Is environmental management an economically sustainable business?

This paper investigates whether environmental management is an economically sustainable business. While firms invest in green production and green supply chain activities with the primary purpose of reducing their environmental impact, the reciprocal relationships with economic performance need to be clarified. Would firms and suppliers adjust their environmental strategies if the higher economic value that environmental management generates is reinvested in greening actions? We found out that environmental management positively influences economic performance as second order (long term) target, to be reached conditioned by higher environmental performance; in addition, firms can increase their performance if they reinvest the higher economic value gained through environmental management in green practices: While investing in environmental management programs is a short term strategy, economic rewards can be obtained only with some delays. Consequently, environmental management is an economically sustainable business only for patient firms. In the evaluation of these reciprocal relationships, we discovered that green supply chain initiatives are more effective and more economically sustainable than internal actions.

College quality and hourly wages: evidence from the self-revelation model, sibling models and instrumental variables

This paper addresses the recent discussion on confounding in the returns to college quality literature using the Norwegian case. The main advantage of studying Norway is the quality of the data. Norwegian administrative data provide information on college applications, family relations and a rich set of control variables for all Norwegian citizens applying to college between 1997 and 2004 (N = 141,319) and their succeeding wages between 2003 and 2010 (676,079 person-year observations). With these data, this paper uses a subset of the models that have rendered mixed findings in the literature in order to investigate to what extent confounding biases the returns to college quality. I compare estimates obtained using standard regression models to estimates obtained using the self-revelation model of Dale and Krueger (2002), a sibling fixed effects model and the instrumental variable model used by Long (2008). Using these methods, I consistently find increasing returns to college quality over the course of students' work careers, with positive returns only later in students' work careers. I conclude that the standard regression estimate provides a reasonable estimate of the returns to college quality.

The function of wisdom dimensions in ego-identity development among Chinese university students

This study investigates the relationship between wisdom and ego-identity among university students in China. Using Marcia's ego-identity statuses and Ardelt's wisdom dimensions as the theoretical and conceptual framework, the study investigates 356 university students in China. After exploratory and confirmatory factor analyses, four factors from wisdom and five factors from ego-identity were retrieved. A structural equation model was then conducted to analyse the relationships. The findings were: (1) among wisdom dimensions, cognitive, and reflective wisdom, especially perspective-taking best predicted achievement, (2) all three dimensions of wisdom predicted moratorium, but reflective wisdom was the most pronounced predictor, (3) all three dimensions of wisdom predicted diffusion, but resentment items from reflective wisdom were the most pronounced predictors, and (4) gender was a significant predictor of ego-identity achievement and diffusion. These findings suggest that efforts to build reflective wisdom might contribute to healthier ego-identity formation.

The mediational effects of FDG hypometabolism on the association between cerebrospinal fluid biomarkers and neurocognitive function

Positive cerebrospinal fluid (CSF) biomarkers of tau and amyloid beta42 suggest possible active underlying Alzheimer's disease (AD) including neurometabolic dysfunction and neurodegeneration leading to eventual cognitive decline. But the temporal relationship between CSF, imaging markers of neural function, and cognition has not been described. Using a statistical mediation model, we examined relationships between cerebrospinal fluid (CSF) analytes (hyperphosphorylated tau (p-Tau(181p)), β-amyloid peptides 1-42 (Aβ(1-42)), total tau (t-Tau), and their ratios); change in cognitive function; and change in [18F]fluorodeoxyglucose (FDG) uptake using positron emission tomography (PET). We hypothesized that a) abnormal CSF protein values at baseline, result in cognitive declines by decreasing neuronal glucose metabolism across time, and b) the role of altered glucose metabolism in the assumed causal chain varies by brain region and the nature of CSF protein alteration. Data from 412 individuals participating in Alzheimer's Disease Neuroimaging (ADNI) cohort studies were included in analyses. At baseline, individuals were cognitively normal (N = 82), or impaired: 241 with mild cognitive impairment, and 89 with Alzheimer's disease. A parallel-process latent growth curve model was used to test mediational effects of changes in regional FDG-PET uptake over time in relation to baseline CSF biomarkers and changes in cognition, measured with the 13-item Alzheimer Disease's Assessment Scale-cognitive subscale (ADAS-Cog). Findings suggested a causal sequence of events; specifically, FDG hypometabolism acted as a mediator between antecedent CSF biomarker alterations and subsequent cognitive impairment. Higher baseline concentrations of t-Tau, and p-Tau(181p) were more predictive of decline in cerebral glucose metabolism than lower baseline concentrations of Aβ(1-42). FDG-PET changes appeared to mediate t-Tau or t-Tau/Aβ(1-42)-associated cognitive change across all brain regions examined. Significant direct effects of alterations in Aβ(1-42) levels on hypometabolism were observed in a single brain region: middle/inferior temporal gyrus. Results support a temporal framework model in which reduced CSF amyloid-related biomarkers occur earlier in the pathogenic pathway, ultimately leading to detrimental cognitive effects. Also consistent with this temporal framework model, baseline markers of neurofibrillary degeneration predicted changes in brain glucose metabolism in turn causing longitudinal cognitive changes, suggesting that tau-related burden precedes neurometabolic dysfunction. While intriguing, the hypothesized mediational relationships require further validation.

Modeling factors explaining the acceptance, actual use and satisfaction of nurses using an Electronic Patient Record in acute care settings: an extension of the UTAUT

BACKGROUND AND PURPOSE

End-user acceptance and satisfaction are considered critical factors for successful implementation of an Electronic Patient Record (EPR). The aim of this study was to explain the acceptance and actual use of an EPR and nurses' satisfaction by testing a theoretical model adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT).

METHODS

A multicenter cross-sectional study was conducted in the medical-surgical wards of four hospitals ranked at different EPR adoption stages. A randomized stratified sampling approach was used to recruit 616 nurses. Structural equation modeling techniques were applied.

RESULTS

Support was found for 13 of the model's 20 research hypotheses. The strongest effects are those between performance expectancy and actual use of the EPR (r=0.55, p=0.006), facilitating conditions and effort expectancy (r=0.45, p=0.009), compatibility and performance expectancy (r=0.39, p=0.002). The variables explained 33.6% of the variance of actual use, 54.9% of nurses' satisfaction, 50.2% of performance expectancy and 52.9% of effort expectancy.

CONCLUSIONS

Many results of this study support the conclusions of prior research, but some take exception, such as the non-significant relationship between the effort expectancy construct and actual use of the EPR. The results highlight the importance of the mediating effects of the effort expectancy and performance expectancy constructs. Compatibility of the EPR with preferred work style, existing work practices and the values of nurses were the most important factors explaining nurses' satisfaction. The results reveal the complexity of this change and suggest several avenues for future research and for the implementation of IT in healthcare.

Replication and evaluation of a proposed two-factor Binge Eating Scale (BES) structure in a sample of bariatric surgery candidates

BACKGROUND

The Binge Eating Scale (BES) is a widely-used self-report measure of binge eating severity. Hood et al. reported a 2-factor structure for the BES in a sample of bariatric surgery candidates, with factors labeled feelings/cognitions and behavioral manifestations. The present study aims to replicate and extend the factor structure obtained by Hood et al. by testing the utility of a bifactor model that removes binge eating severity variance, which the total BES score purports to assess, in another sample of bariatric surgery candidates.

