Representative Sample Research Articles

The relation between peritraumatic dissociation and coping strategies: A network analysis.

Peritraumatic dissociation (PD) and coping strategies (CS) around the time of trauma are significant predictors of acute and long-term posttraumatic symptomatology (PTS), but it is unclear how they relate to each other. The aim of this study was to examine their association using a nationwide, representative sample following the September 11 attacks in the United States (N = 3,134). We used exploratory and confirmatory network analyses to estimate reliable associations between PD and CS, as well as looking at those variables as predictors of PTS at 2, 6, and 12 months after the attack. Analyses showed that: (a) PD formed 3 factors (alterations of consciousness, depersonalization, and compartmentalization) distinct from coping strategies; (b) PD related only to some CS; (c) coping through denial had a particularly strong link to alterations of consciousness among adults. Both altered consciousness and denial predicted PTS significantly 2, 6, and 12 months after the attack, with altered consciousness being the stronger predictor (and a better predictor of PTS than other types of PD). For teens, the only significant link between PD and CS was for compartmentalization and substance abuse. PD and CS were related in adults and contributed independently to later PTS. Future research should evaluate longitudinally the interactions between specific types of PD and CS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association between acquiring SARS-CoV-2 during pregnancy and post-acute sequelae of SARS-CoV-2 infection: RECOVER electronic health record cohort analysis

Little is known about post-acute sequelae of SARS-CoV-2 infection (PASC) after acquiring SARS-CoV-2 infection during pregnancy. We aimed to evaluate the association between acquiring SARS-CoV-2 during pregnancy compared with acquiring SARS-CoV-2 outside of pregnancy and the development of PASC. This retrospective cohort study from the Researching COVID to Enhance Recovery (RECOVER) Initiative Patient-Centred Clinical Research Network (PCORnet) used electronic health record (EHR) data from 19 U.S. health systems. Females aged 18-49 years with lab-confirmed SARS-CoV-2 infection from March 2020 through June 2022 were included. Validated algorithms were used to identify pregnancies with a delivery at >20 weeks' gestation. The primary outcome was PASC, as previously defined by computable phenotype in the adult non-pregnant PCORnet EHR dataset, identified 30-180 days post-SARS-CoV-2 infection. Secondary outcomes were the 24 component diagnoses contributing to the PASC phenotype definition. Univariable comparisons were made for baseline characteristics between individuals with SARS-CoV-2 infection acquired during pregnancy compared with outside of pregnancy. Using inverse probability of treatment weighting to adjust for baseline differences, the association between SARS-CoV-2 infection acquired during pregnancy and the selected outcomes was modelled. The incident risk is reported as the adjusted hazard ratio (aHR) with 95% confidence intervals. In total, 83,915 females with SARS-CoV-2 infection acquired outside of pregnancy and 5397 females withSARS-CoV-2 infection acquired during pregnancy were included in analysis. Non-pregnant females with SARS-CoV-2 infection were more likely to be older and have comorbid health conditions. SARS-CoV-2 infection acquired in pregnancy as compared with acquired outside of pregnancy was associated with a lower incidence of PASC (25.5% vs 33.9%; aHR 0.85, 95% CI 0.80-0.91). SARS-CoV-2 infection acquired in pregnant females was associated with increased risk for some PASC component diagnoses including abnormal heartbeat (aHR 1.67, 95% CI 1.43-1.94), abdominal pain (aHR 1.34, 95% CI 1.16-1.55), and thromboembolism (aHR 1.88, 95% CI 1.17-3.04), but decreased risk for other diagnoses including malaise (aHR 0.35, 95% CI 0.27-0.47), pharyngitis (aHR 0.36, 95% CI 0.26-0.48) and cognitive problems (aHR 0.39, 95% CI 0.27-0.56). SARS-CoV-2 infection acquired during pregnancy was associated with lower risk of development of PASC at 30-180 days after incident SARS-CoV-2 infection in this nationally representative sample. These findings may be used to counsel pregnant and pregnant capable individuals, and direct future prospective study. National Institutes of Health (NIH) Other Transaction Agreement (OTA) OT2HL16184.

Population assessment of health system performance in 16 countries.

