Significant Individual Predictors Research Articles

Exploring the relationship between COVID-19 risk and employment quality among a sample of individuals with disabilities

Background Physical and psychosocial contexts of employment and the quality of the work environments impact both physical and mental health, particularly among individuals with disabilities. Objective Given the relationship between health and employment and the need to understand the relationship between quality of work and COVID-19 acquisition risk, this project focused on studying the impacts of job quality following the emergence of the COVID-19 virus. Method GLM logistic regression to explore odds ratios of employment quality factors on our dependent variable, contracting COVID-19. Results The overall model was significant, indicating selection of predictor and control variables have an impact on COVID-19 risk (χ2(11) = 59.53, p < .001, N = 2325). Age and race were significant individual predictors. Finally, among the employment quality variables, only one comparison was significant. Individuals with some but not all markers of employment quality, compared to individuals who were unemployed, were 1.3 times more likely to contract COVID-19 (OR = 1.3, p = 0.03). Conclusion Employment, in light of COVID-19, is full of complexity and nuances. Even more so is the relationship between COVID-19, health, and employment for PWDs. The significant findings from the current study have important implications for the incorporation of employment, and specifically quality employment, as a predictor of physical health among PWDs.

Predicting Clinical Improvement in Early Psychosis Using Circuit-Based Resting-State Functional Magnetic Resonance Imaging.

Identifying biomarkers that predict treatment response in early psychosis (EP) is a priority for psychiatry research. Previous work suggests that resting-state connectivity biomarkers may have promise as predictive measures, although prior results vary considerably in direction and magnitude. Here, we evaluated the relationship between intrinsic functional connectivity of the attention, default mode, and salience resting-state networks and 12-month clinical improvement in EP. Fifty-eight individuals with EP (less than 2 years from illness onset, 35 males, average age 20 years) had baseline and follow-up clinical data and were included in the final sample. Of these, 30 EPs showed greater than 20% improvement in Brief Psychiatric Rating Scale (BPRS) total score at follow-up and were classified as "Improvers." The overall logistic regression predicting Improver status was significant (χ2 = 23.66, Nagelkerke's R2 = 0.45, P < .001, with 85% concordance). Significant individual predictors of Improver status included higher default mode within-network connectivity, higher attention-default mode between-network connectivity, and higher attention-salience between-network connectivity. Including baseline BPRS as a predictor increased model significance and concordance to 92%, and the model was not significantly influenced by the dose of antipsychotic medication (chlorpromazine equivalents). Linear regression models predicting percent change in BPRS were also significant. Overall, these results suggest that resting-state functional magnetic resonance imaging connectivity may serve as a useful biomarker of clinical outcomes in recent-onset psychosis.

The Relationships of Historical Loss, Acculturation, and Alcohol Expectancies with Alcohol Use Among American Indian and Alaska Native People.

The primary purpose of this study was to 1) explore the relationship among the following variables: thoughts and feelings associated with historical loss, levels of acculturation, alcohol expectancies, and alcohol use among American Indian and Alaska Native (AI/AN) people, as well as to 2) explore predictive relationships among historical loss thoughts and feelings, alcohol expectancies, and alcohol use for AI/AN people within this sample. A convenience (community, non-clinical) sample of 188 AI/AN people completed an online survey, including questions related to alcohol use, alcohol expectancies, thoughts and feelings of historical loss, and acculturation experiences. Results indicated that gender and feelings of historical loss were the significant individual predictors of alcohol use and alcohol expectancies in a sample of AI/AN people. In addition, specific types of alcohol expectancies, when considered together, explained 24% of the variance in alcohol use experiences. Gender differences were noted in that AI/AN men were more likely than AI/AN women to engage in hazardous drinking and expected more feelings of social and physical pleasure as well as power and aggression as a result of drinking alcohol. Areas for further research were highlighted, with an emphasis on further research exploring the correlates and predictors of alcohol use and alcohol expectancies for community, non-clinical samples of AI/AN people, to further understand alcohol use motivation among AI/AN people.

