The interaction effect of metals exposure and dietary habit on cognitive function in Chinese older adult cohort

BACKGROUND

As the important factors in cognitive function, dietary habits and metal exposures are interactive with each other. However, fewer studies have investigated the interaction effect of them on cognitive dysfunction in older adults.

METHODS

2,445 registered citizens aged 60-85 years from 51 community health centers in Luohu District, Shenzhen, were recruited in this study based on the Chinese older adult cohort. All subjects underwent physical examination and Mini-cognitive assessment scale. A semi quantitative food frequency questionnaire was used to obtain their food intake frequency, and 21 metal concentrations in their urine were measured.

RESULTS

Elastic-net regression model, a machine learning technique, identified six variables that were significantly associated with cognitive dysfunction in older adults. These variables included education level, gender, urinary concentration of arsenic (As) and cadmium (Cd), and the frequency of monthly intake of egg and bean products. After adjusting for multiple factors, As and Cd concentrations were positively associated with increased risk of mild cognitive impairment (MCI) in the older people, with OR values of 1.19 (95% CI: 1.05-1.42) and 1.32 (95% CI: 1.01-1.74), respectively. In addition, older adults with high frequency of egg intake (≥30 times/month) and bean products intake (≥8 times/month) had a reduced risk of MCI than those with low protein egg intake (<30 times/month) and low bean products intake (<8 times/month), respectively. Furthermore, additive interaction were observed between the As exposure and egg products intake, as well as bean products. Cd exposure also showed additive interactions with egg and bean products intake.

CONCLUSIONS

The consumption of eggs and bean products, as well as the levels of exposure to the heavy metals Cd and As, have been shown to have a substantial influence on cognitive impairment in the elderly population.

How Do Pandemic Policies and Communication Shape Intergroup Outcomes? Initial Findings From the COVID-19 Pandemic and Open Questions for Research and Policy

Government policies can be productive tools for protecting citizens while simultaneously forging more egalitarian societies. At the same time, history has shown that well-intentioned governmental actions, such as those meant to quell pandemics (e.g., blood-donation restrictions), can single out members of marginalized groups (e.g., men who have sex with men). How did government actions shape intergroup outcomes during the COVID-19 pandemic? Here, we draw from emerging research to provide informed conjectures regarding whether and how government actions affected stereotypes (e.g., beliefs about gender), prejudice (e.g., anti-Asian bias), and intergroup violence (e.g., hate crimes against Asian individuals) during the COVID-19 pandemic. We discuss research examining the impact of policies intended to curb the spread of the disease, and we consider possible effects of the strategies used to communicate about the virus. Furthermore, we highlight open questions regarding how and why pandemic policies and communication shape intergroup outcomes, propose key directions for future research, and note possible implications for future development of policy and communication strategies.

Understanding patterns of accumulation: Improving forecast-based decisions via nudging

In this study we investigated challenges associated with comprehension of graphical patterns of accumulation (Experiment 1) and how to improve accumulation-based reasoning via nudging (Experiment 2). On each trial participants were presented with two separate graphs, each depicting a linear, saturating, or exponential data trajectory. They were then asked to make a binary decision based on their forecasts of how these trends would evolve. Correct responses were associated with a focus on the rate of increase in graphs; incorrect responses were driven by prior knowledge and beliefs regarding the context and/or selective attention towards the early phases of the line trajectories. To encourage participants to think more critically and accurately about the presented data, in Experiment 2, participants completed a nudge phase: they either made a forecast about a near horizon or read particular values on the studied trajectories prior to making their decisions. Forecasting about how the studied trajectories would progress led to improvements in determining expected accumulation growth. Merely reading values on the existing trajectory did not lead to improvements in decision accuracy. We demonstrate that actively asking participants to make specific forecasts prior to making decisions based on the accumulation trajectories improves decision accuracy.

The role of loneliness in the association between sexual orientation and depressive symptoms among older adults: A prospective cohort study

BACKGROUND

This study aims to understand the mechanisms contributing to the elevated risk of depression among sexual minority older adults compared to heterosexuals. Specifically, the role of loneliness as a potential mediator is investigated to inform targeted interventions for preventing depression in sexual minority populations.

METHODS

Data from the English Longitudinal Study of Ageing, focusing on adults aged over 50, were analysed. Sexual orientation (sexual minority or heterosexual) and loneliness scores (UCLA scale) were assessed at wave six (2010-2011), while depressive symptoms (CESD) were assessed at wave seven (2013-14). Linear regression models and mediation analyses, using g-computation formula and adjusted for confounders, were conducted.

RESULTS

The sample included 6794 participants, with 478 (7.0 %) identifying as sexual minorities. After adjustments, sexual minorities scored higher on depressive symptoms at wave seven (mean difference): 0.23, 95 % CI 0.07 to 0.39) and loneliness at wave six (MD: 0.27, 95 % CI 0.08 to 0.46). Loneliness was positively associated with depressive symptoms (coefficient: 0.27, 95 % CI 0.26 to 0.29). In mediation analyses, loneliness explained 15 % of the association between sexual orientation and subsequent depressive symptoms.

LIMITATIONS

The dataset used sexual behaviour rather than desire and identity, potentially skewing representation of sexual minorities. Additionally, transgender older adults were not included due to limited gender diversity reported within the ELSA dataset.

CONCLUSIONS

Loneliness appears to be a significant modifiable mechanism contributing to the heightened risk of depressive symptoms in sexual minority older adults compared with their heterosexual counterparts.

Assessing the Training for Certified Peer Support Specialists Who Provide Mental Health and Substance Use Services

The behavioral health system's peer support workforce must be adequately trained to perform peer support services, but evidence of the adequacy of their training needs to be improved. With survey data from 667 certified peer support specialists (CPSS) from North Carolina, Kentucky, Virginia, and Tennessee, this study used (a) binomial probability test to assess perceptions about the adequacy of the workforce's training, (b) latent profile analysis to identify patterns and predictors of perceptions about the SAMHSA core competencies covered in their training, and (c) thematic analysis to identify additional training needs. Most respondents identified as White (72%), female (73%), and had some college education (83%). Most of the workforce (> 90%) felt prepared to provide services, regardless of their state. Highly and moderately sufficient coverage emerged as two distinct response patterns regarding coverage of the SAMSHA core competencies, with respondents' years of experience, state of residence, education level, race, and sense of preparedness predicting the probability of fitting into either profile. Participants desired additional training in trauma-informed practices, motivational interviewing, and new treatment approaches. Peers' experiences and perspectives were similar across different states. The findings suggest booster training sessions or continuing education opportunities are needed to maintain a robust and well-prepared peer support workforce. States should consider reciprocity agreements to enable the trained workforce to practice across states. A key implication for the training content is the need to incorporate contemporary issues relating to mental health and substance use disorders to better meet behavioral health needs.

Cognitive control training with domain-general response inhibition does not change children's brains or behavior

Cognitive control is required to organize thoughts and actions and is critical for the pursuit of long-term goals. Childhood cognitive control relates to other domains of cognitive functioning and predicts later-life success and well-being. In this study, we used a randomized controlled trial to test whether cognitive control can be improved through a pre-registered 8-week intervention in 235 children aged 6-13 years targeting response inhibition and whether this leads to changes in multiple behavioral and neural outcomes compared to a response speed training. We show long-lasting improvements of closely related measures of cognitive control at the 1-year follow-up; however, training had no impact on any behavioral outcomes (decision-making, academic achievement, mental health, fluid reasoning and creativity) or neural outcomes (task-dependent and intrinsic brain function and gray and white matter structure). Bayesian analyses provide strong evidence of absent training effects. We conclude that targeted training of response inhibition does little to change children's brains or their behavior.

Social Environment, Lifestyle, and Genetic Predisposition With Dementia Risk: A Long-Term Longitudinal Study Among Older Adults

BACKGROUND

The role of social environment, that is, the aggregate effect of social determinants of health (SDOHs), in determining dementia is unclear.

METHODS

We developed a novel polysocial risk score for dementia based on 19 SDOH among 5 199 participants in the Health and Retirement Study, United States, to measure the social environmental risk. We used a survival analysis approach to assess the association between social environment and dementia risk in 2006-2020. We further studied the interaction between social environment and lifestyles, and explored racial disparities.

