Omnibus Model Research Articles

Efficiently Quantifying Egocentric Social Network Cannabis Use: Initial Psychometric Validation of the Brief Cannabis Social Density Assessment.

Social environment is a key determinant of substance use, but cannabis-related social network analysis is not common, in part due to the assessment burden of comprehensive egocentric social network analysis. The current pre-registered secondary analysis assessed the psychometric properties (i.e., convergent, criterion-related, incremental validity) of the Brief Cannabis Social Density Assessment (B-CaSDA) in a cross-sectional sample of adults who use cannabis (N = 310) using a survey-based design. The B-CaSDA assesses the quantity and frequency of cannabis use for the respondent's four closest (non-parent) relationships. Cannabis use severity was elevated for each additional person who used cannabis at all or daily in the individual's social network. B-CaSDA indices (i.e., frequency, quantity, total score) were positively correlated with cannabis consumption, cannabis use severity indicators, and established risk factors for harmful cannabis use. B-CaSDA indices also discriminated between those above and below a clinical cutoff on the Cannabis Use Disorder Identification Test - Revised (CUDIT-R). Finally, in omnibus models that included common risk factors for cannabis use severity, the B-CaSDA quantity index contributed additional variance when predicting CUDIT-R total score, and B-CaSDA frequency contributed additional variance in predicting the CUDIT-R quantity-frequency subscale. The results suggest that the B-CaSDA has the potential to expand social network research on cannabis use and misuse by increasing its assessment feasibility in diverse designs.

Assessing structural models of neighborhood and family sociodemographic characteristics and their relations with externalizing psychopathology.

Externalizing psychopathology has been found to have small to moderate associations with neighborhood and family sociodemographic characteristics. However, prior studies may have used suboptimal operationalizations of neighborhood sociodemographic characteristics and externalizing psychopathology, potentially misestimating relations between these constructs. To address these limitations, in the current study we test different measurement models of these constructs and assess the structural relations between them. Using a population-representative sample of 2,195 twins and siblings from the Georgia Twin Study and data from the National Neighborhood Data Archive and 2000 U.S. Census, we assessed the fit of competing measurement models for family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics. In structural models, we regressed a general externalizing dimension on different operationalizations of these variables separately and then simultaneously in a final model. Latent variable operationalizations of family sociodemographic, neighborhood sociodemographic, and neighborhood environment characteristics explained no more variance in broad externalizing psychopathology than other operationalizations. In an omnibus model, family sociodemographic characteristics showed a small association with externalizing psychopathology, while neighborhood sociodemographic and environmental characteristics did not. Family sociodemographic characteristics showed small associations with neighborhood sociodemographic and environmental characteristics, and neighborhood sociodemographic characteristics were moderately associated with neighborhood environment. These findings suggest that family sociodemographic characteristics are more associated with the development of broad externalizing psychopathology in youth than neighborhood sociodemographic characteristics and neighborhood environment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Quasi‐Likelihood Estimation in Volatility Models for Semi‐Continuous Time Series

Time series containing non‐negligible portion of possibly dependent zeros, whereas the remaining observations are positive, are considered. They are regarded as GARCH processes consisting of non‐negative values. Our first aim lies in estimation of the omnibus model parameters taking into account the semi‐continuous distribution. The hurdle distribution together with dependent zeros cause that the classical GARCH estimation techniques fail. Two different quasi‐likelihood approaches are employed. Both estimators are proved to be strongly consistent and asymptotically normal. The second goal consists in the proposed predictions with bootstrap add‐ons. The considered class of models can be reformulated as multiplicative error models. The empirical properties are illustrated in a simulation study, which demonstrates computational efficiency of the employed methods. The developed techniques are presented through an actuarial problem concerning insurance claims.

Clinical Manifestations.

