The Feasibility of Remotely Delivered Exercise Session in Adults With Alzheimer's Disease and Their Caregivers.

Adults with Alzheimer's disease (AD) and their caregivers represent a segment of the population with low levels of moderate-intensity physical activity (MPA) and limited options for increasing MPA. The purpose of this study was to evaluate the feasibility of a group video conference approach for increasing MPA in adults with AD and their caregivers. Adults with AD and their caregivers attended 30-min group exercise sessions three times per week for 12 weeks. Exercise sessions and support sessions were delivered in their homes on a tablet computer over video conferencing software. Nine adults with AD/caregiver dyads enrolled, and seven completed the 12-week intervention. Adults with AD attended 77.3% of the group exercise sessions, and caregivers attended 79.2% of group exercise sessions. Weekly MPA increased in both adults with AD (49%) and caregivers (30%). Exercise delivered by group video conferencing is a feasible and potentially effective approach for increasing MPA in adults with AD and their caregivers.

Synergistic effects of social support and self-efficacy on dietary motivation predicting fruit and vegetable intake.

BACKGROUND: Self-efficacy and social support are considered relevant predictors of fruit and vegetable intake. This study examines whether the effect of self-efficacy on fruit and vegetable intake is mediated by intention and whether this motivational process is moderated by received dietary social support. METHODS: A longitudinal study with two measurement points in time, four weeks apart, on fruit and vegetable intake was carried out with 473 students aged 19 years on average (52% women). In a conditional process analysis, dietary intention was specified as a mediator between self-efficacy and fruit and vegetable intake, whereas received dietary support was specified as a moderator of the self-efficacy-intention association, controlling for baseline fruit and vegetable intake. RESULTS: Self-efficacy was positively associated with fruit and vegetable intake four weeks later, and intention mediated this process. Moreover, an interaction between received dietary support and self-efficacy on intention emerged. CONCLUSIONS: The effect of self-efficacy on fruit and vegetable intake was fully mediated by intention. Moreover, received support exhibited a moderating role within the motivational process: high dietary support appeared to accentuate the positive relationship between self-efficacy and dietary intention.

A comparison of individual and group equivalence-based instruction delivered via Canvas.

Equivalence-based instruction (EBI) is an efficient method that has been used to teach various skills, including content in college courses. This study extended the literature on EBI in higher education by teaching 13 graduate students to identify features of functional analysis conditions and variations. Equivalence-based instruction methods were implemented using Canvas, an online learning management system. Participants completed pretests, experienced EBI individually and in small groups, and completed a posttest, all using the quiz feature in Canvas. The EBI modules increased students' posttest scores relative to pretest scores by 36%, on average, and there was a slight increase in correct responding in the group relative to the individual teaching condition. Furthermore, responses to social-validity surveys indicated that EBI was acceptable to most students; however, students' preferences for group and individual EBI varied.

The Psychometric Properties of the Universal Design in Healthcare Education Instrument.

BACKGROUND AND PURPOSE: Universal design (UD) teaching approaches provide access to learning environments for diverse postsecondary students; however, UD practices in healthcare education have rarely been examined. The purpose of this study was to evaluate the construct validity and reliability of the revised Universal Design in Healthcare Education (UDinHE) instrument. METHODS: The exploratory structural equation model (ESEM). RESULTS: The ESEM revealed an acceptable model with good internal consistency for the subscales, except trialability (α = .59). All scales had a Cronbach's alpha > .70, except social system support. In the final CFA without trialabiity, the model showed good adjustment to the data Χ²(334, n = 222) = 651.188, comparative fit index (CFI) = 0.91, Tucker-Lewis index (TLI) = 0.90, root mean square error of approximation (RMSEA) = 0.90, 95% confidence interval [CI] [0.06, 0.07]). CONCLUSION: This instrument performs similarly with a broader population of healthcare educators as with nurse educators; however, future instrument refinement is warranted.

Lessons Learned From Decentralization of an Elective Surgery Medical-Surgical Unit.

