Confirmatory Sample Research Articles

The Chinese version of the Nursing Student Academic Resilience Inventory: A validity and reliability study

AimTo translate and adapt the Nursing Student Academic Resilience Inventory (NSARI) into Chinese and assess its validity and reliability among Chinese nursing students. BackgroundNursing students frequently encounter stress during their clinical education and academic resilience is an important skill to help students withstand stress. The NSARI is a valid and reliable tool for assessing the level of academic resilience of nursing students during clinical practice. Currently, there is no valid and reliable measurement tool to assess academic resilience for nursing students in China. DesignA descriptive, methodological and cross-sectional design was used. MethodThis study was conducted on 600 nursing students in Northeast China. A socio-demographic form, the Chinese version of the NSARI and the nurse resilience scale were used for data collection between May to November 2023. The exploratory factor analysis and confirmatory factor analysis samples comprised 300 students, respectively, to test the structural validity of the inventory. In addition, internal consistency and invariance analyses were conducted to assess the reliability of the inventory. ResultsThe Chinese version of NSARI comprises 24 items separated into six dimensions. Exploratory factor analysis extracted six factors, with a cumulative variance contribution rate of 71.908%. Confirmatory factor analysis showed a satisfactory fit. Cronbach’s alpha coefficient for the internal consistency of the total inventory was 0.939 with a test-retest stability reliability value of 0.957. ConclusionThe Chinese version of NSARI is a valid and reliable measurement tool for assessing the level of academic resilience of nursing students during clinical placement.

Prospective study on stereotactic body radiotherapy for small pancreatic neuroendocrine tumors: tolerance and effectiveness analysis.

Surgery is the standard treatment for pancreatic neuroendocrine tumors (pNETs), obtaining favorable results but associating high morbidity and mortality rates. This study assesses stereotactic body radiation therapy (SBRT) as a radical approach for small (< 2cm) nonfunctioning pNETs. From January 2017 to June 2023, 20 patients with small pNETs underwent SBRT in an IRB-approved study. Endpoints included local control, tolerance, progression-free survival, and overall survival (OS). Diagnostic assessments comprised endoscopy, CT scans, OctreScan or PET-Dotatoc, abdominal MRI, and histological confirmatory samples. In a 30-month follow-up of 20 patients (median age 55.5years), SBRT was well-tolerated with no grade > 2 toxicity. 40% showed morphological response, 55% remained stable. Metabolically, 50% achieved significant improvement. With a median OS of 41.5months, all patients were alive without local or distant progression or need for surgical resection. SBRT is a feasible and well-tolerated approach for small neuroendocrine pancreatic tumors, demonstrating effective local control. Further investigations are vital for validation and extension of these findings.

Children of parents with a mental illness - stigma questionnaire: validation and revision.