RESULTS

The study participants (mean age = 73.4 years, SD = 8.3; 58.0% female; 11.6% African American) were followed up for an average of 6.2 years, and 1 089 participants developed dementia. Every 1-point increase in the polysocial risk score (ranging from 0 to 10) was associated with a 21.6% higher risk (adjusted hazard ratio [aHR] = 1.21, 95% confidence intervals [95% CI] = 1.15-1.26) of developing dementia, other things being equal. Among participants with high social environmental risk, regular exercise and moderate drinking were associated with a 43%-60% lower risk of developing dementia (p < .001). In addition, African Americans were 1.3 times (aHR = 2.28, 95% CI = 1.96-2.66) more likely to develop dementia than European Americans, other things being equal.

CONCLUSION

An adverse social environment is linked to higher dementia risk, but healthy lifestyles can partially offset the increased social environmental risk. The polysocial risk score can complement the existing risk tools to identify high-risk older populations, and guide the design of targeted social environmental interventions, particularly focusing on improving the companionship of the older people, to prevent dementia.

Team functioning in Neurorehabilitation: a mixed methods study

The objective of this study was to enhance understanding of team functioning in a neurorehabilitation team by identifying the factors that impede and facilitate effective interprofessional team collaboration. We focused on team identification, psychological safety, and team learning, and conducted the research at a neurorehabilitation center treating young patients with severe acquired brain injury in the Netherlands. A mixed-methods approach was employed, integrating quantitative data from questionnaires (N = 40) with qualitative insights from a focus group (n = 6) and in-depth interviews (n = 5) to provide a comprehensive perspective on team dynamics. Findings revealed strong team identification among participants, denoting a shared sense of belonging and commitment. However, limited psychological safety was observed, which negatively affected constructive conflict and team learning. Qualitative analysis further identified deficiencies in shared mental models, especially in shared decision-making and integrated care. These results highlight the crucial role of psychological safety in team learning and the development of shared mental models in neurorehabilitation settings. Although specific to neurorehabilitation, the insights gained may be applicable to enhancing team collaboration in various healthcare environments. The study forms a basis for future research to investigate the impact of improvements in team functioning on patient outcomes in similar settings.

Educational Attainment Moderates Task-State Control Network Connectivity Relations to Response Conflict Among Healthy Older Adults

OBJECTIVES

Older adult executive function varies widely due to brain and cognitive aging. Variance in older adult executive function is linked to increased response conflict from cognitive and brain aging. Cognitive reserve (CR) is a theoretical protective mechanism that lessens brain aging's impact on cognition and is associated with greater educational attainment. Recent work in rest-state functional magnetic resonance imaging (fMRI) suggests CR proxies moderate the relationship between functional connectivity (FC) and cognitive performance. Brain network FC in "control networks," including the salience (SN), dorsal attention and frontoparietal networks, are associated with cognitive processes in older adults. CR is hypothesized to maintain cognitive processing in part through changes in how brain networks respond to cognitive demands. However, it is unclear how CR proxies like educational attainment are related to control network FC during performance when cognitive demands are increased relative to rest. Because CR is expressed more in those with higher education, we hypothesized stronger control network FC would relate to better performance, where this relationship would be strongest among the most educated.

METHODS

We collected flanker task data during fMRI to assess the impact of a CR proxy (i.e., educational attainment) on response conflict among older adult subjects (n = 42, age = 65-80).

RESULTS

Linear mixed-effects models showed more educated older adults with greater SN-FC had a smaller flanker effect (i.e., less influence of distractors; p < .001) during task performance.

DISCUSSION

For the first time, we show that educational attainment moderates the relationship between task-state SN-FC and executive function among older adults.

Psychological endurance: how grit, resilience, and related factors contribute to sustained effort despite adversity

Many concepts describe how individuals sustain effort despite challenging circumstances. For example, scholars and practitioners may incorporate discussions of grit, hardiness, self-control, and resilience into their ideas of performance under adversity. Although there are nuanced points underlying each construct capable of generating empirically sound propositions, the shared attributes make them difficult to differentiate. As a result, substantial confusion arises when debating how these related factors concomitantly contribute to success, especially when practitioners attempt to communicate these ideas in applied settings. The model proposed here-psychological endurance-is a unified theory to explore how multiple concepts contribute to sustained goal-directed behaviors and individual success. Central to this model is the metaphor of a psychological battery, which potentiates and sustains optimal performance despite adversity. Grit and hardiness are associated with the maximum charge of the psychological battery, or how long an individual could sustain effort. Self-control modulates energy management that augments effort required to sustain endurance, whereas resilience represents the ability to recharge. These factors are constrained by both psychological and physiological stressors in the environment that drain the psychology battery. Taken together, these ideas form a novel framework to discuss related psychological concepts, and ideally, optimize intervention to enhance psychological endurance.

Intellectual humility as a tool to combat false beliefs: An individual-based approach to belief revision

False beliefs pose significant societal threats, including health risks, political polarization and even violence. In two studies (N = 884) we explored the efficacy of an individual-based approach to correcting false beliefs. We examined whether the character virtue of intellectual humility (IH)-an appreciation of one's intellectual boundaries-encourages revising one's false beliefs in response to counter-information. Our research produced encouraging but also mixed findings. Among participants who held false beliefs about the risks of vaccines (Study 1) and the 2020 US Election being rigged (Study 2), those with higher IH explored more information opposing these false beliefs. This exploration of opposing information, in turn, predicted updating away from these inaccurate health and political beliefs. IH did not directly predict updating away from false beliefs, however, suggesting that this effect-if it exists-may not be particularly powerful. Taken together, these results provide moderate support for IH as a character trait that can foster belief revision but, simultaneously, suggest that alternate pathways to combat false beliefs and misinformation may be preferred.

Running a successful STEMM summer program: A week-by-week guide

While some established undergraduate summer programs are effective across many institutions, these programs may only be available to some principal investigators or may not fully address the diverse needs of incoming undergraduates. This article outlines a 10-week science, technology, engineering, mathematics, and medicine (STEMM) education program designed to prepare undergraduate students for graduate school through a unique model incorporating mentoring dyads and triads, cultural exchanges, and diverse activities while emphasizing critical thinking, research skills, and cultural sensitivity. Specifically, we offer a straightforward and adaptable guide that we have used for mentoring undergraduate students in a laboratory focused on mitochondria and microscopy, but which may be customized for other disciplines. Key components include self-guided projects, journal clubs, various weekly activities such as mindfulness training and laboratory techniques, and a focus on individual and cultural expression. Beyond this unique format, this 10-week program also seeks to offer an intensive research program that emulates graduate-level experiences, offering an immersive environment for personal and professional development, which has led to numerous achievements for past students, including publications and award-winning posters.

Experiences of physical healthcare services in Māori and non-Māori with mental health and substance use conditions

OBJECTIVES

Inequities in physical health outcomes exist for people with mental health and substance use conditions and for Indigenous populations (Māori in Aotearoa New Zealand). These inequities may be partly explained by poorer quality of physical healthcare services, including discrimination at systemic and individual levels. This study investigated the experiences of people with mental health and substance use conditions accessing physical healthcare and differences in service quality for non-Māori relative to Māori.

METHODS

A cross-sectional online survey of people with mental health and substance use conditions in New Zealand asked about four aspects of service quality in four healthcare settings: general practice, emergency department, hospital and pharmacy. The quality domains were: treated with respect; listened to; treated unfairly due to mental health and substance use conditions; mental health and substance use condition diagnoses distracting clinicians from physical healthcare (diagnostic and treatment overshadowing).

RESULTS

Across the four health services, pharmacy was rated highest for all quality measures and emergency department lowest. Participants rated general practice services highly for being treated with respect and listened to but reported relatively high levels of overshadowing in general practice, emergency department and hospital services. Experiences of unfair treatment were more common in emergency department and hospital than general practice and pharmacy. Compared to Māori, non-Māori reported higher levels of being treated with respect and listened to in most services and were more likely to report 'never' experiencing unfair treatment and overshadowing for all health services.

CONCLUSION

Interventions to address discrimination and poor-quality health services to people with mental health and substance use conditions should be tailored to the physical healthcare setting. More needs to be done to address institutional racism in systems that privilege non-Māori.

