Variance In Outcomes Research Articles

Differences in familiarity with oral immunotherapy among caregivers of White and Black children with food allergy

BackgroundPotential racial and ethnic disparities related to oral immunotherapy (OIT) have not been fully described among children with food allergy (FA). ObjectiveTo characterize the differences in attitudes toward, familiarity with, and utilization of OIT among non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic or Latino (H/L) caregivers of children with FA. MethodsSurveys were administered to the caregivers of children enrolled in Food Allergy Outcomes Related to White and African American Racial Differences, a prospective, multisite cohort of children with FA. The distribution of responses by caregiver-reported race and ethnicity was described using an analysis of variance for continuous outcomes and χ2 tests for categorical outcomes. A logistic regression model was used to determine associations between familiarity with OIT as a treatment option and various other covariates. ResultsThe NHB and H/L respondents were more frequently not familiar with OIT compared with NHW responders (54.3% and 62.5% vs 9.2%, P < .001). This finding remained true, even after adjusting for household income (odds ratio: 0.1, 95% CI: 0.1-0.4 for NHB participants and odds ratio: 0.1, 95% CI: 0.0-0.3 for H/L participants). NHB and H/L participants more frequently reported that they had never heard of OIT before the survey compared with NHW participants (76.7% and 50.0% vs 26.7%, P < .001). None of the NHB and H/L respondents initiated OIT compared with 14.8% of NHW participants (P < .001). ConclusionIn the Food Allergy Outcomes Related to White and African American Racial Differences cohort, familiarity with OIT was lower among caregivers of minoritized racial and ethnic groups, even after adjusting for household income.

Outcome prediction in psychological therapy with continuous time dynamic modeling of affective states and emotion regulation.

To date, many prediction studies in psychotherapy research have used cross-sectional data to predict treatment outcome. The present study used intensive longitudinal assessments and continuous time dynamic modeling (CTDM) to investigate the temporal dynamics of affective states and emotion regulation in the early phase of therapy and their ability to predict treatment outcome. Ninety-one patients undergoing psychological treatment at a university outpatient clinic took part in a 2-week ecological momentary assessment (EMA) period. Participants answered self-report measures on positive affect (PA), negative affect, and emotion regulation (ER) four times a day. Hierarchical Bayesian CTDM was conducted to identify temporal effects within (autoregressive) and between (cross-regressive) PA, negative affect, and ER. The resulting CTDM parameters, simple EMA parameters (e.g., mean), and cross-sectional predictors were entered into a LASSO model to be examined as predictors of treatment outcome at Session 15. Two significant predictors were identified: initial impairment and the continuous time cross-effect of PA on ER. The final model explained 40% of variance in treatment outcome, with the cross-effect (PA-ER) accounting for 4% of variance beyond initial impairment. The results demonstrate that temporal patterns of affective EMA data are valuable for the mapping of individual differences and the prediction of treatment outcome. This information can be used to provide therapists with feedback to personalize treatments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Hope and its associations with academic-related outcomes and general wellbeing among college students: the importance of measurement specificity

BackgroundHope has been extensively studied as a predictor of college students’ academic success. Most previous studies used domain-general, global hope measures to gauge the association between hope and academic performance among college students. However, a few studies have suggested that hope is domain-specific and domain-specific academic hope measures should be included in related research to better assess the influence of hope on academic outcomes. In this study, we aimed to further examine this issue to ascertain if there is value in including academic hope measures when studying the link between hope and academic outcomes in college students.MethodsTwo samples of Hong Kong college students (total N = 1321) were recruited. Each participant completed a set of self-reported online questionnaires.ResultsIn both samples, global hope and academic hope emerged as related but separate factors in confirmatory factor analyses. Academic hope had consistently stronger unique explanatory power on academic performance and goal setting than global hope did. On the other hand, global hope explained more variance in general wellbeing than academic hope did, but its explanatory role in academic performance was not significant.ConclusionsThe findings support domain-specificity and show that hope measures explain more variance in outcomes in the matched domains. Therefore, academic hope measures should more routinely be included in related research to better evaluate the role of hope in academic pursuit among college students. Possible implications for hope interventions are also discussed.