Global Cognition, Gender, and Level of Education Predict Dual-Task Gait Speed Variability Metrics in Older Adults

Introduction: The purpose of this study was to determine if demographic variables and measures of cognitive function, functional mobility, self-reported balance self-efficacy, and self-reported physical activity can predict gait speed variability during single-task walking (STGSCV), during cognitive-motor dual-tasking (DTGSCV), and dual-task effect on gait speed variability (DTEGSCV) in older adults. Methods: In 62 older adults, demographics were recorded and cognitive function (including the Montreal Cognitive Assessment, MoCA), functional mobility, balance self-efficacy (Activities-specific Balance Confidence Scale, ABC), and self-reported physical activity (Physical Activity Scale for the Elderly, PASE) were assessed. Three linear regression models were used to determine whether the functional mobility tests, PASE score, ABC score, and tests of cognitive function predicted gait speed variability outcomes (STGSCV, DTGSCV, DTEGSCV), with demographics included as covariates. Results: MoCA score (p = 0.003), gender (p = 0.040), and years of education (p = 0.010) significantly predicted DTGSCV (R2 = 0.297, p = 0.002). MoCA score (p = 0.008) and years of education (p < 0.001) also significantly predicted DTEGSCV. Despite a significant regression model (R2 = 0.316, p = 0.001), there were no significant individual predictors of STGSCV. Conclusion: Older adults with lower cognitive function scores, according to the MoCA, and higher levels of education demonstrate larger gait speed variability during dual-tasking and may be at increased risk of real-world mobility issues or falling.

What psychosocial support do first year university students need? A mixed creative methods study

Higher education students need help and support to enable them to cope with the challenges of their studies. The aim of this study was to investigate the perspectives of first-year undergraduate students on predictors of psychosocial support in challenging situations. A creative art-based descriptive research design was employed utilising an individual One-Page Profile form to gather data from 240 first-year students from two different universities in Slovakia. Data was collected and analysed using a content-thematic and visual approach. Four significant individual predictors of psychosocial support were identified: emotional, instrumental, informational and appraisal. Emotional support consists of desirable mental health, defined by the students as experiencing happiness, self-satisfaction, self-development, relationships which are satisfying, loving and safe, trust, empathic acceptance, and care from others. Instrumental support varies from personnel up to material resources e.g., people, animals, and assistance such as financial services. The preferred informational support is peer-to-peer counselling, followed by professional counselling. When students describe appraisal support their needs are primarily in the areas of well-being and self-efficacy. The study makes various suggestions on how University staff can provide first-year students with support and counselling in their everyday challenges.

Emotion Dysregulation and E-Cigarette Expectancies among College Student E-Cigarette Users

Background: E-cigarette outcome expectancies (i.e., beliefs about the expected consequences of e-cigarette use) are a key factor in motivating use. Emotion regulation difficulties have demonstrated significant associations with outcome expectancies; however, there has yet to be an examination of associations between specific emotion regulation difficulties and specific e-cigarette outcome expectancies, which could serve as targets for intervention efforts. Therefore, the current study sought to examine the unique predictive ability of specific emotion regulation difficulties in terms of e-cigarette outcome expectancies. Methods: Participants were 116 college student e-cigarette users (Mage = 19.72, SD = 1.88; 71.6% female) who completed self-report questionnaires for course credit. Results: Greater difficulties engaging in goal-directed behavior when experiencing negative emotions and fewer difficulties accessing effective emotion regulation strategies were associated with positive reinforcement outcome expectancies. Greater emotion regulation difficulties in general were also associated with negative reinforcement outcome expectancies, though there were no significant individual predictors. Conclusion: These results suggest that greater emotion regulation difficulties are associated with mood-related e-cigarette outcome expectancies, and targeting emotion regulation difficulties, particularly difficulty engaging in goal-directed behavior when upset, may be useful to incorporate into intervention efforts.

THEORETICALLY BASED FACTORS ASSOCIATED WITH STROKE FAMILY CAREGIVER HEALTH

Abstract Background Most stroke survivors are cared for at home by family members, many of whom experience depressive symptoms and life changes as a result of providing care. While many studies have explored the factors associated with depressive symptoms and quality of life in family caregivers, few have focused on caregiver health. Purpose: To determine theoretically based factors associated with unhealthy days in stroke family caregivers. Methods A conceptual model derived from Lazarus’ theory of stress and coping was used to guide analysis. Secondary data analysis was conducted using baseline data from a large randomized controlled clinical trial testing the Telephone Assessment and Skill-building Kit (TASK II) program with 254 family caregivers of stroke survivors within 2 weeks of discharge from acute care and rehabilitation settings in participating Midwestern facilities. Data were analyzed using multiple regression with unhealthy days as the dependent variable, and theoretically based factors (i.e., caregiver task difficulty, level of optimism, threat appraisal, depressive symptoms, and life changes) as independent variables. All scales demonstrated evidence of internal consistency reliability with Cronbach alpha scores above .70. Results Caregivers were mostly female (78%), white (71%), spouses (47%) or adult children (30%). Caregivers reported 9 unhealthy days on average within the past month. Unhealthy days were significantly correlated with caregiver task difficulty (r=.32), level of optimism (r=-.29), threat appraisal (r=.44), depressive symptoms (r=.60), and life changes (r=-.40) (p&amp;lt;.05). 37.8% variance in unhealthy days was explained, with depressive symptoms being the only significant individual predictor due to shared variance.

