Confirmatory Analysis Research Articles

A competency model for basic public health professionals in public health emergencies.

To develop and validate a comprehensive competency model for basic public health professionals to enhance their response to public health emergencies. Staff working in basic public health institutions such as the Centre for Disease Control, community health services and township health centres were selected as the study population. Through an integrative literature review, structured questionnaire survey (n = 1310), exploratory factor analysis and confirmatory factor analysis, we developed and validated a competency model. Exploratory factor analysis was utilized to extract common factors, and confirmatory factor analysis was employed to establish the model and ensure its robustness. Identified competencies by exploratory factor analysis encompass professional and technical skills, medical professionalism, specialized medical knowledge, cognitive and managerial aptitude, public health service competence, emergency response proficiency and physical and mental quality. The model displayed high validity, with a Kaiser-Meyer-Olkin score of 0.933, the χ2 value of Bartlett's test of sphericity was 4169.238 at 889 degrees of freedom (df) (p < 0.001) and the cumulative contribution rate was 60.7%. The confirmatory analysis yielded a final model fit (χ2/df = 2.461) with satisfactory adjusted fit indicators. This validated competency model provides a robust framework for selecting, training and evaluating basic public health professionals, potentially enhancing overall emergency response capabilities.

Green lean six sigma practices: a scale development and measurement model from an engineer’s perspective

PurposeSince the advent of Industry 4.0, there has been a growing research interest in developing the Green Lean Six Sigma concept in the direction of achieving sustainable development, primarily aligned with Goal 12 of the agenda. Given that the concept is still in its early stages of exploration and requires further development through empirical validation, opportunities exist for innovative research. Yet, difficulties arise in adopting this green initiative due to an inadequate understanding of its strategic practices. Thus, this study aims to establish strategic practices facilitating its adoption in the Industry 4.0 era and develop a validated multi-item scale to measure the practices.Design/methodology/approachA three-phase methodological approach is designed to perform the techniques of exploratory and confirmatory analyses in the manufacturing context. To be a sound study, engineers have been involved since they play a pivotal role in the realm of manufacturing; however, the existing research on engineers' viewpoints on this subject is limited, emphasizing the need for further investigation.FindingsUpon validation of the ultimate fallouts, the analyses demonstrated a confirmatory model with eighteen scales determining five practices: strategic integrity, human resource management, technologies and tools, eco-production, and eco-networks. The findings further revealed robust correlations among these core practices within the model.Originality/valueThe contribution of this study entails depicting and discussing a measurement model for future research since there is currently no empirically validated model available to measure this multidimensional green initiative.

Design and validation of an instrument to evaluate Person-Centered care in health services

BackgroundThe concept of quality in health care has evolved, placing greater importance on the patient’s needs, culture, and social context, as well as their participation in clinical decision-making, as highlighted by Mead and Bower’s Person-Centered Care Model. The aim of the present study was to design and validate an instrument to assess the extent to which healthcare services provided by PEMEX (Petróleos Mexicanos) offer person-centered care according to user perceptions.MethodsThe first phase comprised the development of 57 items based on the analysis of responses from an open-ended questionnaire administered to 30 users of Pemex healthcare services. This questionnaire was designed considering the four factors of the person-centered care model, however, the high correlation between the 4 factors (i.e., r ≥ .80) indicated an overfactoring effect and consequently an increase in the risk of overfitting. Therefore, an exhaustive analysis of the instrument was performed, starting with the review of the individual behavior of each item, and carrying out exploratory and confirmatory factor analysis. Using a sample of 330 individuals, an exploratory factor analysis was perfomed. Afterward, a confirmatory factorial analysis was carried out with 335 participants. Finally, a new confirmatory factorial analysis included 130 participants due to the refinements made in the previous phase. Internal consistency was assessed using Cronbach’s α and McDonald’s ω at every phase.ResultsThe exploratory factor analysis retained 35 items in a single factor that accounted for 49% of the variance with an internal consistency of Cronbach’s α and McDonald’s ω = 0.97. Because the factorial structure by confirmatory factorial analysis was unsatisfactory, the initial model was refined, leading to the retention of 11 items and a final model with adjustment index of χ2 = 127.53, χ2/gl = 2.89, RMSEA = 0.07, IC RMSEA 0.06 to 0.09, TLI = 0.95 and CFI = 0.96, with an internal consistency of Cronbach’s α and McDonald’s ω = 0.93. Due to the refinements, a new confirmatory factorial analysis was conducted with suitable goodness-of-fit criteria in most items (χ2 = 151.44, χ2/gl = 3.43, RMSEA = 0.13, IC RMSEA 0.11 to 0.16, TLI = 0.93 and CFI = 0.94), resulting in a Cronbach’s α and McDonald’s ω = 0.98.ConclusionsThe instrument exhibits suitable psychometric properties to be employed to measure the degree to which medical care is patient centered. This instrument represents a strategy for promoting an innovative healthcare model.

