Notes to Factor Analysis Techniques for Construct Validity

This paper introduces and discusses factor analysis techniques for construct validity, including some suggestions for reporting using the evidence to support the construct validity from exploratory and confirmatory factor analysis techniques. Construct validity is a vital part of psychological testing and a prerequisite to every measurement instrument, including aptitude, achievement, and interests. Research, particularly in nursing and the health sciences, depends on reliable and valid measurements. Therefore, a growing emphasis is on assessing validity regarding the structure of test variables commonly estimated by factor analysis techniques. However, it is not always clear how to report the analysis and use it to support the construct validity. Both exploratory and confirmatory factor analysis techniques provide vital evidence to support the construct validity. However, these are not the only available evidence for construct validity, and the researcher should always consider other sources of evidence to develop and support the construct validity of their intended measures. In addition, the collection and presentation of this evidence are not limited to a time, but the validity of constructs is a continuous process that leads to validating the underlying theories from which constructs have emerged.

The development and validation of the One Health Community Assessment

Interdisciplinary collaborations to address human, animal, and environmental health have been emphasized since the inception of the One Health framework. A quantitative survey instrument was developed to measure perceptions of the impacts of pets on One Health. Using the exploratory sequential mixed methods approach, 20 interviews were conducted with individuals from a racially diverse and low-socioeconomic status community in the U.S. to understand their perceptions of One Health. Data from those interviews informed the development of a Likert scale survey measuring individual perceptions of community, human, pet, and environmental health and welfare, as well as the connections between the domains of the One Health triad (human, animal, and environment). The resulting One Health Community Assessment (OHCA) was administered in two urban and two rural underserved U.S. communities longitudinally (2018-2021) through door-to-door data collection as well as phone, email, and text surveys. Validation of the instrument was completed using data collected in the third and fourth years of the study (n = 654). Factor analysis with orthogonal varimax rotation was used to assess the structure and internal consistency of the OHCA. Five subscales explained 42.4% of the variance in our 92-item instrument: community health (Cronbach's α = 0.897), human health (α = 0.842), pet health (α = 0.899), environmental health (α = 0.789), and connections between domains of One Health (α = 0.762). The OHCA represents the first reliable and validated instrument to measure the impacts of pets on One Health.

Development of the scrupulosity inventory: A factor analysis and construct validity study

BACKGROUND AND OBJECTIVES

Scrupulosity, despite its considerable prevalence and morbidity, remains under-investigated. The present study develops and examines the psychometric properties of a comprehensive assessment tool, the Scrupulosity Inventory (SI).

METHODS

The SI, along with other measures of obsessive-compulsive disorder (OCD) and perfectionism, were administered to a sample (N = 150) of college undergraduates similar in size to other scale development studies of related measures. We conducted exploratory and confirmatory factor analyses of the SI, examined its convergent and divergent validity, and assessed its ability to predict categorical diagnoses of scrupulosity using a receiver operator characteristic analysis.

RESULTS

We found a well-fitting confirmatory bifactor model (RMSEA = 0.049) with a strong general Scrupulosity factor ( [Formula: see text] ) and specific factors for Personal Violations ( [Formula: see text] ), Ritualized Behavior ( [Formula: see text] ), Interference with Life ( [Formula: see text] ), and Problem Pervasiveness ( [Formula: see text] ). As predicted, we also found the strongest convergence (r = 0.63) between the SI and the Penn Inventory of Scrupulosity (PIOS), intermediate convergence (r = 0.54) between the SI and Perfectionism Inventory (PI), and weaker convergence (r = 0.47) between the SI and YBOCS. Finally, we found that a categorical diagnosis of scrupulosity was highly predicted by the SI (AUC = 0.84), less well-predicted by the PIOS (AUC = 0.75) and less well predicted by the YBOCS (AUC = 0.69).

LIMITATIONS

This study was conducted among a sample of undergraduates at a religiously affiliated university.

CONCLUSIONS

These results suggest utility in using the SI to measure the severity of scrupulosity symptoms and that scrupulosity and OCD may present significantly different clinical features.

A new comprehensive quantitative index for the assessment of essential amino acid quality in beef using Vis-NIR hyperspectral imaging combined with LSTM

The quality of beef is usually predicted by measuring a single index rather than a comprehensive index. To precisely determine the essential amino acid (EAA) contents in 360 beef samples, the feasibility of optimized spectral detection techniques based on the comprehensive EAA index (CEI) and comprehensive weight index (CWI) constructed by factor analysis was explored. Two-dimensional correlation spectroscopy (2D-COS) was used to analyse the mechanisms of spectral peak shifts in complex disturbance systems with CEI and CWI contents, and 15 sensitive feature variables were extracted to establish a quantitative analysis model of a long short-term memory network (LSTM). The results indicated that 2D-COS had good predictive performance in both CEI-LSTM (R2P of 0.9095 and RPD of 2.76) and CWI-LSTM (R2P of 0.8449 and RPD of 2.45), which reduced data information by 88%. This indicates that utilizing 2D-COS can eliminate collinearity and redundant information among variables while achieving data dimensionality reduction and simplification of calibration models. Furthermore, a spatial distribution map of the comprehensive EAA content was generated by combining the optimal prediction model. This study demonstrated that the comprehensive index method furnishes a new approach to rapidly evaluate EAA content.

Perception of cognitive change by individuals with Parkinson's disease or essential tremor seeking deep brain stimulation: Utility of the cognitive change index

OBJECTIVE

The Cognitive Change Index (CCI-20) is a validated questionnaire that assesses subjective cognitive complaints (SCCs) across memory, language, and executive domains. We aimed to: (a) examine the internal consistency and construct validity of the CCI-20 in patients with movement disorders and (b) learn how the CCI-20 corresponds to objective neuropsychological and mood performance in individuals with Parkinson's disease (PD) or essential tremor (ET) seeking deep brain stimulation (DBS).

METHODS

216 participants (N = 149 PD; N = 67 ET) underwent neuropsychological evaluation and received the CCI-20. The proposed domains of the CCI-20 were examined via confirmatory (CFA) and exploratory (EFA) factor analyses. Hierarchical regressions were used to assess the relationship among subjective cognitive complaints, neuropsychological performance and mood symptoms.

RESULTS

PD and ET groups were similar across neuropsychological, mood, and CCI-20 scores and were combined into one group who was well educated (m = 15.01 ± 2.92), in their mid-60's (m = 67.72 ± 9.33), predominantly male (63%), and non-Hispanic White (93.6%). Previously proposed 3-domain CCI-20 model failed to achieve adequate fit. Subsequent EFA revealed two CCI-20 factors: memory and non-memory (p < 0.001; CFI = 0.924). Regressions indicated apathy and depressive symptoms were associated with greater memory and total cognitive complaints, while poor executive function and anxiety were associated with more non-memory complaints.

CONCLUSION

Two distinct dimensions were identified in the CCI-20: memory and non-memory complaints. Non-memory complaints were indicative of worse executive function, consistent with PD and ET cognitive profiles. Mood significantly contributed to all CCI-20 dimensions. Future studies should explore the utility of SCCs in predicting cognitive decline in these populations.

Development and validation of the Chiropractic Professional Identity Embodiment Scale (CPIES)

BACKGROUND AND PURPOSE

Chiropractic professional identity (CPI) encompasses diverse values, beliefs, experiences, and philosophies about one's work, specific to the chiropractic profession. Yet currently, there is no instrument available to measure CPI. This study aimed to develop and validate the Chiropractic Professional Identity Embodiment Scale (CPIES).

MATERIALS AND METHODS

A mixed-methods sequential exploratory design was employed where qualitative inquiry preceded quantitative analysis of survey items conducted in New Zealand in 2022. Expert key informants provided feedback on candidate items via one-to-one cognitive interviews. Candidate items were administered to Board-registered chiropractors or chiropractic students through an online survey. The suitability of candidate items was evaluated using a variety of psychometric analyses including conceptually guided exploratory factor analysis (EFA) and reliability testing.

RESULTS

Based on relevant professional identity literature and feedback from 15 expert key informants, a draft survey instrument with 92 candidate items (across six domains) was rated by 231 participants. Using EFA, the number of items was reduced to 15. The CPIES sum score exhibited significant correlations with individuals' philosophical self-categorisation and five of the six optional subscales.

CONCLUSION

The 15-item CPIES, either as a unidimensional score or with six separate subscale scores, has been demonstrated to provide valid and reliable measurement of CPI. Future research could utilise the CPIES to investigate how CPI influences clinical practice, patient outcomes, career satisfaction, and public perception of the chiropractic profession, further advancing professionalisation and recognition within healthcare.

An assessment of the psychometric properties of the Coping Strategies Questionnaire - Sickle Cell Disease (CSQ-SCD) among adults in the United States

BACKGROUND

Previous studies have reported conflicting factor structures of the Coping Strategies Questionnaire - Sickle Cell Disease (CSQ-SCD). This study examined the psychometric properties of the CSQ-SCD among adults with SCD in the United States.

METHODS

This study implemented a cross-sectional study design with web-based self-administered surveys. Individuals with SCD were recruited via an online panel. Psychometric properties, including factorial and construct validity, and internal consistency reliability, of the CSQ-SCD were assessed.