To demonstrate how the new internationally comparable instrument, the People's Voice Survey, can be used to contribute the perspective of the population in assessing health system performance in countries of all levels of income. We surveyed representative samples of populations in 16 low-, middle- and high-income countries on health-care utilization, experience and confidence during 2022-2023. We summarized and visualized data corresponding to the key domains of the World Health Organization universal health coverage framework for health system performance assessment. We examined correlation with per capita health spending by calculating Pearson coefficients, and within-country income-based inequities using the slope index of inequality. In the domain of care effectiveness, we found major gaps in health screenings and endorsement of public primary care. Only one in three respondents reported very good user experience during health visits, with lower proportions in low-income countries. Access to health care was rated highest of all domains; however, only half of the populations felt secure that they could access and afford high-quality care if they became ill. Populations rated the quality of private health systems higher than that of public health systems in most countries. Only half of respondents felt involved in decision-making (less in high-income countries). Within countries, we found statistically significant pro-rich inequalities across many indicators. Populations can provide vital information about the real-world function of health systems, complementing other system performance metrics. Population-wide surveys such as the People's Voice Survey should become part of regular health system performance assessments.

Assessing prevalence, validity, and correlates of ICD-11 posttraumatic stress disorder and complex posttraumatic stress disorder in Ireland.

The most frequently used measure of the 11th edition of the International Classification of Diseases (ICD-11) complex posttraumatic stress disorder (CPTSD) is the International Trauma Questionnaire (ITQ). While there is strong support for the psychometric properties of the ITQ, few studies have assessed its reliability and validity in nationally representative samples. Additionally, several correlates of ICD-11 CPTSD have been identified; however, few studies have assessed multiple correlates simultaneously. To assess the factorial validity and internal reliability of the ITQ in a nationally representative sample of adults living in Ireland (N = 1,100); determine the prevalence rates of ICD-11 posttraumatic stress disorder (PTSD) and CPTSD; and identify correlates of CPTSD symptoms and how CPTSD symptoms relate to risk of suicide. Confirmatory factor analysis was performed to evaluate the factorial validity of the ITQ, and structural equation modeling (SEM) was used to determine the unique multivariate associations between 10 predictor variables (age, sex, urban dwelling, unemployment status, number of traumatic events, COVID-19 infection, knowing someone who died from COVID-19, loneliness, social support, and sleep problems) and symptoms of CPTSD, and the unique associations between CPTSD symptoms and suicide risk. The ITQ produces reliable and valid scores, 11.2% of people met requirements for ICD-11 PTSD (2.4%) or CPTSD (8.8%), exposure to a higher number of traumatic life events, higher levels of loneliness, and more sleep problems predicted CPTSD symptoms; and negative self-concept (NSC) symptoms were most strongly associated with suicidality. Where the risk of suicide is high, treating symptoms of NSC, loneliness, and sleep problems may be advisable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Mediating Role of Perceived Investment in Employee Development in the Relationship between Transformational Leadership and Task Performance among First-Line Managers in the Banking Sector

The Multiple leadership studies have established a connection between transformational leadership behaviors and the achievement of individual, team, and corporate success. The correlation between transformative leadership and followers' task performance remains ambiguous across many contexts and levels of analysis. Multiple variables and methodologies can influence the correlation. This study examined the impact of transformational leadership on the task performance of banking professionals. The concept of Perceived Investment in Employee Development (PIED) was introduced as a potential mediator between transformational leadership and employee task performance. The suggested approach was evaluated using a representative sample of 449 individuals from six Palestinian banks. The model was tested using Partial Least Squares (PLS)-based structural equation Modelling (SEM). The SmartPLS analyses demonstrated a positive relationship between perceived transformational leadership and task performance. These data further validated the concept of mediation. Furthermore, this study examines the theoretical and practical consequences, constraints, and recommendations for future research.