Quality of Life and Well-Being in Adults With Fontan Physiology: Findings From the Australian and New Zealand Fontan Registry Quality of Life Study.

To characterize global and health-related quality of life (QOL) among adults with Fontan physiology enrolled in the Australian and New Zealand Fontan Registry (ANZFR), and identify sociodemographic, clinical, psychological, and relational factors associated with outcomes. Using a cross-sectional survey design, 66 adults with Fontan physiology (58% women; mean age, 29.6±7.7 years; range, 18-50 years) completed validated self-report measures. Health-related QOL was assessed using the Pediatric Quality of Life Inventory, and global QOL was assessed using a visual analog scale (0-10). Participants reported lower total health-related QOL (P<0.001), as well as lower physical (P<0.001) and social (P=0.002) functioning compared with normative data. Median global QOL was 7.0 (interquartile range: 5.0-8.0) and most participants (71%) rated their QOL ≥6. For health-related QOL, age, sex, university education, and length of hospital stay in the past 12 months explained 27% of the variance in scores, while general psychological stress, medical traumatic stress, communication problems, and access to emotional support explained a further 44% of variance (final model: 71% of variance explained). For global QOL, sociodemographic and clinical factors explained 20% of the variance in scores, while psychological stress and sense of coherence explained a further 24% (final model: 44% of variance explained). Adults with Fontan physiology reported lower overall health-related QOL compared with community-based norms. Variance in QOL outcomes were predominantly attributable to psychological and relational factors. Tailored screening and assessment to identify Fontan patients at greatest risk of lower QOL, and a proactive approach to supportive care, are needed.

Inpatient Skin-to-skin Care Predicts 12-Month Neurodevelopmental Outcomes in Very Preterm Infants

To examine the relationship between inpatient skin-to-skin care rates and neurodevelopmental scores measured at 12months in very preterm (VPT) infants. From a retrospective review of medical records of 181 VPT infants (<32weeks gestational age [GA] at birth), we derived skin-to-skin care rate, ie, total minutes of skin-to-skin care each infant received over the number of days of hospital stay. We used scores on the Capute Scales from routine follow-up assessments at 12months to measure neurodevelopmental outcomes. Families averaged approximately 17minutes/day of skin-to-skin care (2days/week, 70minutes/session), although there was substantial variability. Variation in skin-to-skin rate was positively associated with outcomes at 12months corrected age (r=0.25, P<.001). Skin-to-skin rate significantly predicted 6.2% unique variance in 12-month neurodevelopmental outcomes, after adjusting for GA, socioeconomic status (SES), health acuity, and visitation frequency. A 20-minute increase in skin-to-skin care per day was associated with a 10-point increase (0.67 SDs) in neurodevelopmental outcomes at 12months. GA and infant health acuity did not moderate these relations. VPT infants who experienced more skin-to-skin care during hospitalization demonstrated higher scores on 12-month neurodevelopmental assessments. Results provide evidence that skin-to-skin care confers extended benefits to VPT infants through the first year of life. Skin-to-skin care offers promise as a family-centered intervention designed to promote positive developmental outcomes in at-risk infants.

Exploring changing trends in depression and anxiety among adolescents from 2012 to 2019: Insights from My World repeated cross-sectional surveys.

