Behavioral Factors Research Articles

Increases in drug-related infant mortality in the United States.

We explored temporal trends in drug-related infant deaths in the United States (U.S.) from 2018 to 2022. We used data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (WONDER). A total of 295 drug-involved infant deaths were identified from 2018 to 2022 (provisional mortality data for year 2022) based on the underlying cause of death. In the U.S. from 2018 to 2022, there was a significant 2.2-fold increase in drug-involved infant mortality. The observed increases were higher in non-Hispanic White and Black infants. The findings show that drug-involved infant deaths were more likely to occur in the postneonatal period, defined as ages 28-364days (81.4 %) compared to the neonatal period. The most prevalent underlying causes of death included assault (homicide) by drugs, medicaments and biological substances (35.6 %) followed by poisoning dueto exposure to narcotics and psychodysleptics (hallucinogens) (15.6 %). The most common multiple causes of drug-involved infant deaths were psychostimulants with abuse potential of synthetic narcotics. Drug-related infant mortality has increased significantly from 2018 to 2022. These increases are particularly evident among White and Black infants and occurred predominantly in the postneonatal period. These findings require more research but also indicate the need to address drug-involved infant deaths as preventable clinical and public health issues. Effective strategies to reduce drug-involved infant deaths will require preventing and treating maternal substance use disorders, enhancing prenatal care access, and addressing broader social and behavioral risk factors among vulnerable maternal and infant populations.

Persistent trends and inefficiencies in the Greek housing market: a sentiment based approach

PurposeWe examine the aggregate price trend of the Greek housing market from a behavioral perspective.Design/methodology/approachWe construct a behavioral real estate sentiment index, based on relevant real estate search terms from Google Trends and websites, and examine its association with real estate price distributions and trends. By employing EGARCH(1,1) on the New Apartments Index data from the Bank of Greece, we capture real estate price volatility and asymmetric effects resulting from changes in the real estate search index. Enhancing robustness, macroeconomic variables are added to the mean equation. Additionally, a run test assesses the efficiency of the Greek housing market.FindingsThe results show a significant relationship between the Greek housing market and our real estate sentiment index; an increase (decrease) in search activity, indicating a growing interest in the real estate market, is strongly linked to potential increases (decreases) in real estate prices. These results remain robust across various estimation procedures and control variables. These findings underscore the influential role of real estate sentiment on the Greek housing market and highlight the importance of considering behavioral factors when analyzing and predicting trends in the housing market.Originality/valueTo investigate the behavioral effect on the Greek housing market, we construct our behavioral pattern indexes using Google search-based sentiment data from Google Trends. Additionally, we incorporate the Google Trend index as an explanatory variable in the EGARCH mean equation to evaluate the influence of online search behavior on the dynamics and prices of the Greek housing market.

Association of optimism and social support with health-related quality of life among Australian women cancer survivors - A cohort study.

Large-scale studies investigating health-related quality of life (HRQL) in cancer survivors are limited. This study aims to investigate HRQL and its relation to optimism and social support among Australian women following a cancer diagnosis. Data were from the Australian Longitudinal Study on Women's Health, a large cohort study (n=14,715; born 1946-51), with 1428 incident cancer cases ascertained 1996-2017 via linkage to the Australian Cancer Database. HRQL was measured using the Short Form-36 (median 1.7 years post-cancer-diagnosis). Multivariable linear regression was performed on each HRQL domain, separately for all cancers combined, major cancer sites, and cancer-free peers. Higher optimism and social support were significantly associated with better HRQL across various domains in women with and without a cancer diagnosis (p<0.05). Mean HRQL scores across all domains for all cancer sites were significantly higher among optimistic versus not optimistic women with cancer (p<0.05). Adjusting for sociodemographic and other health conditions, lower optimism was associated with reduced scores across all domains, with greater reductions in mental health (adjusted mean difference (AMD)=-11.54, p<0.01) followed by general health (AMD=-11.08, p<0.01). Social support was less consistently related to HRQL scores, and following adjustment was only significantly associated with social functioning (AMD=-7.22, p<0.01) and mental health (AMD=-6.34, p<0.01). Our findings highlight a strong connection between optimism, social support, and HRQL among cancer survivors. Providing psychosocial support and addressing behavioral and socioeconomic factors and other health conditions associated with optimism and social support may improve HRQL.

