Pathways explaining racial/ethnic disparities in incident all-cause dementia among middle-aged US adults

INTRODUCTION

Racial disparities in dementia incidence exist, but less is known about their presence and drivers among middle-aged adults.

METHODS

We used time-to-event analysis among a sample of 4378 respondents (age 40-59 years at baseline) drawn from the third National Health and Nutrition Examination Surveys (NHANES III) with administrative linkage-spanning the years 1988-2014-to evaluate potential mediating pathways through socioeconomic status (SES), lifestyle, and health-related characteristics.

RESULTS

Compared with Non-Hispanic White (NHW) adults, Non-White adults had a higher incidence of AD-specific (hazard ratio [HR] = 2.05, 95% confidence interval [CI]: 1.21, 3.49) and all-cause dementia (HR = 2.01, 95% CI: 1.36, 2.98). Diet, smoking, and physical activity were among characteristics on the pathway between race/ethnicity, SES, and dementia, with health-mediating effects of smoking and physical activity on dementia risk.

DISCUSSION

We identified several pathways that may generate racial disparities in incident all-cause dementia among middle-aged adults. No direct effect of race was observed. More studies are needed to corroborate our findings in comparable populations.

Pathways explaining racial/ethnic and socio-economic disparities in dementia incidence: the UK Biobank study

BACKGROUND

Pathways explaining racial/ethnic disparities in dementia risk are under-evaluated.

METHODS

We examine those disparities and their related pathways among UK Biobank study respondents (50-74 y, N = 323,483; 3.6% non-White minorities) using a series of Cox proportional hazards and generalized structural equations models (GSEM).

RESULTS

After ≤15 years, 5,491 all-cause dementia cases were diagnosed. Racial minority status (RACE_ETHN, Non-White vs. White) increased dementia risk by 24% (HR = 1.24, 95% CI: 1.07-1.45, P = 0.005), an association attenuated by socio-economic status (SES), (HR = 1.12, 95% CI: 0.96-1.31). Total race-dementia effect was mediated through both SES and Life's Essential 8 lifestyle sub-score (LE8LIFESTYLE), combining diet, smoking, physical activity, and sleep factors. SES was inversely related to dementia risk (HR = 0.69, 95% CI: 0.67, 0.72, P < 0.001). Pathways explaining excess dementia risk among racial minorities included 'RACE_ETHN(-) → SES(-) → DEMENTIA', 'RACE_ETHN(-) → SES(-) → Poor cognitive performance, COGN(+) → DEMENTIA' and 'RACE_ETHN(-) → SES(+) → LE8LIFESTYLE(-) → DEMENTIA'.

CONCLUSIONS

Pending future interventions, lifestyle factors including diet, smoking, physical activity, and sleep are crucial for reducing racial and socio-economic disparities in dementia.

"In Flow"! Why Do Users Share Fake News about Environmentally Friendly Brands on Social Media?

Social media has triggered an increase in fake news spread about different aspects of modern lives, society, politics, societal changes, etc., and has also affected companies' reputation and brands' trust. Therefore, this paper is aimed at investigating why social media users share fake news about environmentally friendly brands. To examine social media users' behavior towards environmentally friendly brands, a theoretical research model proposed and analyzed using structural equations modeling in SmartPLS on a convenience sample consisting of 922 questionnaires. Data was collected by means of a quantitative-based approach via a survey conducted among social media users from an emerging market. The results show that social media flow has a mediated impact on sharing fake news about environmentally friendly brands on social media. Considering the critical consequences of fake news, the paper argues that understanding the dissemination process of this type of bogus content on social media platforms has important theoretical and managerial implications. Understanding the psychological mechanisms that influence people's behavior in sharing fake news about environmentally friendly brands on social networking sites (SNS) could help in better understanding the factors and the effects of this phenomenon. The originality of this research consists of proposing flow theory from positive psychology to be used as a theoretical framework to explain users' behavior of sharing fake news about environmentally friendly brands on social media.