Mental disorders are often stigmatized in society. The stigma of mental illness affects people with a mental illness themselves as well as their family members-a phenomenon called stigma by association (SBA). Children of parents with a mental illness (COPMI) are a particular vulnerable group for SBA. In our systematic review, experienced SBA, anticipated SBA, affiliate SBA, and structural discrimination were identified as relevant stigma dimensions for children of parents with a mental illness. To assess SBA in adolescents who grow up with a parent with a mental illness, the COPMI-SQ was developed. N = 930 adolescents completed the study. Of those, N = 380 adolescents (sample 1; 72.6% female, mean age 17.12 (SD = 2.01) years) reported growing up with at least one parent with a mental illness. Using confirmatory (CFA) and exploratory factor analyses (EFA) as well as standard item and reliability analyses, we analyzed and revised the COPMI-SQ in the first sample. To validate the factorial structure of the revised COPMI-SQ, CFA was also conducted in the independent sample of the other N = 550 adolescents (sample 2; 80.0% female, mean age 16.36 (SD = 1.98) years) who reported not growing up with a parent with a mental illness. To test four measurement invariance, a multiple-group CFA was conducted in the combined sample of adolescents who reported growing up with and without a parent with a mental illness (sample 1 and sample 2). CFA in sample 1 resulted in an inadequate model fit for the theoretically assumed four-factor structure (CFI = .687; RMSEA = .064 (90% CI = .062-.066); SRMR = .092; AIC = 229 155.63). Following EFA and item and reliability analyses in sample 1, the COPMI-SQ was reduced to four scales ("Experienced SBA," "Affiliate SBA," "Shame," and "Anticipated SBA") and two additional screening scales ("Healthcare" and "Social support"). To facilitate questionnaire use, only the three best items were retained in each scale, reducing the total item number to 12 plus five additional screener items. CFA in sample 2 also resulted in an inadequate model fit for the theoretically assumed four factor structure (CFI = .667; RMSEA = .065 (90% CI = .063-.066); SRMR = .101; AIC = 335 651.99). In comparison, the final version of the COPMI-SQ-r showed the best model fit (CFI = .945; RMSEA = .062 (90% CI = .052-.072); SRMR = .049; AIC = 60 008.05). In the multiple-group CFA (sample 1 and sample 2), metric invariance was established (χ2 (208) = 481.58, p < .001; CFI = .939; RMSEA = .053 (90% CI = .047-.059); SRMR = .056). In sample 2, internal consistency was found to be good for the total scale (α = .84) and almost acceptable to almost good for the subscales (α = .64 to.78). The revised version of the COPMI-SQ (COPMI-SQ-r) is a reliable and economic questionnaire to assess SBA in adolescents who grow up with a parent with a mental illness. The COPMI-SQ-r can be used to help develop and evaluate anti-stigma and general interventions for affected adolescents.

Aspirin Responsiveness in a Cohort of Pediatric Patients with Right Ventricle to Pulmonary Artery Conduits and Transcatheter Valve Replacement Systems.

The aim of this study was to determine the rate of aspirin responsiveness in a cohort of pediatric patients with in situ xenograft valved right ventricle to pulmonary artery (RV-PA) conduits and/or transcatheter valve replacements (TVR). Aspirin is routinely prescribed to these patients. Optimizing anti-platelet therapy could promote valve longevity and reduce the risk of infective endocarditis in this at-risk group. This was a prospective, observational study. Patients were recruited from both ward and outpatient settings. Patients were eligible if under 18 years and taking aspirin. Non-response to aspirin was defined as >20% platelet aggregation using light transmission platelet aggregometry (LTA) and <50% platelet inhibition by thromboelastography with platelet mapping (TEGPM). Participants were invited to provide a confirmatory sample in cases of aspirin resistance and dose adjustments were made. Thirty patients participated. Median age was 9 years (2 months to 18 years). The majority (93%) had complex right ventricular outflow tract pathology. 13 (43%) had an RV-PA conduit and 24 (80%) had a TVR, with valve situated in conduit in 7 (23%) cases. Rate of aspirin non-response on initial testing was 23% (n=7/30) with median LTA 74.55% (60-76%) and TEG 13.25% (0-44%) in non-responders. Non-responders were more likely to be under 1 year. Two patients required dose increases and one patient non-adherence to dose was identified. Four patients on repeat testing were responsive to aspirin by laboratory tests. The rate of aspirin non-response on laboratory testing in this cohort of patients was 23% and resulted in therapeutic intervention in 10%.

Multidimensional Measurement of Attitudes Toward Consensual Non-Monogamy

ABSTRACT Despite increased interest in consensual non-monogamy (CNM), significant stigma remains against CNM. Consequently, there is a need for scales to assess attitudes toward CNM. In response to this need we developed the Multidimensional Attitudes toward CNM Scale (MACS). Items were developed in consultation with content experts and data were collected from two samples at two different Canadian Universities. Fit indices of exploratory (Sample A) and confirmatory (Sample B) factor analysis suggested a 16-item scale with three underlying factors: CNM is Dysfunctional, CNM is Immoral, and CNM is Healthy and Satisfying. Validity analyses, conducted using the combined sample (n = 806; 79% women; 67% heterosexual), demonstrated that participants with higher MACS total scores (i.e. more negative attitudes) were less likely to have ever been involved in a CNM relationship and were more likely to report monogamy as their ideal relationship style. Higher MACS scores were also associated with more negative attitudes toward bisexuality and toward women, and higher scores on measures of homophobia and jealousy. In contrast, individuals with higher scores on the CNM is Healthy subscale tended to score higher on measures of empathy. The MACS demonstrates strong psychometric properties and can assist in better understanding attitudes toward CNM relationships in research and clinical settings.

