Hierarchical Logistic Regression Analysis Research Articles

The relationships of inflammatory blood markers with maternal periodontal and dental states and their effects on preterm membrane rupture development

BackgroundThe influence of maternal oral and dental health on the occurrence of Preterm Premature Rupture of Membranes (P-PROM) and its underlying mechanisms remain uncertain. This research seeks to investigate the impact of maternal oral and dental health on the incidence of P-PROM and its association with inflammatory markers in the blood.MethodsThis study adopts a prospective case-control design methodology. The study involved 70 women diagnosed with P-PROM and delivered by an obstetrician and 79 women who had healthy deliveries with no prenatal complications. The values for DMFT (Number of decayed, missing and filled teeth) index, Gingival Index (GI), Plaque index (PI), Pocket depth (PD), Clinical attachment loss (CAL) and medical history were recorded. Mann-Whitney U test and hierarchical binomial logistic regression analysis were applied. It was considered statistically significant at p < 0.05.ResultsThe case group’s DMFT, PI, GI, PD values were statistically significantly higher than the control group (p < 0.001). There was no relationship between DMFT, GI, PD, CAL and inflammatory blood markers (p > 0.05). In the regression analysis for possible risk factors that may be effective in P-PROM, oral and dental health parameters were the most effective.ConclusionsOral and dental health of women with P-PROM was found to be worse than that of the control group. Oral and dental health may be a potential risk factor that may contribute to adverse pregnancy outcomes associated with P-PROM.

Factors influencing menstrual regularity among female workers: a cross-sectional analysis study

BackgroundRegularity of menstrual cycles is an important indicator of women’s health and fertility, and female workers are exposed to several factors, such as sleep disorders, stress, and shift work, that affect their menstrual regularity. This makes it necessary to comprehensively identify the determinants of menstrual regularity. Therefore, this study identified the factors affecting menstrual regularity among female workers from physiological, psychological, and situational dimensions based on the theory of unpleasant symptoms.MethodsThis was a secondary analysis of the 2010–2012 Korea National Health and Nutrition Examination Survey and utilized the data of 2418 female workers. Based on the theory of unpleasant symptoms, physiological factors included age, age at menarche, childbirth experience, body mass index, and sleep duration. Psychological factors included stress level, depressive mood, and suicidal ideation. Situational factors included education level, household income, consumption of alcohol, engagement in smoking, and work schedule. The χ²-test and hierarchical logistic regression analysis were performed, reflecting the complex sample design.ResultsAge at menarche, childbirth experience, and body mass index among physiological factors and education level and work schedule among situational factors were found to be related to menstrual regularity. A higher risk of menstrual irregularities was found among those who had given birth (versus those who had not), had a high age at menarche (versus those with a low age at menarche), were obese (versus those who had a normal body mass index), had elementary school-level or lesser educational achievements (versus those with college graduate-level or higher educational achievements), and who had a shift work schedule (versus those with a fixed schedule).ConclusionsIntervention is needed for female workers who have these risk factors, and special attention must be paid to female workers who have a shift work schedule. Additionally, since body mass index can be controlled, intervention concerning body mass index is necessary to reduce menstrual irregularity.

Ethnocultural disparities in loneliness among women in Israel: A population-based study.

Loneliness was predicted for women in three ethnocultural groups in Israel: native Jews, Israeli Arabs, and Former Soviet Union (FSU) immigrants. The study was based on Lund et al.'s (2018) conceptualization of social determinant domains of mental health disorders, as in the United Nations Sustainable Development Goals. Social determinants were demographic, economic, social-cultural, and neighborhood factors. We examined whether ethnocultural disparities in loneliness persist when controlling for social determinants in these four domains or whether ethnic disparities are related to other forms of inequality among the three study groups, as reflected in these four domains. Next, we explored associations between the co-occurrence of key social determinants with loneliness. We used cross-sectional representative data of working-age women from the Israeli Social Survey (N = 5,600). Hierarchical logistic regression analyses indicated a higher risk for loneliness among FSU immigrants and Israeli Arabs than among native Jews. Economic risk factors significantly increased the risk of loneliness. Social and cultural factors decreased the risk of loneliness, while discrimination increased it. Improved neighborhood conditions decreased the risk of loneliness. Ethnocultural disparities in loneliness diminished when economic determinants were controlled. Co-occurrence of risk factors greatly increased the risk for loneliness, demonstrating a stepped relationship. Developing supportive networks for women, mainly from minority groups, to increase trust and fight discrimination against any background is necessary. Moreover, significant efforts must be made to combat poverty and narrow socioeconomic inequalities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Development of Malaysian-MIND diet scores for prediction of mild cognitive impairment among older adults in Malaysia.