Attenuation of the effect of salinity on redwood (Caesalpinia platyloba) by saline compost

The objective of this research is to evaluate the effect of saline compost on the attenuation of salinity stress in palo colorado (Caesalpinia platyloba). A representative sample of saline soil was taken at Ciudad Universitaria Intercultural, sieved (mesh < 5mm) and composted with cattle manure and Cynodon dactylon garden grass pruning, in a 3:1:1 ratio (stubble: manure: saline soil), for 120 days, the characterization consisted of measuring the bulk density (DA), saturation point, pH and EC of the saturated paste extract. The effect of different concentrations of NaCl on the in vitro germination of palo colorado seeds was evaluated in a randomized complete block design with two substrates (blocks), B1) sand-perlite; B2) sand-perlite-salt compost, five treatments 0 M, 0.3 M, 0.4 M, 0.5 M and 0.6 M of NaCl, eight replicates per treatment. The control irrigation was with distilled water. The plants transference to polyethylene cups was fifteen days after sowing; the cups had the same substrate mixture. The variables measured were survival, leaf biomass and dry root biomass. The EC decreased during composting, from 9.45 dS/m low to 2.4 dS/m; the pH of the samples did not show a significant difference. It is concluded that neither the substrate nor the NaCl concentration significantly influenced the germination of palo colorado seeds, and that the saline compost had no effect on the mitigation of salt stress in palo colorado plants.

Prevalence of celebrity worship: Development and application of the short version of the Celebrity Attitude Scale (CAS-7) on a large-scale representative sample.

Celebrity worship, defined as an excessive admiration towards celebrities, has generated considerable research and public interest. A widely used assessment instrument to measure celebrity worship is the 23-item Celebrity Attitude Scale. However, concerns have been raised regarding the measurement, including the inconsistent factor structure and lack of a cut-off point to identify "celebrity worshipers". The present study aims to address these concerns by testing the psychometric appropriateness of a short, 7-item version of the CAS (i.e., CAS-7) and estimating the prevalence of individuals with high-level celebrity admiration using a representative sample of Hungarian adults (between 18 and 64 years of age) according to gender, age, geographic location, and size of residence. The total sample comprised 2028 respondents, of which 769 valid responses were administered from participants who reported having a favorite celebrity (51.11% men, Mage = 36.38 years, SD = 13.36). Results indicated an excellent model fit for the two-factor and bifactor model of the CAS-7. Based on the suggested cut-off score of 26, the prevalence of high-level celebrity admiration is 4.53% in the Hungarian adult population (18-64 years of age) and 8.51% among young adults (18-34 years of age). Individuals with this high level of admiration towards a favorite celebrity reported more symptoms of problematic Internet use, depression, anxiety, and stress than individuals with general celebrity admiration levels. TheCAS-7 demonstrated sound psychometric properties, confirming its applicability in research and practice.

Metformin use correlated with lower risk of cardiometabolic diseases and related mortality among US cancer survivors: evidence from a nationally representative cohort study

BackgroundIn the USA, the prolonged effective survival of cancer population has brought significant attention to the rising risk of cardiometabolic morbidity and mortality in this population. This heightened risk underscores the urgent need for research into effective pharmacological interventions for cancer survivors. Notably, metformin, a well-known metabolic regulator with pleiotropic effects, has shown protective effects against cardiometabolic disorders in diabetic individuals. Despite these promising indications, evidence supporting its efficacy in improving cardiometabolic outcomes in cancer survivors remains scarce.MethodsA prospective cohort was established using a nationally representative sample of cancer survivors enrolled in the US National Health and Nutrition Examination Survey (NHANES), spanning 2003 to 2018. Outcomes were derived from patient interviews, physical examinations, and public-access linked mortality archives up to 2019. The Oxidative Balance Score was utilized to assess participants’ levels of oxidative stress. To evaluate the correlations between metformin use and the risk of cardiometabolic diseases and related mortality, survival analysis of cardiometabolic mortality was performed by Cox proportional hazards model, and cross-sectional analysis of cardiometabolic diseases outcomes was performed using logistic regression models. Interaction analyses were conducted to explore the specific pharmacological mechanism of metformin.ResultsAmong 3995 cancer survivors (weighted population, 21,671,061, weighted mean [SE] age, 62.62 [0.33] years; 2119 [53.04%] females; 2727 [68.26%] Non-Hispanic White individuals), 448 reported metformin usage. During the follow-up period of up to 17 years (median, 6.42 years), there were 1233 recorded deaths, including 481 deaths from cardiometabolic causes. Multivariable models indicated that metformin use was associated with a lower risk of all-cause (hazard ratio [HR], 0.62; 95% confidence interval [CI], 0.47–0.81) and cardiometabolic (HR, 0.65; 95% CI, 0.44–0.97) mortality compared with metformin nonusers. Metformin use was also correlated with a lower risk of total cardiovascular disease (odds ratio [OR], 0.41; 95% CI, 0.28–0.59), stroke (OR, 0.44; 95% CI, 0.26–0.74), hypertension (OR, 0.27; 95% CI, 0.14–0.52), and coronary heart disease (OR, 0.41; 95% CI, 0.21–0.78). The observed inverse associations were consistent across subgroup analyses in four specific cancer populations identified as cardiometabolic high-risk groups. Interaction analyses suggested that metformin use as compared to non-use may counter-balance oxidative stress.ConclusionsIn this cohort study involving a nationally representative population of US cancer survivors, metformin use was significantly correlated with a lower risk of cardiometabolic diseases, all-cause mortality, and cardiometabolic mortality.

