Bias-corrected Confidence Intervals Research Articles

Dimensionality and optimal combination of autonomic fear-conditioning measures in humans.

Fear conditioning, also termed threat conditioning, is a commonly used learning model with clinical relevance. Quantification of threat conditioning in humans often relies on conditioned autonomic responses such as skin conductance responses (SCR), pupil size responses (PSR), heart period responses (HPR), or respiration amplitude responses (RAR), which are usually analyzed separately. Here, we investigate whether inter-individual variability in differential conditioned responses, averaged across acquisition, exhibits a multi-dimensional structure, and the extent to which their linear combination could enhance the precision of inference on whether threat conditioning has occurred. In a mega-analytic approach, we re-analyze nine data sets including 256 individuals, acquired by the group of the last author, using standard routines in the framework of psychophysiological modeling (PsPM). Our analysis revealed systematic differences in effect size between measures across datasets, but no evidence for a multidimensional structure across various combinations of measures. We derive the statistically optimal weights for combining the four measures and subsets thereof, and we provide out-of-sample performance metrics for these weights, accompanied by bias-corrected confidence intervals. We show that to achieve the same statistical power, combining measures allows for a relevant reduction in sample size, which in a common scenario amounts to roughly 24%. To summarize, we demonstrate a one-dimensional structure of threat conditioning measures, systematic differences in effect size between measures, and provide weights for their optimal linear combination in terms of maximal retrodictive validity.

THE RELATIONSHIP BETWEEN TEACHING LEADERSHIP OF COLLEGE AND UNIVERSITY TEACHERS AND ACADEMIC ACHIEVEMENT OF COLLEGE AND UNIVERSITY STUDENTS: THE MEDIATING ROLE OF LEARNING ENGAGEMENT

This article uses the learning engagement mediating variable to explain the relationship between college and university teachers' teaching leadership and college and university students' academic achievement. Method: A survey of 985 college and university students was conducted using the University Teacher Teaching Leadership Questionnaire, Learning Engagement Questionnaire, and College Student Academic Achievement Questionnaire. Results: The teaching leadership of college and university teachers has a significant positive impact on learning engagement. Estimate = 0.674, p<0.001. Learning investment has a significant positive impact on college and university students' academic achievement. Estimate = 0.532, p<0.001. The direct effect of college and university teachers' teaching leadership on college and university students' academic achievement is significant (= 0.29, p<0.001). The mediating effect of learning investment is significant (mediating effect = 0.359), and the Bootstrap 95% bias-corrected confidence interval is [0.272, 0.461]. Conclusion: Learning engagement plays a mediating role in the relationship between college and university teachers’ teaching leadership and college and university students’ academic achievement.

Are state-space stock assessment model confidence intervals accurate? Case studies with SAM and Barents Sea stocks

Our main contribution is to examine the reliability of confidence intervals using the SAM state-space fish stock assessment model used for the assessment of many stocks by the International Council for the Exploration of the Seas. We focus on frequentist statistical inferences and more specifically on inference conditioned on specific values of the state-space model random effects drawn from their process distribution. This is somewhat consistent with simulation self-test procedures that are commonly used to examine the reliability of state-space assessment model results. However, recent research has indicated that some estimation bias may be expected in the conditional setting. Hence, we also investigate recently proposed bias corrected confidence intervals appropriate for the conditional inference setting. The SAM simulation coverage probabilities of 95% confidence intervals for SSB and Fbar were usually slightly larger than 95%, but in a small number of years these coverage probabilities could be much smaller than 95%. The bias corrected confidence intervals were more reliable. When averaged over years, the SAM and bias corrected confidence interval coverage probabilities were similar for the Northeast Artic cod and saithe case studies, but the bias corrected confidence intervals performed much better overall for the haddock case study.