Research has indicated a rise in the prevalence of depression and anxiety among adolescents over the past three decades. However, the factors underpinning increases in mental health difficulties remain poorly understood. This study examines psychological, social and environmental risk and protective factors that may explain changes in depression and anxiety among adolescents. Data were taken from two nationally representative My World Surveys of adolescents aged 12-19 years in 2012 (N = 5,490) and 2019 (N = 9,844). Survey data on depression and anxiety and a range of potential risk (e.g., alcohol use, psychotic symptoms) and protective factors (e.g., resilience, self-esteem) were assessed at both time points. Multiple group analyses assessed whether the predictive ability of risk/protective factors changed from wave 1 to wave 2. Results showed that the prevalence of depression and anxiety increased significantly between 2012 and 2019, particularly among females. Predictors accounted for between 37% and 61%of the variance in outcomes across waves. While some risk/protective factors were consistent predictors of depression and anxiety at both waves (e.g., bullying, discrimination, optimism), reporting female genderand having higher formal help-seeking tendencies more strongly predicted anxiety at wave 2, while lower self-esteem andlowerresilience(personalcompetence)strongly predicted both depression and anxiety at wave 2. Findings highlight the need to prioritize adolescent mental health service provision, especially in females. Self-esteem and resilience are potentially important targets for supporting adolescent mental health. Further research is required to understand the causal factors associated with increases in anxiety and depression.

Impact of meso-scale weather uncertainty on building performance simulation outcomes

Building performance simulation is a complex experiment that has many inputs that are assumed tobe deterministic but are, in-fact probabilistic. In case of low-risk facile simulations, deterministic inputs may be assumed for the simulation parameters as they do not warrant experiments that cover all the possibilities. However, for high-risk design decisions, uncertainty assessment is a must to avert any failures that result in subpar operational performance.Weather in a city may be localized due to natural or altered urban attributes and any deviation from the statistically derived “average” weather data must be examined for uncertainties in performance outcomes. Case studies on three different buildings in Chicago and Atlanta indicate a large variance in performance outcomes when weather related uncertainties are accounted for in the Uncertainty Analysis as compared to deterministic weather from the nearest airport.The findings of this study suggest that for scenarios with large penalty on not meeting the performance targets, the modeler should be careful about the relative location of the proposed building in the city and should not, de-facto accept weather data that is derived from a remote location such as an airport.

Development and validation of a community risk score for sexual and reproductive health in the United States.

Equitable access to sexual and reproductive health (SRH) care is key to reducing inequities in SRH outcomes. Publicly funded family-planning services are an important source of SRH care for people with social risk factors that impede their access. This study aimed to create a new index (Local Social Inequity in SRH [LSI-SRH]) to measure community-level risk of adverse SRH outcomes based on social determinants of health (SDoH). We evaluated the validity of the LSI-SRH scores in predicting adverse SRH outcomes and the need for publicly funded services. The data were drawn from more than 200 publicly available SDoH and SRH measures, including availability and potential need for publicly supported family planning from the Guttmacher Institute. The sample included 72 999 Census tracts (99.9%) in the 50 states and the District of Columbia. We used random forest regression to predict the LSI-SRH scores; 42 indicators were retained in the final model. The LSI-SRH model explained 81% of variance in the composite SRH outcome, outperforming 3 general SDoH indices. LSI-SRH scores could be a useful for measuring community-level SRH risk and guiding site placement and resource allocation.

Genetic susceptibility to neurodevelopmental conditions associates with neonatal DNA methylation patterns in the general population: an individual participant data meta-analysis.

Autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and schizophrenia (SCZ) are highly heritable and linked to disruptions in foetal (neuro)development. While epigenetic processes are considered an important underlying pathway between genetic susceptibility and neurodevelopmental conditions, it is unclear (i) whether genetic susceptibility to these conditions is associated with epigenetic patterns, specifically DNA methylation (DNAm), already at birth; (ii) to what extent DNAm patterns are unique or shared across conditions, and (iii) whether these neonatal DNAm patterns can be leveraged to enhance genetic prediction of (neuro)developmental outcomes. We conducted epigenome-wide meta-analyses of genetic susceptibility to ASD, ADHD, and schizophrenia, quantified using polygenic scores (PGSs) on cord blood DNAm, using four population-based cohorts (n pooled=5,802), all North European. Heterogeneity statistics were used to estimate overlap in DNAm patterns between PGSs. Subsequently, DNAm-based measures of PGSs were built in a target sample, and used as predictors to test incremental variance explained over PGS in 130 (neuro)developmental outcomes spanning birth to 14 years. In probe-level analyses, SCZ-PGS associated with neonatal DNAm at 246 loci (p<9×10-8), predominantly in the major histocompatibility complex. Functional characterization of these DNAm loci confirmed strong genetic effects, significant blood-brain concordance and enrichment for immune-related pathways. 8 loci were identified for ASD-PGS (mapping to FDFT1 and MFHAS1), and none for ADHD-PGS. Regional analyses indicated a large number of differentially methylated regions for all PGSs (SCZ-PGS: 157, ASD-PGS: 130, ADHD-PGS: 166). DNAm signals showed little overlap between PGSs. We found suggestive evidence that incorporating DNAm-based measures of genetic susceptibility at birth increases explained variance for several child cognitive and motor outcomes over and above PGS. Genetic susceptibility for neurodevelopmental conditions, particularly schizophrenia, is detectable in cord blood DNAm at birth in a population-based sample, with largely distinct DNAm patterns between PGSs. These findings support an early-origins perspective on schizophrenia. HorizonEurope; European Research Council.

Viral and non-viral episodes of wheezing in early life and the development of asthma and respiratory phenotypes among urban children.

Viral wheezing is an important risk factor for asthma, which comprises several respiratory phenotypes. We sought to understand if the etiology of early-life wheezing illnesses relates to childhood respiratory and asthma phenotypes. Data were collected prospectively on 429 children in the Urban Environment and Childhood Asthma (URECA) birth cohort study through age 10 years. We identified wheezing illnesses and the corresponding viral etiology (PCR testing of nasal mucus) during the first 3 years of life. Six phenotypes of respiratory health were identified at 10 years of age based on trajectories of wheezing, allergic sensitization, and lung function. We compared the etiology of early wheezing illnesses to these wheezing respiratory phenotypes and the development of asthma. In the first 3 years of life, at least one virus was detected in 324 (67%) of the 483 wheezing episodes documented in the study cohort. Using hierarchical partitioning we found that non-viral wheezing episodes accounted for the greatest variance in asthma diagnosed at both 7 and 10 years of age (8.0% and 5.8% respectively). Rhinovirus wheezing illnesses explained the most variance in respiratory phenotype outcome followed by non-viral wheezing episodes (4.9% and 3.9% respectively) at 10 years of age. Within this high-risk urban-residing cohort in early life, non-viral wheezing episodes were frequently identified and associated with asthma development. Though rhinovirus wheezing illnesses had the greatest association with phenotype outcome, the specific etiology of wheezing episodes in early life provided limited information about subsequent wheezing phenotypes.

Integrating external summary information in the presence of prior probability shift: an application to assessing essential hypertension.

Recent years have witnessed a rise in the popularity of information integration without sharing of raw data. By leveraging and incorporating summary information from external sources, internal studies can achieve enhanced estimation efficiency and prediction accuracy. However, a noteworthy challenge in utilizing summary-level information is accommodating the inherent heterogeneity across diverse data sources. In this study, we delve into the issue of prior probability shift between two cohorts, wherein the difference of two data distributions depends on the outcome. We introduce a novel semi-parametric constrained optimization-based approach to integrate information within this framework, which has not been extensively explored in existing literature. Our proposed method tackles the prior probability shift by introducing the outcome-dependent selection function and effectively addresses the estimation uncertainty associated with summary information from the external source. Our approach facilitates valid inference even in the absence of a known variance-covariance estimate from the external source. Through extensive simulation studies, we observe the superiority of our method over existing ones, showcasing minimal estimation bias and reduced variance for both binary and continuous outcomes. We further demonstrate the utility of our method through its application in investigating risk factors related to essential hypertension, where the reduced estimation variability is observed after integrating summary information from an external data.