Older adults may experience decreased social support, which has been linked to cognitive decline and increased risk of dementia. Immigrants may also experience more social isolation due to discrimination and fear of deportation. This study examined social networks, nativity status, and neurocognitive functioning(NC) in an ethnoculturally diverse sample of middle/older adults. Participants included 26 immigrants (Mage= 64.12, SD = 5.64) and 109 U.S.-born adults (Mage= 65.37, SD = 7.10). Participants completed a comprehensive NC battery and the Berkman-Syne Social Network Index(SNI; a well-validated self-reported questionnaire assessing close social support, where higher scores represent more social support). Demographically-adjusted norms were used to compute average global NC and domain T-scores. A series of hierarchical multiple regressions were computed to predict global and domain NC T-scores. SNI and age were entered at Step-One, the interaction term(age*SNI) was entered at Step-Two, and nativity status was entered at Step-Three. Results revealed that the omnibus model was significantly associated with Attention/Working Memory(A/WM) (R² = .13; ps = .009) and Processing Speed(PS) (R² = .20; ps = .002). Notably Step-Three of the model significantly contributed to the association of AWM (R²Δ= .11; ps<.05) and PS (R²Δ= .09; ps<.05) beyond Step-One and Step-Two. For A/WM, the interaction term, and nativity status (𝛽s = .04-6.96, respectively; ps<.05) were significantly associated with A/WM. For PS, SNI, the interaction term, and nativity status (𝛽s = -3.91-8.17; ps<.05) were significantly associated with PS. Such that, there is a main effect of nativity status with immigrants scoring lower on measures of A/WM by 6.96 and PS by 8.17 units. Overall, there is a negative association between age and A/WM and PS but as SNI increases the relation between age and NC becomes positive. Only nativity status (𝛽s = 5.99-8.23; ps<.05) significantly predicted Memory, Verbal Fluency, and Global NC functioning scores. Findings show that among middle/older adults, both SNI and nativity status are associated with A/WM and PS, suggesting that a larger SNI can serve as a protective factor against the effects of aging on NC functioning. Importantly, even when SNI and age were not significantly related to NC T-scores, nativity status was. Nativity status likely serves as a proxy for other risk factors (e.g., healthcare access), which should be explored in future studies.

Modelling the kinetics of Staphylococcus aureus in goat's raw milk under different sub-pasteurisation temperatures

In this study, the heat resistance of S. aureus in goats’ raw milk subjected to thermisation temperatures was characterised through tests at various temperatures and modelling the survival curves using the Weibull model, through a two-step and an omnibus approach, which can model a full dataset covering all experimental conditions in one step. The fitting capacity of the secondary models obtained from the two-step approach was reasonable (adj. R2 > 0.639) and both demonstrated the negative linear effects of temperature on χ (p = 0.0004) and β (p = 0.017). The fitting capacity of the omnibus model was more satisfactory (adj. R2 = 0.996) and also hinted at the negative linear effect of temperature on χ (p < 0.0001), with the added advantage that, in this model, random effects can be used to account for the variability in the parameters. Our study estimated the significant inactivation parameters and established a model capable of predicting S. aureus behaviour at various temperatures. This information is useful to create time-temperature tables to reach target log reductions of S. aureus in goats’ raw milk to be used by artisanal cheesemakers; hence providing an opportunity to increase the microbiological safety of cheeses made from unpasteurised milk.

Cannabis Use Frequency and Cannabis-Related Consequences in High-Risk Young Adults Across Cannabis Legalization

A key concern about recreational cannabis legalization is increases in use and adverse consequences, particularly among young adults (aged 18-29 years) who have the highest prevalence of cannabis use, and especially in higher-risk, more vulnerable young adults. However, few longitudinal studies have examined patterns of cannabis consumption in high-risk young adults over the course of legalization. To examine changes in cannabis use frequency and cannabis-related consequences over recreational cannabis legalization in Canada in a longitudinal sample of high-risk young adults. Longitudinal observational cohort study following young adults in Ontario, Canada, aged 19.5 to 23.0 years who reported regular heavy episodic drinking (65% past-month cannabis use) at enrollment. Participants were surveyed every 4 months for 3 years between February 2017 and February 2020 (3 prelegalization waves, 4 postlegalization waves). Data were analyzed from March to May 2023. Recreational cannabis legalization in Canada and 4 potential moderators of change: sex, income, education, and prelegalization cannabis use frequency. Cannabis use frequency and cannabis-related adverse consequences. In a cohort of 619 high-risk young adults (baseline mean [SD] age, 21.0 [1.2] years; 346 female participants [55.9%]), omnibus model testing revealed significant overall decreases in both cannabis use frequency (F = 2.276, 3000.96; P = .03) and cannabis-related consequences (F = 10.436, 3002.21; P < .001) over time, but these changes were substantially moderated by prelegalization frequency (frequency: F = 7.5224, 3021.88; P < .001; consequences: F = 7.2424, 2986.98; P < .001). Follow-up tests showed individuals who used cannabis more frequently prelegalization significantly decreased their use and cannabis-related consequences postlegalization. In contrast, individuals who did not use cannabis prelegalization exhibited a small magnitude increase in frequency over time but nonsignificant changes in cannabis-related consequences. Sex, income, and education did not moderate changes over time. In this cohort study of high-risk young adults, individuals using cannabis frequently prelegalization showed significant reductions in use and consequences over time, reflecting an aging out pattern. Small increases in use among participants with no prelegalization use were observed over time, but without parallel changes in cannabis-related consequences. The results did not reveal substantive adverse near-term outcomes across the legalization period, although a within-participants design cannot rule out the possibility of alternative trajectories in the absence of legalization.