AGING-IN-PLACE TECHNOLOGY: PROGRAMMING TO ADDRESS SOCIAL CONNECTEDNESS AND MENTAL HEALTH

Abstract According to the National Academies of Sciences, Engineering, and Medicine, the drastic increase of older adult social isolation from the pandemic has contributed to premature death, dementia, anxiety, and suicide. Jewish Family Service of Central New Jersey (JFSCNJ) clients corroborated this phenomenon with 65% meeting the diagnostic criteria for moderate to severe older adult depression or anxiety in 2020. In 2022, JFSCNJ established the Fig Tree Virtual Senior Center, a dynamic program that focused on older adults as they readjust to a post-pandemic world. By addressing social isolation through a Person-Centered Trauma Informed and biopsychosocial approaches, various wellness programs were provided in-home via the use of virtual video programming. Sixteen older adults (age range 68-95 years-old) were assessed on anxiety and depressive symptoms and social connectedness both prior to and six months following the start of the video programming intervention. Paired samples t-testing found a significant reduction in self-reported anxiety (p=.01) and depressive (p=.05) symptoms after video programming engagement at six-months follow-up. Path analysis using bootstrapping with bias corrected confidence intervals found amount of video programming with a positive and significant indirect effect on both increased social connectedness and improved well-being. Implications for homebound older adult social engagement and well-being programming will be discussed.

Factors influencing health-related quality of life for young single-person households: the mediating effect of resilience

Purpose: To identify factors influencing health-related quality of life for young single-person households, this study investigated physical and mental health status, health behavior, depression, resilience, and health-related quality of life. Methods: An online survey was administered to members of young single-person households from March 22 to 30, 2022. The data were analyzed using the chi-square test, independent t-test, one-way analysis of variance, Pearson correlation coefficients, multiple regression, and a simple mediation model applying the PROCESS macro model 4 with 95% bias-corrected bootstrapped confidence intervals. Results: The participants were 229 members of young single-person households. Health-related quality of life showed significant relationships with residence (t = 2.80, p = .006), monthly income (F = 3.70, p = .026), mental health status (F = 20.33, p < .001), and high-intensity exercise (F = 7.35, p = .001) among general and health-related characteristics. Health-related quality of life had significant correlations with depression (r = -.72, p < .001) and resilience (r = .58, p < .001). Multiple regression analysis showed that depression (β = -.57, p < .001) and resilience (β = .21, p < .001) influenced health-related quality of life. Moreover, resilience had a mediating effect between depression and health-related quality of life (indirect effect = -0.002, 95% bias-corrected bootstrapped confidence interval = -0.003 to -0.001). Conclusion: Members of young single-person households tended to be more vulnerable to emergency situations, such as during the coronavirus disease 2019 pandemic, when lockdowns and quarantines were frequent. To improve health-related quality of life in young single-person households, people with high levels of depression or low levels of resilience need special attention and support to promote mental health.

The Influence of Caregiver Contribution to Self-care on Symptom Burden in Patients With Heart Failure and the Mediating Role of Patient Self-care: A Longitudinal Mediation Analysis.

Patients with heart failure experience high symptom burden, which can be mitigated with adequate self-care. Caregiver contribution to self-care has been theorized to improve patient symptom burden. The mediating role of patient self-care in this relationship has not been tested yet. The aim of this study was to test whether (a) caregiver contribution to self-care influences patient self-care, (b) patient self-care influences symptom burden, and (c) patient self-care mediates the relationship between caregiver contribution to self-care and symptom burden. In this study, the authors conducted a secondary analysis of the baseline and 3-month data from the MOTIVATE-HF trial, which enrolled 510 dyads (patient with heart failure and caregiver) in Italy. Multigroup confirmatory factor analysis was used to test measurement invariance. Autoregressive longitudinal path analysis with contemporaneous mediation was used to test our hypotheses. On average, caregivers were 54 years old and mainly female, whereas patients were 72.4 years old and mainly male. Better caregiver contribution to self-care maintenance was associated with better patient self-care maintenance (β = 0.280, P < .001), which, in turn, was associated with lower symptom burden (β = -0.280, P < .001). Patient self-care maintenance mediated the effect of caregiver contribution to self-care maintenance on symptom burden (β = -0.079; 95% bias-corrected bootstrapped confidence interval, -0.130 to -0.043). Better caregiver contribution to self-care management was associated with better patient self-care management (β = 0.238, P = .006). The model significantly accounted for 37% of the total variance in symptom burden scores (P < .001). This study expands the situation-specific theory of caregiver contribution to heart failure self-care and provides new evidence on the role of caregiver contribution to self-care and patient self-care on symptom burden in heart failure.