METHODS

Bariatric surgery candidates (n = 517; 71.2% women; mean body mass index = 49.50 kg/m(2); SD = 10.17) were sampled. Twenty-four percent met DSM-IV-TR diagnostic criteria for binge eating disorder.

RESULTS

Consistent with previous research, a 2-factor structure for the BES was supported; however, the 2 factors were substantially correlated (r = .89). A bifactor model significantly improved model fit, supporting the presence of a higher-order severity factor accounting for a significant amount of variance. This factor was primarily marked by binge eating severity as demonstrated by associations with number of objective binge eating episodes and DSM-IV-TR diagnosis. In the bifactor model, the feelings/cognitions factor was modestly associated with self-reported mood psychopathology. However, contrary to expectations, the behavioral manifestation factor was not associated with empirically derived behavioral problems.

CONCLUSIONS

The current findings partially converge with those of Hood et al. However, the use of the BES as a 2-factor measure is not recommended at this point because of lack of incremental validity demonstrated by the behavioral manifestation factor. Continued use of the BES as a unidimensional measure of binge eating severity, in conjunction with a comprehensive clinical interview, can provide useful guidance for presurgical treatment recommendations.

Factors associated with positive relationships between stepfathers and adolescent stepchildren

This study employs nationally representative data on adolescents and their stepfathers (n=2085) from the National Longitudinal Study of Adolescent Health (Add Health) to examine factors associated with positive stepfather-stepchild relationships in married stepfamilies. Results reveal substantial variability in the perceived quality of adolescents' relationships with stepfathers. Structural equation models using Wave I data reveal that close relationships with mothers and close ties between mothers and stepfathers are positively related to the perceived quality of adolescents' relationships with stepfathers. Longitudinal models using Waves I and II do not yield definitive results but suggest that the direction of influence runs in both directions, with the mother-child relationship and the stepfather-stepchild relationship mutually reinforcing one another. We identify a number of other factors that are associated with positive stepfather-stepchild ties, as well as a few factors that may be less consequential than previously thought. Most of the correlates of positive stepfather-stepchild relationships are similar for boys and girls; for Whites, Blacks, and Hispanics; and for stepfamilies of various durations.

Depression and pain impair daily functioning and quality of life in patients with major depressive disorder

BACKGROUND

Depression and pain frequently occur together. The objective of this study was to investigate the effects of depression and pain on the impairment of daily functioning and quality of life (QOL) of depressed patients.

METHODS

We enrolled 131 acutely ill inpatients with major depressive disorder. Depression, pain, and daily functioning were assessed using the 17-item Hamilton Depression Rating Scale, the Short-Form 36 (SF-36) Body Pain Index, and the Work and Social Adjustment Scale. Health-related QOL was assessed using three primary domains of the SF-36: social functioning, vitality, and general health perceptions. Pearson׳s correlation and structural equation modeling were used to examine relationships among the study variables. Five models were proposed.

RESULTS

In all, 129 patients completed all the measures. Model 5, both depression and pain impaired daily functioning and QOL, was the most fitted structural equation model (χ(2)=9.2, df=8, p=0.33, GFI=0.98, AGFI=0.94, TLI=0.99, CFI=0.99, RMSEA=0.03). The correlation between pain and depression was weak (r=-0.27, z=-2.95, p=0.003).

LIMITATION

This was a cross-sectional study with a small sample size.

CONCLUSION

Depression and pain exert a direct influence on the impairment of daily functioning and QOL of depressed patients; this impairment could be expected regardless of increased pain, depression, or both pain and depression. Pain had a somewhat separate entity from depression.

A model of environmental correlates of adolescent obesity in the United States

PURPOSE

The purpose of this study was to test a conceptual model of proximal (home) and distal (neighborhood) environmental correlates of adolescent obesity.

METHODS

This was a descriptive, cross-sectional study, using the 2007 National Survey of Children's Health, of 39,542 children aged 11-17 years. Structural equation modeling was used to test the fit of the model, identify direct and indirect effects of the proximal and distal environmental correlates, and determine reliabilities for latent constructs (Access to Physical Activity, Neighborhood Conditions, Social Capital Home Sedentary Behavior, and Physical Activity).

RESULTS

The model fitted the data well (Root Mean Square Standard Error of Approximation: .038 (90% confidence interval .038-.039), Comparative Fit Index: .950, and Tucker-Lewis Index: .934). Access to Physical Activity, Social Capital, Home Sedentary Behavior, and Physical Activity had direct effects on obesity (-.026, p = .001; .061, p < .001; .110, p < .001; and -.119, p < .001, respectively). Neighborhood Condition had indirect effects on obesity through Access to Physical Activity, Social Capital, and Home Sedentary Behavior (-.001, p = .009; .032, p < .001; and .044, p < .001, respectively). Access to Physical Activity had indirect effects on obesity through Physical Activity, Social Capital, and Home Sedentary Behavior (-.013, p < .001; -.005, p < .001; and -.005, p = .003, respectively). Home Sedentary Behavior had indirect effect on obesity through Physical Activity (.052, p <.001).

CONCLUSIONS

Results of this model fit to the U. S. population-based data suggest that interventions should target not only sedentary behavior and physical activity but also parent perceptions of safety, access to physical activity, and the neighborhood condition.

Effect of social support on depression of internet addicts and the mediating role of loneliness

BACKGROUND

Many studies have determined the existence of an extremely close association between Internet addiction and depression. However, the reasons for the depression of Internet addicts have not been fully investigated.

AIM

This cross-sectional study aims to explore the factors that influence depression among Internet addicts.

METHODS

A total of 162 male Internet addicts completed the Emotional and Social Loneliness Scale, Multidimensional Scale of Perceived Social Support, and Self-Rating Depression Scale.

RESULTS

Loneliness and lack of social support are significantly correlated with depression among Internet addicts. Structural Equation Modeling results indicate that social support partially mediates loneliness and depression.

CONCLUSIONS

Both social support and loneliness were negatively associated with depression of Internet addicts whereas loneliness plays a mediating role between social support and depression.

Structural modeling of safety performance in construction industry

BACKGROUND

With rapid economic development and industrialization, the construction industry continues to rank among the most hazardous industries in the world. Therefore, construction safety is always a significant concern for both practitioners and researchers. The objective of this study was to create a structural modeling of components that influence the safety performance in construction projects.

METHODS

We followed a two-stage Structural Equation Model based on a questionnaire study (n=230). In the first stage, we applied the Structural Equation Model to the proposed model to test the validity of the observed variables of each latent variable. In the next stage, we modified the proposed model. The LISREL 8.8 software was used to conduct the analysis of the structural model.

RESULTS

A good-fit structural model (Goodness of Fit Index=0.92; Root Mean Square Residual=0.04; Root Mean Square Error of Approximation=0.04; Comparative Fit Index=0.98; Normalized Fit Index=0.96) indicated that social and organizational constructs influence safety performance via the general component of the safety climate.

CONCLUSION

The new structural model can be used to provide better understanding of the links between safety performance indicators and contributing components, and make stronger recommendations for effective intervention in construction projects.

A mediation model of mindfulness and decentering: sequential psychological constructs or one and the same?

BACKGROUND

Mindfulness and decentering are closely related processes both assumed to promote well-being. While some researchers claim that mindfulness and decentering can be clearly differentiated others suggest to use these concepts interchangeably. The precise relation between mindfulness and decentering remains unclear and therefore the present study aims to determine the relation between mindfulness and decentering.