The moral role models scale: Assessing connections to and functions of moral exemplars

ABSTRACT Recent accounts of character formation highlight the role of admiring and emulating moral role models or exemplars as a key facilitator of moral development. However, validated measures that assess the extent to which individuals affiliate with and are impacted by moral exemplars have not been developed. The present research fills this gap by developing and providing initial validity evidence for the Moral Role Models Scale (MRMS). Through exploratory and confirmatory analyses of data drawn from 456 participants, a single-factor version (10 items) of the MRMS was found to have both strong internal structure and satisfactory convergent and discriminant validity. The MRMS can be a useful tool to both researchers and practitioners of character education in exploring, clarifying, and evaluating the role of moral exemplars in moral formation.

Comparative effectiveness of vancomycin and metronidazole on event-free survival after initial infection in patients with Clostridioides difficile—a German multicentre cohort study

ObjectivesThe objective of this study is to examine the comparative effectiveness of vancomycin and metronidazole in a confirmatory analysis of event-free survival (EFS) after initial infection in patients with Clostridioides difficile from a German multicentre cohort study. MethodsThe IBIS multicentre cohort enrolled patients with an index episode of C. difficile infection between August 2017 and September 2020. The primary endpoint was EFS, defined as response to treatment with metronidazole or vancomycin within 10 days of initiation, absence of recurrence and death from any cause up to 90 days post-treatment. A Cox proportional hazards model with inverse probability of treatment weighting was used to investigate the comparative effectiveness of this outcome. Additionally, subgroup analyses were performed based on severe and non-severe infections. ResultsOf the 489 patients included, 118 (24%) received initial treatment with metronidazole and 371 (76%) with vancomycin. Of these, 78/118 (66.1%) and 247/371 (66.6%), respectively, responded to treatment within 10 days, neither developed a recurrence nor died within 90 days and thus achieved the outcome of EFS. In the subgroup of non-severe infections, 74/293 patients (25.3%) received metronidazole, and 219/293 (74.7%) received vancomycin. Of these, 33/74 (44.6%) metronidazole patients and 150/219 (68.5%) vancomycin patients survived event free. The Cox proportional hazards model revealed differences in EFS for the overall population and both subgroups (reference metronidazole: all severity levels: hazard ratio [HR] 0.46, [95% CI, 0.33–0.65]; non-severe: HR 0.39; [95% CI, 0.24–0.60]; severe: HR 0.52; [95% CI, 0.28–0.95]). DiscussionOur analysis confirms current changes in guidelines, as it supports the superiority of vancomycin compared with metronidazole across all severity levels.