RESULTS

A total of 196 adults with SCD completed the survey. Confirmatory factor analysis (CFA), using maximum likelihood estimation and the 13 subscale scores as factor indicators, supported a three-factor model for the CSQ-SCD compared to a two-factor model. Model fit statistics for the three-factor model were: Chi-square [df] = 227.084 [62]; CFI = 0.817; TLI = 0.770; RMSEA [90% CI] = 0.117 [0.101-0.133]; SRMR = 0.096. All standardized factor loadings (except for the subscales isolation, resting, taking fluids, and praying and hoping) were > 0.5 and statistically significant, indicating evidence of convergent validity. Correlations between all subscales (except praying and hoping) were lower than hypothesized; however, model testing revealed that the three latent factors, active coping, affective coping, and passive adherence coping were not perfectly correlated, suggesting discriminant validity. Internal consistency reliabilities for the active coping factor (α = 0.803) and affective coping factor (α = 0.787) were satisfactory, however, reliability was inadequate for the passive adherence coping factor (α = 0.531). Given this overall pattern of results, a follow-up exploratory factor analysis (EFA) was also conducted. The new factor structure extracted by EFA supported a three-factor structure (based on the results of a parallel analysis), wherein the subscale of praying and hoping loaded on the active coping factor.

CONCLUSIONS

Overall, the CSQ-SCD was found to have less than adequate psychometric validity in our sample of adults with SCD. These results provide clarification around the conflicting factor structure results reported in the literature and demonstrate a need for the future development of a SCD specific coping instrument.

Enhancing prediction and analysis of UK road traffic accident severity using AI: Integration of machine learning, econometric techniques, and time series forecasting in public health research

This research project explored into the intricacies of road traffic accidents severity in the UK, employing a potent combination of machine learning algorithms, econometric techniques, and traditional statistical methods to analyse longitudinal historical data. Our robust analysis framework includes descriptive, inferential, bivariate, multivariate methodologies, correlation analysis: Pearson's and Spearman's Rank Correlation Coefficient, multiple logistic regression models, Multicollinearity Assessment, and Model Validation. In addressing heteroscedasticity or autocorrelation in error terms, we've advanced the precision and reliability of our regression analyses using the Generalized Method of Moments (GMM). Additionally, our application of the Vector Autoregressive (VAR) model and the Autoregressive Integrated Moving Average (ARIMA) models have enabled accurate time series forecasting. With this approach, we've achieved superior predictive accuracy and marked by a Mean Absolute Scaled Error (MASE) of 0.800 and a Mean Error (ME) of -73.80 compared to a naive forecast. The project further extends its machine learning application by creating a random forest classifier model with a precision of 73%, a recall of 78%, and an F1-score of 73%. Building on this, we employed the H2O AutoML process to optimize our model selection, resulting in an XGBoost model that exhibits exceptional predictive power as evidenced by an RMSE of 0.1761205782994506 and MAE of 0.0874235576229789. Factor Analysis was leveraged to identify underlying variables or factors that explain the pattern of correlations within a set of observed variables. Scoring history, a tool to observe the model's performance throughout the training process was incorporated to ensure the highest possible performance of our machine learning models. We also incorporated Explainable AI (XAI) techniques, utilizing the SHAP (Shapley Additive Explanations) model to comprehend the contributing factors to accident severity. Features such as Driver_Home_Area_Type, Longitude, Driver_IMD_Decile, Road_Type, Casualty_Home_Area_Type, and Casualty_IMD_Decile were identified as significant influencers. Our research contributes to the nuanced understanding of traffic accident severity and demonstrates the potential of advanced statistical, econometric, machine learning techniques in informing evidence based interventions and policies for enhancing road safety.

Exploring phenotypic overlap across schizotypy and autism spectrum conditions in American and Chinese young adults

Competing theories have been proposed to explain the considerable overlap in social-cognitive features and risk factors across schizotypy and autism spectrum conditions (ASCs). Six previous factor analyses have been reported in the literature, yet all have major limitations; evidence for the clear superiority of any of the competing theories is insufficient and warrants further investigation. The primary aim of the present research was to identify dimensions that cut across schizotypy and ASCs while addressing limitations of past research. Data were collected from three independent samples (n = 1006, 544, and 2469) in the U.S. and China using the Autism-Spectrum Quotient, the Schizotypal Personality Questionnaire, and the Wisconsin Schizotypy Scales. Exploratory factor analyses in Sample 1 identified an interpretable three-factor structure, which was replicated in Samples 2 and 3 using confirmatory factor analyses. We found consistent evidence for three dimensions (Aberrant Salience, Asociality, and Concrete Thinking) underlying schizotypy and ASCs. This three-dimension model is consistent with a common vulnerability model of schizotypy and ASCs. Implications of these findings for the schizotypy and ASCs literature are discussed.

Development and validation of a Context-sensitive Positive Health Questionnaire (CPHQ): A factor analysis and multivariate regression study

BACKGROUND

The concept of Positive Health (PH) has gained increasing attention as a way of measuring individuals' ability to adapt in the face of contextual challenges. However, a suitable measurement instrument for PH that encompasses contextual factors has not yet been developed. This paper responds to this need by developing a Context-specific Positive Health (CPH) measurement instrument that aligns with the Capability Approach (CA).

METHODS

The measurement instrument was developed and tested among a representative sample of 1002 Dutch internet survey panel members with diverse sociodemographic backgrounds. The instrument was developed in two stages: a preparation phase consisting of focus groups and expert consultations, and a validation among a representative panel of Dutch citizens. The goal of the preparation phase, was to pilot test and refine previously proposed Positive Health questionnaires into an initial version of the CPHQ. The validation phase aimed to examine the initial CPHQ's factorial validity using Factor Analysis, and its concurrent validity using Multivariate Regression Analysis.

RESULTS

The developed questionnaire demonstrated adequate factorial and concurrent validity. Furthermore, it explicitly includes an assessment of resilience, this being a key component of PH.

CONCLUSIONS

The introduced measurement tool, the CPHQ, comprises 11 dimensions that we have labeled as follows: relaxation, autonomy, fitness, perceived environmental safety, exclusion, social support, financial resources, political representation, health literacy, resilience, and enjoyment. In this article, we present four major contributions. Firstly, we embedded the measurement in a theoretical framework. Secondly, we focused the questionnaire on a key concept of Positive Health - the "ability to adapt." Thirdly, we addressed issues of health inequality by considering contextual factors. Finally, we facilitated the development of more understandable measurement items.

A case study on the relationship between risk assessment of scientific research projects and related factors under the Naive Bayesian algorithm

This paper delves into the nuanced dynamics influencing the outcomes of risk assessment (RA) in scientific research projects (SRPs), employing the Naive Bayes algorithm. The methodology involves the selection of diverse SRPs cases, gathering data encompassing project scale, budget investment, team experience, and other pertinent factors. The paper advances the application of the Naive Bayes algorithm by introducing enhancements, specifically integrating the Tree-augmented Naive Bayes (TANB) model. This augmentation serves to estimate risk probabilities for different research projects, shedding light on the intricate interplay and contributions of various factors to the RA process. The findings underscore the efficacy of the TANB algorithm, demonstrating commendable accuracy (average accuracy 89.2%) in RA for SRPs. Notably, budget investment (regression coefficient: 0.68, P < 0.05) and team experience (regression coefficient: 0.51, P < 0.05) emerge as significant determinants obviously influencing RA outcomes. Conversely, the impact of project size (regression coefficient: 0.31, P < 0.05) is relatively modest. This paper furnishes a concrete reference framework for project managers, facilitating informed decision-making in SRPs. By comprehensively analyzing the influence of various factors on RA, the paper not only contributes empirical insights to project decision-making but also elucidates the intricate relationships between different factors. The research advocates for heightened attention to budget investment and team experience when formulating risk management strategies. This strategic focus is posited to enhance the precision of RAs and the scientific foundation of decision-making processes.

Development and Initial Validation of Measures of Proximal Stigmas and Experiences of Discrimination for Minor Attracted People

Stigma-related stressors are central to understanding psychopathology, distress, and coping in stigmatized groups; individuals who experience attractions to children are a highly stigmatized group. Currently, few validated self-report measures exist to assess stigma-related stressors in minor attracted people (MAPs) and the current research describes the development and initial validation of two measures of internalized stigma and experiences of discrimination. A sample of MAPs (n = 289; mean age = 31.8 years, SD = 12.2) was recruited online and completed a set of self-report measures assessing stigma-related stress, negative mental health outcomes, substance use, and coping. Exploratory factor analyses of the two newly developed stigma-related stress measures were conducted and convergent associations with other constructs were examined for validity evidence. Exploratory factor analyses indicated a two-factor solution to both the measure of internalized stigma and experiences of discrimination. The total scale scores and factors scores generally demonstrated the anticipated patterns of correlations with mental health concerns, distress, coping, and substance use. Clinical intervention with MAPs may benefit from an exploration of stigma-related stressors in clients' lives to improve mental health outcomes. The relatively large sample that was recruited from multiple online forums is a strength of the current study. The use of a self-report measurement modality for all measures used in the study weakens that strength of the validation evidence presented here. These results provide initial validity evidence for the measures of stigma-related stress in MAPs and the promise of stigma processes in understanding negative outcomes in this population.

