Multivariate General Linear Model Research Articles

Personality traits as predictors of depression across the lifespan

BackgroundDepression is a major public health concern. A barrier for research has been the heterogeneous nature of depression, complicated by the categorical diagnosis of depression which is based on a cluster of symptoms, each with its own etiology. To address the multifactorial etiology of depression and its high comorbidity with anxiety, we aimed to examine the relations between personality traits, diverse behavioral, cognitive and physical measures, and depression and anxiety over the lifespan. MethodOur sample was drawn from the NKI-RS, a community-based lifespan sample (N = 1494 participants aged 6 to 85). Analyses included multivariate approach and general linear models for group comparisons and dimensional analyses, respectively. A machine learning model was trained to predict depression using many factors including personality traits. ResultsDepression and anxiety were both characterized by increased neuroticism and introversion, but did not differ between themselves. Comorbidity had an additive effect on personality vulnerability. Dimensionally, depression was only associated with personality in adolescence, where it was positively correlated with neuroticism, and negatively correlated with extraversion, agreeableness, and conscientiousness. The relationship between anxiety and personality changed over time, with neuroticism and conscientiousness being the most salient traits. Our machine learning model predicted depression with 70 % accuracy with neuroticism and extraversion contributing most. LimitationsDue to the cross-sectional design, conclusions cannot be drawn about causal relationships between personality and depression. ConclusionThese results underscore the impact of personality on depressive disorders and provide novel insights on how personality contributes to depression across the lifespan.

Determinants of self-perceived quality of life in mildly disabled multiple sclerosis patients: a cross-sectional study.

While the determinants influencing self-perceived health-related quality of life (spHRQoL) in persons with multiple sclerosis (pwMS) and severe physical impairment have been well investigated, their impact on pwMS with mild disability is poorly addressed. We aimed to investigate possible drivers of spHRQoL among Sardinian pwMS with an EDSS lower than 2.5. A sample of 87 fully ambulatory (EDSS < 2.5) pwMS were included after screening for major cognitive impairment. spHRQoL was measured with the Italian version of 36-Item Short Form Health Survey (SF-36). The Physical Component Summary (PCS) and Mental Component Summary (MCS) were used as dependent variables for univariate analysis with Cognitive Behavioral Assessment (CBA) and specific individual factors as independent variables. Subsequent multivariate general linear models (GLMs) for PCS and MCS respectively were run after stepwise regression. Normative data referring to Italian population were used for comparison. As compared to normative data, no statistically significant difference was found for PCS, while MCS was reduced. Multivariate GLMs showed a significant association between lower PCS scores and presence of psychosomatic symptoms, older age and fatigue (p < 0.05). Furthermore, a significant association was shown between lower MCS scores and presence of anxiety (p < 0.001). Mood, presence of psychosomatic symptoms, fatigue and age can have a relevant impact on spHRQoL in people with mildly disabling MS and should be considered in the management of such individuals.

Impact of metabolic syndrome on bone mineral density in men over 50 and postmenopausal women according to U.S. survey results