Behavioral traits of fund managers: a systematic literature review

PurposeThe purpose of the study is to investigate, synthesize and critically evaluate empirical research findings on the behavioral traits of fund managers from 1994 to 2024. The ultimate goal is to provide a unified body of literature on three broad topics: first, fund managers' demographic and professional characteristics, such as age, gender, level of education and years of industry experience; second, fund managers' social and political connections; and third, fund managers' behavioral biases that lead to irrational investment decisions.Design/methodology/approachThe relevant papers from selected journals were discovered and manually validated using the Scopus database. From 317 retrieved documents, 57 relevant articles were chosen and analyzed after the forward and backward search of the existing articles.FindingsThis paper presents a categorized summary of behavioral factors that have gained a foothold in influencing the behavior of fund managers in fund management research, with several studies demonstrating their significance leading to improved prediction and model precision, as this review indicates. In addition, the study summarized the contributions of prior empirical studies within the aforementioned three major categories and illustrated their consequences.Originality/valueThe present study contributes to the understanding of the effects of behavioral finance theories on fund managers by providing meaningful explanations of their behavioral traits based on empirical evidence and existing trends and knowledge gaps, both of which can influence the future direction of research.

Scale Validation and Attributional Analysis of Public Stigma in Early-Pandemic COVID-19.

To test the validity of a COVID-19 public stigma scale and an attributional model of stigma during the early stages of the pandemic. We administered a cross-sectional survey that included scales related to COVID-19 stigma to U.S. adults. We used Amazon MTurk online survey panel to recruit participants in June 2020. U.S. adults (N = 170) participated in the study. Participants were average age of 37 and majority were men (61.2%) and White (77.6%). The Stigma Towards Disease Scale (SDS) was adapted to measure public stigma directed towards COVID-19 (SDS-C19). Additional stigma-related measures were adapted for this study. Factorial structure of SDS-C19 was assessed using confirmatory factor analysis (CFA). Validity of SDS was examined using Pearson correlations with other stigma measures. We evaluated the attributional model of stigma using structural equation modeling. Internal consistency of SDS-C19 was high and a three-factor model reflecting cognitive, affective, and behavioral factors was supported (χ2 [71, N = 170] =140.954, P = .00, CFI= .946, TLI = .931, RMSEA = .076, SRMR = .087). The SDS-C19 had strong correlations with other stigma-related measures. A blame-mediated attribution model was supported (χ2 [8, N = 170] = 21.793, P = .00, CFI = .976, TLI =.956, RMSEA = .101, SRMR = .058). The SDS-C19 is a valid tool for assessing COVID-19 stigma. SDS-C19 and the attribution model can guide public health communication.

Physician-nurse collaboration in the relationship between professional autonomy and practice behaviors.

Nurses and physicians are key members of healthcare teams. While physicians are responsible for the diagnosis and treatment of patients, nurses are part of the treatment and the primary practitioners of patient care. Nurses' professional autonomy, collaboration with physicians, and practice behaviors in treatment and patient care practices are interrelated. In the present study, we examined the mediating effect of physician-nurse collaboration on the relationship between nurses' practice behaviors and their professional autonomy. The present study utilized a cross-sectional survey design following quantitative methods. This study was conducted in the Istanbul Province of Turkiye from September to October 2022. The sampling method used was a convenience sampling strategy to provide easier access to participants when selecting nurses from different health institutions. The mean age of the 295 nurses was 31.23 years, with ages ranging from 21 to 59years. The data analysis was conducted using IBM's SPSS 24.0 software package and the Process Macro 4.0 plug-in. Research ethics approval was obtained from the researcher's university. Physician-nurse collaboration is positively associated with practice behaviors and professional autonomy. Nurses' professional autonomy in practice behaviors through physician-nurse collaboration is significant (95% CI [0.043, 0.135]). Our results revealed the relationships among physician‒nurse collaboration, professional autonomy, and practice behaviors among nurses. Our results provide evidence on the underlying factors of nurses' practice behaviors in patient care and guide the development of an intervention program to enhance this collaboration. Hospital managers can contribute to a collaborative physician‒nurse working environment.