Integrative taxonomy reveals inflated biodiversity in the European Temnothorax unifasciatus complex (Hymenoptera: Formicidae)

AbstractTemnothorax unifasciatus (Latreille, 1798) is a widely distributed pan‐European species from the Iberian Peninsula to the Caucasus. This taxon's relatively high morphological variability prompts the taxonomists of earlier times and today to mention the morphologically different elements at specific or subspecific ranks. This paper aims to understand the population structure and genetic diversity within this lineage via integrative taxonomy, incorporating molecular phylogenetics, species delimitation analyses and multivariate analyses of continuous morphometric data from across the geographic range of the T. unifasciatus complex. Phylogenetic analyses yielded incongruent trees. The genealogical diversity index (gdi) and the confirmatory analyses on morphological data found only weak, ambiguous delimitations within the unifasciatus complex. The most highly supported scenario splits T. brackoi from the remaining unifasciatus complex with ambiguous support (gdi = 0.56). This scenario is supported by multivariate morphometry with 100% accuracy in classification success. Instead, our results suggest complex morphological and genetic population structuring within the broad range of T. unifasciatus. Therefore, we confirm the validity of two species, T. brackoi Salata &amp; Borowiec, 2019 and T. unifasciatus (Latreille, 1798), and propose five new junior synonymies, T. cordieri (Bondroit, 1918) syn. nov., T. tauricus (Ruzsky, 1902) syn. nov., T. berlandi (Bondroit, 1918) syn. nov., T. unifasciatus staegeri (Bondroit, 1918) syn. nov., T. tuberum ciscaucasicus (Arnol'di, 1977) syn. nov. with the latter. To achieve maximal taxonomic stability, we designated a lectotype for Temnothorax unifasciatus (Latreille, 1798).

Association between diabetes mellitus and giant cell arteritis: a bidirectional 2-sample mendelian randomization study

ObjectiveRecent studies have indicated a potential association between giant cell arteritis (GCA) and diabetes mellitus, encompassing both type 1 diabetes (T1D) and type 2 diabetes (T2D). However, the exact nature of this relationship requires further investigation to be fully elucidated.MethodsGenetic links between T1D/T2D and GCA were explored using data from genome-wide association studies available to the public, focusing on populations of European ancestry. We applied a bidirectional mendelian randomization (MR) approach to assess the potential association between these diseases. Confirmatory analyses, including additional datasets and a comprehensive meta-analysis, were utilized. The inverse-variance-weighted (IVW) method was applied to pinpoint heterogeneity and pleiotropy, while subsequent sensitivity analyses aimed to trace the origins of any heterogeneity.ResultsInitial analysis demonstrated a correlation between T1D and an elevated likelihood of developing GCA (IVW odds ratio = 1.33, with a 95% confidence interval of 1.22–1.46, and a P-value of 9.42E−10). The causal association was verified through four validation datasets and meta-analysis (all P-value < 0.001). However, the reverse MR analysis was unable to detect any genetic basis for the increased risk of T1D due to GCA. Furthermore, we could not establish any causal links between T2D and GCA.ConclusionT1D patients may have a higher risk of developing GCA, whereas an inverse causal relationship was not evident. Furthermore, no causal relationship was detected between T2D and GCA. These insights shed light on the possible pathological mechanisms underlying GCA and may influence the future clinical handling of both T1D and GCA.

Greater ventral striatal functional connectivity in cigarette smokers relative to non-smokers across a spectrum of alcohol consumption.

Cigarette smoking is associated with elevated risk of disease and mortality and contributes to heavy healthcare-related economic burdens. The nucleus accumbens is implicated in numerous reward-related behaviors, including reinforcement learning and incentive salience. The established functional connectivity of the accumbens includes regions associated with motivation, valuation, and affective processing. Although the high comorbidity of cigarette smoking with drinking behaviors may collectively affect brain activity, there could be independent effects of smoking in alcohol use disorder that impact brain function and behavior. We hypothesized that smoking status, independent of alcohol use, would be associated with aberrations of nucleus accumbens functional connectivity to brain regions that facilitate reward processing, salience attribution, and inhibitory control. Resting state functional magnetic resonance imaging data from thirty-one nonsmokers and nineteen smoking individuals were analyzed using seed-based correlations of the bilateral accumbens with all other brain voxels. Statistical models accounted for drinks consumed per week. The smoking group demonstrated significantly higher functional connectivity between the left accumbens and the bilateral insula and anterior cingulate cortex, as well as hyperconnectivity between the right accumbens and the insula. Confirmatory analyses using the insula and cingulate clusters generated from the original analysis as seed regions reproduced the hyperconnectivity in smokers between the bilateral insular regions and the accumbens. In conclusion, smoking status had distinct effects on neural activity; hyperconnectivity between the accumbens and insula in smokers may reflect enhanced encoding of the reinforcing effects of smoking and greater orientation toward smoking-associated stimuli.