Development of a new observer-rated measure to assess the real relationship in psychotherapy sessions

Objectives Real relationship (RR) refers to a genuine human relationship between client and therapist, that has been found to be positively related to treatment outcome, and to predict unique variance in outcome over and above the working alliance. However, thus far, the measurement of RR has been limited to self-report. We aimed to develop an observer-rated version of the RR measure (RR-O) to assess RR in therapy sessions. Methods We adapted items from the self-report measures to an observer rated measure, which was reviewed by RR experts. The final 24-item RR-O was rated in 540 session transcripts from 27 psychoanalytic treatments that already had existing process and outcome scores. Results The RR-O showed good internal consistency and good interrater reliability. In hierarchical EFA, items clustered into a general RR factor, and client realism, client genuineness, therapist genuineness, and therapist realism group factors. In addition, the RR-O was positively related to another RR measure and to the therapeutic alliance. Conclusion The RR-O shows initial reliability and validity as an observer-rated measure of the RR to be used in post-hoc psychotherapy research. Future research should clarify the relation between RR-O and treatment outcome.

The Role of Children's Picture Books in Promoting Innovation and Creativity among Children in China

This study explored the role of children's picture books in promoting innovation and creativity among young learners in China. Recognizing the potential impact of early literacy on cognitive development, this research aimed to objectively measure how engagement with picture books influences children's creativity. Employing a quantitative research methodology, the study gathered data from a diverse sample of 1000 children aged 5 to 8 years across various urban and rural schools in China. The study utilized a stratified random sampling technique to ensure a representative distribution across socioeconomic, educational, and cultural backgrounds. Our findings reveal a significant correlation between creativity, the frequency of reading, and the diversity of books read. Moreover, parental involvement emerged as the most influential predictor of creativity scores. Although digital books positively impacted traditional reading interactions, they substantially attained higher creativity levels. The study's robust statistical model explains 72% of the variance in creativity outcomes, emphasizing the predictability of factors. The conclusion underscores the essential role of diverse and interactive reading practices in fostering children's creativity. Implications of these findings suggest that integrating a variety of picture books and encouraging parental engagement in children's reading routines can significantly enhance creative development.

A risk stratification analysis of atherosclerotic cardiovascular disease events post-statin discontinuation in patients who underwent sleeve gastrectomy or Roux-en-Y gastric bypass bariatric/metabolic surgeries

BackgroundCardiovascular disease remains a leading cause of mortality globally, and its prevalence is notably elevated in individuals with obesity. Bariatric surgery is an effective intervention to reduce obesity-related health risks. However, the implications of discontinuing statin therapy, particularly post-bariatric surgery, among those with a history of atherosclerotic cardiovascular disease have yet to be clarified. We aimed to ascertain the risk of atherosclerotic cardiovascular disease events following statin cessation after bariatric surgery and to delineate the variance in outcomes between primary and secondary prevention cohorts. MethodsThe TriNetX database, encompassing electronic medical records from 69 United States healthcare institutions, spanning 2012 to 2021. Using a retrospective cohort design, patients aged ≥18 years who underwent bariatric surgery and were concurrently on statin therapy were selected. Discontinuation was defined as a 90-day lapse after the last statin prescription. Patients were categorized as "primary" or "secondary" prevention based on their atherosclerotic cardiovascular disease history. The primary outcome was the occurrence of an atherosclerotic cardiovascular disease event post-statin cessation. Multivariable Cox proportional hazards models discerned factors influencing this outcome. ResultsOf the 453 statin users who underwent bariatric surgery, 332 (73.1%) were in the primary prevention group and 121 (26.7%) in the secondary prevention group. At 1-year post-surgery, atherosclerotic cardiovascular disease event-free rates were 93% for primary and 68% for secondary prevention groups. Primary prevention patients showed an 82% reduced risk of post-statin cessation atherosclerotic cardiovascular disease events than secondary prevention patients (hazard ratio, 0.181; 95% confidence interval, 0.119–0.274). Additionally, Hispanic/Latino patients had heightened post-statin cessation atherosclerotic cardiovascular disease risks compared to non-Hispanic/Latino peers. ConclusionPost-bariatric surgery statin discontinuation can pose significant risks, especially for those with atherosclerotic cardiovascular disease history and certain demographic groups, such as those over age 40 with diabetes. Ethnic disparities in outcomes necessitate individualized, equitable healthcare strategies. Optimal decisions about statin cessation necessitate comprehensive evaluations of cardiovascular determinants, with future research crucial to refine therapeutic approaches based on these insights.