Pattern and risk factors for suicidal behaviors of people accessing HIV care in Ogun State, Nigeria: a cross-sectional survey

Pattern and risk factors for suicidal behaviors of people accessing HIV care in Ogun State, Nigeria: a cross-sectional survey

Social Determinants of Health Among American Indians and Alaska Natives and Tribal Communities: Comparison with Other Major Racial and Ethnic Groups in the United States, 1990–2022

Background and Objective Limited research exists on health inequities between American Indians and Alaska Natives (AIANs), tribal communities, and other population groups in the United States. To address this gap in research, we conducted time-trend analyses of social determinants of health and disease outcomes for AIANs as a whole and specific tribal communities and compared them with those from the other major racial/ethnic groups. Methods We used data from the 1990–2022 National Vital Statistics System, 2015–2022 American Community Survey, and the 2018–2020 Behavioral Risk Factor Surveillance System to examine socioeconomic, health, disability, disease, and mortality patterns for AIANs. Results In 2021, life expectancy at birth was 70.6 years for AIANs, lower than that for Asian/Pacific Islanders (APIs) (84.1), Hispanics (78.8), and non-Hispanic Whites (76.3). All racial/ethnic groups experienced a decline in life expectancy between the pre-pandemic year of 2019 and the peak pandemic year of 2021. However, the impact of COVID-19 was the greatest for AIANs and Blacks whose life expectancy decreased by 6.3 and 5.8 years, respectively. The infant mortality rate for AIANs was 8.5 per 1,000 live births, 78% higher than the rate for non-Hispanic Whites. One in five AIANs assessed their physical and mental health as poor, at twice the rate of non-Hispanic Whites or the general population. COVID-19 was the leading cause of death among AIANs in 2021. Risks of mortality from alcohol-related problems, drug overdose, unintentional injuries, and homicide were higher among AIANs than the general population. AIANs had the highest overall disability, mental and ambulatory disability, health uninsurance, unemployment, and poverty rates, with differences in these indicators varying markedly across the AIAN tribes. Conclusion and Global Health Implications AIANs remain a disadvantaged racial/ethnic group in the US in many health and socioeconomic indicators, with poverty rates in many Native American tribal groups and reservations exceeding 40%.

Exploring home fall events among infants and toddlers using social media information: an infodemiology study in China

BackgroundPractical interventions of fall prevention are challenging for infants and toddlers. This study aimed to explore specific details of falls that occurred at home for kids 0–3 years old using...

