The value of a mobile educative Application additional to Standard counselling on aspirin Adherence in Pregnancy: the ASAP study, a randomised controlled trial

Objective

To assess the added value of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy versus standard counselling alone.

Methods

Participants were randomly assigned for additional use of a mobile educative application or standard counselling alone. Main outcome measures were adherence to aspirin measured by two validated questionnaires: Simplified Medication Adherence Questionnaire (SMAQ), Believes and Behaviour Questionnaire (BBQ), and patients reported tablet intake >90%.

Results

A total of 174 women with an indication for aspirin during pregnancy were included. The questionnaires were filled in by 126 out of the 174 participants (72.4%). Similar results were found in the app group and the standard counselling groups for both validated questionnaires. Tablet intake >90% was seen in 88.7% and 87.5% (p = 0.834) of the app group and standard counselling group respectively. Subgroup analyses demonstrated a negative effect of BMI and a positive effect of educational level on adherence.

Conclusions

Our study revealed no added effect of a novel, mobile educative application to standard counselling on aspirin adherence during pregnancy. Tablet intake was equally high in both groups probably explained by our high educated population.

Innovation

Future studies should focus on tailored counselling on medication to pregnant women's needs including medication reminders, addressing concerns, adequate health literacy and side effects, offering rewards to further stimulate aspirin adherence in pregnancy with optimal outcome for mother and their neonate.

The importance of competitive potential in building the international competitiveness of food industry companies: Evidence from Poland

The economic and social changes taking place in the environment mean that the conditions in which enterprises operate and compete are changing and demanding. This also applies to food industry enterprises, the economic importance is emphasized by many economists. The literature on this subject lacks research on the current factors influencing the competitiveness of food industry enterprises. Thus, the aim of the study was to adopt a multidimensional assessment of the importance of selected components of competitive potential in building the international competitiveness of food industry enterprises. The following research hypothesis was adopted: the key components of the competitive potential of food industry enterprises are intangible. To achieve the main goal and verify the research hypothesis, the empirical study uses information collected using a CATI survey among representatives of food industry enterprises in Poland. The analysis used descriptive statistics, the Mann‒Whitney test, the Kruskal‒Wallis test and exploratory factor analysis, which are rarely used in research on competitiveness. Research has shown that the most important component of competitiveness is intangible assets. The punctuality of deliveries, product quality, company image and relations with suppliers and recipients play special roles. According to factor analysis, four general factors related to competitive potential were distinguished: internal competences and activities, material resources, marketing and clusters, and the market. The results of the study fill a knowledge gap related to the current competitiveness factors of food companies. On a practical level, identifying competitive potential helps improve the ability to compete, better adapt to the environment and gain a sustainable competitive advantage in international markets.

Stigma processes, psychological distress, and attitudes toward seeking treatment among pedohebephilic people

While stigma theories predict that stigma relates to negative attitudes toward seeking help, previous studies found mixed results among pedohebephilic individuals. We tested whether different stigma processes (i.e., general anticipated stigma, anticipation of negative therapist behavior upon disclosure, and internalized stigma), psychological distress, previous treatment experiences, and knowledge about psychotherapy can clarify attitudes toward seeking professional psychological help for this population. We conducted a pre-registered, online survey of English-speaking pedohebephilic individuals (N = 283, 88% male). Expected links between variables of interest and attitudes toward seeking treatment were assessed via structural equation modeling. After modification, the final model showed acceptable fit to the data, χ2 = 2170.61, df = 1462, p < .001, CFI = .905, RMSEA = .04, [.04,.05]. Internalized stigma predicted more positive attitudes toward seeking treatment. Lower anticipation of negative therapist behavior upon disclosure and higher knowledge about psychotherapy were also significant predictors of positive attitudes toward seeking treatment. General anticipated stigma did not predict attitudes toward seeking treatment. Our results suggest a complex association between different stigma processes and treatment-seeking, which differs from associations found for mental illness stigma. Specificity in our understanding of the components of stigma and how they interact with attitudes toward seeking treatment is required to tailor clinical work as well as messages around treatment services.

Exploring career interest and STEM self-efficacy: implications for promoting gender equity

This study explores the relationship between career interests and self-efficacy in Science, Technology, Engineering, and Mathematics (STEM) among young girls in Riyadh, Saudi Arabia. Employing a quantitative research design with a correlational approach, we utilize the S-STEM survey to measure changes in students' STEM subject efficacy and their interest in STEM careers. Our sample comprises 671 middle and high school female students from 49 schools, representing a diverse cross-section of the population. The findings indicate that female students exhibit high levels of STEM self-efficacy and have a strong preference for medicine as a career choice. While the overall interest in STEM careers among students is moderate, there are notable variations in interest across different STEM fields. Importantly, a positive and significant correlation was observed between female students' interest in STEM careers and their self-efficacy in STEM. This research holds important implications for the promotion of STEM education and careers among female students. By recognizing the unique context of Saudi Arabia and the perspectives of young girls in Riyadh, this study offers a fresh perspective on the factors influencing STEM career aspirations and highlights the importance of fostering self-efficacy beliefs among female students.

Reliability of Theory of Mind Tasks in Schizophrenia, ASD, and Nonclinical Populations: A Systematic Review and Reliability Generalization Meta-analysis

Though theory of mind (ToM) is an important area of study for different disciplines, however, the psychometric evaluations of ToM tasks have yielded inconsistent results across studies and populations, raising the concerns about the accuracy, consistency, and generalizability of these tasks. This systematic review and meta-analysis examined the psychometric reliability of 27 distinct ToM tasks across 90 studies involving 2771 schizophrenia (SZ), 690 autism spectrum disorder (ASD), and 15,599 nonclinical populations (NC). Findings revealed that while all ToM tasks exhibited satisfactory internal consistency in ASD and SZ, about half of them were not satisfactory in NC, including the commonly used Reading the Mind in the Eye Test and Hinting Task. Other than that, Reading the Mind in the Eye Test showed acceptable reliability across populations, whereas Hinting Task had poor test-retest reliability. Notably, only Faux Pas Test and Movie for the Assessment of Social Cognition had satisfactory reliability across populations albeit limited numbers of studies. However, only ten studies examined the psychometric properties of ToM tasks in ASD adults, warranting additional evaluations. The study offered practical implications for selecting ToM tasks in research and clinical settings, and underscored the importance of having a robust psychometric reliability in ToM tasks across populations.

A Study of the Psychometric Properties of the Pediatric Symptom Checklist-17 for Children With Developmental Delays and Disorders

Primary care physicians (PCPs) frequently serve pediatric patients with developmental delays and disorders (DD/D). Although the most widely used primary care behavioral health screener, the Pediatric Symptom Checklist-17 (PSC-17), is validated for use with children without DD/D, it is unclear whether this measure accurately identifies behavioral health symptoms in youth with DD/D. Thus, the purpose of this study was to assess the psychometric properties of the PSC-17 for children with DD/D. Medical record data from 3596 pediatric patients at a primary care clinic were analyzed. Descriptive analyses, measurement invariance testing, and internal consistency evaluations were conducted to assess the psychometric properties of the PSC-17. The results of these analyses support the use of the PSC-17 for behavioral health screening for children with DD/D. Behavioral health screening in this population is critical, because the timely identification of behavioral health concerns can facilitate early intervention, which may enhance long-term functioning.

Design and Validation of a Scale to Measure Perceptions and Misconceptions about Menstruation in Nursing College Students: The METCON© Scale

Menstruation remains surrounded by taboo and symbolic violence for many adolescents and young women today, and it is urgent to identify existing stereotypes. The objective was to validate a Spanish-language instrument to assess perceptions, false beliefs, gender stereotypes, fears, and taboos surrounding menstruation in nursing women's studies. A cross-sectional study for psychometric validation of the METCON© scale (22 item version) was assessed in a cohort of 401 female nursing university students (2016-2019), assessing the psychometric properties in terms of internal consistency and structural validity. Furthermore, an invariance analysis was conducted to discern structural disparities before and after studying the subject of gender and health. The METCON© scale showed acceptable internal consistency scores measured by Cronbach's alpha. Exploratory factor analysis indicated a structure of six factors which explained 60.50% of the total variance with a total of 19 items. Reliability analysis indicated adequate internal consistency (α = 0.613). Confirmatory factor analysis showed adequate values, confirming this structure. The invariance analyses identified that the structure remained adequate when evaluated before and after studying the subject of gender and health. Once validated, this instrument could serve as a valid and reliable tool for comprehensively examining perceptions, beliefs, and myths surrounding menstruation, addressing not only biological but also social and cultural aspects.