Examining the performance of the chi-square difference test when the unrestricted model is slightly misspecified

Structural equation models are used to model the relationships between latent constructs and observable behaviors such as survey responses. Researchers are often interested in testing nested models to determine whether additional constraints that create a more parsimonious model are also supported by the data. A popular statistical tool for nested model comparison is the chi-square difference test. However, there is some evidence that this test performs suboptimally when the unrestricted model is misspecified. In this paper, we examine the type I error rate of the difference test within the context of single-group confirmatory factor analyses when the less restricted model is misspecified but the constraints imposed by the restricted model are correct. Using empirical simulations and analytic approximations, we find that the chi-square difference test is robust to many but not all forms of realistically sized misspecification in the unrestricted model.

If you really love nothing. Evaluating second-order factors in the case of Italian constitutional referendum of 2020

The paper evaluates several second-order factors to explain the outcomes of the 2020 constitutional referendum held in Italy. This particular referendum serves as a relevant case study to assess the significance of second-order factors, given its unique characteristics, including the simplicity of the referendum question regarding the reduction in the number of parliamentarians (MPs), the minimal impact on public finances resulting from this reduction, and the subsequent decrease in territorial democratic representation. While it might have been expected that a significant majority would vote in favour of the "No" option, thus preserving the current levels of territorial coverage (and democratic representation) of MPs, the actual results saw a substantial majority in favour of the "Yes" vote (69%). Our argument posits that the overwhelming prevalence of the "Yes" vote (to reduce the number of MPs), especially in poorer areas of the country, can be attributed to specific factors that influence individual evaluations in a direct-democratic setting. In greater detail, by using cross-sectional data, the paper tests the role of socio-economic condition, trust in institutions and political participation in affecting the referendum outcome. The results of our empirical analysis confirm our hypotheses, demonstrating that second-order factors indeed influenced the referendum's outcome. Specifically, our analysis reveals that: (i) a higher socio-economic condition could generate a higher share of "No" votes; (ii) a higher trust in institutions could lead to an increase in the share of "No" votes; finally, that (iii) an increase in political participation could produce a decrease in the share of "No" votes. In the concluding section of the paper, we discuss how this analysis contributes new insights to the study of voting behaviour in direct-democratic contexts.

Measuring social-emotional development in schoolchildren: A national-level analysis of ECLS-B cohort data

The present study examined the social-emotional development items assessed by kindergarten teachers in the Early Childhood Longitudinal Study-Birth Cohort to determine the optimal factor structure underlying the items as well as the reliability and validity of the resulting factors. This study identified an empirically derived factor structure for teacher-reported social development, investigated whether there was evidence of bias in teacher assessments of social-emotional constructs, examined factor invariance across demographic characteristics (i.e., race and ethnicity, sex, and poverty status), and examined the external validity of the derived factors by determining the extent to which they were associated with well-established measures of early childhood competencies. Findings suggested a 4-factor solution was optimal, consisting of (a) Interpersonal Skills, (b) Externalizing Behavior, (c) Approaches to Learning, and (d) Perspective Taking. Findings offer suggestive evidence of teacher biases in assessments and some, although not conclusive, support for the invariance of social-emotional dimension across demographic characteristics. Results provide a useful next step toward documenting reliable and valid social-emotional measures for use in early childhood research and challenges users of national datasets to think critically about the use of "scales" without a priori attention to important psychometric properties.

Spatial-temporal characteristics and influencing factors of carbon emission in Chengdu-Chongqing area: an urban transportation perspective

The Chengdu-Chongqing twin-city economic circle is a vital growth pole and a new power source for Chinese high-quality development. Studying the spatial-temporal characteristics of carbon emissions and the role of factors affecting them under the transportation perspective is of great significance for this region to realize the carbon peak and carbon neutrality and to formulate carbon emission reduction policies. We use the exploring spatial data analysis (ESDA) and spatial regression model combined with the STIRPAT model, and research finding: (1) The total carbon emissions in the research area gradually increased from 2014 to 2020, but the growth rate showed a significant decline in 2019. (2) There is significant spatial heterogeneity of carbon emissions in the study area; the hotspot areas of total carbon emissions are in Chongqing and Chengdu, forming a high-low aggregation of carbon emissions. Per capita carbon emissions show a high trend in the southwest and a low in the northeast. (3) From the factors of transportation perspective, highway density and private vehicles have a positive impact on carbon emissions, and urban road areas and public transportation have a very significant inhibition of carbon emissions and a spatial spillover effect. (4) Other factors, such as population size, national economic development, urbanization level, and industrial structure, all have a positive effect on carbon emissions, and disposable income has a negative effect on carbon emissions.

Exploratory factor analysis of shared trauma in psychiatric-mental health nurses using the Shared Trauma Professional Posttraumatic Growth Inventory (STPPG)

INTRODUCTION

The Shared Trauma Professional Post Traumatic Growth Inventory (STPPG) was developed by Tosone et al. (2014) to help understand shared trauma (ST) in social workers. ST occurs when the healthcare professional and client both experience the same collective traumatic event. This inventory has been adapted for use with mental health nurses. A cross-sectional study of N = 552 mental health nurses was completed in the spring of 2023 to assess the feasibility of using the STPPG to explore shared trauma in mental health nurses.

METHODS

An exploratory factor analysis was run for the STPPG using squared multiple correlations with the maximum likelihood method.

RESULTS

The alpha coefficient ranged from 0.82 to 0.89 for 2-factors and 0.73 to 0.89 for 3-factors. The results indicated that all correlations were significant among the total scales and subscales. All correlations were positive, ranging from 0.81 to 0.95 for two factors and 0.58 to 0.89 for three factors.

CONCLUSION

The STPPG has confirmed a two-factor analysis for mental health nurses. The STPPG is a valid inventory to measure ST in mental health nurses and will allow the concept to be further studied.

Selection of waterlogging tolerant sesame genotypes (Sesamum indicum L.) from a dataset using the MGIDI index

The dataset explores the impact of waterlogging stress on sesame plants during the pre-flowering stage, recognizing its global impact on crop yield and the identification of tolerant genotypes using the MGIDI index. Carried out in Bangladesh, the research assesses the survival status, grain yield, and stress tolerance indices of 40 sesame genotypes, revealing that twelve of them demonstrated resilience under 72 h of waterlogging stress at the pre-flowering stage. There were variations in genotypic grain yield, and G15 exhibited the highest yields, recording 5.22 g/plant under normal conditions and 4.10 g/plant under waterlogging stress. The MGIDI index, evaluating waterlogging tolerance, identified G4 as the most favorable genotype, followed by G5 and G12. Factor analysis within the MGIDI index uncovered distinct tolerance and susceptibility indices, highlighting strengths and weaknesses in the selected genotypes. The selection gain percentages of these genotypes ranged from 12.9 to 37.4, indicating high broad-sense heritability (≥0.97). These results underscore the potential of genotype selection based on waterlogging stress indices, providing valuable insights for breeders addressing stress-related crop challenges in the face of changing climatic conditions.

Factorial analysis of the Brazilian-Portuguese version of the Work Ability Index, reproducibility and validity of the single item and the short version for online application

BACKGROUND

The Work Ability Index (WAI) assesses work demands, health status, and physical and mental resources.

OBJECTIVES

To evaluate the measurement properties of the WAI, single-item work ability score (WAS), and short version for online applications.

METHODS

One hundred three workers completed the 3 versions of the WAI and the Perceived Stress Scale (PSS-10) questionnaire. The reproducibility and construct validity of the 3 versions of the WAI and their concurrent validity with the PSS-10 were tested. Statistical tests were performed with IBM® SPSS 28.0.

RESULTS

The test-retest reliability of the WAI, WAS, and WAI short version ranged from good to excellent. The WAI and WAI short version showed excellent internal consistency. The construct validity of the WAS was moderate and positive and it was excellent and positive for the WAI short version. Concurrent validity of the WAI, WAS, and WAI short version was moderate and negative, and item mental resources were strong and negative. Factor analysis reached an acceptable level for all indexes (≥ 0.90). The analysis with two factors reached an acceptable level for all indexes (≥ 0.90) and was the best model.

CONCLUSION

The reliability and construct and concurrent validity of the various versions of the WAI were strong to excellent in online applications. Confirmatory factor analysis demonstrated a new grouping of items for the WAI Brazilian version. However, it is necessary to be careful in the choice due to the distribution model of items in health domains and aspects of work.