ФІНАНСОВИЙ КОНТРОЛІНГ ПРОЦЕСУ ЗЛИТТЯ ТА ПОГЛИНАННЯ КОМПАНІЙ В УМОВАХ ГЕОПОЛІТИЧНИХ РИЗИКІВ

Introduction. Geopolitical risks and crises have become a significant factor affecting financial and investment decisions. Military actions, pandemics, climate change, supply chain disruptions, and social upheavals have become drivers of uncertainty, leading to unpredictable volatility in global markets. This necessitates a reevaluation of traditional tools for supporting financial and investment decisions, including decisions regarding mergers and acquisitions (M&amp;A transactions). Problem Statement. The problem lies in the insufficient adaptation of traditional decision-support tools for M&amp;A to the new geopolitical reality, characterized by permanent crises, supply chain disruptions, and increased levels of uncertainty. Purpose. To determine the nature of the impact of geopolitical risks and behavioral factors on investment decision-making and to substantiate the concept of financial controlling in M&amp;A. Methods. A mixed-method approach (Mixed Methods Research) was employed, whereby hypotheses were formulated based on inductive observations and then deductively tested. Within this framework, both qualitative and quantitative research methods were applied, including content analysis, abstract-logical and synthesis methods, regression-correlation analysis, and the online survey method (CAWI – Computer Assisted Web Interviewing). Results. The nature of the impact of geopolitical risks on the dynamics of the merger and acquisition market has been clarified. Based on empirical analysis, the influence of the subjective, behavioral component on investment decision-making as a whole and decisions regarding mergers and acquisitions in particular has been confirmed. For the first time, the concept of financial controlling in M&amp;A has been substantiated, aimed at providing informational, methodological, and analytical support for relevant decisions. The essence of the ecosystem approach to the process of mergers and acquisitions has been revealed. Conclusions. It has been proven that geopolitical risks are insufficiently taken into account in the process of making investment decisions regarding M&amp;A, which often leads to unsuccessful deals. This is a consequence of the shortcomings of existing company valuation and rating methodologies, as well as the influence of the subjective, behavioral component on investment decision-making. To address the complex issues associated with M&amp;A, it is advisable to implement a comprehensive concept of financial controlling and an ecosystem approach to the merger and acquisition process.

Protective and Risk Factors for Suicidal Behaviour in Self-Declared LGBTIQ+ Adolescents

Background: Adolescents who identify as sexual minorities often face social stigmatisation, which can lead to increased adversity and a higher risk of suicidal behaviours. However, there are also protective factors that may promote resilience to these risk behaviours. This study aims to identify factors that predict resilience in sexual minority adolescents with high suicidal vulnerability. Methods: The study sample comprised 78 self-reported LGBTIQ+ adolescents aged between 13 and 18 years old (M = 16.11, SD = 1.56) who had previously attempted suicide. They completed several psychosocial instruments to measure risk and protective variables related to suicidal vulnerability. Results: Entrapment was found to be the most predictive risk variable for suicide attempts. However, protective variables promoting resilience were also found, such as adequate parental communication, life satisfaction, and cognitive reframing. Discussion: The findings related to prevention of suicide attempts are discussed and we highlight the urgent need to enhance certain internal and contextual protective factors to promote resilience in the face of suicidal vulnerability in certain clinical subpopulations exposed to highly adverse situations.

Factors Associated with Cytomegalovirus (CMV) Procto-Colitis in Immunocompetent Adults: A Systematic Review

Objective: The pathophysiology of CMV procto-colitis in immunocompetent adults is poorly understood. We aimed to systematically review the literature to explore factors, presenting symptoms and endoscopy findings associated with CMV procto-colitis in immunocompetent adults. Methods: Following PRISMA guidelines, we conducted a narrative systematic review by searching MEDLINE, EMBASE, EMCARE and CINAHL for manuscripts published up to August 2023. One author screened manuscript abstracts; two authors independently conducted a full text review. We included manuscripts which included primary data of immunocompetent adults with CMV procto-colitis except case reports. Quality and risk of bias was assessed independently by two authors using the Joanna Briggs institute critical appraisal tools. Results: 8 manuscripts were included in the final review from the USA (n=2), China (n=2), Korea (n=2), India (n=1) and Brazil (n=1) and consisted of 6 case series, one case-control study and one cross-sectional study published between 1988-2022. We identified demographic and behavioural factors (older age, lower BMI, receptive anal sex), infection factors (urinary tract infections, shigellosis, Hepatitis C, COVID-19, sepsis, antimicrobial use), medical conditions (cardiovascular disease, respiratory disease, renal disease, auto-immune disease, diabetes) and hospitalisation factors (intensive care admission, longer length of hospital stay) associated with CMV procto-colitis in immunocompetent adults. Patients presented with rectal bleeding, diarrhoea, melaena, fever, nausea/vomiting, abdominal pain/bloating and constipation. Large bowel endoscopy findings were ulcers, erosions, and erythema and polyp/mass lesions. Conclusion: We have highlighted factors, presenting symptoms and endoscopy findings associated with CMV procto-colitis in immunocompetent patients which provides insight for clinical guideline development and future research.

