Purpose
The aim of this study was to explore the construction of breastfeeding in public, as depicted in the stories and the opinions of women participating in discussions on public forums.
Method
...There were 8 discussion forums selected, from which 769 messages were subjected to a narrative analysis further informed by recurrent themes identified in the literature and across messages. The emerging narratives were grouped based on their valence, and three broader categories of themes were formed, highlighting the predominant tone towards breastfeeding in public.
Results
The three broader themes, ‘public restraint of breast(feeding) as acknowledgement of the cultural status-quo’, ‘permission within boundaries’ and ‘breast(feeding) as a human right’, depict various meanings and experiences associated with public breastfeeding. People seeing breasts as mainly a cultural symbol of sexuality were more against public breastfeeding and more in favour of covering up or striving to discretion. Those arguing that breastfeeding is no more than exercising a fundamental right and pleading for breast as a primary maternal symbol were more in favour of breastfeeding in public.
Conclusion
Aiming to understand personal and social perspectives on public breastfeeding is informative for understanding cultural differences in breastfeeding rates but also for designing effective interventions to promote it.
Abstract Objective This study aimed to evaluate the factor structure of the Depression Anxiety and Stress Scale (DASS‐21) among caregivers of young children in Southeastern Europe. Background The ...DASS‐21 is a widely used measure in prevention and intervention research with families. Studies regarding the scale's psychometric properties among caregivers, particularly from non‐Western countries, are limited and additional research is required. Method The DASS‐21 was administered to N = 835 primary caregivers from North Macedonia, the Republic of Moldova, and Romania. Competing models were tested with confirmatory factor analysis (CFA). Measurement invariance was assessed using multigroup CFA (MGCFA). Bifactor dimensionality and reliability indices were used to evaluate the validity of the composite and subscale scores. Results A tripartite bifactor model with two specific factors (depression and anxiety) and one general factor (negative affectivity) represented the data well. This model showed cross‐country configural and partial metric invariance. Dimensionality and reliability indices supported a unidimensional interpretation of the measure, with the general negative affectivity factor accounting for a substantial share of the variance (82%) compared to the specific factors of depression (10%) and anxiety (8%). Conclusion The tripartite model best represented the data. Configural and partial metric invariance were verified for this model. Dimensionality and reliability indices, however, indicate that the DASS‐21 functions best as a general measure of negative affectivity. Implications Future intervention studies involving caregivers from Southeastern Europe should consider using the DASS‐21 as an overall measure of negative affectivity and utilize the composite score instead of the subscale scores.
Objective
Cervical Cancer (CC) lingers as a severe public health issue due to low vaccination coverage and poor screening addressability. Hence, this systematic review explored psychological factors ...influencing the Human Papilloma Virus (HPV) vaccination uptake in European women.
Methods
As of September 2022, PubMed, EMBASE, Scopus, and Web of Science were systematically searched to include English studies assessing diverse factors influencing vaccination uptake in European women. Only studies comparing vaccinated with unvaccinated women were included. Quality assessment, publication attrition assessment, and sensitivity analyses were performed.
Results
Eighteen studies were included, totaling a population of 18,611 participants. Results indicated that knowledge about HPV infection could positively influence vaccination rates with an Odds Ratio (OR) of 1.82 and a confidence interval (CI) between 1.27 and 2.61, showing statistical significance at a Z value of 3.24 with a p‐value of 0.001. Neither knowledge about HPV vaccination (OR = 1.39, CI: 0.73–2.65, Z = 1.01, p = 0.31) nor knowledge about CC screening (OR = 1.05, CI: 0.55–1.98, Z = 0,14, p = 0.89) seem to affect vaccination rates. Regardless, intention to undertake CC screening (CCS) showed an OR = 1.68 in favor of the group intending to perform it, with a CI between 1.37 and 2.07, showing statistical significance at a Z = 4.94 and p = 0.00001. Other aspects affecting vaccination uptake were fear of side effects, insufficient information, and belief that chances of being infected are low.
Conclusions
Results demonstrated that diverse aspects could affect the vaccination intent, while personalized interventions focusing on population and country characteristics need to be assembled to mitigate vaccination coverage.
