UNASSIGNED: This study aimed to develop and validate an instrument, Dental Visiting Behavior Based on Health Belief Model among Adults (DVBHBM), and to assess factors influencing adults\' dental visiting behavior based on Health Belief Model.
UNASSIGNED: This cross-sectional study was conducted among 277 adults in Hyderabad, India. The DVBHBM instrument, based on Health Belief Model, was developed, validated, and distributed among participants. Exploratory factor analysis, reliability analysis, descriptive analysis, independent t-tests, and path analysis were conducted to explore construct validity, internal consistency, attitudes, and relationship among variables.
UNASSIGNED: Participants with discomfort exhibited higher perceived susceptibility (3.70 ± 1.15) compared to those with regular dental visits (2.84 ± 1.26, p < 0.05). Conversely, individuals with regular dental visits demonstrated significantly greater perceived benefits (22.32 ± 2.5) than those experiencing discomfort (19.76 ± 3.36, p = 0.001). Perceived barriers were lower among individuals with regular dental visits (11.01 ± 4.61) compared to those experiencing discomfort (12.71 ± 4.26, p = 0.001). Participants with regular dental visits also perceived the severity of not visiting a dentist (3.87 ± 0.95) more strongly than those experiencing discomfort (2.91 ± 1.03, p = 0.000). Cues to action were more pronounced in individuals with discomfort (3.34 ± 1.06) compared to those with regular dental visits (2.98 ± 1.07, p < 0.05).
UNASSIGNED: Participants exhibiting discomfort in dental visits had significantly higher perceived susceptibility, perceived barriers, cues to action and self-efficacy towards dental visits. However, factors such as age, gender, marital status, income, brushing, flossing and tobacco use did not impact dental visiting behaviour of adults.

School psychologists have many roles and responsibilities that often lead to high stress levels. Wise (1985) authored the School Psychologists and Stress Inventory (SPSI), but it has not been updated substantially since its publication. We developed two studies to address the stressors faced by currently practicing school psychologists. Study 1 included 229 practicing school psychologists who evaluated the relevancy of the SPSI items and who listed five highly stressful events experienced considering the current context of practice. Based on these results, 13 SPSI items were removed, 21 SPSI items were revised, and 12 new items were added. The resulting measure, the School Psychologist Distress Inventory (SPDI), consists of 33 items and an additional item addressing overall stress. Study 2 examined validity evidence associated with the SPDI score structure. Using data from a sample of 350 practicing school psychologists, a sequence of exploratory factor analytic methods indicated the presence of a general factor of distress as well as four more specific factors, including Heavy Workload, Student Needs, Lack of Professional Support, and Parental and Legal Conflicts. Convergent relations and discriminant relations were evident between (a) SPDI total and subscales and (b) measures reflecting general stress level, role stressors, role overload, and job satisfaction. Examination of SPDI scores revealed they were not significantly related to age in years, educational levels, or school-psychologist-to-student ratio by state; however, lack of professional support was statistically significantly but weakly related to years of experience. Student needs were significantly more stressful across participants in the Western region of the United States than the Midwest region. Results from these two studies suggest the promise of using the SPDI to examine general and specific experiences of school psychologists\' distress and they reveal that distress across school psychologists is remarkably high-especially in the area associated with having a heavy workload. Additional research with more racially and ethnically diverse samples of school psychologists would enhance confidence in using the SPDI as a measure of distress. Results suggest an urgent need to address structural influences on stress and personal coping strategies employed by school psychologists.