Groundwater chemical characteristic analysis and water source identification model study in Gubei coal mine, Northern Anhui Province, China

This study aims to accurately identify mine water sources and reduce the hazards caused by water inrush accidents in coal mines. Taking the Gubei coal mine as an example, the water quality results of the water samples from the Cenozoic unconsolidated aquifer, Permian sandstone fracture aquifer, and Carboniferous Taiyuan Formation limestone karst fracture aquifer in the mine area were tested, and K++Na+, Ca2+, Mg2+, Cl-, SO42-, HCO3-, TDS (Total Dissolved Solids), and pH were selected as the main indicators to study the water chemistry characteristics of the aquifer through water chemistry component analysis, major ion content analysis, Piper trilinear analysis, and correlation analysis. Thirty-five groups of water samples were randomly selected and imported into SPSS software for factor analysis (FA) and downsized to three main factors as the input variables of the artificial neural network model. The particle swarm optimization (PSO) code was written based on the MATLAB platform to improve the self-adjustment weights and acceleration factors for optimizing the initial weights and thresholds of the Back-Propagation (BP) neural network. The training and prediction samples were learned in the ratio of 8:2, and the recognition results were compared with the traditional BP neural network model. Results showed that the groundwater of the Gubei coal mine demonstrated a water quality vertical zoning pattern, and the chemical composition was dominated by cation K++Na+ and anion Cl-. The FA-PSO-BP neural network model has a higher accuracy of water source discrimination compared with the cluster analysis and the FA-BP neural network model. The FA-PSO-BP neural network model is worthy of further application in the problem of water source identification in mine water inrush.

Analysis of the dimensional structure of the Patient Health Questionnaire-9 (PHQ-9) in undergraduate students at a public university in Brazil

BACKGROUND

The prevalence of mental health-related problems has increased in recent years, especially among young adults, such as university students. Several measurement instruments have been developed to identify individuals at risk for depression, such as the Patient Health Questionnaire-9 (PHQ-9). However, different dimensional structures of the PHQ-9 can make it difficult to interpret and compare research results. To analyze the dimensional structure and convergent validity of the PHQ-9 in university students.

METHODS

This is a cross-sectional study developed with 3163 students enrolled in different courses at a university in southern Brazil. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to identify the most parsimonious and best-fitting model. Convergent validity was verified through the significant relationship (p < 0.05) between theoretically related constructs (sleep quality, alcohol consumption, and physical activity practice).

RESULTS

The EFA resulted in two models (unidimensional and two-dimensional), with better indices for the two-dimensional model. In the CFA, both the unidimensional and the two-dimensional models presented satisfactory fit indices that were higher for the unidimensional model.

LIMITATIONS

The analysis of convergent validity is limited by the absence of a gold standard for comparison.

CONCLUSIONS

This study provided support for the unidimensional structure of the PHQ-9, with adequate convergent validity, among university students.

Factors and predictive model for malnutrition in poststroke disabled patients: A multicenter cross-sectional study

BACKGROUND

Although malnutrition has been shown to influence the clinical outcome of poststroke disabled patients, the associated factors and the prediction model have yet to be uncovered.

OBJECTIVES

This study aims to assess the current prevalence and factors associated with malnutrition in poststroke disabled patients and establish a prediction model.

METHODS

A multicenter cross-sectional survey among Chinese poststroke disabled patients (≥18 y old) was conducted in 2021. Information on patients' basic data, medical history, Barthel Index, dysphagia, and nutritional status was collected. A multivariable logistic regression model was used to identify the factors that influence malnutrition. Nomogram was developed and internal validation was conducted using 5-fold cross-validation. External validation was performed using the data from a preliminary survey. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curve analysis (DCA) were used to analyze the predictive value of the nomogram.

RESULTS

Four hundred fifty-seven cases were enrolled, with the prevalence of malnutrition as 71.77%. Age (aOR = 1.039, 95% CI: 1.006-1.078), pulmonary infection (aOR = 4.301, 95% CI: 2.268-14.464), dysphagia (aOR = 24.605, 95% CI: 4.966-191.058), total intake volume (aOR = 0.997, 95% CI: 0.995-0.999), Barthel Index (aOR = 0.965, 95% CI: 0.951-0.980), and nasogastric tube (aOR = 16.529, 95% CI: 7.418-52.518) as nutrition support mode (compared to oral intake) were identified as the associated factors of malnutrition in stroke-disabled patients (P < 0.05). ROC analysis showed that the area under the curve (AUC) for nomogram was 0.854 (95% CI: 0.816-0.892). Fivefold cross-validation showed the mean AUC as 0.829 (95% CI: 0.784-0.873). There were no significant differences between predicted and actual probabilities. The DCA revealed that the model exhibited a net benefit when the risk threshold was between 0 and 0.4.

CONCLUSIONS

Age, pulmonary infection, dysphagia, nutrition support mode, total intake volume, and Barthel Index were factors associated with malnutrition in stroke-related disabled patients. The nomogram based on the result exhibited good accuracy, consistency and values.

Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey

BACKGROUND

It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities.

METHODS

We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach's alpha, assessed the questionnaire's validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms.

RESULTS

The questionnaire was found to be reliable in assessing HCWs' knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach's alpha = 0.9), but not heat strain symptoms (Cronbach's alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced.

CONCLUSIONS

The questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs' attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.

Correlation of olfactory function factors with cardiac sympathetic denervation in Parkinson's disease

BACKGROUND

Hyposmia is a common nonmotor symptom of Parkinson's disease (PD) and reportedly associated with dysautonomia in PD. The smell identification test for measuring olfactory function consists of multiple items to discriminate specific scents. In the present study, factor analysis of the smell identification test was performed, and the correlation of extracted factors with cardiac sympathetic denervation (CSD) in patients with PD was investigated.

METHODS

The present study included 183 early PD patients who underwent the Cross-Cultural Smell Identification Test (CC-SIT) and 123I-meta-iodobenzylguanidine (123I-MIBG) myocardial scintigraphy. Factor analysis of 12 items on the CC-SIT was performed using the computed correlation matrix for the binary items, and five smell factors were extracted. Multiple linear regression was performed to determine the correlation of olfactory function with late heart-to-mediastinum (H/M) ratio of 123I-MIBG uptake.

RESULTS

The mean CC-SIT score was 6.1 ± 2.6, and 133 patients (72.7%) had CSD. The CC-SIT score and five smell factors were not associated with dopamine transporter uptake or cognitive functions. However, the CC-SIT score significantly correlated with age (P < 0.001) and late H/M ratio (P < 0.001). Factors 1 and 5 showed an increasing trend with larger H/M ratio, although it was not statistically significant (β = 0.203, P = 0.085 and β = 0.230, P = 0.085, respectively). Factor 5 significantly correlated with the H/M ratio in PD patients with CSD (β = 0.676, P = 0.036).

DISCUSSION

The results showed olfactory dysfunction to be selectively associated with cardiac sympathetic burden in PD. The correlation of certain factors with CSD indicates the possibility of selective hyposmia in PD patients.

Atherothrombotic and thrombolytic biomarkers in incident stroke and atrial fibrillation-related stroke: The Multi-Ethnic Study of Atherosclerosis (MESA)

BACKGROUND AND AIMS

Although several biomarkers have been studied in thromboembolic stroke, measuring the balance between thrombus formation and thrombolysis and data on its role in predicting stroke and atrial fibrillation (AF)-related stroke is limited. We sought to assess atherothrombotic biomarkers grouped into composite factors that reflect thrombotic and thrombolytic potential, and the balance between these factors as it relates to incident stroke or transient ischemic attack (TIA) and stroke/TIA in AF.

METHODS

A Thrombotic Factor, derived from fibrinogen, plasmin-antiplasmin complex, factor VIII, D-dimer, and lipoprotein(a); and a Thrombolytic Factor, derived from plasminogen and oxidized phospholipids on plasminogen, were evaluated at baseline in 5,764 Multi-Ethnic Study of Atherosclerosis (MESA) participants. We evaluated the association between these two factors representative of thrombotic and thrombolytic potential and incident stroke/TIA (n = 402), and AF-related stroke/TIA (n = 82) over a median of 13.9 and 3.7 years, respectively. Cox proportional hazard models adjusted for medication use, cardiovascular risk factors and CHA2DS2-VASc score were utilized. Harrell's C-index was estimated to evaluate model performance.

RESULTS

In models including both factors, Thrombotic Factor was positively while Thrombolytic Factor was inversely associated with incident stroke/TIA and AF-related stroke/TIA. Incorporating these factors along with the CHA2DS2-VASc in adjusted models resulted in a small improvement in risk prediction of incident stroke/TIA and AF-related stroke/TIA compared to models without the factors (C-index from 0.697 to 0.704, and from 0.657 to 0.675, respectively).

CONCLUSIONS

Composite biomarker factors, representative of the balance between thrombotic and thrombolytic propensity, provided an improvement in predicting stroke/TIA beyond CHA2DS2-VASc score.

Establishing psychometric properties of the older volunteer competency scale in the community

AIM(S)

To investigate the factorial structure, test-retest reliability, and internal consistency of the Older Volunteer Competency Scale and establish its psychometric properties.

DESIGN

Cross-sectional survey.

METHODS

A total of 1,000 older volunteers were recruited through random sampling and asked to complete the Older Volunteer Competency Scale. Subsequently, 100 participants were selected to participate in a second test to determine the scale's test-retest reliability. Factorial structure was assessed through exploratory factor analysis and confirmatory factor analysis, and internal consistency was assessed using Cronbach's α.

