Large US Sample Research Articles

Mild to moderate cognitive impairment does not bias the Geriatric Depression Scale in a large US sample of older adults.

The Geriatric Depression Scale (GDS) is widely used to screen for depression in clinical practice and to assess symptoms of depression in research about older adults. To determine whether the 15-item GDS can be used in adults with dementia, this study investigated whether item- or test-level bias in the GDS-15 is associated with the respondent's level of cognitive impairment. Using a large U.S. sample of 24,674 adults, we first conducted sample matching procedures between the five groups defined by CDR® Dementia Staging Instrument scores to control for potential confounding effects of common demographic variables. Then, we employed confirmatory factor analysis (for single-group and configural-invariance models only) and item response theory models to test potential differential item/test functioning effects associated with the GDS-15 across the five CDR groups. Practical consequences of the identified biases were quantified using sample-based Cohen's d effect sizes and misclassification rates. In general, people with higher CDR scores were older and had fewer years of education. In comparison to the normal cognition group (CDR-0), negligible biases in GDS-15 scores were found for the groups with questionable, mild, or moderate cognitive impairment (CDR-0.5/1/2). For individuals with severe cognitive impairment (CDR-3), their responses were inconsistent with the normal cognition group and their depression scores were significantly biased with a small-to-medium effect size. The GDS-15 can be used to assess depression in individuals with mild or moderate cognitive impairment, but not in individuals with severe cognitive impairment.

Public perception of individuals who commit Child Sexual Abuse Material offences: Exploring the impact of demographic variables and cross-national differences

BackgroundLay perceptions of persons who download and distribute Child Sexual Abuse Material (CSAM) is an underexplored subject. There is a need for understanding the factors that influence perceptions as the public perceptions have implications for endorsement of sex offender rehabilitation that in turn can influence the availability of treatment programs and stigma for help-seeking. ObjectiveTo explore public perceptions of individuals that commit child sexual abuse offences, to compare the results to those obtained in a large US sample, and to explore associations between demographic variables, general perceptions and endorsement of imprisonment and treatment for individuals that commit CSAM offences. Participants and settingAn online survey were distributed in Norway in February 2023. 618 individuals responded, 76 % were female, mean age 34.99 (SD = 14.23), the majority (>70 %) had higher education, and 44 % had children. ResultsConsistent with prior research, the public perceptions overestimated the risk of future contact offences and recidivism. Women overestimated the percentage of risk of contact offences and pedophilic interest more than men. The overestimation was significantly less in this sample compared to the US sample (d = 0.39–0.96). Those working with online child abuse had perceptions of persons committing CSAM offences that were more aligned with empirical findings. Demographic variables were only marginally associated with endorsement for treatment and imprisonment, except for having children, which was associated with endorsement of imprisonment. Perceived risk of contact offences, pedophilic preference, and assumed childhood sexual victimization were associated with perceptions of individuals committing CSAM offences as different than those committing physical sexual abuse and both endorsement of treatment and imprisonment. Conclusions.The perceptions of those who commit CSAM offences showed a stronger association with endorsement for treatment and imprisonment than demographic variables.

Fair values in extreme markets

AbstractThis study investigates the valuation of fair values in extreme market conditions. Using a modified Ohlson model and a large US sample, this study finds that the valuation of fair values in extreme market conditions is consistent with the presence of a positive feedback loop bias. This bias manifests as irrational exuberance in overheated markets and undue panic in depressed markets. The results are robust under several different test designs. Additional tests of moderating factors show that good performance and low risk intensify irrational exuberance in overhead markets, and poor performance and high risk worsen undue panic in depressed markets.

0513 Assessment of Sleep Fragmentation in a Large US Sample by Home Under-Mattress Devices

0513 Assessment of Sleep Fragmentation in a Large US Sample by Home Under-Mattress Devices

Delay discounting is associated with addiction and mental health measures while controlling for health behaviors and health barriers in a large US sample