OBJECTIVE: Restricted and/or repetitive displays of behavior, interests, or activities (RRBs) are one of the core symptom domains of autism spectrum disorder (ASD). Current and past research indicates two \'clusters\' of RRBs in children with ASD: repetitive sensorimotor (e.g., hand/finger and more complex motor mannerisms) and insistence on sameness (e.g., resistance to changes in the environment) behaviors. The current study aims to fill a gap by examining how RRBs may diverge in individuals with ASD and with other neurodevelopmental disorders (ONDD) in a clinical sample.
METHODS: A total of 558 individuals were seen at a tertiary care clinic for a comprehensive clinical assessment of ASD. The sample was split into ASD (n = 292 individuals) and ONDD (n = 266) groups based on clinical diagnosis. Exploratory factor analyses were conducted using Autism Diagnostic Interview-Revised (ADI-R) RRB item scores for the overall sample, the ASD group, and the ONDD group.
RESULTS: Exploratory factor analysis of ADI-R RRB items indicated a 2-factor solution for the full sample and ASD group. Items loaded onto two factors comprised of \"Repetitive Sensorimotor\" and \"Insistence on Sameness\" behaviors, consistent with previous literature. Results demonstrated a unique loading pattern for the non-ASD group, with items clustering into \"Higher Order\" (e.g., circumscribed interests) and \"Lower Order\" (e.g., hand and finger mannerisms) behaviors.
CONCLUSIONS: The results of the current study may point towards using RRBs to guide screening of children who are referred for an ASD evaluation to better identify children who are at higher risk of having ASD.

UNASSIGNED: Bone mineral density (BMD) is a crucial index for predicting fracture risk and diagnosing osteoporosis. With the global rise in osteoporosis prevalence, understanding the relationship between dietary patterns and BMD is vital for public health. This study aimed to explore the association between various dietary patterns and BMD among adults using data from the National Health and Nutrition Examination Survey (NHANES).
UNASSIGNED: Data were analyzed from 8,416 NHANES participants aged 40 years and older across three non-consecutive survey cycles from 2013 to 2020. Dietary patterns were identified using a combination of factor analysis and cluster analysis. BMD measurements were then assessed, and associations with the identified dietary patterns were analyzed, with adjustments made for demographic variables.
UNASSIGNED: The analysis identified three distinct dietary patterns: \"Low protein-High Dietary fiber-Vitamin A-Magnesium (LP-HDF-Vit A-Mg)\", \"High macronutrient-Choline-Selenium (HM-Cho-Se)\", and \"Low macronutrient-Vitamin D-Calcium (LM-Vit D-Ca)\", and then we found that women, older adults, and certain ethnic groups were at higher risk for low BMD. Participants adhering to the \"HM-Cho-Se\" and \"LP-HDF-Vit A-Mg\" dietary patterns exhibited significantly higher BMD compared to those following the \"LM-Vit D-Ca\" pattern. After adjusting for demographic variables, the \"HM-Cho-Se\" pattern remained positively associated with BMD, while the \"LM-Vit D-Ca\" pattern showed no significant association with BMD or the risk of low BMD.
UNASSIGNED: The findings suggest that adherence to the \"HM-Cho-Se\" dietary pattern may reduce the risk of low BMD, indicating potential synergies between these nutrients for bone health. However, the study has limitations, including the cross-sectional design and potential subjectivity in factor analysis. Future research should focus on longitudinal studies involving diverse age groups to better understand the causal relationship between dietary patterns and BMD. Despite these limitations, the study highlights the importance of dietary factors in maintaining bone health and suggests potential dietary interventions to reduce the risk of low BMD and osteoporosis.

BACKGROUND: Adver Childhood Experiences (ACEs) and Parental Alienation (PA)are forms of adverse events negatively affecting children globally. The current study was to identify a revised ACEs measure that includes a screening item for PA.
METHODS: A total of 231 undergraduate students, ages 18 to 37, were surveyed for this analysis. A factor analyses was performed to identify what PA item, out of four, would correlate most strongly with existing ACEs scale items. Convergent and divergent validity was assessed. An exploratory factory analyses was conducted to identify factor structure of scale items and a confirmatory factory analysis of extracted factors was used to assess model fit.
RESULTS: Over half (60 %) of the sampled population reported at least one ACEs item. All four PA items were significantly correlated with converging constructs (r = 0.68, p < .01). Out of four PA items, one PA item significantly outperformed the other three items in relation to convergent validity and was used to create a new ACEs-PA scale item (r = 0.33, p < .01). A two factor solution was identified with the new PA item loading, accounting for 35 % of the variance, explaining more variance in both outcomes (R2 = 0.43 and R2 = 0.16) than the original ACEs scale when comparing the adjusted R2 values (R2 = 0.35 and R2 = 0.13). Limitations This study used participant self-reporting methods subjecting it to retrospective bias.
CONCLUSIONS: Within the population, the new PA item factored significantly with existing ACEs, suggesting the capture of an additional adverse childhood experience.

