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The Child Opportunity Index is an index of 29 indicators of social determinants of health linked to the United States of America Census. Disparities in the treatment of Wolff–Parkinson–White have not be reported. We hypothesise that lower Child Opportunity Index levels are associated with greater disease burden (antiarrhythmic use, ablation success, and Wolff–Parkinson–White recurrence) and ablation utilisation.
Methods:
A retrospective, single-centre study was performed with Wolff–Parkinson–White patients who received care from January 2021 to July 2023. Following exclusion for <5 years old and with haemodynamically significant CHD, 267 patients were included (45% high, 30% moderate, and 25% low Child Opportunity Index). Multi-level logistic and log-linear regression was performed to assess the relationship between Child Opportunity Index levels and outcomes.
Results:
Low patients were more likely to be Black (p < 0.0001) and to have public insurance (p = 0.0006), though, there were no significant differences in ablation utilisation (p = 0.44) or time from diagnosis to ablation (p = 0.37) between groups. There was an inverse relationship with emergency department use (p = 0.007). The low group had 2.8 times greater odds of having one or more emergency department visits compared to the high group (p = 0.004).
Conclusion:
The Child Opportunity Index was not related with ablation utilisation, while there was an inverse relationship in emergency department use. These findings suggest that while social determinants of health, as measured by Child Opportunity Index, may influence emergency department utilisation, they do not appear to impact the overall management and procedural timing for Wolff–Parkinson–White treatment.
Prior research finds that liberals and conservatives process information differently. Predispositions toward intuitive versus reflective thinking may help explain this individual level variation. There have been few direct tests of this hypothesis and the results from the handful of studies that do exist are contradictory. Here we report the results of a series of studies using the Cognitive Reflection Test (CRT) to investigate inclinations to be reflective and political orientation. We find a relationship between thinking style and political orientation and that these effects are particularly concentrated on social attitudes. We also find it harder to manipulate intuitive and reflective thinking than a number of prominent studies suggest. Priming manipulations used to induce reflection and intuition in published articles repeatedly fail in our studies. We conclude that conservatives—more specifically, social conservatives—tend to be dispositionally less reflective, social liberals tend to be dispositionally more reflective, and that the relationship between reflection and intuition and political attitudes may be more resistant to easy manipulation than existing research would suggest.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
A multiproxy record from Twin Ponds, VT, is used to reconstruct climatic variability during the late Pleistocene to early Holocene transition. Pollen, ostracodes, δ18O, and lithologic records from 13.5 to 9.0 cal ka BP are presented. Pollen- and ostracode-inferred climatic reconstructions are based on individual species’ environmental preferences and the modern analog technique. Principal components analysis of all proxies highlights the overall warming trend and centennial-scale climatic variability. During the Younger Dryas cooling event (YD), multiple proxies show evidence for cold winter conditions and increasing seasonality after 12.5 cal ka BP. The early Holocene shows an initial phase of rapid warming with a brief cold interval at 11.5 cal ka BP, followed by a more gradual warming; a cool, wet period from 11.2 to 10.8 cal ka BP; and cool, dry conditions from 10.8 to 10.2 cal ka BP. The record ends with steady warming and increasing moisture. Post-YD climatic variability has been observed at other sites in the northeastern United States and points to continued instability in the North Atlantic during the final phases of deglaciation.
Building on a growing body of research suggesting that political attitudes are part of broader individual and biological orientations, we test whether the detection of the hormone androstenone is predictive of political attitudes. The particular social chemical analyzed in this study is androstenone, a nonandrogenic steroid found in the sweat and saliva of many mammals, including humans. A primary reason for scholarly interest in odor detection is that it varies so dramatically from person to person. Using participants’ self-reported perceptions of androstenone intensity, together with a battery of survey items testing social and political preferences and orientations, this research supports the idea that perceptions of androstenone intensity relate to political orientations—most notably, preferences for social order—lending further support to theories positing the influence of underlying biological traits on sociopolitical attitudes and behaviors.
