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Structural equation models (SEMs) involving feedback loops may offer advantages over standard instrumental variables estimators in terms of modelling causal effects in the presence of bidirectional relationships. In the following note, we show that in the case of a single "exposure" and "outcome" variable, modelling relationships using a SEM with a simple bidirectional linear feedback loop offers no advantage over traditional instrumental variables estimators in terms of consistency (i.e. both approaches yield consistent estimates of the causal effect, provided that causal estimates are obtained in both directions). In the case of finite samples, traditional IV estimators and SEM exhibited similar power across many of the conditions we examined, although which method performed best depended on the residual correlation between variables and the strength of the instruments. In particular, the power of SEM was insensitive to the residual correlation between variables, whereas the power of the Wald estimator/2SLS improved (deteriorated) relative to SEM as the magnitude of the residual correlation increased (decreased) assuming a positive causal effect of the exposure on the outcome. The power of SEM improved relative to the Wald estimator/2SLS as the instruments explained more residual variance in the "outcome" variable.
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Análise da Randomização Mendeliana , Humanos , Análise da Randomização Mendeliana/métodos , Modelos Genéticos , Modelos Estatísticos , Causalidade , RetroalimentaçãoRESUMO
BACKGROUND: There are very few mechanistic studies of the long-term impact of psychosocial interventions in childhood. The parent-mediated Paediatric Autism Communication Therapy (PACT) RCT showed sustained effects on autistic child outcomes from pre-school to mid-childhood. We investigated the mechanism by which the PACT intervention achieved these effects. METHODS: Of 152 children randomised to receive PACT or treatment as usual between 2 and 5 years of age, 121 (79.6%) were followed 5-6 years after the endpoint at a mean age of 10.5 years. Assessors, blind to the intervention group, measured Autism Diagnostic Observation Scale Calibrated Severity Score (ADOS CSS) for child autistic behaviours and Teacher Vineland (TVABS) for adaptive behaviour in school. Hypothesised mediators were child communication initiations with caregivers in a standard play observation (Dyadic Communication Measure for Autism, DCMA). Hypothesised moderators of mediation were baseline child non-verbal age equivalent scores (AE), communication and symbolic development (CSBS) and 'insistence on sameness' (IS). Structural equation modelling was used in a repeated measures mediation design. RESULTS: Good model fits were obtained. The treatment effect on child dyadic initiation with the caregiver was sustained through the follow-up period. Increased child initiation at treatment midpoint mediated the majority (73%) of the treatment effect on follow-up ADOS CSS. A combination of partial mediation from midpoint child initiations and the direct effect of treatment also contributed to a near-significant total effect on follow-up TVABS. No moderation of this mediation was found for AE, CSBS or IS. CONCLUSIONS: Early sustained increase in an autistic child's communication initiation with their caregiver is largely responsible for the long-term effects from PACT therapy on autistic and adaptive behaviour outcomes. This supports the theoretical logic model of PACT therapy but also illuminates fundamental causal processes of social and adaptive development in autism over time: early social engagement in autism can be improved and this can have long-term generalised outcome effects.
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Transtorno do Espectro Autista , Transtorno Autístico , Criança , Pré-Escolar , Humanos , Transtorno do Espectro Autista/diagnóstico , Transtorno Autístico/terapia , Transtorno Autístico/psicologia , Comunicação , Seguimentos , PaisRESUMO
Carnivore community dynamics are governed by a complex set of often interacting biotic, abiotic and anthropogenic factors that are increasingly volatile as a result of global change. Understanding how these changing conditions influence carnivore communities is urgent because of the important role carnivores play within ecosystems at multiple trophic levels, and the conservation threats that many carnivores face globally. While a great deal of research attention has historically been focused on large carnivores within ecosystems, the size-mediated sensitivity hypothesis has recently been proposed where the smallest carnivore in a system is likely to be the most responsive to the diverse suite of ongoing environmental and anthropogenic changes within ecological communities. We deployed camera traps at 197 sites over 4 years to monitor a diverse suite of mammalian carnivores within the Blue Ridge Mountains of western North Carolina and then used a two-step occupancy modelling-structural equation modelling framework to investigate the relative support for four primary hypothesized drivers (interspecific competition/predation, habitat complexity, food availability and anthropogenic disturbance) on carnivore occurrence. We found that each of the 10 carnivores in our system responded differently to conditions associated with each of these four hypothesized drivers, but that small and medium-sized carnivores had a greater number of significant (p < 0.05) pathways by which these conditions were influencing occupancy relative to large carnivores. In particular, the smallest carnivore observed in our study was the only species for which we found support for each of the four hypothesized drivers influencing occupancy. Collectively, our study supports the size-mediated sensitivity hypothesis and suggests that small carnivores are ideal sentinel species for global change. We echo recent calls for adopting a middle-out approach to investigations into carnivore community dynamics by refocusing sustained monitoring and research efforts on smaller carnivores within systems.
