Prevalence and factors associated with the use of alternative (folk) medicine practitioners in 8 countries of the former Soviet Union.

BACKGROUND: Research suggests that since the collapse of the Soviet Union there has been a sharp growth in the use of complementary and alternative medicine (CAM) in some former Soviet countries. However, as yet, comparatively little is known about the use of CAM in the countries throughout this region. Against this background, the aim of the current study was to determine the prevalence of using alternative (folk) medicine practitioners in eight countries of the former Soviet Union (fSU) and to examine factors associated with their use. METHODS: Data were obtained from the Living Conditions, Lifestyles and Health (LLH) survey undertaken in eight former Soviet countries (Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine) in 2001. In this nationally representative cross-sectional survey, 18428 respondents were asked about how they treated 10 symptoms, with options including the use of alternative (folk) medicine practitioners. Multivariate logistic regression analysis was used to determine the factors associated with the treatment of differing symptoms by such practitioners in these countries. RESULTS: The prevalence of using an alternative (folk) medicine practitioner for symptom treatment varied widely between countries, ranging from 3.5% in Armenia to 25.0% in Kyrgyzstan. For nearly every symptom, respondents living in rural locations were more likely to use an alternative (folk) medicine practitioner than urban residents. Greater wealth was also associated with using these practitioners, while distrust of doctors played a role in the treatment of some symptoms. CONCLUSIONS: The widespread use of alternative (folk) medicine practitioners in some fSU countries and the growth of this form of health care provision in the post-Soviet period in conditions of variable licensing and regulation, highlights the urgent need for more research on this phenomenon and its potential effects on population health in the countries in this region

Correction: Psychotic-Like Experiences and Nonsuidical Self-Injury in England: Results from a National Survey

The word "Nonsuicidal" is misspelled in the title. The correct title is: Psychotic-Like Experiences and Nonsuicidal Self-Injury in England: Results from a National Surve

Psychotic-Like Experiences and Nonsuicidal Self-Injury in England: Results from a National Survey

Correction in the title (Jan 2016) https://doi.org/10.1371/journal.pone.0147095Background: Little is known about the association between psychotic-like experiences (PLEs) and nonsuicidal self-injury (NSSI) in the general adult population. Thus, the aim of this study was to examine the association using nationally-representative data from England. Methods: Data from the 2007 Adult Psychiatric Morbidity Survey was analyzed. The sample consisted of 7403 adults aged ≥16 years. Five forms of PLEs (mania/hypomania, thought control, paranoia, strange experience, auditory hallucination) were assessed with the Psychosis Screening Questionnaire. The association between PLEs and NSSI was assessed by multivariable logistic regression. Hierarchical models were constructed to evaluate the influence of alcohol and drug dependence, common mental disorders, and borderline personality disorder symptoms on this association. Results: The prevalence of NSSI was 4.7% (female 5.2% and male 4.2%), while the figures among those with and without any PLEs were 19.2% and 3.9% respectively. In a regression model adjusted for sociodemographic factors and stressful life events, most types of PLE were significantly associated with NSSI: paranoia (OR 3.57; 95%CI 1.96-6.52), thought control (OR 2.45; 95%CI 1.05-5.74), strange experience (OR 3.13; 95%CI 1.99-4.93), auditory hallucination (OR 4.03; 95%CI 1.56-10.42), and any PLE (OR 2.78; 95%CI 1.88-4.11). The inclusion of borderline personality disorder symptoms in the models had a strong influence on the association between PLEs and NSSI as evidenced by a large attenuation in the ORs for PLEs, with only paranoia continuing to be significantly associated with NSSI. Substance dependence and common mental disorders had little influence on the association between PLEs and NSSI. Conclusions: Borderline personality disorder symptoms may be an important factor in the link between PLEs and NSSI. Future studies on PLEs and NSSI should take these symptoms into account

Neighborhood farm density, types of agriculture, and depressive symptoms among older farmers: a cross-sectional study

BACKGROUND: Farmers may have an increased risk for poor mental health. In connection with this, factors specific to the neighborhood environment such as farm density and the type of agriculture, might be important for mental wellbeing. In this study we aimed to clarify the cross-level interaction on depressive symptoms between farm density at the neighborhood level by type of agriculture and the longest occupation of individuals (farmer or non-farmer). METHODS: Data came from the 2016 wave of the Japan Gerontological Evaluation Study (JAGES) that were linked to governmental agricultural data. Information was analyzed from 147, 549 respondents aged 65 years or older, residing in 1024 neighborhoods in 39 municipalities. We calculated farm (crop or animal husbandry) density at the neighborhood level, dividing the number of agricultural management entities by the population. Three-level (individual, neighborhood, and municipality) Poisson regression analysis was used to calculate the prevalence rate ratios of depressive symptoms. RESULTS: The prevalence of depressive symptoms was higher among individuals whose longest occupation was farmer compared to non-farmer. The estimated probability of depressive symptoms by a cross-level interaction analysis showed that among farmers of both genders, those who were residing in neighborhoods where the farm density was low had a higher prevalence of depressive symptoms, regardless of the type of agriculture. The slope of the relationship between depressive symptoms and animal husbandry farm density varied by occupation, with a higher prevalence of depressive symptoms observed in male farmers compared to male non-farmers. CONCLUSIONS: The high prevalence of depressive symptoms among farmers in neighborhoods with a low farm density may reflect a scarcity of formal and informal social support in such communities. The health effects of the neighborhood environment on farmers, such as farm density, which may vary by the type of agriculture, should be further researched

Achieving MDG 4 in Sub-Saharan Africa: What Has Contributed to the Accelerated Child Mortality Decline in Ghana?