Entrepreneurship education and its gendered effects on feasibility, desirability and intentions for technology entrepreneurship among STEM students

PurposeThis study aims to examine how entrepreneurship education influences intentions for starting a technology venture among science, technology, engineering and mathematics (STEM) students with particular attention to gender differences. This study builds on the model of entrepreneurial event and social role theory to assess the impact of entrepreneurship education on feasibility, desirability and intentions for technology entrepreneurship.Design/methodology/approachThe hypotheses are tested with a sample of 879 Bulgarian science and engineering students from 15 universities. To test the models, this study uses ordinary least squares and logistic regressions with robust standard errors and Hayes mediation analysis with bootstrap bias-corrected confidence interval estimations for indirect effects. Two-stage Heckman regressions to control for sample selection bias and other robustness checks including propensity score matching were used.FindingsResults show that entrepreneurship education, measured as participation in an entrepreneurship course, has a stronger impact on feasibility, desirability and intentions for technology entrepreneurship for female STEM students compared to their male counterparts. As such, this study supports the notion that entrepreneurship education could be part of a solution to counteract societal norms that position technology entrepreneurship as a less desirable and/or less feasible choice for women in STEM. However, attention should be paid to the operationalization of entrepreneurship education, as other measures of entrepreneurship education (role models, entrepreneurship education support) did not have a moderation effect with gender.Research limitations/implicationsThe authors assume a positive correlation between entrepreneurial intentions and entrepreneurial behavior. Future studies should include actual entrepreneurial behavior to paint a more complete picture of the effect of entrepreneurship education.Originality/valueLittle is known about the role of entrepreneurship education in the field of technology entrepreneurship, and even less about the potential gender differences in entrepreneurship education among STEM students. The study contributes to the literature by examining factors that could help close the persistent gender gap in technology entrepreneurship.

0154 Perceived Stress Partially Mediates the Association Between Adverse Childhood Experiences and Sleep Quality in Young Adults

Abstract Introduction Growing evidence suggests that Adverse Childhood Experiences (ACEs) are associated with poor sleep in young adulthood. It has also been proposed that ACEs may cause stress sensitization, and perceived stress has been linked with poor sleep. We hypothesized that the relation between ACE exposure and poor sleep is mediated by perceived stress. Methods One-hundred and twenty-five (86% Female; mean±SD, age = 22±3 y) young adults between the ages of 18 and 30 years completed the 10-item ACE questionnaire, the Perceived Stress Scale, and the Pittsburgh Sleep Quality Index to quantify ACE exposure, perceived stress (PS), and global sleep quality (GSQ), respectively. Zero-order correlations were used to examine relations among ACE exposure, PS, and GSQ. Multiple linear regression analyses were used to examine the effect of ACE exposure on PS and GSQ after adjustment for sex, age, Race, and Ethnicity. Mediation analysis was then performed using the Bootstrapped Bias-Corrected Percentile Confidence Interval method, and the variance accounted for (VAF) was calculated as the ratio of the indirect effect to total effect β-coefficients. Results ACEs were highly prevalent (69% with ≥1 ACE; 30% with ≥4 ACEs) and variable (range = 0 – 10 ACEs). ACE exposure was associated with greater PS (r=0.40; p&amp;lt; 0.0001) and worse GSQ (r=0.31; p&amp;lt; 0.0001). Higher PS was associated with worse GSQ (r=0.31; p=0.0005). After adjustment, ACE exposure remained a significant predictor of both GSQ (β=0.29; p=0.002) and PS (β=0.39; p&amp;lt; 0.0001). PS significantly, partially mediated the association between ACE exposure and GSQ (indirect effect standardized β-estimate = 0.035 [95% CI = 0.013 – 0.069]; VAF = 29%). Conclusion ACE exposure is associated with greater perceived stress and poorer sleep quality among young adults. Perceived stress partially mediated the association of ACE exposure with sleep quality. Studies confirming the directionality and causality of these associations (including longitudinal mediation), and subsequently whether stress reduction interventions can promote improvements in sleep among individuals with ACEs are needed. Support (if any) Research reported in this publication was supported in part by the NCATS of the NIH (UL1TR002537) and by the Injury Prevention Research Center through the CDC (R49 CE003095).