Enhanced analysis of equine plasma for the presence of recombinant human erythropoietin - Implementation of an improved workflow.

An improved screening workflow and a robust capillary flow LC-MS confirmatory method for the detection of recombinant human erythropoietin (rHuEPO) has been implemented to increase the sensitivity of rHuEPO detection and to reduce the number of suspect samples committed to confirmatory testing. The influence of repeated dosing of epoetin-β on the detection window of rHuEPO in equine plasma was assessed using the optimised method. Samples were initially assessed using an economical R&D Human EPO Duo-Set ELISA Development System. Samples indicating a result greater than the batch baseline were analysed using the complementary R&D Human EPO Quantikine IVD ELISA kit. All samples recording an abnormal screening result were subjected to confirmatory analysis. Confirmation of rHuEPO in plasma (≥2.5ml) in the range of 4-13 mIU/ml (n = 6) was achieved using immunoaffinity enrichment, tryptic digestion, and capillary flow LC-MS/MS. Four horses were administered a single dose of epoetin-β (10,000 IU) via the subcutaneous and intravenous routes, on two occasions, seven days apart. The excretion profile was rapid with epoetin-β detection times of 48 to 72 h following each administration, with no appreciable difference observed between the two routes of administration. This workflow has been shown as an effective anti-doping strategy related to rHuEPO misuse and supports the use of out-of-competition testing of horses in the 2 to 3-day period prior to race-day.

Confirmatory analysis of the 13-MD and ranking of its meta-dimensions and items.

The 13-MD is a new generic instrument developed to measure general health-related quality of life (GHRQoL). This instrument considers all aspects of health (i.e., physical, mental, and social) in a balanced way. A previous study led to minor changes in the original version of the 13-MD. The objective of this study was to confirm the validity of the modified 13-MD. Validity was assessed with recent data from the general population of Quebec, Canada. The meta-dimensions and items composing the 13-MD were also subjected to a ranking procedure, which allowed to determine the most important aspects for respondents. A total of 1337 French-speaking participants were recruited with 1099 completing the 13-MD for validation purposes and 1084 completing the ranking procedure. The 13-MD showed very satisfactory results and confirmed to be a valid instrument. The ranking of the meta-dimensions revealed that "Well-being" received the most points, followed by "Sleep and energy" and "Body functioning." These results will be very useful in the continuous improvement of the 13-MD, ultimately leading to the valuation stage (i.e., development of a value set).

Assessing Decision Fatigue in General Practitioners' Prescribing Decisions Using the Australian BEACH Data Set.