Metabolic Syndrome (MetS) and bone mineral density (BMD) have shown a controversial link in some studies. This research aims to study their association in males over 50 and postmenopausal females using National Health and Nutrition Examination Survey (NHANES) data. Postmenopausal females and males over 50 were included in the study. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines. BMD values were measured at the thoracic spine, lumbar spine, and pelvis as the primary outcome. Weighted multivariate general linear models have been employed to explore the status of BMD in patients with MetS. Additionally, interaction tests and subgroup analyses were conducted. Utilizing the NHANES database from 2003 to 2006 and 2011–2018, we included 1924 participants, with 1029 males and 895 females. In postmenopausal women, after adjusting for covariates, we found a positive correlation between MetS and pelvic (β: 0.030 [95%CI 0.003, 0.06]) and thoracic (β: 0.030 [95%CI 0.01, 0.06]) BMD, though not for lumbar spine BMD (β: 0.020 [95%CI − 0.01, 0.05]). In males over 50 years old, MetS was positively correlated with BMD in both Model 1 (without adjusting for covariates) and Model 2 (considering age and ethnicity). Specifically, Model 2 revealed a positive correlation between MetS and BMD at the pelvis (β: 0.046 [95%CI 0.02, 0.07]), thoracic spine (β: 0.047 [95%CI 0.02, 0.07]), and lumbar spine (β: 0.040 [95%CI 0.02, 0.06]). Subgroup analysis demonstrated that the relationship between MetS and BMD remained consistent in all strata, underscoring the stability of the findings. In postmenopausal women, after adjusting for all covariates, a significant positive correlation was observed between MetS and BMD in the pelvis and thoracic spine, whereas this correlation was not significant for lumbar spine BMD. Conversely, in males, positive correlations between MetS and BMD at the lumbar spine, thoracic spine, and pelvis were identified in Model 2, which adjusted for age and ethnicity; however, these correlations disappeared after fully adjusting for all covariates. These findings highlight the potential moderating role of gender in the impact of MetS on BMD.

Abstract P493: A Multivariate Analysis of Genetic Risk Scores for Heart Failure and Left Ventricular Mass Derived From Multi-Ancestry Populations and Left Ventricular Mass Amongst African Americans: The Jackson Heart Study

Background: Increased left ventricular (LV) mass is an outcome of LV remodeling that can result in development of left ventricular hypertrophy (LVH), a maladaptive disorder that increases the risk of heart failure. Elevated LV mass is a sensitive predictor of adverse cardiovascular events. African Americans experience a disproportionate burden of heart failure risk and development of LVH. The influence of genetics on this health disparity is unclear and a topic of interest. Genome-wide association studies (GWAS) have uncovered many variants associated with numerous adverse cardiovascular outcomes, such as heart failure and LV phenotypes. However, the relevance of these studies for African Americans may be limited as these analyses have been conducted in multi-ancestry populations with limited representation of African heritage. The question of whether these genetic risk variants can be used to predict LV phenotypes in an independent African American population remains unanswered. Hypothesis: Variant loci that have been associated with heart failure and LV mass in multi-ancestry populations will be associated with LV mass amongst African Americans in the Jackson Heart Study (JHS). Methods: Thirty-nine (39) SNPs associated with heart failure and ten (10) SNPs associated with LV mass were identified from two published studies in which participants of African ancestry or Black individuals comprised less than 15% and 2%, respectively. Using the published effect size estimates, genetic risk scores (GRSs) for heart failure and LV mass were computed for 2,175 African American participants (mean age 55, 63% female) in the JHS with complete data and consent for genetic research. We assessed the linear association of heart failure and LV mass GRSs with LV mass indexed to height (LVM h ) and indexed to body surface area (LVM bsa ). A multivariate general linear model was fit to both LVM h and LVM bsa containing both GRS predictors and accounting for age, sex, BMI (mean 31.5), diabetes (22%), and hypertension (52%). No multicollinearity was noted among these explanatory variables using variance inflation factors. Due to non-constant error variance, a log transformation was conducted on both LV mass response variables. Type III MANOVA Pillai tests were run to assess the effects of the GRSs on the log LVM bsa and log LVM h values. Conclusion: When accounting for age, BMI, sex, diabetes, and hypertension, we found that neither the heart failure GRS (p-val = 0.4012) nor the LV mass GRS (p-val = 0.8332) had an effect on both log LVM bsa and log LVM h . There is insufficient evidence to suggest that heart failure and LV mass variants derived from predominantly European multi-ancestry populations are linearly associated with log LV mass amongst African Americans in the Jackson Heart Study. Our work highlights the need for greater recruitment and targeted studies of populations with African ancestry for GWAS of LV phenotypes.

Flourishing and Functional Difficulties among Autistic Youth: A Confirmatory Factor Analysis.