Engagement in the digital age: Understanding “what works” for participatory technologies in environmental decision-making

Effective engagement is crucial for enhancing environmental decision-making processes, fostering more sustainable and equitable outcomes. However, the success of engagement is highly variable and context-dependent. While theoretical frameworks have been developed to explain outcome variance in engagement in environmental decision-making, they have not yet been tested in digital contexts, leaving their applicability to digital engagement processes unclear. More broadly, there are unanswered questions about the effectiveness of digital tools in achieving the goals of engagement, which have become increasingly pertinent amidst growing concerns about the potential of digital technologies for exacerbating exclusions, ethical issues, and systematically undermining democratic progress. This paper addresses this evidence gap by presenting findings from interviews with practitioners in UK public, private, and third sector organisations. Our results provide empirical insights into the technical, ethical, and inclusivity debates surrounding digital tools and their effectiveness in promoting accessible engagement, high-quality social interaction, place-based decision-making, and more trustworthy and credible outcomes. Our findings indicate that while current engagement theories are applicable to digital environments, the key explanatory factors acquire new dimensions in digital compared to in-person contexts. Drawing on the findings, this study contributes novel insights to expand current theory for explaining “what works” in engagement in environmental decisions, enhancing its relevance and applicability in the digital age. The paper concludes with evidence-led recommendations for environmental practitioners to improve engagement processes in digital and remote settings.

Balancing the Scales: Caution in Reduction Mammaplasty Recommendations for Obesity Class III Patients.

The prevalence of obesity has risen worldwide, posing a problem to surgeons as obesity is a well-known risk factor for surgical outcomes. While prior studies have suggested performing reduction mammaplasty (RM) in patients with obesity, the variance in outcomes and quality of life (QoL) for obesity classes are ill-defined. We investigated whether obesity classes should be considered for RM by examining the surgical outcomes and QoL across different weight classes, aiming to pinpoint when outcomes become less favorable. Patients undergoing RM by nine surgeons from 2016 to 2022 were included. Body mass index (BMI) cohorts were formed according to the Center for Disease Control and Prevention (CDC) guidelines: Healthy (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), obesity class I (30-34.9 kg/m2), II (35-39.9 kg/m2), and III (>40 kg/m2). QoL was assessed by comparing preoperative and postoperative BREAST-Q scores within cohorts. A comparison analysis was performed between weight classes. A total of 461 RM patients were identified (healthy: 83, overweight: 178, I: 142, II: 39, III: 19). Percentage of Black patients, procedure length, weight of tissue removed, and inferior pedicle technique all significantly increased as BMI increased (P < 0.001). Higher BMI cohorts, especially class III, had significantly higher rates of surgical site infections (healthy: 0%, overweight: 1.1%, I: 1.4%, II: 0%, III: 15.8%, P < 0.01), fat necrosis (healthy: 1.2%, overweight: 5.1%, I: 7%, II: 0%, III: 22.2%, P = 0.01), dehiscence (healthy: 3.6%, overweight: 2.8%, I: 2.1%, II: 5.1%, III: 31.6%, P < 0.01), delayed healing (health: 4.8%, overweight: 11.2%, I: 16.9%, II: 28.2%, III: 42.1%, P < 0.01), minor T-point breakdown (healthy: 10.8%, overweight: 15.7%, I: 23.9%, II: 23.1%, III: 52.6%, P = 0.01), and surgical site occurrence requiring procedural intervention (healthy: 6.0%, overweight: 5.6%, I: 6.3%, II: 15.4%, III: 21.1%, P < 0.05). When compared to the other weight classes independently, class III was associated with unfavorable outcomes (P < 0.05). Significant improvement in average postoperative QoL scores in satisfaction with breast, psychosocial well-being, sexual well-being, and physical well-being were seen in all cohorts except class III (P < 0.05). Severe obesity class III patients undergoing RM have a higher yet still acceptable risk profile and should be counseled on the risks despite its improved quality of life.