Reduced Sleep Efficiency Mediates the Association of Adverse Childhood Experience Exposure with Impaired Vascular Endothelial Function in Young Adults

Introduction: Adverse childhood experiences (ACEs) are severe psychosocial stressors during the first 18 years of life that promote substantial increases in lifetime risk of cardiovascular disease. ACEs are highly prevalent and associated with impaired vascular endothelial function (VEF) and poor sleep, established cardiovascular risk factors. The purpose of this study was to investigate the role of sleep efficiency (SE%) in the association of ACEs with impaired VEF in young adults. We hypothesized that SE% would mediate the association of ACEs with impaired VEF. μethods: In 22 young adults (75% Female; age = 26 ± 7 y), we assessed ACE exposure and anxiety and depressive symptoms using the Zung Self-Rating Anxiety and Center for Epidemiologic Studies Depression scales, respectively. We assessed SE% as the reported total sleep duration relative to the time-in-bed from the Pittsburgh Sleep Quality Index. We also measured VEF using the flow mediated dilation technique normalized to the shear rate area under the curve. Using zero-order correlations we examined relations among ACE exposure, anxiety and depression symptoms, SE%, VEF, and age. We then utilized multiple-linear regression to examine the effect of ACE exposure and SE% on VEF while accounting for anxiety and depression symptoms. Finally, to better understand the role of SE% in the association of ACE exposure with VEF, we conducted mediation analysis with SE% as the mediator using the bootstrapped bias-corrected percentile confidence interval method. Results: ACEs were highly prevalent (64% with ≥1 ACE; 32% with ≥3 ACEs) and variable (range = 0 – 8 ACEs) in our sample. ACE exposure was associated with anxiety (r=0.48, p=0.018) and depression symptoms (r=0.48, p=0.024), SE% (r=-0.46, p=0.03), and VEF (r=-0.63, p=0.002), but was not associated with age (p=0.96). SE% was associated with VEF (r=0.59, p=0.004), but not correlated with age, anxiety, or depressive symptoms (all p≥0.14). Multiple linear regression analyses indicated that ACE exposure (β=-0.54, p&lt;0.01) and SE% (β=0.45, p=0.02) predicted VEF independently of anxiety and depression symptoms. Further, SE% mediated the association of ACE exposure with VEF (indirect path β-estimate = -0.08 [95% CI = -0.21 – -0.009). Conclusions: ACE exposure is negatively associated with endothelial function, while SE% is positively associated with endothelial function independently of anxiety or depression symptoms among young adults. Notably, SE% appears to be a mediator in the relation between ACE exposure and endothelial function. Larger studies will be needed to more precisely quantify the role of disturbed sleep in the association of ACE exposure with impaired VEF and to determine whether improving sleep causes improvements in vascular health among those with high ACE exposure. This project was supported, in part, by funding from a pilot grant from the Iowa Injury Prevention Research Center through the CDC (R49 CE003095; NDMJ), an Old Gold Summer Fellowship (University of Iowa; NDMJ), the National Center For Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR002537 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Impact of clinical note format on diagnostic accuracy and efficiency.

Clinician notes are structured in a variety of ways. This research pilot tested an innovative study design and explored the impact of note formats on diagnostic accuracy and documentation review time. To compare two formats for clinical documentation (narrative format vs. list of findings) on clinician diagnostic accuracy and documentation review time. Participants diagnosed written clinical cases, half in narrative format, and half in list format. Diagnostic accuracy (defined as including correct case diagnosis among top three diagnoses) and time spent processing the case scenario were measured for each format. Generalised linear mixed regression models and bias-corrected bootstrap percentile confidence intervals for mean paired differences were used to analyse the primary research questions. Odds of correctly diagnosing list format notes were 26% greater than with narrative notes. However, there is insufficient evidence that this difference is significant (75% CI 0.8-1.99). On average the list format notes required 85.6 more seconds to process and arrive at a diagnosis compared to narrative notes (95% CI -162.3, -2.77). Of cases where participants included the correct diagnosis, on average the list format notes required 94.17 more seconds compared to narrative notes (75% CI -195.9, -8.83). This study offers note format considerations for those interested in improving clinical documentation and suggests directions for future research. Balancing the priority of clinician preference with value of structured data may be necessary. This study provides a method and suggestive results for further investigation in usability of electronic documentation formats.

The indirect effect of positive aspects of caregiving on the relationship between cognitive decline and dementia caregiver burden.