Evaluating the Factors Associated With Increased Risk of Self-Reported Ischemic Heart Disease in Patients With Arthritis

Introduction. Arthritis has increased systematic repercussions either by extra-articular manifestations or due to limited activities. Methods. In this study, we used the 2020 and 2021 Behavioral Risk Factor Surveillance System (BRFSS), a large, nationally representative, cross-sectional telephone survey. The data was divided into the participants having arthritis and no arthritis. Results represented as an odds ratio (OR) with a 95% confidence interval (CI). We used a multivariate-adjusted logistic regression model to analyze the results. Fisher’s t-test was used to compare between 2 groups. P-value &lt; 0.05 was considered significant. Results. BRFSS survey results led to 835,452 participants included in the final analysis. Of the included participant, 267020 has arthritis, and 568432 do not. In the arthritis group, 38.7% were males, and 61.3% were females. We found that patients with arthritis have a higher prevalence of diabetes and stroke. Adjusted logistic regression analysis showed that patients with arthritis have higher odds of reporting ischemic heart disease (IHD) (OR = 1.05, 95% CI 1.05-1.05, p-value &lt; 0.001). Also, poor health status (mental, general, and physical) patients are more likely to report IHD. Conclusion. Patients with arthritis are more likely to report IHD, which further increases in patients with poor health status.

Behavioral dedication, constraint or obligation? A tripartite model of active participation in multiplayer online battle arena game community

PurposeActive participation is critical to the survival and development of the multiplayer online battle arena (MOBA) game community. However, this issue has not received much attention in the information systems literature. To address this issue, we develop a tripartite model that accounts for the roles of behavioral dedication, constraint, obligation mechanisms on active participation in the MOBA community.Design/methodology/approachThe research model is empirically validated by online survey data among 971 users of a popular MOBA community.FindingsThe results show that perceived enjoyment, perceived escapism, and affective commitment are key behavioral dedication factors, which further promote active participation in the MOBA community. In addition, past investment, self-efficacy for change, and calculative commitment are important behavioral constraint factors, which ultimately influence active participation in the MOBA community. Finally, subjective norm, group norm, social identity, and normative commitment are influential behavioral obligation factors, which in turn facilitate active participation in the MOBA community.Originality/valueThis study contributes to the theoretical understanding of active participation in the MOBA community and offers practical guidance for promoting active participation in the community.

Mature beyond their years: young children who escape detection of parasitemia despite living in settings of intense malaria transmission.

Despite having the highest risk of progressing to severe disease due to lack of acquired immunity, the youngest children living in areas of highly intense malaria transmission have long been observed to be infected at lower rates than older children. Whether this observation is due to reduced exposure to infectious mosquito bites from behavioral and biological factors, maternally transferred immunity, genetic factors, or enhanced innate immunity in the young child has intrigued malaria researchers for over half a century. Recent evidence suggests that maternally transferred immunity may be limited to early infancy and that the young child's own immune system may contribute to control of malarial symptoms early in life and prior to the development of more effective adaptive immunity. Prospective studies of active and passive detection of Plasmodium falciparum blood-stage infections have identified young children (<5 years old) who remain uninfected through a defined surveillance period despite living in settings of highly intense malaria transmission. Yet, little is known about the potential immunological basis for this 'aparasitemic' phenotype. In this review, we summarize the observational evidence for this phenotype in field studies and examine potential reasons why these children escape detection of parasitemia, covering factors that are either extrinsic or intrinsic to their developing immune system. We discuss the challenges of distinguishing malaria protection from lack of malaria exposure in field studies. We also identify gaps in our knowledge regarding cellular immunity in the youngest age group and propose directions that researchers may take to address these gaps.