METHODS

In a structural equation modeling framework, a mediation model was tested among a sample group of 495 university students (average age 20.8 years, 30.3% female).

RESULTS

The identified model shows an acceptable fit to the data and illustrates the role of decentering as a mediator of the relationship between mindfulness and depressive symptoms by complementary mediation and indirect-only mediation.

CONCLUSION

The present results cannot sustain previous research, which converted mindfulness and decentering into one single variable. Rather the data suggests to treat mindfulness and decentering as two separable concepts and to regard decentering as an important working mechanism of mindfulness.

Relationships between default-mode network connectivity, medial temporal lobe structure, and age-related memory deficits

Advanced aging negatively impacts memory performance. Brain aging has been associated with shrinkage in medial temporal lobe structures essential for memory--including hippocampus and entorhinal cortex--and with deficits in default-mode network connectivity. Yet, whether and how these imaging markers are relevant to age-related memory deficits remains a topic of debate. Using a sample of 182 older (age 74.6 ± 6.2 years) and 66 young (age 22.2 ± 3.6 years) participants, this study examined relationships among memory performance, hippocampus volume, entorhinal cortex thickness, and default-mode network connectivity across aging. All imaging markers and memory were significantly different between young and older groups. Each imaging marker significantly mediated the relationship between age and memory performance and collectively accounted for most of the variance in age-related memory performance. Within older participants, default-mode connectivity and hippocampus volume were independently associated with memory. Structural equation modeling of cross-sectional data within older participants suggest that entorhinal thinning may occur before reduced default-mode connectivity and hippocampal volume loss, which in turn lead to deficits in memory performance.

Predicting aggression in children with ADHD

OBJECTIVE

The present study uses structural equation modeling of latent traits to examine the extent to which family factors, cognitive factors and perceptions of rejection in mother-child relations differentially correlate with aggression at home and at school.

METHODS

Data were collected from 476 school-age (7-15 years old) children with a diagnosis of ADHD who had previously shown different types of aggressive behavior, as well as from their parents and teachers. Structural equation modeling was used to examine the differential relationships between maternal rejection, family, cognitive factors and aggression in home and school settings.

RESULTS

Family factors influenced aggression reported at home (.68) and at school (.44); maternal rejection seems to be related to aggression at home (.21). Cognitive factors influenced aggression reported at school (.-05) and at home (-.12).

CONCLUSIONS

Both genetic and environmental factors contribute to the development of aggressive behavior in ADHD. Identifying key risk factors will advance the development of appropriate clinical interventions and prevention strategies and will provide information to guide the targeting of resources to those children at highest risk.

The neural changes in connectivity of the voice network during voice pitch perturbation

Voice control is critical to communication. To date, studies have used behavioral, electrophysiological and functional data to investigate the neural correlates of voice control using perturbation tasks, but have yet to examine the interactions of these neural regions. The goal of this study was to use structural equation modeling of functional neuroimaging data to examine network properties of voice with and without perturbation. Results showed that the presence of a pitch shift, which was processed as an error in vocalization, altered connections between right STG and left STG. Other regions that revealed differences in connectivity during error detection and correction included bilateral inferior frontal gyrus, and the primary and pre motor cortices. Results indicated that STG plays a critical role in voice control, specifically, during error detection and correction. Additionally, pitch perturbation elicits changes in the voice network that suggest the right hemisphere is critical to pitch modulation.

The impact of depressive symptoms in adults with ADHD symptoms on family function and ADHD symptoms of their children

OBJECTIVE

People with attention-deficit/hyperactivity disorder (ADHD) exhibit considerable impairment in social, academic, or occupational functioning. The present study aimed to examine the patterns of associations between ADHD symptoms, depression, and family functioning.

METHODS

The sample consisted of 1,022 adults randomly selected from a district in Seoul, South Korea. Several self-assessment scales were utilized to rate ADHD symptoms (both past and current), current symptoms of depression, and level of family functioning. ADHD symptoms in the children of these participants were also assessed. Pearson's correlation and multiple linear regression analyses were performed; structural equation modeling (SEM) was conducted to determine the best fitting model.

RESULTS

Adult ADHD symptoms were positively associated with depressive symptoms. Depressive symptoms, in turn, mediated the relationship between adult ADHD symptoms and cohesion among family members. In addition, depressive symptoms mediated the relationship between adult ADHD symptoms and their children's ADHD symptoms.

CONCLUSION

The relationship between adult ADHD symptoms and family dysfunction may be influenced by depressive symptoms. When treating ADHD in adults, clinicians should pay attention to the presence or absence of depression.

Negative confounding by essential fatty acids in methylmercury neurotoxicity associations

BACKGROUND

Methylmercury, a worldwide contaminant of fish and seafood, can cause adverse effects on the developing nervous system. However, long-chain n-3 polyunsaturated fatty acids in seafood provide beneficial effects on brain development. Negative confounding will likely result in underestimation of both mercury toxicity and nutrient benefits unless mutual adjustment is included in the analysis.

METHODS

We examined these associations in 176 Faroese children, in whom prenatal methylmercury exposure was assessed from mercury concentrations in cord blood and maternal hair. The relative concentrations of fatty acids were determined in cord serum phospholipids. Neuropsychological performance in verbal, motor, attention, spatial, and memory functions was assessed at 7 years of age. Multiple regression and structural equation models (SEMs) were carried out to determine the confounder-adjusted associations with methylmercury exposure.

RESULTS

A short delay recall (in percent change) in the California Verbal Learning Test (CVLT) was associated with a doubling of cord blood methylmercury (-18.9, 95% confidence interval [CI]=-36.3, -1.51). The association became stronger after the inclusion of fatty acid concentrations in the analysis (-22.0, 95% confidence interval [CI]=-39.4, -4.62). In structural equation models, poorer memory function (corresponding to a lower score in the learning trials and short delay recall in CVLT) was associated with a doubling of prenatal exposure to methylmercury after the inclusion of fatty acid concentrations in the analysis (-1.94, 95% CI=-3.39, -0.49).

CONCLUSIONS

Associations between prenatal exposure to methylmercury and neurobehavioral deficits in memory function at school age were strengthened after fatty acid adjustment, thus suggesting that n-3 fatty acids need to be included in analysis of similar studies to avoid underestimation of the associations with methylmercury exposure.

Application of a health-related quality of life conceptual model in community-dwelling older Chinese people with diabetes to understand the relationships among clinical and psychological outcomes

Aims/Introduction

The present study applied the Wilson–Cleary model of health-related quality of life (HRQOL) by using the structural equation modeling (SEM) approach to understand the interrelationships among clinical, sociodemographic and psychological characteristics in older people with diabetes.

Materials and Methods

This was a cross-sectional study with 452 Chinese older people with diabetes recruited from three primary care clinics. A series of assessments were made, including four instruments: the Chinese version of the Short Form 36 Health Survey, Older American Resources and Services Multidimensional Functional Assessment Questionnaire, Rand Mental Health Inventory and Medical Outcomes Study Social Support Survey; and clinical outcomes (diabetes-related characteristics and physiological data).

Results

In the present study, we identified six patient individual and environmental characteristics, namely, age, sex, physical activity, psychological distress, social support and adequacy of income, that significantly influence HRQOL directly or by way of physical functional status and general health perception.