OBJECTIVE: The objective of this study was to examine changes in healthcare practitioners' perception of supportiveness of their physical work environment, and trend in patient fall, when moving from a centralized to a decentralized unit configuration. BACKGROUND: Previous studies on decentralization have not uniformly provided findings consistent with desired outcome. METHOD: A pretest-posttest study was conducted in an elective surgery medical-surgical unit in the mid-Atlantic region of the United States. The independent variable was the physical design supporting centralized versus decentralized nursing models. Data were collected from healthcare staff with a self-report survey "before" (September 2017; n = 42) and "after" (June 2019; n = 22), and interviews. Before-after data were analyzed using both parametric and nonparametric tests to identify significant differences. Qualitative responses were analyzed to identify triangulating evidences. Monthly patient fall data were collected for a 3-year period and analyzed using log-linear Poisson Regression model. RESULTS: Results show favorable assessments in the areas of overall supportiveness of design, equipment and soiled utility location, peer support, process flow visualization, and overall satisfaction. A reduction in patient falls was observed. Unfavorable outcomes were found in the contexts of walking distance, multidisciplinary collaboration, alarm audibility, nurse station size, and PPE location. CONCLUSIONS: This study underscores that the success of a unit cannot be achieved without coordinated and successful interventions in the areas of operations, processes, policies, culture, and the physical design.

A Structural Equation Modelling Approach to Examine the Relationship between Socioeconomic Status, Diet Quality and Dyslipidaemia in South African Children and Adolescents, 6-18 Years.

This study utilised a structural equation model to examine the relationship between diet quality, socioeconomic status, and cardiovascular disease (CVD) risk in South African learners. Confirmatory factor analysis was used to test the indirect effects model for diet, socioeconomic status, diet quality and cardiovascular risk using pre-existing cross-sectional data. The structural equation model was fit using Lavaan version 0.6-5 in R version 3.6.1. Data were analysed from 178 children and adolescents, aged 6-18 years, from five rural schools in Cofimvaba, South Africa. Latent variables were created for dietary quality, dyslipidaemia and the socioeconomic status of participants. A negative association was observed between socioeconomic status and dyslipidaemia in school-aged children (p = 0.029).

Empowering the poor: A field study of the social psychological consequences of receiving autonomy or dependency aid in Panama.

This field study investigated the consequences of receiving poverty aid through conditional transfer programmes in the form of autonomy-oriented help (i.e., cash) or dependency-oriented help (i.e., vouchers) in impoverished rural communities in Panama. The empowering effects of autonomy- (vs. dependency-) help have so far only been studied in laboratory settings, or in settings where help could easily be refused. Little is known about the reactions of people who rely on help for extended periods of time. This study provides insights into how aid recipients are influenced by the type of aid they receive. Results showed that, as expected, recipients of cash reported more autonomy, empowerment, and life improvements than recipients of vouchers. Training, another type of autonomy-oriented help, was positively related to empowerment, personal, and family change beliefs. These findings illustrate the benefits of autonomy-oriented help programmes in empowering people from extremely poor communities around the world, who rely on aid for extended periods of time.

Depressive Symptoms Affect Working Memory in Healthy Older Adult Hispanics.

OBJECTIVES: Low and middle income nations will experience an unprecedented growth of the elderly population and subsequent increase in age-related neurological disorders. Worldwide prevalence and incidence of all-types of neurological disorders with serious mental health complications will increase with life expectancy across the globe. One-in- ten individuals over 75 has at least moderate cognitive impairment. Prevalence of cognitive impairment doubles every 5 years thereafter. Latin America's population of older adult's 65 years and older is growing rapidly, yet little is known about cognitive aging among healthy older Latinos. Clinically significant depressive symptomatology is common among community-dwelling older adults and is associated with deficits across multiple cognitive domains, however much of the literature has not modeled the unique effects of depression distinct from negative and low positive affect. Our objective was to understand how mental health affects cognitive health in healthy aging Latinos. METHODS: The present study used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to examine the relative effects of Negative Affect, Positive Affect and Geriatric Depression on Verbal Memory, Verbal Reasoning, Processing Speed, and Working Memory in healthy aging Latinos. Data was collected from a sample of healthy community dwelling older adults living in San Jose, Costa Rica. Modeling of latent variables attenuated error and improved measurement reliability of cognition, affect, and depression variables. RESULTS: Costa Ricans enjoy a notoriety for being much happier than US citizens and are renowned as one of the happiest nations in the world in global surveys. This was born out in these data. Costa Rican affective profiles differed substantively from US profiles. Levels of negative affect and depression were similar to US samples, but their levels of positive affect were much higher. Cognitive performance of these Costa Rican older adults was similar to US-age and education matched peers. CFA and SEM found that increased depressive symptomatology had deleterious effects on Working Memory made up of subtest scores sampling simple attention and vigilance for numbers. Verbal Memory, Verbal Reasoning, and Processing Speed were not affected by self-reported Positive Affect, Negative Affect or Depressive symptoms. CONCLUSION: Costa Rican older adults were happy, as evidenced by the high ratio of positive affect to relatively low negative affect. Thus, we were somewhat surprised to find that depressive symptoms were selectively correlated to decrements in working memory and that negative and positive affect contributed negligible amounts of variance to any of the cognitive factors. Because of the methodological rigor of latent variable analysis, these results are very specific. The Working Memory factor is not contaminated with Speed of Processing or other measured cognitive factors. Likewise, the measured Geriatric Depression represents symptoms that are richly cognitive, not overtly affective.