The International Classification of Functioning, Disability, and Health for Children and Youth outlines body structures and functions and activities and participation to fully describe elements that support or detract from participation. While flourishing has gained attention in recent literature, research also points to the role of functional difficulties among autistic youth in influencing participation. Clearly, function is a multi-dimensional and complex construct and likely consists of both indicators of flourishing and functional difficulties. We used data from the National Survey of Children's Health (NSCH) from 2016 to 2020 to identify aspects of flourishing functional difficulties to achieve the following aims: (1) Investigate the factor structure of flourishing and functional difficulties among autistic youth ages 10-17 years; and (2) examine the extent to which child variables (i.e., sex, age, race, ethnicity, autism severity, poverty) are associated with flourishing and functional difficulties. Autistic children (n = 2960) between the ages of 10 and 17 years were included. We used confirmatory factor analysis followed by a multivariate general linear model (GLM) to examine the association between child variables and factors. Results indicated a six-factor structure (medical conditions, instrumental activities of daily living, activities of daily living, social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08 [p = 0.926], comparative fit index = 0.94, Tucker-Lewis index = 0.91). Multivariate GLM showed that child factors were differentially and significantly associated with factors of functional difficulties and flourishing. Current findings suggest that 16 items measured by the NSCH result in a six-factor structure of flourishing and functional difficulties among autistic youth. A comprehensive approach to capture function among autistic youth must assess aspects of flourishing and difficulties.

Postoperative hypothermia is associated with reduced length of stay in adult acute burn survivors

BackgroundThe hypermetabolic response after a burn predisposes patients to hypothermia due to dysfunction of thermoregulation. Traditionally, hypothermia is avoided actively in burn care due to reported complications associated with low body temperature. The likelihood of hypothermia with acute burn surgery is compounded by general anesthesia, exposure of wound areas and prolonged operation times. However, we find limited studies exploring the effects of perioperative hypothermia on length of stay in the adult burn population. ObjectiveTo determine associations between postoperative hypothermia and hospital length of stay in adult burns patients. MethodThis retrospective cohort study involved patients admitted to the State Adult Burn Unit in Western Australia between 1st January 2015 to 28th February 2021. All adults who underwent surgery for acute burn, and had postoperative recovery room body temperature recorded, were included in the study. In this study, we defined normothermia as >36.5C and hypothermia as < 36.0 °C with mild, moderate, and severe hypothermia being 35.0–35.9 °C, 34.0–34.9 °C and < 34.0 °C, respectively. Patients with hyperthermia were excluded. Multivariable general linear models explored if hypothermia was independently associated with length of stay. ResultsAmong 1486 adult patients, 1338 (90%) were normothermic postoperatively, with temperatures >36.0C. We included 148 (10%) patients with hypothermia (temperature <36.0 °C) postoperatively. Most burns in the study population were minor: 96% had burns < 15% TBSA. Data modelling demonstrated that hypothermia was associated with a shorter length of hospital stay (coefficient = −0.129, p = 0.041). ConclusionIn adult acute burn patients, postoperative hypothermia was associated with reduced length of stay after surgery. The positive results of this study indicate that a review of the core temperature targets with acute burn surgery, and timing of burn patient cooling practices in general is warranted.

Implementing an osteoarthritis management program to deliver guideline-driven care for knee and hip osteoarthritis in a U.S. academic health system

ObjectiveAssess implementation feasibility and outcomes for an Osteoarthritis Management Program (OAMP) at an academic center. DesignThis open study assessed an OAMP designed to deliver care in 1–5 individual or group visits across ≤12 months. Eligibility included adults with knee or hip osteoarthritis with ≥1 visit from 7/1/2017–1/15/2021. A multidisciplinary care team provided: education on osteoarthritis, self-management, exercise, weight loss; pharmacologic management; assessments of mood, sleep, quality of life, and diet. Clinic utilization and growth are reported through 2022. Patient outcomes of body mass index (BMI), pain, and function were analyzed using multivariable general linear models. OAMP outcomes were feasibility and sustainability. ResultsMost patients were locally referred by primary care. 953 patients attended 2531 visits (average visits 2.16, treatment duration 187.9 days). Most were female (72.6%), older (62.1), white (91.1%), and had medical insurance (95.4%). Obesity was prevalent (84.7% BMI ≥30, average BMI 40.9), mean Charlson Comorbidity Index was 1.89, and functional testing was below average. Longitudinal modeling revealed statistically but not clinically significant pain reduction (4.4–3.9 on 0–10 scale, p ​= ​0.002). BMI did not significantly change (p ​= ​0.87). Higher baseline pain and BMI correlated with greater reductions in each posttreatment. Uninsured patients had shorter treatment duration. Increasing clinic hours (4–24 ​h weekly) and serving 953 patients over four years demonstrated OAMP sustainability. ConclusionsOAMP implementation was feasible and sustainable. Patients with high baseline pain and BMI were more likely to improve. Noninsurance was a barrier. These results contribute to understanding OAMP outcomes in U.S. healthcare.