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Carnívoros , Ecossistema , Animais , North CarolinaRESUMO
BACKGROUND: Responsiveness to the population's non-clinical needs encompasses various dimensions, including responsive research and an educational outreach plan at the community level. This study aims to develop a community-responsive research model in the healthcare system to ensure the connection between community-identified health priorities and research funds, as well as capacity-building efforts. METHODS: A mixed-methods research study was conducted in three main phases, including a comprehensive literature review, a qualitative analysis of an expert panel's points of view, and the developing of a model using the Equation Modeling (SEM) technique. R software version 3.2.4 was used to conduct statistical analysis, considering a significance level of 0.05. RESULTS: Based on the literature review, 41 responsiveness components were identified from sixteen relevant studies conducted between 2000 and 2022. Ten sub-themes in four major themes, including planning, implementation, monitoring and evaluation, and action, were identified through qualitative content analysis. Standardized coefficients revealed that components such as dissemination of results to all stakeholders, research prioritization aligned with community needs, commitment to implement research findings, and collaborative learning had statistically significant effects on the community-responsive research model. CONCLUSION: It is essential to identify community health priorities by following a community-focused, priority-setting process based on the principles of community engagement to develop a community-responsive research model. Afterward, dissemination of research findings to all stakeholders, commitment to apply the obtained results in the real world, and promotion of shared learning among research partners have been proven to facilitate collaborative investigation and mutual understanding between the community and academic partners.
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Atenção à Saúde , Humanos , Pesquisa sobre Serviços de Saúde , Prioridades em Saúde , Pesquisa Qualitativa , Fortalecimento Institucional/métodosRESUMO
BACKGROUND: This study takes on the challenge of quantifying a complex causal loop diagram describing how poverty and health affect each other, and does so using longitudinal data from The Netherlands. Furthermore, this paper elaborates on its methodological approach in order to facilitate replication and methodological advancement. METHODS: After adapting a causal loop diagram that was built by stakeholders, a longitudinal structural equation modelling approach was used. A cross-lagged panel model with nine endogenous variables, of which two latent variables, and three time-invariant exogenous variables was constructed. With this model, directional effects are estimated in a Granger-causal manner, using data from 2015 to 2019. Both the direct effects (with a one-year lag) and total effects over multiple (up to eight) years were calculated. Five sensitivity analyses were conducted. Two of these focus on lower-income and lower-wealth individuals. The other three each added one exogenous variable: work status, level of education, and home ownership. RESULTS: The effects of income and financial wealth on health are present, but are relatively weak for the overall population. Sensitivity analyses show that these effects are stronger for those with lower incomes or wealth. Physical capability does seem to have strong positive effects on both income and financial wealth. There are a number of other results as well, as the estimated models are extensive. Many of the estimated effects only become substantial after several years. CONCLUSIONS: Income and financial wealth appear to have limited effects on the health of the overall population of The Netherlands. However, there are indications that these effects may be stronger for individuals who are closer to the poverty threshold. Since the estimated effects of physical capability on income and financial wealth are more substantial, a broad recommendation would be that including physical capability in efforts that are aimed at improving income and financial wealth could be useful and effective. The methodological approach described in this paper could also be applied to other research settings or topics.