Predicting academic success: machine learning analysis of student, parental, and school efforts

AbstractUnderstanding what predicts students’ educational outcomes is crucial to promoting quality education and implementing effective policies. This study proposes that the efforts of students, parents, and schools are interrelated and collectively contribute to determining academic achievements. Using data from the China Education Panel Survey conducted between 2013 and 2015, this study employs four widely used machine learning techniques, namely, Lasso, Random Forest, AdaBoost, and Support Vector Regression, which are effective for prediction tasks—to explore the predictive power of individual predictors and variable categories. The effort exerted by each group has varying impacts on academic exam results, with parents’ demanding requirements being the most significant individual predictor of academic performance; the category of school effort has a greater impact than parental and student effort when controlling for various social-origin-based characteristics; and significant gender differences among junior high students in China, with school effort exhibiting a greater impact on academic achievement for girls than for boys, and parental effort showing a greater impact for boys than for girls. This study advances the understanding of the role of effort as an independent factor in the learning process, theoretically and empirically. The findings have substantial implications for education policies aimed at enhancing school effort, emphasizing the need for gender-specific interventions to improve academic performance for all students.

92 Biber Figure Learning Test Outperforms Other Cognitive Measures in Predicting Subjective Cognitive Decline

Objective:Subjective Cognitive Decline (SCD), the perception of deteriorating cognition in the absence of apparent impairment on objective testing, has gained momentum in recent literature as a risk marker for AD. Traditional neuropsychological assessments, while typically inclusive of a word list learning task, often do not include a comparable figure learning task. Growing evidence suggests that nonverbal assessments may be particularly sensitive to the earliest cognitive changes associated with Alzheimer’s disease. The Biber Figure Learning Test (BFLT), a visuospatial analogue to verbal list learning tasks, has been shown to associate with brain-based biomarkers of Alzheimer’s disease (AD; hippocampal volume, amyloid load). This study investigates the utility of the BFLT in capturing SCD above and beyond other cognitive measures sensitive to AD progression.Participants and Methods:50 community-dwelling, cognitively normal individuals (78% White, 16% Black, 6% Other; 92% Non-Hispanic; 64% Female; Education M=17.1, SD=2.1; Age M=72.7, SD=6.2) participated in a study of SCD. All participants performed &gt;-1.5 SD on clinical neuropsychological testing including a word list learning task. SCD was assessed using a 20-item scale querying individuals’ perception of difficulty across a range of memory and non-memory abilities in relation to others of the same age. Participants completed the BFLT, Loewenstein-Acevedo Scales of Semantic Interference and Learning (LASSI-L), Short-Term Memory Binding (STMB), and Face-Name Associative Memory Exam (FNAME), previously established as being sensitive to pre-clinical AD, were examined as predictors of SCD. A multiple regression adjusted for demographics (age, gender, education) was used to investigate the extent to which BFLT Trial 1 (T1) predicted SCD above and beyond these other cognitive measures sensitive to AD progression. Trial 1 of the BFLT was used based on a separate abstract examining which BFLT score was most highly associated with SCD (Kann et al., pending acceptance).Results:Adjusting for demographics, the present model accounts for 42% of the variance in SCD, while Biber T1 alone accounts for 20% and is the only significant individual predictor of SCD (β=-0.55, p=0.004). In contrast, other variables in the model independently accounted for less than 1% to 4% each (age β=-0.23, p=0.15; gender β=-0.15, p=0.34; education β=0.06, p=0.66; LASSI-L β=-0.11, p=0.55; STMB β=-0.03, p=0.85; FNAME β=-0.10, p=0.64).Conclusions:The present study demonstrates the usefulness of the first learning trial of the BFLT as an independent predictor of SCD above and beyond other verbal and nonverbal measures sensitive to AD pathology. It also highlights the value of including even one trial of figure learning (&lt; 5 minutes) in both clinical and research assessments seeking to capture cognitive changes which may be the earliest indicators of a neurodegenerative process. Ongoing longitudinal research is examining the predictive utility of the BFLT for future cognitive decline and transition to Mild Cognitive Impairment. Further research should explore the association between Biber T1, specifically, and neuropathological biomarkers of AD to further establish its utility as a portent of AD.