Mild Cognitive impairment (MCI) is a pre-demented state in the elderly populace. The Mediterranean & Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet has shown promise in reducing the risk of MCI and Alzheimer's disease in older people. Notably, the existing MIND diet is not adapted to the specific needs of older adults in Malaysia, considering distinct food cultures and availability. Consequently, this study aimed to develop the Malaysian version of the MIND diet (MY-MINDD) scores and investigate their association with MCI in the older adult populace of Malaysia. A comprehensive pooled data analysis was conducted on combined data from 810 participants sourced from the longitudinal Long-Term Research Grant Scheme-Towards Useful Aging (LRGS-TUA) and Fundamental Research Grant Scheme (FRGS) studies. The MY-MINDD scores were developed by incorporating existing MIND diet food groups, their corresponding scoring mechanisms, and consideration of common Malaysian foods which are proven to be beneficial and detrimental to cognitive function. To substantiate the MY-MINDD scoring system, its association with MCI was evaluated using a series of validated neuropsychological test batteries. MY-MINDD consists of seven food groups promote brain health and four food groups exert negative cognitive outcomes. The study participants had an average age of 67.9 ± 4.7 years. The collective MY-MINDD score for all participants was 6.4 ± 0.1 (out of a maximum 11 points), revealing a lower score in individuals with MCI at 6.0 ± 1.7 compared to those without MCI at 6.6 ± 1.6 (p < 0.001). According to hierarchical multivariate binary logistic regression analysis, being in the highest tertile of MY-MINDD score was linked to reduced odds of MCI (odds ratio (OR) = 0.43, 95% confidence interval (CI): 0.26-0.72, p < 0.001) in the fully adjusted model in comparison to the lowest tertile. The development of the MY-MINDD scores for Malaysian older population revealed that a stronger adherence to this diet is linked to a reduced risk of MCI. Further substantiation of the MY-MINDD scores using more objective measures, such as neuroimaging approaches and other neuropsychological batteries, is necessary.

Revenge Sex: Weaponizing Infidelity

ABSTRACT Given that infidelityhas been consistently cited as one of the primary reasons for relationshipdissolution throughout most of the world, this study explored its relationshipto (a) revenge sex, (b) Sternberg’s triangulartheory of love, and (c) inherent powerdynamics withinintimate and romantic relationships. Data gleaned from Wave IV ofthe National Longitudinal Study of Adolescent Health (Add Health) measured asubsample of 1912 participants who reported being married and living together. Hierarchical logistic regressionanalyses indicated that the constructs of passion and intimacy negligiblyaccounted for any relationship to infidelity, but that the construct ofcommitment accounted for 17.4% of the variance regarding infidelity. Finally, the construct of revenge sex, whichevaluated if an individual believed that his/her partner committed infidelityaccounted for an additional 10.4% of the variance explained. The decision to be unfaithful issolely an individualistic quality in which zero culpability should be directedtoward one’s partner, as having more sex and developing a deeper bond withone’s partner did not serve as a deterrent for infidelity. Furthermore, individuals who perceive their partner may have cheated onthem are statistically significantly more likely to engage in revenge sex.