Which dimensions of nature contact in Urban Green Spaces most significantly contribute to mental wellbeing? A multidimensional analysis in Brazilian metropolitan cities

BACKGROUND

Urban environments pose challenges to mental health, an issue that Urban Green Spaces (UGS) can potentially mitigate. While the benefits of nature contact for mental wellbeing are recognized, a multidimensional analysis remains unexplored.

PURPOSE

This study aims to fill this gap by examining the association between nature contact within UGS and mental health. It underscores the importance of considering multiple dimensions of nature engagement-such as naturalness, intensity, duration, frequency, and infrastructure-in enhancing psychological wellbeing.

METHOD

A comprehensive analysis, including canonical correlation, multivariate analyses of variance, and Fisher discriminant analysis, was applied to survey data from several Brazilian metropolitan cities to assess how different aspects of nature contact influence mental health.

RESULTS AND CONCLUSIONS

Findings reveal association between these dimensions and mental wellbeing indicators, highlighting the importance of a multidimensional perspective.

PRACTICAL IMPLICATIONS

Results advocate for incorporating diverse aspects of nature contact in UGS design and policy-making to enhance urban dwellers' mental health.

FUTURE DIRECTIONS

Further research should focus on longitudinal studies and explore the mediating effects of socio-demographic factors. Additionally, expanding research to include other developing countries will provide valuable comparative insights.

Variation in Skin Red and Yellow Undertone: Reliability of Ratings and Relevance for Perceived Social Experiences

It is well established that skin lightness-darkness is associated with social outcomes, but little is known regarding the social salience of skin undertones (redness and yellowness). Our study addresses two related research questions on this topic: first, we ask whether red and yellow undertones are consistently perceived by observers; second, we ask whether red and yellow undertones are associated with expectations of discrimination across a range of social settings. We address these questions using novel survey data in which skin lightness-darkness and undertones are captured using CIELAB measurements and a two-dimensional categorical skin color scale. Although we find skin lightness-darkness to be the strongest and most consistent predictor of discrimination expectations, respondents also perceived skin undertones consistently, and skin yellowness was associated with a higher predicted likelihood of discrimination net of lightness-darkness in certain social settings. Our findings suggest that colorism can extend beyond a light-dark binary and emphasize the value of capturing undertones, particularly yellowness, in social surveys assessing skin color.

Validation of the Scale of Emotional Development-Short (SED-S) in Healthy Adults with an Intellectual Disability

Background: The Scale of Emotional Development-Short (SED-S) assesses the level of emotional development (ED) of persons with intellectual disability (ID) in eight domains across five stages with reference ages from 0 to 12 years. The aim of this study was to apply and validate the SED-S in a sample of healthy adults with ID. Method: Eighty-three mentally healthy adults with ID were assessed using the SED-S. Factor analysis, Cronbach's alpha, and correlational analyses were used to test the scale's internal structure and associations. Results: The results showed that the eight-domain structure of the SED-S is supported by strong inter-domain correlations, a high Cronbach's alpha, and a one-factor confirmatory factor analysis. The SED-S was associated with the severity of ID but not with age or gender. Conclusions: The SED-S can be used in non-clinical settings to better understand and meet the emotional needs of adults with ID.

Balancing efficacy and computational burden: weighted mean, multiple imputation, and inverse probability weighting methods for item non-response in reliable scales

IMPORTANCE

Scales often arise from multi-item questionnaires, yet commonly face item non-response. Traditional solutions use weighted mean (WMean) from available responses, but potentially overlook missing data intricacies. Advanced methods like multiple imputation (MI) address broader missing data, but demand increased computational resources. Researchers frequently use survey data in the All of Us Research Program (All of Us), and it is imperative to determine if the increased computational burden of employing MI to handle non-response is justifiable.

OBJECTIVES

Using the 5-item Physical Activity Neighborhood Environment Scale (PANES) in All of Us, this study assessed the tradeoff between efficacy and computational demands of WMean, MI, and inverse probability weighting (IPW) when dealing with item non-response.

MATERIALS AND METHODS

Synthetic missingness, allowing 1 or more item non-response, was introduced into PANES across 3 missing mechanisms and various missing percentages (10%-50%). Each scenario compared WMean of complete questions, MI, and IPW on bias, variability, coverage probability, and computation time.

RESULTS

All methods showed minimal biases (all <5.5%) for good internal consistency, with WMean suffered most with poor consistency. IPW showed considerable variability with increasing missing percentage. MI required significantly more computational resources, taking >8000 and >100 times longer than WMean and IPW in full data analysis, respectively.

DISCUSSION AND CONCLUSION

The marginal performance advantages of MI for item non-response in highly reliable scales do not warrant its escalated cloud computational burden in All of Us, particularly when coupled with computationally demanding post-imputation analyses. Researchers using survey scales with low missingness could utilize WMean to reduce computing burden.

The influence of emotional intelligence and behavioural biases on mutual fund churning frequency: Evidence from India

Behavioural finance invalidates the rationalistic assumptions of the efficient market hypothesis by proposing a realistic explanation for overreaction and underreaction. These phenomena are caused by investors making financial decisions based on their emotions without realizing them. This study attempts to establish the effect of investors' emotional intelligence on behavioural biases, namely, herding, overconfidence bias, and disposition effects, and its consequences for the churning frequency of mutual fund portfolios. This quantitative cross-sectional study was undertaken to collect data from 499 mutual fund investors using a self-administered questionnaire. We found that the disposition effect has a negative impact and that overconfidence bias positively affects the churning frequency of mutual fund portfolios. Furthermore, emotional intelligence, particularly its subconstructs, affects herding bias and overconfidence bias, ultimately impacting the churning frequency of investors. An investor with a higher level of self-motivation is likely to have a disposition effect and herding bias. Investors with disposition impact may be encouraged to reorganize their portfolio if there are any schemes that have been providing negative returns for more than two years or that are not projected to offer significant returns in the future. By understanding how they stack up on each emotional intelligence metric, investors and financial advisors may focus on avoiding the biases that could jeopardize long-term portfolio returns.

Relationship between forensic medicine education, stress factors, and mobbing perception from the perspective of specialists in Turkey's universities

INTRODUCTION

The current situation needs to be presented with scientific data to ensure and improve the quality of specialist training. This study examined the quality of education, instructor competence, stress factors, mobbing, and their interconnections in the domain of forensic medicine specialty education in Turkey.

MATERIALS AND METHODS

This cross-sectional study was conducted through an anonymous, web-based survey targeting forensic medicine specialists who have completed their specialist training in university forensic medicine departments within the last three years. The survey consisted of questions regarding issues included in the core education curriculum, educator characteristics, and perceptions of stress and mobbing. Based on the responses provided, the relationships between these factors were statistically analysed.

RESULTS

72.7 % of the study population completed the survey. Nearly half of the participants (46.3 %) did not consider the number of instructors adequate. The quality of instructors (scientific competence, educational and teaching skills, interpersonal relations, accessibility, management, and problem-solving abilities) was determined to be partially sufficient (mean = 3.36). Approximately one-third of the respondents indicated that instructors made the greatest contribution to their specialist training, whereas the proportion of those who said otherwise was much higher. Education received for topics included in the core curriculum was partially sufficient level (mean = 3.04). It was observed that there was a significant relationship between the instructor characteristics, sufficiency score of the taught topics, and perception of mobbing (p < 0.01). The sufficiency scores of instructor characteristics had a 1.02-fold impact on sufficiency ratings of the topics covered in residency training. Among the respondents, 76.9 % reported encountering stress factors during their specialty training, with the most frequently exposed stress factor (52.2 %) being disorganisation within the training program. Among the participants, 22.8 % reported experiencing mobbing.

CONCLUSIONS

Education and instructor qualifications were correlated; however, stress factors and mobbing adversely affected education. A close association was observed between education, instructors, stressors, and mobbing. Thus independent and objective auditors tasked with verifying whether institutions meet the established educational standards need to be established.