Risk Factors for Tailor Workers with the Incident of Flak Pain at PT X

Flank pain is a type of problem in the musculoskeletal system. This condition causes pain that appears both on the right and on the left, behind the waist, precisely in the area below the ribs and above the pelvis. Back pain is still a problem from the decline in work productivity in various parts of the world. The purpose of this study is to analyze job risk factors, namely length of sitting, sitting position, and length of work and to find the most influential occupational risk factors among the 3 variables. Research method Quantitative research design through a "cross sectional" approach. This researcher uses Simple Random Sampling with obtained as many as 155 respondents. The data analysis technique uses the Logistic Regression test. The results of this study note that the factor of sitting too long is the most influential factor in the incidence of "flank pain". The results showed that of the 155 respondents who were studied by the researchers, 132 respondents (85%) experienced Flak pain. Respondents with a long duration of sitting &gt; 9 hours were 134 respondents (84%), most of the respondents were in a non-ergonomic sitting position of 132 respondents (92%), as many as 100 respondents (59%) had worked &gt; 10 years. Based on the Logistic Regression test based on the omnibus model test, it shows a significance value of p-value = 0.000 &lt;α = 0.05, meaning that H0 is rejected and H1 is accepted, this means that there is a joint effect between the factors of length of work, length of sitting and duration of work on the incidence of flak pain on Toilor at PT X. . Based on the Exp (B) value with the highest Exp (B) value. ) namely 15,808, it can be concluded that the factor that most influences the incidence of flak pain is long sitting. There is a joint influence of long sitting, sitting position, and length of work with the incidence of Flak Pain in Tailors at PT X and It was found that the most dominant factor influencing the incidence of Flak Pain in Tailor workers was long sitting.

The Pathway of Adopting Omnibus Law in Indonesia's Legislation: Challenges and Opportunities in Legal Reform

The omnibus law model has become a new method of legislative drafting in Indonesia, first applied to the Job Creation Law and later enacted as Law 11/2020. While there were no implicit guidelines in Legislative Drafting Law 12/2011, this adoption was imported from several countries like the United States and Ireland to simplify regulations before the method was subsequently formalized and included in Legislative Drafting Law 13/2022. This paper explored the pathway and dynamics of the omnibus law adoption in Indonesia's law-making procedure and analyzed its further impacts on whether such a method has fruitfully improved the quality of the enacted regulation in establishing a more friendly investment policy. Through doctrinal method, this study showed that the opportunity to apply the omnibus model in Indonesia depends on the effectiveness, success, and benefits of respective regulations. In contrast, the application of the omnibus law model should respect democratic principles and avoid public harm. As shown in three different countries, i.e., Indonesia, the United States, and Canada, public concerns on lack of participation should be taken seriously to hinder undemocratic ends through "democratic" means. Alternatively, accountability of the drafting process should be considered a priority. In summary, the increasing trend of adopting the omnibus model should be first adopted and promulgated through legislative products whose promulgation must be with a formidable law-making procedure.