Action control bridges the planning-behaviour gap: a longitudinal study on physical exercise in young adults.

OBJECTIVES: Maintaining physical exercise levels may not only require motivation and planning but also action control which is supposed to mediate between planning and exercise. DESIGN: Behavioural intention, action planning, coping planning and past behaviour were assessed at baseline, and action control and concurrent exercise were measured one month later in 497 young adults. METHOD: Three nested structural models were specified to examine different mediation mechanisms. One model reflected the intention-planning-behaviour chain, the other one focused on the intention-action control-behaviour chain and the third model comprised the full sequence. RESULTS: Indirect effects from intentions on exercise involved either planning or action control as mediating variables. In Model 3, all three constructs (action planning, coping planning and action control) were sequential mediators between intentions and later physical exercise levels. Action and coping planning were not directly but indirectly related to exercise via action control. CONCLUSIONS: Findings support the sequential mediation for planning and action control as antecedents of physical exercise. Action control is needed for exercise, because planning in itself is not always sufficient. Maintaining exercise levels may be attributed to effective self-regulatory strategies such as action control in combination with planning.

Self-efficacy, action control, and social support explain physical activity changes among Costa Rican older adults.

BACKGROUND: Self-efficacy, action control, and social support are considered to influence changes in physical activity levels in older adults. This study examines the relationship among these variables and explores the putative mediating and moderating mechanisms that might account for activity changes. METHODS: A longitudinal study with 54 older adults (≥ 50 years of age) was carried out in Costa Rica. In a moderated mediation analysis, action control was specified as a mediator between self-efficacy and physical activity, whereas social support was specified as a moderator between self-efficacy and action control. Baseline physical activity, age, and sex were specified as covariates. RESULTS: Action control mediated between self-efficacy and physical activity. An interaction between social support and self-efficacy on action control pointed to a synergistic effect at the first stage of the mediating process. CONCLUSIONS: The effect of self-efficacy on physical activity was partly explained by action control, providing evidence of action control as a proximal mediator of physical activity. Moreover, the moderator role of social support was confirmed: high social support appeared to compensate for low levels of self-efficacy.

No le tema a los datos perdidos: enfoques modernos para el manejo de datos perdidos

La mayoría de los datos en ciencias sociales y educación presentan valores perdidos debido al abandono del estudio o la ausencia de respuesta. Los métodos para el manejo de datos perdidos han mejorado dramáticamente en los últimos años, y los programas computacionales ofrecen en la actualidad una variedad de opciones sofisticadas. A pesar de la amplia disponibilidad de métodos considerablemente justificados, muchos investigadores e investigadoras siguen confiando en técnicas viejas de imputación que pueden crear análisis sesgados. Este artículo presenta una introducción conceptual a los patrones de datos perdidos. Seguidamente, se introduce el manejo de datos perdidos y el análisis de los mismos con base en los mecanismos modernos del método de máxima verosimilitud con información completa (FIML, siglas en inglés) y la imputación múltiple (IM). Asimismo, se incluye una introducción a los diseños de datos perdidos así como nuevas herramientas computacionales tales como la función Quark y el paquete semTools. Se espera que este artículo incentive el uso de métodos modernos para el análisis de los datos perdidos.

Most of the social and educational data have missing observations due to either attrition or nonresponse. Missing data methodology has improved dramatically in recent years, and popular computer programs as well as software now offer a variety of sophisticated options. Despite the widespread availability of theoretically justified methods, many researchers still rely on old imputation techniques that can create biased analysis. This article provides conceptual introductions to the patterns of missing data. In line with that, this article introduces how to handle and analyze the missing information based on modern mechanisms of full-information maximum likelihood (FIML) and multiple imputation (MI). An introduction about planned missing designs is also included and new computational tools like Quark function, and semTools package are also mentioned. The authors hope that this paper encourages researchers to implement modern methods for analyzing missing data.