Determinants of institutional delivery service utilization in Nepal.

Maternal mortality continues to be a pressing concern in global health, presenting an enduring and unmet challenge for healthcare systems worldwide. Utilization of institutional delivery services has been established as a proven intervention to mitigate life-threatening risks for both mothers and newborns. Exploring the determinants of institutional delivery is crucial to improve and enhance maternal and newborn safety. This study aimed to assess the contextual and individual factors associated with institutional delivery in Nepal. This study utilized that data form Nepal Multiple Indicator Survey 2019, which included a sample of 1,932 women who had given birth within the two years prior to the survey. A multilevel logistic regression analysis was performed to determine the significant external environment, contextual and individual predictors of institutional delivery. The women from Madhesh province [Adjusted Odds Ratio (aOR): 0.32, 95% Confidence Interval (CI): 0.17-0.61], as compared to Bagmati province, women from rural areas (aOR: 0.55, 95% CI: 0.39-0.78) as compared to urban areas, and women from a relatively less-advantaged ethnic groups (aOR: 0.52, 95% CI: 0.35-0.76) as compared to the relatively advantaged ethnic groups were less likely to deliver in health institutions. Similarly, women from the poorest (aOR: 0.09, 95% CI: 0.04-0.22) and second wealth groups (aOR: 0.29, 95% CI: 0.13-0.64) were less likely to attend institute for delivery compared to women from the richest household. Women with formal education (aOR: 1.65, 95% CI: 1.16-2.35) were more likely to deliver in an institution over uneducated women. Moreover, the uptake of institutional delivery increased by 59% (aOR: 1.59, 95% CI: 1.43-1.75) for each additional ANC visit. The findings highlight the importance of stepping up efforts to achieve universal health care from the standpoint of long-term government investment, focusing particularly on illiterate women in rural areas, poorer households, and socially disadvantaged groups. Expanding the benefits of maternal benefit schemes targeting the women from the poorest households in the communities is recommended.

Outcomes of pancreatic malignancy in octogenarians: A single tertiary center experience.

e24008 Background: Pancreatic adenocarcinoma (PC) is generally diagnosed at a late stage, with a dismal prognosis. Patients aged 75-84 years constitute 28% of all patients. Surgery is the only way to cure, however, some surgeons have been hesitant to offer surgery to patients with advanced age due to lack of evidence available about the effectiveness and safety of treatments for this age group. Deficits accumulation frailty indices (FI) utilize readily available clinical data and easily obtained patient-reported information to predict hospitalization and mortality of older individuals. The goal of this large sample study is to profile octogenarians with PC. Methods: From 2015-2017, 440 patients over the age of 70 with biopsy confirmed PC were retrospectively reviewed. Among those, the outcomes of 129 (29.3%) pts older than 80 years of age were evaluated including patient’s characteristics, local control, systemic therapy, comprehensive geriatric assessment domains, specific geriatric outcomes and survival duration. Results: Median patients' age was 83 years (range 83-91) and 61(47.4%) were female. Patients with ECOG 0-1 at diagnosis were 109 pts (84.4%). Based on the FI, 28 patients (21.7%) were fit, while 79 (61.2%) were prefrail and 22 patients (17.1%) were frail. 33 patients (25.5%) presented as stage IV disease and 96(74.5%) as locally advanced PC. 46 patients (35.6%) had elective surgical resection. 53 patients (41.1%) received chemotherapy, 14 (10.8%) neoadjuvant, 17(20.9%) adjuvant and 12 (17.1%) palliative therapy. Among patients who had surgery, 10 (21.7%) had grade ≥3 adverse events and 6 (13%) had unplanned hospitalization. Median overall survival of resectable patients was 25.3 months. There was no statistically significant difference in survival after surgery in patients older than 80 years of age compared to younger than 80. Results of the multiple linear regression indicated that there was a moderate collective significant effect between the frailty index, ECOG, surgery, WT loss, albumin level, Cr clearance, Hb, and survival, (F(3,120) = 22, p &lt; .001, R = 0.35, R = 0.34). Frailty index (p = .027), ECOG (p &lt; .001) and surgery (p = .009) were significant individual predictors of the outcomes. Conclusions: Among older adult, Fit octogenarians experienced similar rate of mortality as patients younger than 80years old after elective pancreatic cancer surgery. Specific factors may also affect the outcome of surgery for older adults with cancer. These should be considered when assessing patients’ health and selecting them for surgery. A thorough preoperative evaluation can help ensure a better postoperative outcome.