Conclusions

Improving social and financial support as well as providing interventions to promote physical activity and to cope with psychological distress in this patient population might be effective to eventually enhance their HRQOL. The present findings add to the literature the underlying complex biological and psychological processes of HRQOL, and take the body of knowledge in HRQOL of older people with diabetes to a theoretical level, and provide insights for development of appropriate strategies to optimize their HRQOL.

Exploring dimensionality of effortful control using hot and cool tasks in a sample of preschool children

Effortful control (EC) is an important developmental construct associated with academic performance, socioemotional growth, and psychopathology. EC, defined as the ability to inhibit or delay a prepotent response typically in favor of a subdominant response, undergoes rapid development during children's preschool years. Research involving EC in preschool children can be aided by ensuring that the measured model of EC matches the latent structure of EC. Extant research indicates that EC may be multidimensional, consisting of hot (affectively salient) and cool (affectively neutral) dimensions. However, there are several untested assumptions regarding the defining features of hot EC. Confirmatory factor analysis was used in a sample of 281 preschool children (Mage=55.92months, SD=4.16; 46.6% male and 53.4% female) to compare a multidimensional model composed of hot and cool EC factors with a unidimensional model. Hot tasks were created by adding affective salience to cool tasks so that hot and cool tasks varied only by this aspect of the tasks. Tasks measuring EC were best described by a single factor and not distinct hot and cool factors, indicating that affective salience alone does not differentiate between hot and cool EC. EC shared gender-invariant associations with academic skills and externalizing behavior problems.

Correction of distortion in distressed mothers' ratings of their preschool-aged children's Internalizing and Externalizing scale score

Increased maternal psychopathology may bias mothers' ratings about child psychopathology. In this study we examined whether internalizing and externalizing behavior problems in young children were biased through maternal psychopathology. The clinical sample comprised 247 preschool-age patients who attended the Family Day Hospital in Münster, Germany. Internalizing and externalizing behavior problems were assessed by the CBCL/1.5-5, and maternal psychopathology was assessed by the SCL-90-R Global Severity Index (GSI). Three theoretical perspectives were tested by comparing the model fit of three structural equation models, namely the accuracy, distortion, and combinatory model. All of the models aimed to integrate multi-informant ratings from mother, therapists, and kindergarten teachers, but differed in the question which paths had to be significant. The distortion model fit the data best and supported the notion that there was a psychopathology-related bias in mothers' ratings. On the basis of this finding, we developed correction formulas comparable to Müller and Furniss (2013), in order to statistically control for this distortion. We discussed post-hoc explanations about why mothers with increased psychopathology gave higher ratings on the CBCL/1.5-5, including a better recall of internalizing symptoms, less flexible and effective parenting, and more perceived distress by child externalizing behavior.

Attachment insecurities, maladaptive perfectionism, and eating disorder symptoms: a latent mediated and moderated structural equation modeling analysis across diagnostic groups

Although 96-100% of individuals with eating disorders (EDs) report insecure attachment, the specific mechanisms by which adult insecure attachment dimensions affect ED symptomatology remain to date largely unknown. This study examined maladaptive perfectionism as both a mediator and a moderator of the relationship between insecure attachment (anxiety and avoidance) and ED symptomatology in a clinical, treatment seeking, sample. Insecure anxious and avoidant attachment, maladaptive perfectionism, and ED symptomatology were assessed in 403 participants from three medium size specialized care centres for EDs in Italy. Structural equation modeling indicated that maladaptive perfectionism served as mediator between both insecure attachment patterns and ED symptomatology. It also interacted with insecure attachment to predict higher levels of ED symptoms - highlighting the importance of both insecure attachment patterns and maladaptive aspects of perfectionism as treatment targets. Multiple-group comparison analysis did not reveal differences across diagnostic groups (AN, BN, EDNOS) in mediating, main and interaction effects of perfectionism. These findings are consistent with recent discussions on the classification and treatment of EDs that have highlighted similarities between ED diagnostic groups and could be viewed through the lens of the Trans-theoretical Model of EDs. Implications for future research and intervention are discussed.

DSM-5 PTSD's symptom dimensions and relations with major depression's symptom dimensions in a primary care sample

Existing literature indicates significant comorbidity between posttraumatic stress disorder (PTSD) and major depression. We examined whether PTSD's dysphoria and mood/cognitions factors, conceptualized by the empirically supported four-factor DSM-5 PTSD models, account for PTSD's inherent relationship with depression. We hypothesized that depression's somatic and non-somatic factors would be more related to PTSD's dysphoria and mood/cognitions factors than other PTSD model factors. Further, we hypothesized that PTSD's arousal would significantly mediate relations between PTSD's dysphoria and somatic/non-somatic depression. Using 181 trauma-exposed primary care patients, confirmatory factor analyses (CFA) indicated a well-fitting DSM-5 PTSD dysphoria model, DSM-5 numbing model and two-factor depression model. Both somatic and non-somatic depression factors were more related to PTSD's dysphoria and mood/cognitions factors than to re-experiencing and avoidance factors; non-somatic depression was more related to PTSD's dysphoria than PTSD's arousal factor. PTSD's arousal did not mediate the relationship between PTSD's dysphoria and somatic/non-somatic depression. Implications are discussed.

Comprehensive examination of the trans-diagnostic cognitive behavioral model of eating disorders in males

The Trans-diagnostic Model (TM) of eating pathology describes how one or more of four hypothesized mechanisms (i.e., mood intolerance, core low self-esteem, clinical perfectionism and interpersonal difficulties) may interrelate with each other and with the core psychopathology of eating disorders (i.e., over-evaluation of weight and shape) to maintain the disordered behaviors. Although a cognitive behavioral treatment based on the TM has shown to be effective in treating eating disorders, the model itself has undergone only limited testing. This is the first study to both elaborate and test the validity of the TM in a large sample (N=605) of undergraduate men. Body mass index was controlled within structural equation modeling analyses. Although not all expected associations for the maintenance variables were significant, overall the validity of the model was supported. Concern about shape and weight directly led to exercise behaviors. There was a direct path from binge eating to exercise and other forms of compensatory behaviors (i.e., purging); but no significant path from restriction to binge eating. Of the maintaining factors, mood intolerance was the only maintaining variable directly linked to men's eating disorder symptoms. The other three maintaining factors of the TM indirectly impacted restriction through concerns about shape and weight, whereas only interpersonal difficulties predicted low self-esteem and binge eating. Potential implications for understanding and targeting eating disturbances in men are discussed.

Relief of depression and pain improves daily functioning and quality of life in patients with major depressive disorder

OBJECTIVE

The objective of this study was to investigate the effects of depression relief and pain relief on the improvement in daily functioning and quality of life (QOL) for depressed patients receiving a 6-week treatment of fluoxetine.

METHOD

A total of 131 acutely ill inpatients with major depressive disorder (MDD) were enrolled to receive 20mg of fluoxetine daily for 6 weeks. Depression severity, pain severity, daily functioning, and health-related QOL were assessed at baseline and again at week 6. Depression severity, pain severity, and daily functioning were assessed using the 17-item Hamilton Depression Rating Scale, the Short-Form 36 (SF-36) Body Pain Index, and the Work and Social Adjustment Scale. Health-related QOL was assessed by three primary domains of the SF-36, including social functioning, vitality, and general health perceptions. Pearson's correlation and structural equation modeling were used to examine relationships among the study variables. Five models were proposed. In model 1, depression relief alone improved daily functioning and QOL. In model 2, pain relief alone improved daily functioning and QOL. In model 3, depression relief, mediated by pain relief, improved daily functioning and QOL. In model 4, pain relief, mediated by depression relief, improved daily functioning and QOL. In model 5, both depression relief and pain relief improved daily functioning and QOL.

