Introduction: Postpartum Depression and postpartum depressive symptoms have been found to have a strong association with breastfeeding duration in a significant portion of women across a variety of geographical locations. The aim of this study was to explore the correlation between postpartum depressive symptoms at 6 months postpartum and total duration of breastfeeding measured at 15 months postpartum in Appalachian women. Methods: A longitudinal study was conducted in which 1,063 mostly low socioeconomic status women were recruited across 6 prenatal practices in Appalachia. At 6 weeks, 6 months, and 15 months postpartum, depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). From the original sample, 134 completed a self-report measure of breastfeeding initiation and duration at 15 months postpartum. Results: EPDS score did not predict whether or not women breastfed, only their duration of breastfeeding. Women who scored in the clinically significant range (13 or higher) on the EPDS at 6 months postpartum breastfed a significantly shorter length of time (Mean = 1.75 months, SD = 2.70) than women who scored below 13 on the EPDS (Mean = 4.48 months, SD 5.22; t(133) = 3.61, p = .001). Conclusion: Clinically significant Edinburgh Postnatal Depression Scale scores were predictive of shorter duration of breastfeeding.

Abstract available through the Annals of Behavioral Medicine.

No description available.

Abstract available through the Annals of Behavioral Medicine.

Abstract available through the Annals of Behavioral Medicine.

Many instruments have been developed to determine whether someone claims to be religious, but they do not address the degree to which someone is satisfied with their religious commitment. Therefore, an instrument was revised to measure both a person’s level of religious commitment and satisfaction with that level of religious commitment. The instrument was named the Religious Surrender and Attendance Satisfaction Scale (RSASS). This study was conducted to determine initial validity for the satisfaction portion of the RSASS. Construct validity measures provided initial confirmation of the utility of RSASS as a measure of satisfaction with religious commitment that can be used by nurses in practice and research.

Intimate partner violence (IPV) during pregnancy can lead to myriad poor physical and psychological outcomes for both mother and child. There is a paucity of research examining IPV risk factors for rural pregnant women and the course of specific types of IPV throughout pregnancy. The current project investigated the prevalence of IPV and the risk factors for different types of IPV in an Appalachian sample that contained pregnant women from rural and non-rural locations (Study 1). Additionally, for women reporting IPV, the different types of IPV were examined throughout the course of their pregnancies (Study 2). Study 1 included 1063 pregnant womenparticipating in the Tennessee Intervention for Pregnant Smokers (TIPS) program. IPV prevalence was measured using a modified Hurt Insult Threaten Scream (HITS) screen administered at entry into prenatal care, and rural status was defined using Rural Urban Commuting Area Codes based on the participants’ ZIP codes. Self-report prevalence rates during pregnancy were 26% for psychological, 2% for physical, and 1% for sexual IPV. With the exception of one woman, all women that reported physical or sexual violence also reported experiencing psychological violence occurring at the same time (3.5%). Chi-squared analyses indicated that rural pregnant women were not significantly more likely to experience any of the types of IPV compared to non-rural pregnant women.Furthermore, logistic regression analysis supported previous literature findings that pregnant women who are younger, have an unplanned pregnancy, have high levels of stress, and have low levels of social support, are at a greater risk of experiencing anytype of IPV during pregnancy compared to those without these risk factors. To investigate IPV over the course of pregnancy, Study 2 participants included a TIPS participant subsample of 337 pregnant women who indicated they had experienced IPV at any timeduring their current pregnancy. The modified HITS screen was administered up to four times throughout the course of pregnancy, with responses coded based on gestational age at the time of assessment (first trimester, first half of second trimester, secondhalf of second trimester, and third trimester). Generalized estimating equation logistic models indicated that women who experienced IPV at some point during pregnancy were most likely to experience IPV during the third trimester. These results speak to the importance of screening for all types of IPV multiple times throughout the course of pregnancy. If multiple screens do not occur as the pregnancy progresses, some women may not be identified as having experienced IPV, and therefore miss opportunities toassuage the possible negative health outcomes due to IPV. Information obtained from the current research is valuable to prenatal health care providers who need to be aware of IPV risk factors, and that different types of IPV, especially psychological IPV,can occur at any time during pregnancy.

Criminal rehabilitation continues to be a significant social problem. Previous research suggests that the majority of offenders leave the penal system with little to no discharge planning (Placido, Simon, Gu, and Wong, 2005). Researchers have also found that rates of recidivism are often influenced by the degree of the offender’s motivation to succeedand their personal outlook on life (Allen, 2013). Thus, the combination of intrinsic and extrinsic factors can affect the offender’s chances of successful and persistent rehabilitation. This qualitative case study sought to examine and describe the experiences of formerly incarcerated adults (n=4, all male) and describe a rehabilitation program currently in place in the East Tennessee region. The Day Reporting Center (DRC) is a rehabilitation program where offenders are on house arrest and are required to attend scheduled program classes and counseling. The DRC is part of an $800,000 crime reduction grant funded by the Department of Justice. All respondents have had issues with substance abuse at some point which is a selection requirement of the program. All claim to be completely disassociated from past bad influences, and report having been in and out of jail. Participants indicated that the DRC has been extremely helpful for them and all four have support from their family, partner, or both. In addition,3 out of 4 participants have had parents who struggled or currently struggle with substance or drug abuse. 2 out of 4 participants experienced physical and emotional abuse growing up. Moreover, 3 out of 4 participants stated that being a convicted felon and getting a job outside of the program hours has been difficult. One participant has already received his GED and is currently working on a degree in Automotive Technology in addition to attending the DRC Program. Another participant aspires to attend trade school after graduating from the rehabilitation program. Although respondents reported challenges faced by those in the penal system, they are hopeful for their success in this program. For example, one participant brought up one of his most memorable moments from prison, where he watched his son take his first steps and watched him walk for the first time in prison through the glass. He was genuine and honest about this moment and said, “To be honest with you, I cried. It was so hard. You just want to give him a hug and praise him for his accomplishment, and you can’t, because of the glass.” This participant also recalled the first time he walked on grass after getting out of prison and discussed how this was “one of the greatest feelings in the world” for him. As a final point, remembering those types of moments in the darkest of times may in fact be enough reason for an offender to never want to resort back to that kind of lifestyle again. Keywords: incarcerated, real-world, forensic psychology, criminology, penal system, rehabilitation, rehabilitation programs, research, offenders

