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Factors determining choice of complementary and alternative medicine in acute and chronic diseases.

Background Systematic analysis of the determinants of choice of a treatment modality aids to the understanding of decision process of healthcare utilization. The revealed preference of a single modality may differ according to the nature of disease. Existing studies have not integrated possible causal factors in a model with respect to diseases. This study identifies major determinants and formulates their integral effect on choice of a particular modality on acute and chronic diseases in accordance to socio-behavioural model. Methodology A cross-sectional study on 300 samples using a 30-point questionnaire, developed in Likert scale and dichotomous scale. Possible determinants are tested on choice of CAM in case of acute disease and of chronic disease separately. Results Revealed single modality treatment preference (of CAM) varies widely between acute disease (13%) and chronic disease (58.67%). Bivariate associations are significant for gender (For, overall CAM preference, p=0.001, acute disease, p<0.001, chronic disease, p=0.024), Disease burden (overall and chronic: p<0.001, acute: p=0.008) and previous CAM usage (overall and chronic: p<0.001, acute: p=0.016). Social factor individually has significant influence on choosing CAM both acute (OR=1.096, p<0.001) and chronic disease (OR=1.036, p<0.001). Ideation of philosophical need factor, guided by philosophical congruence with CAM (OR=1.047, p<0.001) is a novel finding of this study. While with multiple logistic regression male gender (p=0.03), social factor (p<0.001), perception of CAM efficacy (p=0.02) and negative ideation about CAM cost-effectiveness (p=0.002) are found to be important in Acute disease; choosing CAM in chronic disease is guided by female gender (p=0.001), making decision in-group (p=0.001), low disease burden (p<0.001), philosophical need factor (p=0.001), and perception of CAM efficacy (p<0.001). Conclusion Demographic, social, cognitive and philosophical factors are important determinants of choosing CAM as a treatment modality over conventional medicine, but they act differently on CAM preference in acute and chronic diseases.

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A Bayesian Framework for Robust Quantitative Trait Locus Mapping and Outlier Detection.

We introduce a Bayesian framework for simultaneous feature selection and outlier detection in sparse high-dimensional regression models, with a focus on quantitative trait locus (QTL) mapping in experimental crosses. More specifically, we incorporate the robust mean shift outlier handling mechanism into the multiple QTL mapping regression model and apply LASSO regularization concurrently to the genetic effects and the mean-shift terms through the flexible extended Bayesian LASSO (EBL) prior structure, thereby combining QTL mapping and outlier detection into a single sparse model representation problem. The EBL priors on the mean-shift terms prevent outlying phenotypic values from distorting the genotype-phenotype association and allows their detection as cases with outstanding mean shift values following the LASSO shrinkage. Simulation results demonstrate the effectiveness of our new methodology at mapping QTLs in the presence of outlying phenotypic values and simultaneously identifying the potential outliers, while maintaining a comparable performance to the standard EBL on outlier-free data.

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Behavioral problems in preadolescence: Does gender matter?

Behavioral problems in children are increasingly acknowledged as a global issue in mental health. Preadolescence is the transitory phase of development that links childhood and adolescence, and the presence of behavioral problems in this phase could be detrimental to children's present and future. This study aimed to describe the epidemiology of "behavioral problems" in preadolescents aged 11 to 12 years and to examine their distribution by socioeconomic status and children's characteristics while developing an in-depth understanding of the role of gender as a risk factor for such problems. A school-based, cross-sectional study was conducted in Karachi, Pakistan. Participants were selected from a middle-class, coeducational school chain. Sociodemographic questionnaires and an officially adapted version of Youth Self Report Form, which is child- and adolescent-reported version of Child Behavior Checklist, were used to collect data from children. The prevalence of Overall Behavioral Problems was 28.6%. From Broadband Scales, the relative prevalence of internalizing problems was about 52% higher than that of externalizing problems. Among the Narrowband Scales, somatic complaints were the most prevalent (23.2%). Male children significantly had higher odds for being at risk of Overall Behavioral problems, internalizing problems, and co-occurring behavioral issues, as compared to female children. The study concludes that the prevalence of overall behavioral problems is at the higher end of the global range. Male children are more at risk for overall behavioral problems, and contrary to previous studies, they are significantly more at risk of internalizing problems. Our study is the first to report the risk of co-occurrence of multiple issues with respect to gender, and adds that male children are significantly at risk of multiple co-occurring behavioral problems. Our study highlights the need for an in-depth understanding of cultural, sociopolitical conditions for actionable and gender-sensitive interventions for preadolescents.

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