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01.
medRxiv (Medicine) 2026-06-15

Bidirectional associations between cannabis use, oddball performance, and P3 event-related potential

Importance: Cannabis use remains prevalent in youth despite concerns regarding its potential impact on cognitive function. Unraveling whether the association between cannabis use and cognition is partially due to preexisting differences or primarily related to use is vital to understanding underlying mechanisms. Objective: To estimate the longitudinal association between cannabis initiation and cognitive trajectories, indexed by task performance and P3 event-related potential (ERP), and to estimate whether baseline cognition is associated with cannabis initiation. Design: Data were analyzed from the ongoing longitudinal Collaborative Study on the Genetics of Alcoholism (COGA) cohort, which was followed up approximately every 2-5 years from 2004 to 2025. Setting: 6 sites across the United States. Participants: Adolescent and young adult offspring of past COGA participants and control families who reported on their cannabis use and who had Visual Oddball (VOP) performance and P3 ERP data (N=4814; 52.4% female, 68.4% white) were grouped based on the timing of cognitive data collection relative to cannabis initiation into Pre-onset (n=2,449; [&ge;]1 assessment) and Post-onset (n=998; [&ge;]3 assessments) subsamples. Main Outcomes and Measures: VOP measures include performance accuracy (%), reaction times (ms), and P3 amplitude (V) and latency (ms) during target trials. Cannabis measures included lifetime use of cannabis (i.e., ever used) and age at first use. Results: High P3 amplitude, and prolonged P3 latency and reaction time were associated with a reduced hazard of cannabis initiation (All Hazards Ratio, [H.R.s]< 0.91, p's

02.
medRxiv (Medicine) 2026-06-15

Unveiling the Awareness of Private Health Insurance Coverage among Healthcare Professionals in Freetown, Sierra Leone: Insights Extracted from Their Perspectives.

Our study is an assessment of the knowledge, personal coverage, and related determinants of private health insurance as revealed by healthcare professionals in Freetown, the urban capital of Sierra Leone. This study stands as a precursor for Low- and Middle-Income Countries (LMICs), like Sierra Leone, seeking to establish Universal Health Coverage (UHC) to provide healthcare access and coverage through publicly arranged risk pooling, designed to help protect against unmanageable medical costs. In parallel, such countries face significant challenges with achieving sustainable universal coverage due to limited public resources, inefficient allocation systems, uneasy reliance on out-of-pocket payments, and large struggling populations. Our research sheds particular light on how healthcare professionals view their own participation with private healthcare options. A cross-sectional, analytical study was conducted, openly recruiting individuals from various facilities in Freetown. Using the Yamane Formula, a sample size of 109 participants was calculated. STATA 14.0 was used for data analysis. Our findings revealed that 96 (88.9%) participants did not have private health insurance, while 12 (11.1%) did have private coverage. However, 105 (97.2%) reported other modes of health insurance, with only 3 (2.8%) uninsured. Notably, 97.2% expressed willingness to join a private health insurance scheme. Our study found no statistically significant associations between selected indicators (demographic or socioeconomic fac tors) and current insurance coverage among study participants. These results highlight a low prevalence and understanding of private health insurance among healthcare professionals in a representative urban center in Sub-Saharan Africa (SSA), while acknowledging high willingness to enroll. The lack of any significant determinants suggests other unexamined factors, such as cost, accessibility, or awareness, capable of influencing the adoption and implementation of a universal health program.