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Pobreza , Humanos , Países Baixos , Estudos Longitudinais , Análise de Classes Latentes , Feminino , Masculino , Renda , Nível de Saúde , Adulto , Pessoa de Meia-IdadeRESUMO
Fractional vegetation cover (FVC) has changed significantly under various disturbances over northern China in recent decades. This research examines the dynamics of FVC and how it is affected by climate and human activity during the period of 1990-2018 in northern China. The effects of climate change (i.e., temperature, precipitation, solar radiation, and soil moisture) and human activity (socioeconomic data and land use) on vegetation coverage change in northern China from 1990 to 2018 were quantified using the Sen + Mann-Kendall test, partial correlation analysis, and structural equation modelling (SEM) methods. The findings of this research indicate the following: (1) From 1990 to 2018, the overall trend in FVC in northern China was increased. The areas with obvious increases were mainly situated on the northern slope of Tianshan Mountains, Xinjiang, the Loess Plateau, the Northeast China Plain, and the Sanjiang Plain, while the areas with distinct degradation were located in the Inner Mongolia Plateau, the Changbai Mountain and the eastern part of north China. (2) In the past 29 years, the FVC in northern China has been mainly affected by precipitation and soil moisture. (3) Based on structural equation modelling, we discovered that certain variables impacted the main factors influencing the amount of FVC in northern China. Human activity has had a larger impact on FVC than climate change. Our findings can accelerate the comprehension of vegetation dynamics and their underlying mechanisms and provide a theoretical basis for regional ecological environmental protection.
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Mudança Climática , Ecossistema , Humanos , China , Atividades Humanas , Temperatura , SoloRESUMO
INTRODUCTION: The relationship among physiologic reserve, intrinsic capacity, and physical resilience has not been examined, and a conceptual model that includes these key determinants of healthy ageing is needed. This study aimed to test a conceptual model using real-world data to determine the relationships among physiologic reserve, intrinsic capacity, physical resilience, and clinical outcomes. METHODS: This longitudinal study was conducted at a 1,343-bed tertiary-care medical centre. Patients were eligible for inclusion if they were 65 years of age or older and able to communicate independently. Demographic factors, cumulative illness rating scale for geriatrics [CIRS-G] (assessing physiologic reserve), intrinsic capacity, physical resilience instrument for older adults [PRIFOR] (assessing physical resilience), and clinical frailty scale [CFS] were collected at admission. The CFS and EuroQoL 5-dimension 3-level questionnaire [EQ5D] were administered at discharge. RESULTS: The mean age of the 413 patients was 76.34 ± 6.72 (52.5% female). Two conceptual models were identified and supported. Specifically, the path coefficients in the two models showed that the CIRS-G had diverse associations with each intrinsic capacity domain, and that all intrinsic capacity domains (except vitality) were significantly associated with PRIFOR. Moreover, PRIFOR was significantly associated with follow-up CFS, baseline control, and EQ5D scores. CONCLUSION: Physiologic reserve positively correlated with the cognitive and locomotive domains of intrinsic capacity. Moreover, older patients with better intrinsic capacity may have improved physical resilience, which may lead to better clinical outcomes. Efforts to improve the intrinsic capacity and physical resilience of older patients are necessary to promote healthy ageing.
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Resiliência Psicológica , Humanos , Feminino , Idoso , Masculino , Estudos Longitudinais , Análise de Classes LatentesRESUMO
Sensation seeking is bidirectionally associated with levels of alcohol consumption in both adult and adolescent samples, and shared neurobiological and genetic influences may in part explain these associations. Links between sensation seeking and alcohol use disorder (AUD) may primarily manifest via increased alcohol consumption rather than through direct effects on increasing problems and consequences. Here the overlap among sensation seeking, alcohol consumption, and AUD was examined using multivariate modelling approaches for genome-wide association study (GWAS) summary statistics in conjunction with neurobiologically informed analyses at multiple levels of investigation. Meta-analytic and genomic structural equation modelling (GenomicSEM) approaches were used to conduct GWAS of sensation seeking, alcohol consumption, and AUD. Resulting summary statistics were used in downstream analyses to examine shared brain tissue enrichment of heritability and genome-wide evidence of overlap (e.g., stratified GenomicSEM, RRHO, genetic correlations with neuroimaging phenotypes), and to identify genomic regions likely contributing to observed genetic overlap across traits (e.g., H-MAGMA and LAVA). Across approaches, results supported shared neurogenetic architecture between sensation seeking and alcohol consumption characterised by overlapping enrichment of genes expressed in midbrain and striatal tissues and variants associated with increased cortical surface area. Alcohol consumption and AUD evidenced overlap in relation to variants associated with decreased frontocortical thickness. Finally, genetic mediation models provided evidence of alcohol consumption mediating associations between sensation seeking and AUD. This study extends previous research by examining critical sources of neurogenetic and multi-omic overlap among sensation seeking, alcohol consumption, and AUD which may underlie observed phenotypic associations.