BackgroundExcessive discounting of future rewards [delay discounting (DD)] may be a transdiagnostic process and treatment target underlying behavioral health outcomes, including trauma, depression, anxiety, and problematic substance use. However, multiple health behaviors and barriers are also related to these outcomes, including social media usage, adverse childhood experiences (ACEs), sleep quality, healthcare access, housing status, and exercise. To extend research examining DD as transdiagnostic process, we recruited a large, heterogenous sample to examine the association between DD, problematic substance use, and mental health outcomes while controlling for certain health behaviors and health barriers. MethodIn a cross-sectional online survey of 3992 US residents, we administered validated measures of PTSD, depression, anxiety, and problematic alcohol, stimulant, and opioid use. Using linear or ordinal logistic models, scores for each outcome were regressed onto DD while controlling for demographics, health behaviors, and health barriers. ResultsIncluding only DD and demographics, DD was associated with each outcome at low effect sizes (ƒ2 = .013, OR range = 1.08–1.16). Except for opioid ASSIST scores, these relationships held when controlling for social media usage, sleep, housing status, healthcare access, ACEs, physical exercise, and demographic variables (ƒ2 = .002, OR range = 1.03–1.12), increasing confidence that DD concurrently and directly relates to four of these five clinical outcomes. DiscussionThese findings support the conceptualization of DD as a transdiagnostic process underlying certain psychopathologies and suggest targeting DD in co-occurring substance use disorder and/or mental health treatments may result in clinically significant outcomes.

Climate policy uncertainty and corporate dividends

This paper investigates whether climate policy uncertainty (CPU) matters to a firm's dividend policy. Using Gavriilidis's (2021) novel measure of uncertainty related to climate policy and a large sample of US publicly traded firms over the period 1987–2022, we found a positive association between CPU and dividend payouts. This association is stronger for firms with talented managers and less pronounced for firms in climate sensitive industries and headquartered in US States with more stringent environmental regulations. These results contribute to the nascent literature on the implications of uncertainty related to climate policy to corporate financial decisions.

Maladaptive daydreaming: A shortened assessment measure and its mental health correlates in a large United States sample

Background and aimsMaladaptive Daydreaming (MD) is a suggested syndrome where individuals addictively engage in fanciful, narrative and emotional daydreaming for hours on end, often relying on stereotypical movements and music to facilitate the absorbed state. Many individuals suffering from MD to the point of clinically significant distress and functional impairment have advocated for its medicalization as a disorder. Maladaptive daydreamers exhibit high rates of psychopathology, but most studies were biased by self-selection. We developed a brief measure for efficient assessment of suspected MD and then administered it in a large non-selected US sample to gauge the significance of MD for public mental health. MethodsTwo previous datasets were utilized to develop the 5-item measure, labeled the Maladaptive Daydreaming Short Form (MD-SF5). Then, a large survey was conducted using the Qualtrics panel, administering the MD-SF5 alongside several validated measures of mental health to a general sample of panelists (N = 2512, 84.6% females, age M = 39.74, SD = 18.53, Race/Ethnicity: 66.3% White, 14.7% Black, 9.3% Hispanic, and 9.7% Other). ResultsThe MD-SF5 showed good to excellent agreement with the existing measure. Generally, the new sample had high psychopathology rates. Suspected MD was associated with psychological distress, loneliness, psychotic experiences, heavy drinking, and suicidality. Notably, even after controlling for psychological distress, suspected maladaptive daydreamers were more than twice as likely to have recently attempted suicide (Odds Ratio = 2.44, 95% CI [1.44, 4.16], Wald = 10.86, p = .001). Discussion and conclusionsMD harbors public health significance and can be screened for with a short self-report tool. Thus, MD should be addressed by mental health practitioners.

Individual and Organizational Factors Associated With Nurse Manager Success.

The aim of this study was to synthesize previous findings and provide practical guidance for maximizing nurse manager and nurse performance. Two recent studies have linked nurse manager job design factors and individual differences to a variety of valued outcomes, but practical implications remain unclear. A large US sample of nurse managers was divided on the basis of nurse and patient outcomes. Various characteristics are compared across the highest and lowest performers. Wider nurse manager span of control is associated with negative outcomes; the availability of support positions does not fully alleviate the consequences of wide spans. Nurse managers with fewer subordinates can effectively manage multiple units. Nurse manager experience is critical for success and cannot be fully replaced by leadership training programs. Staffing and job design decisions have critical downstream implications. The present research provides guidance for effective staffing and job design.