Psychometric Properties of the OBCS Body Shame Scale in a Sample of Female Residents in Puerto Rico

The purpose of this study is to analyze the psychometric properties of the Spanish version of the Body Shame scale within the Objectified Body Consciousness Scale (OBCS) in a sample of women living in Puerto Rico. The sample consisted of 117 heterosexual women. A confirmatory factor analysis was conducted to evaluate the structure of the scale and internal consistency was examined. Findings revealed that the 6-item Spanish version of the Body Shame scale shows better model-data fit than the original 8-item version. The results of the study support the use of the final 6-item version of the Body Shame scale in research and practice, given that it demonstrated appropriate structure and internal consistency. In conclusion, the findings support the use of the 6-item version of the Body Shame scale.

Overall Quality of Sporting Events and Emotions as Predictors of Future Intentions of Duathlon Participants

The present study is intended to analyze the effect of global quality, perceived value, general satisfaction, and emotions on future behavior patterns among participants in the European Duathlon Championship. In this sense, a questionnaire was administered (n = 210), composed of four sections: essential demographic and profiling variables, perceived quality, overall quality, and emotions. Consequently, a relational model was designed to be examined by means of structural equation modeling (SEM) and fuzzy set qualitative comparative analysis (fsQCA). Results reveal that global quality and general satisfaction are key dimensions for determining future behaviors of participants, but not so the perceived value. Moreover, up to three combinations of these dimensions together with emotions -pleasure and arousal- emerged as enough for depicting future intentions to a great extent. In this line, a remarkably sufficient combination consists of global quality, general satisfaction, pleasure, and arousal. These findings will guide organizers to design strategies that provide exciting experiences, as well as quality and satisfaction to the participants of sports events.

Latent Growth Curve and Repeated Measures ANOVA Contrasts: What the Models are Telling You

The relationship between the latent growth curve and repeated measures ANOVA models is often misunderstood. Although a number of investigators have looked into the similarities and differences among these models, a cursory reading of the literature can give the impression that they are very different models. Here we show that each model represents a set of contrasts on the occasion means. We demonstrate that the fixed effects parameters of the estimated basis vector latent growth curve model are merely a transformation of the repeated measures ANOVA fixed effects parameters. We further show that differences in fit in models that estimate the same means structure can be due to the different error covariance structures implied by the model. We show these relationships both algebraically and through using data from a simulation.

The Clinical Trials Mosaic: Toward a Range of Clinical Trials Designs to Optimize Evidence-Based Treatment

OBJECTIVE

Dichotomizing clinical trials designs into nomothetic (e.g., randomized clinical trials or RCTs) versus idiographic (e.g., N-of-1 or case studies) precludes use of an array of hybrid designs and potential research questions between these extremes. This paper describes unique clinical evidence that can be garnered using idiographic clinical trials (ICTs) to complement RCT data. Proposed and illustrated herein is that innovative combinations of design features from RCTs and ICTs could provide clinicians with far more comprehensive information for testing treatments, conducting pragmatic trials, and making evidence-based clinical decisions.

METHOD

Mixed model trajectory analysis and unified structural equations modeling were coupled with multiple baseline designs in (a) a true N-of-1 pilot study to improve severe autism-related communication deficits and (b) a small sample preliminary study of two complimentary interventions to relieve wheelchair discomfort.

RESULTS

Evidence supported certain mechanisms of treatment outcomes and ruled out others. Effect sizes included mean phase differences (i.e., effectiveness), trajectory slopes, and differences in path coefficients between study phases.

CONCLUSIONS

ICTs can be analyzed with equivalent rigor as, and generate effect sizes comparable to, RCTs for the purpose of developing hybrid designs to augment RCTs for pilot testing innovative treatment, efficacy research on rare diseases or other small populations, quantifying within-person processes, and conducting clinical trials in many situations when RCTs are not feasible.