OBJECTIVE: To evaluate the psychometric properties of the Union Physio-Psycho-Social Assessment Questionnaire (UPPSAQ-70) among general hospital psychiatric outpatients.
METHODS: A total of 2000 participants responded to the survey. Factor analyses were used to test the construct validity of the scale. Convergent validity was evaluated by the correlation between UPPSAQ-70 and symptoms measured using the Chinese versions of Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Patient Health Questionnaire-15 (PHQ-15), Somatic Symptom Disorder - B Criteria Scale (SSD-12) and Pittsburgh Sleep Quality Index (PSQI).
RESULTS: The nine-factor model was supported (χ2 = 8816.395, df = 2309, χ2/df = 3.818, RMSEA = 0.053, CFI = 0.929). The UPPSAQ-70 showed significant correlation with the SAS (r = 0.396, P < .001), SDS (r = 0.451, P < .001), PHQ-15 (r = 0.381, P < .001), SSD-12 (r = 0.324, P < .001) and PSQI (r = 0.220, P < .001). UPPSAQ-70 and its subscales showed good internal consistency with Cronbach\'s alpha coefficients ranging from 0.79 to 0.96.
CONCLUSIONS: The UPPSAQ-70 was a rating scale with good construct validity and reliability, which can measure overall health in the biological, psychological, and social domains for Chinese psychiatric outpatients, but its convergent validity still requires further empirical research.

UNASSIGNED: Many nurses join the profession because they have altruistic intentions, but some nurses experience barriers to acting on altruistic intentions which may be a source of job dissatisfaction or burnout.
UNASSIGNED: The purpose of this study was to evaluate construct validity, internal consistency, and convergence reliability of the Nursing Altruistic Execution Scale (NAES), a novel instrument assessing the perceived ability to help others through work.
UNASSIGNED: The NAES was developed based upon a literature review examining altruistic behavior as a motivator for nursing work, with expert feedback for instrument refinement. Participants completed the NAES, Copenhagen Burnout Inventory Work-Related Burnout Scale, and Satisfaction of Employees in Health Care Survey. Exploratory factor analysis examined construct validity and factor loadings. Confirmatory factor analysis verified consistency in factor structure. Linear regression assessed for convergence reliability with burnout and job satisfaction.
UNASSIGNED: The sample included 843 acute care hospital nurses surveyed in January-March 2023. Exploratory factor analysis revealed a two-factor solution, named altruistic engagement with work and workplace barriers to altruism. Nine instrument items were retained and demonstrated strong internal consistency (Cronbach\'s alpha 0.79). There was a significant relationship between both factors of the NAES and both burnout and job satisfaction, demonstrating that greater altruistic execution is associated with lower burnout and greater job satisfaction.
UNASSIGNED: Preliminary findings support the use of the NAES as a valid and reliable scale. Findings show there is correlation between altruistic intentions and burnout. Interventions aimed at enhancing altruistic execution may reduce nurse burnout and thereby improve retention.

Recent advancements in modeling suggest that microbial inactivation in leafy greens follows a nonlinear pattern, rather than the simple first-order kinetics. In this study, we evaluated 17 inactivation models commonly used to describe microbial decline and established the conditions that govern microbial survival on leafy greens. Through a systematic review of 65 articles, we extracted 530 datasets to model the fate of Shiga toxin-producing Escherichia coli O157:H7 on leafy greens. Various factor analysis methods were employed to evaluate the impact of identified conditions on survival metrics. A two-parameter model (jm2) provided the best fit to most of both natural and antimicrobial-induced persistence datasets, whereas the one-parameter exponential model provided the best fit to less than 20% of the datasets. The jm2 model (adjusted R2 = .89) also outperformed the exponential model (adjusted R2 = .58) in fitting the pooled microbial survival data. In the context of survival metrics, the model averaging approach generated higher values than the exponential model for >4 log reduction times (LRTs), suggesting that the exponential model may be overpredicting inactivation at later time points. The random forest technique revealed that temperature and inoculum size were common factors determining inactivation in both natural and antimicrobial-induced die-offs.. The findings show the limitations of relying on the first-order survival metric of 1 LRT and considering nonlinear inactivation in produce safety decision-making.