Personality Traits Predict Proximal Goals Among Emerging Adults

Introduction: Individuals often grapple with questions regarding how to accomplish their major life goals. In fact, selecting which goals to pursue is an important developmental task in emerging adulthood 1. Personality traits have been shown to be associated with which major life goals adults pursue 2. Little research, though, has examined whether these associations are present among the proximal goals emerging adults pursue. Methods: The influence of personality traits on goal pursuit of emerging adults was examined, using data from 716 emerging adults (M = 19.32, SD = 1.25) who completed measures regarding proximal goals (e.g., health, socioemotional, spiritual/religious, and cognitive) and the Big Five personality traits. Results: Using SEM, the model fit the data well, χ2 (17, N = 716) = 99.10, p &lt; .001. The overall omnibus model showed that higher neuroticism, openness to experience, and agreeableness contributed to the number of proximal goals emerging adults are currently pursuing. Post hoc analyses showed that different personality traits contributed to the goal domains that emerging adults pursue. Conclusions: Personality may be a factor that enhances or undermines the motivation for the goals that emerging adults pursue 3, 4. Results are discussed in terms of how individual characteristics influence goal pursuit and how such activity might reinforce or further shape personality.

Abnormal Sympathetic Responses To Orthostasis After Concussion Explored Through Blood Pressure Variability

PURPOSE: Orthostasis causes a gravity-dependent redistribution of blood volume to the lower extremities. The baroreflex coordinates an effector response through the sympathetic nervous system (SNS) to the peripheral vasculature to buffer changes in systolic blood pressure (SBP). In autonomic dysfunction (AD), impaired or exaggerated responses may lead to orthostatic hypotension (OHypo) or hypertension (OHTN). AD is becoming an increasingly recognized consequence of an acute concussion injury. The purpose of this study was to evaluate the SNS responses to orthostasis in recently concussed athletes. METHODS: A prospective study was performed in 32 concussed college athletes (gender: 22 female, 10 male; age: 20 ± 1 yrs; height: 1.74 ± 0.11 m; weight: 74 ± 13 kg) and 14 athlete controls (gender: 8 female, 6 male; age: 20 ± 2 yrs; height: 1.70 ± 0.10 m; weight: 69 ± 13 kg). Beat-to-beat SBP was assessed digitally at rest for 10 minutes in the supine (SUP) position and then for 3 minutes in the standing (STND) position within 48 hours (48H) of concussion. The change in SBP (ΔSBP) was computed from the difference between SUP and the final 15 seconds of STND. ΔSBP was then categorized as Normal (NR: ΔSBP -19 to +19 mmHg); OHypo (SBP fall ≥20 mmHg); and, OHTN (SBP rise ≥20 mmHg) for each group. Fast-Fourier transform was performed and power calculated for the total, very low, low and high frequency power (TP, vLF, LF and HF, respectively) spectra in each position; the variables were log10 transformed for parametric analyses. RESULTS: Fourteen control and 14 concussion participants had a NR ΔSBP, whereas 11 concussion participants had OHypo and 7 had OHTN. There were no differences across these four groups for the TP, vLF, LF, and HF in the SUP position. In the STND position, TP (p < 0.0001), vLF (p < 0.0001), and HF (p < 0.05) were significant for the omnibus model. Bonferroni post hoc analyses revealed that the OHypo concussion group had a significantly lower TP and vLF than each of the 3 other groups, and the OHTN concussion group had a significant elevation and trend toward a significant elevation of HF compared to the OHypo and NR concussion groups, respectively. CONCLUSIONS: Different mechanisms appear to contribute to and influence AD during orthostasis within 48H of concussion injury.

Omnibus Modeling of Listeria monocytogenes Growth Rates at Low Temperatures

Listeria monocytogenes is a pathogen of considerable public health importance with a high case fatality. L. monocytogenes can grow at refrigeration temperatures and is of particular concern for ready-to-eat foods that require refrigeration. There is substantial interest in conducting and modeling shelf-life studies on L. monocytogenes, especially relating to storage temperature. Growth model parameters are generally estimated from constant-temperature growth experiments. Traditionally, first-order and second-order modeling (or primary and secondary) of growth data has been done sequentially. However, omnibus modeling, using a mixed-effects nonlinear regression approach, can model a full dataset covering all experimental conditions in one step. This study compared omnibus modeling to conventional sequential first-order/second-order modeling of growth data for five strains of L. monocytogenes. The omnibus model coupled a Huang primary model for growth with secondary models for growth rate and lag phase duration. First-order modeling indicated there were small significant differences in growth rate depending on the strain at all temperatures. Omnibus modeling indicated smaller differences. Overall, there was broad agreement between the estimates of growth rate obtained by the first-order and omnibus modeling. Through an appropriate choice of fixed and random effects incorporated in the omnibus model, potential errors in a dataset from one environmental condition can be identified and explored.