Discontinuation of HIV oral pre-exposure prophylaxis: findings from programmatic surveillance within two general population HIV programs in Nigeria

BackgroundAs oral PrEP scales up in Nigeria, information about uptake, use pattern and client preference in a real-world, implementation setting is invaluable to guide refining service provision and incorporation of oral PrEP and other prevention measures into routine health services. To add to this body of knowledge, our study examines factors associated with discontinuation of PrEP among HIV negative individuals across two large scale programs in Nigeria.MethodsUsing program implementation data from two large-scale HIV projects in Akwa Ibom and Cross River states in Nigeria between January 2020 and July 2021, we used logistic regression to explore factors associated with early discontinuation (i.e., stopping PrEP within one month of starting) among HIV-negative individuals who initiated PrEP in the programs.ResultsOf a total of 26,325 clients; 22,034 (84%) discontinued PrEP within the first month. The odds of PrEP discontinuation were higher among clients who enrolled in community-based distribution sites (aOR 2.72; 95% C.I: 2.50–2.96) compared to those who enrolled in program-supported facilities and never married (aOR 1.76; 95% C.I: 1.61–1.92) compared to married clients. Clients who initiated PrEP because of high-risk sexual behaviour (aOR 1.15, 95% C.I 1.03–1.30) or inconsistent use or non-use of condoms (aOR 1.96, 95% C.I 1.60–2.41) had greater odds of discontinuing PrEPthan those who initiated PrEP because they were in a serodifferent relationship.ConclusionThe behavioural and demographic factors associated with early discontinuation of PrEP suggest that risk stratification of pre-initiation and follow up counselling may be helpful in raising continuation rates. On the service delivery side, strategies to strengthen follow-up services provided by community-based distribution sites need to be introduced. Overall, the low continuation rate calls for a review of programmatic approaches in provision of PrEP services in Nigeria.

Longitudinal comparisons in health, participation, life satisfaction, and depressive symptoms from pre-to post Covid 19 pandemic among people with spinal cord injuries.

To identify changes in health, healthcare utilization, participation, and life satisfaction and depressive symptoms from pre-pandemic to post-pandemic among ambulatory and nonambulatory participants with spinal cord injury (SCI). Longitudinal study with the first measurement taken within three months prior to pandemic restrictions and two follow-ups at approximately one year intervals. Medical University in the Southeastern USA. 219 adult participants with SCI, including ambulatory (n= 155) and nonambulatory (n= 64). Self-report assessment of health outcomes from the Behavioral Risk Factor Surveillance System; health service utilization including physician visits, emergency department visits and hospitalizations; items from the Craig Handicap Assessment Reporting Technique; three life satisfaction scales from the Life Situation Questionnaire, and the brief version of the Patient Health Questionnaire. Not applicable. After using a Z score correction for nonnormality, none of the time effects or interaction effects of time by ambulatory status were significant. Six comparisons between ambulatory and nonambulatory were statistically significant. Ambulatory participants reported significantly 3 more days in poor physical health (p = .02) and 2 more days feeling worried, tense, or anxious in the last 30 days (p = .03). They visited emergency department on 0.3 fewer occasions (p = .02), while reporting leaving the house 1 more day every week (p = .02), 2 hours more sitting tolerance (p<.01), and 1 higher score of vocational satisfaction (p = .03). The absence of statistically significant changes from pre- to post-pandemic and the absence of time by ambulatory status interactions suggest stability of outcomes, even in the presence of pandemic challenges.

Changing risk factors for developing SARS-CoV-2 infection from Delta to Omicron.