Another way to measure balanced time perspective: Development and validation of the Time Perspective Inventory.

The existing scales for measuring balanced time perspective (BTP) have limitations, such as poor-fitting structures or a complex calculation method. Based on previous studies, we conceptualize BTP as an individual's overall positive outlook on the past and future and mindfully living in the present. The present study aimed to develop the Time Perspective Inventory (TPI) for Chinese adults, determine its psychometric properties, and examine a simple calculation method for generating a score to represent BTP. In study 1, a 7-factor structure of TPI - Past Positive, Past Negative, Mindful Present, Present Hedonistic, Present Excessively Task-oriented, Future Positive, and Future Negative - was established through exploratory (sample 1, N = 529) and confirmatory (sample 2, N = 577) factor analyses. Findings supported the internal consistency, test-retest reliability, and criterion-related validity of the TPI. We proposed using the score difference between positive time perspectives and negative time perspectives to calculate the BTP. Findings showed that the correlations between BTP and subjective well-being indicators and anxiety were higher than among individual dimensions of TPI. Study 2 (sample 3, N = 713) compared the effects of the TPI and the Chinese version of the Zimbardo Time Perspective Inventory (ZTPI-C) on well-being indicators and anxiety. Results indicated that the variance of life satisfaction, positive affect, negative affect, and anxiety explained by BTP measured with TPI was higher than deviation from BTP (DBTP) measured with ZTPI-C. Together, the TPI yields reliable and valid BTP scores among Chinese adults.

Turkish version of the Adlerian inferiority and superiority complex shortened scales: Validity and reliability

The aim of this study was to test the psychometric properties of Adlerian Inferiority and Superiority Complex Shortened Scales in a Turkish sample. Exploratory factor analysis sample consisted of 331 individuals (192 female and 139 men) between the ages of 15 and 65, while confirmatory factor analysis sample consisted of 192 individuals (113 female and 79 men) between the ages of 15 and 64. As a result of exploratory factor analysis, inferiority complex showed a structure of 10 items, while superiority complex showed a structure of 9 items. Confirmatory factor analysis showed that the scales had acceptable fit values in a two-factor structure. Findings related to the internal consistency coefficient, test-retest reliability and concurrent validity showed that Adlerian Inferiority Complex and Superiority Complex Shortened Scales are valid and reliable tools for evaluate the inferiority and superiority complex levels of individuals aged 15 and older in Turkey sample.

Home capillary sampling and screening for type 1 diabetes, celiac disease, and autoimmune thyroid disease in a Swedish general pediatric population: the TRIAD study.

