Substance use disorder (SUD) is a polygenic psychiatric condition characterized by persistent drug use despite negative consequences. Several studies support that higher cognitive performance and educational attainment (EA) are associated with a reduced risk for SUD. Here, we aimed to understand better the genetic relationship between EA and SUD, using a general addiction risk-factor (addiction) as a proxy of SUD. We used GWAS summary statistics on EA (n = 766 345) and addiction (n = 647 703) and applied a multistep approach to: (i) examinate the genetic overlap between EA and addiction; (ii) test the polygenic contribution of addiction and EA on SUD diagnosis and its clinical heterogeneity in an independent in-house clinical sample (1427 individuals with SUD and 2309 controls); and (iii) dissect the genetic liability of addiction according to its role in EA and assessing its genetic overlap with SUD-related traits, other mental disorders and behavioral traits. We confirmed a negative genetic correlation between addiction and EA [rg = -0.33, standard error (SE) =0.02, P = 1.14e-57]. When we dissected the genetic liability of addiction by its relationship with EA we found that the discordant overlapping variation between addiction and EA, highly enriched for the genetic background of addiction (h2 SNP=2.42%, P = 6.37e-21), showed the strongest effect on SUD (OR =1.66, 95% confidence interval =1.54-1.79, P = 2.01e-40) and was associated with worse sociodemographic, health and SUD-related outcomes in individuals with SUD compared with the other genomic partitions studied. Our results provide new evidence on the shared genetic basis between addiction and educational attainment. By separating the genetic liability of addiction according to its relationship with educational attainment, we were able to clarify its polygenic effects on substance use disorder diagnosis and related outcomes, providing novel insights into the shared genetic signatures between addiction and other comorbid traits.

Transitioning into and out of economic hardship and their effects on depressive symptoms: Moderating roles of housing tenure and educational attainment.

Research on technology-facilitated child sex offenders outside of forensic and clinical samples is scarce but necessary to inform prevention, early intervention, and investigation. This article describes and compares the demographic characteristics and internet use habits of technology-facilitated child sex offenders sourced from three quota-based samples comparable to the Australian (n = 1,945), U.S. (n = 1,473), and U.K. (n = 1,506) adult male population. The odds (99% CI) of technology-facilitated child sex offending, relative to non-offenders, were calculated for demographic factors (e.g. age, sexual orientation, and number of children in household), hours per day spent online, frequency of engagement in common online behaviours (e.g. sending emails, online messaging, and private video chatting), use of social media platforms (e.g. Facebook, Twitter, and Snapchat), online pornography viewership, and use of privacy software (e.g. The Onion Router [TOR], Telegram, and Element). Logistic regression analysis adjusted for age, educational attainment, household income, and residential location were conducted separately for each sample, with effect sizes formally compared between countries. The study identified significantly higher rates of technology-facilitated offending against children in the United States (10.9%) compared to Australia (7.5%) and United Kingdom (7.0%). Online offenders were between 2 and 3.7 times more likely to work with children and, depending on the jurisdiction, were significantly more likely to be employed, married/living with a partner, have a bachelor's degree or higher, and live with a child. Across all jurisdictions, technology-facilitated offenders were significantly more sexually active online, including paying for sexual services and content, visiting romance and dating websites, and viewing violent or animal pornography. The article considers the implications of these findings for prevention, early intervention, and more effective detection of technology-facilitated offending, including the role of internet regulation and the financial sector in online child protection.

Pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD) are efficacious and safe; however, substantial interindividual variability in treatment response persists, with many patients experiencing suboptimal outcomes or early discontinuation. Although genetic factors have been proposed as contributors to this variability, clinically actionable predictors remain elusive. Here, we present the first meta-analysis evaluating whether polygenic liability for ADHD and related psychiatric and behavioral-cognitive phenotypes is associated with clinically meaningful response to methylphenidate in 1000 ADHD cases from Norway, Brazil, and Spain assessed in real-world settings. Polygenic scores (PGS) for ADHD, autism, bipolar disorder, educational attainment, major depressive disorder, neuroticism, and schizophrenia were calculated separately for each cohort. Treatment response was assessed using evaluations of global clinical improvement and harmonized by categorizing individuals as responders or non-responders. Cohort-specific associations were combined using fixed-effects meta-analysis. No PGS showed a significant association with treatment response. Effect sizes were small, consistent across cohorts, and characterized by minimal between-study heterogeneity. Sensitivity analyses incorporating clinical and treatment-related covariates yielded convergent results. As the first meta-analytic evaluation of polygenic predictors evaluating clinically meaningful ADHD stimulant response, these findings delineate the current limits of PGS in pharmacogenomic applications. Rather than supporting immediate clinical utility, our results highlight key methodological and conceptual constraints, including limited sample sizes, heterogeneous outcome definitions, and the indirect nature of susceptibility-based PGS for predicting treatment response. By mapping these boundaries, this study provides a framework to recalibrate research priorities and guide the next generation of ADHD pharmacogenomic studies toward larger, harmonized, and more informative definitions of treatment response.