Social cognitive models of parenting consider the role of unrealistic parental expectations (UE) regarding children’s abilities and behaviors as antecedents to the occurrence of child abuse. However, ...existing self-report measures of UE yield inconsistent results, often failing to differentiate aggressive and non-aggressive parents, raising questions about their validity and utility in understanding maladaptive parenting. To address these concerns, we developed and tested a new measure of parental UE in two samples of parents. The first sample ( N = 179) was used to test the initial structure of the scale, while the second sample ( N = 249) was used to replicate the structure and examine the concurrent validity, criterion validity, and internal consistency of the new measure. The final scale demonstrated adequate internal consistency, criterion, and concurrent validity. More unrealistic expectations predicted unique variance in parental negative behavior after controlling for other related variables. The current study provides preliminary evidence for the reliability and validity of the Parental Expectations Scale (PES), discussing its utility in the clinical assessment of parents at risk for child abuse and in tailoring parenting interventions.
Child abuse is prevalent worldwide, with most of the burden in developing countries. To reduce and prevent child abuse occurrence, many efforts are directed toward reducing maladaptive parental ...behaviors (MPBs), a predictor of parents' risk of engaging in child abusive behaviors. MPBs have been associated with child (e.g., behavioral difficulties) and parent characteristics (e.g., parenting stress and parental cognitions), although little research tested for mediational pathways. This study aimed to test the pathways through which child and parent characteristics are linked to MPB. Consistent with the social information processing model of parenting, we hypothesized that child behavioral difficulties would exert an indirect influence on MPB through parenting stress and that parenting stress will exert a direct and indirect effect on MPB through parental cognitions (i.e., expectations, attitudes, and attributions). This study used data from 243 mothers of children aged between 2 and 9 years in Romania. Two-stage structural equation modeling was employed to test the hypothesized model. Results support the role of child behavior, parenting stress, and parental cognitions in predicting MPB (R
= 0.69). Significant indirect effects were found from child behavior to MPB via parenting stress and parental cognitions. Direct effects from parenting stress and parental cognitions to MPB were significant. Findings show that parenting stress and parental cognitions are important mechanisms through which child behavioral difficulties influence maladaptive parental behavior, underscoring the need to focus on these mechanisms when assessing or intervening with families at risk for child abuse.
The COVID-19 pandemic has affected people's engagement in health behaviors, especially those that protect individuals from SARS-CoV-2 transmission, such as handwashing/sanitizing. This study ...investigated whether adherence to the World Health Organization's (WHO) handwashing guidelines (the outcome variable) was associated with the trajectory of the COVID-19 pandemic, as measured by the following 6 indicators: (i) the number of new cases of COVID-19 morbidity/mortality (a country-level mean calculated for the 14 days prior to data collection), (ii) total cases of COVID-19 morbidity/mortality accumulated since the onset of the pandemic, and (iii) changes in recent cases of COVID-19 morbidity/mortality (a difference between country-level COVID-19 morbidity/mortality in the previous 14 days compared to cases recorded 14-28 days earlier).
The observational study (#NCT04367337) enrolled 6064 adults residing in Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Data on handwashing adherence across 8 situations (indicated in the WHO guidelines) were collected via an online survey (March-July 2020). Individual-level handwashing data were matched with the date- and country-specific values of the 6 indices of the trajectory of COVID-19 pandemic, obtained from the WHO daily reports.
Multilevel regression models indicated a negative association between both accumulation of the total cases of COVID-19 morbidity (B = -.041, SE = .013, p = .013) and mortality (B = -.036, SE = .014 p = .002) and handwashing. Higher levels of total COVID-related morbidity and mortality were related to lower handwashing adherence. However, increases in recent cases of COVID-19 morbidity (B = .014, SE = .007, p = .035) and mortality (B = .022, SE = .009, p = .015) were associated with higher levels of handwashing adherence. Analyses controlled for participants' COVID-19-related situation (their exposure to information about handwashing, being a healthcare professional), sociodemographic characteristics (gender, age, marital status), and country-level variables (strictness of containment and health policies, human development index). The models explained 14-20% of the variance in handwashing adherence.
To better explain levels of protective behaviors such as handwashing, future research should account for indicators of the trajectory of the COVID-19 pandemic.
Clinical Trials.Gov, # NCT04367337.