To screen a general pediatric population for type 1 diabetes (T1D), celiac disease (CD), and autoimmune thyroid disease (AITD) after home capillary sampling. Swedish schoolchildren between 6-9 years and 13-16 years of age were invited to screening by taking a capillary sample at home. Samples were returned by mail and assessed for autoantibodies associated with T1D, CD, and AITD. Persistently autoantibody-positive children were referred for clinical follow-up. Of 19,593 invited, 3,527 (18.0%) consented to participate and 2,315/3,527 (65.6%) returned a blood sample of sufficient volume. Hemolysis occurred in 830/2,301 (36.1%) samples. After exclusion of 42 children with previously known T1D, CD, or AITD, and two autoantibody-positive children who declined a confirmatory sample, 2,271/19,593 (11.6%) were included. 211/2,271 (9.3%) had persistent autoantibodies: 60/2,271 (2.6%) with T1D autoantibodies, 61/2,271 (2.7%) with CD autoantibodies, and 99/2,271 (4.4%) with AITD autoantibodies; 9/2,271 (0.4%) were autoantibody positive for ≥1 disease. After clinical follow-up, 3/2,271 (0.1%) were diagnosed with T1D, 26/2,271 (1.1%) with CD, and 6/2,271 (0.3%) with AITD. Children with a first-degree relative (FDR) with T1D, CD, and/or AITD, had higher occurrence of autoantibodies compared to children without an FDR (63/344, 18.3%, vs. 148/1,810, 8.2%) (p < 0.0001, OR 2.52, 95% CI 1.83-3.47), and higher occurrence of screening-detected diagnosis (14/344, 4.1%, vs. 21/1,810, 1.2%) (p < 0.0001, OR 3.61, 95% CI 1.82-7.18). Half of these children screened positive for another disease than the FDR. Screening for T1D, CD, and AITD by home capillary sampling in a Swedish general pediatric population detected autoimmunity in 9.3% and undiagnosed disease in 1.5%.

Improving the TIR3B oncological stratification: try to bridge the gap through a comprehensive presurgical algorithm

PurposeIndeterminate cytology still puzzles clinicians, due to its wide range of oncological risks. According to the Italian SIAPEC–IAP classification, TIR3B cytology holds up to 30% of thyroid cancer, which justifies the surgical indication, even if more than half of cases do not result in a positive histology. The study aim is to identify potential clinical, ultrasound or cytological features able to improve the surgical indication.MethodsRetrospective analysis. A consecutive series of TIR3B nodules referred to the Endocrine Unit of Careggi Hospital from 1st May 2014 to 31st December 2021 was considered for the exploratory analysis (Phase 1). Thereafter, a smaller confirmatory sample of consecutive TIR3B diagnosed and referred to surgery from 1st January 2022 to 31st June 2022 was considered to verify the algorithm (Phase 2). The main clinical, ultrasound and cytological features have been collected. A comprehensive stepwise logistic regression was applied to build a prediction algorithm. The histological results represented the final outcome.ResultsOf 599 TIR3B nodules referred to surgery, 451 cases were included in the exploratory analysis. A final score > 14.5 corresponded to an OR = 4.98 (95% CI 3.24–7.65, p < 0.0001) and showed a PPV and NPV of 57% and 79%, respectively. The Phase 2 analysis on a confirmatory sample of 58 TIR3B cytology confirmed that a threshold of 14.5 points has a comparable PPV and NPV of 53% and 80%, respectively.ConclusionsA predictive algorithm which considers the main clinical, US and cytological features can significantly improve the oncological stratification of TIR3B cytology.

The association between material-psychological-behavioral framework of financial hardship and markers of inflammation: a cross-sectional study of the Midlife in the United States (MIDUS) Refresher cohort

BackgroundMeasures of financial hardship have been suggested to supplement traditional indicators of socioeconomic status (SES) to elucidate household economic well-being. This study formally tested the construct validity of financial hardship and examined its association with markers of inflammation.MethodsThis study utilized data from the Midlife Development in the United States Refresher Study (MIDUS-R; Age = 23-76, 53.7% female, 71% white). Participants were divided into exploratory factor analysis (EFA; completed SAQs only; N = 2,243) and confirmatory factor analysis sample (CFA; completed SAQs and biomarker assessment; N = 863). Analysis was divided into three steps. First, exploratory factor analysis (EFA) is used to examine if the three-domain factor (material, psychological, and behavioral) is the best fitting model for financial hardship measures. Second, we conducted CFA to test the hypothesized three-factor measurement model of financial hardship. Third, we tested the association between domains and the general latent factor of financial hardship and inflammation (interleukin 6/IL6, c-reactive protein/CRP, and fibrinogen).ResultsResults from EFA supported the three-domain model of financial hardship. The hypothesized three-domain measurement model fits well in a different sample within MIDUS-R. In the models adjusted for age and sex, higher material hardship was associated with elevated IL6, CRP, and fibrinogen, while higher behavioral hardship was associated with higher CRP. The association between the material domain and IL6 remained significant after adding body mass index, education, and race as additional covariates. The second-order financial hardship measurement model was associated with IL6, CRP, and fibrinogen, adjusted for age, sex, BMI, education, and race.ConclusionExplicating the socioeconomic environment to include indicators of financial hardship can help researchers better understand the pathway between SES and the inflammation process, which may help elucidate pathways between SES and age-related chronic diseases associated with inflammation.