0502 Number of Nights to Achieve High Sensitivity/Specificity for Detecting OSA Using a Large US Sample by Home Under-Mattress Devices

Abstract Introduction Clinical sleep studies typically rely on one night for OSA detection and diagnosis. However, uncertainty exists regarding the degree of AHI stability across different nights. Population studies collecting continuous nightly data on a large scale enable detection of night-to-night variability in OSA severity; this study is the largest to date for evaluation of the number of nights to achieve high sensitivity/specificity for OSA detection. Methods Sleep-disordered breathing was analyzed by a commercially available home monitoring device (Sleeptracker-AI Monitor, Fullpower Technologies Inc., California, USA) that passively monitors sleep using piezo-electric sensors. Validated sleep/respiratory parameters were derived from device data. De-identified data were analyzed, following review and exemption of the study (#57681) from Stanford University IRB. Data from 10/01/2021 to 09/30/2022 were reviewed in 96,228 individuals with 19,148,323 recorded nights. Individuals with at least 300 nights with a computed AHI (TST≥4hrs) were included in the analytic dataset. Results A total of 23,105 individuals (10,711 men, 49.6±12.93 years; 9,430 women, 49.4±12.85 years; 2,964 no gender provided, 50.4±14.37 years) with 7,947,840 recorded nights met the inclusion criteria. Maximum (but not mean) AHIs for each individual for 3 randomly-selected (vs. consecutive) nights revealed sensitivities (≥95%)/specificities [and CIs] of 94.9%[94.8,95.1]/82.5%[82.2,82.7], 95.2%[95.0,95.5]/94.3%[94.1,94.5], and 96.2%[95.8,96.6]/97.9%[97.8,98.0] for detecting any, moderate-to-severe, and severe OSA, respectively, as categorized by mean AHI over 1 year. Sensitivities for a single night were in the low 70s, and, for maximum AHI over two randomly-selected nights, near 90%, with a tradeoff for decreased specificities for 3+ nights. For moderate-to-severe and severe OSA subjects over 1 year, means of 5.1±7.7% and 5.4±7.3% nights, respectively, showed OSA severity decreases by 2+ categories (i.e., moderate to normal, severe to mild/normal). Conclusion Use of a noninvasive in-home monitoring device enabling collection and analysis of a large sample of sleep/respiratory data on a continuous nightly basis showed that a single night yields low sensitivity for detection of OSA and on average OSA severity decreased by 2 categories on 5% or more nights. Maximum (but not mean) AHI across 3 non-consecutive nights yields good sensitivities/specificities for moderate-to-severe and severe OSA detection. Ongoing work explores statistics for nights beyond 3 to further improve sensitivity/specificity. Support (if any)

Seasonal variation of orofacial clefting in the United States

Seasonal variation in occurrence of fetal anomalies may provide clues as to etiologic factors. Published literature has inconsistently reported an association of orofacial clefting with season of birth in international cohorts, and there is limited national data assessing this relationship. We sought to assess the association of seasonality with orofacial clefting in the setting of other potential etiologic factors in a large US sample.

Antibiotic Susceptibility Profile for the US Neisseria meningitidis Urethritis Clade.

The US Neisseria meningitidis urethritis clade (US_NmUC) harbors gonococcal deoxyribonucleic acid alleles and causes gonorrhea-like urogenital tract disease. A large convenience sample of US_NmUC isolates (N = 122) collected between January 2015 and December 2019 in Columbus, Ohio demonstrated uniform susceptibility to antibiotics recommended for gonorrhea treatment and meningococcal chemoprophylaxis.

Associations Between Physical Activity, Tinnitus, and Tinnitus Severity.

To examine the associations between physical activity and tinnitus development and physical activity and tinnitus severity in a large representative sample of US adults. Data were obtained from 3826 eligible participants (20 to 69 years) in the National Health and Nutrition Examination Survey between 2015 and 2016. Physical activity was assessed using a Global Physical Activity Questionnaire. We used multivariable logistic regression to test the associations of physical activity (without physical activity, with physical activity) and amount of physical activity (min/week, in quartiles) with tinnitus symptoms. Adults with depressive symptoms were excluded, and the models were controlled for relevant sociodemographic, lifestyle, and health-related covariates. A restricted cubic spline was used to explore the dose-response relationship between the amount of physical activity and tinnitus. Overall, 12.8% of the population who engaged in physical activity reported tinnitus, compared with 18.5% of the population who did not ( p = 0.005). Subgroup analysis based on the amount of physical activity showed that participants who performed physical activity (150 to 300, 310 to 540, and 550 to 4800 min/week) had lower risks of tinnitus than those with no physical activity (odds ratio = 0.72, 0.56, and 0.62, respectively), after adjusting for covariates. However, no correlation was observed between physical activity and tinnitus severity in the present study. The dose-response analysis showed a nonlinear relationship (P for nonlinearity = 0.04) between the amount of physical activity and the risk of tinnitus. Physical activity may be associated with a reduced risk of tinnitus. Further research using a longitudinal design is required to confirm these findings and clarify the direction of causation.