RESULTS

One hundred and six patients completed all the measures at baseline and at week 6. Model 5 was the most fitted structural equation model (χ(2) = 8.62, df = 8, p = 0.376, GFI = 0.975, AGFI = 0.935, TLI = 0.992, CFI = 0.996, RMSEA = 0.027).

CONCLUSION

Interventions which relieve depression and pain improve daily functioning and QOL among patients with MDD. The proposed model can provide quantitative estimates of improvement in treating patients with MDD.

Unraveling the relationship between obesity, schizophrenia and cognition

INTRODUCTION

Previous studies investigating the relationship between obesity and cognition as well as gender differences in these relationships reported equivocal results. Here, we examined age, years of education, schizophrenia, and gender differences which might affect the relationship between obesity and cognition.

METHODS

1012 healthy controls and 707 participants with schizophrenia were recruited. Information on body mass index (BMI) was obtained and a neurocognitive battery was administered. Structural equation modeling (SEM) was performed to examine the relationship between BMI, schizophrenia, cognition and its covariates.

RESULTS

No significant direct effect of BMI on cognition was found when cognition was regressed on age, years of education, diagnosis of schizophrenia and BMI. Instead, two SEM models indicated that indirect effects between BMI and cognition exist. The indirect effect of BMI on cognition through schizophrenia was present in both genders, while the indirect effect of cognition on BMI through schizophrenia was only found in females. BMI affecting cognition through age, years of education and schizophrenia appears to be the most plausible model that explains the data. This indirect effect was larger in females and was masked by diagnosis of schizophrenia.

CONCLUSION

With increased rates of obesity in schizophrenia, it is important to highlight the potentially deleterious effect of obesity on cognition. BMI could be used as a candidate risk marker to identify people at higher risk of cognitive deficits, and as an intervention target for modifications of cognitive outcomes.

BMI and depressive symptoms: the role of media pressures

Obese and overweight individuals experience higher risk for depression and emotional distress. One factor that may contribute to depression in obese or overweight individuals is exposure to unrealistic images in the media. Indeed, overall media consumption is associated with body image dissatisfaction in adolescents and young adults. Despite these compelling links, prior work has not examined the mediating effect of media pressures on the link between BMI and depression. In the present study, young adults (N = 743) completed an online survey assessing demographic information, perceived pressure from the media to conform to a certain body standard, and symptoms of depression. Structural equation modeling analyses indicated a direct effect of BMI on media pressure, a direct effect of media pressure on depressive symptoms, and an indirect effect of BMI on depressive symptoms mediated by media pressures. Findings indicate that higher BMI levels are associated with greater depressive symptoms when there is greater perceived media pressure on body image. Results suggest the need for clinicians to assess media consumption and perceived pressure to conform to physical appearance standards in individuals who are obese or overweight as well as individuals at risk for eating disorders.

Enhanced Religiosity Following Illness? Assessing Evidence of Religious Consolation Among Black and White Americans

This study assesses variation among Black and White Americans in the impact of ill-health on public and subjective religiosity. It is the first longitudinal assessment of race-based variation in "religious consolation." The under-explored consolation thesis anticipates ill-health influencing religiosity rather than the reverse, with religiosity functioning as a coping resource marshaled by the ill. Effects across races of physical ill-health indicators (chronic illnesses and impaired functioning) on religiosity outcomes are the main focus; but across-race variation in psychological distress-induced "consolation" is also assessed. Findings yield only limited evidence of consolation in each race, and restricted variation across races: Change in impaired functioning slightly enhances Whites' subjective religiosity; but that effect does not significantly eclipse the impact among Blacks. There is no evidence of physical illness-induced consolation among Blacks; and the proposition that Blacks are more inclined toward consolation than Whites is affirmed only for psychological distress. There are no signs in either race that consolation is intensified by aging or higher religiosity, and no significant across-race differentials in effects of these illness-age and illness-religiosity interactions on subsequent religiosity. The multi-population model utilizes Americans' Changing Lives data.

Exploring the risk factors associated with the size and severity of roadway crashes in Riyadh

INTRODUCTION

Recently, growing concern has been shifting toward the necessity of improving traffic safety in the Kingdom of Saudi Arabia (KSA). KSA has a unique traffic safety problem in that: (a) it can be classified as a developed country in terms of the magnitude and quality of the roadway networks available and its compatibility with international standards; however, (b) it can also be considered a developing country as the rate of increase in the number of road crashes is substantial compared with relevant figures of other developing countries and other countries of the Gulf region. Hence, more research efforts are still needed.

OBJECTIVES

This paper examines the nature and causes of fatal and serious traffic crashes in KSA so that solutions and/or future studies can be suggested.

METHOD

Data from 11,545 reported fatal and injury traffic crashes that occurred in Riyadh (the capital of KSA) during the period 2004-2011 were analyzed by alternative and complementary methods. A logistic regression model was estimated and the results revealed that crash reason (speeding), damages in public property, day of the week, crash location (non-intersection location), and point of collision (head-on) were the significant variables affecting the binary target variable (fatal and non-fatal crashes). Additionally, the structural equation modeling approach was developed to identify and quantify the impacts of significant variables influencing crash size (e.g., no. of injuries, no. of vehicles involved in the crash). Crash size is one of the important indices that measure the level of safety of transportation facilities.

RESULTS

The results showed that road factor was the most significant factor affecting the size of the crash followed by the driver and environment factors.

IMPACT ON INDUSTRY

Considering the results of this study, practical suggestions on how to improve traffic safety in KSA are also presented and discussed.

Outcomes associated with breach and fulfillment of the psychological contract of safety

INTRODUCTION

The study investigated the outcomes associated with breach and fulfillment of the psychological contract of safety.

METHOD

The psychological contract of safety is defined as the beliefs of individuals about reciprocal employer and employee safety obligations inferred from implicit or explicit promises. When employees perceive that safety obligations promised by the employer have not been met, a breach of the psychological contract occurs, termed employer breach of obligations. The extent to which employees fulfill their safety obligations to the employer is termed employee fulfillment of obligations. Structural equation modeling was used to test a model of safety that investigated the positive and negative outcomes associated with breach and fulfillment of the psychological contract of safety. Participants were 424 health care workers recruited from two hospitals in the State of Victoria, Australia.

RESULTS

Following slight modification of the hypothesized model, a good fitting model resulted. Being injured in the workplace was found to lower perceptions of trust in the employer and increase perceptions of employer breach of safety obligations. Trust in the employer significantly influenced perceived employer breach of safety obligations such that lowered trust resulted in higher perceptions of breach. Perceptions of employer breach significantly impacted employee fulfillment of safety obligations with high perceptions of breach resulting in low employee fulfillment of obligations. Trust and perceptions of breach significantly influenced safety attitudes, but not safety behavior. Fulfillment of employee safety obligations significantly impacted safety behavior, but not safety attitudes. Implications of these findings for safety and psychological contract research are explored. A positive emphasis on social exchange relationships in organizations will have positive outcomes for safety climate and safety behavior.