Subjective sleep more predictive of global cognitive function than objective sleep in older adults: A specification curve analysis

OBJECTIVES

Sleep is associated with cognitive function in older adults. In the current study, we examined this relationship from subjective and objective perspectives, and determined the robustness and dimensional specificity of the associations using a comprehensive modelling approach.

METHODS

Multiple dimensions of subjective (sleep quality and daytime sleepiness) and objective sleep (sleep stages, sleep parameters, sleep spindles, and slow oscillations), as well as subjectively reported and objectively measured cognitive function were collected from 55 older adults. Specification curve analysis was used to examine the robustness of correlations for the effects of sleep on cognitive function.

RESULTS

Robust associations were found between sleep and objectively measured cognitive function, but not with subjective cognitive complaints. In addition, subjective sleep showed robust and consistent associations with global cognitive function, whereas objective sleep showed a more domain-specific association with episodic memory. Specifically, subjective sleep quality and daytime sleepiness correlated with global cognitive function, and objective sleep parameters correlated with episodic memory.

CONCLUSIONS

Overall, associations between sleep and cognitive function in older adults depend on how they are measured and which specific dimensions of sleep and domains of cognitive function are considered. It highlights the importance of focusing on specific associations to ameliorate the detrimental effects of sleep disturbance on cognitive function in later life.

Sensorimotor regulation of facial expression - An untouched frontier

Facial expression is a critical form of nonverbal social communication which promotes emotional exchange and affiliation among humans. Facial expressions are generated via precise contraction of the facial muscles, guided by sensory feedback. While the neural pathways underlying facial motor control are well characterized in humans and primates, it remains unknown how tactile and proprioceptive information reaches these pathways to guide facial muscle contraction. Thus, despite the importance of facial expressions for social functioning, little is known about how they are generated as a unique sensorimotor behavior. In this review, we highlight current knowledge about sensory feedback from the face and how it is distinct from other body regions. We describe connectivity between the facial sensory and motor brain systems, and call attention to the other brain systems which influence facial expression behavior, including vision, gustation, emotion, and interoception. Finally, we petition for more research on the sensory basis of facial expressions, asserting that incomplete understanding of sensorimotor mechanisms is a barrier to addressing atypical facial expressivity in clinical populations.

The Effects of Computerized Cognitive Training in Older Adults' Cognitive Performance and Biomarkers of Structural Brain Aging

OBJECTIVES

Cognitive training (CT) has been investigated as a means of delaying age-related cognitive decline in older adults. However, its impact on biomarkers of age-related structural brain atrophy has rarely been investigated, leading to a gap in our understanding of the linkage between improvements in cognition and brain plasticity. This study aimed to explore the impact of CT on cognitive performance and brain structure in older adults.

METHODS

One hundred twenty-four cognitively normal older adults recruited from 2 study sites were randomly assigned to either an adaptive CT (n = 60) or a casual game training (active control, AC, n = 64).

RESULTS

After 10 weeks of training, CT participants showed greater improvements in the overall cognitive composite score (Cohen's d = 0.66, p < .01) with nonsignificant benefits after 6 months from the completion of training (Cohen's d = 0.36, p = .094). The CT group showed significant maintenance of the caudate volume as well as significant maintained fractional anisotropy in the left internal capsule and in left superior longitudinal fasciculus compared to the AC group. The AC group displayed an age-related decrease in these metrics of brain structure.

DISCUSSION

Results from this multisite clinical trial demonstrate that the CT intervention improves cognitive performance and helps maintain caudate volume and integrity of white matter regions that are associated with cognitive control, adding to our understanding of the changes in brain structure contributing to changes in cognitive performance from adaptive CT.

CLINICAL TRIAL REGISTRATION

NCT03197454.

A Multi-Method Study Examining the Role of Swiping on Dating Apps: Mate Value Preferences, Sexual Satisfaction, and Need Satisfaction with Matches in Emerging Adults

Intrinsic (i.e., personality traits) and extrinsic mate value (i.e., resources, physical attractiveness) preferences play a crucial role in (online) relationship formation. The role of mate values in dating applications was unclear and was addressed in a multi-method study. A first content analytical study examined the prevalence of mate values (MVs) on Tinder profiles (Study 1) and two subsequent cross-sectional studies explored the relationships between dating app use, various swiping behaviors, sexual satisfaction (Studies 2-3), need satisfaction with matches (Study 3), having a committed relationship versus casual sex motivation for using dating apps and users' gender. The content analysis of 307 Tinder profiles indicated that resources and physical attractiveness were most salient in biographies and pictures, respectively. The first cross-sectional study (nfullsample = 325, ndating app users = 133) revealed no significant relationships between dating app frequency/swiping frequency, intrinsic and extrinsic MV preferences, and sexual satisfaction. The second cross-sectional study (n = 323) showed no significant relationships between picture-based or biography-based swiping, intrinsic and extrinsic MV preferences, and need satisfaction with matches. Gender differences emerged in the presentation of MVs on Tinder (Study 1) and general MV preferences (Study 2-3), but not in the relationships between different types of dating app use/swiping and MV preferences (Study 2-3). A committed relationship and a casual sex motivation played a role in the relationships between different types of swiping behaviors and MV preferences, and between MV preferences, and sexual satisfaction/need satisfaction with matches.

Assessment of Cognitive Flexibility in Jordanian Diabetic Patients by Wisconsin Card Sorting and Trail Making Tests: Implications with Demographic, Anthropometric and Therapeutic Variables

Purpose

Cognitive flexibility is a mental ability that aids in smoothly alternating between them tasks in the brain. Diabetes Mellitus (DM) is a, common disorder that has been associated with impairments in cognitive functions. This research is a retrospective case-control study aimed at establishing a clear relationship between cognitive flexibility and diabetes among Jordanians, considering demographic, anthropometric, and therapeutic variables.

Patients and Methods

The Wisconsin Card Sorting Test (WCST)-64 item and the Trail Making Test (TMT) assessed cognitive flexibility in 268 people with diabetes and healthy control. Demographic, therapeutic data were collected. We also measured waist-to-hip ratio (WHR) and body mass index (BMI). As the variables were non-normally distributed, non-parametric statistical tests were used to examine differences (Kruskal-Wallis) and correlation (Spearman) between variables.

Results

The patient group did worse on the WCST In contrast to the control group, patients exhibited more significant delays for both Part A and Part B of the TMT (p<0.05). Males had higher WCST conceptual level responses than females. In addition, participants with professional jobs showed less delay in TMT Part A (p<0.05). Age was positively correlated with WCST's total errors and TMT's Parts A and B (p<0.05). BMI was negatively correlated with the WCST's conceptual level of responses and positively correlated with TMT's Part B (p<0.05). In addition, urea and albumin levels were positively correlated with TMT's Part A (p<0.05). Furthermore, creatinine was positively correlated with WCST's total errors and TMT's Part A (p<0.05).

Conclusion

Some measures of cognitive flexibility are associated with DM status in the studied sample of Jordanians and other variables (educational levels, occupation, lifestyle, average duration of illness, and age).

The influence of spousal support on the outcomes and willingness of work from home for female knowledge workers

This study identified the key factors of spousal support that influence the outcomes and willingness of female knowledge workers to work from home (WFH). A questionnaire of 59 items was developed, covering basic personal information, spousal support, work perception, work-life balance, and willingness to WFH: 139 valid responses from female participants were collected and analysed. Exploratory factor analysis revealed six distinct factors of spousal support. Regression analysis found that personal-related emotional support, personal-related instrumental support, work-related emotional support, and work-related instrumental support demonstrated positive correlations with work perception and work-life balance, while family-related instrumental support positively correlated with work-life balance. Personal-related emotional support and personal-related instrumental support positively correlated with the willingness to WFH. Notably, personal-related emotional support exhibited the strongest correlation coefficients for willingness and outcomes. The findings could provide information on how a husband could improve his wife's well-being when WFH.Practitioner summary: A survey was conducted among female knowledge workers to examine the influence of different factors of spousal support on the outcomes and willingness of WFH. The results shed light on how husbands can improve their wives' well-being during WFH, offering practical guidance for supporting spouses in this context.

