Hierarchical Regression Research Articles

Social Support’s Dual Mechanisms in the Loneliness–Frailty Link Among Older Adults with Diabetes in Beijing: A Cross-Sectional Study of Mediation and Moderation

Background: The mechanisms linking loneliness to frailty in older adults with diabetes remain unclear. Guided by the Loneliness–Health Outcomes Model, this study is the first to simultaneously validate the dual mechanisms (mediation and moderation) of social support in the loneliness–frailty relationship among older Chinese adults with diabetes. Methods: A cross-sectional study enrolled 442 community-dwelling adults aged ≥ 60 years with type 2 diabetes in Beijing. Standardized scales assessed loneliness (UCLA Loneliness Scale), frailty (Tilburg Frailty Indicator), and social support (SSRS). Analyses included Pearson’s correlations, hierarchical regression, and PROCESS macro to evaluate mediating/moderating effects, after adjusting for demographics and comorbidities. Results: The frailty prevalence was 55.2%. Loneliness was positively correlated with frailty (r = 0.327, p < 0.01), while social support showed inverse associations with both loneliness (r = −0.496) and frailty (r = −0.315) (p < 0.01). Social support partially mediated loneliness’s effect on frailty (indirect effect: 30.86%; 95% CI: 0.028–0.087) and moderated this relationship (interaction β = −0.003, p = 0.011). High-risk clusters (e.g., aged ≥ 80 years, widowed, and isolated individuals) exhibited combined “high loneliness–low support–high frailty” profiles. Conclusions: Social support reduces the frailty risk through dual mechanisms. These findings advocate for tiered clinical interventions: (1) targeted home-visit systems and resource allocation for high-risk subgroups (e.g., solo-living elders aged ≥80 years); and (2) the integration of social support screening into routine diabetes care to identify individuals below the protective threshold (SSRS < 45.47). These findings advance psychosocially informed strategies for diabetes management in aging populations.

Social Exchange in Intergenerational Relationships over the Family Life Course: Reciprocity Dynamics in Support to Older Mothers

Abstract Objectives Parent-child relationships are characterized by exchanges of support across the family life course. This investigation examined whether earlier financial and service support provided by parents incentivized adult children to provide support to older mothers. Direct, indirect, anticipatory, and contingent reciprocity are employed to test four types of intergenerational exchange. Methods Data derived from 470 baby-boom children and their parents participating in the Longitudinal Study of Generations. Parental provisions (financial and childcare support, bequest intentions, and assistance provided to grandparents) served as lagged predictors of instrumental and socio-emotional support provided to older mothers in five waves between 1997 and 2021/22. Multilevel models were estimated for 1,324 child-mother observations and tested the direct effects of parental provisions and their interaction with mothers’ vulnerability. Results Financial support received by children predicted greater frequency of both types of support to mothers, demonstrating direct reciprocity. Adult children provided more socio-emotional support to mothers who assisted their own parents, supporting indirect reciprocity. Financial support produced higher marginal returns of instrumental support to mothers with greater vulnerability, consistent with contingent reciprocity. Little evidence was found for anticipatory reciprocity inherent in a bequest motive. Discussion Results were consistent with reciprocity as an underlying mechanism in intergenerational exchanges and revealed long-term consequences of parents’ resource distribution to children. Reciprocity as insurance against unmet needs was mostly limited to financial assistance, a key resource helping children manage the economic challenges of adulthood. We suggest future research continue to refine the theory and empirical identification of motivations behind intergenerational exchanges.

Geographic and social inequalities in public school proximity to active landfills in the U.S.

ABSTRACT This study is the first nationwide analysis of the proximity between public schools and landfills in the United States. Early environmental justice (EJ) research examined waste sites near schools, but little work has been conducted since then. Using 2021–2022 data on public school locations and demographics, we assessed associations between school-level characteristics and proximity to landfills at 1 km, 3 km, and 5 km distances. We found that 986 public schools, serving over nearly half a million students, are located < 1 km of an active landfill. In multilevel models (n = 86,664), schools with higher proportions of students of color were more likely to be proximate to landfills. School poverty was also associated with proximate landfills, as was charter school status. Elementary schools had lower odds of landfill proximity compared to high schools, while special education schools had higher odds. Inequalities in landfill proximity were more pronounced in urban vs rural areas for students of color, poor schools, and high schools. Inequalities were more pronounced in rural areas for alternative schools. Racial disparities in landfill proximity, rooted in historic and systemic inequalities, reflect the broader phenomenon of environmental racism continuing to shape educational environments in the United States.