Research has linked increased cognitive decline in a dementia care recipient to worsening caregiver burden, but the presence of positive aspects of caregiving is associated with better outcomes. As cognitive decline worsens, a lack of positive caregiving experiences could lead to burden for the caregiver. This study investigated relationships among dementia caregiver burden, cognitive decline, and positive aspects of caregiving in dementia, predicting an indirect effect of positive aspects of caregiving. Data from 724 patients of an outpatient memory clinic in Ohio were examined and dyads included based on clinically supported patient diagnoses on the dementia spectrum. Caregivers completed the Zarit Burden Interview (ZBI) and Positive Aspects of Caregiving (PAC) measures. The Montreal Cognitive Assessment and Mini-Mental State Examination were used to estimate cognitive decline, standardized to create a single variable. Multiple potential covariates were considered for inclusion in the model. A cross-sectional mediation analysis using the Hayes PROCESS macro explored the presence of an indirect effect of PAC on the relationship between cognitive decline and ZBI using 5000 bootstrap samples. Only the potential covariate caregiver age was correlated with any of the primary variables; this variable was controlled in analyses. Significant relationships emerged between cognitive decline and ZBI (r = -0.12, P < 0.001), between PAC and ZBI (r = -0.23, P < 0.001), and between cognitive decline and PAC (r = -0.07, P < 0.05). An indirect effect of positive aspects of caregiving on the relationship between cognitive decline and ZBI was statistically significant (B = 0.0092, 95% bias-corrected confidence interval: 0.0008, 0.0185), accounting for 14.4% of the variance in the model. A lack of positive aspects of caregiving could be partially responsible for development of dementia caregiver burden as cognitive decline worsens. Longitudinal examination of these relationships is needed to understand causality fully. Findings may help healthcare providers tailor treatment to alleviate caregiver burden.

Supervisor interactional injustice and employee counterproductive work behaviour and organisational citizenship behaviours: the mediating role of distrust

PurposeThe purpose of this paper is to draw on the agent-system model of (in)justice and negative norm of reciprocity of social exchange theory to examine the indirect impact of supervisory interactional injustice (i.e. interpersonal and informational) on employees’ target-specific extra-role work behaviours [counterproductive work behaviour directed at supervisor (CWB-S) and organisational citizenship behaviour directed at supervisor (OCB-S)] via distrust in supervisor.Design/methodology/approachThe authors conducted a two-wave study, and participants (n = 401) were recruited via Amazon Mechanical Turk using a survey methodology. Bias-corrected confidence intervals (CIs) constructed in 20,000 bootstrap samples were used to test the mediation effects.FindingsThe findings indicated that interpersonal and informational injustice are positively related to employees’ distrust in supervisor. Furthermore, interpersonal and informational injustice indirectly affected CWB-S and OCB-S via distrust in supervisor.Research limitations/implicationsSeveral limitations and future research should be discussed. First, the cross-sectional nature of this study prevented us from establishing the causal direction implied by the mediation models in this research. Second, the authors cannot rule out the potential for common method variance. These limitations can be addressed by collecting data from multiple sources (e.g. supervisor and coworkers) at different points in time or by experimental study design. Lastly, the authors did not consider contextual variables (e.g. formal policies, practices, ethical rules and cultural climate) that may influence the proposed relationships’ strengths and directions.Practical implicationsEven though perceptions of distributive and procedural injustice can affect employee deviant behaviours targeted at the organisation and organisational members, the present findings suggest that practitioners should be aware that perceptions of supervisory interactional injustice (i.e. interpersonal and informational) are likely be requited with employees’ extra-role work behaviours targeted at the supervisor. The present findings suggest that, via distrust in supervisor, employees are likely to engage in more CWB-S and fewer OCB-S as a result of supervisory interactional injustice. Considering the costs associated with high CWB-S and low OCB-S, supervisors should be trained in adhering to interactional justice rules. Additionally, supervisors should be mindful and practice caution when interacting with subordinates, to ensure that interactional justice norms are not violated. Lastly, supervisors can seek feedback from subordinates regarding their perceptions of supervisory interactional injustice, as these assessments will allow the supervisors to adapt their behaviours to impede subordinates’ deviant behaviours aimed towards them.Originality/valueThis study contributes to the literature on organisational injustice and workplace behaviour. First, most injustice research assumes that injustice is the opposite of justice; this study examines the effect of interactional injustice. Second, the authors develop a target-specific model focusing on the interactions between two key organisational stakeholders (i.e. supervisors and employees). The authors suggest that supervisor’s disrespect and untruthfulness towards the employee will eventually result in employee revenge (i.e. CWB-S) and lack of cooperation (i.e. OCB-S) towards supervisor. Finally, the authors examine the mechanism (i.e. distrust in supervisor) through which supervisory interactional injustice may ensue in employee extra-role behaviours directed at the supervisor.