The study of bureaucratic behavior—focusing on control, decision-making, and institutional arrangements—has historically leaned heavily on theories of rational choice and bounded rationality. Notably absent from this research, however, is attention to the growing literature on biological and especially evolutionary human behavior. This article addresses this gap by closely examining the extant economic and psychological frameworks—which we refer to as “Adam Smith’s bureaucrat” and “Herbert Simon’s bureaucrat”—for their shortcomings in terms of explanatory and predictive theory, and by positing a different framework, which we call “Charles Darwin’s bureaucrat.” This model incorporates new insights from an expanding multidisciplinary research framework and has the potential to address some of the long-noted weaknesses of classic theories of bureaucratic behavior.
Treatment for hoarding disorder is typically performed by mental health professionals, potentially limiting access to care in underserved areas.
Aims
We aimed to conduct a non-inferiority trial of group peer-facilitated therapy (G-PFT) and group psychologist-led cognitive–behavioural therapy (G-CBT).
Method
We randomised 323 adults with hording disorder 15 weeks of G-PFT or 16 weeks of G-CBT and assessed at baseline, post-treatment and longitudinally (≥3 months post-treatment: mean 14.4 months, range 3–25). Predictors of treatment response were examined.
Results
G-PFT (effect size 1.20) was as effective as G-CBT (effect size 1.21; between-group difference 1.82 points, t = −1.71, d.f. = 245, P = 0.04). More homework completion and ongoing help from family and friends resulted in lower severity scores at longitudinal follow-up (t = 2.79, d.f. = 175, P = 0.006; t = 2.89, d.f. = 175, P = 0.004).
Conclusions
Peer-led groups were as effective as psychologist-led groups, providing a novel treatment avenue for individuals without access to mental health professionals.
Declaration of interest
C.A.M. has received grant funding from the National Institutes of Health (NIH) and travel reimbursement and speakers’ honoraria from the Tourette Association of America (TAA), as well as honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. K.D. receives research support from the NIH and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. R.S.M. receives research support from the National Institute of Mental Health, National Institute of Aging, the Hillblom Foundation, Janssen Pharmaceuticals (research grant) and the Alzheimer's Association. R.S.M. has also received travel support from the National Institute of Mental Health for Workshop participation. J.Y.T. receives research support from the NIH, Patient-Centered Outcomes Research Institute and the California Tobacco Related Research Program, and honoraria and travel reimbursement from the NIH for serving as an NIH Study Section reviewer. All other authors report no conflicts of interest.
Previously undescribed plant and animal fossils from the Whidbey Formation represent two environments. An upper sand unit contains predominantly terrestrial molluscs (4 taxa), insects, and a vole (cf. Phenacomys), whereas a lower clay unit contains ostracodes (9 taxa), freshwater molluscs (6 taxa), insects (9 taxa), freshwater plant seeds (6 taxa), and fish (cf. Gasterosteus : stickleback). These taxa are compatible with interglacial climatic conditions on a coastal plain environment. The inferred freshwater and terrestrial environments of the Whidbey Formation imply local tectonic subsidence of the regional since the last interglaciation.
FFQ are commonly used to examine the association between diet and disease. They are the most practical method for usual dietary data collection as they are relatively inexpensive and easy to administer. In Australia, the Cancer Council of Victoria FFQ (CCVFFQ) version 2 and the online Commonwealth Scientific and Industrial Research Organisation FFQ (CSIROFFQ) are used. The aim of our study was to establish the level of agreement between nutrient intakes captured using the online CSIROFFQ and the paper-based CCVFFQ. The CCVFFQ and the online CSIROFFQ were completed by 136 healthy participants. FFQ responses were analysed to give g per d intake of a range of nutrients. Agreement between twenty-six nutrient intakes common to both FFQ was measured by a variety of methods. Nutrient intake levels that were significantly correlated between the two FFQ were carbohydrates, total fat, Na and MUFA. When assessing ranking of nutrients into quintiles, on average, 56 % of the participants (for all nutrients) were classified into the same or adjacent quintiles in both FFQ, with the highest percentage agreement for sugar. On average, 21 % of participants were grossly misclassified by three or four quintiles, with the highest percentage misclassification for fibre and Fe. Quintile agreement was similar to that reported by other studies, and we concluded that both FFQ are suitable tools for dividing participants’ nutrient intake levels into high- and low-consumption groups. Use of either FFQ was not appropriate for obtaining accurate estimates of absolute nutrient intakes.