RESULTS

Favorable exploratory and confirmatory factor analysis results were obtained. In addition, the three dimensions of the Older Volunteer Competency Scale, namely service awareness, service skills, and interpersonal interaction, had high internal consistency and test-retest reliability.

CONCLUSION

The Older Volunteer Competency Scale is an effective and reliable research instrument for evaluating competency and needs among older volunteers.

Psychometric Properties of the Turkish Version of the Abiloco: Factor Analysis

The ABILOCO is a questionnaire measuring mobility in stroke patients. The aim of the study was to evaluate the psychometric properties of the ABILOCO-Turkish. One hundred forty stroke patients were included. Thirteen items were rated according to 3 levels: difficult, easy, and impossible. The construct validity of the ABILOCO-Turkish was investigated using exploratory and confirmatory factor analysis. The reliability of the ABILOCO-Turkish was investigated through internal consistency approaches and test-retest reliability. The ABILOCO-Turkish was compared with the Timed Up & Go (TUG) test and the Berg Balance Scale for validity. The scale was repeated 1 week later for test-retest reliability. The Cronbach's alpha value calculated was 0.96 and item-total score correlations were between 0.464 and 0.899. The intraclass correlation coefficient (ICC) calculated for test-retest reliability was 0.989. According to the results, the ABILOCO-Turkish is highly correlated with the TUG (r: -0.830, p < 0.001) and the Berg Balance Scale (r: 0.919, p < 0.001). The exploratory factor analysis of the ABILOCO-Turkish showed that it is unidimensional, with this factor explaining 66.56% of the variance, and the construct validity was proven by confirmatory factor analysis. The Turkish version of the ABILOCO is a reliable and valid scale for evaluating mobility in stroke patients.

Psychometric evaluation of the Chinese version of the attitudes, subjective norms, perceived behavioural control and intention to pursue a career in mental health nursing scale

AIM

To adapt culturally and assess the reliability and validity of the Attitudes, Subjective Norms, Perceived Behavioural Control and Intention to Pursue a Career in Mental Health Nursing (ASPIRE) scale among Chinese nursing students.

BACKGROUND

Mental health nurses make up a substantial proportion of the mental health workforce and are pivotal for improving access to professional mental health care. However, a shortage of mental health nurses persists across various countries. Although new nursing graduates have the potential to alleviate the labor shortages, there is currently no standardized tool specifically designed to measure nursing students' intentions to pursue a career in mental health nursing in China.

DESIGN

A quantitative and cross-sectional design.

METHODS

Following email authorization from the author, the Chinese version of the ASPIRE scale was translated following the cross-cultural adaptation process guidelines established by the American Association of Orthopedic Surgeons (AAOS). A questionnaire survey was conducted among 540 nursing students from three universities in Hunan Province from April 2023 to October 2023. Nine experts were invited to evaluate the content equivalence of each item. Item analysis, exploratory factor analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability were used to test reliability and validity.

RESULTS

The Chinese version of the ASPIRE scale retained 14 items and it has high content validity. Pearson correlation analysis revealed a statistically significant difference in the correlation between the total scores of the items (P < 0.001). Exploratory factor analysis indicated that the one-factor solution explained 65.82% of the total variance and confirmatory factor analysis results indicated a good fit (CMIN/DF = 2.64, RMSEA = 0.079, GFI = 0.908, IFI = 0.964, SRMR = 0.0326). The Cronbach's alpha coefficient for the scale was 0.958 and the test-retest coefficient was 0.783.

CONCLUSION

The Chinese version of the ASPIRE scale has great reliability and validity and can be used for assessing Chinese nursing students' intention to pursue a career in mental health nursing.

Revisiting delusion subtypes in schizophrenia based on their underlying structures

A clear understanding of the pathophysiology of schizophrenia and related spectrum disorders has been limited by clinical heterogeneity. We investigated whether relative severity and predominance of one or more delusion subtypes might yield clinically differentiable patient profiles. Patients (N = 286) with schizophrenia spectrum disorders (SSD) completed the 21-item Peters et al. Delusions Inventory (PDI-21). We performed factor analysis followed by k-means clustering to identify delusion factors and patient subtypes. Patients were further assessed via the Brief Psychiatric Rating Scale, Brief Negative Symptom Scale, Digit Symbol and Digit Substitution tasks, use of cannabis and tobacco, and stressful life events. The overall patient sample clustered into subtypes corresponding to Low-Delusion, Grandiose-Predominant, Paranoid-Predominant, and Pan-Delusion patients. Paranoid-Predominant and Pan-Delusion patients showed significantly higher burden of positive symptoms, while Low-Delusion patients showed the highest burden of negative symptoms. The Paranoia delusion factor score showed a positive association with Digit Symbol and Digit Substitution tasks in the overall sample, and the Paranoid-Predominant subtype exhibited the best performance on both tasks. Grandiose-Predominant patients showed significantly higher tobacco smoking severity than other subtypes, while Paranoid-Predominant patients were significantly more likely to have a lifetime diagnosis of Cannabis Use Disorder. We suggest that delusion self-report inventories such as the PDI-21 may be of utility in identifying sub-syndromes in SSD. From the current study, a Paranoid-Predominant form may be most distinctive, with features including less cognitive impairment and a stronger association with cannabis use.

Identifying a stable and generalizable factor structure of major depressive disorder across three large longitudinal cohorts

The Patient Health Questionnaire 9 (PHQ-9) is the current standard outpatient screening tool for measuring and tracking the nine symptoms of major depressive disorder (MDD). While the PHQ-9 was originally conceptualized as a unidimensional measure, it has become clear that MDD is not a monolithic construct, as evidenced by high comorbidities with other theoretically distinct diagnoses and common symptom overlap between depression and other diagnoses. Therefore, identifying reliable and temporally stable subfactors of depressive symptoms could allow research and care to be tailored to different depression phenotypes. This study improved on previous factor analysis studies of the PHQ-9 by leveraging samples that were clinical (participants with depression only), large (N = 1483 depressed individuals in total), longitudinal (up to 5 years), and from three diverse (matching racial distribution of the United States) datasets. By refraining from assuming the number of factors or item loadings a priori, and thus utilizing a solely data-driven approach, we identified a ranked list of best-fitting models, with the parsimonious one achieving good model fit across studies at most timepoints (average TLI >= 0.90). This model categorizes the PHQ-9 items into four factors: (1) Affective (Anhedonia + Depressed Mood), (2) Somatic (Sleep + Fatigue + Appetite), (3) Internalizing (Worth/Guilt + Suicidality), (4) Sensorimotor (Concentration + Psychomotor), which may be used to further precision psychiatry by testing factor-specific interventions in research and clinical settings.

Psychometric properties of the family assessment task parental monitoring scenario among adolescents receiving substance use treatment

INTRODUCTION

The Family Assessment Task (FAsTask) is an observer-rated parent-child interaction task used in adolescent substance use intervention. The parental monitoring component of the FAsTask is thought to provide an objective assessment of parental monitoring that can guide treatment planning and circumvent the potential limitations of self-report measures. Yet, the factor structure, measurement invariance, and concurrent validity of the parental monitoring FAsTask has not been evaluated; doing so is essential to effectively guide clinical care. This study examined if the parental monitoring FAsTask can be reliably administered across adolescent age and sex, and to identify which components of the parental monitoring FAsTask are most consistently associated with adolescent substance use.

METHODS

The study pooled data from 388 adolescent-caregiver dyads across six separate clinical trials (adolescents [Mage = 15.7, 57.5% male, 61.9% White, 31.2% Latine]; caregivers [Mage = 42.14, 88.7% female, 72.7% White, 24.2% Latine]). Dyads completed the FAsTask and the Timeline Followback at baseline, prior to randomization. Analyses proceeded in three steps. First, exploratory factor analysis (EFA) was conducted in half of the sample, followed by a confirmatory factor analysis (CFA) in the second half of the sample. Second, measurement invariance was tested as a function of adolescent age and biological sex. Third, a series of structural equation models were used to assess the associations of each factor with alcohol use, binge drinking, and cannabis use.

RESULTS

EFA and CFA indicated the presence of four factors (labeled Supervised/Structured, Active Monitoring, Task Engagement, and Parental Rules/Strategies). Evidence of measurement invariance was found across adolescent age and sex. The Supervision/Structure was negatively associated with adolescent alcohol use, binge drinking, and cannabis use.

CONCLUSIONS

The parental monitoring FAsTask demonstrates validity and retains its structure across adolescent age and sex. Items focused on parental supervision and structure are most strongly associated with adolescent substance use and may best inform clinical care for adolescent substance use.

Multi-index comprehensive evaluation model for assessing risk to trainees in an emergency rescue training base for building collapse

Rescues from building collapse accidents present a significant challenge for China's emergency rescue system. However, there are also many risk factors in a training scenario, which have been summarized in this study. A hierarchical indicator system for personnel safety was established, including 12 first-level indicators and 23s-level indicators. Then, an improved Grey-DEMATEL-ISM-MICMAC evaluation model was constructed to evaluate the level of risk. Influencing factor scores were determined according to the responses from the questionnaire survey. The influencing degree, influenced degree, centrality, and causality were identified, and the importance, relevance, and clustering of the various factors were obtained after making quantitative calculations. The results showed that the order of priority for solving the essential issues was safety education (A2), operating standards and proficiency (A10), equipment inspection (A4), equipment warehousing maintenance and records (A21). The solving of safety education was identified to be the most essential priority. The priority control order of direct causes was Scientific design and construction (A5), Potential fixed hazards in the facility (A12), Physical fitness of personnel (A1), Weather influences (A18), and Initiation efficiency of emergency plans (A20), and direct control measures for these five factors could achieve a relatively significant effect.