Attachment insecurity mediates the relationship between childhood trauma and eating disorder psychopathology in a clinical sample: a structural equation model

OBJECTIVES

Childhood maltreatment occurs often among those with an eating disorder and is considered a nonspecific risk factor. However, the mechanisms by which childhood maltreatment may lead to an eating disorder are not well understood. The current study tests a model in which attachment insecurity is hypothesized to mediate the relationship between childhood maltreatment and eating disorder psychopathology.

METHOD

Treatment seeking adults with eating disorders (N=308) completed questionnaires about childhood maltreatment, eating disorder psychopathology, and adult attachment.

RESULTS

Structural equation models indicated that childhood trauma had a direct effect on eating disorder symptoms. Also, attachment anxiety and avoidance each equally mediated the childhood maltreatment to eating disorder psychopathology relationship.

CONCLUSIONS

Attachment insecurity, characterized by affect dysregulation and interpersonal sensitivities may help to explain why eating disorder symptoms may be one consequence of childhood maltreatment in a clinical sample. Clinicians treating primarily those with trauma might assess for disordered eating as a potential manifestation of the sequelae of trauma and attachment insecurity.

The progression of severe behavior disorder in young children with intellectual and developmental disabilities

Behavior disorders, such as self-injurious, stereotypic, and aggressive behavior are common among individuals with intellectual or developmental disabilities. While we have learned much about those behaviors over the past few decades, longitudinal research that looks at developmental trajectory has been rare. This study was designed to examine the trajectory of these three forms of severe behavior disorders over a one year time period. The behaviors were measured on two dimensions: frequency of occurrence and severity. Participants were 160 infants and toddlers at risk for developmental delays in Lima, Peru. Using structural equation modeling, we found that the frequency of self-injury and stereotypic behavior and the severity of aggressive behavior remained stable over the 12-month period. Uni-directional structural models fit the data best for self-injurious and aggressive behavior (with frequency being a leading indicator of future severity of self-injury and severity being a leading indicator of future frequency for aggression). For stereotypic behavior, a cross-lagged autoregressive model fit the data best, with both dimensions of frequency and severity involved as leading indicators of each other. These models did not vary significantly across diagnostic groups, suggesting that toddlers exhibiting behavior disorders may be assisted with interventions that target the specific frequencies or severities of behaviors, regardless of diagnostic category.

DSM-IV personality disorders and associations with externalizing and internalizing disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions

BACKGROUND

Although associations between personality disorders and psychiatric disorders are well established in general population studies, their association with liability dimensions for externalizing and internalizing disorders has not been fully assessed. The purpose of this study is to examine associations between personality disorders (PDs) and lifetime externalizing and internalizing Axis I disorders.

METHODS

Data were obtained from the total sample of 34,653 respondents from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). Drawing on the literature, a 3-factor exploratory structural equation model was selected to simultaneously assess the measurement relations among DSM-IV Axis I substance use and mood and anxiety disorders and the structural relations between the latent internalizing-externalizing dimensions and DSM-IV PDs, adjusting for gender, age, race/ethnicity, and marital status.

RESULTS

Antisocial, histrionic, and borderline PDs were strong predictors for the externalizing factor, while schizotypal, borderline, avoidant, and obsessive-compulsive PDs had significantly larger effects on the internalizing fear factor when compared to the internalizing misery factor. Paranoid, schizoid, narcissistic, and dependent PDs provided limited discrimination between and among the three factors. An overarching latent factor representing general personality dysfunction was significantly greater on the internalizing fear factor followed by the externalizing factor, and weakest for the internalizing misery factor.

CONCLUSION

Personality disorders offer important opportunities for studies on the externalizing-internalizing spectrum of common psychiatric disorders. Future studies based on panic, anxiety, and depressive symptoms may elucidate PD associations with the internalizing spectrum of disorders.

Temperament and Anxiety: The Mediating Role of Metacognition

The present study examines a simple model for the relationship between temperament, anxiety and maladaptive metacognition. A clinical sample of patients diagnosed with anxiety disorders (n = 216) completed a set of self-reported questionnaires measuring temperament dimensions, state anxiety and metacognitions. Three temperament traits were included in the hypothesized model: emotional reactivity, perseveration and briskness. A structural equation modeling analysis supported a model in which the relationship between the three temperament traits and anxiety were fully mediated by metacognition. Dissimilar models were identified for the male and female subgroups, and also with reference to individual categories of maladaptive metacognition. The findings support the significance of metacognition as a factor influencing the temperament-anxiety relationship. Moreover, they confirm the roles both of emotional reactivity and of perseveration, being major traits related to anxiety which also turned out to be strongly associated with metacognition. In case of the models for the categories of metacognition, emotional reactivity was associated with negative beliefs, perseveration with negative and positive beliefs, while briskness predicted anxiety independently of metacognition. These results suggest the existence of more specific associations between temperament traits, anxiety, and various types of metacognition.

Developmental effects of micronutrient supplementation and malaria in Zanzibari children

BACKGROUND

Children's development is affected by the interplay of internal and external factors and changes in one factor can precipitate changes in multiple developmental domains.

AIMS

The aim of this study was to test a theoretical model of children's development using structural equation modeling.

STUDY DESIGN

This was designed as a substudy of a randomized, placebo-controlled, 2 × 2 factorial trial of the effects of daily supplementation with iron (12.5 mg) + folic acid (50 μg) (FeFA) with or without zinc (10 mg) (Zn) on child mortality.

SUBJECTS

Zanzibari children aged 5-9 mo (n = 106) and 10-14 mo (n = 141) at baseline were included in this sub study.

OUTCOME MEASURES

Longitudinal data on children's hemoglobin, growth, malaria infection, motor development, motor activity, and language development and caregiver behavior were used to test the fit of the theoretical model for two age groups and to examine the direct and indirect relationships among the variables in the model.

RESULTS

The theoretical models were a good fit to the data for both age groups and revealed that FeFA with or without Zn had positive effects on motor development. FeFA alone had negative effects on language development in both age groups and Zn alone had negative effects on language development in children aged 10-14 mo. The incidence of malaria had negative effects on the majority of health and development outcomes in children aged 5-9 mo, and on motor development and hemoglobin in children aged 10-14 mo.

CONCLUSIONS

These findings illustrate how nutrition and health factors can affect different domains of development and how these changes can precipitate changes in other domains. More work is needed to better understand the multiple impacts of internal and external factors on children's development and how changes in developmental domains interact with each other over time to determine children's overall developmental trajectory. The randomized, placebo-controlled study was registered as an International Standard Randomized Controlled Trial, number ISRCTN59549825.

