Comparing the Clique Percolation algorithm to other overlapping community detection algorithms in psychological networks: A Monte Carlo simulation study.

In psychological networks, one limitation of the most used community detection algorithms is that they can only assign each node (symptom) to a unique community, without being able to identify overlapping symptoms. The clique percolation (CP) is an algorithm that identifies overlapping symptoms but its performance has not been evaluated in psychological networks. In this study, we compare the CP with model parameters chosen based on fuzzy modularity (CPMod) with two other alternatives, the ratio of the two largest communities (CPRat), and entropy (CPEnt). We evaluate their performance to: (1) identify the correct number of latent factors (i.e., communities); and (2) identify the observed variables with substantive (and equally sized) cross-loadings (i.e., overlapping symptoms). We carried out simulations under 972 conditions (3x2x2x3x3x3x3): (1) data categories (continuous, polytomous and dichotomous); (2) number of factors (two and four); (3) number of observed variables per factor (four and eight); (4) factor correlations (0.0, 0.5, and 0.7); (5) size of primary factor loadings (0.40, 0.55, and 0.70); (6) proportion of observed variables with substantive cross-loadings (0.0%, 12.5%, and 25.0%); and (7) sample size (300, 500, and 1000). Performance was evaluated through the Omega index, Mean Bias Error (MBE), Mean Absolute Error (MAE), sensitivity, specificity, and mean number of isolated nodes. We also evaluated two other methods, Exploratory Factor Analysis and the Walktrap algorithm modified to consider overlap (EFA-Ov and Walk-Ov, respectively). The Walk-Ov displayed the best performance across most conditions and is the recommended option to identify communities with overlapping symptoms in psychological networks.

Development and validation of the COVID-19 Impact Scale in Australia.

OBJECTIVE: The COVID-19 pandemic significantly impacted and continues to impact the health and well-being of Australian adults. However, there has been no instrument validated to comprehensively measure how the COVID-19 pandemic impacted adults in Australia across several domains (e.g. fear of COVID-19, attitudes towards vaccination, psychosocial impact of lockdowns).The current study conducted a rigorous psychometric process to develop and validate an instrument to measure the impact of the COVID-19 pandemic in Australia, the COVID-19 Impact Scale (CIS). METHOD: Data was obtained from the Australian population. Participants (N = 563) aged between 19 and 91 years (M = 54.50, SD = 16.16) provided online responses between June, 2021 and May, 2022. The majority of participants were female (60.9%), employed either full-time (37.7%) or part-time (22.0%), and had completed an undergraduate degree or higher (70.1%). An initial pool of 30 items was developed based on a review of the literature and input from a panel of experts including psychologists, epidemiologists, and public health experts, among others. The study used network psychometrics to examine the psychometric properties of: (1) item score distributions; (2) item redundancy; (3) dimensionality; (4) model fit; (5) measurement invariance; (6) reliability; and (7) criterion validity. RESULTS: Following an evaluation of items for ceiling/floor effects and redundancy, the final CIS network model included eighteen nodes and displayed a three-dimensional structure. The three communities of "Fear" (consisting of three nodes; ω = 0.82), "Attitudes" (consisting of ten nodes; ω = 0.89), and "Ill-being" (consisting of five nodes; ω = 0.79) displayed adequate reliability. The evaluation of model fit indicated a good fit of the network model (RMSEA = 0.047; CFI =0.98). CONCLUSION: The instrument is available to be used by Australian researchers and implemented to evaluate public policies, adapted for future pandemics, or used internationally.

A combined multilevel factor analysis and covariance regression model with mixed effects in the mean and variance structure.

Li et al developed a multilevel covariance regression (MCR) model as an extension of the covariance regression model of Hoff and Niu. This model assumes a hierarchical structure for the mean and the covariance matrix. Here, we propose the combined multilevel factor analysis and covariance regression model in a Bayesian framework, simultaneously modeling the MCR model and a multilevel factor analysis (MFA) model. The proposed model replaces the responses in the MCR part with the factor scores coming from an MFA model. Via a simulation study and the analysis of real data, we show that the proposed model is quite efficient when the responses of the MCR model are not measured directly but are latent variables such as the patient experience measurements in our motivating dataset.

Drop-the-p: Bayesian CFA of the Multidimensional Scale of Perceived Social Support in Australia.