Transitions in comorbidity patterns of depression and internet gaming disorder among adolescents: A random intercept latent transition analysis.

Quantifying the impact of modifiable risk factors on frailty: A population-attributable fraction analysis in older adults.

Age at natural menopause and cognitive aging in U.S. women: Educational attainment as a modifiable resilience factor.

Compulsory schooling laws introduced across Europe in the 20th century aimed to expand educational attainment and may have shaped key determinants of cognitive health. We exploit variations in compulsory schooling laws in England to assess whether increased education, mandated by these policies, impacts cognitive function, dementia risk, and related risk factors in older age. We focus on two major reforms: the 1947 reform, which raised the school-leaving age from 14 to 15, and the 1972 reform, which increased it to 16. Using data from the English Longitudinal Study of Ageing (ELSA) and a novel dementia risk algorithm based on the Harmonized Cognitive Assessment Protocol (HCAP), we find that while both reforms increased schooling, their effects on cognitive aging differ. We find suggestive evidence that the 1947 reform improved cognitive outcomes and reduced dementia and mild cognitive impairment risk specifically for women and individuals from low parental education backgrounds. In contrast, we find no statistically detectable reductions in dementia risk associated with exposure to the 1972 reform. Our findings suggest that the impact of compulsory schooling laws on cognitive aging and dementia is context dependent. Findings highlight the importance of institutional context and heterogeneity when assessing the long-run effects of education policies.

To assess how key risk factors contribute to differences in low patient activation between dual-eligible and Medicare-only beneficiaries and to examine whether these contributions vary by disability status or age-informing more equitable engagement strategies. This observational study used nationally representative data from the 2019-2022 Medicare Current Beneficiary Survey. Survey-weighted descriptive statistics assessed variation in risk factors between dual-eligible and Medicare-only beneficiaries. Survey-weighted logistic regression models with state, year, state, and regional fixed effects estimated associations between individual risk factors and low patient activation, defined as limited knowledge, skills, and confidence to manage one's health. Marginal effects were reported. The Fairlie decomposition method quantified the extent to which specific factors (e.g., spoken English proficiency, education, vision impairment) explained differences in low patient activation. Subgroup analyses examined whether these explanatory factors differed by age and disability status. The analytic sample included 23,805 community-dwelling, continuously enrolled Medicare beneficiaries, representing 39,591 unweighted beneficiary-years. Among 189,843,094 weighted beneficiary-years, 14.4% were dual-eligible and 85.6% were Medicare-only. Low patient activation was more prevalent among dual-eligible (42.5%) than Medicare-only beneficiaries (32.1%). Among older beneficiaries, differences in activation were explained by limited English proficiency, poor perceived health, psychological distress, vision impairment, and difficulties with activities of daily living (ADL). Among disabled beneficiaries, differences were primarily driven by the presence of an intellectual disability and instrumental ADL (iADL) difficulties. Low educational attainment contributed to differences across both subgroups. Different factors contribute to low patient activation among dual-eligible versus Medicare-only beneficiaries, with notable variation between older and disabled subgroups. These findings support the need for tailored engagement strategies and policy efforts focused on improving activation among high-need Medicare populations. Targeted interventions may help reduce activation gaps, promote equity, and improve health outcomes.

Korean dioxin risk patterns: Modulation by dietary-socio-demographic and behavioral factors.