Evaluating Restrictive Models in Educational and Behavioral Research: Local Misfit Overrides Model Tenability.

The frequent practice of overall fit evaluation for latent variable models in educational and behavioral research is reconsidered. It is argued that since overall plausibility does not imply local plausibility and is only necessary for the latter, local misfit should be considered a sufficient condition for model rejection, even in the case of omnibus model tenability. The argument is exemplified with a comparison of the widely used one-parameter and two-parameter logistic models. A theoretically and practically relevant setting illustrates how discounting local fit and concentrating instead on overall model fit may lead to incorrect model selection, even if a popular information criterion is also employed. The article concludes with the recommendation for routine examination of particular parameter constraints within latent variable models as part of their fit evaluation.

Factors Influencing 30‐Day Readmission to the Hospital during Home Health Services

Research ObjectiveOur purpose was to investigate agency‐level and clinical variables that influence 30‐day hospital readmissions during home health (HH) services. The objective was exploration of variables that predict or protect against 30‐day hospital readmission, from real‐world HH operations data.Study DesignThis retrospective cohort study used one, northern California HH agency’s de‐identified electronic health record to investigate variables relating to 30‐day hospital readmissions during HH services. Binary logistic regression was used to build the most parsimoniously fitted model, with no more than 3 predictors in the model due to sample size. Fit criteria included statistical significance of predictors, little multicollinearity among the predictors, a significant omnibus model test, a nonsignificant Hosmer‐Lemeshow statistic for goodness of fit, and clinical meaningfulness of the predictors to benefit HH organizations in their attempts to reduce preventable 30‐day readmissions. t tests and chi‐square tests were used to compare characteristics differentiating readmission and nonreadmission cohorts.Population StudiedThe final, eligible sample consisted of 130 discharged patients seen between July 2016 and January 2018; 55 patients had a 30‐day hospital readmission and 75 patients did not have a 30‐day hospital readmission during HH services.Principal FindingsA significant model emerged with two variables associated with risk, and one variable protective against, 30‐day hospital readmission during HH services: 1) full code status designation (AOR = 3.324, P = .004); 2) the difference between nursing visits made and ordered (AOR = 0.779, P = .000); 3) speech ability (the M1230 OASIS form item for HH developed by the Centers for Medicare and Medicaid services) (AOR = 1.621, P = .031). Patients with full code status designations in place were more than 3 times more likely to have a readmission to the hospital within 30 days of starting HH services than those with DNR and no code status recorded combined. Patients with 30‐day readmission had significantly fewer nursing visits than originally ordered at the beginning of their HH episode, than patients without 30‐day hospital readmission (t = ‐3.374, P = 0.001). For every one more nursing visit made, there was a 22% lesser chance for a patient to experience 30‐day hospital readmission during their HH service. The proportion of patients having experienced 30‐day hospital readmission during HH services were scored as having significantly more speech disability than the proportion of patients not having experienced 30‐day hospital readmission during HH services (χ2 = 11.124, P = .025). In regression, for every incremental increase in severity of speech disability as scored on the OASIS M1230, patients were 1.6 times more likely to experience a 30‐day hospital readmission during their HH service than patients with less severe speech disability.ConclusionsHH agencies can potentially improve quality to reduce 30‐day hospital readmissions, by adhering to nursing visits, and care planning with patients/families to reduce risks of readmission such as speech disability and full code designation.Implications for policy or practiceFuture studies can validate these predictor variables and increase sample size and generalizability through more HH study sites. Quality improvement activities in HH agencies can enhance reduction of 30‐day hospital readmission during HH services by focusing on risks and protectors of readmission.

Omnibus Model Checks of Linear Assumptions through Distance Covariance

Omnibus Model Checks of Linear Assumptions through Distance Covariance

Community Model - A New Data Fusion Filter Paradigm

Data fusion is an important area in different fields of applications as it provides a detailed analysis of the data store which helps in analytics and decision support system. Among the numerous Data Fusion models available in literature, the six pioneer pieces of work in terms of Data Fusion Models are – Waterfall Model, Multisensor Integration Fusion Model, Behavioral Knowledge-based Data Fusion Model, Omnibus Model, Dasarathy Model and JDL Model. In this paper, we have given a comparative study of the above models based on basic features like signalling overhead, power consumption, fault tolerance, survivability and robustness facilities subsequently. Here, a new improved model, named Community Model has been proposed for better throughput in terms of Data Transmission Time (DTT). This model can be applied to any number of filter levels irrespective of application areas.