AIM: We aimed to investigate whether the 12-item Multidimensional Scale of Perceived Social Support (MSPSS) constitutes a valid and reliable measure of social support for the general adult Australian population. METHODS: Data were from Australia's National Survey of Adult Oral Health 2004-2006 and included 3899 participants aged 18 years old and over. The psychometric properties were evaluated with Bayesian confirmatory factor analysis. One-, two-, and three-factor (Significant Other, Family and Friends) structures were tested. Model fit was assessed with the posterior predictive p-value (PPPχ2), Bayesian root mean square error of approximation (BRMSEA), and Bayesian comparative fit index (BCFI). Dimensionality was tested by comparing competing factorial structures with the Bayes factor (BF). Reliability was evaluated with the Bayesian Ω H . Convergent validity was investigated with the Perceived Stress Scale (PSS) and discriminant validity with the Perceived Dental Control scale (PDC-3). RESULTS: The theoretical three-factor model (Significant Other, Family, and Friends) provided a good fit to the data [PPPχ2 < 0.001, BRMSEA = 0.089-95% credible interval (CrI) (0.088, 0.089); BCFI = 0.963-95% CrI (0.963, 0.964)]. The BF provided decisive support for the three-factor structure in relation to the other structures. The SO [BΩ H = 0.95 - 95% CrI (0.90, 0.99)], FA (BΩ H = 0.92 - 95% CrI (0.87, 0.97), and FR (BΩ H = 0.92 - 95% CrI (0.88, 0.97)] subscales displayed excellent reliability. The MSPSS displayed initial evidence of convergent and discriminant validity. CONCLUSION: The MSPSS demonstrated good psychometric properties and excellent reliability in a large Australian sample. This instrument can be applied in national surveys and provide evidence of the role of social support in the Australian population.

Bayesian model selection in linear mixed models for longitudinal data.

Linear mixed models (LMMs) are popular to analyze repeated measurements with a Gaussian response. For longitudinal studies, the LMMs consist of a fixed part expressing the effect of covariates on the mean evolution in time and a random part expressing the variation of the individual curves around the mean curve. Selecting the appropriate fixed and random effect parts is an important modeling exercise. In a Bayesian framework, there is little agreement on the appropriate selection criteria. This paper compares the performance of the deviance information criterion (DIC), the pseudo-Bayes factor and the widely applicable information criterion (WAIC) in LMMs, with an extension to LMMs with skew-normal distributions. We focus on the comparison between the conditional criteria (given random effects) versus the marginal criteria (averaged over random effects). In spite of theoretical arguments, there is not much enthusiasm among applied statisticians to make use of the marginal criteria. We show in an extensive simulation study that the three marginal criteria are superior in choosing the appropriate longitudinal model. In addition, the marginal criteria selected most appropriate model for growth curves of Nigerian chicken. A self-written R function can be combined with standard Bayesian software packages to obtain the marginal selection criteria.

Contribution of HCAHPS Specific Care Experiences to Global Ratings Varies Across 7 Countries: What Can be Learned for Reporting These Global Ratings?

BACKGROUND: Given the increased international interest in improvement strategies for patient experiences with care, it is important to understand whether the same specific care experiences affect global ratings across countries. Moreover, reporting of these global ratings currently substantially varies in both research and public reporting. OBJECTIVES: The objectives of this study were to examine the differential magnitude of associations between Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) specific care experiences and global ratings, and to explore implications for reporting these global ratings. METHODS: HCAHPS data were collected from 11,289 patients across 7 European countries. We studied the association between 11 experience items and 2 global ratings (0-10 hospital rating, hospital recommendation) using multilevel ordered logistic regression analysis. Using interaction terms, we examined consistency of these associations across countries. Assuming homogeneous use and interpretations of response categories of these specific experiences across patients within and between countries, we investigated what the associations between specific experiences and global ratings imply for reporting global ratings across countries. RESULTS: All specific experiences were associated with both global ratings. "Being talked to about care after leaving the hospital" showed the strongest association. There were relatively little differential effects across countries. A reporting strategy with different cutpoints across countries might provide a more equitable comparison of global ratings. CONCLUSIONS: Our findings highlight a differential contribution of HCAHPS specific experiences to overall ratings across countries. Research and public reporting may consider examining in more detail within and across populations global rating cutpoints that represent the same true level of positive patient experiences.

Comparing hierarchical models via the marginalized deviance information criterion.