Supporting Emergency Medical Services Clinicians Through Acute and Sustained Crises With Informal Peer Support and Intentional Acts of Kindness: The Emergency Medical Services Code Lavender Program

OBJECTIVE

Given the recommendations against the use of critical incident stress debriefing, the emergency medical services (EMS) Code Lavender program was created as a mechanism to consistently recognize and reach out to EMS clinicians after acute crisis events, offer nonintrusive informal peer support and acts of kindness, and provide stepwise support via mental health professionals as needed. The study aimed to assess program utilization and evaluate the program's impact on EMS clinicians' perceptions of support and resources available to them after an acute crisis event.

METHODS

Anonymous surveys were distributed before program implementation and 18 months later. Program utilization was tracked using REDCap (Vanderbilt University, Nashville, TN). Fisher exact tests and logistic regression were used to analyze the survey results.

RESULTS

Within 30 months, 87 referrals were made. Seventy-seven preprogram (59% response rate) and 104 intraprogram (88% response rate) surveys were collected. There were no differences between respondents by sex or role. There were significant improvements in knowing where to go for help (from 40% to 85%, P < .001) and willingness to seek help if needed (from 40% to 59%, P = .02).

CONCLUSION

The implementation of an EMS Code Lavender program led to significant increases in EMS clinician self-reported knowledge of where to go and willingness to seek help after acute crisis events.

Bidirectional Association Between Internet Use and Episodic Memory Among Older Adults: A Longitudinal Mediation Study

Using nationally representative longitudinal data from three waves of the China Health and Retirement Longitudinal Study (CHARLS), we assessed whether social participation and mental health were channels through which internet use and episodic memory mutually influenced each other. Cross-lagged panel models with multiple mediators were employed for the mediation analysis. The results reveal that social participation and depressive symptoms were mechanisms underlying the internet-cognition interplay. Among men, an increased chance of contacting friends served as a pathway connecting internet use with better episodic memory. Conversely, men with better episodic memory were more likely to use the internet partially due to their higher chances of having contact with friends and engaging in group activities. Among women, engagement in group activities and depressive symptoms were two channels through which internet use and episodic memory positively influenced each other. Our findings provide practical implications for slowing cognitive aging and narrowing the digital divide.

Older adults' online activities and cognition: Investigating the psychological mechanisms and age and gender differences

OBJECTIVES

This study aimed to investigate psychological mechanisms underlying the association between older adults' Internet use and cognition and examine potential age and gender group differences.

METHODS

2064 older participants were extracted from the Waves 2012, 2013, and 2016 Health and Retirement Study. Internet use was measured by two sets of variables: Internet access and different types of online activities (i.e., informational use, social use, online shopping, and online banking). Path analyses were applied to test the proposed mechanisms via three mediators (i.e., loneliness, depressive symptoms, and perceived control). Multi-group analyses were conducted to examine the potential group differences.

RESULTS

Internet use was positively associated with cognition. Despite the large direct effect, small but significant indirect effects via depressive symptoms and perceived control were identified across all online activities. Multi-group analyses revealed age-group differences in the mechanisms: depressive symptoms mediated the effects of all online activities on cognition among young-old adults, while perceived control mediated all the effects among old-old adults. Gender group differences were also identified: depressive symptoms mediated the effects of all online activities on cognition among older women and most online activities among older men, whereas perceived control mediated the associations between informational and instrumental (i.e., online shopping and banking) use and cognition among older men.

DISCUSSION

This study highlights the mediating effect of depressive symptoms and perceived control and age and gender differences regarding the Internet use-cognition association. Internet-based cognitive interventions should consider these psychological mediators and age and gender differences for the best results.

Phonological syllables allow children with developmental dyslexia to access words

Learning to read is a middle-distance race for children worldwide. Most of them succeed in this acquisition with "normal" difficulties that ensue from the progressive (re)structuring of the phonological and orthographic systems. Evidence accumulated on reading difficulties in children with developmental dyslexia (DYS children, henceforth) shows a pervasive phonological deficit. However, the phonological deficit may not be due to degraded phonological representations but rather due to impaired access to them. This study focused on how and to what extent phonological syllables, which are essential reading units in French, were accessible to DYS children to segment and access words. We tested the assumption that DYS children did not strictly have pervasive degraded phonological representations but also have impaired access to phonological and orthographic representations. We administered a visually adapted word-spotting paradigm, engaging both sublexical processing and lexical access, with French native-speaking DYS children (N = 25; Mage in months = 121.6, SD = 3.0) compared with chronological age-matched peers (N = 25; Mage in months = 121.8, SD = 2.7; CA peers henceforth) and reading level-matched peers (N = 25; Mage in months = 94.0, SD = 4.6; RL peers henceforth). Although DYS children were slower and less accurate than CA and RL peers, we found that they used phonological syllables to access and segment words. However, they exhibit neither the classical inhibitory syllable frequency effect nor the lexical frequency effect, which is generally observed in typically developing children. Surprisingly, DYS children did not show strictly degraded phonological representations because they demonstrated phonological syllable-based segmentation abilities, particularly with high-frequency syllables. Their difficulties are rather interpreted in terms of impaired access to orthographic and phonological representations, which could be a direct effect of difficulties in generalizing and consolidating low-frequency syllables. We discuss these results regarding reading acquisition and the specificities of the French linguistic system.

[Formula: see text] Cognitive dysfunction in pediatric systemic lupus erythematosus: current knowledge and future directions

Cognitive dysfunction (CD) is a neurologic complication of pediatric systemic lupus erythematosus (SLE) that remains poorly understood and understudied, despite the potential negative effects of CD on long-term socioeconomic status and quality of life. Data regarding the prevalence and risk factors for CD in pediatric SLE as well as the optimal screening, treatment, and long-term outcomes for CD are lacking. In this review, we present current knowledge on CD in pediatric SLE with a focus on the application to clinical practice. We discuss the challenges in diagnosis, clinical screening methods, potential impacts, and interventions for this complication. Finally, we discuss the remaining gaps in our knowledge of CD in pediatric SLE, and avenues for future research efforts.

Motivating parents to protect their children from wildfire smoke: the impact of air quality index infographics

Background. Wildfire smoke events are increasing in frequency and intensity due to climate change. Children are especially vulnerable to health effects even at moderate smoke levels. However, it is unclear how parents respond to Air Quality Indices (AQIs) frequently used by agencies to communicate air pollution health risks. Methods. In an experiment (3 × 2 × 2 factorial design), 2,100 parents were randomly assigned to view one of twelve adapted AQI infographics that varied by visual (table, line, gauge), index type (AQI [0-500], AQHI [1-11+]), and risk level (moderate, high). Participants were told to imagine encountering the infographic in a short-term exposure scenario. They reported worry about wildfire smoke, intentions to take risk-mitigating actions (e.g., air purifier use), and support for various exposure reduction policies. Subsequently, participants were told to imagine encountering the same infographic daily during a school week in a long-term exposure scenario and again reported worry, action intentions, and policy support. Results. Parents' responses significantly differentiated between risk levels that both pose a threat to children's health; worry and action intentions were much higher in the high-risk group than the moderate-risk group in both short-exposure (F = 748.68 p<.001; F = 411.59, p<.001) and long-exposure scenarios (F = 470.51, p<.001; F = 212.01, p<.001). However, in the short-exposure scenario, when shown the AQHI [1-11+] with either the line or gauge visuals, parents' action intentions were more similar between moderate- and high-risk level groups (3-way interaction, F = 6.03, p = .002). Conclusions. These results suggest some index formats such as the AQHI-rather than the AQI-may better attune parents to moderate levels of wildfire smoke being dangerous to children's health. Our research offers insights for agencies and officials seeking to improve current public education efforts during wildfire smoke events and speaks to the critical need to educate parents and help them act short-term and long-term to protect children's health.

Credibility of misinformation source moderates the effectiveness of corrective messages on social media

To examine how different features of corrective messages moderate individuals' attitudes toward misinformation on social media, a 2 (misinformation source credibility: high vs low) × 2 (corrective message source: algorithmic vs peer correction) × 2 (correction type: factual elaboration vs simple rebuttal) between-subjects experiment was conducted. To reduce perceived credibility and respondents' attitudes toward the misinformation, peer corrections were more effective than algorithmic corrections for misinformation from a source with lower credibility; for misinformation from a highly credible source, the superiority effect of peer corrections was still significant on perceived credibility but not on respondents' attitudes toward the misinformation. For the fact-checking tendency, we did not find a robust effect about how different features of corrective messages interacted. Our findings provide important insights into message design in combatting misinformation on social media.