“Mapping Out” Sustainable Social Farming Paths in Italian Municipalities

Social farming in Italy has not developed homogeneously. In view of this, this article adopts a multivariate analysis approach to analyse the heterogeneity and the similarities in the development paths of social farming in Italian municipalities. The article takes into account the information from a representative sample of 410 interviews. The results suggest that the offer of social farming activities is highly correlated with the distinct nature of the enterprises and with the interest of local actors, who in many cases finance these activities. Regarding the characteristics of social farms, the results of principal component analysis show that the consolidated experience of offering social services and the continuation of activities are the most important organisational elements. Concerning the territorial distribution, the findings of a hierarchical cluster analysis show that Italian municipalities have distinct experiences according to the level of maturity of the social farms in each cluster, with differences in location, the agricultural system, the organisational culture and the social services provided. Assessing enterprise characteristics and recent development paths for social services in Italy can have far-reaching implications for policy. The latter should provide information and training to farmers and users to increase understanding of the social value of social farming and foster a collaborative and sustainable approach to social farming practice.

Live from Here: Comparing the Programming of Rural and Urban Public Radio Stations

ABSTRACT This paper is an examination of the vitality of U.S. public radio stations in rural areas. Previous empirical research suggests that the increased presence of commercial underwriting and listener donations (collectively referred to as “listener sensitive income”) has influenced National Public Radio and its local affiliate stations to behave in a way that more closely resembles commercial radio. This shift may have come at the expense of the initial intent and mission of public broadcasting which is to add diversity to the marketplace of ideas, serve underserved audiences, and most relevant to this study, provide a service that is reflective of local communities. This study analyzes data from a nationally representative sample (N = 178) of the 408 unique local NPR stations to determine if greater reliance on market-based funding sources is associated with a shift away from the mission of public radio in terms of its programming. The analysis suggested that rural public stations offer more overall diversity of programming, and specifically are more likely to offer minority-oriented programming, thus suggesting that rural stations have not become as commercialized as their urban counterparts.

Self-reported sensory impairment and social participation among Korean older adults: mediating roles of cognitive function and digital technology use

Objectives This study investigates the correlation between self-reported sensory impairment, cognitive function, digital technology use, and social participation among older adults in South Korea. Method Data from the 2020 National Survey of Older Koreans, comprising a nationally representative sample of 7849 individuals aged 65 years or older, were analyzed. A serial mediation analysis (Model = 6) was conducted using the PROCESS macro for SPSS. Results Following adjustment for covariates, cognitive function and digital technology use serially mediated the relationship between self-reported sensory impairment and social participation among older adults (B = −0.0020, SE = 0.0005, 95% confidence interval [CI] = [−0.0030, −0.0010]). Specifically, self-reported sensory impairment exhibited a negative correlation with cognitive function (B = −0.3277, SE = 0.0753, p < .001), which was positively associated with digital technology use (B = 0.0763, SE = 0.0056, p < .001), subsequently linking to enhanced social participation (B = 0.0784, SE = 0.0037, p < .001). Conclusion Through cross-sectional analysis, this study confirms that self-reported sensory impairment in older adults may precede cognitive decline, hindering digital technology use and reducing social participation. Early diagnosis and treatment are crucial in preventing cognitive decline, while age-friendly digital devices may alleviate cognitive burden and promote social engagement.