In the United States (US), Tobacco 21 (T21) laws set the minimum legal sale age for all tobacco products to 21 years. This study aimed to examine whether e-cigarette-inclusive T21 laws were associated with e-cigarette use behaviors and related disparities among US adolescents. We used nationally representative, repeated cross-sectional Monitoring the Future data to compare self-reported current e-cigarette use (2014-2022) and first e-cigarette initiation (2015-2022) among adolescents in counties with 100% ('full') versus <100% ('partial or no') e-cigarette-inclusive T21 law population coverage using modified Poisson regression, examining differences by sex, race and ethnicity, parental educational attainment and college educational expectations through interactions. United States. 8th, 10th and 12th graders. County-level e-cigarette-inclusive T21 law population coverage was determined using Tobacco 21 Population Coverage Database and US Census Bureau population data. Current e-cigarette use was defined as any past 30-day use among the entire sample. First e-cigarette initiation was defined as first use in the current grade among adolescents who had not initiated use prior to the current grade. Compared with 8th, 10th and 12th graders in counties with partial or no e-cigarette-inclusive T21 law coverage, 8th [marginal effect (ME) = -1.8%, 95% confidence interval (CI) = -3.1% to -0.6%], 10th (ME = -2.6%, 95% CI = -4.6% to -0.6%) and 12th graders (ME = -2.7%, 95% CI = -5.2% to -0.1%) in counties with full coverage had a lower current e-cigarette use prevalence. For current e-cigarette use, we also observed statistically significant interactions by sociodemographic factors. Across all grades, full [8th: predicted prevalence (PP) =5.9%, 95% CI =4.7%-7.1%; 10th: PP = 11.8%, 95% CI =10.2%-13.4%; 12th: 18.1%, 95% CI = 15.6%-20.6%] versus partial or no coverage (8th: PP =7.5%, 95% CI =6.2%-8.8%; 10th: PP = 16.3%, 95% CI = 15.0%-17.6%; 12th: 23.4%, 95% CI = 21.9%-24.8%) was associated with lower current e-cigarette use among males but not females. By race and ethnicity, associations were statistically significant across all grades, but the magnitude and direction of these associations varied by subgroup and grade. Among 12th graders, full (PP = 16.1%, 95% CI = 13.9%-18.3%) versus partial or no coverage (PP = 20.5%, 95% CI = 19.0%-22.1%) was associated with lower current e-cigarette use among those who said they 'probably will' graduate from a four-year college but not among those with other educational expectations. We did not find sufficient evidence to support an association between e-cigarette-inclusive T21 law coverage and first e-cigarette initiation overall or across sociodemographic subgroups. E-cigarette-inclusive Tobacco 21 laws appear to be associated with lower current e-cigarette use among US adolescents. However, we lacked sufficient evidence to support an association with first e-cigarette use initiation. We also observed sociodemographic differences in these associations for current e-cigarette use.

Multimorbidity and memory-related disorders in older adults: A cross-national study based on three large longitudinal cohorts.

To determine if the level of educational attainment mediates the relationship between a history of cancer experienced as an adolescent and young adult (AYA) and subsequent employment status. We identified AYAs with a history of cancer diagnosis between the ages of 15 and 22 using the Canadian Community Health Survey (years 2000 to 2017) linked to the Canadian Cancer Registry. Marginal structural mediation models were used to decompose the total effect of cancer on employment into the natural direct effect and the natural indirect effect through education completed. Employment status was categorized as full-time (reference category), part-time, or not employed and analyzed using a multinomial logistic marginal structural model. We identified 202,960 individuals, of whom 270 were diagnosed with cancer as an AYA. The average elapsed time from diagnosis to survey completion was 8.7 (SD, 5.1) years. Compared to cancer-free peers, survivors had 1.62 (95% CI, 1.22, 2.10) times the odds of non-employment compared to full-time employment. Educational attainment mediated 14.0% (95% CI, -2.1%, 30.8%) of this total effect. No evidence of a significant effect of cancer on part-time employment was observed. Being diagnosed with cancer between the ages of 15 and 22 contributes to subsequent non-employment. Findings highlight the employment challenges faced by AYA survivors of cancer. Cancer's adverse effect on AYA survivors is directly on employment status rather than through the level of education attained, highlighting opportunities for interventions that promote work ability among survivors.

Flourishing in Early Adulthood Among Victimized Children: A Longitudinal Cohort Study.

ABSTRACT This study investigates the gender-specific short-term impacts of the COVID-19 lockdown policy on labor market outcomes enforced in the Philippines in April 2020. More specifically, we employ the triple difference estimator, focusing on the ex-ante and ex-post differences between men and women working in areas subjected to Enhanced Community Quarantine (ECQ) and those who do not. The findings indicate that the lockdown policy had a more detrimental impact on male workers than on females, partly attributed to the higher number of men engaged in sectors forced to suspend operations due to the lockdown measures. Additionally, the study identified significant variations across demographic groups regarding age, educational attainment, and the number of children. The insights gathered can help policymakers create targeted interventions to lessen the gender-specific impacts of economic downturns.