Small dense low-density lipoprotein cholesterol and coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis.

Elevated small dense LDL cholesterol (sd-LDL-C) increases atherosclerotic cardiovascular disease (CVD) risk. Although coronary artery calcification (CAC) is widely used for predicting CVD events, few studies have examined the relationship between sd-LDL-C and CAC. This study included 4672 individuals with directly measured baseline sd-LDL-C and CAC from the Multi-Ethnic Study of Atherosclerosis [mean (standard deviation) age: 61.9 (10.4) years; 52.5% women; 47.3% with baseline CAC (mean score >0)]. We used multi-variable general linear models and restricted cubic splines with the goodness of fit testing to evaluate the association of sd-LDL-C with the presence of CAC. Odds ratios [OR (95% confidence interval)] were adjusted for demographics and cardiovascular risk factors, including estimated total LDL-C. Higher quartiles of sd-LDL-C were associated with the presence of CAC, even after accounting for total LDL-C. Compared with the lowest quartile of sd-LDL-C, participants in Quartiles 2, 3, and 4 had higher odds for the presence of baseline CAC [Quartile 2 OR: 1.24 (1.00, 1.53); Quartile 3 OR: 1.51 (1.19, 1.93); and Quartile 4 OR 1.59 (1.17, 2.16)]. Splines suggested a quadratic curvilinear relationship of continuous sd-LDL-C with CAC after adjustment for demographics and CVD risk factors (quadratic vs. first-order sd-LDL-C terms likelihood ratio test: P = 0.015), but not after accounting for total LDL-C (quadratic vs. first-order terms: P = 0.156). In a large, multi-ethnic sample without known CVD, higher sd-LDL-C was associated with the presence of CAC, above and beyond total LDL-C. Whether selective direct measurement of sd-LDL-C is indicated to refine cardiovascular risk assessment in primary prevention warrants further investigation.

Association of Metabolic Syndrome with Macular Thickness and Volume in Older Adults: A Population-Based Optical Coherence Tomography Study.

Background: To explore the associations of the metabolic syndrome (MetS) and individual components with macular thickness and volume among rural-dwelling Chinese older adults. Methods: This population-based cross-sectional study included 705 participants (age ≥60 years) derived from the MIND-China study. In 2018-2019, we collected data through face-to-face interview, clinical examination, optical coherence tomography (OCT) examination, and blood test. We measured macular thickness and volume using spectral-domain OCT. MetS was defined following the International Diabetes Federation (IDF) criteria, the IDF/American Heart Association (AHA) criteria, the National Cholesterol Education Program-Adult Treatment Panel III criteria, and the Chinese Diabetes Society (CDS) criteria. Data were analyzed with multivariable general linear models. Results: MetS was significantly associated with thinner macula in central (multivariable-adjusted β = -5.29; 95% confidence interval: -9.31 to -1.26), parafoveal (-2.85; -5.73 to 0.04) and perifoveal regions (-4.37; -6.79 to -1.95) when using the IDF criteria, in the perifoveal regions (-3.82; -6.18 to -1.47) when using the IDF/AHA criteria, and in the central region (-5.63; -10.25 to -1.02) when using the CDS criteria, and with reduced macular volume when using the IDF (-0.16; -0.26 to -0.07) and IDF/AHA (-0.13; -0.22 to -0.04) criteria. In the parafoveal region, the IDF-defined MetS was significantly associated with thinner retina in men (β = -6.25; -10.94 to -1.56) but not in women. Abdominal obesity (-2.83; -5.41 to -0.25) and elevated fasting blood glucose (-2.65; -5.08 to -0.21) were associated with thinner macular thickness in the perifoveal region. Conclusion: MetS is associated with macular thinning and reduced macular volume among rural-dwelling older adults, and the associations vary by the defining criteria of MetS.