Separating the Effects of Transitions Into and Out of Social Isolation and Loneliness on Cognitive Function in Later Life

OBJECTIVES

This study investigates the effects of social isolation and loneliness on cognitive function, distinguishing between the effects of transitioning into and out of these states.

METHODS

This study analyzed data from 6,663 adults aged 65 or older collected over the course of 7 waves (12 years) of the Korean Longitudinal Study of Aging from 2006 to 2018. A novel asymmetric fixed effects model was utilized to separately estimate the effects of transitions into and out of social isolation or loneliness.

RESULTS

The association of transitions into social isolation due to a lack of informal social contact or loneliness with cognitive function (b = -1.387, p < .001 and b = -0.601, p < .001, respectively) was stronger than the association of transitions out of these states (b = 0.345, p < .05 and b = 0.353, p < .001, respectively). The magnitude of the negative and positive coefficients was statistically different (F-statistic = 45.29, p < .001 and F-statistic = 5.12, p < .05, respectively). In contrast, no such asymmetric effects were observed for social isolation due to a lack of formal activity (F-statistic = 0.06, p = .800).

DISCUSSION

The detrimental effects of transitioning into social isolation due to a lack of informal social contact (but not formal activity) or loneliness on cognitive function outweigh the beneficial effects of transitioning out of these states. Preventing the onset of social disconnection should be prioritized as an intervention to improve the cognitive function of older adults.

Intersectional Inequalities in the Transition to Grandparenthood and Cognitive Functioning: A Longitudinal Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy

OBJECTIVES

In aging societies, more people become vulnerable to experiencing cognitive decline. Simultaneously, the role of grandparenthood is central for older adults and their families. Our study investigates inequalities in the level and trajectories of cognitive functioning among older adults, focusing on possible intersectional effects of social determinants and grandparenthood as a life course transition that may contribute to delaying cognitive decline.

METHODS

Using longitudinal data from the Survey of Health, Aging, and Retirement in Europe, we analyzed a sample of 19,953 individuals aged 50-85 without grandchildren at baseline. We applied multilevel analysis of individual heterogeneity and discriminatory accuracy to investigate variation in cognitive functioning across 48 intersectional strata, defined by sex/gender, migration, education, and occupation. We allowed the impact of becoming a grandparent on cognitive functioning trajectories to vary across strata by including random slopes.

RESULTS

Intersectional strata accounted for 17.43% of the overall variance in cognitive functioning, with most of the stratum-level variation explained by additive effects of the stratum-defining characteristics. Transition to grandparenthood was associated with higher cognitive functioning, showing a stronger effect for women. Stratum-level variation in the grandparenthood effect was modest, especially after accounting for interactions between grandparenthood and the stratum-defining variables.

DISCUSSION

This study highlights the importance of social determinants for understanding heterogeneities in older adults' level of cognitive functioning and its association with the transition to grandparenthood. Cumulative disadvantages negatively affect cognitive functioning, hence adopting an intersectional lens is useful to decompose inequalities and derive tailored interventions to promote equal healthy aging.

Investigating if high-quality kindergarten teachers sustain the pre-K boost to children's emergent literacy skill development in North Carolina

This study tested the hypothesis that high-quality kindergarten teachers sustain and amplify the skill development of children who participated in North Carolina's NC Pre-K program during the previous year, compared to matched non-participants (N = 17,330; 42% African American, 40% Non-Hispanic White, 15% Hispanic; 51% male; Mage = 4.5 years at fall of pre-K). Kindergarten teacher quality was measured using a "value-added" approach. NC Pre-K participants outperformed non-participants in the fall of kindergarten (β = .22) and 11% of this boost remained evident by the spring of kindergarten. Higher value-added teachers promoted the skill development of all children (β = .30 in the spring) but did not differentially benefit the skill development of former NC Pre-K participants compared to non-participants.

Association of Hypertension with Well-Being: Results from the Behavioral Risk Factor Surveillance System (BRFSS) Study

INTRODUCTION

It remains unclear how hypertension affects subjective well-being, especially in light of its potential gender-specific impacts.

AIM

In this study, we aimed to study the association between hypertension and subjective well-being and the potential gender differences in this relationship as well as mediating factors.

METHODS

We use individual-level data from > 1 million Americans who participated in six waves of the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) survey. We employ descriptive and regression analyses to determine the association between hypertension and subjective well-being while controlling for the usual well-being covariates identified from the related literature.

RESULTS

Hypertension was negative associated with subjective well-being (p < 0.001) and our results for covariates were in line with the findings in the related literature. The association between hypertension and subjective well-being was only found in males (p < 0.001) but not in females. The relationship is mediated by age and exercising but only for females.

CONCLUSION

Hypertension is negatively associated with well-being among males. The diagnosis of hypertension should not only lead to medical treatments but also involve a careful psychological management.

Somatized or stigma? Causal attributions and emotional responses in shaping social distance towards people with mental illness, China

Background

Mental illness in China has traditionally been attributed to physical factors and somatization tendencies, which seldom result in stigma. How has this perception changed after decades of social change?

Methods

Based on the Chinese General Social Survey database in 2011, this study constructed a structural equation model to analyze the effects of causal attribution and emotional responses on social distance. The causal attributions include dangerousness, controllability, and responsibility. And the emotional responses encompass negative affect, traditional prejudice, treatment carryover, and exclusionary sentiments. In addition, higher scores indicating greater social distance, whereas a low score reflected stronger emotional responses or a greater degree of internal attribution.

Results

The results reported a high level of social distance towards people with mental illness. These findings indicated that emotional responses have a direct impact on social distance. Specifically, when negative affect, traditional prejudice, and exclusionary sentiments increase by one standard deviation, the social distance decreases by 0.497, 0.178, and 0.073 standard deviation, respectively. Conversely, as the level of treatment carryover rises, social distance increases by 0.087. Meanwhile, the causal attribution only exerts a significant indirect effect on social distance by the function of emotional causal responses.

Conclusion

The results indicated that the public attributes mental illnesses like depression primarily to psychological issues rather than somatic ones. It suggested widespread stereotypes and public stigma towards people with mental illness in China, as well as an arduous task in anti-stigma. In addition, a targeted way to address public stigma lies in changing the stereotype of people with mental illness.

Function estimation: Quantifying individual differences of hand-drawn functions

Graphical perception is an important part of the scientific endeavour, and the interpretation of graphical information is increasingly important among educated consumers of popular media, who are often presented with graphs of data in support of different policy positions. However, graphs are multidimensional and data in graphs are comprised not only of overall global trends but also local perturbations. We presented a novel function estimation task in which scatterplots of noisy data that varied in the number of data points, the scale of the data, and the true generating function were shown to observers. 170 psychology undergraduates with mixed experience of mathematical functions were asked to draw the function that they believe generated the data. Our results indicated not only a general influence of various aspects of the presented graph (e.g., increasing the number of data points results in smoother generated functions) but also clear individual differences, with some observers tending to generate functions that track the local changes in the data and others following global trends in the data.

The Role of Occipitotemporal Network for Speed-Reading: An fMRI Study

The activity of occipitotemporal regions involved in linguistic reading processes, such as the ventral occipitotemporal cortex (vOT), is believed to exhibit strong interactions during higher-order language processing, specifically in the connectivity between the occipital gyrus and the temporal gyrus. In this study, we utilized functional magnetic resonance imaging (fMRI) with psychophysiological interaction (PPI) and dynamic causal modeling (DCM) to investigate the functional and effective connectivity in the occipitotemporal network during speed reading. We conducted the experiment with native Japanese speakers who underwent and without speed-reading training and subsequently performed established reading tasks at different speeds (slow, medium, and fast) while undergoing 3-Tesla Siemens fMRI. Our activation analyses revealed significant changes in occipital and temporal regions as reading speed increased, indicating functional connectivity within the occipitotemporal network. DCM results further demonstrated more intricate effective connections and high involvement within the occipitotemporal pathway: (1) reading signals originated from the inferior occipital gyrus (iO), distributed to the vOT and the posterior superior temporal sulcus (pSTS), and then gathered in the anterior superior temporal sulcus (aSTS); (2) reading speed loads had modulation effects on the pathways from the aSTS to vOT and from the iO to vOT. These findings highlight the complex connectivity and dynamic interactions within the occipitotemporal network during speed-reading processes.