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.

Tampa Scale for Kinesiophobia in chronic neck pain patients (TSK-neck): structural and construct validity and reliability in a Brazilian population

BACKGROUND

To date, there are no studies in the literature that define the internal structure of the Tampa Scale for Kinesiophobia (TSK) in patients with chronic neck pain based on factorial analysis. As such, we aimed to verify and identify the best structure of the Brazilian version of the TSK in patients with chronic neck pain.

METHODS

We included Brazilian participants aged ≥18 years, both sexes, with self-reported neck pain for more than 3 months and pain intensity ≥3 on the Numerical Pain Rating Scale (NPRS). Dimensionality and number of TSK items were assessed using confirmatory factor analysis (CFA). We tested the following internal structures: structure 1 (1 domain and 17 items), structure 2 (1 domain and 11 items), structure 3 (2 domains and 11 items), and structure 4 (2 domains and 9 items). We used the Pain-Related Catastrophizing Thoughts Scale (PCTS) and the NPRS for construct validity. In addition, we assessed test-retest reliability for the seven-day interval using intraclass correlation coefficient (ICC2,1), Cronbach's alpha to assess internal consistency, and ceiling and floor effects.

RESULTS

The study sample included of 335 patients. Most were women (77.6%), young adults (~ 34 years), single (48.4%), with complete primary education (57.3%), physically inactive (66.6%), with a mean pain duration of 46 months and a mean pain intensity of ~ 5 points on the NPRS. Redundancy was found in the following items: item 1 with item 2 (modification indices = 21.419) and item 13 with item 15 (modification indices = 13.641). Subsequently, based on these paired analyses, the items with the lowest factor loadings (items 2 and 15) were excluded. As such, TSK structure 4 was composed of two domains ("somatic focus" and "activity avoidance") and 9 items, which showed adequate fit indices and lower AIC and SABIC values. We observed significant values (p < 0.05) with a correlation magnitude greater than 0.142 to 0.657 between the two domains of the TSK-neck and the other instruments (PCTS and NPRS). We found excellent reliability (ICC2,1 ≥ 0.96) and adequate internal consistency (Cronbach's alpha ≥0.98) of the TSK-neck. Finally, ceiling and floor effects were not observed.

CONCLUSION

The TSK-neck structure with two domains (somatic focus and activity avoidance) and nine items is the most appropriate for patients with chronic neck pain.

Spatial-temporal variation, source apportionment and risk assessment of lead in surface river sediments over ∼20 years of rapid industrialisation in the Pearl River Basin, China

Lead (Pb) is a highly toxic element and is not essential to the human body. Lead pollution caused by human activities and a high geological background is considered a global environmental issue. According to the China Geochemical Baseline (CGB) project, the Pearl River Basin had the highest Pb content in alluvial sediments of 30 first-level basins in China. For this reason, it is of great significance to determine the temporal and spatial variations in Pb and their influencing factors in the Pearl River Basin. In this study, 956 stream sediment samples collected in the 1980 s (early stage) and 129 river sediment samples collected from 2008 to 2010 (late stage) were used to study the background value and spatial-temporal variation characteristics of Pb in river sediments in the Pearl River Basin. The Pb source apportionment and an ecological risk assessment were also carried out. The background value of Pb (36.2 mg·kg-1) in the river sediments of the Pearl River Basin was significantly higher than that in China (22.1 mg·kg-1). The parent rocks determine the Pb background in sediments and the high Pb background areas mainly comprised carbonate rocks and acid volcanic rocks. Over 20 years of rapid industrialisation, the average Pb increased from 43.3 to 68.3 mg·kg-1 in the Pearl River Basin. The BCR analysis revealed that Pb mainly existed in the reducible phase (48 % on average) and residue phase (42 % on average). The enrichment factor and geo-accumulation index indicated that the late-stage sediments experienced more Pb pollution than the early-stage sediments. However, the risk assessment code (RAC) showed that there was a low ecological risk of Pb in the late-stage sediments. The factor analysis results for the two rounds of data were significantly different. The Pb content in early-stage sediments was closely related to Al2O3 and Zr, while Pb in the late-stage sediments was mainly related to Zn, As, Sb, Au and Hg, indicating that the increase in Pb in the later samples was mainly influenced by human activities. The Pb isotope composition of the late-stage sediments confirmed that low Pb content was mainly controlled by natural sources, while high Pb content was significantly affected by anthropogenic sources. Combining the results of spatial-temporal variation, chemical speciation and source apportionment indicated that the rapid rise of Pb in late-stage sediments in certain areas could be attributed to mining and smelting activities during the process of industrialisation over 20 years. The anthropogenic exogenous Pb could be immobilised by Fe-Mn (hydro)oxides when it entered the soil, so although there was a high background the ecological risk of Pb in river sediments was low. In the future, Pb pollution control and remediation needs to be strengthened in the Pearl River Basin to avoid the outbreak of potential ecological risks linked to Pb.

Exploring nurses' clinical judgment concerning the relative importance of fall risk factors: A mixed method approach using the Q Methodology

BACKGROUND

Nurses are pivotal in averting patient falls through their assessment of cues presented by patients and their environments, rendering clinical judgments regarding the risk of falling, and implementing tailored interventions. Despite the intricate cognitive processes entailed in nurses' judgment, no prior studies have explored their approach to assessing the risk of falling.

OBJECTIVE

This study aimed to examine how nurses judge the risk of falling among patients with different conditions, whether there are differences in the importance of risk factors as judged by nurses, how they justify their judgments, and what attributes of the nurses influence their judgments.

DESIGN

A mixed method approach using the Q Methodology was employed.

SETTING(S)

Three public and private hospitals in Japan.

PARTICIPANTS

Eighteen nurses participated in the study.

METHODS

Participants were tasked with ranking 36 patient scenarios, each featuring a distinct set of fall risk factors. Subsequently, post-sorting interviews were conducted to gather insights into their typical approach to assessing fall risk and the rationale behind their ranking decisions. A by-person principal component factor extraction was employed to examine differences in the rankings of the scenarios. The interview data were analyzed descriptively to elucidate the reasons behind these discrepancies.

RESULTS

Nurses engage in complex cognitive manipulations when evaluating the risk of patient falls, drawing extensively from their wealth of experience while utilizing assessment tools to support their judgments. In essence, nurses identify patients' tendency to act alone without calling a nurse, impaired gait and cognition, sedative use, drains, and limited information sharing among healthcare professionals as key fall risks. In addition, nurses vary in the importance they attribute to certain risk factors, leading to the discrimination of three distinct judgment profiles. One group of nurses judges patients with cognitive impairment and acting alone as high risk. Another group of nurses considers patients with unstable gait and acting alone as high risk. The last group of nurses sees patients wearing slippers as high risk. The post-sorting interviews revealed that their judgments are closely related to the healthcare context and patient population.

CONCLUSIONS

Nurses operate within diverse contexts, wherein they interact with patients of varying characteristics, collaborate with professionals from diverse disciplines, and have access to varying levels of human and physical resources. This nuanced understanding empowers the formulation of judgments that are finely attuned to the specific context at hand.

STUDY REGISTRATION

Not registered.

The impact of different data handling strategies in exploratory and confirmatory factor analysis of diary measures: an evaluation using simulated and real-world asthma nighttime symptoms diary data

BACKGROUND

Daily diaries are an important modality for patient-reported outcome assessment. They typically comprise multiple questions, so understanding their underlying structure is key to appropriate analysis and interpretation. Structural evaluation of such measures poses challenges due to the high volume of repeated measurements. Potential strategies include selecting a single day, averaging item-level observations over time, or using all data while accounting for its multilevel structure.

METHOD

The above strategies were evaluated in a simulated dataset via exploratory and confirmatory factor modelling by comparing their impact on various estimates (i.e., inter-item correlations, factor loadings, model fit). Each strategy was additionally explored using real-world data from an observational study (the Asthma Nighttime Symptoms Diary).

RESULTS

Both single day and item average strategies resulted in biased factor loadings. The former displayed lower overall bias (single day: 0.064; item average: 0.121) and mean square error (single day: 0.007; item average: 0.016) but greater frequency of incorrect factor number identification compared with the latter (single day: 46.4%; item average: 0%). Increased estimated inter-item correlations were apparent in the item-average method. Non-trivial between- and within-person variance highlighted the utility of a multilevel approach. However, convergence issues and Heywood cases were more common under the multilevel approach (90.2% and 100.0%, respectively).

CONCLUSIONS

Our findings suggest that a multilevel approach can enhance our insight when evaluating the structural properties of daily diary data; however, implementation challenges still remain. Our work offers guidance on the impact of data handling decisions in diary assessment.