General practitioners (GPs) make numerous care decisions throughout their workdays. Extended periods of decision making can result in decision fatigue, a gradual shift toward decisions that are less cognitively effortful. This study examines whether observed patterns in GPs' prescribing decisions are consistent with the decision fatigue phenomenon. We hypothesized that the likelihood of prescribing frequently overprescribed medications (antibiotics, benzodiazepines, opioids; less effortful to prescribe) will increase and the likelihood of prescribing frequently underprescribed medications (statins, osteoporosis medications; more effortful to prescribe) will decrease over the workday. This study used nationally representative primary care data on GP-patient encounters from the Bettering the Evaluation and Care of Health program from Australia. The association between prescribing decisions and order of patient encounters over a GP's workday was assessed with generalized linear mixed models accounting for clustering and adjusting for patient, provider, and encounter characteristics. Among 262,456 encounters recorded by 2,909 GPs, the odds of prescribing antibiotics significantly increased by 8.7% with 15 additional patient encounters (odds ratio [OR] = 1.087; confidence interval [CI] = 1.059-1.116). The odds of prescribing decreased significantly with 15 additional patient encounters by 6.3% for benzodiazepines (OR = 0.937; CI = 0.893-0.983), 21.9% for statins (OR = 0.791; CI = 0.753-0.831), and 25.0% for osteoporosis medications (OR = 0.750; CI = 0.690-0.814). No significant effects were observed for opioids. All findings were replicated in confirmatory analyses except the effect of benzodiazepines. GPs were increasingly likely to prescribe antibiotics and were less likely to prescribe statins and osteoporosis medications as the workday wore on, which was consistent with decision fatigue. There was no convincing evidence of decision fatigue effects in the prescribing of opioids or benzodiazepines. These findings establish decision fatigue as a promising target for optimizing prescribing behavior. We found that as general practitioners progress through their workday, they become more likely to prescribe antibiotics that are reportedly overprescribed and less likely to prescribe statins and osteoporosis medications that are reportedly underprescribed.This change in decision making over time is consistent with the decision fatigue phenomenon. Decision fatigue occurs when we make many decisions without taking a rest break. As we make those decisions, we become gradually more likely to make decisions that are less difficult.The findings of this study show that decision fatigue is a possible target for improving guideline-compliant prescribing of pharmacologic medications.

Validation of the SCALE/Polaris–PARCS Code Procedure With the ENDF/B-VII.1 AMPX 56-Group Library: Boiling Water Reactor

The SCALE/Polaris–PARCS code procedure has been used in the confirmatory analysis for boiling water reactors by the US Nuclear Regulatory Commission. In this study, the SCALE/Polaris v6.3.0–PARCS v3.4.2 code procedure with the Evaluated Nuclear Data File (ENDF)/B-VII.1 AMPX 56-group library was validated by comparing the simulated results with the measured data for operating boiling water reactors, including Peach Bottom Unit 2 cycles 1–3, Hatch Unit 1 cycles 1–3, and Quad Cities Unit 1 cycles 1–3. The uncertainties and biases of the SCALE/Polaris–PARCS code package for boiling water reactor physics analysis were evaluated in the validation for key nuclear parameters such as reactivity and traversing in-core probe data.

A higher-order job crafting mediation model with PLS-SEM: relationship between organizational identification and communication satisfaction

AbstractIn recent years, global events have redefined working life, stimulating new organizational models. This work focuses on job crafting, which is considered the way to improve the relationship between some organizational variables and other individual variables such as organizational identification and satisfaction with communication, both of which are crucial to achieving sustainable levels of well-being. The study examines the role of latent constructs that can promote adaptive responses as well as their relations. In particular, we focus on organizational identification in promoting adaptive responses, including the increase in structural resources, the increase in challenging demands, and the increase in social resources as adaptive strategies to improve satisfaction with communication. The analysis is carried out using robust statistical techniques that are suited to the study of causal relations between abstract constructs. Specifically, after Confirmatory Composite Analysis (CCA-PLS) to evaluate the quality of the data collected, a higher order mediation model, based on partial least squares structural equation modeling (PLS-SEM), was performed to test the mediation role of the job crafting. In addition, we prioritize such latent constructs using importance–performance map analysis (IPMA) to evaluate the relevance and performance of each construct of this model. The results show a relationship between organizational identification, corresponding to a high sense of belonging, and communication satisfaction at all levels through the mediation of job crafting.

From antibiotic to antiviral: computational screening reveals a multi-targeting antibiotic from Streptomyces spp. against Nipah virus fusion proteins.