Association between asthma and work absence in working adults in the United States

Objectives: The present study aimed to investigate the association between asthma and work absence in a large sample of US working adults, while controlling for several sociodemographic and health characteristics. Methods: This study used data from the 2019 Health and Functional Capacity Survey of the RAND American Life Panel (ALP). Work absence corresponded to the number of days of absence from work for health-related reasons in the past 12 months. Current asthma was self-reported and was included in the analyses as a dichotomous variable. Control variables included sex, age, ethnicity, marital status, education, occupation, annual family income, health insurance, and number of chronic physical or psychiatric conditions. Finally, the association between asthma and work absence was analyzed using logistic regression models. Results: This study included 1,323 adults aged 22–65 years (53.1% males; mean [SD] age 43.1 [11.7] years). Individuals with asthma were more likely to report at least one (81.5% versus 56.8%, p-value<0.001) or three days of absence (56.9% versus 31.3%, p-value=0.003) from work in the past 12 months than those without asthma. These findings were corroborated in the regression analyses, as asthma was positively and significantly associated with work absence after adjusting for all control variables (at least one day of absence: OR=3.24, 95% CI=1.44–7.29; at least three days of absence: OR=2.61, 95% CI=1.26–5.40). Conclusions: This US study of working adults showed that asthma was a risk factor for work absence. Further research is warranted to better understand the factors predisposing to work absence in the asthma population.

Strategic deviation and debt maturity structure

We examine the relationship between strategic deviation and debt maturity structure. Using a large sample of US publicly listed firms from 1981 to 2020, we find that strategic deviation is positively associated with short-term debt. We also find that this relationship is driven by both direct and indirect channels (information asymmetry and corporate governance channels). Our finding remains robust to a series of sensitivity analyses and endogeneity tests. Taken together, we show that strategic deviation has crucial effects on corporate financing decisions.

Heavy metal and phthalate contamination and labeling integrity in a large sample of US commercially available cannabidiol (CBD) products

BackgroundThe demand and availability of commercially available cannabidiol (CBD) products has grown substantially, which is of particular interest among medically vulnerable people. Because the cannabis plant is recognized as a bioaccumulator, which is highly effective at absorbing and retaining contaminants (e.g., heavy metals) in soil, it is important to characterize the degree of contamination in CBD products and their label accuracy to better estimate potential health benefits and risks associated with consumption. MethodsLevels of lead, cadmium, arsenic, mercury, four phthalates, and CBD labeling accuracy were quantified in a selection of commercially available CBD products in the US. Heavy metal concentrations were quantified by inductively coupled plasma-mass spectrometry. Phthalates were quantified by liquid chromatography-tandem mass spectrometry. CBD labeling accuracy was determined by extracting samples into a suitable organic solvent and analyzing using liquid chromatography with diode array detection. ResultsLead was detected in 42 %, cadmium in 8 %, arsenic in 28 %, and mercury in 37 % of 121 edible CBD products. Four edible CBD products exceeded the California Proposition 65 threshold for daily lead consumption of 0.5μg in two servings. The percentage of edible products with detectable phthalate concentrations varied between 13 % and 80 % across the four phthalates, with DEHP being most prevalent. Among all products tested for CBD labeling accuracy (topicals, edibles, N = 516), 40 % contained <90 % of the CBD indicated on the product label, 18 % contained >110 %, and only 42 % of products fell within ±10 % of the CBD claimed on the manufacturer label. Concentrations of heavy metals and phthalates were not associated with CBD potency. ConclusionsLow-level contamination of edible CBD products with heavy metals and phthalates is pervasive. There is substantial discrepancy between the product label claims for CBD potency and the amount measured in both edible and topical products, underscoring the need for tight regulations for CBD product label integrity to protect consumers.

The Impact of Breastfeeding and Safe Sleep Mobile Health Messaging on Breastfeeding and Bedsharing.