BACKGROUND: Recent analyses have suggested an accelerated decline in child mortality in Ghana since 2000. This study examines the long-term child mortality trends in the country, relates them to changes in the key drivers of mortality decline, and assesses the feasibility of the country's MDG 4 attainment. METHODOLOGY: Data from five Demographic and Health Surveys (DHS) between 1988 and 2008 and the Maternal Health Survey 2007 were used to generate two-year estimates of under-five mortality rates back to 1967. Lowess regression fitted past and future trends towards 2015. A modified Poisson approach was applied on the person-period data created from the DHS 2003 and 2008 to examine determinants of under-five mortality and their contributions to the change in mortality. A policy-modelling system assessed the feasibility of the country's MDG 4 attainment. FINDINGS: The under-five mortality rate has steadily declined over the past 40 years with acceleration since 2000, and is projected to reach between 45 and 69 per 1000 live births in 2015. Preceding birth interval (reference: 36+ months, relative risk [RR] increased as the interval shortened), bed net use (RR 0.71, 95% confidence interval [CI]: 0.52-0.95), maternal education (reference: secondary/higher, RR 1.71, 95% CI: 1.18-2.47 for primary), and maternal age at birth (reference: 17+ years, RR 2.13, 95% CI: 1.12-4.05) were primarily associated with under-five mortality. Increased bed-net use made a substantial contribution to the mortality decline. The scale-up of key interventions will allow the possibility of Ghana's MDG 4 attainment. CONCLUSIONS: National and global efforts for scaling up key child survival interventions in Ghana are paying off--these concerted efforts need to be sustained in order to achieve MDG 4

Relationship of the Acoustic Startle Response and Its Modulation to Adaptive and Maladaptive Behaviors in Typically Developing Children and Those With Autism Spectrum Disorders: A Pilot Study

Background: Autism spectrum disorder (ASD) is associated with persistent impairments in adaptive functioning across multiple domains of daily life. Thus, investigation of the biological background of both adaptive and maladaptive behaviors may shed light on developing effective interventions for improving social adaptation in ASD. In this study, we examined the relationship between adaptive/maladaptive behaviors and the acoustic startle response (ASR) and its modulation, which are promising neurophysiological markers for ASD translational research.Method: We investigated the ASR and its modulation in 11 children with ASD and 18 with typical development (TD), analyzing the relationship between startle measures and adaptive/maladaptive behaviors assessed with the Vineland Adaptive Behavior Scales (VABS) Second Edition.Results: Peak-ASR latency was negatively correlated with the VABS total score and socialization domain score of adaptive behaviors, while the ASR magnitude for relatively weak stimuli of 75–85 dB was positively correlated with VABS maladaptive behavior scores. Prepulse inhibition (PPI) at the prepulse intensity of 70–75 dB was also correlated with VABS maladaptive behavior. However, these relationships did not remain significant after adjustment for multiple comparisons.Conclusions: Our results indicate that the prolonged peak-ASR latency of ASD children might be associated with impairment in the developmental level of adaptive behavior, and that the greater ASR magnitude to relatively weak acoustic stimuli and smaller PPI of ASD children might increase the risk of maladaptive behavior. Future studies that have larger sample sizes will be important for further elucidating the neurophysiological factors that underpin adaptive as well as maladaptive behaviors in ASD

Serious physical injury and depressive symptoms among adolescents aged 12-15 years from 21 low- and middle-income countries

Background: Little is known about the relationship between physical injury and depression in youths from low- and middle-income countries (LMICs). Therefore, the aim of this study was to analyze the association between serious physical injury and depressive symptoms among adolescents in 21 LMICs. Methods: Data from the Global School-based Student Health Survey (2003-2008) were analyzed. Serious physical injury and depressive symptoms in the past 12 months were assessed with self-report measures. The association between serious physical injury and depressive symptoms was examined using multivariable logistic regression analysis and meta-analysis. Results: The final sample consisted of 44,333 adolescents aged 12-15 years. After adjustment for sex, age, food insecurity, alcohol consumption, and country, an increasing number of serious physical injuries in the past 12 months was associated with increments in the odds for depressive symptoms in a dose-dependent fashion. Those who had ≥6 serious injuries (vs. no injuries) were 2.79 (95%CI=2.23-3.48) times more likely to have depressive symptoms. The pooled odds ratio (OR) (95%CI) for the association between at least one serious physical injury and depressive symptoms obtained by meta-analysis based on country-wise estimates was 1.83 (1.67-2.01) with a moderate level of between-country heterogeneity (I2=56.0%). Limitations: This was a cross-sectional study and causality of the association cannot be deduced. Conclusions: Serious physical injury may be a risk factor for depressive symptoms among adolescents in LMICs. Efforts to prevent physical injury and the provision of adequate health care for those who are injured may improve mental wellbeing among adolescents in this setting

Smoking cessation and desire to stop smoking in nine countries of the former Soviet Union.