Type 1 diabetes, particularly with childhood onset, is associated with altered neurocognitive traits, yet the underlying biological mechanisms are unclear. Here, we integrate genome-wide association results with single-cell epigenomic profiles and show that type 1 diabetes heritability is enriched in accessible chromatin of human brain-resident cells, most notably microglia, across neurodevelopment into adulthood. Bonferroni-corrected cross-trait genetic correlation analyses reveal negative correlations of type 1 diabetes with intelligence, executive function, and bipolar disorder, and a positive correlation with myasthenia gravis. Conjunctional false discovery rate analysis identifies pleiotropic loci jointly influencing type 1 diabetes and neurocognitive traits, including the 17q21.31 neurogenomic hub. Mendelian randomization further demonstrates protective effects of educational attainment, intelligence, Alzheimer's disease, and bipolar disorder on type 1 diabetes risk, whereas liability to multiple sclerosis and myasthenia gravis increases type 1 diabetes risk. In the reverse direction, liability to type 1 diabetes is associated with increased risk of myasthenia gravis. We identify several gene expression regulatory variants in brain and immune cells that jointly influence type 1 diabetes and neurocognitive traits, some of which show concordant differential expression in disease-affected versus control tissue. Together, these findings highlight pleiotropic genetic and neuroimmune mechanisms that link type 1 diabetes with cognition and neuropsychiatric disease risk.

Influencing factors and enhancement paths of college students' learning motivation: Evidence from Nanjing.

Adolescent mental health is a growing concern in the United States. Promoting health equity through addressing social determinants of health (SDOH) is a national priority and aligns with the Social Work Grand Challenge to "close the health gap." School-based mental health services (SBMHS) provide interdisciplinary support to enhance students' emotional, behavioral, and social functioning. This study analyzed data from 12th-grade participants in the 2022 and 2023 Monitoring the Future surveys-an annual, nationally representative, cross-sectional study-to (a) identify SDOH associated with depressive symptoms and happiness among high school seniors and (b) assess the influence of SBMHS on these outcomes. Two hierarchical regression analyses (n = 2,574 for depressive symptoms; n = 2,844 for happiness) revealed that attending schools in medium-sized cities (versus small cities) and having more friends using substances were social determinants associated with both higher depressive symptoms and lower happiness. Higher parental educational attainment and living with both parents were protective social determinants specific to depressive symptoms. SBMHS were significantly associated with reduced depressive symptoms and enhanced happiness. These findings highlight the importance of addressing social determinants of adolescent mental health and advocate for expanding SBMHS.

The increasing use of smartphones among older adults offers new opportunities for social connection but may also pose risks associated with adverse mental health outcomes, including depression. This study examined the relationship between smartphone use and depression among older adults in Guangzhou, China, to identify key predictors and complex configurations associated with depression. Using a hybrid analytic approach applied to survey data from 2585 older adults in Guangzhou, machine learning methods first identified the strongest predictors of depression. Subsequent fuzzy-set qualitative comparative analysis delineated distinct configurations associated with depression. The analysis identified high levels of smartphone addiction and a low preference for interactive use as central configurations associated with depression. These patterns appeared to operate through 2 distinct mechanisms: structural exclusion related to resource limitations and agentic maladaptation associated with relational deficiencies. This underlying vulnerability, in combination with specific sociodemographic factors, delineated distinct depression-related typologies. High-risk profiles included unmarried men with limited educational attainment and socially withdrawn individuals with greater socioeconomic resources. Problematic smartphone use, particularly when it displaces social interaction, is significantly associated with depression among older adults. Interventions should therefore promote healthier interactive digital behaviors and provide targeted support for high-risk groups.

This study investigated the dynamics and drivers of multidimensional poverty among tomato producers in Northwest Nigeria. A multi-stage sampling technique was utilized, approximately, 200 tomato farmers from Kano and Kaduna states were selected. The Multidimensional Poverty Index (MPI), Probit regression model and t-test analysis were employed with the MPI which measures severe deprivations by mirroring the Human Development Index in the dimensions of health, education, and living standard which are reflected in 10 indicators, each with equal weight within its dimension. The results revealed that 72% of the respondents are multidimensional poor, with an average poverty intensity of 62.37% and an MPI value of 0.4490—exceeding Nigeria’s national average. The standard of living contributed most significantly (39.5%) to poverty, followed by health (35.9%) and education (24.6%). The Probit regression analysis showed that educational attainment and income were the most significant factors negatively associated with multidimensional poverty, while variables such as age, access to credit, farming experience, and cooperative membership had no statistically significant effect. A cost-return analysis using a t-test confirmed the profitability of tomato farming, with average returns significantly exceeding costs (₦903,960 vs. ₦368,250.34). However, the persistence of poverty among growers, despite profitability, suggests that income alone cannot eliminate multidimensional deprivations without improvements in infrastructure, healthcare, and education. The study recommends holistic poverty alleviation strategies that integrate agricultural support with social infrastructure development to enhance the overall well-being of farming households.