Abstract P160: Sex-Differences in Physical Activity-Mediated Associations of Perceived Neighborhood Environments With Severity of Metabolic Syndrome Among Jackson Heart Study Participants

Introduction: Metabolic syndrome (MetS) can lead to harmful effects on cardiovascular health. Assessing whether links between perceived neighborhood social environment (PNSE) and MetS are mediated by physical activity (PA) levels will inform interventions to reduce population-level mortality attributed to MetS. Hypothesis: PNSE will be both directly and indirectly related to MetS severity via PA. Methods: This study utilized baseline data from the Jackson Heart Study, a prospective, community-based cohort of African American adults in Jackson, MS (total sample=3082; mean age 53.3 years; 64% female). PNSE variables included neighborhood violence, problems (higher value=more violence or problems), and social cohesion (higher value=more cohesion). MetS severity Z-score was the outcome (higher score indicates worse MetS). Validated self-reported total PA, based on active living, sports, and home/yard indices, was tested as the mediator. Linear regressions with bootstrap-generated 95% bias-corrected confidence intervals ( BC CIs ) were estimated to test for significant unstandardized indirect effects, controlling for covariates (age, education, smoking status, alcohol consumption, and diet). All analyses were stratified by sex. Results: In women, neighborhood violence, problems, and social cohesion were indirectly related to MetS via PA (B for indirect effects=.04, 95% BC CI =.01, .08; .03, 95% BC CI =.01, .06; and -.03, 95% BC CI =-.07, -.01, respectively). That is, higher violence and problems were related to lower PA (B=-1.06, 95%CI=-1.76, -.36; B=-.79, 95%CI=-1.26, -.32, respectively), while higher social cohesion was associated with higher PA (B=.86, 95%CI=.15, 1.58). In turn, higher PA was associated with lower MetS. All PNSE factors were directly related to MetS (p&lt;.05). In men, neighborhood violence, problems, and social cohesion were indirectly related to MetS via PA (B for indirect effects=.06, 95% BC CI =.02, .12; .04, 95% BC CI =.01, .08; and -.06, 95% BC CI =-.11, -.02, respectively). Again, higher violence and problems were related to lower PA (B=-1.65, 95%CI=-2.58, -.71; B=-1.02, 95%CI=-1.64, -.40, respectively), while higher social cohesion was associated with higher PA (B=1.58, 95%CI=.64, 2.52). In turn, higher PA was associated with lower MetS. No PNSEs were directly related to MetS. Conclusions: Consistent with what we expected, higher perceived neighborhood violence and problems were positively related to MetS, and vice versa for social cohesion. These associations may be explained in part by PA levels. The data showed that indirect effects by PA were more pronounced in men than women. Future interventions to reduce MetS attributed to neighborhood issues should consider PA promotion tailored to women and men in conjunction with community efforts to reduce neighborhood violence and problems and encourage cohesive neighborhoods.

Coverage error optimal confidence intervals for local polynomial regression

This paper studies higher-order inference properties of nonparametric local polynomial regression methods under random sampling. We prove Edgeworth expansions for t statistics and coverage error expansions for interval estimators that (i) hold uniformly in the data generating process, (ii) allow for the uniform kernel, and (iii) cover estimation of derivatives of the regression function. The terms of the higher-order expansions, and their associated rates as a function of the sample size and bandwidth sequence, depend on the smoothness of the population regression function, the smoothness exploited by the inference procedure, and on whether the evaluation point is in the interior or on the boundary of the support. We prove that robust bias corrected confidence intervals have the fastest coverage error decay rates in all cases, and we use our results to deliver novel, inference-optimal bandwidth selectors. The main methodological results are implemented in companion R and Stata software packages.

A Group Videogame-Based Physical Activity Program Improves Walking Speed in Older Adults Living With a Serious Mental Illness.