Factors associated with blood mercury concentrations and their interactions with three glutathione S-transferase genes (GSTT1, GSTM1, and GSTP1): an exposure assessment study of typically developing Jamaican children

BackgroundJamaican soil is abundant in heavy metals including mercury (Hg). Due to availability and ease of access, fish is a traditional dietary component in Jamaica and a significant source of Hg exposure. Mercury is a xenobiotic and known neuro-toxicant that affects children's neurodevelopment. Human glutathione S-transferase (GST) genes, including GSTT1, GSTM1, and GSTP1, affect Hg conjugation and elimination mechanisms.MethodsIn this exposure assessment study we used data from 375 typically developing (TD) 2–8-year-old Jamaican children to explore the association between environmental Hg exposure, GST genes, and their interaction effects on blood Hg concentrations (BHgCs). We used multivariable general linear models (GLMs).ResultsWe identified the child’s age, consumption of saltwater fish, canned fish (sardine, mackerel), string beans, grain, and starches (pasta, macaroni, noodles) as the environmental factors significantly associated with BHgCs (all P < 0.05). A significant interaction between consumption of canned fish (sardine, mackerel) and GSTP1 in relation to BHgC using either a co-dominant or recessive genetic model (overall interaction P = 0.01 and P < 0.01, respectively) indicated that consumption of canned fish (sardine, mackerel) was significantly associated with higher mean BHgC only among children with the GSTP1 Ile105Val, Ile/Ile [Ratio of mean Hg (95% CI) = 1.59 (1.09, 2.32), P = 0.02] and Ile/Val [Ratio of mean Hg (95% CI) = 1.46 (1.12, 1.91), P = 0.01] genotypes.ConclusionsSince this is the first study from Jamaica to report these findings, replication in other populations is recommended.

Blood Markers in Relation to a History of Traumatic Brain Injury Across Stages of Cognitive Impairment in a Diverse Cohort.

Traumatic brain injury (TBI) has been linked to multiple pathophysiological processes that could increase risk for Alzheimer's disease and related dementias (ADRD). However, the impact of prior TBI on blood biomarkers for ADRD remains unknown. Using cross-sectional data, we assessed whether a history of TBI influences serum biomarkers in a diverse cohort (approximately 50% Hispanic) with normal cognition, mild cognitive impairment, or dementia. Levels of glial fibrillary acidic protein (GFAP), neurofilament light (NFL), total tau (T-tau), and ubiquitin carboxy-terminal hydrolase-L1 (UCHL1) were measured for participants across the cognitive spectrum. Participants were categorized based on presence and absence of a history of TBI with loss of consciousness, and study samples were derived through case-control matching. Multivariable general linear models compared concentrations of biomarkers in relation to a history of TBI and smoothing splines modelled biomarkers non-linearly in the cognitively impaired groups as a function of time since symptom onset. Each biomarker was higher across stages of cognitive impairment, characterized by clinical diagnosis and Mini-Mental State Examination performance, but these associations were not influenced by a history of TBI. However, modelling biomarkers in relation to duration of cognitive symptoms for ADRD showed differences by history of TBI, with only GFAP and UCHL1 being elevated. Serum GFAP, NFL, T-tau, and UCHL1 were higher across stages of cognitive impairment in this diverse clinical cohort, regardless of TBI history, though longitudinal investigation of the timing, order, and trajectory of the biomarkers in relation to prior TBI is warranted.