Four dimensions of naturalistic language production in aphasia after stroke.

There is a rich tradition of research on the neuroanatomical correlates of spoken language production in aphasia using constrained tasks (e.g., picture naming), which offer controlled insights into the distinct processes that govern speech and language (i.e., lexical-semantic access, morphosyntactic construction, phonological encoding, speech motor programming/execution). Yet these tasks do not necessarily reflect everyday language use. In contrast, naturalistic language production (also referred to as connected speech or discourse) more closely approximates typical processing demands, requiring the dynamic integration of all aspects of speech and language. The brain bases of naturalistic language production remain relatively unknown, however, in part because of the difficulty in deriving features that are salient, quantifiable, and interpretable relative to both speech-language processes and the extant literature. The present cross-sectional observational study seeks to address these challenges by leveraging a validated and comprehensive auditory-perceptual measurement system that yields four explanatory dimensions of performance-Paraphasia (misselection of words and sounds), Logopenia (paucity of words), Agrammatism (grammatical omissions), and Motor speech (impaired speech motor programming/execution). We used this system to characterize naturalistic language production in a large and representative sample of individuals with acute post-stroke aphasia (n = 118). Scores on each of the four dimensions were correlated with lesion metrics, and multivariate associations among the dimensions and brain regions were then explored. Our findings revealed distinct yet overlapping neuroanatomical correlates throughout the left-hemisphere language network. Paraphasia and Logopenia were associated primarily with posterior regions, spanning both dorsal and ventral streams, which are critical for lexical-semantic access and phonological encoding. In contrast, Agrammatism and Motor speech were associated primarily with anterior regions of the dorsal stream that are involved in morphosyntactic construction and speech motor planning/execution respectively. Collectively, we view these results as constituting a brain-behavior model of naturalistic language production in aphasia, aligning with both historical and contemporary accounts of the neurobiology of spoken language production.

A Performance Comparison of 3D Survey Instruments for Their Application in the Cultural Heritage Field.

Thanks to the recent development of innovative instruments and software with high accuracy and resolution, 3D modelling provides useful insights in several sectors (from industrial metrology to cultural heritage). Moreover, the 3D reconstruction of objects of artistic interest is becoming mandatory, not only because of the risks to which works of art are increasingly exposed (e.g., wars and climatic disasters) but also because of the leading role that the virtual fruition of art is taking. In this work, we compared the performance of four 3D instruments based on different working principles and techniques (laser micro-profilometry, structured-light topography and the phase-shifting method) by measuring four samples of different sizes, dimensions and surface characteristics. We aimed to assess the capabilities and limitations of these instruments to verify their accuracy and the technical specifications given in the suppliers' data sheets. To this end, we calculated the point densities and extracted several profiles from the models to evaluate both their lateral (XY) and axial (Z) resolution. A comparison between the nominal resolution values and those calculated on samples representative of cultural artefacts was used to predict the performance of the instruments in real case studies. Overall, the purpose of this comparison is to provide a quantitative assessment of the performance of the instruments that allows for their correct application to works of art according to their specific characteristics.