Relationship Between Activity Level and Knee Function Is Influenced by Negative Affect in Patients Undergoing Cell Therapy for Articular Cartilage Defects in the Knee.

Increased activity level is generally reported to be positively related to improved knee function after knee surgery. However, little research has been conducted into this relationship on an individual patient basis, or the influence of demographic and psychosocial factors such as patient affect-the subjective experience of emotion. The relationship between postoperative activity level and knee function will vary between patients and will be influenced by the patients' affect and demographic characteristics. Cohort study; Level of evidence, 3. Activity, knee function, demographic, and affect data were collected from patients enrolled in an ongoing trial for the treatment of articular cartilage lesions at preoperative and 2-, 12-, and 15-month postoperative points. Quantile mixed regression modeling was used to determine the patient-to-patient variation in activity level and knee function. Multiple linear regression and partial correlation analyses were performed to determine whether demographic characteristics and patient affect were associated with this variation. A total of 62 patients were included in the study (23 female; 39 male; mean age, 38.3 ± 9.5 years). We found substantial variation between patients in the relationship between activity level and knee function, with most patients (n = 56) demonstrating a positive relation (positive slope), but 6 patients demonstrating a negative relation (negative slope). A negative affect (NA) score was significantly correlated with the slope between activity level and knee function (r S = -0.30; P = .018) and was a significant individual predictor of knee function at 15 months postoperatively (coefficient = -3.5; P = .025). Our results suggest that the relationship between activity level and knee function varies between patients. The patients with a higher NA score were likely to report smaller improvements in knee function with increasing activity levels compared with those with a lower NA score.

Self-esteem, Interpersonal Communication Competence, and Media and Technology Usage as Predictors of Loneliness Among University Students

Loneliness is a common concern among university students, as these individuals experience many of the risk factors associated with loneliness. This experience of loneliness tends to lead to numerous consequences such as negative self-evaluations, anxiety, and depression, which in turn lead to impaired concentration and a decline in academic motivation and performance. The overarching aims of this study were to identify the predictor variable(s) or combination of predictor variables, namely self-esteem, interpersonal communication competence, and media and technology usage, that explain a significant percentage of the variance in loneliness amongst undergraduate university students, as well as to investigate whether differences exist in loneliness with regards to gender, ethnicity, and generational status. The sample consisted of 1,191 South African undergraduate university students between the ages of 18 and 30. This study was non-experimental in nature and a correlational research design was used. The results indicated that the combination of the independent (predictor) variables accounted for 51.9% of the variance in the Loneliness scores of the sample. Interpersonal Communication Competence and Self-esteem served as statistically and practically significant individual predictor variables of the students’ loneliness. Male students and first-generation students tend to be lonelier than female students and non-first-generation students, respectively.

TESTING A PORTION OF THE OKLAHOMA AGING INMATE FORGIVENESS MODEL

Abstract The study assessed the viability of the published Oklahoma Aging Forgiveness Model on women in custody using cross-sectional data collected from females, violent and non-violent, in custody in Oklahoma. The theoretical model led to a hierarchical regression of a measure of positive mental health (Positive Evaluation of Life) on a block of control variables (age, education, and crime type), a block consisting of items from the Duke Religiosity measure, and a final block utilizing forgiveness of self, others, and situation (Heartland Forgiveness Scale). Results from the complete sample, N=447, explained 36% of the variance in the outcome. Significant individual predictors included in the final model were crime type, religiosity, and forgiveness of self and situations. We split the sample on crime type and found that for the violent offenders (N=228), 39% of the variance in the outcome was explained; in addition to religiosity, all three assessments of forgiveness were significant predictors. For the non-violent offenders (N=209), 35% of the outcome’s variability was explained. Religiosity, forgiveness of self and situation were significant predictors for this sub-sample. Discussion will focus on the Oklahoma Aging Forgiveness Model and how it works similarly for men in custody (published) and for women in custody. Further, the discussion will focus on the significant role played both by religiosity and forgiveness for those in custody. Findings from this study and that of studies with men clearly demonstrate that religiosity and forgiveness are important aspects of a prisoner’s life.