Longitudinal relationships between anxiety, depression, and pain: results from a two-year cohort study of lower extremity trauma patients

Previous studies have shown that pain, depression, and anxiety are common after trauma. A longitudinal relationship between depression, anxiety, and chronic pain has been hypothesized. Severe lower extremity trauma patients (n = 545) were followed at 3, 6, 12, and 24 months after injury using a visual analog "present pain intensity" scale and the depression and anxiety scales of the Brief Symptom Inventory. Structural model results are presented as Standardized Regression Weights (SRW). Multiple imputation was used to account for missing data. A single structural model including all longitudinal pain intensity, anxiety symptoms, and depression symptoms time-points yielded excellent fit measures. Pain weakly predicted depression (3-6 months SRW = 0.07, P = .05; 6-12 months SRW = 0.06, P = .10) and anxiety (3-6 months SRW = 0.05, P = .21; 6-12 months SRW = 0.08, P = .03) during the first year after injury, and did not predict either construct beyond 1 year. Depression did not predict pain over any time period. In contrast, anxiety predicted pain over all time periods (3-6 months SRW = 0.11, P = .012; 6-12 months SRW = 0.14, P = .0065; 12-24 months SRW = 0.18, P < .0001). The results suggest that in the early phase after trauma, pain predicts anxiety and depression, but the magnitude of these relationships are smaller than the longitudinal relationship from anxiety to pain over this period. In the late (or chronic) phase after injury, the longitudinal relationship from anxiety on pain nearly doubles and is the only significant relationship. Despite missing data and a single item measure of pain intensity, these results provide evidence that negative mood, specifically anxiety, has an important role in the persistence of acute pain.

Separating the influences of prereading skills on early word and nonword reading

The essential first step for a beginning reader is to learn to match printed forms to phonological representations. For a new word, this is an effortful process where each grapheme must be translated individually (serial decoding). The role of phonological awareness in developing a decoding strategy is well known. We examined whether beginning readers recruit different skills depending on the nature of the words being read (familiar words vs. nonwords). Print knowledge, phoneme and rhyme awareness, rapid automatized naming (RAN), phonological short-term memory (STM), nonverbal reasoning, vocabulary, auditory skills, and visual attention were measured in 392 prereaders 4 and 5 years of age. Word and nonword reading were measured 9 months later. We used structural equation modeling to examine the skills-reading relationship and modeled correlations between our two reading outcomes and among all prereading skills. We found that a broad range of skills were associated with reading outcomes: early print knowledge, phonological STM, phoneme awareness and RAN. Whereas all of these skills were directly predictive of nonword reading, early print knowledge was the only direct predictor of word reading. Our findings suggest that beginning readers draw most heavily on their existing print knowledge to read familiar words.

The association of subjective workload dimensions on quality of care and pharmacist quality of work life

BACKGROUND

Workload has been described both objectively (e.g., number of prescriptions dispensed per pharmacist) as well as subjectively (e.g., pharmacist's perception of busyness). These approaches might be missing important characteristics of pharmacist workload that have not been previously identified and measured.

OBJECTIVES

To measure the association of community pharmacists' workload perceptions at three levels (organization, job, and task) with job satisfaction, burnout, and perceived performance of two tasks in the medication dispensing process.

METHODS

A secondary data analysis was performed using cross-sectional survey data collected from Wisconsin (US) community pharmacists. Organization-related workload was measured as staffing adequacy; job-related workload was measured as general and specific job demands; task-related workload was measured as internal and external mental demands. Pharmacists' perceived task performance was assessed for patient profile review and patient consultation. The survey was administered to a random sample of 500 pharmacists who were asked to opt in if they were a community pharmacist. Descriptive statistics and correlations of study variables were determined. Two structural equation models were estimated to examine relationships between the study variables and perceived task performance.

RESULTS

From the 224 eligible community pharmacists that agreed to participate, 165 (73.7%) usable surveys were completed and returned. Job satisfaction and job-related monitoring demands had direct positive associations with both dispensing tasks. External task demands were negatively related to perceived patient consultation performance. Indirect effects on both tasks were primarily mediated through job satisfaction, which was positively related to staffing adequacy and cognitive job demands and negatively related to volume job demands. External task demands had an additional indirect effect on perceived patient consultation performance, as it was associated with lower levels of job satisfaction and higher levels of burnout.

IMPLICATIONS/CONCLUSIONS

Allowing community pharmacists to concentrate on tasks and limiting interruptions while performing these tasks are important factors in improving quality of patient care and pharmacist work life. The results have implications for strategies to improve patient safety and pharmacist performance.

Heritability of subcortical brain measures: a perspective for future genome-wide association studies

Several large imaging-genetics consortia aim to identify genetic variants influencing subcortical brain volumes. We investigated the extent to which genetic variation accounts for the variation in subcortical volumes, including thalamus, amygdala, putamen, caudate nucleus, globus pallidus and nucleus accumbens and obtained the stability of these brain volumes over a five-year period. The heritability estimates for all subcortical regions were high, with the highest heritability estimates observed for the thalamus (.80) and caudate nucleus (.88) and lowest for the left nucleus accumbens (.44). Five-year stability was substantial and higher for larger [e.g., thalamus (.88), putamen (.86), caudate nucleus (.87)] compared to smaller [nucleus accumbens (.45)] subcortical structures. These results provide additional evidence that subcortical structures are promising starting points for identifying genetic variants that influence brain structure.

Predictors of older adults' personal and community mobility: using a comprehensive theoretical mobility framework

PURPOSE OF THE STUDY

Forty-six percent of older adults report limitations in their mobility, and maintaining mobility is considered an important factor in keeping adults independent and active in later life. This study tests a comprehensive theoretical framework of mobility (Webber, S. C., Porter, M. M., & Menec, V. H. [2010]. Mobility in older adults: A comprehensive framework. The Gerontologist, 50[4], 443-450. doi:10.1093/geront/gnq013) identifying multiple determinants that additively influence mobility (financial, psychosocial, environmental, physical, and cognitive), as well as cross-cutting influences of gender, culture, and biography.

DESIGN AND METHODS

Structural equation modeling was used to examine several models of mobility using data from 6,112 respondents in the Health and Retirement Study (mean age: 74.74, 85% white, 41% male, 57% married).

RESULTS

The original measurement model fit the data well. When both personal and community mobility were simultaneously predicted, only the physical, cognitive, psychosocial, and environmental determinants were retained in the independent models. Age and marital status also predicted personal and community mobility. Although most of these relationships were in the expected direction, interestingly when both forms of mobility were included in the model, poorer cognitive ability was associated with greater personal mobility in the final model.

IMPLICATIONS

Results indicate the importance of accounting for and examining comprehensive models of mobility. The factors affecting older adults' mobility are complex, and these relationships need to be explored in more depth to ensure the maintenance of individuals' independence and quality of life.

The relationships between asthma control, daytime sleepiness, and quality of life among children with asthma: a path analysis

OBJECTIVES

We aimed to examine the relationships between asthma control, daytime sleepiness, and asthma-specific health-related quality of life (HRQOL) among children with asthma. Path analyses were conducted to test if daytime sleepiness can mediate the effect of asthma control status on asthma-specific HRQOL.

METHODS

160 dyads (pairs) of asthmatic children and their parents were collected for analyses. The Asthma Control and Communication Instrument (ACCI) was used to categorize adequate and poor asthma control status. The Cleveland Adolescent Sleepiness Questionnaire (CASQ) was used to measure children's daytime sleepiness, including sleep in school, awake in school, sleep in evening, and sleep during transport. The Patient-Reported Outcomes Measurement Information System (PROMIS) Asthma Impact Scale was used to measure asthma-specific HRQOL.

RESULTS

Poorly controlled asthma was associated with daytime sleepiness and impaired asthma-specific HRQOL. Asthma control status was directly associated with asthma-specific HRQOL (P<.05), whereas sleep in school and sleep in evening domains of daytime sleepiness significantly mediated the relationship between poor asthma control and impaired HRQOL (P<.01).