Data sharing in academic publications: The case of education journals

While there is a rich literature reporting the prevalence of data sharing in many academic disciplines, and particularly STEM-related ones, the extent of data sharing in journals in Social Science fields has been subject to only little empirical enquiry, hitherto. Focusing on a particular Social Science discipline, Education, this research examines empirically two related issues associated with data sharing in Education. First, journal data sharing policies were scrutinized via a search of the websites of 47 randomly selected Education journals. Over half of the journals in the representative sample had issued statements on websites encouraging authors to make the data underlying published research, generally available to the academic community, though only a handful of journals make such sharing mandatory. Thus, while the importance of data sharing is well recognized by journals in the Education field, a sizeable minority seems not to have taken a stand on this issue. The second issue related to the efficacy of the positive stance taken by journals, in eliciting the desired response from authors, leading to the sharing of their data. This was probed in a limited, mainly qualitative, survey of the authors of papers published in journals that encouraged data sharing through their websites. It was found that not a single author had made data available – indeed, some authors were even unaware of the journal’s policy on this matter. Thus, journals’ well-intentioned procedures to encourage greater data sharing are seen to be markedly ineffective. Two main sets of reasons were offered to justify author reticence to data share: either authors did not regard it as being in their interest or data sharing was seen to be inappropriate or not possible for the data set in question. However, these fears relating to engaging in data sharing may not necessarily present insurmountable barriers to its wider adoption, as measures are available to circumvent, at least partially, or to meliorate their effect.

The Use of Artificial Intelligence for Skin Disease Diagnosis in Primary Care Settings: A Systematic Review.

The prevalence of dermatological conditions in primary care, coupled with challenges such as dermatologist shortages and rising consultation costs, highlights the need for innovative solutions. Artificial intelligence (AI) holds promise for improving the diagnostic analysis of skin lesion images, potentially enhancing patient care in primary settings. This systematic review following PRISMA guidelines examined primary studies (2012-2022) assessing AI algorithms' diagnostic accuracy for skin diseases in primary care. Studies were screened for eligibility based on their availability in the English language and exclusion criteria, with risk of bias evaluated using QUADAS-2. PubMed, Scopus, and Web of Science were searched. Fifteen studies (2019-2022), primarily from Europe and the USA, focusing on diagnostic accuracy were included. Sensitivity ranged from 58% to 96.1%, with accuracies varying from 0.41 to 0.93. AI applications encompassed triage and diagnostic support across diverse skin conditions in primary care settings, involving both patients and primary care professionals. While AI demonstrates potential for enhancing the accuracy of skin disease diagnostics in primary care, further research is imperative to address study heterogeneity and ensure algorithm reliability across diverse populations. Future investigations should prioritise robust dataset development and consider representative patient samples. Overall, AI may improve dermatological diagnosis in primary care, but careful consideration of algorithm limitations and implementation strategies is required.

Associations between circadian alignment and cognitive functioning in a nationally representative sample of older adults

Proper alignment of activity-rest and light–dark patterns allows for healthy bodily functions to occur at optimal times of the day. Disruptions to this alignment may cause poor sleep as well as physical, mental, and cognitive problems. The purpose of this cross-sectional study was to determine if poorer circadian alignment was associated with decreased cognitive functioning among older (> 60 years) participants in the National Health and Nutrition Examination Survey. We utilized actigraphy-based rest-activity and dark-light measurements to calculate phasor magnitude (strength of circadian alignment coupling) and phasor angle (phase difference between activity-rest and light–dark cycles). Multiple linear regression models were used to determine associations of phasor magnitude and angle with performance in various cognitive tests, including Digit Symbol Substitution Test score (DSSS), CERAD Savings Percentage (CSP), and Animal Fluency Test (AFT) score. The results showed that a lower phasor magnitude (which indicates decreased strength of alignment coupling between rest-activity and dark–light cycles) was significantly associated with decreased DSSS (indicating slower processing speed and poorer working memory) when controlling for many important sociodemographic factors. However, this association became non-significant when accounting for sleep duration and total physical activity. Phasor angle did not have a significant association with any of the cognitive scores. Overall, we provided evidence indicating that circadian alignment may be a predictor of cognitive performance. Future studies should investigate whether improving circadian alignment may improve cognitive function and prevent cognitive decline.