Polygenic and socioeconomic contributions to nicotine use and cardiometabolic health in early mid-life.

Early mid-life is marked by accumulating risks for cardiometabolic illness linked to health-risk behaviors like nicotine use. Identifying polygenic indices (PGI) has enriched scientific understanding of the cumulative genetic contributions to behavioral and cardiometabolic health, though few studies have assessed these associations alongside socioeconomic (SES) and lifestyle factors. Drawing on data from 2,337 individuals from the United States participating in the National Longitudinal Study of Adolescent to Adult Health, the current study assesses the fraction of variance in five related outcomes - use of conventional and electronic cigarettes, body mass index (BMI), waist circumference, and glycosylated hemoglobin (A1c) - explained by PGI, SES, and lifestyle. Regression models on African ancestry (AA) and European ancestry (EA) subsamples reveal that the fraction of variance explained by PGI ranges across outcomes. While adjusting for sex and age, PGI explained 3.5%, 2.2%, and 0% in the AA subsample of variability in BMI, waist circumference, and A1c, respectively (in the EA subsample these figures were 7.7%, 9.4%, and 1.3%). The proportion of variance explained by PGI in nicotine-use outcomes is also variable. Results further indicate that PGI and SES are generally complementary, accounting for more variance in the outcomes when modeled together versus separately. PGI are gaining attention in population health surveillance, but polygenic variability might not align clearly with health differences in populations or surpass SES as a fundamental cause of health disparities. We discuss future steps in integrating PGI and SES to refine population health prediction rules. Study findings point to the complementary relationship of polygenic indices (PGI) and socioeconomic indicators in explaining population variance in nicotine outcomes and cardiometabolic wellness. Population health surveillance and prediction rules would benefit from the combination of information from both polygenic and socioeconomic risks. Additionally, the risk for electronic cigarette use among users of conventional cigarettes may have a genetic component tied to the cumulative genetic propensity for heavy smoking. Further research on PGI for vaping is needed.

A Quasi-Experimental Clinical Trial of the Detached Mindfulness Group Therapy for Married Women with Major Depressive Disorder

Background: In an effort to make psychotherapy more widely available, group therapy sessions have recently emerged as a type of treatment. Although there is a lack of evidence about the effectiveness of psychotherapy groups in treating Major Depressive Disorder (MDD) in adults, literature shows that married women with a diagnosis of MDD could benefit from these treatments. Objective: This research aims to shed light on a quasi-experimental trial of the Detached Mindfulness Group Therapy (DMGT) for married women with a diagnosis of MDD. Methods: This study examined the effect of a twelve-week intervention in a quasi-experimental trial by using a pre- and post-intervention design. Results. Based on the results, the DMGT treatment is an effective strategy for treating major depressive disorder. It was found to have a large significant pre-post effect sizes on self-reported depressive symptoms, level of depression, and knowledge development. The level of satisfaction with the intervention was quite high. Conclusions: The strong evidence on treatment protocol acceptability, effect magnitude, outcome variance, and group members variables strongly support a future study to test the effectiveness of the DMGT among married women. Quasi-experimental trials should be used in future studies to determine the effectiveness of this DMGT treatment.