Who are the patients who deny suicidal intent? Exploring patients' characteristics associated with self-disclosure and denial of suicidal intent.

Patients' non-disclosure of suicidal ideation and intent concealment represent a major obstacle to the effective assessment of suicide risk and to the delivery of suicide prevention treatments. The present study aimed to investigate this phenomenon and to assess (1) if outpatient psychiatric patients are more or less likely to disclose intent to mental health clinicians in the context of psychiatric/psychological treatment than they are to in the context of research interviews with non-clinicians; and (2) if certain demographic, trait-like, and state-like characteristics may predict such disclosure differences. A total of 780 psychiatric outpatient participants aged 18 to 84 and 193 clinician participants aged 25 to 54 were included in the study. The proportion of patients who disclosed to clinicians only, to research assistants (RAs) only, to both, and to none, was compared using a z-test. Univariate analyses were used to compare the participants' variables across disclosure groups, and significant individual predictors were included in multilevel regression analyses. Participants were more significantly more likely to disclose to RAs (10.4%) than to clinicians (5.6%), p< 0.001. Neuroticism and trait anxiety predicted disclosure to RAs vs no disclosure; low extraversion predicted disclosure to clinician versus no disclosure; and extraversion and trait anxiety predicted disclosure to RAs versus to clinicians. Patients' disclosure patterns, the personality variables predicting them, and their clinical implications were discussed in the context of the extant literature on patients' reasons for concealing suicidal ideation and intent.

Dark Triad traits and relationship dissolution

A substantial body of research exists documenting the relationship between Dark Triad traits and the formation and maintenance of close personal relationships. Relatively few studies have, however, considered Dark Triad traits in the context of relationship dissolution. The present studies investigate the relationship between Dark Triad traits and the strategies used during the dissolution of romantic relationships (Study 1) and friendships (Study 2). For each study participants (Study 1: N = 722; Study 2: N = 177) completed the Short Dark Triad-3 (SD3) and Break-up Strategies Questionnaire. In Study 1, Machiavellianism predicted greater use of avoidance / withdrawal, cost escalation / manipulation, and de-escalation when terminating a romantic relationship and lower open confrontation. Further, psychopathy predicted greater use of cost escalation / manipulation and distant / mediated communication but lower positive tone / self-blame and open confrontation when terminating a romantic relationship. In Study 2, psychopathy predicted greater distant / mediated communication only and Machiavellianism was not a significant individual predictor of strategies used during the dissolution of friendship. Narcissism was less closely associated with break-up strategies than Machiavellianism or psychopathy, predicting greater open confrontation with romantic partners only (Study 1).

Healthcare Disparities in Early Childhood Brain Injury

<h3>Research Objectives</h3> While healthcare and educational disparities are known to impact minoritized groups, few research studies have been conducted to examine disparities after childhood acquired brain injury (ABI). The purpose of this study was to explore child factors associated with referral (i.e., race, socioeconomic status, type and time since injury, length of hospital stay), parent education, and long-term need for children who experienced an early childhood ABI. <h3>Design</h3> Secondary-analysis of data collected through retrospective cohort chart review and prospective caregiver phone surveys. <h3>Setting</h3> Large, urban Trauma 1 pediatric hospital in the Midwestern US. <h3>Participants</h3> 29 caregivers of children who experienced an ABI before five years of age and currently in elementary or middle school. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Medical records and a 10-min phone survey that included a series of yes/no and short open-ended questions. <h3>Results</h3> Logistic regressions indicated a significant association between child factors and 1) referral to services at hospital discharge (p = .004) and 2) caregiver-reported long-term need for special education services (met and unmet; p = .009). The models for caregiver-reported receipt of education on ABI and caregiver-reported unmet need for special education were not significant. For both significant models, there were no significant individual predictors, but some factors appear to have stronger associations than others. <h3>Conclusions</h3> Differences in acute and long-term service provision and need after childhood ABI are likely influenced by a complex interaction of individual, injury, and social-environmental factors. Future research should consider how healthcare and education practice and policy might account for these interactions to support more equitable access to and utilization of services to improve long-term outcomes for all children with ABI. <h3>Author(s) Disclosures</h3> Jessica Salley Riccardi and Jennifer Lundine have no financial or non-financial relationships to disclose.

