examine characteristics of 15- to 16-year-old adolescents who used over-the-counter analgesics daily to weekly (high-frequency users) as compared to those who used less or no analgesics (low-frequency users). Further to analyse the differences in pain experience, lifestyle, self-esteem, school attendance and educational ambition. Methods An anonymous cross-sectional questionnaire-based study. The questionnaire covered the use of over-the-counter analgesics, pain experience, sociodemographics, lifestyle factors, self-esteem, school absence and future educational plans. The study took place in the 10th grade in six junior high schools in a medium-sized town in Norway. The local sales data for analgesics and antipyretics were close to the national average. We invited 626 adolescents to participate. Of the 367 adolescents (59%) who responded, 51% were girls. Associations between the frequency of use of over-the-counter analgesic and the mentioned variables were analysed using multiple logistic regression. Results In total, 26% (42 boys and 48 girls) used over-the-counter analgesics daily to weekly. These high-frequency users experienced more widespread pain, slept less, had more paid spare-time work, drank more caffeinated drinks, participated more often in binge drinking, had lower self-esteem, less ambitious educational plans and more frequent school absence than did the low-frequency users. These associations remained significant when controlling for gender, cultural background and self-evaluated economic status. Conclusion Adolescent, who are high-frequency users of over-the-counter analgesics, suffer more pain and have identifiable characteristics indicative of complex problems. Their ability to handle stress appears to be discordant with the kind of situations to which they are exposed. The wear and tear associated with allostatic mechanisms counteracting stress may heighten their pain experience. [ABSTRACT FROM AUTHOR]

In line with the 'Work environment hypothesis,' role stressors have been proposed as important antecedents of bullying in the workplace. Only a few longitudinal studies on the relationship between role stressors and bullying exist, however, and earlier studies have largely been cross-sectional. The aim of the present prospective study was to determine whether role stressors at baseline predict new cases of workplace bullying at follow-up. A total of 2,835 Norwegian employees participated at both baseline and follow-up, with an interval of two years between the measurements. The study supports the hypotheses that role ambiguity and role conflict, independently, contribute to subsequent new reports of workplace bullying. However, there was a weak reverse effect: reporting being bullied at work at baseline predicted reporting increased levels of role ambiguity and role conflict at follow-up. Even though the results may indicate a circular relationship between the variables at hand, the weak reverse relationship seems to have little practical impact compared to the stronger relationship from role stressors to bullying. Hence, the results mainly support the hypotheses stating that role ambiguity and role conflict, independently, predict subsequent exposure to workplace bullying. [ABSTRACT FROM AUTHOR]

Background Very few studies have investigated psychopathology in children of mothers with eating disorders (ED). We aimed to determine the effect of maternal ED on childhood psychopathology in a large population-based cohort and investigate relevant risk pathways using structural equation modeling (SEM). Methods Data on emotional and behavioral problems at 3½ years were obtained prospectively on 8,622 children from the Avon Longitudinal Study of Parents and Children (ALSPAC). Children of exposed women who self-reported lifetime anorexia nervosa (AN, N = 193) or bulimia nervosa (BN, N = 158) in pregnancy were compared with children of unexposed women ( N = 8,271) using linear and logistic regression models. SEM was used to determine best-fitting risk models by child gender. Results There was evidence that girls of AN women were more likely to have emotional, conduct, and hyperactivity disorders [Odds Ratio (OR): 1.7 (95% Confidence Intervals 1.0-3.0); OR: 2.2 (1.2-4.0); OR: 1.8 (1.1-3.1), respectively] and boys of AN women to have emotional disorders compared with unexposed [OR: 2.0(1.2-3.4)]. Girls of women with BN were more likely to show hyperactivity [OR: 1.7 (1.0-3.1)]; and boys to show emotional and conduct disorders compared with unexposed [OR: 2.2 (1.2-3.9); OR: 2.4 (1.4-4.2), respectively]. SEM models showed that pregnancy anxiety and depression mediated the effect of maternal ED on child psychopathology. Conclusions Maternal ED are associated with different childhood psychopathology outcomes in boys and girls. Pregnancy anxiety and depression and active ED symptoms are important mediators of risk and are preventable; the direct effect of maternal lifetime ED was small. [ABSTRACT FROM AUTHOR]