Using theoretical constraints and the TASI taxonomy to delineate predictably replicable findings

The focus of the present article is not on failures to replicate but on the more optimistically framed and more fruitful question: What stable findings can be reproduced reliably and can be trusted by decision makers, managers, health agents, or politicians? We propagate the working hypothesis that a twofold key to stable and replicable findings lies in the existence of theoretical constraints and, no less important, in researchers' sensitivity to metatheoretical, auxiliary assumptions. We introduce a hierarchy of four levels of theoretical constraints-a priori principles, psychophysical, empirical, and modelling constraints-combined with the TASI taxonomy of theoretical, auxiliary, statistical, and inferential assumptions Trafimow, Journal for the Theory of Social Behaviour, 52, 37-48, (2022). Although theoretical constraints clearly facilitate stable and replicable research findings, TASI reminds us of various reasons why even perfectly valid hypotheses need not always be borne out. The presented framework should help researchers to operationalize conditions under which theoretical constraints render empirical findings most predictable.

Fifteen-minute consultation: Empowering children, young people and families through shared decision-making: a practical guide

Shared decision-making (SDM) is a collaborative approach to healthcare decision-making that involves patients and healthcare professionals working together to make decisions that are informed by the best available medical evidence, as well as the patient's values, preferences and goals. The importance of SDM and the intricate interplay among parents, children and young people (CYP), and healthcare professionals are increasingly acknowledged as the crucial aspects of delivering high-quality paediatric care. While there is a substantial evidence base for SDM improving knowledge and reducing decisional conflict, the evidence for long-term measures such as improved health outcomes is limited and mainly inconclusive. To support healthcare teams in implementing SDM, the authors offer a practical guide to enhance decision-making processes and empower CYP and their families.

Risk and protective factors for cognitive decline in Brazilian lower educated older adults: A 15-year follow-up study using group-based trajectory modelling

BACKGROUND

Patterns of cognitive change and modifiable factors for cognitive decline versus stable cognitive trajectories have rarely been described in lower-educated older adults.

OBJECTIVES

We aimed to identify long-term trajectories of cognitive functioning and possible factors associated with cognitive decline.

DESIGN AND PARTICIPANTS

We used data from 1,042 adults aged ≥ 60 participating in the Health, Welfare and Aging Study (SABE), São Paulo, Brazil, without cognitive impairment at baseline. Data were collected across four waves (2000-2015). Group-based trajectory modelling was used to identify cognitive trajectories. Associations with socioeconomic variables, childhood background, lifestyle, and cardiovascular risk factors were explored using weighted multinomial logistic regressions.

MEASUREMENTS

The abbreviated Mini-Mental State Examination was used to measure cognition.

RESULTS

Three cognitive trajectories were identified: stable (n= 754, 68.6%), mild-decline (n= 183, 20.8%), and strong-decline (n= 105, 10.7%). At baseline, respondents in the strong-decline group were more likely to be older than those with stable and mild-decline trajectories. Furthermore, participants in both the mild and strong-decline groups were more likely to have no schooling, be divorced/separated, receive less than 4 monthly wages, and be underweight (BMI < 18.5) compared to the stable group. Finally, the mild-decline group was more likely to have lived in rural areas during childhood than participants located in a stable trajectory.

CONCLUSIONS

Our findings suggest that interventions to reduce cognitive decline for low-educated older adults might include strategies addressing inequalities and improving modifiable risk factor burden.

Cross-sectional and longitudinal associations between late-life depressive symptoms and cognitive deficits: 20-year follow-up of the Kuakini Honolulu-Asia aging study

OBJECTIVE

To examine depressed affect, somatic complaints, and positive affect as longitudinal predictors of fluid, crystallized and global cognitive performance in the Kuakini Honolulu-Asia Aging Study (HAAS), a large prospective cohort study of Japanese-American men.

METHODS

We assessed 3,088 dementia-free Kuakini-HAAS participants aged 71-93 (77.1 ± 4.2) years at baseline (1991-1993). Depressive symptoms were evaluated by the Center for Epidemiologic Studies Depression (CES-D) Scale. Baseline CES-D depression subscales (depressed and positive affects; somatic complaints) were computed. The Cognitive Abilities Screening Instrument (CASI) measured cognitive performance on a 100-point scale; fluid and crystallized cognitive abilities were derived from CASI factor analysis. Cognition was also evaluated at 4 follow-up examinations over a 20-year period. Multiple regression assessed baseline CES-D subscales as predictors of cognitive change. The baseline covariates analyzed were CASI, age, education, prevalent stroke, APOE ε4 presence, and the longevity-associated FOXO3 genotype.

RESULTS

Cross-sectionally, baseline CES-D subscales were related to cognitive measures; e.g., higher depressed affect was associated with lower crystallized ability (β = -0.058, p ≤ 0.01), and somatic complaints were linked to poorer fluid ability (β = -0.045, p ≤ 0.05) and to worse global cognitive function as measured by total CASI score (β = -0.038, p ≤ 0.05). However, depression subscales did not significantly or consistently predict fluid ability, crystallized ability, or global cognitive performance over time.

CONCLUSION

Psychological and physical well-being were associated with contemporaneous but not subsequent cognitive functioning. Assessment of depressive symptoms may identify individuals who are likely to benefit from interventions to improve mood and somatic health and thereby maintain or enhance cognition.

Health-Related Quality of Life Using the KIDSCREEN-27 Questionnaire among Adolescents with High Myopia

Background/Objectives: The aim of the study was to explore Health-Related Quality of Life (HRQoL) using the KIDSCREEN-27 questionnaire among adolescents with high myopia (HM). Methods: Sixty-nine adolescents with HM and 71 healthy participants aged 12-17 years and their parents or legal guardians were enrolled in the study. Results: Adolescents with HM showed significantly lower scores on the Physical Well-Being dimension in comparison with controls (p = 0.003), particularly girls with HM in comparison with girls from the control group (p = 0.008), and 15-17-year-old adolescents in comparison with same-aged controls (p = 0.020). Girls with HM were characterised by significantly worse scores on the Psychological Well-Being dimension compared with boys with HM (p < 0.042). Sociodemographic factors and refractive error, its duration, and acceptance of disease had no impact on HRQoL. Conclusions: HM may have a negative impact on the HRQoL of children, affecting particularly the physical and psychological well-being of girls. It is important that a holistic approach to the treatment of HM in adolescents is taken by measuring their HRQoL as part of the routine diagnostic process. Use of the KIDSCREEN-27 questionnaire seems justified as it allows for determination of the type of intervention required to improve the HRQoL of individuals affected by the disease.

Mental Health and Cognition in Women Veterans Enrolled in the Health of Vietnam Era Veteran Women's Study (HealthViEWS)

Objective: This analysis explored relationships between mental health symptoms and conditions and cognitive function in a cohort of Vietnam-era women veterans from the Health of Vietnam Era Veteran Women's Study (HealthViEWS). Methods: Vietnam-era women veterans completed a mail survey assessing self-reported symptom severity of posttraumatic stress disorder (PTSD) and depression. A telephone-based structured interview assessed mental health conditions and cognitive function (telephone interview for cognitive status [TICS]). Participants were categorized using a TICS threshold of ≤29 to designate possible cognitive impairment versus nonimpaired. Separate logistic regression models were used to determine associations between possible cognitive impairment and each self-reported and interviewer-rated assessment of PTSD and depression while adjusting for age, education, race, marital status, and wartime service location. Results: The sample consisted of 4,077 women veterans who were ≥60 years old and completed the TICS. Of these women, 7.20% were categorized with possible cognitive impairment. Logistic regression models indicated that self-reported PTSD and depression symptom severity were each significantly associated with higher odds of possible cognitive impairment (adjusted odds ratios [aOR]: 1.03 [95% confidence interval [CI]: 1.02-1.04] and 1.07 [95% CI: 1.04-1.09], respectively). Women veterans with a probable diagnosis of depression had higher odds of possible cognitive impairment compared to those without depression (aOR: 1.61 [95% CI: 1.07-2.42]). No association was found for probable diagnosis of PTSD. Conclusions: Although further examination remains necessary, results suggest that Vietnam-era women veterans with self-reported PTSD and depression symptom severity or a probable diagnosis of depression may benefit from screening of cognitive function to inform clinical care.