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Alcoolismo , Adulto , Adolescente , Humanos , Alcoolismo/genética , Multiômica , Estudo de Associação Genômica Ampla , Consumo de Bebidas Alcoólicas/genética , SensaçãoRESUMO
BACKGROUND: Cardiometabolic diseases are a major global health concern. This study aims to identify areas for targeted interventions and investigate the impact of socioeconomic status and lifestyle as a potential mediator in the context of the US. METHODS: Our study analyzed data from the Health Information National Trends Survey 5, a nationwide survey by the National Cancer Institute. Using standardized scales and questions, we examined cardiometabolic disease outcomes, lifestyle factors, and socioeconomic status of non-institutionalized civilians aged 18 + in the US. We analyzed the data using structural equation modelling. RESULTS: Our findings show that socioeconomic status and lifestyle significantly predict cardiometabolic disease outcomes. However, our analysis did not support lifestyle as the primary mediating factor in the association between socioeconomic status and cardiometabolic diseases, suggesting that other factors may significantly influence this relationship. CONCLUSIONS: Cardiometabolic diseases require lifestyle and structural interventions addressing socioeconomic factors. Policymakers must consider multifaceted factors to prevent, detect, and manage these diseases effectively and equitably.
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Doenças Cardiovasculares , Estilo de Vida , Classe Social , Humanos , Estudos Transversais , Estados Unidos/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Doenças Cardiovasculares/epidemiologia , Adolescente , Idoso , Adulto Jovem , Fatores de Risco Cardiometabólico , Inquéritos EpidemiológicosRESUMO
BACKGROUND: Food and nutrition insecurity is a major health issue in developing countries. Homestead food production (HFP) programs are strategies for improving food and nutrition security of a country. Iran implemented a HFP program entitled "Nutrition Improvement of Rural and Nomadic Women" in its villages for a five-year period from 2017. The current study assessed the outcomes of this mentioned program and its determinants among rural women in Tehran province. METHODS: The population of this cross-sectional study comprised a group covered by the program (n = 143) and a non-covered group (n = 160). The participants were selected randomly from 32 villages of five counties in Tehran province. Data was collected using five questionnaires: (1) General information, (2) Women's empowerment, (3) Nutritional knowledge, (4) Dietary diversity, and (5) Household Food Insecurity Access Scale (HFIAS). Data was analyzed using the IBM SPSS version 21 and the IBM Amos SPSS version 22 software. RESULTS: The results of the study showed no significant improvement in the expected indicators, such as frequency of home gardening, nutritional knowledge, dietary diversity, women's empowerment, and household food insecurity status among women covered by the program (p > 0.05). The structural equation modelling (SEM) results indicated that women's empowerment from the dimension of decision-making power (r = 0.151) and nutritional knowledge (r = 0.135) were the significant positive predictors of dietary diversity (p < 0.05), while household food insecurity predicted it negatively (r=-0.138) (p < 0.05). CONCLUSION: Because the current evaluated program has not been able to improve the expected indicators, modification of the program implementation may be needed, such as: addressing the probable barriers and challenges and strengthening the facilities in the covered villages. The current study presents a model of the dietary diversity predictors for consideration in redesigning or enhancing the program.