INTRODUCTION: Smoking rates and corresponding levels of premature mortality from smoking-related diseases in the former Soviet Union (fSU) are among the highest in the world. To reduce this health burden, greater focus on smoking cessation is needed, but little is currently known about rates and characteristics of cessation in the fSU. METHODS: Nationally representative household survey data from a cross-sectional study of 18,000 respondents in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine were analyzed to describe patterns of desire and action taken to stop smoking, quit ratios (former ever-smokers as a percent of ever-smokers, without a specified recall period), and help used to stop smoking. Multivariate logistic regression was used to analyze characteristics associated with smoking cessation and desire to stop smoking. RESULTS: Quit ratios varied from 10.5% in Azerbaijan to 37.6% in Belarus. About 67.2% of respondents expressed a desire to quit, and 64.9% had taken action and tried to stop. The use of help to quit was extremely low (12.6%). Characteristics associated with cessation included being female, over 60, with higher education, poorer health, lower alcohol dependency, higher knowledge of tobacco's health effects, and support for tobacco control. Characteristics associated with desire to stop smoking among current smokers included younger age, poorer health, greater knowledge of tobacco's health effects, and support for tobacco control. CONCLUSIONS: Quit ratios are low in the fSU but there is widespread desire to stop smoking. Stronger tobacco control and cessation support are urgently required to reduce smoking prevalence and associated premature mortality

Are attention-deficit/hyperactivity disorder symptoms associated with negative health outcomes in individuals with psychotic experiences? Findings from a cross-sectional study in Japan

ObjectiveAlthough research has indicated that the prevalence of attention-deficit/hyperactivity disorder (ADHD) may be elevated in individuals with psychotic disorders, as yet, there has been comparatively little research on this association and its effects among adults at the subclinical level. To address this deficit, the current study examined the association between psychotic experiences (PE) and ADHD symptoms in Japanese individuals and whether the presence of ADHD symptoms increases the risk for negative health outcomes in people with PE.MethodData were analyzed from an online sample of 1,452 individuals (age 18–89; 51.5% female) collected in 2021. Information on PE was obtained with the PRIME Screen-Revised (PS-R), while the Adult ADHD Self-Report Scale (ASRS) Screener was used to measure ADHD symptoms. Information was also obtained on a number of health outcomes including anxiety and depressive symptoms and suicidal ideation. Logistic regression was used to assess associations.ResultsIn a fully adjusted analysis PE were associated with almost three times higher odds for ADHD symptoms (OR: 2.92, 95%CI: 1.19–7.17). In an analysis that was restricted to individuals with PE, ADHD symptoms were associated with significantly increased odds for depressive symptoms, lifetime suicidal ideation, perceived stress and severe sleep problems.ConclusionADHD symptoms are present in some individuals with PE and increase the odds for several detrimental health outcomes in this population. Identifying co-occurring PE and ADHD/ADHD symptoms may facilitate treatment options and help prevent negative health outcomes in individuals with these conditions

Male solitary drinking and hazardous alcohol use in nine countries of the former Soviet Union.

BACKGROUND: Despite evidence that many people engage in solitary drinking and that it might be associated with negative consequences, to date, little research has focused on this form of drinking behaviour. This study examined the prevalence and factors associated with solitary drinking, and assessed whether it is linked with hazardous alcohol use among males in nine countries of the former Soviet Union (fSU). METHODS: Data came from a cross-sectional population-based survey undertaken in 2010/11 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, and Ukraine. Information was obtained on the frequency of solitary drinking among male regular drinkers (i.e., those consuming alcoholic drinks at least once a month), and on problem drinking (CAGE) and heavy episodic drinking (HED). Logistic regression analysis was used to examine associations between the variables. RESULTS: The prevalence of occasional and frequent solitary drinking ranged from 8.4% (Georgia) to 42.4% (Azerbaijan), and 3.1% (Kazakhstan) to 8.2% (Armenia), respectively. Solitary drinking was associated with being older, divorced/widowed, living alone, having a bad/very bad household financial situation, lower levels of social support, and poor self-rated health. Occasional solitary drinking was linked to problem drinking and HED, while frequent solitary alcohol use was related to problem drinking. CONCLUSIONS: Solitary drinking is relatively common among male regular drinkers in the fSU and is linked to older age, social and economic disadvantage, and hazardous alcohol use