Reward responsivity and habit formation in the co-occurrence of restrictive eating and nonsuicidal self-injury

Dysfunctions in reward and/or habit formation have been proposed as factors contributing individually to the maintenance of restrictive eating and nonsuicidal self-injury (NSSI). However, despite the high comorbidity between these behaviors, the associations between reward and habit formation in their co-occurrence remains unclear. This study examined self-reported reward responsivity and habit strength among individuals with co-occurring restrictive eating and NSSI (Comorbid group; n = 108) and those with one behavior only (One-behavior group; n = 113). Hierarchical logistic regression analyses assessed the association between reward and habit features and the co-occurrence of restrictive eating and NSSI, accounting for the effects of impulsivity (a characteristic commonly considered to underlie co-occurring disordered eating and NSSI). Partial correlations examined the relationships between these features and the severity of eating disorder and NSSI symptoms, also controlling for impulsivity. Lower reward responsivity was associated with the co-occurrence of restrictive eating and NSSI, even after accounting for impulsivity (p = 0.017). In exploratory analyses, this relationship was no longer significant after accounting for self-reported depression. No significant associations were found regarding habit formation and restrictive eating and NSSI co-occurrence. Lower reward responsivity was linked to increased NSSI frequency and versatility in both groups and associated with severity of eating pathology in the Comorbid group (ps < 0.05). Our findings suggest that blunted reward responsivity may relate to the co-occurrence of restrictive eating, NSSI, and depressive symptoms, as well as the severity of restrictive eating and NSSI. Reward disturbances may serve as a crucial target in the treatment of multiple self-destructive behaviors.

Association between Levels of Loneliness, Laboratory Measurements, and Behavioral Aspects in a Primary Care Setting in Crete, Greece.

This paper examines potential associations of loneliness with laboratory data and specific psychosocial and behavioral attitudes. The sample collection took place in an urban Primary Health Care unit between May and July 2023, consecutively, and once exclusion criteria were implemented. Participants were aged between 40 and 75 years. Routine laboratory test results upon study initiation and six months before were used. The University of California, Los Angeles (UCLA), Loneliness Scale (Version 3), blood glucose, serum lipids, Fibrosis-4 index, and Creatinine Clearance (CrCl) were assessed through hierarchical multiple logistic regression analysis. Based on full model (3rd) analysis, those who were engaged in an individual sport or activity or had contacts with more friends presented significantly lower odds for increased loneliness levels (odds ratio (OR): 0.28 [95% confidence interval (CI) 0.09-0.91], p = 0.034 and OR: 0.76 [95%CI 0.66-0.88], p < 0.001, respectively). The consumption of alcohol was associated with increased loneliness (OR: 5.55 [95%CI 1.42-21.63], p = 0.014). Elevated triglyceride levels were linked with moderate or no loneliness (OR: 0.20 [95%CI 0.05-0.83], p = 0.026), while an increased LDL/HDL atherosclerotic index was related to increased subjective loneliness (OR: 4.50 [95%CI 1.12-18.13], p = 0.035). The need for holistic approaches-involving primary care personnel-in understanding and addressing loneliness, recognizing its multifaceted nature as well as the diverse factors that contribute to this issue, is considered challenging.

Prevalence and Correlates of Substance Use Among Youth Living with HIV in Fishing Communities in Uganda.

Alcohol and drug use (ADU) poses a significant barrier to optimal HIV treatment outcomes for adolescents and youths living with HIV (AYLHIV). We aimed to investigate the prevalence and correlates of ADU among ALHIV in Ugandan fishing communities, areas characterized by high HIV and poverty rates. AYLHIV aged 18-24, who knew they were HIV-positive, were selected from six HIV clinics. Substance use was determined through self-report in the last 12 months and urine tests for illicit substances. Utilizing a socioecological framework, the study structured variables into a hierarchical logistic regression analysis to understand the multi-layered factors influencing ADU. Self-reported past 12 months substance use was 42%, and 18.5% of participants had a positive urine test for one or more substances, with alcohol, benzodiazepines, and marijuana being the most commonly used. With the addition of individual-level socio-demographics, indicators of mental health functioning, interpersonal relationships, and community factors, the logistic regression analysis revealed greater exposure to adverse childhood experiences increased the odds of substance use (Odds Ratio [OR] = 1.24; 95% Confidence Interval [CI]: 1.03-1.55). Additionally, exposure to alcohol advertisements at community events significantly raised the odds of substance use (OR = 3.55; 95% CI: 1.43-8.83). The results underscore the high prevalence among AYLHIV and emphasize the need for comprehensive interventions targeting individual (e.g., life skills education and mental health supports), interpersonal (e.g., peer support and family-based interventions), community (e.g., community engagement programs, restricted alcohol advertisements and illicit drug access), and policies (e.g., integrated care models and a national drug use strategy), to address ADU.