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Dieta , Alimentos , Feminino , Humanos , Irã (Geográfico) , Estudos Transversais , Segurança AlimentarRESUMO
BACKGROUND: Smoking rationalisation beliefs are a huge barrier to quitting smoking. What types of rationalisations should be emphasised in smoking cessation interventions? Although past literature has confirmed the negative relationship between those beliefs and motivation to stop smoking, little is known regarding the importance and performance of those beliefs on motivation with varying cigarette dependence. The study aimed to ascertain rationalisations that are highly important for motivation yet perform poorly in different cigarette dependence groups. METHODS: The cross-sectional study was conducted from November 19 to December 9, 2023 in Guiyang City, China. Adult male current smokers were enrolled. Partial least squares structural equation modelling was used to test the hypothesis. The multi-group analysis was used to determine the moderating effect of cigarette dependence, and the importance-performance map analysis was utilised to assess the importance and performance of rationalisations. RESULTS: A total of 616 adult male current smokers were analysed, and they were divided into the low cigarette dependence group (n = 297) and the high cigarette dependence group (n = 319). Except for risk generalisation beliefs, smoking functional beliefs (H1: -ß = 0.131, P < 0.01), social acceptability beliefs (H3: ß = -0.258, P < 0.001), safe smoking beliefs (H4: ß = -0.078, P < 0.05), self-exempting beliefs (H5: ß = -0.244, P < 0.001), and quitting is harmful beliefs (H6: ß = -0.148, P < 0.01) all had a significant positive influence on motivation. Cigarette dependence moderated the correlation between rationalisations and motivation. In the high-dependence group, the social acceptability beliefs and smoking functional beliefs were located in the "Concentrate Here" area. In the low-dependence group, the social acceptability beliefs were also situated in there. CONCLUSIONS: Social acceptability beliefs and smoking functional beliefs showed great potential and value for improvement among high-dependence smokers, while only social acceptability beliefs had great potential and value for improvement among low-dependence smokers. Addressing these beliefs will be helpful for smoking cessation. The multi-group analysis and the importance-performance map analysis technique have practical implications and can be expanded to other domains of health education and intervention practice.
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Motivação , Abandono do Hábito de Fumar , Humanos , Masculino , China , Estudos Transversais , Adulto , Abandono do Hábito de Fumar/psicologia , Pessoa de Meia-Idade , Fumantes/psicologia , Fumantes/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Adulto Jovem , Tabagismo/psicologia , Tabagismo/terapia , População do Leste AsiáticoRESUMO
OBJECTIVES: Procrastination is an almost universal behaviour and yet little research to date has focused on procrastination among older adults. The purpose of this study was to explore the potential association between age and procrastination, and the potential mediating roles of depressive symptomatology and loneliness. METHOD: Structural equation modelling was applied to data from 1309 participants (aged 29-92) from two waves United States Health and Retirement Study (2016-2020). Within the model, sex, education, marital status, and job status were added as covariates. RESULTS: There was no statistically significant direct effect between age and procrastination (ß = 0.06, p = 0.106). However, an indirect effect was present via depressive symptomatology (ß = -0.40, p < 0.001). No mediating effect of loneliness was observed (ß = - 0.01, p = 0.371). Subsequent analysis revealed that the symptoms, fatigue, loneliness, and lack of motivation significantly predicted procrastination. CONCLUSION: While age was not directly associated with procrastination, increasing age was associated with a decreased likelihood of depressive symptomatology, which was in turn associated with an increased likelihood of procrastination. Such findings indicates that age demonstrates no association with procrastination because of the suppressing effect of depressive symptomatology.
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Depressão , Solidão , Procrastinação , Humanos , Solidão/psicologia , Masculino , Idoso , Feminino , Depressão/psicologia , Depressão/epidemiologia , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Adulto , Estados Unidos/epidemiologia , Envelhecimento/psicologia , Fatores Etários , MotivaçãoRESUMO
Symptomatic effects of mental disorders in parents could bias their reporting on their child's mental health. This study aimed to investigate the measurement invariance of the French version of the parental Strengths and Difficulties Questionnaire (SDQ) across parental mental health in a sample (N = 20,765) of parents of children aged 3 to 17 years in France. Confirmatory factor analysis (CFA) and Exploratory Structural Equation Modelling (ESEM) were used to evaluate the fit of three known alternative SDQ factor structures (five, three, or second-order factor structures). Invariance was tested across parental mental health (present anxiety and depressive symptoms, psychiatric history) and across socio-demographic characteristics (child's age, child's gender, parent's gender, parent's educational level). CFA models showed a poor fit, while all ESEM models achieved acceptable or good fit, with the five-factor model presenting the best fit. Invariance was observed for all characteristics tested, indicating that the SDQ can be used to study the links between parental mental health and their child's mental health without bias. However, ESEM showed that the hyperactivity/inattention and conduct problems dimensions were not well differentiated in the French version of the SDQ.