Equivalent analysis of different estimations under a multivariate general linear model

&lt;p&gt;This article explores the mathematical and statistical performances and connections of the two well-known ordinary least-squares estimators (OLSEs) and best linear unbiased estimators (BLUEs) of unknown parameter matrices in the context of a multivariate general linear model (MGLM) for regression, both of which are defined under two different optimality criteria. Tian and Zhang &lt;sup&gt;[&lt;xref ref-type="bibr" rid="b38"&gt;38&lt;/xref&gt;]&lt;/sup&gt; once collected a series of existing and novel identifying conditions for OLSEs to be BLUEs under general linear models: &lt;italic&gt;On connections among OLSEs and BLUEs of whole and partial parameters under a general linear model, Stat. Probabil. Lett., 112 (2016), 105–112&lt;/italic&gt;. In this paper, we show how to extend this kind of results to multivariate general linear models. We shall give a direct algebraic procedure to derive explicit formulas for calculating the OLSEs and BLUEs of parameter spaces in a given MGLM, discuss the relationships between OLSEs and BLUEs of parameter matrices in the MGLM, establish many algebraic equalities related to the equivalence of OLSEs and BLUEs, and give various intrinsic statistical interpretations about the equivalence of OLSEs and BLUEs of parameter matrices in a given MGLM using some matrix analysis tools concerning ranks, ranges, and generalized inverses of matrices.&lt;/p&gt;

Common Wrist-Extensor Tendon and Pectoralis Muscle Stiffness in Healthy Recreational Tennis Players.

Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players. Cross-sectional study. The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues. Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC > .78 for the pectoralis musculature) and excellent (ICC > .94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, -22.8 to 252.5kPa for the dominant arm [P = .039]). Mean pectoralis major and minor stiffness differences were not significant (P > .214). Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected.

Do SOD2 and SOD3 gene polymorphisms impact the oral health-related quality of life in Para athletes?

The aim of this study was to evaluate whether polymorphisms in SOD2 and SOD3 genes modulate the oral health-related quality of life (OHRQoL) of Para athletes with dental caries experience. The cross-sectional study included 264 Para athletes (143 in athletics, 61 in weightlifting and 60 in swimming). A trained and calibrated team recorded the decayed, missing and filled teeth index (DMFT). The Brazilian version of the Oral Health Impact Profile (OHIP-14) was used to measure OHRQoL. Genomic DNA was extracted from the athletes' saliva, and genetic polymorphisms in the SOD2 (rs5746136 and rs10370) and SOD3 (rs2855262 and rs13306703) genes were analyzed by real-time polymerase chain reaction. Univariate and multivariate analyses were performed. A multivariate General Linear Model analysis, adjusted for sex, revealed that the SOD3 gene polymorphism (rs2855262) had a significant effect on the psychological disability domain [codominant (p = 0.045) and recessive (p=0.038) models]. The SOD2 gene polymorphism (rs5746136) had a significant effect on the total OHIP-14 score [dominant model (p = 0.038)] and the psychological discomfort [dominant model (p = 0.034)] and physical disability [codominant model (p=0.037)] domains. Presence of the SOD2 rs10370 polymorphism led to statistical differences in the total score [codominant (p = 0.026) and dominant (p = 0.023) models] and the handicap domain scores [codominant (p = 0.027) and dominant (p = 0.032) models]. Polymorphisms of the SOD2 and SOD3 genes may be important biomarkers of OHRQoL in Para athletes with dental caries experience.

Effectiveness of sponsorship type, sport team identification, team support and congruence

PurposeThe aim of this paper is to investigate the interaction effect that sponsor-team congruence and team fan (home/rival team) have on the influence of different types of sports sponsorship (joint, corporate social responsibility [CSR]-linked and conventional sponsorship) on fans' attitudes and purchase intentions toward the sponsor.Design/methodology/approachTwo experimental studies were conducted on 391 and 297 participants. The data gathered underwent analysis through five multivariate general linear model analyses.FindingsThe study found that CSR-linked sponsorship had the strongest positive impact and the weakest negative impact on the attitude and purchase intention of home team supporters and the attitude of rival team supporters. Nonetheless, the sponsor-team congruence did not significantly moderate the relationship. Additionally, the research demonstrated that the fan identity of both home and rival teams moderates the impact of sports sponsorships on attitude and purchase intention.Originality/valuePrevious research has studied the effectiveness of sponsorship format types independently. This is the first research comparing sponsorship formats regarding fan type and congruence.