The Influence of Demographics and Workforce Innovation Opportunity Act (WIOA) Employment and Training Services on Employment Outcomes for Teenagers Receiving Supplemental Security Income (SSI) and Their Parents

Transition age youth with disabilities and their families can access a variety of Workforce Innovation Opportunity Act (WIOA)-funded employment and training services. This study evaluated the impact of these services on youth and parent employment outcomes. These services were coordinated as part of the Wisconsin Promoting Readiness of Minors in SSI (PROMISE) federal demonstration grant. Youth with disabilities receiving Supplemental Security Income (SSI) benefits were randomly assigned to ‘usual’ services, including those available through school and vocational rehabilitation (VR) transition services, or ‘enhanced’ case management and transition services through the Wisconsin PROMISE demonstration. Parents who consented to participate could receive educational, employment, and financial self-sufficiency services and support through the Family Service Plan (FSP) connected to the youth’s PROMISE VR case. Youth and parents could also choose to receive WIOA Title I and Title III employment and training services, as well as Youth Apprenticeship, available through the Wisconsin Department of Workforce Development’s Division of Employment and Training (DET). A hierarchical logistic regression analysis demonstrated that VR services predicted higher youth employment rates and DET services predicted higher youth and parent employment rates. A linear regression analysis demonstrated that PROMISE services predicted higher youth wages and DET services predicted higher youth and parent employment wages. Findings suggest the coordination of employment-focused services across programs leads to increases in employment outcomes. Limitations and implications are discussed regarding the relationship between VR services, DET employment and training services, and employment outcomes.

Who gets screened and who tests positive? Drug screening among justice-involved youth in a midwestern urban county

BackgroundGiven high rates of substance use among justice-involved youth, justice systems have attempted to monitor use through drug screening (DS) procedures. However, there is discretion in deciding who is screened for substance use, as not every youth who encounters the system is screened. The aim of the current study was to examine factors associated with selection for and results of oral DS among justice-involved youth assigned to probation to better inform potential DS policy. Electronic court records from 4,668 youth with first-incident records assigned to probation in a midwestern urban county’s juvenile justice system between 2011 and 2016 were included in the analytical sample. Race/ethnicity, gender, age, number of charges and charge type for the current incident were included as independent variables.ResultsMultivariable hierarchical logistic regression analyses indicated that males were more likely to be assigned to DS (aOR = 0.40, 95%CI [0.34, 0.46]), and more likely to test positive for use (aOR = 0.43, 95% CI [0.34, 0.54]) than females. As age increased, youth were less likely to be assigned to DS (aOR = 0.91, 95% CI [0.87, 0.94]), with non-significant differences in DS results. Greater number of charges were associated with a higher likelihood of being assigned to DS (aOR = 1.55, 95% CI [1.43, 1.68]). Youth with violent offenses were more likely to be assigned to DS than those with other offense types (property offenses, drug offenses, statutory offenses, disorderly conduct, and all other offenses), but less likely to test positive for use.ConclusionsMany factors were associated with differences in DS, but these factors were not always associated with differential DS results. Demographic or charge-based decisions may not be appropriate for DS assignment.

Psychological resilience and mental health among older Tekun men in long-term care facilities in rural China

ABSTRACT This study examines age differences in the association of psychological resilience with mental health among older Tekun (socially and economically vulnerable) men. It analyzed the 2019 data from 718 Tekun men (≥60 years) residing in rural long-term care (LTC) facilities in Anhui Province, China. Results indicated that the oldest-old (≥80 years) reported significantly lower levels of psychological resilience than the other age groups (the young-old: 60–69 years and the middle-old: 70–79 years). Hierarchical logistic regression analyses revealed a significant negative association between psychological resilience and poor mental health among the middle-old (OR = 0.95, 95% CI: 0.93–0.98) and the oldest-old (OR = 0.93, 95% CI: 0.88–0.98) groups. Psychological resilience plays a more crucial role in maintaining mental health among the oldest-old participants compared to the young-old and middle-old participants. Implications for social work practice were discussed.