Sleep duration is associated with appetitive traits in school-age years - results from the Generation XXI birth cohort

Sleep may influence appetite regulation through physiological and neurocognitive pathways. However, the association between sleep and appetite in childhood has been scarcely reported, particularly using a prospective design. We aimed to test associations between sleep duration at 7 years of age (y) and appetitive traits at both 7 and 10 y. Participants are from the population-based birth cohort Generation XXI (Porto, Portugal), at 7 (n = 2437) and 10 y (n = 1938) follow-ups. Data on sleep was gathered at 7 y and, considering bedtime and get-up time, total mean sleep duration was calculated and further categorized according to the 10th and 90th percentiles. Appetitive traits were assessed at 7 and 10 y using the parent-reported Children's Eating Behaviour Questionnaire. Associations were tested through Generalized Linear Models (co-variates: child's sex; maternal age, education and pre-pregnancy body mass index at 7 y). At 10 y, associations were further adjusted for the respective appetitive trait at 7 y. Children slept a mean of 10.2 h/night, and 13% and 9% slept ≤9.5 and ≥ 11.0 h/night at 7 y, respectively. For each additional hour in sleep duration, children scored 0.078 (99%CI: -0.145; -0.011) lower on Food Responsiveness, 0.065 (99%CI: -0.129; -0.002) lower on Emotional Undereating and 0.096 (99%CI: -0.161; -0.032) lower on Food Fussiness. Lastly, children sleeping ≤9.5 h/night scored higher on Food Responsiveness (β = 0.145 99%CI: 0.020; 0.271); while those sleeping ≥11.0 h/night scored lower on Food Fussiness (β = -0.255 99%CI: -0.370; -0.079). No significant prospective associations were found. In conclusion, in 7 y children, sleep duration was cross-sectionally associated with lower scores on food approach (Food Responsiveness) and avoidant traits (Emotional Undereating and Food Fussiness). However, the magnitude of the associations was small and further studies are warranted.

Perceptions of academic staff toward the objective structured clinical examination (OSCE) in clinical nursing: Assessment method

BACKGROUND

Clinical competence is critical to evaluating nursing students' capacity to undertake professional nursing practice in a safe and professional environment without any bias of examiners. Objective structured clinical examination (OSCE) is used as an assessment method of students' clinical practice skills.

AIMS

The aim of this study is to assess the nursing faculty members' perception toward OSCE to be used as an assessment method of nursing students in their performing of nursing procedures, as well as explore the advantages and disadvantages of OSCE as perceived by study participants.

METHOD

A descriptive cross-sectional study was used among nursing faculty members (N = 73) who participated on a workshop that were conducted by Jordanian Nursing Council (JNC) between January 2022 and March 2023.

RESULT

The mean perception toward OSCE was 105.87 ± 22.02 (p value = 0.001). The majority of faculty members reported a positive perception toward the OSCE (82.2%). The negative perception was significant in gender, age group, level of education, and academic experience (p < 0.05). The majority of faculty members were agree on the advantages of OSCE.

CONCLUSION

OSCE is a vital assessment and an objective method in assessing the student's clinical competence. More studies exploring the differences of OSCE perceptions and participant's characteristics are required.

Assessing Weight Stigma: Validating Attitudes and Beliefs Questionnaires Among Future Healthcare Professionals

Background This study aimed to establish the reliability and validity of the Anti-Fat Attitudes (AFA) questionnaire and the Beliefs About Obese Persons (BAOP) scale. Methodology A convenience sample of 257 students from three distinct sections of the University of Medicine and Pharmacy "Grigore T. Popa" Iasi (Medical Faculty, Nutrition and Dietetics, and Nursing) participated in an observational study. Construction validity was tested with exploratory factor analysis. The students completed a form containing sociodemographic data, the AFA questionnaire, and the BAOP scale. Weight and height were self-reported and used to determine the body mass index. Results The value of the Cronbach alpha coefficient for the AFA questionnaire indicated adequate internal consistency (0.862). The exploratory factor analysis identified the following three factors corresponding to the original questionnaire: Dislike, Fear of Fat, and Willpower. We validated a single-factor structure of the BAOP scale, which had adequate internal consistency (0.781). There were statistically significant differences (AFA: p = 0.02; BAOP: p = 0.03) between the scores of the students from Nutrition and Dietetics, Nursing, and General Medicine. Conclusions This study demonstrated that the AFA questionnaire and the BAOP scale could be used to evaluate weight stigma in healthcare students, providing a useful tool to assess the effects of weight stigma awareness interventions in this population.

Drowning in the ripple effect: identifying a syndemic network of health experience (with modifiable health behaviours) using the UK Biobank

A Syndemic model of health experience in severe mental illness (SMI) involving modifiable health behaviour contributors has been theorised but has not yet been investigated. Over the next 10 years mental ill-health and suicidal behaviours have been predicted to increase which will decrease health experience and increase hospitalisation and associated costs. This paper investigated a Syndemic model of health experience in people with SMI informed by physical activity levels, exposure to nature, personal resilience levels, drugs related (tobacco smoking and alcohol consumption), and sleep behaviours using UK Biobank data. Results implementing SEM indicate partial evidence for a Syndemic model, with personal resilience being at its centre. Contrary to previous findings, drugs related behaviours did not play an important role in the model. Implementing a Syndemic framework approach to current health care strategies could be beneficial in the development of self-management strategies for people with SMI. This is the first paper using SEM analyses to investigate SMI under the Syndemic theory paradigm.

Is Having Urban Green Space in the Neighborhood Enough to Make a Difference? Insights for Healthier City Design

Background: Prior research indicates that engagement with nature is associated with mental well-being; however, the impact of accessibility to urban green spaces (UGS) with suitable infrastructure for visitation and physical activities, like leisure or recreation, remains underexplored, particularly in developing countries. Purpose: This study delves into whether merely having green space in the neighborhood is sufficient to impact residents' mental health in Brazilian metropolitan regions. Method: Utilizing a cross-sectional survey, data were collected from 2136 participants. The analyzed variables included the intensity, duration, and frequency of nature engagement, suitability of UGS for visitation and physical activities, and mental well-being indicators measured by the DASS-21 scale. Multivariate statistical analyses and multiple regression models were employed to verify hypothetical relationships. Results and conclusions: Higher intensity, duration, and frequency of nature engagement in UGS were significantly associated with lower depression, anxiety, and stress scores. Notably, having urban UGS in the neighborhood alone was not enough to reduce mental health issues. Practical implications: The findings point out the need for urban planning policies that prioritize the development of high-quality, accessible green spaces to maximize mental well-being benefits. These insights could inform city designs that foster healthier urban environments. Future directions: Longitudinal studies are needed to establish causality between nature engagement and mental health improvements. Further research should incorporate objective measures of nature engagement and explore more aspects of green space quality, such as biodiversity and amenities.

Experiences with Negative Behavior and Incivility: Perspectives of Unlicensed Assistive Personnel and Registered Nurses

Healthcare professionals experience negative behaviors such as incivility from various sources within the hospital environment. However, little is known regarding the experience of unlicensed assistive personnel with these behaviors. Using a cross-sectional survey design, the research team aimed to examine the presence, sources, and impact of negative behaviors among registered nurses and unlicensed assistive personnel within a US hospital. Descriptive and inferential statistics were used to analyze quantitative data, while thematic analysis was used to analyze the qualitative responses. A total of 309 participants completed the survey, and 135 participants responded to three qualitative questions. Most respondents identified inadequate staffing/resources to handle workload (87%) and job stress leading to loss of control over behavior as contributing factors to lateral/vertical aggression in the work environment (71%). Impacts of negative behavior on job performance were related to both personal well-being and the work environment. Demoralization was identified as a common consequence of negative behaviors for individuals and within the work environment. The results suggested that registered nurses, unlicensed assistive personnel, and nursing leadership may benefit from system-wide approaches addressing negative behaviors such as incivility within the clinical environment. Specifically, efforts and policies aimed at aiding clinicians in responding to negative behaviors could potentially improve the clinical environment.

Impact of analytic decisions on test-retest reliability of individual and group estimates in functional magnetic resonance imaging: a multiverse analysis using the monetary incentive delay task

Empirical studies reporting low test-retest reliability of individual blood oxygen-level dependent (BOLD) signal estimates in functional magnetic resonance imaging (fMRI) data have resurrected interest among cognitive neuroscientists in methods that may improve reliability in fMRI. Over the last decade, several individual studies have reported that modeling decisions, such as smoothing, motion correction and contrast selection, may improve estimates of test-retest reliability of BOLD signal estimates. However, it remains an empirical question whether certain analytic decisions consistently improve individual and group level reliability estimates in an fMRI task across multiple large, independent samples. This study used three independent samples (Ns: 60, 81, 119) that collected the same task (Monetary Incentive Delay task) across two runs and two sessions to evaluate the effects of analytic decisions on the individual (intraclass correlation coefficient [ICC(3,1)]) and group (Jaccard/Spearman rho) reliability estimates of BOLD activity of task fMRI data. The analytic decisions in this study vary across four categories: smoothing kernel (five options), motion correction (four options), task parameterizing (three options) and task contrasts (four options), totaling 240 different pipeline permutations. Across all 240 pipelines, the median ICC estimates are consistently low, with a maximum median ICC estimate of .43 - .55 across the three samples. The analytic decisions with the greatest impact on the median ICC and group similarity estimates are the Implicit Baseline contrast, Cue Model parameterization and a larger smoothing kernel. Using an Implicit Baseline in a contrast condition meaningfully increased group similarity and ICC estimates as compared to using the Neutral cue. This effect was largest for the Cue Model parameterization; however, improvements in reliability came at the cost of interpretability. This study illustrates that estimates of reliability in the MID task are consistently low and variable at small samples, and a higher test-retest reliability may not always improve interpretability of the estimated BOLD signal.