Nipah Virus is a re-emerging zoonotic paramyxovirus that poses a significant threat to both swine industry and human health. The pursuit of potential antiviral agents with both preventive and therapeutic properties holds promise for targeting such viruses. To expedite this search, leveraging computational biology is essential. Streptomyces is renowned for its capacity to produce large and diverse metabolites with promising bioactivities. In the current study, we conducted a comprehensive structure-based virtual screening of 6524 Streptomyces spp. metabolites sourced from the StreptomeDB database to evaluate their potential inhibitory effects on three Nipah virus fusion (NiVF) protein conformations: NiVF pre-fusion 1-mer (NiVF-1mer), pre-fusion 3-mer (NiVF-3mer), and NiVF post-fusion (NiVF-PoF). Prior to virtual screening, the drug-likeness of Streptomyces spp. compounds was profiled using ADMET properties. From the 913 ADMET-filtered compounds, the subsequent targeted and confirmatory blind docking analysis revealed that S896 or virginiamycin M1, a known macrolide antibiotic, showed a maximum binding affinity with the NiVF proteins, suggesting a multi-targeting inhibitory property. In addition, the 200-ns molecular dynamics simulation and MM/PBSA analyses revealed stable and strong binding affinity between the NiVF-S896 complexes, indicating favorable interactions between S896 and the target proteins. These findings suggest the potential of virginiamycin M1, an antibiotic, as a promising multi-targeting antiviral drug. However, in vitro and in vivo experimental validations are necessary to assess their safety and efficacy.

Scale of Perceptions of Future Primary School Teachers on Unaccompanied Foreign Minors: Exploratory and Confirmatory Analysis

Scale of Perceptions of Future Primary School Teachers on Unaccompanied Foreign Minors: Exploratory and Confirmatory Analysis

Reliability and validity of the online Pittsburgh sleep quality index in college students from low-income regions.

We aimed to test the reliability and structural validity (also called dimensionality) of the online Pittsburgh Sleep Quality Index among college students from low-income regions. We assessed 195 Brazilian college students from a low-income region (Gini index of 0.56), of whom 117 were reassessed to evaluate the reliability. We collected all data in a self-reported online twice, 2-week apart. We evaluated reliability and structural validity. All questionnaire components showed reliability, correlation coefficient ≥0.49. In the structural validity, the confirmatory analysis showed better global model adjustment for the one-factor (RMSEA = 0.019; SRMR = 0.041; CFI = 0.992; TLI = 0.986) solution compared with two-factor (RMSEA = 0.099; SRMR = 0.070; CFI = 0.764; TLI = 0.619) and three-factor (RMSEA = 0.108; SRMR = 0.066; CFI = 0.763; TLI = 0.548) solutions, respectively. The online questionnaire presents acceptable reliability and structural validity in Brazilian low-income regions.

Phylogenetic signatures reveal multilevel selection and fitness costs in SARS-CoV-2.

Large-scale sequencing of SARS-CoV-2 has enabled the study of viral evolution during the COVID-19 pandemic. Some viral mutations may be advantageous to viral replication within hosts but detrimental to transmission, thus carrying a transient fitness advantage. By affecting the number of descendants, persistence times and growth rates of associated clades, these mutations generate localised imbalance in phylogenies. Quantifying these features in closely-related clades with and without recurring mutations can elucidate the tradeoffs between within-host replication and between-host transmission. We implemented a novel phylogenetic clustering algorithm ( mlscluster, https://github.com/mrc-ide/mlscluster) to systematically explore time-scaled phylogenies for mutations under transient/multilevel selection. We applied this method to a SARS-CoV-2 time-calibrated phylogeny with >1.2 million sequences from England, and characterised these recurrent mutations that may influence transmission fitness across PANGO-lineages and genomic regions using Poisson regressions and summary statistics. We found no major differences across two epidemic stages (before and after Omicron), PANGO-lineages, and genomic regions. However, spike, nucleocapsid, and ORF3a were proportionally more enriched for transmission fitness polymorphisms (TFP)-homoplasies than other proteins. We provide a catalog of SARS-CoV-2 sites under multilevel selection, which can guide experimental investigations within and beyond the spike protein. This study provides empirical evidence for the existence of important tradeoffs between within-host replication and between-host transmission shaping the fitness landscape of SARS-CoV-2. This method may be used as a fast and scalable means to shortlist large sequence databases for sites under putative multilevel selection which may warrant subsequent confirmatory analyses and experimental confirmation.