Despite the variety of available analytic methods, longitudinal research in nursing has been dominated by use of a variable-centered analytic approach. The purpose of this article is to present the utility of person-centered methodology using a large cohort of American women 65 and older enrolled in the Women's Health Initiative Clinical Trial ( N = 19,891). Four distinct trajectories of energy/fatigue scores were identified. Levels of fatigue were closely linked to age, socio-demographic factors, comorbidities, health behaviors, and poor sleep quality. These findings were consistent regardless of the methodological framework. Finally, we demonstrated that energy/fatigue levels predicted future hospitalization in non-disabled elderly. Person-centered methods provide unique opportunities to explore and statistically model the effects of longitudinal heterogeneity within a population. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background and aims British alcohol consumption and abstinence rates have increased substantially in the last 3 decades. This study aims to disentangle age, period and birth cohort effects to improve our understanding of these trends and suggest groups for targeted interventions to reduce resultant harms. Design Age, period, cohort analysis of repeated cross-sectional surveys using separate logistic and negative binomial models for each gender. Setting Great Britain 1984-2009. Participants Annual nationally representative samples of approximately 20 000 adults (16+) within 13 000 households. Measurements Age (eight groups: 16-17 to 75+ years), period (six groups: 1980-84 to 2005-09) and birth cohorts (19 groups: 1900-04 to 1990-94). Outcome measures were abstinence and average weekly alcohol consumption. Controls were income, education, ethnicity and country. Findings After accounting for period and cohort trends, 18-24-year-olds have the highest consumption levels (incident rate ratio = 1.18-1.15) and lower abstention rates (odds ratio = 0.67-0.87). Consumption generally decreases and abstention rates increase in later life. Until recently, successive birth cohorts' consumption levels were also increasing. However, for those born post-1985, abstention rates are increasing and male consumption is falling relative to preceding cohorts. In contrast, female drinking behaviours have polarized over the study period, with increasing abstention rates accompanying increases in drinkers' consumption levels. Conclusions Rising female consumption of alcohol and progression of higher-consuming birth cohorts through the life course are key drivers of increased per capita alcohol consumption in the United Kingdom. Recent declines in alcohol consumption appear to be attributable to reduced consumption and increased abstinence rates among the most recent birth cohorts, especially males, and general increased rates of abstention across the study period. [ABSTRACT FROM AUTHOR]