Recovery from substance use disorder among adolescents: Roles of adverse and positive childhood experiences

AbstractThis study examines the roles of positive childhood experiences (PCEs) and adverse childhood experiences (ACEs) on the recovery from substance use disorder (SUD) among adolescents ages 12–17, utilizing data from the 2016–2019 National Survey of Children's Health (NSCH). On a sample of 256 adolescents who have had SUD, a hierarchical binary logistic regression analysis demonstrated that the cumulative PCEs significantly increased the odds of SUD recovery, whereas the cumulative ACEs did not decrease the odds.

Demographic and Vocational Rehabilitation Service Correlates of Employment Outcomes in People With Substance Use Disorders During COVID-19

This study examined the demographic and vocational rehabilitation (VR) service correlates of employment outcomes (achievement of competitive employment, hourly wage, and weekly hours) among individuals with substance use disorders (SUDs) during the COVID-19 pandemic, using the Rehabilitation Services Administration Case Services Report (RSA-911) database for fiscal year 2020. Data from 9,536 individuals were analyzed. Hierarchical logistic regression and hierarchical linear regression analyses revealed that multiple demographic and VR service variables were significantly associated with achievement of competitive employment, hourly wage, and weekly work hours at exit. Particularly, having a vocational training license/certificate, employment at Individualized Plan for Employment, and having an associate or bachelor’s degree were the strongest demographic correlates of more positive employment outcomes; while short-term job supports, maintenance, and other services were the strongest VR service correlates of more positive employment outcomes. Implications of the findings were discussed to promote VR service outcomes for people with SUD in the postpandemic era.

Comparing the effectiveness of game literacy education and game coding education in improving problematic internet gaming.

Problematic internet gaming by adolescents has been thought to be associated with low self-esteem, depression, anxiety, and attention problems. We hypothesized that both game literacy and coding education would effectively improve problematic internet use. However, game coding education would be more effective in enhancing self-esteem and social anxiety in adolescents than game literacy education. A total of 733 adolescent volunteers were included and randomly assigned to either the game coding education or game literacy education programs. Both programs consisted of eight sessions, each lasting 45 minutes, over four weeks. The coding education sessions included game planning and development lessons and allowed students to create the game's characters, stages, and tutorials directly using Scratch, a free coding program. Game literacy education sessions included lessons on enjoying gaming with a healthy rationale and etiquette. Data on demographics, gaming patterns, and psychological status, including positive/negative perceptions of online games, depression, social anxiety, and self-esteem, were collected. Both game coding and game literacy education significantly improved YIAS scores compared to baseline, and there was no significant difference in the YIAS scores between the two groups after the interventions. In the hierarchical logistic regression analysis of all participants, higher YIAS scores, stronger negative perceptions of gaming, and lower attention problem scores at baseline predicted lower levels of internet gaming addiction after interventions. In the hierarchical logistic regression analysis among individuals with game coding education, higher YIAS scores, stronger negative perceptions of gaming, lower attention problem scores, and higher self-esteem scores at baseline predicted lower levels of internet gaming addiction after intervention. In addition, game coding education greatly improved negative perceptions of games, self-esteem, and social anxiety compared to game literacy education. Both game literacy and game coding education effectively mitigate internet game addiction. However, game coding education effectively mitigated problematic internet gaming by improving negative perceptions of games, self-esteem, and social anxiety in adolescents. We found that the application of knowledge by students in creating their own games was more effective than simply developing a conceptual understanding of the games.

The Mediating Effect of Depression on the Relationship between Loneliness and Substance Use in Korean Adolescents.