Duarte et al. are correct that the social science enterprise would improve on several fronts if the number of politically conservative researchers were to increase; however, because they misunderstand the degree to which liberals and conservatives are dispositionally different, they fail to appreciate the full range of reasons that conservatives are reluctant to enter the modern social sciences.
Influenza A (H1N1) pdm09 became the predominant circulating strain in the United States during the 2013–2014 influenza season. Little is known about the epidemiology of severe influenza during this season.
METHODS
A retrospective cohort study of severely ill patients with influenza infection in intensive care units in 33 US hospitals from September 1, 2013, through April 1, 2014, was conducted to determine risk factors for mortality present on intensive care unit admission and to describe patient characteristics, spectrum of disease, management, and outcomes.
RESULTS
A total of 444 adults and 63 children were admitted to an intensive care unit in a study hospital; 93 adults (20.9%) and 4 children (6.3%) died. By logistic regression analysis, the following factors were significantly associated with mortality among adult patients: older age (>65 years, odds ratio, 3.1 [95% CI, 1.4–6.9], P=.006 and 50–64 years, 2.5 [1.3–4.9], P=.007; reference age 18–49 years), male sex (1.9 [1.1–3.3], P=.031), history of malignant tumor with chemotherapy administered within the prior 6 months (12.1 [3.9–37.0], P<.001), and a higher Sequential Organ Failure Assessment score (for each increase by 1 in score, 1.3 [1.2–1.4], P<.001).
CONCLUSION
Risk factors for death among US patients with severe influenza during the 2013–2014 season, when influenza A (H1N1) pdm09 was the predominant circulating strain type, shifted in the first postpandemic season in which it predominated toward those of a more typical epidemic influenza season.
Infect. Control Hosp. Epidemiol. 2015;36(11):1251–1260
Disputes between those holding differing political views are ubiquitous and deep-seated, and they often follow common, recognizable lines. The supporters of tradition and stability, sometimes referred to as conservatives, do battle with the supporters of innovation and reform, sometimes referred to as liberals. Understanding the correlates of those distinct political orientations is probably a prerequisite for managing political disputes, which are a source of social conflict that can lead to frustration and even bloodshed. A rapidly growing body of empirical evidence documents a multitude of ways in which liberals and conservatives differ from each other in purviews of life with little direct connection to politics, from tastes in art to desire for closure and from disgust sensitivity to the tendency to pursue new information, but the central theme of the differences is a matter of debate. In this article, we argue that one organizing element of the many differences between liberals and conservatives is the nature of their physiological and psychological responses to features of the environment that are negative. Compared with liberals, conservatives tend to register greater physiological responses to such stimuli and also to devote more psychological resources to them. Operating from this point of departure, we suggest approaches for refining understanding of the broad relationship between political views and response to the negative. We conclude with a discussion of normative implications, stressing that identifying differences across ideological groups is not tantamount to declaring one ideology superior to another.
A broad, multidisciplinary empirical literature reports that individual-level differences in psychology and biology map onto variation in political orientation. In our target article we argued that negativity bias can explain a surprisingly large share of these findings. The commentators generally support the negativity bias hypothesis but suggest theoretical and empirical revisions and refinements. In this response, we organize these proposals, suggestions, and criticisms into four thematic categories and assess their potential for furthering theories and empirical investigations of the bases for individual-variation in political ideology.
Recently in this journal, Charney and English (2012) presented an extensive critique of candidate gene association studies using the widely noted Fowler and Dawes (2008) article on the relationship between self-reported voter turnout and both 5-HTT (serotonin transporter) and MAOA (monoamine oxidase A) as the driving example of their evaluation. Reanalysis of the Fowler and Dawes data by Charney and English, based on four critiques of candidate gene studies, led to the conclusion that neither polymorphism is related to variations in turnout. We add to this empirical debate by conducting an independent test using an original dataset containing 5-HTT data and two separate participation variables: self-reported participation and actual voting records. Our results confirm the original conclusions by Fowler and Dawes on 5-HTT, but also support several of the critiques suggested by Charney and English. We conclude by offering suggestions for the way candidate gene association studies should be interpreted by the discipline and processed by journal editors.