The validation of a Japanese version of the New Freezing of Gait Questionnaire (NFOG-Q)

OBJECTIVE

This study aimed to develop a Japanese version of the New Freezing of Gait Questionnaire (NFOG-Q) and investigate its validity and reliability.

METHODS

After translating the NFOG-Q according to a standardised protocol, 56 patients with Parkinson's disease (PD) were administered it. Additionally, the MDS-UPDRS parts II and III, Hoehn and Yahr (H&Y) stage, and number of falls over 1 month were evaluated. Spearman's correlation coefficients (rho) were used to determine construct validity, and Cronbach's alpha (α) was used to examine reliability.

RESULTS

The interquartile range of the NFOG-Q scores was 10.0-25.3 (range 0-29). The NFOG-Q scores were strongly correlated with the MDS-UPDRS part II, items 2.12 (walking and balance), 2.13 (freezing), 3.11 (freezing of gait), and 3.12 (postural stability) and the postural instability and gait difficulty score (rho = 0.515-0.669), but only moderately related to the MDS-UPDRS item 3.10 (gait), number of falls, disease duration, H&Y stage, and time of the Timed Up-and-Go test (rho = 0.319-0.434). No significant correlations were observed between age and the time of the 10-m walk test. The internal consistency was excellent (α = 0.96).

CONCLUSIONS

The Japanese version of the NFOG-Q is a valid and reliable tool for assessing the severity of freezing in patients with PD.

An Initial Psychometric Evaluation of a Novel Upper Extremity Pediatric Stroke Hemiplegic Motor Impairment Scale

BACKGROUND

Our team designed an innovative, observation-based motor impairment measure-the Pediatric Stroke Hemiplegic Motor Impairment Scale (Pedi HEMIs). Here we present the results of a survey describing common practices in the pediatric stroke community and the initial psychometric properties of the upper extremity subscale of the Pedi HEMIs (Pedi HEMIs-UE).

METHODS

This is a cross-sectional study whereby participants completed a battery of assessments including the novel Pedi HEMIs-UE. Internal consistency was measured via Cronbach alpha (α). Intraclass correlation (ICC) was used to assess inter-rater reliability (IRR). Concurrent validity was investigated using Pearson or polychoric correlations and simple linear regressions.

RESULTS

The study sample consisted of 18 children aged 1.08 to 15 years. Two participants completed two sets of evaluations, totaling 20 data sets. Cronbach α, a measure of internal consistency, was on average 0.91 (range: 0.89 to 0.92). IRR was excellent with the six raters in almost perfect agreement (ICC = 0.91; 95% confidence interval [CI]: 0.83 to 0.96). Pearson correlation coefficient between the Pedi HEMIs-UE and logit Assisting Hand Assessment (AHA)/mini-AHA was -0.938 (95% CI: -0.979 to -0.827, P < 0.001), indicating excellent concurrent validity.

CONCLUSIONS

We found excellent feasibility, reliability, and validity of the Pedi HEMIs-UE in a convenience sample of youth with hemiparesis after stroke.

Though Forced, Still Valid: Examining the Psychometric Performance of Forced-Choice Measurement of Personality in Children and Adolescents

Unveiling the roles personality plays during childhood and adolescence necessitates its accurate measurement, commonly using traditional Likert-type (LK) scales. However, this format is susceptible to various response biases, which can be particularly prevalent in children and adolescents, thus likely undermining measurement accuracy. Forced-choice (FC) scales appear to be a promising alternative because they are largely free from these biases by design. However, some argue that the FC format may not perform satisfactorily in children and adolescents due to its complexity. Little empirical evidence exists regarding the suitability of the FC format for children and adolescents. As such, the current study examined the psychometric performance of an FC measure of the Big Five personality factors in three children and adolescent samples: 5th to 6th graders (N = 428), 7th to 8th graders (N = 449), and 10th to 11th graders (N = 555). Across the three age groups, the FC scale demonstrated a better fit to the Big Five model and better discriminant validity in comparison to the LK counterpart. Personality scores from the FC scale also converged well with those from the LK scale and demonstrated high reliability as well as sizable criterion-related validity. Furthermore, the FC scale had more invariant statements than its LK counterpart across age groups. Overall, we found good evidence showing that FC measurement of personality is suitable for children and adolescents.

Hierarchical analysis of barriers to circular business models in the recycling industry

Circular business models in manufacturing, especially in the recycling industry, face many barriers that need to be managed and mitigated for successful business implementation. Therefore, this study aims to analyse the hierarchy of the main barriers to the implementation of circular business models in the recycling industry and evaluate strategies to overcome them. To achieve this goal, we first conducted a systematic literature review on barriers to implementing circular business models. Second, barriers were prioritized through a survey followed by an expert focus group. Building on these steps, we used interpretive structural modeling combined with a 'matrix of cross-impact multiplications applied to classification' to identify the hierarchy among barriers and describe their interdependencies. As key findings, 10 barriers were prioritized through a survey to identify the most important barriers for the recycling industry. The hierarchy of these barriers highlights regulation and government incentives as the most important, followed by those related to supply chain collaboration and lack of material flow indicators. Finally, internal barriers appear as high investments and associated risks. Finally, we suggest strategies to overcome these barriers based on their hierarchy. The implications of this study provide a proposal of strategies for implementing circular business models in the recycling industry, derived from the hierarchical correlation among the barriers, and can be applied in different regions through expert opinion assessment.

The relationship between bullying victimization and problematic behaviors: A focus on the intrapersonal emotional competence and interpersonal social competence

BACKGROUND

Evidence consistently demonstrated that bullying victimization was associated with problematic behaviors among adolescents. However, scant attention has been given to simultaneous comparisons of the impacts of two distinct forms of victimization, traditional bullying victimization and cyberbullying victimization. In addition, the mechanisms underlying the relationship between bullying victimization and problem behavior remain inadequately explored.

OBJECTIVE

This study aimed to examine the correlation between bullying victimization and problematic behaviors, as well as the mediating roles of intrapersonal emotional competence and interpersonal social competence.

PARTICIPANTS AND SETTING

A sample of 26,450 adolescents with a mean age of 15.44 (SD = 0.56) across nine countries was derived from the Study on Social and Emotional Skills (SSES).

METHODS

Data analysis was conducted using structural equation modeling, comprising three key components: the measurement model, the structural model, and the bootstrapping analysis for mediating effects.

RESULTS

Both traditional bullying and cyberbullying victimization exhibited positive correlations with problematic behaviors, with cyberbullying victimization demonstrating a stronger effect. The mediating effects of intrapersonal emotional competence and interpersonal social competence were observed in the correlation between bullying victimization and problematic behaviors.

CONCLUSIONS

This study not only contributed to our comprehension of the underlying mechanisms connecting bullying victimization and adolescent problematic behaviors, but also holds significance for policy development and practice.

Community support, social isolation and older adults' life satisfaction: evidence from a national survey in China

OBJECTIVES

Despite the recognized importance of community social service and community built facility for enhancing older adults' life satisfaction, the mechanisms underlying their relationship have not been thoroughly examined. This study aims to complement the existing knowledge by investigating the mediating role of social disconnectedness and loneliness in the association between community support and life satisfaction among older adults.

METHODS

Using data from the 2018 China Longitudinal Aging Social Survey, the study analyzes responses from 9,874 Chinese older adults (mean age = 71.30 years, SD = 7.30). We conducted descriptive statistics and Pearson's correlation to explore the variables. This study also used Mplus 8.0 to conduct a path analysis model that evaluated both the direct and indirect effects of community social service and built facility on life satisfaction. Social disconnectedness and loneliness were included as mediating variables in this model.

RESULTS

The present study results show that both community social service and community built facility are positively associated with life satisfaction among older adults, and community social service is more imporatant for enhancing the life satisfaction. In addition, these associations are mediated by social disconnectedness and loneliness.

CONCLUSION

Our research suggests that strengthening community social service programs and improving the built environment can reduce social disconnectedness and loneliness among older adults, ultimately enhancing their life satisfaction. Specifically, policymakers can invest in targeted interventions to enhance social connectedness and reduce loneliness, with the goal of improving the overall well-being of older adults.