Substance use among adolescents is a major emerging health problem worldwide. Although loneliness and depression are major risk factors for substance use, few studies have examined the relationship between loneliness, depression, and substance use in adolescents. This study aimed to determine the mediating effect of depression on the relationship between loneliness and substance use among Korean adolescents, based on the data from 53,310 adolescents from the 17th Korea Youth Risk Behavior Web-based Survey in 2021. Using a complex sample analysis module, hierarchical logistic regression analysis was employed to confirm the mediating effect of depression on the relationship between loneliness and substance use. The results showed that loneliness and depression have a significant effect on substance use (smoking, drinking alcohol, and drug use). Depression was found to have a partial mediating effect on the relationship between loneliness and substance use. Overall, the results suggested that loneliness and depression in adolescents increase substance use, and loneliness can affect substance use through depression. Therefore, proactive strategies to prevent and reduce loneliness and depression in adolescents can be effective in preventing substance use.

Effect of the Presence of Emergency Departments with 300 or More Hospital Beds in Health Service Areas on 30-Day Mortality in Korea: A Nationwide Retrospective Cross-sectional Study.

Disparities in emergency care accessibility exist between health service areas (HSAs). There is limited evidence on whether the presence of an emergency department (ED) that exceeds a certain hospital bed capacity is associated with emergency patient outcomes at the regional level. The objective of this study was to evaluate the effect of HSAs with or without of regional or local emergency centers with 300 or more hospital beds (EC300 or nEC300, respectively) by comparing the 30-day mortality of patients with severe emergency diseases (SEDs) admitted to the hospital through the ED. The study retrospectively evaluated data from the Korean National Health Insurance Claims database and enrolled patients who were admitted from the ED for SEDs. SEDs were defined using ICD-10 codes for 28 disease categories with high severity, and 56 HSAs were designated as published by the Korean National Health Insurance Service. We performed hierarchical logistic regression analysis using multilevel models with the generalized linear mixed model (GLIMMIX) procedure to evaluate whether EC300 was associated with the 30-day mortality of SED patients, adjusting for patient-level, prehospital-level, hospital-level, and HSA-level variables. In total, 662,478 patients were analyzed, of whom 54,839 (8.3%) died within 30 days after hospital discharge. Of the 56 HSAs, 46 (82.1%) were included in the EC300 group. After adjustment for patient-level, prehospital-level, hospital-level and HSA-level variables, nEC300 was significantly associated with increased 30-day mortality in SED patients (AOR: 1.33, 95% CI: 1.137-1.153). In addition, patients who visited EDs with fewer annual SED admissions were associated with higher 30-day mortality. nEC300 had a greater risk of 30-day mortality in patients treated with SEDs than EC300. The results indicate that not only the number of EDs in each HSA is important for ensuring adequate patient outcomes but also the presence of EDs with adequate receiving capacity.

Political Polarization in Thailand: Urban vs. Rural Dynamics

This study aims to achieve two research objectives: (1) to examine the disparities in democratic attitudes and political participation between urban and rural areas in Thailand, and (2) to formulate policy recommendations aimed at mitigating political polarization between urban and rural areas in the country. It utilized a survey methodology, drawing data from the 7th World Values Survey, with a representative sample of Thai citizens from both urban and rural regions. The study analyzed four independent variables—place of residence, gender, socioeconomic status, and education level—alongside two categories of dependent variables, namely democratic attitudes and political participation. Data analysis was conducted using SPSS, encompassing a range of descriptive statistics as well as hierarchical linear and logistic regression analyses. The findings indicate that rural residents in Thailand tend to exhibit stronger democratic values than their urban counterparts. However, they also display lower levels of political participation. To enhance democracy in Thailand, it is imperative to create an environment conducive to political engagement, particularly in rural communities that often feel marginalized and resentful due to policies that appear to favor urban elites. Addressing this divide is crucial for the stability and development of Thailand’s democratic system.