Hierarchical models are extensively used in pharmacokinetics and longitudinal studies. When the estimation is performed from a Bayesian approach, model comparison is often based on the deviance information criterion (DIC). In hierarchical models with latent variables, there are several versions of this statistic: the conditional DIC (cDIC) that incorporates the latent variables in the focus of the analysis and the marginalized DIC (mDIC) that integrates them out. Regardless of the asymptotic and coherency difficulties of cDIC, this alternative is usually used in Markov chain Monte Carlo (MCMC) methods for hierarchical models because of practical convenience. The mDIC criterion is more appropriate in most cases but requires integration of the likelihood, which is computationally demanding and not implemented in Bayesian software. Therefore, we consider a method to compute mDIC by generating replicate samples of the latent variables that need to be integrated out. This alternative can be easily conducted from the MCMC output of Bayesian packages and is widely applicable to hierarchical models in general. Additionally, we propose some approximations in order to reduce the computational complexity for large-sample situations. The method is illustrated with simulated data sets and 2 medical studies, evidencing that cDIC may be misleading whilst mDIC appears pertinent.

Multilevel covariance regression with correlated random effects in the mean and variance structure.

Multivariate regression methods generally assume a constant covariance matrix for the observations. In case a heteroscedastic model is needed, the parametric and nonparametric covariance regression approaches can be restrictive in the literature. We propose a multilevel regression model for the mean and covariance structure, including random intercepts in both components and allowing for correlation between them. The implied conditional covariance function can be different across clusters as a result of the random effect in the variance structure. In addition, allowing for correlation between the random intercepts in the mean and covariance makes the model convenient for skewedly distributed responses. Furthermore, it permits us to analyse directly the relation between the mean response level and the variability in each cluster. Parameter estimation is carried out via Gibbs sampling. We compare the performance of our model to other covariance modelling approaches in a simulation study. Finally, the proposed model is applied to the RN4CAST dataset to identify the variables that impact burnout of nurses in Belgium.

Eficacia de un programa de enfermería para mantener y fortalecer la funcionalidad física y cognitiva en el anciano hospitalizado / Efficacy of a nursing program to maintain and strengthen physical and cognitive functionality in the hospitalized elderly / Eficácia de um programa de enfermagem para manter e fortalecer a funcionalidade física e cognitiva em idosos hospitalizados

Antecedentes. La intervención de Enfermería en la implementación de programas para fortalecer la funcionalidad tanto física como cognitiva en adultos mayores hospitalizados, es fundamental para evitar complicaciones, disminuir los días de estancia y reincorporarlos lo más rápido posible a sus actividades de la vida diaria, favoreciendo su autonomía e independencia, de ahí la importancia de evaluar éstos programas para poder determinar el impacto y la eficacia en la prevención del deterioro funcional físico y cognitivo en éste tipo de pacientes. Objetivo. Determinar la eficacia de un programa de enfermería para mantener y fortalecer la funcionalidad física y cognitiva en el anciano hospitalizado. Método. Se realizó un estudio longitudinal y comparativo, en una muestra de 80 adultos mayores de 60 años y más, hospitalizados en el Instituto Nacional de Ciencias Médicas y la Nutrición Salvador Zubirán (INCMNSZ). Conformándose dos grupos (experimental y control), en ambos grupos se realizaron tres mediciones, un pre test, un pos test inmediato y un postest a los 3 meses de seguimiento, el grupo experimental fue sometido a un programa de enfermería con la ayuda del familiar para mantener y fortalecer la funcionalidad física y cognitiva, el grupo control no se le aplicó el programa, para evaluar la funcionalidad a ambos grupos se les aplicaron los siguientes instrumento: escala de Barthel, Mini mental de Folstein, Yesavage, Atenas y Epworth. Los resultados fueron analizados a través de frecuencias, porcentajes, promedios, ± DE y como pruebas de comparación t pareada. Resultados: Con respecto a los resultados de la evaluación del estado mental, se utilizó la escala de Folstein, se encontró una diferencia estadísticamente significativa en el grupo experimental, (1er 26.54±3.8, 2a 28.06±2.9, 3a 28.9±1.8 P=0.0001) lo cual evidencia que mejoró su estado mental con la intervención comparado con el grupo control( 1er 27.5±2.5, 2a 27.6±2.4, 3a 26.1±3 P=0.002); en relación a los resultado obtenidos en la evaluación de la funcionalidad física en la escala de Barthel, también se observaron resultados estadísticamente significativos en el grupo experimental (1er 90.03±23.4, 2a 91.1±22, 3a 96.8±10.3P=0.009) y en el grupo control( 1er 97.2±5.1 , 2a 98.2±5.1, 3a 93.2±8.6 P=0.006) . En cuanto al análisis de cada ítem de la escala de Barthel comparando ambos grupos, lo más relevante que se observó fue lo relacionado con la incontinencia urinaria ya que se presentó un decremento en el puntaje en el grupo control conforme a lo esperado (1er 9.3±2.2, 2a9.3±2.2, 3a 8±2 P=0.003). Y en el grupo experimental se observó que aumentó el puntaje en la tercera evaluación lo cual fue estadísticamente significativo (1er 8.06±2.62, 2a8.2±2.58, 3a 9.74±0.95 P=0.0001). Conclusión. Los resultados obtenidos sugieren que la implementación de un programa de intervención de enfermería para mantener y fortalecer la funcionalidad física y cognitiva en el anciano hospitalizado, ayuda a mantener la funcionalidad e independencia, disminuyendo el riesgo de complicaciones y con ello la calidad de vida.