Alcohol Use and Clinical Outcomes in Adults in the Type 1 Diabetes Exchange

ObjectivesAlcohol consumption has serious potential consequences for persons with type 1 diabetes. This cross-sectional study examined associations between drinking status and diabetes-related outcomes. MethodsParticipants included 934 adults at Type 1 Diabetes Exchange Registry clinics who responded to an e-mail invitation to complete an electronic survey with items on alcohol consumption; glycated hemoglobin (A1C) and body mass index (BMI) were extracted from medical charts. Participants were an average 38±16 years of age, 61% were women and 90% were non-Hispanic white; A1C was 7.8%±1.5%. The sample was made up of 11% (n=103) never drinkers, 9% (n=89) former drinkers, 61% (n=567) current (past year) nonbinge drinkers and 19% (n=174) current binge drinkers. ResultsAfter controlling for covariates, diabetes distress was lower among never drinkers compared with former and nonbinge drinkers (p<0.009). Never drinkers compared with former drinkers had lower odds of past-year severe hypoglycemia (p=0.001) and lower odds of a neuropathy diagnoses (p=0.006). There were omnibus model trends toward associations between drinking status and diabetes self-care (p=0.10) and between drinking status and BMI (p=0.06). Never drinkers did not differ from other groups on daily frequency of blood glucose self-monitoring, A1C or past-year diabetic ketoacidosis (p>0.05). ConclusionsThese results suggest complex relationships between drinking and diabetes-related distress, and that recent severe hypoglycemia and the presence of neuropathy may motivate some to stop drinking. Prospective studies may improve understanding of these findings.

PENGUNGKAPAN CORPORATE GOVERNANCE TERHADAP INDIKASI FRAUD DALAM PELAPORAN KEUANGAN

Pada penelitian ini memiliki tujuan yaitu untuk mengetahui pengaruh pengungkapan corporate governance yang meliputi dewan komisaris (BOC), komisaris independen (BOC_IND), komite audit (AC), audit internal (IA) dan KAP big four terhadap indikasi fraud dalam pelaporan keuangan. Populasi pada penelitian ini adalah perusahaan sektor keuangan non bank yang terdaftar di Bursa Efek Indonesia dari tahun 2016-2018. Teknik pengambilan sampel menggunakan purposive sampling sebanyak 108 perusahaan. Metode analisis data menggunakan regresi logistik dengan memperhatikan uji kelayakan model (goodness of fit test) melalui Hosmer and Lameshow test, pengujian model secara simultan yaitu menggunakan Omnibus Test of Model Coefficient, dan uji hipotesis melalui nilai variable in the equation. Hasil penelitian menunjukan bahwa dewan komisaris (BOC) dan KAP big four memiliki pengaruh positif dan signifikan terhadap indikasi fraud dalam pelaporan keuangan. Sedangkan untuk variabel komisaris independen (BOC_IND) memiliki pengaruh negatif dan signifikan terhadap indikasi fraud. Pada variabel komite audit (AC) dan audit internal (IA) tidak memiliki pengaruh terhadap indikasi fraud dalam pelaporan keuangan

Suicidal Ideation among Veterans Living with Cancer Referred to Mental Health

ABSTRACTObjectives: Eliminating Veteran suicide is a top priority for the Department of Veterans’ Affairs (VA). This study identified factors associated with suicidal ideation (SI) among a rarely studied subgroup of Veterans: those with cancer.Methods: Veterans (age M = 61.83) with cancer (N= 175) referred for psychological evaluation completed measures of pain, sleep, depressive, anxiety, and PTSD symptoms. SI was defined by endorsing on paper-and-pencil questionnaire thoughts of killing oneself in the past 2 weeks or during clinical interview.Results: 25.1% reported SI. Compared to those without SI, Veterans with SI had higher ratings on measures of depression, anxiety, and PTSD symptoms. History of suicide attempt(s) was included in the model due to clinical significance. Logistic regression was performed with these variables as predictors of SI. The omnibus model was significant (p< .001). However, only anhedonia and depressed mood had a statistically significant contribution to the model (β = 0.540, p= .001).Conclusions: Anhedonia and depressed mood predicted SI among Veterans with cancer above and beyond other risk factors.Clinical Implications: This study’s findings highlight the importance of incorporating suicide risk screenings in oncology clinics across VA medical centers.