Early effects predict trajectories of response to esketamine in treatment-resistant depression

BackgroundThe efficacy of esketamine in treatment-resistant depression (TRD) has been confirmed. However, its administration is expensive and restrictive, with limited knowledge on how long the treatment should be continued. Predicting the treatment outcome would benefit patients and alleviate the global treatment cost. We aimed to define distinct trajectories of treatment response and assess their predictability. MethodsIn this longitudinal study, two independent samples of patients with unipolar or bipolar TRD were treated with esketamine in real-world settings. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) before each esketamine administration. Latent class analyses were used to define trajectories of response. ResultsIn the original sample (N = 50), we identified two classes whose trajectories depicted response and non-response, respectively. The model was validated in the confirmatory sample (N = 55). Class membership was influenced by a few baseline characteristics such as concomitant benzodiazepine medication, number of depressive episodes or polarity. On the other hand, after only two esketamine administrations, the MADRS score predicted the 90-day trajectory of response with an accuracy of 80 %. LimitationsThis observational study is not placebo-controlled. Therefore, its results and their generalizability need to be confirmed in experimental settings. ConclusionsAfter the first administrations of esketamine, the MADRS score has a good capacity to predict the most plausible trajectory of response. While thresholds and their predictive values need to be confirmed, this finding suggests that clinicians could base on MADRS scores their decision to discontinue treatment because of poor remaining chances of treatment response.

What is work engagement? A text mining approach using employees' self‐narratives

AbstractWe introduce text mining to study work engagement by using this method to classify employees' survey‐based self‐narratives into high or low work engagement and analyzing the text features that contribute to the classification. We used two samples, representing the 2020 and 2021 waves of an annual survey among healthcare employees. In the first study, we used exploratory sample 1 (N = 5591) to explore which text features explain work engagement (unigrams, bigrams, psychological, or linguistic). In the second study, we confirmed whether features persisted over time between exploratory sample 1 and confirmatory sample 2 (N = 4470). We find that psychological features classify employees across two samples with 60% accuracy. These features partly validate the literature: High‐engaged employees refer more to affiliation and positive emotions, and low‐engaged employees refer more to negative emotions and power. We extend the literature by studying linguistics: High‐engaged employees use more first‐person plural (“we”) than low‐engaged employees. Finally, some results question the literature, like the finding that low‐engaged employees refer more to their managers. This study shows text mining can contribute by confirming, extending, or questioning the literature on work engagement and explores how future research could build on our findings with survey‐based or in vivo applications.

When 'good' is not good enough: a retrospective Rasch analysis study of the Berg Balance Scale for persons with Multiple Sclerosis.