Mobile health (mHealth) safe sleep messaging increases rates of safe sleep. Bedsharing is more common among breastfeeders. Advice to not bedshare may negatively impact breastfeeding. We compared the impact of safe sleep or breastfeeding mHealth messaging on bedsharing and breastfeeding at 2 to 5 months. This is a secondary analysis of mothers who initiated breastfeeding from a cluster randomized clinical trial of mHealth messaging for safe sleep or breastfeeding. A multi-ethnic sample of 1600 mothers was recruited from 16 US birth hospitals and surveyed at 2 to 5 months regarding the previous 2 weeks' breastfeeding and bedsharing practices. Data on 997 mothers who initiated breastfeeding were analyzed with multivariable generalized estimating logistic regression models to examine the association of mHealth messaging with infant care practices. Overall, exposure to breastfeeding versus safe sleep messaging was not associated with a difference in any breastfeeding at 2 to 5 months (69.3% vs 65.5%, respectively; adjusted odds ratio [aOR]=1.33 [95% confidence interval, 0.91, 1.94]). Women with shorter planned duration of breastfeeding who received breastfeeding messaging had increased odds of breastfeeding at 2 to 5 months (50% vs 31%; aOR 3.13 [95% CI, 1.47, 6.65]). Mothers who received safe sleep messaging had lower rates of bedsharing overall when compared to breastfeeding messaging (24.8% vs 35.2%; aOR=0.58 [95% CI, 0.44, 0.78]). In this large multi-ethnic US sample, receipt of safe sleep mHealth messaging was associated with lower rates of bedsharing without negatively impacting breastfeeding rates. Future research should focus on continued development of interventions to improve adherence to both safe sleep and breastfeeding recommendations.

Bayesian two-part multilevel model for longitudinal media use data

Multilevel models are effective marketing analytic tools that can test for consumer differences in longitudinal data. A two-part multilevel model is a special case of a multilevel model developed for semi-continuous data, such as data that include a combination of zeros and continuous values. For repeated measures of media use data, a two-part multilevel model informs market research about consumer-specific likeliness to use media, level of use across time, and variation in use over time. These models are typically estimated using maximum likelihood. There are, however, tremendous advantages to using a Bayesian framework, including the ease at which the analyst can take into account information learned from previous investigations. This paper develops a Bayesian approach to estimating a two-part multilevel model and illustrates its use by applying the model to daily diary measures of television use in a large US sample.

Demographic, clinical guideline criteria, Medicaid expansion and state of residency: a multilevel analysis of PrEP use on a large US sample

ObjectiveTo explore the association of clinical guideline-related variables, demographics and Medicaid expansion on pre-exposure prophylaxis (PrEP) uptake in one of the largest US sample of men who have sex with...

Correlates of a caregiver-reported child sleep problem and variation by community disadvantage

BackgroundPrevious studies of sleep patterns and perceived problems in early childhood indicate variation by family socioeconomic status. The purpose of this study was to examine variation in correlates of a caregiver-perceived child sleep problem across and within levels of community disadvantage in a large US sample. MethodsCaregivers of 14,980 young children (ages 0–35.9 months) in the US completed the Brief Infant Sleep Questionnaire—Revised (BISQ-R) on the freely and publicly available Johnson's® Bedtime® Baby Sleep App. Zip code was used to identify a Distressed Communities Index (DCI) score, which represents community disadvantage based on neighborhood indicators. ResultsAcross all levels of community disadvantage, caregivers who reported greater impact of child sleep on their own sleep, bedtime difficulty, more frequent and longer night wakings, and increased total nighttime sleep were more likely to endorse a child sleep problem. These associations varied by level of community disadvantage. For caregivers living in more disadvantaged communities, impact of child sleep on their own sleep and night wakings were the strongest correlates of endorsing a child sleep problem, whereas for those in more advantaged communities the impact of child sleep on their own sleep and night wakings as well as additional aspects of sleep health, such as short sleep duration, were associated with endorsement of a child sleep problem. ConclusionsFindings suggest that families living in more distressed communities are most likely to identify the impact of child sleep on their own sleep and night wakings in reporting a child sleep problem, whereas those from more prosperous communities consider these factors as well as other sleep parameters, including sleep duration. Clinicians should consider expanding screening questions for child sleep problems to include the perceived impact on caregiver sleep.

Heavy Metal and Phthalate Contamination and Labeling Integrity in a Large Sample of Us Commercially Available Cannabinoid (Cbd) Products

Heavy Metal and Phthalate Contamination and Labeling Integrity in a Large Sample of Us Commercially Available Cannabinoid (Cbd) Products