CONCLUSIONS

Asthma control status was associated with pediatric asthma-specific HRQOL, and the association was significantly mediated by daytime sleepiness. Healthcare providers need to address pediatric sleep needs related to poor asthma control to reduce the negative impact on HRQOL.

Factors influencing student perceptions of high-school science laboratory environments

Science laboratory learning has been lauded for decades for its role in fostering positive student attitudes about science and developing students' interest in science and ability to use equipment. An expanding body of research has demonstrated the significant influence of laboratory environment on student learning. Further research has demonstrated differences in student perceptions based on giftedness. To explore the relationship between giftedness and students' perceptions of their learning environment, we examined students' perceptions of their laboratory learning environment in biology courses, including courses designated for high-achieving versus regular-achieving students. In addition, to explore the relationship between students' perceptions and the extent of their experience with laboratory learning in a particular discipline, we examined students' perceptions of their laboratory learning environment in first-year biology courses versus elective biology courses that require first-year biology as a prerequisite. We found that students in high-achieving courses had a more favourable perception of all aspects of their learning environment when compared with students in regular courses. In addition, student perceptions of their laboratory appeared to be influenced by the extent of their experience in learning science. Perceptions were consistent amongst regular- and high-achieving students regardless of grade level. In addition, perceptions of students in first year and beyond were consistent regardless of grade level. These findings have critical applications in curriculum development as well as in the classroom. Teachers can use student perceptions of their learning environment to emphasize critical pedagogical approaches and modify other areas that enable enhancement of the science laboratory learning environment.

Longitudinal measurement invariance of psychosocial measures in physical activity research: An application to adolescent data

The current study served as a practical and substantive guide to establishing longitudinal measurement invariance of psychosocial measures commonly used in adolescent physical activity (PA) research. Psychosocial data on an initial sample of 878 adolescents (ages 11 - 15) recruited through primary care providers were provided at baseline, 6, 12, and 24 months. The target measures included family support, peer support, decisional balance (pros, cons), self-efficacy, and behavioral strategies. Five of the six psychosocial measures exhibited strict longitudinal measurement invariance, with the 6th measure (self-efficacy) exhibiting strong longitudinal measurement invariance. These findings support the equivalence of these measures across time, and provide the foundation to substantively interpret group differences and associations involving these measures and PA.

The sociocultural health behavioral model and disparities in colorectal cancer screening among Chinese Americans

OBJECTIVE

The purpose of this study was to validate a Sociocultural Health Behavior Model using a structural equation analysis to determine the direction and magnitude of the interdependence of model components in relation to health behavior associated with colorectal cancer (CRC) screening among Chinese Americans.

METHODS

A cross-sectional design included a sample of 311 Chinese American men and women age 50 and older. The initial step involved use of confirmatory factor analysis which included the following variables: access/satisfaction with health care, enabling, predisposing, cultural, and health belief factors. Structural equation modeling analyses were conducted on factors for CRC screening.

RESULTS

Education and health insurance status were significantly related to CRC screening. Those with less than a high school education and without health insurance were more likely to be "never screened" for CRC than those having more education and health insurance. The path analysis findings also lend support for components of the Sociocultural Health Belief Model and indicated that there was a positive and significant relationship between CRC screening and the enabling factors, between cultural factors and predisposing, enabling, and access/satisfaction with health care factors and between enabling factors and access/satisfaction with health care.

CONCLUSIONS

The model highlights the significance that sociocultural factors play in relation to CRC screening and reinforced the need to assist Chinese with poor English proficiency in translation and awareness of the importance of CRC screening. The use of community organizations may play a role in assisting Chinese to enhance colorectal cancer screening rates.

Turbulent times: effects of turbulence and violence exposure in adolescence on high school completion, health risk behavior, and mental health in young adulthood

Turbulent social environments are associated with health and developmental risk, yet mechanisms have been understudied. Guided by a life course framework and stress theory, this study examined the association between turbulent life transitions (including frequent residential mobility, school transitions, family structure disruptions, and homelessness) and exposure to violence during adolescence and high school completion, mental health, and health risk behaviors in young adulthood. Participants (n = 4834) from the U.S. National Longitudinal Survey of Youth, 1997 cohort were followed prospectively from age 12-14 years for 10 years. We used structural equation models to investigate pathways between turbulence and cumulative exposure to violence (CEV), and high school completion, mental health, and health risk behaviors, while accounting for early life socio-demographics, family processes, and individual characteristics. Results indicated that turbulence index was associated with cumulative exposure to violence in adolescence. Both turbulence index and cumulative exposure to violence were positively associated with higher health risk behavior, poorer mental health, and inversely associated with high school completion. These findings highlight the importance of considering the cumulative impact of turbulent and adverse social environments when developing interventions to optimize health and developmental trajectory for adolescents transitioning into adulthood.

Changes in effective connectivity according to working memory load: an FMRI study of face and location working memory tasks

OBJECTIVE

The functional strategic mechanisms in the brain during performing visuospatial working memory tasks, especially tasks with heavy load, are controversial. We conducted the functional magnetic resonance imaging (fMRI) while sixteen subjects were performing face- and location-matching n-back tasks to examine causal relations within the frontoparietal networks.

METHODS

We applied a sophisticated method, the structural equation modeling (SEM), to the fMRI data. The imaging data were analyzed by extracting the task-related eigenseries using the principal component analysis (PCA) and then by applying a form of data-driven model called the automated search method.

RESULTS

The SEM analyses revealed a functional shift of network connectivity from the right to the left hemisphere with increasing load in the face-matching n-back tasks while the location-matching tasks required bilateral activation. In the locating matching n-back tasks, a pattern of parallel processing was observed in the left phonological loop and the right inferior parietal regions. Furthermore, object working memory-related activities in the left hemisphere reliably contributed to performance of both the face- and location-matching 2-back tasks.

CONCLUSION

Our results are consistent with previous reports in terms of demonstrating parallel and distributed information processing during performing working memory tasks with heavy loads. Our results additionally suggest a dynamic shift between the fast imagery circuit (right hemisphere) and the stable verbal circuit (left hemisphere), depending on task load.

Application of structure equation modeling for inferring a serial transcriptional regulation in yeast

Revealing the gene regulatory systems among DNA and proteins in living cells is one of the central aims of systems biology. In this study, I used Structural Equation Modeling (SEM) in combination with stepwise factor analysis to infer the protein-DNA interactions for gene expression control from only gene expression profiles, in the absence of protein information. I applied my approach to infer the causalities within the well-studied serial transcriptional regulation composed of GAL-related genes in yeast. This allowed me to reveal the hierarchy of serial transcriptional regulation, including previously unclear protein-DNA interactions. The validity of the constructed model was demonstrated by comparing the results with previous reports describing the regulation of the transcription factors. Furthermore, the model revealed combinatory regulation by Gal4p and Gal80p. In this study, the target genes were divided into three types: those regulated by one factor and those controlled by a combination of two factors.

Componential skills of beginning writing: An exploratory study

The present study examined the components of end of kindergarten writing, using data from 242 kindergartners. Specifically of interest was the importance of spelling, letter writing fluency, reading, and word- and syntax-level oral language skills in writing. The results from structural equation modeling revealed that oral language, spelling, and letter writing fluency were positively and uniquely related to writing skill after accounting for reading skills. Reading skill was not uniquely related to writing once oral language, spelling, and letter writing fluency were taken into account. These findings are discussed from a developmental perspective.