Research documenting the level of work-related stress among therapy dogs is limited. This research was designed to measure salivary cortisol in working therapy dogs. Certified handler/dog (Canis lupus familiaris) teams were recruited to participate from teams currently volunteering in the Tri-Cities, Tennessee area. Male and female dogs of various sizes and breeds were recruited. Ten dogs contributed fivesaliva samples. Dogs were fasted for one hour prior to procedure. Samples were collected over a continuum of events, for comparison of salivary cortisol levels in multiple environments. Samples were collected as follows: (1) sample in the dogs’ homes, (1)sample upon arrival at the “work” place, (1) sample just prior to leaving the “work” place, (1) sample just prior to being groomed and (1) sample taken at the dogs’ regular veterinarians’ offices. This design provided 1 control sample, 2 work samples, and2 samples that may be indicative of elevated stress. It was hypothesized that: 1) Salivary cortisol concentrations will be higher in samples collected during grooming and at a veterinary clinic than in samples collected at home, and 2) Salivary cortisol concentrations will be lower in samples collected during “working” conditions than in samples collected during grooming and at a veterinary clinic. Saliva was collected by placing a Salimetrics Children’s Swab (P/N 5001.06) [dimensions 8 x 125 mm] into the dog’s mouth until saturated, or less than four minutes. After examination of the descriptive statistics of (n=10) across five different environmental conditions, it was decided that one of the cases represented an outlier and was removed from data as subsequent analysis revealed a cortisol level that was more than 23 standard deviations away from the mean. Three dogs had at least one sample with insufficient quantity of saliva for analysis, and were removed from the data. A one-way repeated measures ANOVA was conducted to compare salivary cortisol levels during different environmental conditions (pre-therapy, post-therapy, home, veterinary clinic, and groomer). There was not a significant main effect for condition, Wilks’ Lambda =.299, F (9, 2) =1.17, p=.51,multivariate partial eta squared = .70. The hypotheses were not supported. This research suggests that salivary cortisol of working therapy dogs is not significantly different than home, veterinary, or grooming conditions.

Aspects of ADHD, such as inattention, may be predictive of unplanned pregnancy. An unplanned pregnancy can have negative effects on both maternal and child health. Women surprised by pregnancy may not be physically, emotionally, or financially capable of caring for a child and may postpone or neglect prenatal care.In 2006, approximately 49% of pregnancies were unplanned in the United States. Furthermore, in Tennessee, the percentage was even higher with 56% of pregnancies being unintended. Maternal Attention Deficit Hyperactive Disorder (ADHD) has been linked to decreased female contraceptive use and to increased risky sexual behavior. Failure to use contraception significantly increases the risk of unplanned pregnancy. This study examined inattention (a characteristic known to be elevated in individuals diagnosed with ADHD) and risk factors (i.e., marital status, education, depression) associated with unplanned pregnancy in Appalachian women. Information was collected from pregnant women recruited from Southern Appalachia as part of the Tennessee Intervention for Pregnant Smokers Program. As part of the larger study, women completed detailed research interviews upon entry into prenatal care. A total of 457 pregnant women had responses on the measures of interest in the current investigation. Logistic regression was performed to assess the ability of Inattention (determined by the Current Symptoms Scale) to predict the probability of a woman experiencing an unplanned pregnancy. The full logistic regression model containing all predictors was statistically significant Χ2 (7, N=457) = 92.35, p <.001 indicating that the predictors as a set reliably distinguished between those women who did, and did not, have an unplanned pregnancy. Inattention had an Adjusted Odds Ratio of 1.76, CI (1.09, 2.86) p =.02 indicating that controlling for the other variables in the model, those women who scored high on the Inattention measure were significantly more likely to experience an unplanned pregnancy. This model correctly classified 76.8% of participants. Additionally, consistent with previous research findings, women who were unmarried and had lower levels of education were also significantly more likely to have an unintended pregnancy. Furthermore, women who reported higher levels of depressive symptoms were significantly more likely toexperience an unplanned pregnancy. Ages and at-risk alcohol use (TACE) were also examined in this study but did not significantly contribute to the model. These results confirm that known risk factors were also found in this population. This study found that inattention predicted unplanned pregnancy. Because inattention is one aspect of ADHD, this could suggest that women diagnosed with ADHD would be more likely than others to experience an unplanned pregnancy. Identifying risk factors can assist health practitioners to target women who are at risk for unplanned pregnancy for purposeful discussion on contraceptive options.