Psychometrics of patient-reported outcomes measurement information system in von Willebrand disease, inherited platelet function disorders, and rare bleeding disorders

Background

Patient-reported outcomes measurement information system (PROMIS) measures can be used to measure patient-reported outcomes. PROMIS measures, including computer adaptive tests (CATs) and short forms, have demonstrated the ability to adequately assess outcomes in patients with hemophilia. It is, however, unclear if PROMIS measures are suitable for patients with von Willebrand disease (VWD), inherited platelet function disorders (IPFDs), and rare bleeding disorders (RBDs).

Objectives

To evaluate the feasibility, measurement properties, and relevance of PROMIS measures in adults with VWD, IPFDs, and RBDs.

Methods

In this cross-sectional multicenter study, adults with VWD, IPFDs, and RBDs completed 9 PROMIS measures and the Short Form-36 version 2 (SF-36v2) electronically. Feasibility was determined by the number of completed items and floor/ceiling effects. Measurement properties included construct validity based on a multitrait-multimethod analysis and reliability using the reliability coefficient and greatest lower bound. Relevance was evaluated based on comparison with the Dutch general population.

Results

In total, 111 patients (median age, 57 years [IQR, 44-67]; 60% VWD, 16% IPFD, 24% RBD) participated. Mean number of items answered varied from 5.3 to 8.7 (range, 4-12) per PROMIS CAT in patients with VWD. Construct validity was supported for all CATs and all instruments had a good reliability (≥0.70). The PROMIS measures had less ceiling effects than the SF-36v2.

Conclusion

The PROMIS measures are a feasible, valid, and reliable alternative for the SF-36v2 in patients with primarily nonsevere forms of VWD. The relevance of the selected measures was limited. Additional research is necessary to evaluate the PROMIS measures in adults with IPFDs and RBDs.

Immune Regulation Patterns in Response to Environmental Pollutant Chromate Exposure-Related Genetic Damage: A Cross-Sectional Study Applying Machine Learning Methods

Exposure to hexavalent chromium damages genetic materials like DNA and chromosomes, further elevating cancer risk, yet research rarely focuses on related immunological mechanisms, which play an important role in the occurrence and development of cancer. We investigated the association between blood chromium (Cr) levels and genetic damage biomarkers as well as the immune regulatory mechanism involved, such as costimulatory molecules, in 120 workers exposed to chromates. Higher blood Cr levels were linearly correlated with higher genetic damage, reflected by urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) and blood micronucleus frequency (MNF). Exploratory factor analysis revealed that both positive and negative immune regulation patterns were positively associated with blood Cr. Specifically, higher levels of programmed cell death protein 1 (PD-1; mediated proportion: 4.12%), programmed cell death ligand 1 (PD-L1; 5.22%), lymphocyte activation gene 3 (LAG-3; 2.11%), and their constitutive positive immune regulation pattern (5.86%) indirectly positively influenced the relationship between blood Cr and urinary 8-OHdG. NOD-like receptor family pyrin domain containing 3 (NLRP3) positively affected the association between blood Cr levels and inflammatory immunity. This study, using machine learning, investigated immune regulation and its potential role in chromate-induced genetic damage, providing insights into complex relationships and emphasizing the need for further research.

How secure is the secure base? Romantic attachment, emotion regulation, and psychotherapists' role as secure base figures

In 1988, Bowlby posited that the emotional availability of psychotherapists in establishing a secure base environment is influenced by their personal relational history. Despite the acknowledged influence of the therapist's attachment on therapeutic processes and outcomes, the therapist's role as a secure base figure has received insufficient attention. This study delves into the connection between psychotherapists' attachment organization and their self-perceived roles as secure base figures within clinical contexts. Additionally, we explore the mediating role of emotion regulation processes in this context. The dataset comprises self-reports from 384 psychotherapists with diverse theoretical orientations. Our analysis reveals both direct and indirect effects of psychotherapists' attachment on the provision of a secure base. Emotion regulation, specifically through the dimension of clarity, emerges as a significant mediator in this relationship. This study offers a distinctive contribution to deepening our understanding of the relational dynamics inherent to psychotherapeutic practice. It sheds light on the nuanced relation between attachment and emotion regulation, influencing the psychotherapist's role as a secure base figure in psychotherapy. The discussion of the results additionally emphasizes key implications for clinical practice and therapists' training.

The moderating role of psychological resilience in the relationship between fear of COVID-19 and psychological distress, in a cohort of rural and regional healthcare workers. During major lockdowns in Victoria, Australia 2020-2021

The emergence of the COVID-19 pandemic resulted in substantial pressures for healthcare workers across the world. The association between fear of COVID-19 and psychological distress, and the role of psychological resilience have gained research interest. The current study aimed to investigate the cross-sectional association between fear of COVID-19 and psychological distress, in Australian rural/regional healthcare workers and determine whether resilience modifies this association. Most participants were nurses (38.0%), mean age was 44.9 years, and 80.5% were female (N = 1313). An adjusted logistic regression analysis showed that the highest tertile of the Fear of COVID-19 scale was associated with higher odds of moderate to severe symptoms of anxiety (OR = 3.72, 95% CI = 2.27, 6.11; p < 0.001) and depression (OR = 3.48, 95% CI = 2.30, 5.28; p < 0.001). Healthcare workers with high level of fear of COVID-19 and low level of resilience were much more likely to report moderate to severe symptoms of anxiety (OR = 12.27, 95% CI = 6.65-22.65, p < 0.001) and depression (OR = 12.21, 95% CI = 6.93-21.50, p < 0.001) when compared to healthcare workers with low level of fear of COVID-19 and high level of resilience. A cross-sectional design was used and therefore cause and effect between fear of COVID-19 and psychological distress cannot be inferred. Longitudinal research is needed to investigate the possible causal relationship. These findings highlight the potential mental health effects of fear of COVID-19 on HCWs and demonstrate the importance of resilience as a possible moderator of these effects.

The importance of employee attitude in activity-based work environments and the potential role of personality

In studies of activity-based work environments, employees' prior attitude towards activity-based work environments has been identified as a potentially essential antecedent to how they perceive the new work environment. Using longitudinal data-collected once before and three times after moving to an activity-based office-we seek to reaffirm the moderating effect of this prior attitude on employee perceptions of privacy and psychological ownership in a sample from two smaller organisations (n = 38 combined). We also explore if employee attitude towards an activity-based work environment is related to personality dimensions. The findings support that prior employee attitude to an activity-based work environment moderates subsequent perceptions of privacy and psychological ownership. Only conscientiousness is significant when examining the association of personality and employee attitude towards an activity-based work environment. Implications of the findings and suggestions for future research are discussed.

Practitioner summary: Questions remain about activity-based work environments. The data shows employee perceptions of privacy and psychological ownership are lower after moving to an activity-based office, but only for employees with less favourable attitudes towards activity-based environments beforehand. Conscientiousness is positively associated with employees' attitude towards activity-based environments before the move.

The longitudinal relations between mental state talk and theory of mind

BACKGROUND

Previous investigations of associations between children's Theory of Mind (ToM) and parents' use of words relating to mental states (or mental state talk; MST) have predominantly been performed using cross-sectional designs and false belief tasks as indicators of ToM.

METHODS

We here report a longitudinal study of 3-5 year-olds (n = 80) investigating ToM development using the ToM scale and three different parental MST types: the absolute frequency of words, the proportions of words, and the vocabulary size.

RESULTS

Our results revealed significant relations between all parental MST types and later child ToM. Proportions of parental MST were most often related to the children's ToM at 4 years of age. However, the rate at which the children developed ToM from 3 to 5 years of age was associated with the other two parental MST type measures, namely, absolute frequency and vocabulary size. Additionally, our analyses revealed that parents' use of cognitive MST words (e.g., think, or know) were most frequently associated with children's ToM at 4 years of age compared to emotion and desire-related MST words.

CONCLUSIONS

We conclude that the parental ability to capture the thoughts, beliefs, and knowledge present in different scenarios is associated with children's ability to understand other minds. Moreover, parents' way of talking about the mental states of others is associated with their children's ability to understand and further develop ToM.

Thai Preschoolers' movement behaviors outside kindergarten: prevalence of meeting individual and integrated movement guidelines

BACKGROUND

This study aimed to investigate movement behaviors of Thai preschoolers (aged 3-6 years) occurring outside kindergarten in urban areas across Thailand.

METHODS

Surveillance of digital Media in eArLy chiLdhood Questionnaire® was used to collect data from 1051 parents recruited from 12 schools. Descriptive statistics and logistic regressions were applied for data analysis.