Dietary amino acid patterns and cardiometabolic risk factors among subjects with obesity; a cross-sectional study

BACKGROUND

The prevalence of obesity is a growing global public health concern. Certain dietary amino acids have been shown to have a potential therapeutic role in improving metabolic syndrome parameters and body composition in individuals with obesity. However, some amino acids have been linked to an increased risk of cardiometabolic disorders. This cross-sectional study aims to investigate the association between dietary amino acid patterns and cardiometabolic risk factors in individuals with obesity.

METHODS

This cross-sectional study included 335 participants with obesity (57.9% males and 41.5% females) from Tabriz and Tehran, Iran. The participants were between the ages of 20-50, with a body mass index (BMI) of 30 kg/m2 or higher, and free from certain medical conditions. The study examined participants' general characteristics, conducted anthropometric assessments, dietary assessments, and biochemical assessments. The study also used principal component analysis to identify amino acid intake patterns and determined the association between these patterns and cardiometabolic risk factors in individuals with obesity.

RESULTS

Upon adjusting for potential confounders, the study found that individuals in the third tertiles of pattern 1 and 2 were more likely to have lower LDL levels (OR = 0.99 and 95% CI (0.98-0.99)) for both. Additionally, a significant decrease in total cholesterol was observed in the third tertiles of pattern 2 in model II (OR = 0.99, 95% CI (0.98-0.99)). These findings suggest a potential cardioprotective effect of these amino acid patterns in managing cardiometabolic risk factors in individuals with obesity.

CONCLUSIONS

This study found that two identified amino acid patterns were associated with lower serum LDL and total cholesterol levels, while a third pattern was associated with higher serum triglycerides. The specific amino acids contributing to these patterns highlight the importance of targeted dietary interventions in managing cardiometabolic risk factors in individuals with obesity.

Evaluation of physical fitness and health of young children aged between 3 and 6 based on cluster and factor analyses

BACKGROUND

As life improves and sedentary time increases, young children's physical fitness gradually declines.

METHODS

Multi-stage stratified whole cluster sampling was utilized to sample 5584 preschoolers. Young infants' morphology, function, and quality were revealed using cluster and factor analysis.

RESULTS

The cluster analysis separated 3-6-year-olds into two genders: 1,551 men in group A "high physical fitness" 1,499 men in group B "low physical fitness"; 1,213 women in group A and 1,321 women in group B. Young children's fitness was measured by standing long jump(1.00), weight(1.00), and height(1.00). A cluster analysis of 3-4-year-olds classified them into three groups: 272 "muscular strength," 75 "average physical fitness," and 250 "low agility." Young children's health depends on weight (1.00), height (0.57), and chest circumference (0.54). A cluster analysis of the 4-5-year-olds classified them into two groups: 1070 "balance" and 806 "muscular strength." Young children's health depends on weight (1.00), height (0.74), and chest circumference (0.71). A cluster analysis of the 5-6-year-olds divided them into three groups: 1762 "high physical fitness," 384 "obese," and 105 "low physical fitness." Young children's physical health depends on BMI (1.00), weight (1.00), and chest circumference (1.00). Factor analysis demonstrated that muscle strength, body shape, cardiovascular variables, and physical fitness composite components affected young children's health.

CONCLUSION

Women should focus on motor function and strength, while men on flexibility. Male group B "low physical fitness" should focus on strength, motor function, and balance, whereas male group A "high physical fitness" should focus on flexibility. Then, female group A "high physical fitness" should emphasize variety.2) For 3-4-year-olds, group A "muscular strength" should focus on flexibility, and group C "low agility" on motor function. 3) For 4-5-year-olds, group A "balanced" should focus on strength and motor function; 4) For 5-6-year-olds, group B "obese" should emphasize weight loss, and group C "low fitness" should emphasize strength, motor function, and flexibility; 5) Young children's physical fitness depends on muscle strength, body shape, cardiovascular factors, and physical fitness composite.

Association between dairy-rich dietary pattern and metabolic dysfunction-associated steatotic liver disease: Findings from the Korean Genome and Epidemiology Study

BACKGROUNDS

Dietary components and the development of metabolic dysfunction-associated liver disease (MASLD) are closely linked, but large-scale studies on dietary patterns and MASLD are scarce, most previous studies having focused on individual nutrients or foods rather than overall dietary patterns. Therefore, we aimed to investigate the association between dietary patterns and MASLD in Koreans.

METHODS

A total of 6,052 participants from the Korean Genome and Epidemiology Study. Dietary intake was assessed using a validated Korean semiquantitative food frequency questionnaire comprising 106 food items. Principal component analysis was used to determine the major dietary patterns. Cox proportional hazard regression analysis was performed to assess the association between the incidence of MASLD and dietary patterns.

RESULTS

Four major dietary patterns, namely carnivore, plant-based, dairy-rich, and starch-rich diet patterns, were identified. The carnivore, plant-based, and starch-rich diet patterns showed no significant association with incident MASLD, while the dairy-rich diet pattern was associated with a lower risk of MASLD, also showing significantly lower cumulative incidence of MASLD in the higher adherence to dairy-rich diet pattern.

CONCLUSION

The dairy-rich diet pattern was significantly associated with a lower risk of MASLD in Koreans. Appropriate dietary guidance based on dietary patterns is crucial for preventing MASLD.

Further development of the reflective practice questionnaire

Background

This article provides an update of the Reflective Practice Questionnaire (RPQ). The original RPQ consisted of 40-items with 10-sub-scales. In this article, the RPQ is streamlined into a 10-item single reflective practice construct, and a 30-item extended version that includes additional sub-scales of confidence, uncertainty/stress, and work satisfaction.

Methods

A total of 501 university students filled out an online questionnaire that contained the original Reflective Practice Questionnaire, and two general measures of reflection: The Self-Reflection and Insight Scale, and the Rumination-Reflection Questionnaire.

Results

Based on factor analysis, the RPQ was streamlined into a brief 10-item version, and an extended 30-item version. Small positive correlations were found between the RPQ reflective practice measure and the two measures of general reflection, providing discriminant validity evidence for the RPQ. The RPQ was found to be sensitive to differences among industries, whereas the general measures of reflection were not. Average reflective practice scores were higher for health and education industries compared to retail and food/accommodation industries.

The transcultural adaptation and validation of the Chinese version of the Oral Health Literacy Scale for Diabetic Patients

BACKGROUND

Diabetic patients' oral health concerns are a reality for every diabetic patient in China. The attitudes of diabetic patients toward early identification of oral literacy influence oral literacy in diabetes patients. Diabetes patients' oral health literacy is critical for providing focused education and therapies. However, no instrument exists to measure oral health literacy in Chinese diabetic patients. In this study, the English version of the oral health literacy among people living with diabetes (OHLD) scale was cross-culturally validated to provide a reliable tool for assessing the oral health literacy of diabetic patients in China.

OBJECTIVE

The oral literacy among people living with diabetes (OHLD) scale was Chineseized and its reliability and validity tested, and the OHLD scale was revised to test the reliability and validity of the Chinese version of the OHLD scale and to provide a tool for assessing the oral health literacy of diabetic patients in China.

METHODS

A modified version of the Brislin translation model was used, cross-cultural adaptation was performed through expert consultation and pre-survey, and expert opinion was used to assess content validity to form the Chinese version of the Oral Health Literacy Scale for Diabetic Patients, which was administered to 420 diabetic patients in two tertiary hospitals in Liaoning Province from March to August 2023. The reliability of the scale was tested. SPSS 25.0 and AMOS 23.0 were used to analyze the data.

RESULTS

The Chinese version of the OHLD scale consisted of three dimensions and 10 entries. Structure of the validity analysis: three factors were extracted from the exploratory factors with a cumulative variance contribution of 79.794%; Content validity results:An item's content validity index (I-CVI) was 0.857 to 1 at the entry level, and the content validity index of the scale (S-CVI) was 0.928 at the scale level. The results of the reliability analyses were: the Cronbach's alpha coefficient for the total scale was 0.908; the Cronbach's alpha coefficients for the factors and dimensions were 0.853 to 0.922; the split-half reliability was 0.827; and the test-retest reliability was 0.848. The results of the validation factor analysis showed that (χ2/df) was 1.430, the root mean square of the error of approximation (RMSEA) was 0.045, the comparative fit index (CFI) was 0.989, and the Tucker Lewis index (TLI) was 0.985, which showed that the model had an overall good fit.

CONCLUSION

The Chinese version of the OHLD scale has good reliability and validity and can be used as a valid tool for assessing diabetes mellitus patients in China.

Multi trait stability indexing and trait correlation from a dataset of sweet potato (Ipomoea batatas L.)