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Nature contact has associations with emotional ill-being and well-being. However, the mechanisms underlying these associations are not fully understood. We hypothesised that increased adaptive and decreased maladaptive emotion regulation strategies would be a pathway linking nature contact to ill-being and well-being. Using data from a survey of 600 U.S.-based adults administered online in 2022, we conducted structural equation modelling to test our hypotheses. We found that (1) frequency of nature contact was significantly associated with lesser emotional ill-being and greater emotional well-being, (2) effective emotion regulation was significantly associated with lesser emotional ill-being and greater emotional well-being, and (3) the associations of higher frequency of nature contact with these benefits were partly explained via emotion regulation. Moreover, we found a nonlinear relationship for the associations of duration of nature contact with some outcomes, with a rise in benefits up to certain amounts of time, and a levelling off after these points. These findings support and extend previous work that demonstrates that the associations of nature contact with emotional ill-being and well-being may be partly explained by changes in emotion regulation.
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Regulação Emocional , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Emoções , Adulto Jovem , Satisfação Pessoal , Adolescente , Inquéritos e Questionários , Adaptação Psicológica , Meio AmbienteRESUMO
OBJECTIVES: The aim of this study was to identify the impact of social determinants of health on physical and mental health outcomes in a UK population. STUDY DESIGN: Structural equation modelling was used to hypothesise a model of relationships between health determinants and outcomes within a region in the North of England using large-scale population survey data (6208 responses). METHODS: We analysed responses from a population survey to assess the influence of a deprivation-based index at the environmental level, education and income on a behaviour index (smoking, alcohol consumption, physical activity, and dietary habits) and the influence of all these factors on self-reported physical health and the influence of the behaviour index and income on mental wellbeing. RESULTS: The proposed model was well supported by the data. Goodness-of-fit statistics, most notably a low value of the root mean square error of approximation (RMSEA), supported the validity of the proposed relationships (RMSEA = 0.054). The model revealed all examined paths to be statistically significant. Income and education were influential in determining an individual's behaviour index score, which, with income was the most important predictor of both the correlated outcomes of physical health and mental wellbeing (P < 0.001 in all cases). CONCLUSIONS: Findings challenge the traditional view of singular causal pathways, emphasising that interventions should consider the underlying influencing socio-economic conditions, which would influence behaviour and therefore physical and mental wellbeing. The extent to which the model is supported by the data, and the statistical significance of individual relationships accentuates the imperative for comprehensive public health strategies that integrate multiple socio-economic factors.
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Análise de Classes Latentes , Determinantes Sociais da Saúde , Humanos , Inglaterra/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Saúde Mental/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Nível de Saúde , Idoso , Fatores Socioeconômicos , Adolescente , Adulto Jovem , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Fumar/epidemiologia , Fumar/psicologiaRESUMO
AIM: To examine the relationships between nurses' exposure to workplace violence and self-reports of workplace cognitive failure. DESIGN: A cross-sectional study. METHODS: An online questionnaire was administered in April 2023 to nurses in Michigan, US. Structural equation modelling was used to examine effects of physical and non-physical workplace violence (occupational stressors) and work efficiency and competence development (occupational protective factors) on workplace cognitive failure. RESULTS: Physical violence was a significant predictor of the action subscale of cognitive failure. There were no direct effects of non-physical violence, workplace efficiency, or competence development on any of the workplace cognitive failure dimensions. Both types of violence and efficiency had significant indirect effects on workplace cognitive failure via work-related exhaustion. Work-related exhaustion predicted significantly higher scores for workplace cognitive failure. CONCLUSION: Workplace violence and work efficiency exhibited primarily indirect effects on workplace cognitive failure among nurses via work-related exhaustion. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses experiencing workplace violence may be at increased risk for workplace cognitive failure, especially if they are also experiencing work-related exhaustion. Workplaces that nurses perceive as more efficient can help to mitigate the effects of violence on nurses' cognitive failure. IMPACT: This study addressed the possible effects of workplace violence as well as work efficiency and competence development on nurses' cognitive failure at work. Analyses revealed primarily indirect effects of workplace violence, and indirect protective effects of work efficiency, on nurses' cognitive failure via work-related exhaustion. This research has implications for healthcare organizations and suggests that efforts made by healthcare workplaces to prevent violence and work-related exhaustion, and to enhance work efficiency, may help to mitigate workplace cognitive failure among nurses. REPORTING METHOD: We have followed the STROBE checklist in reporting this study. PATIENT OR PUBLIC CONTRIBUTION: No Patient or public contribution.