RESULTS

Thai preschoolers engaged in physical activity (PA), sedentary screen time, and sleep on weekends significantly more than weekdays with no significant sex differences. Preschoolers met the sleep guidelines the most (62.3%), followed by PA guidelines (48.0%), and screen time (ST) guidelines the least (44.1%). Only 14.6% met the integrated movement guidelines, and 11% met none of the guidelines. Age was positively associated with meeting the PA guidelines, and negatively associated with meeting the sleep and integrated movement guidelines. The number of digital devices at home and geographical region influenced preschoolers in meeting the PA and ST guidelines.

CONCLUSIONS

Thai preschoolers' time spent on all forms of activities outside kindergarten was significantly more on weekends than weekdays with no sex disparity. The prevalence of meeting the integrated movement guidelines was low, and needs to be addressed through comprehensive programs including all forms of activities concurrently.

IMPACT

Thai preschoolers engaged in physical activity (PA), screen time (ST), and sleep on weekends significantly more than weekdays with no significant sex differences. Only 14.6% of preschoolers met the integrated movement guidelines. Age had a significant relationship with meeting the PA, sleep, and integrated movement guidelines. Meeting the PA and ST guidelines in preschoolers was positively associated with the number of digital devices at home. Despite some limitations, this study presented preschoolers' time engaged in the three movement behaviors concurrently, and provided important inputs for development of the national strategic plan to promote PA among Thai children and youth.

FACE-Q for Measuring Patient-reported Outcomes after Facial Skin Cancer Surgery: Cross-cultural Validation

Background

Facial skin cancer and its surgical treatment can affect health-related quality of life. The FACE-Q Skin Cancer Module is a patient-reported outcome measure that measures different aspects of health-related quality of life and has recently been translated into Dutch. This study aimed to evaluate the performance of the translated version in a Dutch cohort using modern psychometric measurement theory (Rasch).

Methods

Dutch participants with facial skin cancer were prospectively recruited and asked to complete the translated FACE-Q Skin Cancer Module. The following assumptions of the Rasch model were tested: unidimensionality, local independence, and monotonicity. Response thresholds, fit statistics, internal consistency, floor and ceiling effects, and targeting were assessed for all scales and items within the scales. Responsiveness was tested for the "cancer worry" scale.

Results

In total, 259 patients completed the preoperative questionnaire and were included in the analysis. All five scales assessed showed a good or sufficient fit to the Rasch model. Unidimensionality and monotonicity were present for all scales. Some items showed a local dependency. Most of the scales demonstrate ordered item thresholds and appropriate fit statistics.

Conclusions

The FACE-Q Skin Cancer Module is a well-designed patient-reported outcome measure that shows psychometric validity for the translated version in a Dutch cohort, using classical and modern test theory.

Validity and reliability of the toxic leadership behaviors of nurse managers scale among Chinese nurses

Objectives

Toxic leadership is increasingly becoming common in the nursing field, but the measurement tools are lacking. Therefore, this study aimed to translate the toxic leadership behaviors of nurse managers (ToxBH-NM) scale into Chinese and test its psychometric properties among Chinese nurses.

Methods

The data for this study were obtained from a cross-sectional survey of 1,195 nurses. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the structural validity of the ToxBH-NM. The following psychometric properties of the scale were assessed: content validity, criterion validity, internal consistency reliability, and test-retest reliability.

Results

The Chinese version of the ToxBH-NM (C-ToxBH-NM) scale had two dimensions and 30 items. The correlation coefficients between the scores of each item and the total scores were 0762-0.922 (p < 0.001), and the range of the CR determination values of all the items were 8.610-18.998, with statistical significance (p < 0.001). The total content validity index (CVI) was 0.996, the average CVI was 0.996, and the item-level CVI was 0.875-1.000. Two common factors were identified in the EFA, and 81.074% of the variation was explained cumulatively. The CFA showed that all the fitting indexes reached the standard, and the model fit degree was good. When the Chinese version of the Destructive Leadership Scale was used as calibration, the correlation coefficient was 0.378 (p < 0.001). The Cronbach's alpha coefficients of the overall scale were 0.989 and of the two dimensions were 0.969 and 0.987, respectively, with a split-half reliability of 0.966 and test-retest reliability of 0.978.

Conclusion

The research results show that the C-ToxBH-NM scale has good reliability and validity and can be used to evaluate the severity of toxic leadership behavior among nursing managers.

Nursing applicants' desire to work in nursing and related factors: a cross-sectional study

BACKGROUND

The desire to work in the nursing profession has recently been identified as an important aspect to consider in the selection process of nursing students but very little is known about nursing applicants' or students' desire to work in nursing.

AIMS

The study aimed to describe and explain the desire of undergraduate nursing applicants to work in nursing.

DESIGN

A cross-sectional study design.

METHODS

The Desire to Work in Nursing Instrument was used to collect the data. All nursing applicants (N = 974) who took part in an entrance examination organised in six Universities in October 2018 were eligible to participate. Eight Hundred and Forty-one applicants (response rate 86%, 102 males) participated in the study. Statistical analysis included the use of descriptive statistics and linear regression was used to assess if dependent variables explained the observed outcomes.

RESULTS

A strong desire to work in nursing was demonstrated in all the four areas. The most common reason to desire this work was suitability to nursing and the nature of work, and the least common was the career opportunities. Gender, previous education, and a realistic image best explain the desire.

CONCLUSIONS

The assessment of desire to work in nursing may assist career choice of nursing applicants, and may enhance recruitment and retention in nursing education. Applicants need to be more aware of the career development possibilities. Further studies are needed to investigate if the desire to work in nursing is different to men than to women to inform recruitment strategies.

Does 'summative' count? The influence of the awarding of study credits on feedback use and test-taking motivation in medical progress testing

Despite the increasing implementation of formative assessment in medical education, its' effect on learning behaviour remains questionable. This effect may depend on how students value formative, and summative assessments differently. Informed by Expectancy Value Theory, we compared test preparation, feedback use, and test-taking motivation of medical students who either took a purely formative progress test (formative PT-group) or a progress test that yielded study credits (summative PT-group). In a mixed-methods study design, we triangulated quantitative questionnaire data (n = 264), logging data of an online PT feedback system (n = 618), and qualitative interview data (n = 21) to compare feedback use, and test-taking motivation between the formative PT-group (n = 316), and the summative PT-group (n = 302). Self-reported, and actual feedback consultation was higher in the summative PT-group. Test preparation, and active feedback use were relatively low and similar in both groups. Both quantitative, and qualitative results showed that the motivation to prepare and consult feedback relates to how students value the assessment. In the interview data, a link could be made with goal orientation theory, as performance-oriented students perceived the formative PT as not important due to the lack of study credits. This led to low test-taking effort, and feedback consultation after the formative PT. In contrast, learning-oriented students valued the formative PT, and used it for self-study or self-assessment to gain feedback. Our results indicate that most students are less motivated to put effort in the test, and use feedback when there are no direct consequences. A supportive assessment environment that emphasizes recognition of the value of formative testing is required to motivate students to use feedback for learning.

Unreliable Continuous Treatment Indicators in Propensity Score Analysis

Propensity score analyses (PSA) of continuous treatments often operationalize the treatment as a multi-indicator composite, and its composite reliability is unreported. Latent variables or factor scores accounting for this unreliability are seldom used as alternatives to composites. This study examines the effects of the unreliability of indicators of a latent treatment in PSA using the generalized propensity score (GPS). A Monte Carlo simulation study was conducted varying composite reliability, continuous treatment representation, variability of factor loadings, sample size, and number of treatment indicators to assess whether Average Treatment Effect (ATE) estimates differed in their relative bias, Root Mean Squared Error, and coverage rates. Results indicate that low composite reliability leads to underestimation of the ATE of latent continuous treatments, while the number of treatment indicators and variability of factor loadings show little effect on ATE estimates, after controlling for overall composite reliability. The results also show that, in correctly specified GPS models, the effects of low composite reliability can be somewhat ameliorated by using factor scores that were estimated including covariates. An illustrative example is provided using survey data to estimate the effect of teacher adoption of a workbook related to a virtual learning environment in the classroom.

The Flow State Scale for Rehabilitation Tasks: A New Flow Experience Questionnaire for Stroke Patients

IMPORTANCE

Flow can be described as a subjective state that people report when they fully engage in an activity and experience pleasure, satisfaction, and enjoyment. Flow experiences are measured to determine the extent to which patients engage in therapy activities. Several flow questionnaires are used in neurorehabilitation. However, none have been validated for patients with (sub)acute stroke.

OBJECTIVE

To develop and validate a new flow questionnaire for patients with (sub)acute stroke.

DESIGN

Single-center prospective cohort study.