Using reaction time procedures to assess implicit attitudes toward violence in a nonconvicted male sample.

In this study, we sought to capture implicit attitudes toward violence by administering response latency measures. We then examined their associations with explicit (e.g., assessed with self-report) attitudes toward violence and self-reported violent behavior in a combined sample of males from a Canadian university and males from the general community (N = 251; 156 students and 95 community members). To date, there have been mixed findings regarding these associations; some of this inconsistency may be due to the difficulty in accurately conceptualizing and assessing implicit attitudes toward violence. Therefore, we administered three response latency measures to assess this construct: a violence evaluation implicit association test (VE-IAT), a personalized VE-IAT (P-VE-IAT), and a violence evaluation relational responding task, along with three self-report measures of explicit attitudes toward violence and three self-report measures of violent behavior. More positive implicit attitudes toward violence were related to more positive explicit attitudes toward violence (for VE-IAT and P-VE-IAT; r = 0.18 to 0.22), greater likelihood of violence (for VE-IAT; r = 0.18 and for P-VE-IAT; r = 0.16), and greater propensity for violence (for the VE-IAT; r = 0.16). All measures of explicit attitudes toward violence and violent behavior were moderately to strongly associated with one another (r = 0.42 to 0.81). Furthermore, implicit attitudes toward violence explained additional variance in some violent outcomes above explicit attitudes alone. Our findings suggest that scores on certain reaction time measures are important for understanding likelihood and propensity for violence, especially when combined with explicit attitude measures.

Rural-urban disparities in colorectal cancer-related mortality changes in the United States.

e13714 Background: Colorectal cancer is the second leading cause of cancer-related death in the world. The incidence of colorectal cancer rates is higher in rural areas compared to urban populations which is attributed to obesity, and lower adherence to screening. It is hence vital to identify large population-based data on rural and urban disparities in colorectal cancer-related mortality. We, therefore, sought to analyze the outcome variances between urban and rural populations. Methods: We retrieved the mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) multiple causes of death database (years:1999-2020) for patients aged 15 years and above, with malignant neoplasm of colorectum (ICD-10: C18.9, C19, C20) listed as underlying cause of death. We analyzed age-adjusted mortality rates (AAMRs) per 100,000 population and assessed temporal trends in the average percent change (APC) of AAMRs by applying the simplest model with a maximum of 3 joinpoints (using the Joinpoint regression program 5.0.2). We conducted nonparallel pairwise comparisons to assess differences in trends between large metropolitan, small/medium metropolitan, and rural areas (per National Center for Health Statistics Urban- Rural Classification Scheme, 2016) using average annual percentage change difference (AAPCD). Results: A total of 810,577 colorectal cancer-related deaths were retrieved, amongst which 418,744 (51.6%), were in the large metropolitan, 249,933 (30.8%) were in the small/medium metropolitan, and 141,900 (17.5%) were in the rural regions. We noted a decline in the AAMR overall and across large metropolitan, small/medium metropolitan, and rural areas. However, the decline in AAMR was significantly higher among large metropolitan areas as compared to rural areas (AAPCD: -1.0043, 95% CI -1.64, -0.35, p=0.0022). There was no statistically significant difference in decline in AAMR when large metropolitan areas were compared to small/medium metropolitan (AAPCD: -0.4517, 95% CI -0.90, -0.002, p=0.051) and when small/medium metropolitan were compared to rural areas (AAPCD: -0.5526, 95% CI -1.16, -0.05, p=0.07). Conclusions: We identified discrepancies in the decline in colorectal cancer AAMR between urban and rural areas. A substantially lower decline in AAMR is eminent in the rural regions, as compared to the large metropolitan counterparts. This raises the concern for poor access to cancer care in this population group. Our results emphasize the imperative of prioritizing and designing strategies to ensure healthcare equity in rural areas. [Table: see text]