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AIMS: To examine the contributions of psychosocial factors (attitude towards drinking, perceived drinking norms [PDNs], perceived behavioural control [PBC]), and biological sex on drinking intention and behaviours among rural Thai adolescents. DESIGN: A cross-sectional study design. METHODS: In 2022, stratified by sex and grade, we randomly selected 474 rural Thai adolescents (Mage = 14.5 years; SD = 0.92; 50.6% male) from eight public district schools in Chiang Mai Province, Thailand, to complete a self-administered questionnaire. Structural equation modelling with the weighted least square mean and variance adjusted was used for data analysis. RESULTS: All adolescents' psychosocial factors contributed significantly to the prediction of drinking intention, which subsequently influenced their drinking onset, current drinking and binge drinking pattern in the past 30 days. PDNs emerged as the strongest psychosocial predictor of drinking intention, followed by PBC. Rural adolescents' drinking intention significantly mediated the relationship between all psychosocial factors and drinking behaviours either fully or partially. The path coefficient between drinking attitude and drinking intention was significantly different between males and females. CONCLUSION: Different from previous studies focus on adolescents' drinking attitude, rural Thai adolescents' PDNs play a significant role on their drinking intention and subsequently their drinking onset and patterns. This nuanced understanding supports a paradigm shift to target adolescents' perceived drinking norms as a means to delay their drinking onset and problematic drinking behaviours. IMPACT: Higher levels of perceived drinking norms significantly led to the increase in drinking intention among adolescents. Minimizing adolescents' perceptions of favourable drinking norms and promoting their capacity to resist drinking, especially due to peer pressure, are recommended for nursing roles as essential components of health education campaigns and future efforts to prevent underage drinking. PATIENT OR PUBLIC CONTRIBUTION: In this study, there was no public or patient involvement.
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Comportamento do Adolescente , Consumo de Álcool por Menores , Feminino , Humanos , Masculino , Adolescente , Consumo de Álcool por Menores/psicologia , Intenção , Tailândia , Estudos Transversais , Comportamento do Adolescente/psicologia , Inquéritos e QuestionáriosRESUMO
AIM: To investigate the structural relationships among perceived stress (PS), positive psychological capital (PsyCap) and health literacy (HL) in patients with multiple chronic conditions (MCC) and construct a model to explore the relationships of PS and PsyCap on HL. BACKGROUND: HL is critical in the rehabilitation and management of patients with MCC. Extensive understanding of the relationships between research variables can help nursing staff to implement effective programmes that improve the level of HL of patients. However, currently there is no research that has evaluated the structural relationships among these variables using a single model. METHODS: This study adhered to the STROBE guidelines for reporting cross-sectional studies. The Health Literacy Scale for Chronic Patients, Chinese Perceived Stress Scale (CPSS) and Positive Psychological Capital Questionnaire were used to assess HL, PS and PsyCap, respectively. Questionnaires were distributed to 317 patients with MCC attending a tertiary general care hospital in China from February to May 2023, using convenience sampling approach. Structural equation modelling was used to validate the proposed model. RESULTS: The findings showed that PS has a negative relationship with HL and PsyCap. PS was indirectly associated with HL through PsyCap. The results indicated that PsyCap was positively associated with HL. The PS and PsyCap explained 64% of the variance in HL. CONCLUSIONS: The findings showed that the proposed model had high validity and structural relationships between chosen variables were observed for MCC patients. RELEVANCE TO CLINICAL PRACTICE: These results may help nursing staff develop strategies to improve the HL of patients with MCC, which should focus on reducing PS and enhancing PsyCap to improve HL. Nursing staff can provide targeted psychological counselling and health guidance for patients to alleviate negative emotions and further promote their HL. PATIENT OR PUBLIC CONTRIBUTION: Participate in research and fill out questionnaires.