Intimate Partner Violence Effects on Children’s Academic Achievement: Results from a Nationally Representative Sample

Intimate Partner Violence Effects on Children’s Academic Achievement: Results from a Nationally Representative Sample

A simulation study of sampling in difficult settings: Statistical superiority of a little-used method

Taking a representative sample to determine prevalence of variables such as disease or vaccination in a population presents challenges, especially when little is known about the population. Several methods have been proposed for second stage cluster sampling. They include random sampling in small areas (the approach used in several international surveys), random walks within a specified geographic area, and using a grid superimposed on a map. We constructed 50 virtual populations with varying characteristics, such as overall prevalence of disease and variability of population density across towns. Each population comprised about a million people spread over 300 towns. We applied ten sampling methods to each. In 1,000 simulations, with different sample sizes per cluster, we estimated the prevalence of disease and the relative risk of disease given an exposure and calculated the Root Mean Squared Error (RMSE) of these estimates. We compared the sampling methods using the RMSEs. In our simulations a grid method was the best statistically in the great majority of circumstances. It showed less susceptibility to clustering effects, likely because it sampled over a much wider area than the other methods. We discuss the findings in relation to practical sampling issues.

Forecasting the 20-Year Incidence of Dementia by Socioeconomic Status, Race/Ethnicity, and Region Based on Mid-Life Risk Factors in a U.S. Nationally Representative Sample.

Alzheimer's disease and related dementias (ADRD) incidence varies based on demographics, but mid-life risk factor contribution to this variability requires more research. The purpose of this study is to forecast the 20-year incidence of dementia in the U.S. overall and stratified by race/ethnicity, socioeconomic status (SES), and U.S. geographic region given prior mid-life risk factor prevalence and to examine the extent to which risk factor differences 20 years ago may explain current SES, race/ethnicity, or regional disparities in dementia incidence. We applied the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) prediction model to the 2006 wave of the Health and Retirement Study (HRS) in participants aged 45 to 64 to estimate the 20-year risk of incident ADRD. The 20-year risk of dementia among middle-aged Americans was 3.3% (95% CI: 3.2%, 3.4%). Dementia incidence was forecast to be 1.51 (95% CI: 1.32, 1.71) and 1.27 (95% CI: 1.14, 1.44) times that in Hispanic and Non-Hispanic Black individuals respectively compared statistically to Non-Hispanic White individuals given mid-life risk factors. There was a progressive increase in dementia risk from the lowest versus highest SES quintile. For geographic region, dementia incidence was forecast to be 1.17 (95% CI: 1.06, 1.30) and 1.27 (95% CI: 1.14, 1.43) times that in Midwestern and Southern individuals respectively compared statistically to Western individuals. Some disparities in dementia incidence could be explained by differences in mid-life risk factors and may point toward policy interventions designed to lessen the ADRD disease burden through early prevention.

Adverse childhood experiences are associated with HIV risk factors in Agbogbloshie, Ghana

ABSTRACT Adverse Childhood Experiences (ACEs) have been associated with increased risk factors for HIV transmission, but the causal pathway is uncertain. This study documents the prevalence of ACEs by gender and their association with HIV risk factors and assesses depressive symptoms as mediating this relationship. A cross-sectional survey was conducted in 2019 among a representative sample of men and women, aged 18–24 years, living in an informal settlement in Accra, Ghana. Data on sociodemographic characteristics, ACEs, ten HIV risk factors (five sexual behaviors, HIV/AIDS knowledge, sexual assault, three substance use behaviors), and depressive symptoms were collected. Multiple logistic regression models were estimated to assess the independent association between four or more ACEs and each of the ten HIV risk factors. Structural equation models examined depressive symptoms as a mediator in these associations. A third (34.6%) of participants reported four or more ACEs, and among those who experienced four or more ACEs 60% were men and 40% were women. Gender did not modify the effect of the association between four or more ACEs and HIV factors and therefore the multiple regression analysis was not stratified by gender. After controlling for sociodemographic covariates and depressive symptoms, having experienced four or more ACEs was associated with alcohol use (OR = 3.88; 95% CI: 1.34, 11.21), injection drug use (OR = 2.78; 95% CI: 1.15, 6.73), low knowledge of HIV (OR = 3.59; 95% CI: 1.43, 9.00), sexually transmitted infection (OR = 3.70; 95% CI: 1.15, 11.96), and sexual assault (OR = 3.58; 95% CI: 1.07, 12.05). There was some evidence that depressive symptoms could be mediating the association between reporting four or more ACEs and ever having a sexually transmitted infection. The mitigation of ACEs and depressive symptoms has the potential to decrease HIV risk factors and thus reduce the risk for HIV transmission among youth living in informal settlements.