Discretion and contextual influences on creative thinking

This investigation used a new method to measure the role of discretion in the creative process. In this context, discretion refers to a particular kind of awareness, and more specifically to an individual's intentional engagement in the creative process. In this investigation, discretion was operationalized as decisions about whether or not to express creative ideas in different social contexts. Discretion may lead an individual to express many creative ideas in one setting but fewer or no creative ideas in a different setting. Two sets of divergent thinking and idea preference measures were adapted from previous research and used to assess creative potential, along with self-reports of ideation, Big Five personality traits, and creative attitudes and values. The divergent thinking tasks were presented with instructions that suggested different social contexts. One context was relaxed and playful conditions, which previous research has shown to support originality. The other instructions described a work environment where there was pressure to succeed and an emphasis on correct ideas. Statistical analyses confirmed differences between the two conditions, suggesting that individuals exercised discretion when they generated ideas. Correlational and hierarchical regression analyses indicated that openness to experience, education, and creative potential were significantly related to discretion. Practical implications and suggestions for future research are discussed.

The Association Between Identity Functioning and Personality Pathology in Female Patients with Eating Disorders

Aims. In the present study, we investigated the associations between the three identity dimensions of Kaufman (Consolidated Identity, Disturbed Identity, Lack of Identity) and symptoms of personality disorders (PDs) in 176 female inpatients with an eating disorder (ED). We examined five aspects: the prevalence of categorical PD diagnoses in patients with EDs; the relationship between dimensional PD scores and identity dimensions as well as their relationships with age and ED subtype; and the unique variance in dimensional PD scores explained by identity dimensions, while controlling for age and ED subtype. Methods. To assess identity functioning, we made use of the Self-Concept and Identity Measure, and to assess PDs, we used the categorical and dimensional scores of the Assessment of DSM-IV Personality Disorders. Results. The findings showed that the avoidant, obsessive–compulsive, and borderline categorical PDs were the most frequently reported PDs. Age was negatively related to all Cluster B PDs and Disturbed Identity, and binge-eating/purging ED patients reported significantly more Cluster B PD features compared to restrictive ED patients. ED subtype and identity dimensions were unrelated. Correlational analysis showed that all dimensional PD scores were positively related to Disturbed Identity and Lack of Identity and negatively related to Consolidated Identity. The results of the hierarchical regression analyses showed that Cluster A PDs were significantly predicted by Lack of Identity, controlled for age and ED subtype. Additionally, Cluster B PDs were significantly predicted by Disturbed Identity. Finally, two of the three cluster C PDs were predicted by Lack of Identity (avoidant and obsessive–compulsive PD), whereas the dependent PD was explained by Disturbed Identity. Conclusions. The co-occurrence of identity issues in both PDs and EDs underscores the role of identity as a transdiagnostic feature. Accordingly, using identity-based interventions in treatment may have broad therapeutic benefits across these disorders.

The underexplored effects of economic transition on intellectual property rights protection: An economic geography perspective

Abstract As an institutional guarantee of technology and innovation, intellectual property rights (IPRs) protection at the national and supranational level has long been an important focus of economics and politics. However, very few studies have examined IPRs protection in the fields of geography and urban studies. Thus, this study aims to investigate IPRs protection within evolutionary economic geography (EEG) by highlighting the effect of economic transition. Taking Huaihai Economic Zone (HEZ), in China, as a sample, the study uses spatial multi-level modelling to better understand the impacts of the threefold process of economic transition (i.e., decentralisation, marketisation and globalisation) on IPRs protection. Our analysis reveals important new insights including: (1) the horizontal spatial distribution of IPRs protection is uneven both horizontally and vertically, and it has significant spatial hotspots; (2) The driving force of China’s internal marketisation and decentralisation policy positively influences IPRs protection, unlike in the Global North, because strong IPRs protection is not suitable for the economic conditions of countries in the Global South due to the negative effects of globalisation; (3) Economic transition has a major influence on IPRs protection at the prefectural level, but not at the provincial level. The contributions of the study are twofold: theoretically, it is one of the first paper to examine IPRs protection at the sub-national level within the framework of EEG, and to use the triangular process of economic transformation to explain the resulting institutional changes. Methodologically, based on the theoretical underpinnings of our study, we take different administrative levels and autocorrelation into consideration in our model.