One of the few studies to estimate infection risk with SARS-CoV-2 in the general population was the UK Office of National Statistics Infection Survey. This survey provided data that allowed us to describe and interpret apparent risk factors for testing positive for SARS-CoV-2 in a period when variants and COVID-19 controls experienced large changes. The ONS published estimates of likelihood of individuals testing positive in two week monitoring periods between 21st November 2021 and 7th May 2022, relating this positivity to social and behavioural factors. We applied meta-regression to these estimates of likelihood of testing positive to determine whether the monitored potential risk factors remained constant during the pandemic. Some risk factors had consistent relationship with risk of infection (always protective or always linked to higher risk, throughout monitoring period). Other risk factors had variable relationship with risk of infection, with changes seeming to especially correlate with the emergence of Omicron BA.2 dominance. These variable factors were mask-wearing habits, history of foreign travel, household size, working status (retired or not) and contact with children or persons age over 70. Relevance of some risk factors to likelihood of testing positive for SARS-CoV-2 may relate to reinfection risk, variant infectiousness and status of social distancing regulations.

Path modeling of socioeconomic, behavioral, and environmental attributes of the Ebola epidemic in West Africa

The 2014 Ebola outbreak stands as one of the most severe outbreaks of the virus, resulting in approximately 15,227 confirmed cases and 11,310 deaths. Despite substantial research conducted on the biological and epidemiological features of the virus, limited attention has been given to how an individual&amp;rsquo;s health behavior contributes to its spread. This study aimed to identify socioeconomic, behavioral, and environmental factors associated with Ebola infection. Guided by the Socioecological Model of Health, a correlational analysis was conducted using data from three English-speaking West African countries with the highest Ebola caseloads and fatalities: Liberia, Nigeria, and Sierra Leone. Each country&amp;rsquo;s Ministry of Health compiled daily reports on Ebola infections, including confirmed cases and deaths within each district. Possible health behavior determinants were gathered from surveys conducted by each country with the assistance of credible international agencies. Path analysis was then conducted to identify the size and direction of direct and indirect effects associated with an Ebola infection. The results revealed that female unemployment men with some secondary education, availability of hand washing soap, female literacy, and total health expenditure significantly predict initial confirmed cases with an R2 of 0.41. Along with the predictors of initial confirmed cases, the main source of drinking water accounted for 59% (R2) of the variance in the latest confirmed deaths. Officials in high-prevalence countries are suggested to address the availability of soap for hand washing, male secondary education proportion, female literacy and unemployment, health expenditure, and main sources of drinking water to reduce the transmission of the Ebola virus.

Maternal Sleep Quality and Executive Function are Associated with Perceptions of Infant Sleep.

This study examined the associations among maternal sleep quality, executive function, and perceptions of infant sleep in a sample of families recruited from human service and public health systems. Seventy-three mothers of infants 5-14 months old were included in the study. Mothers racially and ethnically identified as American Indian/Alaskan Native (4.1%), Asian (4.1%), Black/African American (12.3%), Latina (23.3%), more than one race (12.3%), Pacific Islander (1.4%), and White (42.5%). Mothers completed questionnaires assessing their own sleep (Pittsburgh Sleep Quality Index) and executive function (Behavior Rating Inventory of Executive Function) as well as their perceptions about their infant's sleep (Brief Infant Sleep Questionnaire). Results of the path analysis indicated significant direct effects among maternal sleep quality, executive function, and perceptions of infant sleep. Significant indirect effects were found such that poor maternal sleep quality was linked to poorer perceptions of infant sleep through maternal executive dysfunction, adjusting for infant sleep patterns, infant age, and maternal race and ethnicity. The current study highlights the potential role of maternal behavioral and cognitive factors in shaping mothers' perceptions about infant sleep. These findings support the need for health professionals and researchers to consider maternal sleep quality and executive function when addressing mothers' concerns about infant sleep.