One of the most overlooked populations in our society and in health care are middle-aged and older adults living with a serious mental illness (SMI) despite the growing numbers of this population. Health care communities, including both inpatient and outpatient mental health programs, have a responsibility to provide care that nurtures clients' mental as well as physical health needs. Providing accessible and engaging physical activity programs is an excellent way to provide this type of holistic care. The purpose of this article is to describe the impact of a pilot videogame-based physical activity program on walking speed in older adults with SMI. A one-group pretest post-test pilot study was conducted with a sample of 52 older adults with SMI recruited from community-based mental health programs. Participants played an active videogame (using the Kinect for Xbox 360 game system; Microsoft, Redmond, WA) for 50-minute group sessions 3 times a week for 10 weeks. Walking speed was assessed with the timed 3-m walk from the Short Physical Performance Battery at enrollment, 5 weeks, and 10 weeks. Participants achieved statistically significant improvement in walking speed (0.10 m/s, bias-corrected confidence interval Lower Limit (LL) 0.04, Upper Limit (UL) 0.15) over a 10-week period. This change represents a clinically and statistically (p ≤ .05) significant improvement in walking speed. Best estimates for clinically meaningful changes in walking speed are 0.05 m/s for a small change and 0.10 m/s for a substantial change. Results suggest that engagement in a group videogame-based physical activity program has the potential to improve walking speed in older adults with SMI. In turn, walking speed is an important indicator of premature mortality and cardiorespiratory fitness.

Comparing methods for assessing a difference in correlations with dependent groups, measurement error, nonnormality, and incomplete data.

I compared multiple methods to estimate and test a difference in correlations (ρdiff) between two variables that are repeatedly measured or originate from dyads. Fisher's z transformed correlations are often used for testing ρdiff. However, raw scores are typically used directly to compute correlations under this popular method, whose performance has not been evaluated with measurement error or nonnormality in data. Structural equation modeling (SEM) can handle measurement error via latent-variable modeling. To handle nonnormality for testing a difference in correlations in dependent groups, when measurement error was of no concern, I discussed SEM using maximum likelihood estimation (ML) with sandwich-type standard errors, ML with bootstrap percentile or bias-corrected confidence intervals, and Bayesian credible intervals. In addition, I also examined a mean- and variance-adjusted likelihood ratio test and the Bollen-Stine bootstrapping model fit test. When measurement error existed, ρdiff was tested under a latent variable model. Furthermore, under the same SEM frameworks with complete data, I also assessed ρdiff with ignorable missing data. A simulation study was conducted considering whether measurement error existed, whether data were normal, and whether data were complete. Empirical examples were used for illustration. Recommendations were then given based on the findings. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

On the relationship between procedural justice and organizational citizenship behavior: a test of mediation and moderation effects

PurposeThis study conceptualizes job engagement and satisfaction as a crucial mediating mechanism in the relationship between procedural justice and citizenship behavior at individual level (OCB) under the boundary conditions of perceived supervisor support (PSS) and rewards and recognition (RR).Design/methodology/approachThe survey data were obtained from two periods of time. To reduce the potential bias, the authors approached respondents from different business units and measured RR and OCB from different points of time. The authors assessed the path significance at 95% bias-corrected confidence interval or more by the PLS algorithm and bootstrapping statistics.FindingsUsing an import-export company data, this study substantiates a positive effect of the proposed mediational mechanism of job engagement and satisfaction. In addition, the authors substantiate moderating roles of PSS and RR in the relationships between procedural justice and job satisfaction and, between job engagement and OCB, respectively.Originality/valueThis study is an important extension in enhancing the procedural justice and OCB relationship. The results do not only underscore the contributions of job engagement and satisfaction as vital mediators to the assumed relationship but also lend support to the inclusion of the moderating effects of PSS and RR.