SETTING

Neurorehabilitation unit of the Neurocenter of the Luzerner Kantonsspital in Lucerne, Switzerland.

PARTICIPANTS

Fifty patients with (sub)acute stroke.

OUTCOMES AND MEASURES

Development of the Flow State Scale for Rehabilitation Tasks (FSSRT) and determination of the psychometric properties of the FSSRT (internal consistency, test-retest reliability, structural and construct validity) in (sub)acute stroke patients.

RESULTS

The FSSRT showed good internal consistency and excellent test-retest reliability. Composed of four components-concentration, pleasure, movement control, and absorption-the FSSRT correlated significantly negatively with the Hospital Anxiety and Depression Scale, indicating good divergent validity.

CONCLUSIONS AND RELEVANCE

The FSSRT is a reliable and valid questionnaire measuring flow experience in patients with (sub)acute stroke. This questionnaire can be easily used in occupational therapy as well as in physical therapy and gives therapists important information about the flow experience of patients during therapy to adjust the therapy accordingly. Plain-Language Summary: Measuring flow experience, or the extent to which patients engage in therapy activities, in the context of occupational therapy and physical therapy is a new approach. This study confirmed that the Flow State Scale for Rehabilitation Tasks questionnaire is reliable and valid for measuring the flow experience of patients after (sub)acute stroke. Occupational therapists and physical therapists can use the FSSRT to optimally adjust the therapy program and increase patient engagement during therapy.

Quantification of smooth muscle in human airways by polarization-sensitive optical coherence tomography requires correction for perichondrium

Quantifying airway smooth muscle (ASM) in patients with asthma raises the possibility of improved and personalized disease management. Endobronchial polarization-sensitive optical coherence tomography (PS-OCT) is a promising quantitative imaging approach that is in the early stages of clinical translation. To date, only animal tissues have been used to assess the accuracy of PS-OCT to quantify absolute (rather than relative) ASM in cross sections with directly matched histological cross sections as validation. We report the use of whole fresh human and pig airways to perform a detailed side-by-side qualitative and quantitative validation of PS-OCT against gold-standard histology. We matched and quantified 120 sections from five human and seven pig (small and large) airways and linked PS-OCT signatures of ASM to the tissue structural appearance in histology. Notably, we found that human cartilage perichondrium can share with ASM the properties of birefringence and circumferential alignment of fibers, making it a significant confounder for ASM detection. Measurements not corrected for perichondrium overestimated ASM content several-fold (P < 0.001, paired t test). After careful exclusion of perichondrium, we found a strong positive correlation (r = 0.96, P < 0.00001) of ASM area measured by PS-OCT and histology, supporting the method's application in human subjects. Matching human histology further indicated that PS-OCT allows conclusions on the intralayer composition and in turn potential contractile capacity of ASM bands. Together these results form a reliable basis for future clinical studies.NEW & NOTEWORTHY Polarization-sensitive optical coherence tomography (PS-OCT) may facilitate in vivo measurement of airway smooth muscle (ASM). We present a quantitative validation correlating absolute ASM area from PS-OCT to directly matched histological cross sections using human tissue. A major confounder for ASM quantification was observed and resolved: fibrous perichondrium surrounding hyaline cartilage in human airways presents a PS-OCT signature similar to ASM for birefringence and optic axis orientation. Findings impact the development of automated methods for ASM segmentation.

Validation of a Novel Clinical Dyspnea Scale - A Retrospective Pilot Study

Objective: to examine the validity of a novel dyspnea scale, Edmonton Dyspnea Inventory in idiopathic pulmonary fibrosis (IPF). Methods: Edmonton Dyspnea Inventory (EDI), is a clinical instrument to measure dyspnea severity with activities of daily living, exercise and rest using a numeric rating scale (0 -10). Consecutive IPF patients (2012-2018) with baseline MRC and EDI were included. To validate EDI, psychometric analysis was conducted. Correlations between EDI, MRC and lung function were examined. Group-based trajectory modeling was used to group patients based on dyspnea severity. Net Reclassification Improvement (NRI) was calculated to assess the improvement in 1-year mortality prediction by adding trajectory groups to MRC grade. Results: 100 consecutive IPF patients were identified; mean age 73 years (SD = 9) and 65% males; 73% were in MRC grades ≥3. Item analysis showed all 8 EDI components have excellent discrimination power with ability to differentiate patients with varying dyspnea severity. EDI has good internal consistency (Cronbach α = .92). Exploratory factor analysis showed a one-factor solution with loadings from .66 to .89 suggesting 8 EDI components measured essentially one dimension of dyspnea. All EDI components were correlated with MRC and some with lung function. Modeling data identified three EDI dyspnea severity groups with differing mortality (P = .009). The addition of EDI dyspnea severity groups to the MRC score improved 1-year mortality prediction (NRI = .66; 95% CI, .18-1.14). Conclusions: EDI is a valid dyspnea instrument, correlated with MRC and lung function. It can categorize IPF patients into 3 dyspnea severity groups associated with increased mortality. Key Message: We describe the development of a novel scale, Edmonton Dyspnea Inventory, that facilitates measurement of dyspnea severity in the context of daily activities in patients with IPF. The results indicate that the new instrument is valid and correlated to MRC. It identifies 3 categories of severity not recognized by MRC with impact on mortality. Knowledge of dyspnea severity can help triage patients and assign appropriate therapies.

An exploration of the relationship between loneliness, the severity of eating disorder-related symptoms and the experience of the 'anorexic voice'

OBJECTIVES

Many individuals with eating disorders (EDs) report the experience of an 'Anorexic voice' (AV). Negative experiences of loneliness are also often associated with EDs. This study sought to explore the relationship between experiences of loneliness, the frequency of the AV and the impact of this on ED symptom severity.

DESIGN

165 individuals (mean age 27.54 years) who accessed online forums relating to EDs participated in this study. The sample included individuals who have experienced an AV [AV group (N  = 141)] and those who have not [non-AV group (N  = 23)].

METHODS

The study utilised self-report measures via an online questionnaire to explore the predictive validity of loneliness and frequency of the AV on ED symptom severity.

RESULTS

Confirmatory analysis (AV group only) demonstrated the significance of the independent variables individually predicting ED symptom severity. However, a significant interaction was not found between the two primary variables in predicting ED symptom severity, more significantly than the influence of either variable alone. Exploratory analysis considered the differences between the two groups (AV and Non-AV), as well as considering alternate predictors.

CONCLUSIONS

The findings offer insight into possible drivers behind engagement with the AV, as part of ED presentations in the community.

Factor Structure of the Teacher Strengths and Difficulties Questionnaire in a Large Community-Based Sample: An Investigation of Alternative Measurement Models

The Strengths and Difficulties Questionnaire (SDQ) is a screening measure commonly used to assess behavioral and emotional symptoms and strengths among children and adolescents. However, despite its frequent use, its underlying factor structure remains an important area of inquiry. Whereas the original five-factor structure has often been supported through exploratory factor analysis, results from confirmatory analyses continue to yield mixed results. We analyzed data from youth in Grades K through 12 from a large epidemiologic study in the Southeastern United States. Teacher-report SDQ data were used to test three confirmatory factor models by school level (i.e., elementary [Grades K-5] and secondary [Grades 6-12]): The original five-factor model, a three-factor model, and a bifactor model. Model fit indices and reliability measures supported the original five-factor model as the preferred model when using the teacher-reported SDQ with both elementary and secondary school children. Implications for using the SDQ in applied research and predictive modeling are discussed.

Moral Foundations Partially Explain the Associations of Machiavellianism, Grandiose Narcissism, and Psychopathy With Homonegativity and Transnegativity

People with antagonistic (or "dark") personality traits (e.g., Machiavellianism, grandiose narcissism, and psychopathy) are reportedly more racist, sexist, and xenophobic than their non-antagonistic counterparts. In the present studies (N1 = 709; N2 = 267), we examined whether people with antagonistic personality traits are also more likely to express homonegative and transnegative attitudes, and, if so, whether this can be explained by their endorsement of the moral foundations. We found that people high in Machiavellianism, grandiose narcissism, and psychopathy are more likely to endorse homonegative and transnegative views. The associations of Machiavellianism and psychopathy with homonegativity and transnegativity were primarily explained by low endorsement of individualizing moral foundations (i.e., care and fairness), while the association of narcissism with these beliefs was primarily explained by high endorsement of the binding moral foundations (i.e., loyalty, authority, and purity). These findings provide insight into the types of people who harbor homonegative and transnegative attitudes, and how differences in moral foundations contribute to these associations.