The Berg Balance Scale (BBS) is one of the most used tools to quantify balance in Persons with Multiple Sclerosis, a population at high risk of falling. To evaluate the measurement characteristics of the BBS in Multiple Sclerosis through Rasch analysis. Retrospective study. Outpatients in three Italian Rehabilitation centers. Eight hundred and fourteen persons with Multiple Sclerosis able to stand independently for more than 3 s. The sample (N = 1,220) was split into one validating (B1) and three confirmatory subsamples. Following the Rasch analysis performed on B1, the item estimates were exported and anchored to the three confirmatory subsamples. After obtaining the same final solution across all samples, we studied the convergent and discriminant validity of the final BBS-MS using the EDSS, the ABC scale, and the number of falls. The base analysis on the B1 subsample failed the monotonicity, local independence, and unidimensionality requirements and did not fit the Rasch model. After grouping locally dependent items, the BBS-MS fitted the model (χ28 = 23.8; p = 0.003) and satisfied all requirements for adequate internal construct validity (ICV). However, it was mistargeted to the sample, given the striking prevalence of higher scores (targeting index 1.922) with a distribution-independent Person Separation Index sufficient for individual measurements (0.962). The B1 item estimates were anchored to the confirmatory samples with confirmation of adequate fit (χ2 = [19.0, 22.8], value of ps = [0.015, 0.004]) and satisfaction of all ICV requirements for all subsamples. The final BBS-MS directly correlated with the ABC scale (rho = 0.523) and inversely with EDSS (rho = -0.573). The BBS-MS estimates significantly differed across groups according to the pre-specified hypotheses (between the three EDSS groups, between the ABC cut-offs, distinguishing 'fallers' vs. 'non-fallers', and between the 'low' vs. 'moderate' vs. 'high' levels of physical functioning; and, finally, between 'no falls' vs. 'one or more falls'). This study supports the internal construct validity and reliability of the BBS-MS in an Italian multicentre sample of persons with Multiple Sclerosis. However, as the scale is slightly mistargeted to the sample, it represents a candidate tool to assess balance, mainly in more disabled people with an advanced walking disability.

Thermal Conduction Heating for a 125 ft Deep TCE Source—Multiple Lines of Evidence for Verification of Remedial Goals

AbstractThis paper describes thermal conduction heating of a trichloroethylene (TCE) source zone within vadose zone soils consisting of glacial till at depths of 50 to 125 ft below an active manufacturing facility. The performance objectives and metrics used to determine remediation success are presented. Access limitations inside the facility prevented traditional spatial soil confirmation sampling, which made performance assessment a unique challenge. Instead, the project team developed an approach utilizing multiple lines of evidence to document remedy completeness. These lines of evidence included achievement of target temperatures within the treatment volume, demonstration of asymptotic vapor concentrations extracted from the treatment volume, achieving modeled energy input goals, and verifying TCE concentrations in post‐treatment soil samples collected at the few accessible locations within the operational facility. The treatment volume was divided into three discrete treatment areas or heating groups, each constructed and heated independently in order to meet an aggressive project schedule. Additionally, each line of evidence was required to be met in each group. After approximately 283 days of heating, temperatures exceeded 90 °C at 95% of the temperature monitoring points, TCE levels had diminished to asymptotic levels in the recovered vapors, and mass removal rates from the treatment volume declined to minimal levels. Confirmatory soil sample results indicated that average TCE concentrations achieved were more than an order of magnitude below the remedial goal of 1 mg/kg.

Development and psychometric study of the scale of the positive relationship PRIM + 19 in peruvian university students

BackgroundPositive relationships are one of the most important components within the PERMA model since they facilitate the development of the other components. However, in the scientific literature, few instruments have been identified with solid psychometric properties that measure positive relationships in university students and adequately represent the construct. Therefore, the study aims to develop and study the psychometric properties of the PRI + 19 positive relationships scale through Confirmatory Factor Analysis, factorial invariance, and relationship-based validity with other variables.MethodA pilot sample of 201 university students (43.8% men and 56.2 women) between the ages of 18 and 34 (M = 20.9; SD = 2.74) was collected. The confirmatory sample consisted of 450 university students of both sexes (30.2% men and 69.8 women) between the ages of 18 and 35 years (M = 21.9; SD = 3.15). Along with the PRI + scale, other instruments were applied to measure satisfaction with life and psychological well-being.ResultsIn the pilot study, the Exploratory Factor Analysis showed the presence of three factors that could explain 54.5% of the items. In the confirmatory study, the Confirmatory Factor Analysis showed that the model of three dimensions related to 19 items presents the best adjustment indexes compared to other models (χ2 = 541.61; df = 149; CFI = 0.97; TLI = 0.97; RMSEA = 0.077 [IC90% 0.070 ‒ 0.084]). The scale also showed evidence of being strictly invariant for the groups of men and women. Finally, it was shown that the development of the positive bonds dimension positively predicts psychological well-being (0.35) and life satisfaction (0.20). The positive relationship management dimension positively predicts psychological well-being (0.28) and life satisfaction (0.29). Similarly, the integration dimension positively predicts psychological well-being (0.48) and life satisfaction (0.52).ConclusionThis study suggests that the PRIM + 19 scale is a useful tool from which valid and reliable interpretations of positive relationships in Peruvian university students can be obtained.