Investigating a Novel Approach to Assessing Vocabulary Knowledge

This study explored an alternative approach to assessing individuals’ word knowledge by gauging the ability to recognize subtle similarities and differences among associated terms. Informed by the theoretical and empirical work on relational reasoning, the Measure of Vocabulary Knowledge through Relational Reasoning (MVKR2) was developed and validated. Participants were 338 college students who completed the MVKR2, the Test of Relational Reasoning (TORR), and released items from the SAT Verbal and Math tests. The TORR and SAT tests were administered to examine the convergent and concurrent validities of the MVKR2. Findings from item confirmatory analyses and correlations demonstrated that the MVKR2 is a reliable and valid measure of vocabulary knowledge for college-age students. In addition, fluid relational reasoning ability was associated with the performance on this novel measure, but the association with vocabulary knowledge was stronger. When examined on the scale and item levels, the contribution of fluid relational reasoning varied across scales and items within each scale. This study offered an alternative way to examine vocabulary knowledge that has implications for future empirical research and instructional practice.

Validation of the Portuguese version of the diabetes self-management questionnaire-revised (DSMQ-R) in people with type 2 diabetes mellitus

BackgroundReflecting people with diabetes’ self-management activities is often required in both research and clinical practice. This study evaluated the measurement properties of the Portuguese version of the Diabetes Self-Management Questionnaire-Revised (DSMQ-R) on a sample of people with type 2 diabetes mellitus (T2DM).MethodsTranslation and cultural adaptation were conducted according to guidelines for cross-cultural adaptation and validation of healthcare measurement instruments. A cross-sectional study was performed including 365 people with T2DM in primary care. Reliability, construct validity, and criterion validity were analyzed.ResultsThe total scale of the translated DSMQ-R revealed sufficient internal consistency (alpha = 0.82), and most of the subscales performed adequately. The exploratory factor structure was robust, and confirmatory analysis showed a good model fit with the scale structure of the original scale. The scale scores correlated with the participants’ last HbA1c estimates, supporting convergent validity, and convergence was confirmed by the adequate average variance extracted.ConclusionsThe Portuguese version of the DSMQ-R is a reliable and valid tool for gauging self-management behaviors in people with T2DM and their relationship with glycemic values.

Translation and validation to the Arabic language version of the climate change anxiety scale (CCAS)

BackgroundThe Arab world is one of the global regions the most directly concerned by, and suffering from climate change’s adverse consequences. As such, there appears to be a strong need for an understanding of how Arab people may emotionally respond to climate change. Providing valid and reliable measures of climate change anxiety (CCA) can help gain a clear overview of the situation in Arab countries, and allow to intervene timely and effectively to mitigate any adverse effects on Arab people’s mental health. To this end, the present study sought to validate the Arabic language version of the Climate Change Anxiety Scale (CCAS) in a sample of native Arabic-speaking adults from the general population of Lebanon.MethodsThis study adopted a cross-sectional approach and enrolled 763 adults between July and September 2023.ResultsA confirmatory analysis of the one-factor model showed poor fit indices as follows: CFI = 0.90, GFI = 0.83, SRMR = 0.048 and RMSEA 0.131 [90% CI 0.123, 0.138). The two-factor model showed a satisfactory fit with a high CFI of and a GFI of 0.91 and a SRMR of 0.04 and RMSEA of 0.05 [90% CI 0.04, 0.06]. Both McDonald’s omega and Cronbach alpha values were high for the overall CCAS score (α = 0.96 and ω = 0.96) in the whole sample. Configural, metric and scalar invariance across gender was demonstrated. No significant difference was found between males and females in terms of total CCAS scores (24.53 ± 10.59 vs. 26.03 ± 11.17, t(761) = -1.82, p = .069). Higher CCA, functional impairment and cognitive impairment scores were significantly associated with higher depression, anxiety and stress.ConclusionThe reliability and validity of the CCAS in its Arabic version were proven. The availability of this self-report measure could offer a chance to assess CCA among Adults speaking Arabic, and to spread its future use for screening and research purposes.