A study was conducted in five regions of Bangladesh, specifically Gazipur, Bogura, Jamalpur, Jashore, and Chattogram, each characterized by suitable agro-ecologies for sweet potato cultivation. The purpose of this data article was to demonstrate the correlations between traits and the selection of stable varieties based on the multi-trait stability index (MTSI). The data indicated a direct link between multiple characteristics and both the yield and factors contributing to yield. This implies that enhancing these traits might result in a higher overall production of sweet potato storage roots. Furthermore, the factor analysis for MTSI demonstrated that the desired goal for selection was achieved for all traits, except for mean vine length (VL) and storage root dry weight (DW). The broad sense heritability ranged from 0 to 0.97, and the selection gain percentage ranged from 0 to 42.8. The MTSI analysis identified the sweet potato variety BARI Mistialu-15 as the most stable among the other studied varieties.

Dietary patterns and biochemical markers related to diabetes mellitus: an association analysis based on data from the Study of Cardiovascular Risk in Adolescents (ERICA)

OBJECTIVE

The aim of this study was to investigate the association between dietary patterns and biochemical markers related to diabetes mellitus (DM): glucose, insulin, glycated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance index from 35 454 Brazilian adolescents 12 to 17 y of age.

METHODS

Dietary patterns were derived using factor analysis by the principal components method. The data originated from the school-based study ERICA (Study of Cardiovascular Risk in Adolescents) carried out between 2013 and 2014. Linear regression models analyzed the associations.

RESULTS

Three dietary patterns were found: traditional Brazilian, bread and coffee, and Western. An inverse association was found in young girls between the traditional Brazilian pattern and fasting glucose (β = -0.76; P = 0.005) and HbA1c in the second and third tertiles (β = -0.04; P = 0.002; β = -0 .06; P < 0.001), and the Western pattern with HbA1c (β = -0.02; P = 0.035). In boys, a positive association was found between the second tertile of the dietary pattern and insulin (β = 0.48; P = 0.009) and homeostasis model assessment of insulin resistance index (β = 0.11; P = 0.012).

CONCLUSIONS

This study showed that the traditional Brazilian pattern was inversely associated with blood glucose and HbA1c values in girls. Furthermore, the data suggest that there is an important difference between boys and girls in the association of dietary patterns and the markers used.

Evidence for the factor structure of formal thought disorder: A systematic review

Disorganised speech, or, formal thought disorder (FTD), is considered one of the core features of psychosis, yet its factor structure remains debated. This systematic review aimed to identify the core dimensions of FTD. In line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), a systematic review was conducted on the FTD factor analytic literature. Sixteen studies were identified from PsycINFO, PubMed and Web of Science between October 1971 and January 2023. Across the 39 factor analyses investigated, findings demonstrated the prominence of a three-factor structure. Broad agreement was found for two factors within the three-factor model, which were typically referred to as disorganisation and negative, with the exact nature of the third dimension requiring further clarification. The quality assessment revealed some methodological challenges relating to the assessment of FTD and conducted factor analyses. Future research should clarify the exact nature of the third dimension across different patient groups and methodologies to determine whether a consistent transdiagnostic concept of FTD can be elucidated.

Development and Psychometric Evaluation of the Motivation for Healing Scale in Patients with Cancer

Introduction

This study was conducted to develop and validate a Motivation for Healing Scale (MHS) in Cancer.

Methods

in this methodological study, the MHS draft was developed based on the approach of Waltz and colleagues using existing scales and concept analysis. The psychometric features, including face validity (qualitative and quantitative), content validity (qualitative and quantitative), structural validity (exploratory and confirmatory factors), and construct validity (convergent and discriminant validity) were assessed. Finally, the reliability was evaluated using internal consistency, and stability.

Results

Based on the results of the qualitative phase, an initial item pool was generated with 55 items, Exploratory and confirmatory factor analyses were performed on the data collected from 404 patients. 25 Items were excluded during the psychometric evaluation phases. Reliability assessment and internal consistency assessment revealed that Cronbach's alpha value of the 25-item MHS was 0.912. The results of intraclass correlation coefficient (0.93, 95% CI: 0.86- 0.96) showed the stability was strong.

Conclution

The 25-item MHS is a valid and reliable scale for the assessment of motivation for healing in patients with cancer.

Enhancing effluent quality prediction in wastewater treatment plants through the integration of factor analysis and machine learning

Precisely predicting the concentration of nitrogen-based pollutants from the wastewater treatment plants (WWTPs) remains a challenging yet crucial task for optimizing operational adjustments in WWTPs. In this study, an integrated approach using factor analysis (FA) and machine learning (ML) models was employed to accurately predict effluent total nitrogen (Ntoteff) and nitrate nitrogen (NO3-Neff) concentrations of the WWTP. The input values for the ML models were honed through FA to optimize factors, thereby significantly enhancing the ML prediction accuracy. The prediction model achieved a highest coefficient of determination (R2) of 97.43 % (Ntoteff) and 99.38 % (NO3-Neff), demonstrating satisfactory generalization ability for predictions up to three days ahead (R2 >80 %). Moreover, the interpretability analysis identified that the denitrification factor, the pollutant load factor, and the meteorological factor were significant. The model framework proposed in this study provides a valuable reference for optimizing the operation and management of wastewater treatment.

Associations of major dietary patterns with cardiometabolic risk factors among Iranian patients with type 1 diabetes

Objective

To examine the associations between dietary patterns and cardiometabolic risk factors among type 1 diabetic (T1D) patients.

Methods

This cross-sectional study was conducted on 229 Iranian T1D patients. Data on dietary intakes were collected using a 168-item food frequency questionnaire. To identify major dietary patterns, we merged data on the 168 food items to obtain 23 food groups. Then, we constructed major dietary patterns using factor analysis with varimax rotation. We used binary logistic regression to assess the association between dietary patterns and cardiometabolic risk factors, in which potential confounders were adjusted.

Results

Four dietary patterns were identified: Western, unhealthy, traditional, and semi-healthy patterns. After adjusting for confounders including demographic variables, physical activity, energy intake, and medical history, participants in the highest tertile of the Western dietary pattern had 2.53 (95 % CI: 1.03-6.22) and 3.37 (95 % CI: 1.18-9.63) times more odds of elevated HbA1c and low estimated glucose disposal rate (eGDR), respectively, compared with those in the lowest tertile. Such the positive association was also seen for elevated fasting blood glucose (FBG). Moreover, individuals in the top tertile of unhealthy diet had more odds of elevated LDL-c and abdominal obesity than those in the lowest tertile. Regarding the semi-healthy diet, higher adherence was associated with 51 % lower odds of elevated FBG (OR: 0.49, 95 % CI: 0.24-0.99). For other outcomes, no significant association was found.

Conclusion

We found that T1D patients may take benefit from adherence to a semi-healthy diet with a low amount of unhealthy and Western-related foods.

Validation and bifactor structure of the French Adult ADHD Symptoms Rating Scale v1.1 (ASRS)

BACKGROUND

Three scoring methods for the widely available Adult ADHD Symptoms Rating Scale v1.1 (ASRS) have been proposed to screen for ADHD, but these three methods have rarely been compared against formal clinical diagnoses. We aimed to validate the French version of the ASRS against a clinical interview using DSM-IV and DSM-5 diagnostic algorithms.

METHODS

One hundred five adults from a convenience sample were evaluated with the ASRS and the DIVA 2.0, using both DSM-IV and DSM-5 criteria. We used Confirmatory Factor Analysis to investigate the underlying structure of the ASRS. Sensitivity, specificity, and classification accuracy were compared between the rating algorithms of the ASRS.

RESULTS

The full score method had worse predictive performance than the Screener and the 2-stage scoring method. All characteristics of the three scoring methods for the ASRS were worse when applying DSM-5 criteria. The best-fitting structure was a bi-factor model with a general ADHD factor and three specific factors.

CONCLUSIONS

ADHD was best conceived as a one-dimensional construct. The 2-stage scoring method superseded the Screener with comparable sensitivity and specificity.

Trauma-informed care: Insights from a Q-methodology study of advanced practice registered nursing students

BACKGROUND

Trauma-informed care (TIC) aims to create a safe and supportive healthcare environment that empowers patients and cultivates understanding of the role trauma plays in short-term and long-term health. TIC also has the potential to improve health outcomes and foster clinician wellness. Nurse educators must design evidence-based instruction to develop advanced practice registered nurses (APRNs) who deliver high-quality TIC while also protecting their own wellbeing.

OBJECTIVES

To identify patterns in subjective viewpoints about TIC among APRN students and describe how those patterns influence their learning experience in an advanced health assessment course.

DESIGN

Q methodology was used to explore student perceptions of TIC.

SETTING

A virtual advanced health assessment course at a large, midwestern university in the United States.

PARTICIPANTS

Ninety-five APRN students from six specialty APRN programs.

METHODS

Students completed an online Q-sort activity by ranking 32 TIC statements according to how well the statements aligned with their own perspectives. Q-sorts were analyzed using factor analysis and narrative responses to open-ended questions.

RESULTS

Four factors were extracted that revealed different student viewpoints on TIC and their learning experiences: Comfortable/Confident Learners, Uncomfortable/Apprehensive Learners, Empathetic/Hesitant Learners, and Inexperienced/Uncertain Learners.

CONCLUSIONS

All students acknowledged the need to learn about TIC to implement it effectively in practice. It is important for faculty to understand the potential range of divergent student viewpoints about TIC and acknowledge, accept, and support students who have anxiety related to learning about TIC.