Evaluating HIV Rapid/Point of Care Testing among Risk Factor Groups in Ontario, 2011 to 2018

ObjectivesIn 2014, Ontario’s Point-of-Care (POC) test providers were advised to focus efforts on provincially defined priority populations who experience a greater risk of HIV. Our objective was to describe the POC program before, during and after this change, including tester characteristics, follow-up testing results, positive predictive value (PPV) over time, and trends and characteristics of those with reactive test results without a confirmatory serological specimen.MethodsTest-level data of POC screening and confirmatory results were extracted from the Public Health Ontario HIV Datamart. Final test results were defined based on results of the confirmatory blood sample, or the POC test for “non-reactive” tests. Testing volumes, percent of total tests, percent positivity and PPV were calculated overall, annually, and by exposure group.ResultsOverall testing volumes decreased by 39.8% between 2014 and 2018. The majority of confirmed positive tests were in the men who have sex with men (MSM) exposure category, followed by HIV-endemic and heterosexual – no identified risk (heterosexual—NIR). Overall percent positivity decreased from 0.59% in 2011 to 0.42% in 2015 (change of 0.17%, 95% CI 0.03% to 0.31%), increasing to 0.69% in 2018 (change of 0.27%, 95% CI 0.20% to 0.34%). Increases in percent positivity corresponded with a decrease in the overall proportion of tests conducted in low-risk populations. When compared to the heterosexual-NIR category, PPV was significantly higher for men who have sex with men – people who use injection drugs (MSM-PWID) (52.7% compared to 100%, P < .001), MSM (52.7% compared to 95.4%, P < .001), HIV-endemic (52.7% compared to 91.5%, P < .001), heterosexual – partner with identified risk (heterosexual—PIR) (52.7% compared to 77.3%, P = .042), and people who use injection drugs (PWID) (52.7% compared to 81.3%, P = 0.007). A total of 13.5% of reactive POC results did not have a serological sample submitted.ConclusionsTargeted testing towards populations at higher risk of HIV improved the overall test performance characteristics of Ontario’s POC testing program. While not unexpected, the large discrepancies between PPV in higher-risk, compared to lower-risk populations, suggests the need for greater awareness and messaging of the likelihood of false positive test results in different populations.

Development and validation of the Executive Functioning Scale.

Executive functioning (EF) processes are essential for adaptive and flexible responding to the demands and complexities of everyday life. Conversely, if impaired, these processes are a key transdiagnostic risk factor that cuts across autism and a range of other neurodevelopmental (NDD) and neuropsychiatric (NPD) conditions. However, there are currently no freely available informant-report measures that comprehensively characterize non-affective (e.g., working memory, response inhibition, and set shifting) and affective (e.g., emotion regulation) EF subdomains. This study describes the development, refinement, and initial psychometric evaluation of a new 52-item Executive Functioning Scale (EFS). Two independent data collections yielded exploratory (n = 2004, 169 with autism, ages 2-17) and confirmatory (n = 954, 74 with autism, ages 2-17) samples. Exploratory Structural Equation Modeling (ESEM) model with six specific factors that closely matched hypothesized executive functioning subdomains of working memory and sequencing, response inhibition, set-shifting, processing speed, emotion regulation, and risk avoidance, and one general factor, showed the best fit to the data and invariance across age, sex, race, and ethnicity groups. Model reliability and internal consistency were excellent for the general factor (ω = 0.98; α = 0.97) and specific factors (ω ≥ 0.89-0.96; α ≥ 0.84-0.94). Conditional reliability estimates indicated excellent reliability (≥0.90) for the total EF scale and adequate or better reliability (≥0.70) for subscale scores. With further replication, the EFS has excellent potential for wide adoption across research and clinical contexts.