Background: Nursing Intervention in implementing programs to strengthen both physical and cognitive function in hospitalized older adults, is essential to prevent complications, reduce the length of stay and reinstate them as quickly as possible to their daily life activities, promoting their autonomy and independence, hence the importance of evaluating these programs in order to determine the impact and effectiveness in preventing physical and cognitive functional decline in this type of patients. Objective. To determine the effectiveness of a nursing program in order to maintain and enhance physical and cognitive function in hospitalized elderly patients. Methods. We performed a comparative longitudinal study in a sample of 80 adults aged 60 years and older, hospitalized at the National Nutrition Institute. Comprised of two groups (experimental and control), in both groups there were three measurements: a pre-test, an immediate post-test and a post-test at the 3 months follow-up. The experimental group, was part of a nursing program with the help of the family in order to maintain and enhance physical and cognitive functions. The program was not applied to the control group. To evaluate the functionality of both groups, the following instruments were applied: Barthel scale, Folstein Mini Mental, Yesavage, Athens and Epworth. The results were analyzed by frequencies, percentages, averages, ± SD and as comparison Paired T tests. Results: Regarding the results of the mental status assessment, Folstein scale was used, and there was a statistically significant difference in the experimental group (26.54 ± 3.8 1st , 2nd 28.6 ± 2.9, 3rd 28.9 ± 1.8 P = 0.0001) which shows that their mental state improved with the intervention, in comparison with the control group (27.5 ± 2.5 1st , 2nd 27.6 ± 2.4, 26.1 ± 3 the 3rd p = 0.002), in relation to the results obtained in the evaluation of physical functioning in the Barthel scale, also statistically significant results were observed in the experimental group (90.03 ± 23.4 1st , 2nd 91.1 ± 22, 3rd 96.8 ± 10.3P = 0.009) and in the control group (97.2 ± 5.1 1st, 2nd 98.2 ± 5.1, 3rd 93.2 ± 8.6 P = 0.006). In relation to the analysis of each item of the Barthel scale comparing both groups, the most relevant data observed was the one related to urinary incontinence because it showed a decrease in score in the Control group (9.3 ± 2.2 1st , 2nd 9. 3 ± 2.2, August 3 ± 2 P = 0.003). And in the experimental group, it was observed that the score increased in the third evaluation, which was statistically significant (08.06 ± 2.62 1st , 2nd 8.2 ± 2.58, 3rd 9.74 ± 0.95 P = 0.0001). Conclusion. The results suggest that the implementation of a nursing intervention program to maintain and enhance physical and cognitive function in elderly hospitalized patients, helps to maintain function and independence, reduces complications risk, and improves life quality