Compassion in action: Exploring the relationship between nurse conscientious intelligence and palliative care.

Conscience is a concept that is the foundation of nursing, guiding nurses to ethical practices, and helping them to provide the best professional care possible. Conscience enables nurses to be understanding and careful in patient care. The study had three aims: (1) to determine the level of conscientious intelligence and palliative care practice of intensive care nurses; (2) to determine the effect of sociodemographic and occupational variables on conscientious intelligence and palliative care practices; and (3) to examine the relationship between conscientious intelligence and palliative care practice. This study was designed as a descriptive-correlative study. The sample consisted of 157 nurses from a university hospital. The data were collected using questionnaire form, Conscientious Intelligence Scale and the Palliative Care Self-Reported Practices Scale between February and March 2021. By the general multivariate linear model, while age, educational level, professional experience, total term of employment in the clinic, and training in palliative care were important predictors of palliative care practices, age and gender were significant predictors of conscientious intelligence. It was concluded that the level of palliative care practice of intensive care nurses with a high level of conscientiousness was also higher. The conscientious intelligence levels of intensive care nurses positively affected palliative care practices. It can be said that it is important for nurses to combine their conscience with their professional knowledge and skills while providing care services. In the realm of nursing, it is imperative for professionals to not only possess knowledge and competence, but also to act with conscience when caring for patients. This study demonstrated that nurses with heightened conscientious awareness are more adept at providing palliative care. Consequently, it is vital to support practices and training that foster conscientiousness among nurses, who must exercise patience and diligence in their careers.

Examining the impact of time management and resilience training on work-family conflict among Iranian female nurses: a randomized controlled trial

BackgroundFemale nurses confronting work-family conflict may endure adverse consequences for themselves and their families, leading to a decline in job performance and intentions to quit. Investigating the effects of interventions based on factors contributing to work-family conflict can aid in identifying optimal strategies for conflict reduction and mitigating its negative repercussions. This study aimed to examine the impact of time management and resilience training on work-family conflict among Iranian female Nurses in 2022.MethodsIn this randomized controlled trial employing pre, post, and follow-up measures, 132 female nurses employed in the hospitals of Bushehr University of Medical Sciences (Bushehr, Iran) were selected and subsequently categorized into three groups—time management, resilience training, and control groups—using simple random sampling method. 10 online training sessions were conducted for each intervention group. A demographic form and a work-family conflict questionnaire were used for data collection. Repeated measures ANOVA, one-way ANOVA and multivariate general linear model were used to examine the hypotheses.ResultsRegarding total work-family conflict, posttest mean scores were significantly lower than the pretest in both time management (p < 0.001) and resilience (p < 0.001) training groups, but follow-up mean scores were significantly higher than posttests in both time management (p < 0.001) and resilience (p < 0.001) training groups. In the control group, the mean scores at three time points were not statistically different (P = 0.058). The post-test mean score of work-family conflict was comparable in the two intervention groups (P > 0.05) and lower than the control group (P < 0.001) The follow-up mean score was comparable in the two intervention groups (P > 0.05) and lower than the control group (P < 0.001).ConclusionTime management and resilience training effectively reduced the work-family conflict experienced by female nurses. Therefore, it is recommended that training programs such as time management and resilience training be incorporated into the ongoing education of nurses to alleviate their work-family conflict. Considering the diminishing impact of these interventions over time, training should be reiterated based on the evolving needs of the nurses.Trial registrationNumber (IRCT20190122042453N2),01/27/2022.