Study Protocol for Pain Self-Management and Patient-Oriented Buprenorphine Dosing for Pain and Retention in Office-Based Opioid Treatment: A Hybrid Type 1, 2 × 2 Factorial Randomized Controlled Trial

Chronic pain is a significant factor for patients with opioid use disorder (OUD) contributing to suboptimal retention in buprenorphine treatment, which is a crucial predictor of long-term health outcomes. This study aims to address the critical need for effective interventions targeting chronic pain management within office-based opioid treatment (OBOT) programs. We are conducting a multisite, hybrid type 1, 2 × 2 factorial randomized clinical trial to determine the effectiveness of 2 novel interventions, pain self-management (PSM) and patient-oriented buprenorphine dosing (POD), to decrease pain interference and improve retention in buprenorphine treatment. PSM, a manualized and customizable approach delivered through individual and peer-led group sessions, aims to decrease pain-related symptoms and quality of life. POD involves split dosing of buprenorphine to extend the duration of analgesia to better match its duration of efficacy at managing OUD symptoms, leading to improved retention in buprenorphine treatment. Eligible participants will be randomized into 1 of 4 groups: (1) PSM + POD, (2) PSM + Standard Buprenorphine Dosing, (3) Usual Care + POD, or (4) Usual Care + Standard Buprenorphine Dosing. Usual Care refers to usual care for chronic pain and Standard Buprenorphine Dosing refers to the participant's current dosing regimen. Secondary objectives encompass overall pain reduction, decreased opioid use, improved pain symptom management, and exploration of implementation strategies. The supplemental approved protocol provides comprehensive insights into the procedures and variables being investigated. As part of the HEAL Initiative®-funded Integrative Management of Chronic Pain and OUD for Whole Recovery (IMPOWR) network, this study aims to fill gaps in behavioral and medication treatments for individuals with co-occurring chronic pain and OUDs, improving pain management and retention in care. Successful outcomes from this trial may inform future larger trials, offering essential evidence for implementation considerations and reimbursement decisions.

There is No Supporting Evidence for a Far Transfer of General Perceptual or Cognitive Training to Sports Performance

In this opinion piece I reiterate the concepts of near and far transfer as previously described in the psychological literature. I show that despite very limited evidence, many technologies, tools and methods make questionable claims of eliciting far transfer from generic perceptual and/or cognitive training to sports performance. Specifically, this commentary illustrates with studies on stroboscopic vision, neurofeedback training and executive functions that the claims made for the beneficial effects of these training methods are currently unsubstantiated. I conclude that greater scrutiny by researchers is needed in order to assist practitioners to make better-informed decisions about tools, methods and technologies that may aid sports performance.

Modelling individual differences in reading using an optimised MikeNet simulator: the impact of reading instruction

Reading is vital for acquiring knowledge and studies have demonstrated that phonology-focused interventions generally yield greater improvements than meaning-focused interventions in English among children with reading disabilities. However, the effectiveness of reading instruction can vary among individuals. Among the various factors that impact reading skills like reading exposure and oral language skills, reading instruction is critical in facilitating children's development into skilled readers; it can significantly influence reading strategies, and contribute to individual differences in reading. To investigate this assumption, we developed a computational model of reading with an optimised MikeNet simulator. In keeping with educational practices, the model underwent training with three different instructional methods: phonology-focused training, meaning-focused training, and phonology-meaning balanced training. We used semantic reliance (SR), a measure of the relative reliance on print-to-sound and print-to-meaning mappings under the different training conditions in the model, as an indicator of individual differences in reading. The simulation results demonstrated a direct link between SR levels and the type of reading instruction. Additionally, the SR scores were able to predict model performance in reading-aloud tasks: higher SR scores were correlated with increased phonological errors and reduced phonological activation. These findings are consistent with data from both behavioral and neuroimaging studies and offer insights into the impact of instructional methods on reading behaviors, while revealing individual differences in reading and the importance of integrating OP and OS instruction approaches for beginning readers.

Interactive Electronic Pegboard for Enhancing Manual Dexterity and Cognitive Abilities: Instrument Usability Study

BACKGROUND

Strokes pose a substantial health burden, impacting 1 in 6 people globally. One-tenth of patients will endure a second, often more severe, stroke within a year. Alarmingly, a younger demographic is being affected due to recent lifestyle changes. As fine motor and cognitive issues arise, patient disability as well as the strain on caregivers and health care resources is exacerbated. Contemporary occupational therapy assesses manual dexterity and cognitive functions through object manipulation and pen-and-paper recordings. However, these assessments are typically isolated, which makes it challenging for therapists to comprehensively evaluate specific patient conditions. Furthermore, the reliance on one-on-one training and assessment approaches on manual documentation is inefficient and prone to transcription errors.

OBJECTIVE

This study examines the feasibility of using an interactive electronic pegboard for stroke rehabilitation in clinical settings.

METHODS

A total of 10 patients with a history of stroke and 10 healthy older individuals were recruited. With a limit of 10 minutes, both groups of participants underwent a series of challenges involving tasks related to manual operation, shape recognition, and color discrimination. All participants underwent the Box and Block Test and the Purdue Pegboard Test to assess manual dexterity, as well as an array of cognitive assessments, including the Trail Making Test and the Mini-Mental Status Examination, which served as a basis to quantify participants' attention, executive functioning, and cognitive abilities.

RESULTS

The findings validate the potential application of an interactive electronic pegboard for stroke rehabilitation in clinical contexts. Significant statistical differences (P<.01) were observed across all assessed variables, including age, Box and Block Test results, Purdue Pegboard Test outcomes, Trail Making Test-A scores, and Mini-Mental Status Examination performance, between patients with a history of stroke and their healthy older counterparts. Functional and task testing, along with questionnaire interviews, revealed that patients with a history of stroke demonstrated prolonged completion times and slightly inferior performance. Nonetheless, most patients perceived the prototype as user-friendly and engaging. Thus, in the context of patient rehabilitation interventions or the evaluation of patient cognition, physical functioning, or manual dexterity assessments, the developed pegboard could potentially serve as a valuable tool for hand function, attention, and cognitive rehabilitation, thereby mitigating the burden on health care professionals.

CONCLUSIONS

Health care professionals can use digital electronic pegboards not only as a precise one-on-one training tool but also as a flexible system that can be configured for online or offline, single-player or multiplayer use. Through data analysis, a more informed examination of patients' cognitive and functional issues can be conducted. Importantly, patient records will be fully retained throughout practices, exercises, or tests, and by leveraging the characteristics of big data, patients can receive the most accurate rehabilitation prescriptions, thereby assisting them in obtaining optimal care.

Association of Childhood Exposure to School Racial Segregation with Late-Life Cognitive Outcomes among Older Americans

IMPORTANCE

Disparities in cognition, including dementia occurrence, persist between White and Black older adults, and are possibly influenced by early educational differences stemming from structural racism. However, the relationship between school racial segregation and later-life cognition remains underexplored.

OBJECTIVE

To investigate the association between childhood contextual exposure to school racial segregation and cognitive outcomes in later life.

DESIGN SETTING AND PARTICIPANTS

Data from 16,625 non-Hispanic White (hereafter, White) and 3,335 non-Hispanic Black (hereafter, Black) Americans aged 65 or older were analyzed from the Health and Retirement Study.

EXPOSURES

State-level White-Black dissimilarity index for public elementary schools in the late 1960s (range: 0-100) was used to measure school segregation. States were categorized into high segregation (383.6) and low segregation (<83.6) based on the top quintile.

MAIN OUTCOMES AND MEASURES

Cognitive scores, cognitive impairment (with or without dementia), and dementia were assessed using the Telephone Interview for Cognitive Status (TICS) and proxy assessment. Multilevel regression analyses were conducted, adjusting for demographic covariates, socioeconomic status, and health factors. Stratified analyses by race were performed.