The relationship between customer mistreatment and workplace deviance: mediating and moderating effects

ABSTRACT Customer mistreatment is common in service interactions. Past research has demonstrated its detrimental effects on employee well-being and work outcomes. Using cognitive-motivational-relational theory as our theoretical lens, we proposed a dual moderated mediation model that examines employee deviant behaviours towards both the customer (service sabotage) and the organization (organizational deviance) in reaction to customer mistreatment through employee anger. We further examined the cognitive (self-accountability attribution) and affective (socio-affective sharing) moderators in this mediation process. Data were collected from 292 front-line service employee-co-worker dyads from Taiwan and analysed using structural equation modelling. Bootstrapping procedures were used in estimating the bias-corrected confidence intervals for the hypothesized moderated mediation. The results indicated that employee anger mediated the relationship between customer mistreatment and employee organizational deviant behaviour. Also, self-accountability attribution interacted with customer mistreatment in influencing employee anger. Additionally, socio-affective sharing interacted with employee anger in influencing service sabotage. The mediating effect of customer mistreatment on service sabotage via employee anger was only significant when socio-affective sharing was low. In contrast, the mediating effect on organizational deviance was nonsignificant when socio-affective sharing was low or when employee self-attribution of accountability was very high. We discuss the theoretical and practical implications of these findings.

On the resilience of health systems: A methodological exploration across countries in the WHO African Region.

The need for resilient health systems is recognized as important for the attainment of health outcomes, given the current shocks to health services. Resilience has been defined as the capacity to “prepare and effectively respond to crises; maintain core functions; and, informed by lessons learnt, reorganize if conditions require it”. There is however a recognized dichotomy between its conceptualization in literature, and its application in practice. We propose two mutually reinforcing categories of resilience, representing resilience targeted at potentially known shocks, and the inherent health system resilience, needed to respond to unpredictable shock events. We determined capacities for each of these categories, and explored this methodological proposition by computing country-specific scores against each capacity, for the 47 Member States of the WHO African Region. We assessed face validity of the computed index, to ensure derived values were representative of the different elements of resilience, and were predictive of health outcomes, and computed bias-corrected non-parametric confidence intervals of the emergency preparedness and response (EPR) and inherent system resilience (ISR) sub-indices, as well as the overall resilience index, using 1000 bootstrap replicates. We also explored the internal consistency and scale reliability of the index, by calculating Cronbach alphas for the various proposed capacities and their corresponding attributes. We computed overall resilience to be 48.4 out of a possible 100 in the 47 assessed countries, with generally lower levels of ISR. For ISR, the capacities were weakest for transformation capacity, followed by mobilization of resources, awareness of own capacities, self-regulation and finally diversity of services respectively. This paper aims to contribute to the growing body of empirical evidence on health systems and service resilience, which is of great importance to the functionality and performance of health systems, particularly in the context of COVID-19. It provides a methodological reflection for monitoring health system resilience, revealing areas of improvement in the provision of essential health services during shock events, and builds a case for the need for mechanisms, at country level, that address both specific and non-specific shocks to the health system, ultimately for the attainment of improved health outcomes.

The Risk of Venous Thromboembolism Attributed to Established Prothrombotic Genotypes.

The proportion of venous thromboembolism (VTE) events that can be attributed to established prothrombotic genotypes has been scarcely investigated in the general population. We aimed to estimate the proportion of VTEs in the population that could be attributed to established prothrombotic genotypes using a population-based case-cohort. Cases with incident VTE (n = 1,493) and a randomly sampled subcohort (n = 13,069) were derived from the Tromsø Study (1994-2012) and the Nord-Trøndelag Health (HUNT) study (1995-2008). DNA samples were genotyped for 17 single-nucleotide polymorphisms (SNPs) associated with VTE. Hazard ratios with 95% confidence intervals (CIs) were estimated in Cox regression models. Population-attributable fractions (PAFs) with 95% bias-corrected CIs (based on 10,000 bootstrap samples) were estimated using a cumulative model where SNPs significantly associated with VTE were added one by one in ranked order of the individual PAFs. Six SNPs were significantly associated with VTE (rs1799963 [Prothrombin], rs2066865 [FGG], rs6025 [FV Leiden], rs2289252 [F11], rs2036914 [F11], and rs8176719 [ABO]). The cumulative PAF for the six-SNP model was 45.3% (95% CI: 19.7-71.6) for total VTE and 61.7% (95% CI: 19.6-89.3) for unprovoked VTE. The PAF for prothrombotic genotypes was higher for deep vein thrombosis (DVT; 52.9%) than for PE (33.8%), and higher for those aged <70 years (66.1%) than for those aged ≥70 years (24.9%). Our findings suggest that 45 to 62% of all VTE events in the population can be attributed to known prothrombotic genotypes. The PAF of established prothrombotic genotypes was higher in DVT than in PE, and higher in the young than in the elderly.