Development of the Reading Comprehension Strategies Questionnaire (RCSQ) for late elementary school students.

Late elementary education constitutes a critical period in the development of reading comprehension strategies, a key competence in today's society. However, to date, appropriate measurements to map late elementary students' reading strategies are lacking. In this respect, the present article first describes the development and validation of the 26-item reading comprehension strategies questionnaire (RCSQ). To this aim, exploratory (sample 1: n = 1585 students) and confirmatory (sample 2: n = 1585 students) factor analyses were conducted. These analyses resulted in the RCSQ, consisting of five subscales: (1) overt cognitive reading strategies, (2) covert cognitive reading strategies, (3) monitoring, and (4) evaluating. For non-native and bilingual students, a fifth subscale 'using home language in view of comprehending texts' emerged. Second, multilevel analyses were performed to explore individual differences in late elementary students' reading comprehension strategy use. Implications for practice and future research are discussed.

Development and Validation of the Youth Purpose Orientation Scale Among Chinese Sample.

Purpose orientation has an important impact on the development of adolescence. An effective instrument is needed to describe the purpose orientation of youth. The aim of this research is to develop a reliable and valid scale to measure life purpose orientations of youth. Study 1 established a preliminary pool of items based on a literature review, an open-form questionnaire, and some expert opinions. Study 2 used exploratory factor analysis and performed internal consistency and reliability tests. The sample consisted of 442 young Chinese students, divided into males (49.3%) and females (50.7%) with an age range of 13 to 22 years. Study 3 performed confirmatory factor analysis and tested the scale's calibration validity and test-retest reliability. The confirmatory sample comprised 91,635 young Chinese students, divided into males (43.2%) and females (56.5%) with an age range of 12 to 23 years. The calibration validity sample consisted of 572 participants, aged 12 to 22. The test-retest reliability sample consisted of 200 participants. Through exploratory factor analysis, the four-factor structure revealed contains personal growth, social promotion, family well-being, and personal well-being purpose orientations. This four factor-structure revealed a 65.26% cumulative variance. The four factors' alpha reliability was 0.89 for personal growth, 0.87 for social promotion, 0.86 for family well-being, and 0.87 for personal well-being, respectively. Confirmatory factor analysis showed that the model fitting index had a good four-factor structure. The calibration validity and test-retest reliability were acceptable. These findings demonstrated that the 19-item findings demonstrated that the Youth Purpose Orientation Scale is a valid and reliable measure. In future research, it can be used to measure purpose orientation in youth.

Three clinical indicators of borderline personality disorder in anorexia nervosa: A pilot study

ObjectivesCo-occurrence of Anorexia Nervosa (AN) and borderline personality disorder (BPD) is frequent (8%–40%) and associated with specificities that impact the treatment process. Lifetime history of suicide attempt (HAS), substance use disorder (SUD) and the binge-purging subtype (B-P) might be good markers of such comorbidity. We made the hypothesis that in patients with AN, the presence of HAS, SUD and B-P have sufficient predictive power to efficiently detect an associated BPD comorbidity. MethodsAfter a case report analysis on a pilot sample of 119 patients with AN, we performed a cross-sectional analysis on a confirmatory sample of 84 patients with AN in a single center specialized in eating disorders systematically assessing HAS, SUD, B-P and BPD using the Mini International Neuropsychiatric Interview for DSM-5 and the Diagnostic Interview for Borderline (DIB-R). ResultsB-P had a 100% negative predictive value, and the combination of SUD plus HAS had a 100% positive predictive value. On a quantitative level, B-P, HAS and SUD were independent explanatory factors of the DIB-R total score. ConclusionsThe main limitations were the low number of patients, the single center analyses, the potential overlapping of assessments and the fact that data were exclusively declarative. In this study, every patient with B-P, SUD and HAS had been diagnosed with BPD.