“Obesity Paradox” Evident in the Relationship between Cognitive Function and Hospitalizations in Heart Failure Patients: A Pilot Study

Heart failure (HF) is one of the leading causes of hospitalization and readmission. Given the chronicity of HF, it is critically important to identify risk factors for repeated hospitalizations. Both cognitive dysfunction and obesity are prevalent in HF, and each have been shown to independently be related to hospitalizations. However, while elevated body mass index (BMI) is linked to cognitive dysfunction in HF, how BMI and cognition interact to predict clinical endpoints in HF is unknown. We aimed to explore the retrospective association between BMI, cognitive performance, and 6-month hospitalization rates. As a part of a pilot program to incorporate cognitive and behavioral health screening into regular HF outpatient treatment, 28 participants completed the Montreal Cognitive Assessment (MoCA) and provided demographic and medical information during a routine cardiology visit. Number of inpatient hospitalizations over the previous 6 months was regressed on BMI, MoCA score, and their interaction, adjusting for age and severity of HF. The omnibus model significantly predicted hospitalization (F = 3.56, p = 0.02). The interaction of BMI and MoCA score was related to number of hospitalizations at a trend level (β = 0.016, t(20) = 1.8, p = 0.087), controlling for age and New York Heart Class. Participants with lower BMI demonstrated a negative association between cognitive performance and hospitalizations, such that lower cognitive function, is associated with a greater number of hospitalization in the prior six months. Participants with higher BMIs did not demonstrate this relationship between MoCA score and hospitalization. Our findings are consistent with research suggesting an “obesity paradox” among HF patients. It is unclear whether the interaction of BMI and cognitive dysfunction influences risk for hospitalization, or if hospitalization influences subsequent cognitive function, depending on BMI. Further research is necessary to explore predictors of hospitalizations prospectively. However, these data demonstrate the need for regular cognitive screening in the HF outpatient setting to ensure appropriate coordination of care.

Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset

BackgroundAdolescence is characterized by developmental changes in social relationships, which may contribute to, or protect against, psychopathology and risky behaviors. Non-suicidal self-injury (NSSI) is one type of risky behavior that typically begins during adolescence and is associated with problems in relationships with family members and peers. Prior research on social factors in adolescent NSSI has been limited, however, by a narrow focus on specific interpersonal domains, cross-sectional methods, retrospective self-report of childhood experiences, and a failure to predict NSSI onset among as-yet-unaffected youth.MethodsWe investigated these relationships in 2127 urban-living adolescent girls with no NSSI history at age 13, who were participating in a longitudinal cohort study (Pittsburgh Girls Study). We used discrete-time survival analyses to examine the contribution of time-varying interpersonal risk factors, assessed yearly at ages 13–16, to NSSI onset assessed in the following year (ages 14–17), controlling for relevant covariates, such as depression and race. We considered both behavioral indicators (parental discipline, positive parenting, parental monitoring, peer victimization), and cognitive/affective indicators (quality of attachment to parent, perceptions of peers, and perceptions of one’s own social competence and worth in relation to peers) of interpersonal difficulties.ResultsParental harsh punishment, low parental monitoring, and poor quality of attachment to parent predicted increased odds of subsequent adolescent NSSI onset, whereas positive parenting behaviors reduced the odds of next year NSSI onset. Youth who reported more frequent peer victimization, poorer social self-worth and self-competence, and more negative perceptions of peers were also at increased risk of NSSI onset in the following year. When tested simultaneously, no single parenting variable showed a unique association with later NSSI onset; in contrast, peer victimization and poor social self-worth each predicted increased odds of later NSSI onset in an omnibus model of peer and parent relationship characteristics.ConclusionsIn this urban sample of adolescent girls, both peer and parent factors predicted new onset NSSI, although only peer factors were associated with subsequent NSSI in combined multivariate models. Results further suggest that both behavioral and cognitive/affective indicators of interpersonal problems predict NSSI onset. These findings highlight the relevance of family and peer relationships to NSSI onset, with implications for prevention of NSSI onset among at-risk youth.