BACKGROUND: Different aspects of social relationships (e.g., social network size or loneliness) have been associated with dementia risk, while their overlap and potentially underlying pathways remain largely unexplored. This study therefore aimed to (1) discriminate between different facets of social relationships by means of factor analysis, (2) examine their associations with dementia risk, and (3) assess mediation by depressive symptoms.
METHODS: Thirty-six items from questionnaires on social relationships administered in Wave 2 (2004/2005) of the English Longitudinal Study of Ageing (n = 7536) were used for exploratory and confirmatory factor analysis. Factors were then used as predictors in Cox proportional hazard models with dementia until Wave 9 as outcome, adjusted for demographics and cardiovascular risk factors. Structural equation modeling tested mediation by depressive symptoms through effect decomposition.
RESULTS: Factor analyses identified six social factors. Across a median follow-up time of 11.8 years (IQR = 5.9-13.9 years), 501 people developed dementia. Higher factor scores for frequency and quality of contact with children (HR = 0.88; p = 0.021) and more frequent social activity engagement (HR = 0.84; p < 0.001) were associated with lower dementia risk. Likewise, higher factor scores for loneliness (HR = 1.13; p = 0.011) and negative experiences of social support (HR = 1.10; p = 0.047) were associated with higher dementia risk. Mediation analyses showed a significant partial effect mediation by depressive symptoms for all four factors. Additional analyses provided little evidence for reverse causation.
CONCLUSIONS: Frequency and quality of social contacts, social activity engagement, and feelings of loneliness are associated with dementia risk and might be suitable targets for dementia prevention programs, partly by lowering depressive symptoms.

UNASSIGNED: This retrospective intention-to-treat study aims to identify risk factors associated with intraoperative conversion from Video-Assisted Thoracoscopic Surgery (VATS) Decortication to open thoracotomy in patients with Stage III Tuberculous Empyema, specifically focusing on non-Multi-Drug Resistant (MDR)/Extensively Drug-Resistant (XDR) cases.
UNASSIGNED: The study included 122 patients with non-MDR/XDR tuberculous empyema who were initially scheduled for VATS decortication. Patients were divided into two groups: the Thoracoscopy group (n = 64), who successfully underwent VATS decortication, and the Conversion group (n = 58), who required intraoperative conversion to open thoracotomy. Complex cases were excluded from the study. The analysis focused solely on factors leading to conversion, rather than overall treatment outcomes.
UNASSIGNED: A notable difference was observed in the rate of regular preoperative glucocorticoid utilization between the two cohorts, with the Conversion group exhibiting a lower percentage (46.5 %) in comparison to the Thoracoscopy group (75.0 %). Furthermore, the Thoracoscopy group displayed a significantly reduced frequency of ipsilateral lung abnormalities prior to the surgery (37.5 %), as opposed to that of the Conversion group (65.5 %). Multivariate logistic regression analysis revealed that the regular preoperative glucocorticoid use (odds ratio (OR) = 3.444, 95 % confidence interval (CI): 1.602-7.407) and pre-existing pulmonary lesions (OR = 0.31, 95%CI: 0.150-0.663) were potential influential factors.
UNASSIGNED: Inconsistent preoperative glucocorticoid administration and ipsilateral lung lesions were identified as exacerbating factors leading to the complexity of VATS decortication by causing intraoperative pulmonary tissue contusion or hemorrhage, thus hindering the successful completion of VATS decortication and necessitating a conversion to thoracotomy. Awareness of these factors can aid surgeons in making well-informed decisions regarding the preoperative surgical approach.