Aims To examine how changes in social roles, particularly in the family, predict rises and falls in alcohol consumption from ages 16 to 50 years. Design Longitudinal data from the National Child Development Study. Setting The birth cohort includes 99% of British infants born in 1 week in 1958. Participants After initial assessment of 17 415 infants, the cohort was interviewed at ages 7, 11, 16, 23, 33, 42, 46, and 50. This study uses the six adolescent to adult waves ( n = 7212 women, 7377 men). Measurements Alcohol use [i.e. quantity consumed in past week and heavy-daily drinking), symptoms of problem drinking (i.e. Cut-down, Annoyed, Guilt, Eye-opener ( CAGE)] and social roles (i.e. union formation, parenthood and employment). Findings Estimates from fixed-effects models demonstrate that alcohol use is lower when women reside with child(ren) under age 5, compared to occasions when they do not [estimate = −0.38, 95% confidence interval ( CI) = −0.43, −0.32 for past week units; odds ratio ( OR) = 0.47, CI = 0.36, 0.62 for heavy-daily drinking; OR = 0.66, CI = 0.50, 0.87 for CAGE symptoms]. Associations are similar for men (estimate = −0.29, CI = −0.36, −0.23; OR = 0.64, CI = 0.53, 0.77; OR = 0.69, CI = 0.51, 0.94, respectively). When women and men are married, working and residing with young child(ren), past week units (estimate = −0.51, CI = −0.61, −0.41 for women; estimate = −0.34, CI = −0.44, −0.25 for men), heavy-daily drinking ( OR = 0.49, CI = 0.30, 0.79 for women; OR = 0.47, CI = 0.35, 0.64 for men) and CAGE ( OR = 0.44, CI = 0.23, 0.83 for women; OR = 0.39, CI = 0.18, 0.82 for men) are lower compared to occasions when they are not in these roles. Conclusions From late adolescence to mid-life, women and men in Britain are most at risk for higher levels of alcohol consumption and problem drinking when family roles are absent. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to assess the long-term efficacy and complication rates of posterior intravaginal slingplasty ( IVS) in women suffering from genital prolapse. Material and Methods Posterior IVS or infracoccygeal sacropexy is a minimally invasive procedure for suspension of the vagina with the goal of creating new uterosacral ligaments through the insertion of a polypropylene tape. Forty-four patients were enrolled: 25 patients, affected by uterovaginal prolapse, were subjected to vaginal hysterectomy and posterior IVS; and 19 patients, diagnosed with vaginal vault prolapse, were subjected to posterior IVS alone. The primary outcome for posterior IVS was 12-month, 24-month and annual 9-year postoperative efficacy that is based on a Pelvic Organ Prolapse Quantitative score of −5 at point C, which describes the vaginal apex. Results Of the 44 patients who underwent posterior IVS, none required blood transfusions with an average reduction of perioperative hemoglobin of 1.2 ± 0.4 g/dl, and the average time of hospitalization was 4.3 ± 0.6 days. The rate of success was 93.18% (41/44) at 9 years' follow-up. We had only one case of extrusion (2.27%) and three cases of recurrence (6.82%), such as two cases of cystocele and of rectocele. Conclusions Most patients interviewed confirmed that their quality of life improved after surgery, 86.36% of the operated patients reported that their sexual performance improved and that they would recommend this surgery for their friends. Posterior IVS was a minimally invasive surgical procedure with a high success rate for genital prolapse. [ABSTRACT FROM AUTHOR]

Background Attention-deficit/hyperactivity disorder ( ADHD) symptoms and mathematics ability are associated, but little is known about the genetic and environmental influences underlying this association. Methods Data came from more than 6,000 twelve-year-old twin pairs from the UK population-representative Twins Early Development Study. Parents rated each twin's behaviour using a DSM- IV-based 18-item questionnaire of inattentive and hyperactive-impulsive ADHD symptoms. Mathematics tests based on the UK National Curriculum were completed by each twin. The twins also completed standardised tests of reading and general cognitive ability. Multivariate twin model fitting was applied. Results Inattentive and hyperactive-impulsive ADHD symptoms were highly heritable (67% and 73% respectively). Mathematics ability was moderately heritable (46%). Mathematics ability and inattentiveness showed a significantly greater phenotypic correlation ( rp = −.26) and genetic correlation ( rA = −.41) than mathematics ability and hyperactivity-impulsivity ( rp = −.18; rA = −.22). The genetic correlation between inattentiveness and mathematics ability was largely independent from hyperactivity-impulsivity, and was only partially accounted for by genetic influences related to reading and general cognitive ability. Conclusions Results revealed the novel finding that mathematics ability shows significantly stronger phenotypic and genetic associations with inattentiveness than with hyperactivity-impulsivity. Genetic associations between inattentiveness and mathematics ability could only partially be accounted for by hyperactivity-impulsivity, reading and general cognitive ability. Results suggest that mathematics ability is associated with ADHD symptoms largely because it shares genetic risk factors with inattentiveness, and provide further evidence for considering inattentiveness and hyperactivity-impulsivity separately. DNA markers for ADHD symptoms (especially inattentiveness) may also be candidate risk factors for mathematics ability and vice versa. [ABSTRACT FROM AUTHOR]