Association of COVID-19 preventive behavior and job-related stress with the sleep quality of healthcare workers one year into the COVID-19 outbreak: a Japanese cross-sectional survey

BackgroundThis study aimed to evaluate the association of COVID-19 preventive behavior and job-related stress with sleep quality among healthcare workers (HCWs). We conducted a cross-sectional survey using a questionnaire at the National Center of Neurology and Psychiatry, Tokyo, Japan.MethodsA total of 586 participants who completed the questionnaire were eligible for the study. The Pittsburgh Sleep Quality Index was used to evaluate sleep quality. We examined the level of engagement between poor sleep and COVID-19-related infection preventive behaviors, such as avoiding closed spaces, crowded places, and close contact (three Cs), a distance of at least one meter from others, wearing a face mask regularly, washing hands regularly, and working remotely, as well as job-related stress in the work environment, exposure to patients, potential risk of infection, fear of infecting others, need for social confinement, and financial instability. We conducted a hierarchical logistic regression analysis to examine the relationship between poor sleep and COVID-19 preventive behavior, job-related stress, and other covariates, including age, sex, and the Kessler Psychological Distress Scale (K6), which was used to measure non-specific psychological distress.ResultsPoor sleep was observed in 223 (38.1%) participants. Adherence to COVID-19 preventive measures was relatively high: 84.1% of participants answered “always” for wearing a face mask regularly and 83.4% for washing hands regularly. In the multivariate logistic regression analysis, stress in the work environment (odds ratio [OR] = 2.09, 95% confidence interval [CI], 1.37–3.20; p < 0.001), financial instability (OR = 1.73, 95% CI, 1.12–2.67; p < 0.05), and low adherence to working remotely (OR = 1.65, 95% CI, 1.06–2.57; p < 0.05) were independently and significantly associated with poor sleep after controlling for the covariates.ConclusionsOne year into the COVID-19 pandemic, the poor sleep rates of HCWs remained high. These results emphasize the need to protect HCWs from work environment stress and financial concerns.

Polyvictimization, polystrengths, and their contribution to subjective well-being and posttraumatic growth.

The negative biopsychosocial outcomes associated with exposure to victimization are well-known, however, limited research has examined the protective factors that can enhance well-being and growth following polyvictimization from in-person and digital sources. This study examines the contribution of adversities and a range of psychological and social strengths on perceptions of subjective well-being and posttraumatic growth (PTG). A sample of 478 individuals aged 12-75 (57.5% female; Mage = 36.44) from a largely rural Appalachian region of the United States completed a survey on victimization experiences, other adversities, psychosocial strengths, subjective well-being, and PTG. Approximately 93.3% of individuals reported at least one digital or in-person victimization, with 82.8% reporting two or more forms of victimization. Hierarchical logistic regression analyses indicated that strengths explained more than three times the variance in subjective well-being and PTG compared to adversities, with both models explaining about half of the variance in these outcomes (49% and 50%, respectively). Psychological endurance, sense of purpose, teacher support, and polystrengths were significantly associated with better well-being and/or PTG. Some strengths hold more promise than others for promoting well-being and PTG following polyvictimization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Demographic covariates and vocational rehabilitation services as predictors of employment outcomes of people with physical disabilities: a hierarchical logistic regression analysis

Purpose Stable employment is essential for the health, psychosocial, and financial well-being of people with physical disabilities (PwPD). Unfortunately, the low employment rate for PwPD in the U.S. exposes them to adverse effects of unemployment, including depression, anxiety, low self-esteem, and physical pain. Helping PwPD find gainful employment will improve their general health and well-being. However, few empirical studies examine factors affecting the employment outcomes of PwPD. This study aims to examine the relationship between demographic covariates, vocational rehabilitation (VR) services, and employment outcomes of PwPD. Materials and Methods This secondary data analysis study includes 17,598 PwPD from the U.S. Department of Education’s Rehabilitation Services Administration’s Case Service Report (RSA-911) dataset. Our analysical approach was hierarchical logistic regression analysis. Results For VR services, workplace support, technology support, job placement assistance, and VR counseling significantly contribute to predicting employment outcomes for PwPD. Even after entering VR services, the demographic variables (age, race, education, referral sources, low-income, long-term unemployment, and disability significancy) were still significant predictors of employment. Conclusions Findings from this study can be used by state VR counselors and other disability service providers to plan and select effective employment-related interventions to improve the employment outcomes of PwPD.