A validation study of the Occupational Depression Inventory in Poland and Ukraine

This study examined the psychometric and structural properties of the Polish and Ukrainian versions of the Occupational Depression Inventory (ODI). We relied on two samples of Polish employees (NSample1 = 526, 47% female; NSample2 = 164, 64% female) and one sample of Ukrainian employees (NSample3 = 372, 73% female). In all samples, the ODI exhibited essential unidimensionality and high total-score reliability (e.g., McDonald's omegas > 0.90). The homogeneity of the scale was strong (e.g., 0.59 ≤ scale-level Hs ≤ 0.68). The ODI's total scores thus accurately ranked individuals on a latent occupational depression continuum. We found evidence of complete measurement invariance across our samples, a prerequisite for between-group comparisons involving observed scores. Looking into the criterion validity of the ODI, we found occupational depression to correlate, in the expected direction, with resilience and job-person fit in six areas of working life-workload, control, rewards, community, fairness, and values. The prevalence of occupational depression was estimated at 5% in Sample 1, 18% in Sample 2, and 3% in Sample 3. Our findings support the use of the ODI's Polish and Ukrainian versions. This study adds to a growing corpus of research suggesting that the ODI is a robust instrument.

Understanding the role of risk preferences and perceptions in vaccination decisions and post-vaccination behaviors among U.S. households

COVID-19 vaccines play a critical role in protecting against infection and transmission of the virus. Therefore, understanding public perceptions of COVID-19 vaccines is essential for successful vaccine promotion. Previous literature reported strong associations between vaccination decisions and several sociodemographic variables. However, knowledge about how behavioral factors, including risk perceptions and preferences, impact individuals' attitudes towards receiving COVID-19 vaccination is currently lacking. Using data from a nationally representative survey of 1050 US adults, this study investigates the correlation between individuals' decisions to receive COVID-19 vaccination and both their risk perceptions and preferences. Additionally, we investigate post-vaccination behavior by measuring individuals' participation in three different groups of activities that vary by their degree of social exposure. We find strong correlations between vaccination decisions and four measures of risk preference and risk perception. We also find associations between the four risk measures and individuals' behaviors post-vaccination. We shed light on the main factors discouraging the uptake of COVID-19 vaccines, as well as public opinions regarding the performance of different organizations in addressing the COVID-19 pandemic, and grocery store policies to prevent COVID-19 infections. Our study provides critical information that can help policymakers communicate more effectively with the public and promote vaccine uptake among population groups and geographic areas with higher anti-vaccine sentiments.

Acceptability Assessment of an Executive Function Training Game FISHERMAN for Older Adults

Objective: In recent years, an increasing number of gamification tools have been developed for older adults; however, few studies have explored the acceptability of these tools after initial use and sustained use in older adults. In the current study, we focus on "FISHERMAN," an executive function training game containing a cognitive game and an exergame, with the aim of investigating and comparing the acceptability of both versions of "FISHERMAN" after initial use and 3 months of sustained use in older adults. Materials and Methods: Seventy-six older adults were randomly assigned to the cognitive game training group or the exergame training group. Participants completed two 1-hour sessions per week for 12 weeks. Acceptability was evaluated through a validated, 7-point, self-rating, Interactive Technology Art Installation Technology Acceptance Model Questionnaire after the first and last training sessions, with higher ratings representing higher acceptability. The questionnaire included 22 items and 9 acceptability dimensions: usage behavior, intention to use, perceived usefulness, perceived ease of use, perceived playfulness, subjective norm, image, output quality, and result demonstrability. Descriptive statistics were conducted to evaluate acceptability after initial and sustained use. Two-way (time: initial use and sustained use; group: cognitive game group and exergame group) repeated ANOVAs were conducted to investigate the differences in acceptability. Post hoc, within-group, paired-sample t test analyses were performed to evaluate changes in game acceptability for each group over time. Results: After initial use and 3 months of sustained use, the average scores for overall acceptability and individual dimensions exceeded 5.5 of 7 points in both groups. The two groups presented different changes from initial use to sustained use. The overall acceptability, usage behavior, perceived usefulness, and perceived ease of use were significantly improved after training within the cognitive game group, while perceived playfulness was significantly reduced within the exergame group. Conclusions: The current study provided preliminary evidence that older adults had high acceptability for both the cognitive game and exergame versions of "FISHERMAN." After sustained use, acceptability of the cognitive game increased and acceptability of the exergame decreased, highlighting the importance of assessing game acceptability after initial and sustained use.

A national longitudinal dyadic analysis of spousal education and cognitive decline in the United States

Education plays a significant role in shaping cognitive functioning throughout an individual's life. However, existing research has not adequately explored how the educational attainment of the spouse can impact cognitive functioning over time. This study presents one of the first longitudinal analyses of how spousal education is linked to cognitive trajectories of each member within couples during their later life in the United States. Guided by the linked lives perspective, we analyze data from 8370 couples in the Health and Retirement Study spanning from 2000 to 2018. Results from the Actor-Partner Interdependence Model (APIM) integrated with latent growth curve models reveal that cognitive trajectories exhibit a correlation between spouses over time. Moreover, our analysis uncovers gender-specific effects of spousal education on cognition, shedding light on the underlying mechanisms driving this connection. Notably, the lower educational attainment of husbands is associated with a faster cognitive decline in both themselves and their wives. This association is partially explained by economic resources, but not by health and social behaviors. The lower educational attainment of wives is linked to their own faster cognitive decline as well as lower initial cognitive levels of their husbands, in part via economic resources. However, wives' educational attainment is largely unrelated to their husbands' cognitive decline. Intriguingly, wives' education has a more pronounced impact on the health and social behaviors of their husbands than vice versa, although these health and social behaviors do not appear to influence husbands' cognitive decline. In conclusion, these results underscore the importance of considering spousal education in comprehending the complexities of cognitive decline within dyadic relationships.

Crime Risk and Depression Differentially Relate to Aspects of Sleep in Patients with Major Depression or Social Anxiety

Individuals with internalizing conditions such as depression or anxiety are at risk of sleep difficulties. Social-ecological models of sleep health propose factors at the individual (e.g., mental health) and neighborhood (e.g., crime risk) levels that contribute to sleep difficulties. However, these relationships have been under-researched in terms of internalizing conditions. Therefore, the current study comprised participants diagnosed with major depression (n = 24) or social anxiety (n = 35). Sleep measures included actigraphic variables (i.e., total sleep time, waking after sleep onset, sleep onset latency) and subjective sleep quality. Geocoding was used to assess nationally-normed crime risk exposure at the person level (e.g., murder, assault) and property level (e.g., robbery, burglary). Analyses consisted of independent t-tests to evaluate potential differences between diagnostic groups. To examine relationships, multiple regressions were used with internalizing symptoms, crime risk, and age as independent variables and sleep measures as the dependent variable. The t-test results revealed that groups differed in symptoms and age but not sleep or neighborhood crime. Regression results revealed crime risk positively corresponded with sleep onset latency but no other sleep measures. Also, only depression positively corresponded with total sleep time. Preliminary findings suggest exposure to crime and depression relate differentially to facets of sleep in individuals with internalizing conditions.

The Effects of Childhood Adversity and Self-Regulation on the Well-Being of Adults with Delinquency Histories: A Mediation Model

PURPOSE

Most youth with delinquency histories experience childhood adversity leaving them vulnerable to poor adult well-being. Previous research indicates that self-regulation difficulties could explain how childhood adversity affects adult well-being. Yet, very few studies target adult self-regulation intervention. Therefore, this study examined the intervening effects of emerging adult self-regulation on the association between childhood adversity and adult well-being.

METHOD

Using data from the first four waves of the Add Health Study, the researchers conducted structural equation modeling for mediation with bootstrapping. The researchers tested the mediation effects of emerging adult self-regulation on the association between childhood adversity (child maltreatment and violent victimization) and later adult well-being (mental health problems, alcohol and drug use, criminal behaviors) among people with delinquency histories and/or arrest prior to age 18 (N = 1,792).

RESULTS

Several significant direct effects and one partial mediation effect were found. For example, child maltreatment significantly predicted adult mental health problems and criminal behaviors. Self-regulation (via the dissatisfaction with life and self subscale) mediated the association between child maltreatment and adult mental health problems.

DISCUSSION

Findings highlight the need for social workers to focus on prevention services and trauma-informed treatment for people with delinquency histories. In addition, evidence-based practice requires self-regulation interventions for adults with histories of childhood adversity and delinquency to focus on their emotional and cognitive functioning as well as self-esteem.

CONCLUSION

Implementing self-regulation interventions during emerging adulthood can be useful to mitigate later adult mental health problems among people with histories of childhood adversity and delinquency.