RESULTS

The mean (SD) age of participants was 78.5 (5.7) years, and 11,208 (56.2%) were female. Participants exposed to high segregation exhibited lower cognitive scores (12.6 vs. 13.6; P<0.001) and higher prevalence of cognitive impairment (50.8% vs 41.4%; P<0.001) and dementia (26.0% vs. 19.5%; P<0.001), compared to those with low segregation exposure. Multilevel analyses revealed a significant negative association between school segregation and later-life cognitive even after adjusting sequentially for potential confounders, and these associations were stronger among Black than White participants. Notably, in the fully adjusted model, Black participants exposed to high segregation displayed significantly lower cognitive scores (-0.51; 95% CI: -0.94, -0.09) and higher likelihood of cognitive impairment (adjusted Odds Ratio [aOR]: 1.45, 95% CI: 1.22, 1.72) and dementia (aOR: 1.31, 95% CI: 1.06, 1.63).

CONCLUSIONS AND RELEVANCE

Our study underscores that childhood exposure to state-level school segregation is associated with late-life cognition, especially for Black Americans. Given the rising trend of school segregation in the US, educational policies aimed at reducing segregation are crucial to address health inequities. Clinicians can leverage patients' early-life educational circumstances to promote screening, prevention, and management of cognitive disorders.

Association between support of basic psychological needs and stress response as mediated by motivation for solitude

This study examined the relationship between not self-determined / self-determined solitude and stress responses, as well as the effect of supporting / thwarting of basic psychological needs. The sample consisted of 606 Japanese people aged 20 years and older. We used a cross-sectional survey to measure their motivations for solitude, supporting / thwarting of basic psychological needs, and stress responses. Not self-determined solitude was negatively correlated with supporting of basic psychological needs and positively correlated with thwarting of basic psychological needs. In addition, a cutoff score of 16 for not self-determined solitude was found to be optimal for identifying individuals with a high stress response. Mediation analysis revealed that supporting / thwarting of basic psychological needs has direct effects on stress responses and indirect effects mediated by not self-determined solitude. These findings suggest that fostering environments that support basic psychological needs of autonomy, competence, and relatedness can alleviate not self-determined solitude and reduce stress responses.

Factors Influencing Autonomy in Middle-Aged and Elderly Women with Urinary Incontinence

INTRODUCTION AND HYPOTHESIS

Urinary incontinence (UI) is relatively common among middle-aged and elderly women and can have significant impacts on patients' physiological, psychological, and quality-of-life aspects. A higher level of autonomy can encourage better health behaviors in patients, so as to promote rehabilitation of the disease and improve their quality of life. The study is aimed at exploring the level of autonomy and influencing factors among middle-aged and elderly women with UI.

METHODS

A cross-sectional study was conducted at a tertiary hospital in Shenzhen, China. Middle-aged and elderly women were asked to complete the Index of Autonomous Functioning scale (IAF), the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and the Urinary Incontinence Quality of Life (I-QOL) scale. Data were collected in January 2024 to March 2024. Descriptive statistics, univariate analysis, bivariate correlation and multivariate linear regression were used to analyze data.

RESULTS

A total of 646 women completed the questionnaire. The means and standard deviations (SD) of the IAF section were 45.40 ± 8.92, those of the ICIQ-UI SF section were 11.54 ± 3.67, and those of the I-QOL section were 43.95 ± 9.83. Multivariate linear regression models for the IAF revealed that questionnaire scores were independently associated with family's monthly income, education level, regular exercise, UI severity, and I-QOL score (p < 0.05).

CONCLUSIONS

The factors influencing the level of autonomy among middle-aged and elderly women with UI include family's monthly income, education level, regular exercise, UI severity, and I-QOL score. Higher levels of autonomy were observed among women with high family income, high education level, regular exercise habits, mild to moderate UI, and high quality of life.

Cognitive performance trends among European older adults: exploring variations across cohorts, gender, and educational levels (2007-2017)

BACKGROUND

This study explores recent cohort trends in cognitive performance among older Europeans from 2007 to 2017, addressing three key questions: (1) Did cognitive performance improve universally and across the performance distribution during this period? (2) Did these improvements occur across educational levels and for both men and women? (3) Can established risk factors explain these performance gains?

METHODS

Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) across 12 European countries, we assessed immediate recall, delayed recall, and verbal fluency in individuals aged 60 to 94 in both 2007 and 2017 (n = 32 773). Differences between the two time points were estimated with linear mixed effects regression models and quantile regression.

RESULTS

Cognitive performance improved in all age groups, across educational levels, and for both men and women between 2007 and 2017. Notably, improvements were more pronounced at the upper end of the performance distribution for delayed recall and verbal fluency. Education explained approximately 20% of the observed improvements. Risk factors did not explain the observed improvements.

CONCLUSIONS

European cohorts of both younger-old and older adults continue to exhibit improvements in cognitive performance. Variation in the size of the cohort improvements across the performance distributions in delayed recall and in verbal fluency may contribute to growing inequalities in cognitive outcomes. Future research should further investigate the potential heterogeneity in cognitive performance gains.

TRIAL REGISTRATION

Not applicable.

How emotion is experienced and expressed in multiple cultures: a large-scale experiment across North America, Europe, and Japan

Core to understanding emotion are subjective experiences and their expression in facial behavior. Past studies have largely focused on six emotions and prototypical facial poses, reflecting limitations in scale and narrow assumptions about the variety of emotions and their patterns of expression. We examine 45,231 facial reactions to 2,185 evocative videos, largely in North America, Europe, and Japan, collecting participants' self-reported experiences in English or Japanese and manual and automated annotations of facial movement. Guided by Semantic Space Theory, we uncover 21 dimensions of emotion in the self-reported experiences of participants in Japan, the United States, and Western Europe, and considerable cross-cultural similarities in experience. Facial expressions predict at least 12 dimensions of experience, despite massive individual differences in experience. We find considerable cross-cultural convergence in the facial actions involved in the expression of emotion, and culture-specific display tendencies-many facial movements differ in intensity in Japan compared to the U.S./Canada and Europe but represent similar experiences. These results quantitatively detail that people in dramatically different cultures experience and express emotion in a high-dimensional, categorical, and similar but complex fashion.

Masked emotions: does children's affective state influence emotion recognition?

Introduction

Facial emotion recognition abilities of children have been the focus of attention across various fields, with implications for communication, social interaction, and human behavior. In response to the COVID-19 pandemic, wearing a face mask in public became mandatory in many countries, hindering social information perception and emotion recognition. Given the importance of visual communication for children's social-emotional development, concerns have been raised on whether face masks could impair their ability to recognize emotions and thereby possibly impact their social-emotional development.

Methods

To this extent, a quasiexperimental study was designed with a two-fold objective: firstly, to identify children's accuracy in recognizing basic emotions (anger, happiness, fear, disgust, sadness) and emotional neutrality when presented with faces under two conditions: one with no-masks and another with faces partially covered by various types of masks (medical, nonmedical, surgical, or cloth); secondly, to explore any correlation between children's emotion recognition accuracy and their affective state. Sixty-nine (69) elementary school students aged 6-7 years old from Greece were recruited for this purpose. Following specific requirements of the second phase of the experiment students were assigned to one of three (3) distinct affective condition groups: Group A-Happiness, Group B-Sadness, and Group C-Emotional Neutrality. Image stimuli were drawn from the FACES Dataset, and students' affective state was registered using the self-reporting emotions-registration tool, AffectLecture app.

Results

The study's findings indicate that children can accurately recognize emotions even with masks, although recognizing disgust is more challenging. Additionally, following both positive and negative affective state priming promoted systematic inaccuracies in emotion recognition. Most significantly, results showed a negative bias for children in negative affective state and a positive bias for those in positive affective state.

Discussion

Children's affective state significantly influenced their emotion recognition abilities; sad affective states led to lower recognition overall and a bias toward recognizing sad expressions, while happy affective states resulted in a positive bias, improving recognition of happiness, and affecting how emotional neutrality and sadness were actually perceived. In conclusion, this study sheds light on the intriguing dynamics of how face masks affect children's emotion recognition, but also underlines the profound influence of their affective state.