Antecedentes A intervenção de enfermagem na implementação de programas para fortalecer a funcionalidade física e cognitiva em idosos hospitalizados é essencial para evitar complicações, reduzir os dias de internação e reintegrá-los o mais rápido possível em suas atividades da vida diária, favorecendo sua autonomia e independência, daí a importância de avaliar esses programas para determinar o impacto e a efetividade na prevenção do comprometimento funcional físico e cognitivo desse tipo de paciente. Objetivo. Determinar a eficácia de um programa de enfermagem para manter e fortalecer a funcionalidade física e cognitiva em idosos hospitalizados. Método Foi realizado estudo longitudinal e comparativo em uma amostra de 80 adultos acima de 60 anos, internados no Instituto Nacional de Ciências Médicas e Nutrição Salvador Zubirán (INCMNSZ). Conforme dois grupos (experimental e controle), em ambos os grupos foram realizadas três medições, um pré-teste, um pós-teste imediato e um pós-teste aos 3 meses de seguimento, o grupo experimental foi submetido a um programa de enfermagem com a ajuda do familiar Para manter e fortalecer a funcionalidade física e cognitiva, o grupo controle não aplicou o programa. Para avaliar a funcionalidade de ambos os grupos, foram aplicados os seguintes instrumentos: escala de Barthel, Folstein Mini mental, Yesavage, Atenas e Epworth. Os resultados foram analisados ​​através de frequências, porcentagens, médias, ± DP e testes de comparação pareados. Resultados: Para os resultados da avaliação do estado mental, foi utilizada a escala de Folstein, sendo encontrada diferença estatisticamente significante no grupo experimental (1 26,54 ± 3,8, 2 28,06 ± 2,9, 3 28,9 ± 1,8 P = 0,0001 ) que evidencia que seu estado mental melhorou com a intervenção em comparação com o grupo controle (1º 27,5 ± 2,5, 2º 27,6 ± 2,4, 3º 26,1 ± 3 P = 0,002); em relação aos resultados obtidos na avaliação da funcionalidade física na escala de Barthel, também foram observados resultados estatisticamente significantes no grupo experimental (1º 90,03 ± 23,4, 2º 91,1 ± 22, 3º 96,8 ± 10,3P = 0,009) e em o grupo controle (1 ° 97,2 ± 5,1, 2 ° 98,2 ± 5,1, 3 ° 93,2 ± 8,6 P = 0,006). Com relação à análise de cada item na escala de Barthel, comparando os dois grupos, o mais relevante foi o de incontinência urinária, uma vez que houve uma diminuição no escore no grupo controle como esperado (1º 9,3 ± 2,2, 2nd9,3 ± 2,2, 3rd 8 ± 2 P = 0,003). E no grupo experimental foi observado que o escore aumentou na terceira avaliação, estatisticamente significante (1º 8,06 ± 2,62, 2a8,2 ± 2,58, terceiro 9,74 ± 0,95 P = 0,0001). Conclusão Os resultados obtidos sugerem que a implementação de um programa de intervenção de enfermagem para manter e fortalecer a funcionalidade física e cognitiva em idosos hospitalizados, ajuda a manter a funcionalidade e a independência, reduzindo o risco de complicações e, consequentemente, a qualidade de vida.

Biodisponibilidad de lactato ferroso adicionado a caramelos de goma / Bioavailability of ferrous lactate added to gum caramels

Fundamentos: El enriquecimiento de alimentos consulfato ferroso es la alternativa más usada para combatirla deficiencia de hierro, pero tecnológicamente es difícilde manejar, por lo que se propone en su lugar ellactato ferroso que imprime menos modificaciones.Objetivo: Evaluar la biodisponibilidad del lactato ferrosoadicionado a caramelos de goma, en cerdos en crecimiento.Métodos: La biodisponibilidad del hierro se evaluó enlechonas. Aleatoriamente se formaron 2 grupos que recibieron:alimento bajo en hierro, mas los caramelos adicionadoscon lactato ferroso y alimento normal.Quincenalmente se midieron peso y parámetroshematológicos. Se realizó análisis pareado y comparaciónde medias.Resultados: El producto tuvo características organolépticasaceptables, contenido de hierro de 2,4 mg porgramo. Las lechonas suplementadas con lactato ferrosopresentaron mayor ganancia de peso (15,7% más). Lamortalidad en el grupo de lactato fue del 20% y de 50%en el grupo control. El hierro detectado, fue mayor en elgrupo de lactato (2.987 mg) que en el control (2.792mg); en cambio, la cantidad de hierro consumido fuemayor en este último.Conclusiones: La suplementación con lactato ferrosodemostró ser mejor en el incremento de peso y en lamenor mortalidad de lechonas. La biodisponibilidad dellactato ferroso fue superior en un 30% a la del sulfatoferroso

Background: The enrichment of food with ferrous sulfateis the most frequently use alternative to combat irondeficiency, but it is technologically difficult to managewhich is why we propose ferrous lactate which providesthe benefit of fewer modifications.Objective: To evaluate the bioavailability of ferrous lactateadded to gum caramels to female growing pigs.Methods: The bioavailability of the iron was evaluated inpiglets. At random 2 groups were formed which received:Feed low in iron, plus caramels added with ferrous lactateand normal feed. Every 15 days were weight andhematological parameters were measured. Paired analysiswere made and comparison of measurements.Results: The product had acceptable characters, quantityof iron of 2,4 mg per gram. The female pigs supplementedwith ferrous lactate showed more aid on weight (15,7%more). The mortality in the group of lactate was 20% and50% in the control group. The iron detected, was higherin the group of lactate (2 987 mg) than in the controlgroup (2 792 mg); whereas, the quantity of iron consumedwas higher in the last group.Conclusions: The supplement with ferrous lactate provedto be the best in increasing weight and reduced the mortalityof female pigs. The bioavailability of ferrous lactate wassuperior by 30% compared with ferrous sulfate