Maternal prenatal stress places a substantial burden on mother’s mental health. Expectant mothers in low- and middle-income countries (LMICs) have thus far received less attention than mothers in ...high-income settings. This is particularly problematic, as a range of triggers, such as exposure to traumatic events (e.g. natural disasters, previous pregnancy losses) and adverse life circumstances (e.g. poverty, community violence), put mothers at increased risk of experiencing prenatal stress. The ten-item Perceived Stress Scale (PSS-10) is a widely recognised index of subjective experience of stress that is increasingly used in LMICs. However, evidence for its measurement equivalence across settings is lacking. This study aims to assess measurement invariance of the PSS-10 across eight LMICs and across birth parity. This research was carried out as part of the Evidence for Better Lives Study (EBLS, vrc.crim.cam.ac.uk/vrcresearch/EBLS). The PSS-10 was administered to
N
= 1,208 expectant mothers from Ghana, Jamaica, Pakistan, the Philippines, Romania, South Africa, Sri Lanka and Vietnam during the third trimester of pregnancy. Confirmatory factor analysis suggested a good model fit of a two-factor model across all sites, with items on experiences of stress loading onto a negative factor and items on perceived coping onto a positive factor. Configural and metric, but not full or partial scalar invariance, were established across all sites. Configural, metric and full scalar invariance could be established across birth parity. On average, first-time mothers reported less stress than mothers who already had children. Our findings indicate that the PSS-10 holds utility in assessing stress across a broad range of culturally diverse settings; however, caution should be taken when comparing mean stress levels across sites.
Evidence for the effectiveness of serious games (SGs) and their various features is inconsistent in the motor rehabilitation field, which makes evidence based development of SGs a rare practice.
To ...investigate the effectiveness of SGs in motor rehabilitation for upper limb and movement/balance and to test the potential moderating role of SGs features like feedback, activities, characters and background.
We ran a meta-analysis including 61 studies reporting randomized controlled trials (RCTs), controlled trials (CTs) or case series designs in which at least one intervention for motor rehabilitation included the use of SGs as standalone or in combination.
There was an overall moderate effect of SGs on motor indices, d = 0.59, 95% CI, 0.48, 0.71, p < 0.001. Regarding the game features, only two out of 17 moderators were statistically different in terms of effect sizes: type of activity (combination of group with individual activities had the highest effects), and realism of the scenario (fantasy scenarios had the highest effects).
While we showed that SGs are more effective in improving motor upper limb and movement/balance functions compared to conventional rehabilitation, there were no consistent differences between various game features in their contribution to effects. Further research should systematically investigate SGs features that might have added value in improving effectiveness.
Abstract
Background
This paper enumerates and characterizes latent classes of adverse childhood experiences and investigates how they relate to prenatal substance use (i.e., smoking, alcohol, and ...other drugs) and poor infant outcomes (i.e., infant prematurity and low birthweight) across eight low- and middle-income countries (LMICs).
Methods
A total of 1189 mother-infant dyads from the Evidence for Better Lives Study cohort were recruited. Latent class analysis using the Bolck, Croon, and Hagenaars (BCH) 3-step method with auxiliary multilevel logistic regressions was performed.
Results
Three high-risk classes and one low-risk class emerged: (1)
highly maltreated
(7%,
n
= 89), (2
) emotionally and physically abused with intra-familial violence exposure
(13%,
n
= 152), (3),
emotionally abused
(40%,
n
= 474), and (4)
low household dysfunction and abuse
(40%,
n
= 474). Pairwise comparisons between classes indicate higher probabilities of prenatal drug use in the
highly
maltreated and
emotionally abused
classes compared with the
low household dysfunction and abuse
class. Additionally, the
emotionally and physically abused with intra-familial violence exposure
class had higher probability of low birthweight than the three remaining classes.
Conclusion
Our results highlight the multifaceted nature of ACEs and underline the potential importance of exposure to childhood adversities on behaviors and outcomes in the perinatal period. This can inform the design of antenatal support to better address these challenges.
Background: Building upon previous results, the present study explored the relationship between exposure to unhealthy and healthy food TV commercials, trait self‐control, and food intake. Methods: In ...total, 825 Finns (53% female), 1,055 Germans (55% female), and 971 Romanians (55% female) aged 8–21 reported advertisement exposure, self‐control, and food intake. Results: Altogether, participants indicated higher exposure to unhealthy compared to healthy food advertisements (F(1, 2848) = 354.73, p < .001, partial η2 = .111). Unhealthy food advertisement exposure was positively associated with unhealthy food intake (all β ≥ .16, p < .001). Healthy food advertisement exposure was positively associated with fruit and vegetable consumption (β = .10, p < .001). Self‐control was associated with higher consumption of healthy (β ≥ .09, p < .001) and lower consumption of unhealthy foods (all β ≥ −.11, p < .001). Yet, findings of advertising and self‐control were mainly independent (interactions: β ≤ |.07|, p ≥ .002). Conclusion: Even though the results suggest that healthy advertisement exposure and self‐control might be beneficial for children's and adolescents' diet, self‐control might be insufficient to alleviate the positive relationship between unhealthy food advertising and unhealthy eating.
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