An Exploratory Study on Disparities in Service Provision and Long-Term Need After Early Childhood Acquired Brain Injury.

While health care and educational disparities are known to impact minoritized groups, few research studies have been conducted to examine disparities after childhood acquired brain injury (ABI). The purpose of this study was to explore child and injury factors (i.e., race, socioeconomic status, and length of hospital stay) associated with referral, parent education, and long-term need for children who experienced an early childhood ABI. This study was a secondary analysis of data collected through retrospective cohort chart review and prospective caregiver phone surveys. Exploratory logistic regressions indicated a statistically significant association between child and injury factors and (a) referral to rehabilitation or educational services at hospital discharge (p < .001) and (b) caregiver-reported long-term needs (including both met and unmet needs) for special education services (p = .009). The models for caregiver-reported receipt of education on ABI and caregiver-reported unmet need for special education were not significant. For both significant models, there were no significant individual predictors. Differences in acute and long-term service provision and need after childhood ABI are likely influenced by a complex interaction of individual, injury, and social-environmental factors. Future research should consider how health care and education practice and policy might account for these interactions to support more equitable access to and utilization of services to improve long-term outcomes for all children with ABI. https://doi.org/10.23641/asha.21158878.

Testing predictability of stock returns under possible bubbles

This study reexamines stock return predictability via several financial variables and an investor sentiment index. We develop an IVX bubble-based Wald statistic (IVX-BUB) which extends the IVX-based test (IVX-KMS) proposed by Kostakis, Magdalinos and Stamatogiannis (2015) and accounts for the potential bubble effect in the predictive regression. Simulation results indicate that IVX-BUB performs reasonably well when bubbles exist, while IVX-KMS displays severe size distortion in highly persistent predictors. In the empirical study, we consider the monthly excess returns of S&P 500 during 1927–2016 and identify six bubble episodes using the real-time date-stamping strategy proposed by Phillips, Shi and Yu (2015a, 2015b). The empirical results show that IVX-BUB produces fewer significant individual predictors and their combinations than IVX-KMS, but both methods provide evidence in favor of the strong predictive ability of the investor sentiment index. • This paper develops an inference in predictive regressions with possible bubbles (IVX-BUB). • IVX-BUB is robust to potential bubble effects and highly persistent predictors in predictive regressions. • Simulation results show IVX-BUB exhibits excellent size and power performance. • Empirical findings confirm the strong predictive ability of the investor sentiment index.

Plasma biomarkers inclusive of α-synuclein/amyloid-beta40 ratio strongly correlate with Mini-Mental State Examination score in Parkinson’s disease and predict cognitive impairment

Plasma biomarkers for Parkinson’s disease (PD) diagnosis that carry predictive value for cognitive impairment are valuable. We explored the relationship of Mini-Mental State Examination (MMSE) score with plasma biomarkers in PD patients and compared results to vascular dementia (VaD) and normal controls. The predictive accuracy of an individual biomarker on cognitive impairment was evaluated using area under the receiver operating characteristic curve (AUROC), and multivariate logistic regression was applied to evaluate predictive accuracy of biomarkers on cognitive impairment; 178 subjects (41 PD, 31 VaD and 106 normal controls) were included. In multiple linear regression analysis of PD patients, α-synuclein, anti-α-synuclein, α-synuclein/Aβ40 and anti-α-synuclein/Aβ40 were highly predictive of MMSE score in both full model and parsimonious model (R2 = 0.838 and 0.835, respectively) compared to non-significant results in VaD group (R2 = 0.149) and in normal controls (R2 = 0.056). Α-synuclein and anti-α-synuclein/Aβ40 were positively associated with MMSE score, and anti-α-synuclein, α-synuclein/Aβ40 were negatively associated with the MMSE score among PD patients (all Ps < 0.005). In the AUROC analysis, anti-α-synuclein (AUROC = 0.788) and anti-α-synuclein/Aβ40 (AUROC = 0.749) were significant individual predictors of cognitive impairment. In multivariate logistic regression, full model of combined biomarkers showed high accuracy in predicting cognitive impairment (AUROC = 0.890; 95%CI 0.796–0.984) for PD versus controls, as was parsimonious model (AUROC = 0.866; 95%CI 0.764–0.968). In conclusion, simple combination of biomarkers inclusive of α-synuclein/Aβ40 strongly correlates with MMSE score in PD patients versus controls and is highly predictive of cognitive impairment.