College Students' Trust, Betrayal, and Needs During and After Their Worst Nonassault-Related Healthcare Experiences Differ Based on Sexual Violence Exposure.

The BITTEN theoretical framework conceptually links patient's past healthcare betrayal and trauma experiences with their current and future healthcare interactions. BITTEN was used to examine whether healthcare experiences, behaviors, and needs differ between those with and without a history of sexual violence exposure. College students at two public universities in the southeastern United States (n = 1,381; 59.5% White, 61.0% women) completed measures about their self-selected worst or most frightening but nonassault-related healthcare experience. Multivariate general linear and mediation models were used to test theory-derived hypotheses. Participants exposed to sexual violence reported greater healthcare institutional betrayal, lower trust, and greater need for tangible aid and trauma-informed care during their worst nonassault-related healthcare experience. They also reported greater current healthcare avoidance alongside increased utilization of more physical and mental healthcare appointments, even after accounting for gender and race differences. These results suggest that, with minimal information about past sexual violence exposure, healthcare providers could be better poised to predict and address vulnerable patients' healthcare needs.

Reduced grey matter volume in adolescents with conduct disorder: a region-of-interest analysis using multivariate generalized linear modeling

BackgroundConduct disorder (CD) involves a group of behavioral and emotional problems that usually begins during childhood or adolescence. Structural brain alterations have been observed in CD, including the amygdala, insula, ventrolateral and medial prefrontal cortex, anterior cingulate cortex, and fusiform gyrus. The current study developed a multivariate generalized linear model (GLM) to differentiate adolescents with CD from typically developing (TD) adolescents in terms of grey matter volume (GMV).MethodsThe whole‐brain structural MRI data were collected from 96 adolescents with CD (mean age = 16.188pm 1.259 years; mean IQ = 104.292pm 8.107; 63 males) and 90 TD individuals (mean age = 15.956pm 1.506 years; mean IQ = 106.622pm 9.076; 59 males) matched on age, IQ, and sex. Region-wise GMV was extracted following whole-brain parcellation into 68 cortical and 14 subcortical regions for each participant. A multivariate GLM was developed to predict the GMV of the pre-hypothesized regions-of-interest (ROIs) based on CD diagnosis, with intracranial volume, age, sex, and IQ serving as the covariate.ResultsA diagnosis of CD was a significant predictor for GMV in the right pars orbitalis, right insula, right superior temporal gyrus, left fusiform gyrus, and left amygdala (F(1, 180) = 5.460–10.317, p < 0.05, partial eta squared = 0.029–0.054). The CD participants had smaller GMV in these regions than the TD participants (MCD–MTD = [− 614.898] mm3–[− 53.461] mm3).ConclusionsAltered GMV within specific regions may serve as a biomarker for the development of CD in adolescents. Clinical work can potentially target these biomarkers to treat adolescents with CD.

Fear of birth among Iranian fathers of full-term and preterm neonates: A cross-sectional study

BackgroundPregnancy, childbirth, and parenting can cause different emotional reactions in fathers, in addition to mothers, including fear of childbirth. PurposeTo compares the fear of childbirth among fathers of preterm and term infants. Study designThis cross-sectional study included 157 fathers with preterm neonates (below 37 weeks) and 314 with term neonates (above 37 weeks) in Tabriz, Iran. The instruments used for data collection included socio-demographic and obstetric characteristics and paternal fear of childbirth questionnaires. The data were analyzed using a general linear model. ResultsThere was a statistically significant difference between the two groups regarding the total score of fear of childbirth (p < 0.001). Also, a multivariate general linear model with adjusted socio-demographic and obstetric characteristics found no significant difference in the fear of childbirth between the fathers of term and preterm neonates. There was a statistically significant association between a father's fear of birthing and his wife's gestational age and parity, with men who had primiparous women and premature infants reporting the greatest levels of anxiety. ConclusionThis study found that first-time fathers whose spouses are primiparous and whose gestational ages are short tend to fear childbirth more. Providing support and interventions during the prenatal period is essential for reducing this anxiety.