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Background Self-care behavior has been reported to be below optimum in persons with heart failure, while the underlying decision making is not well understood. The Hot/Cool System model is a psychological model that may have potential applications in decision making process in persons with heart failure. The aim of this study was to examine the decision making process in self-care behavior in persons with heart failure in the light of the Hot/Cool System model. Methods We used the Hoot/Cool System Model to guide this study. Participants with heart failure from in-patients setting ( N = 107) were recruited. Data were collected using self-report questionnaires. Moderated mediation analysis was used to study complex relationships among study variables. Results The current study showed that impulsivity and perceived stress were negatively associated with self-care behavior. The results also showed that self-care confidence and impulsivity significantly predict self-care maintenance. The moderated mediation analysis revealed that self-care confidence mediated the relationship between impulsivity and self-care maintenance at lower levels of perceived stress, but not at higher levels of perceived stress. Conclusion Our findings revealed that persons with heart failure tend to make impulsive choices that may negatively affect disease progression under higher levels of perceived stress. This study provides foundational knowledge regarding the decision making process in persons with heart failure.

BackgroundAlmost 2.5 million children died in the first year of life in the year 2017. These account for almost half of the total deaths of children under the age of five years. Overall, child mortality has declined over the past two decades. Comparatively, the pace of decline in neonatal mortality has remained much slow. Significant inequalities in health across a number of dimensions – including wealth, ethnicity, and geography – continue to exist both between and within countries, and these contribute to neonatal mortality. This study aims to quantify the magnitude of inequalities in neonatal mortality trends by wealth quintile and place of residence with province wise segregation. MethodsThe study was done using raw data from the last three Pakistan Demographic & Health Surveys (20017-18, 2012-13 and 2006-7). The concentration curves were drawn in Microsoft Excel 365 using scatter plot as graph type while the frequencies were calculated using SPSS 24. ResultsThe situation of inequity across provinces and in rural vs urban areas has slightly declined, however, gross inequities continue to exist.ConclusionsPresentation of outcomes data, such as neonatal mortality in various wealth quintiles is an effective way to highlight the inequities amongst income groups as it highlights the vulnerable and at-risk groups. In other countries, rural-urban distribution, or ethnic groups may also reflect similar differences and help in identifying high-risk groups.

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