Structural Model for the Effects of Environmental Elements on the Psychological Characteristics and Performance of the Employees of Manufacturing Systems

This paper analyzes the effects of environmental elements on the psychological characteristics and performance of employees in manufacturing systems using structural equation modeling. Increasing the comprehension of these effects may help optimize manufacturing systems regarding their employees’ psychological characteristics and performance from a macroergonomic perspective. As the method, a new macroergonomic compatibility questionnaire (MCQ) was developed and statistically validated, and 158 respondents at four manufacture companies were considered. Noise, lighting and temperature, humidity and air quality (THAQ) were used as independent variables and psychological characteristics and employees’ performance as dependent variables. To propose and test the hypothetical causal model of significant relationships among the variables, a data analysis was deployed. Results found that the macroergonomic compatibility of environmental elements presents significant direct effects on employees’ psychological characteristics and either direct or indirect effects on the employees’ performance. THAQ had the highest direct and total effects on psychological characteristics. Regarding the direct and total effects on employees’ performance, the psychological characteristics presented the highest effects, followed by THAQ conditions. These results may help measure and optimize manufacturing systems’ performance by enhancing their macroergonomic compatibility and quality of life at work of the employees.

Functional and psychological variables both affect daily physical activity in COPD: a structural equations model

BACKGROUND

Daily physical activity (DPA) level is reduced in patients with COPD. The aim of this study was to investigate the association of DPA with functional and psychological variables in these patients.

METHODS

155 COPD patients (102 males, median (IQR) age 62 years (54-69 years), predicted FEV1 60% (40-75%) were included. We assessed DPA (DigiWalker SW-200), functional capacity and psychological factors.

RESULTS

DPA level was significantly associated with all functional capacity variables and two psychological variables (Perceived Physical Ability Subscale, depression subscale of the Hospital Anxiety and Depression Scale). The six-minute walking distance and St. George Respiratory Questionnaire activity score explained 37% of the variance of DPA in a regression analysis. A structural equations model revealed that psychological variables indirectly explained DPA through functional capacity variables. DPA was stronger associated with functional capacity variables and weaker with psychological variables in patients with lower functional status than in patients with higher functional status.

CONCLUSIONS

Higher levels of DPA are associated with better functional capacity, but interestingly, DPA is also affected by psychological factors, though only indirectly, via functional capacity. The effect of specific treatment addressing psychological factors on DPA level and exercise tolerance needs further investigation.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, NCT00614796.

Associations among calcium intake, resting energy expenditure, and body fat in a multiethnic sample of children

OBJECTIVE

The objective was to determine if calcium intake was associated with resting energy expenditure (REE) and body fat in children after accounting for ancestral genetic background.

STUDY DESIGN

Participants included 315 children. REE, body composition, and dietary calcium were assessed by indirect calorimetry, dual-energy x-ray absorptiometry, and 24-hour recalls, respectively. Structural equations modeling assessed the relationships among REE, calcium intake, and body fat.

RESULTS

There were positive associations between calcium intake and REE (P<.01) and between REE and total body fat (P<.0001). There was indirect effect of calcium intake on total body fat (P<.01). There were positive associations between calcium intake and REE (P<.01), and a trend toward an association of calcium intake and total body fat (P=.065) among boys only, whereas the only significant relationship among girls was an association of REE on total body fat (P<.0001).

CONCLUSIONS

REE was associated with calcium intake and mediated a relationship between calcium intake and total body fat. These findings suggest calcium intake may play a role in fat accumulation and energy balance through its effects on REE, especially in boys.

Neurobehavior disinhibition, parental substance use disorder, neighborhood quality and development of cannabis use disorder in boys

This prospective investigation examined the contribution of neighborhood context and neurobehavior disinhibition to the association between substance use disorder (SUD) in parents and cannabis use disorder in their sons. It was hypothesized that both neighborhood context and son's neurobehavior disinhibition mediate this association. Two hundred and sixteen boys were tracked from ages 10-12 to age 22. The extent to which neighborhood context and neurobehavior disinhibition mediate the association between parental SUD and son's cannabis use disorder was evaluated using structural equation modeling. The best fitting model positioned neighborhood context and neurobehavior disinhibition as mediators of the association between parental SUD and cannabis use disorder in sons. Neurobehavior disinhibition also was a mediator of the association between neighborhood context and son's cannabis use. The implications of this pattern of association between parental SUD, neighborhood context and individual risk for SUD for improving prevention are discussed.