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Despite the recognised risks of human exposure to mercury (Hg), the drivers of gaseous elemental mercury (GEM) emissions from the soil remain understudied. In this study, we aimed to identify the environmental parameters that affect the GEM flux from soil and derive the correlations between environmental parameters and GEM flux. Principal component analysis (PCA), factor analysis (FA), and structural equation modelling (SEM) were performed on samples from forest and non-forest sites. The associated results revealed the impact of each environmental parameter on GEM flux, either due to the interaction between the parameters or as a coherent set of parameters. An introductory correlation matrix examining the relationship between two components showed a negative correlation between GEM flux and atmospheric pressure at the two sites, as well as strong correlations between atmospheric pressure and soil temperature. In cases of non-forest open sites with no trees, the PCA and FA results were consistent, indicating that atmospheric pressure, solar irradiance, and soil moisture-defined as primary causality-are largely independent drivers of GEM flux. In contrast, the PCA and FA results for the forest areas with high humidity, tree coverage, and shade were inconsistent, confirming the hypothesis that primary causality affects GEM flux rather than consequent parameters driven by primary causality, such as air and soil temperature and atmospheric humidity. The SEM results provided further evidence for primary and consequent causality as crucial drivers of the GEM flux. This study demonstrates the importance of key primary parameters, such as atmospheric pressure, solar irradiance, and soil moisture content, that can be used to predict mercury release from soils, as well as the importance of consequent parameters, such as air and soil temperature and atmospheric humidity. Monitoring the magnitude of these environmental parameters alone may facilitate the estimation of mercury release from soils and be useful for detailed modelling of soil-air Hg exchange.
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Poluentes Atmosféricos , Mercúrio , Poluentes do Solo , Humanos , Mercúrio/química , Solo , Poluentes do Solo/química , Monitoramento Ambiental , Temperatura , Poluentes Atmosféricos/análiseRESUMO
Grassland ecology is deteriorating along with a fall in biodiversity and ecosystem services as a result of climate change in the Mediterranean regions. Understanding the mechanism of feedback between soil properties related to available water and increasing aridity is a key component of preserving grassland ecosystems. Structural equation modelling was used to explore a deep understanding of the underlying mechanisms of the feedback between soil properties related to available water and increasing aridity. In most cases, vegetation patches had significantly higher soil properties related to available water than inter-patches. Compared to inter-patches, the fine fractions of silt and clay content, soil organic carbon, saturated hydraulic conductivity, and available water under vegetation patches increased by 3.79%-7.64%, 31.08%-37.64%, 96.65%-141.14%, and 2.63%-9.21%, respectively, under limestone and mica schist lithologies. The fine fractions of silt and clay content, soil organic carbon, and available water were more responsive to the aridity index than the vegetation patch, while saturated hydraulic conductivity was more responsive to the vegetation patch than the aridity index. These complex relationships demonstrated that the available water was significantly positively affected by the vegetation pattern (0.09) and the aridity index (0.21-0.38). Soil texture had a significantly direct effect (0.43-0.53) on available water. Increasing aridity would strengthen the contrast in soil water availability while weakening the contrast in saturated hydraulic conductivity between vegetation patches and inter-patches. Available water was controlled by many aspects except vegetation pattern and aridity index. Understanding these relationships helped in predicting and mitigating the impacts of climate change on soil properties related to available water. The study offered fresh perspectives on the mechanism of vegetation pattern and aridity index on the various soil properties related to available water in arid and semiarid grasslands ecosystems under climate change.