A question of rate? Girl-women differences in motor unit firing rate.

To investigate age-related differences in motor unit (MU) activation patterns in females during submaximal knee extensions. Fourteen young women (22.1 ± 1.5 yrs) and 10 girls (9.8 ± 0.8 yrs) participated in the study. Following the determination of maximal strength (MVC), participants completed trapezoidal isometric contractions to 70%MVC and sEMG was recorded from the vastus lateralis. sEMG signals were decomposed, and MU firing rate (MUFR) and recruitment threshold (RT) were calculated. Group differences in MU activation patterns were assessed using multilevel modelling. Girls' MVC was significantly lower than young women's, even after accounting for body size (2.0 ± 0.4 and 2.6 ± 0.8Nm/body mass, respectively). The y-intercept of the MUFR-RT relationship was significantly lower in girls compared with the young women (estimate = 4.38pps; p < 0.05). There were no group differences in the MUFR-RT slope, reflecting lower MUFR in girls among low and high-threshold MUs. Lastly, the highest RT at which MUs were identified was significantly (p = 0.04) lower in girls (53.4 ± 7.2%MVC) compared with young women (60.5 ± 8.2%MVC). Overall, girls had lower MUFR and recruited their MUs over a smaller range of RTs compared with women. Together, these results suggest that girls and young women utilize different MU activation schemes when performing high-intensity knee extensions. Specifically, compared with women, girls may have to recruit more MUs over a narrower recruitment range due to their lower MUFRs.

Prediction of Depression and Anxiety Symptoms in Older Adults from Objectively Measured Physical Activity

Abstract Background In the context of global population aging, research on physical activity and mental health in older adults is increasingly warranted. While previous studies revealed cross-sectional associations between objectively measured physical activity and depression in older adults, the longitudinal relationship remains unexplored. This longitudinal study aimed to examine the effects of objectively measured physical activity on future depression and anxiety. Methods Data were obtained from 477 residents of Nakanojo town who were able to walk independently. Physical activity was measured using an electronic accelerometer, and participants completed the Hospital Anxiety and Depression Scale (HADS) annually. Using these repeated measurements, a longitudinal dataset was constructed by pairing physical activity data with HADS scores measured the following year. Multilevel models were used to predict HADS depression and anxiety scores measured one year after physical activity data collection. Results For the depression model, based on 1,963 records from 454 participants, longer durations of moderate to vigorous physical activity (MVPA) were associated with lower depression scores the following year (coefficient = -0.44; 95% confidence interval [CI] = -0.59 to -0.28; p &lt; 0.001). Similarly, in the anxiety model, which included 1,938 records from 452 participants, longer MVPA durations were linked to lower anxiety scores in the subsequent year (coefficient = -0.27; 95% CI = -0.41 to -0.13; p &lt; 0.001). Conclusions These findings suggest that higher levels of physical activity may be associated with reduced future symptoms of depression and anxiety in community-dwelling older adults capable of walking.

An Integrative Literature Review on Sustainability-Oriented HRM: How Multilevel Thinking May Help to Extend the State of the Art

ABSTRACT The purpose of this study is to integrate literature on different types of sustainability-oriented HRM concepts (SOHRM) with the use of multilevel thinking as well as to provide recommendations for future research in this stream. An integrative literature review was used to aggregate a body of studies. A total of 220 articles have been examined with the focus on an in-depth content analysis of 125 empirical papers which are based on quantitative research and include HRM system as a variable. This study reveals that despite of growing interest in change towards sustainable orientation, SOHRM field is underdeveloped in the theoretical, methodological, and empirical domains of scholarly inquiry. There are shortcomings related to the understanding of both the antecedents and outcomes of S-HRM and the mediators and moderators of relationships between SOHRM and outcomes, which may impede both change towards implementing the SOHRM practices and the development of theory in this area. The proposed multilevel model explains how SOHRM is influenced by stakeholders at different levels and impact them referring to the achievement of Sustainable Development Goals. This interplay between HRM practices and stakeholder engagement can offer novel insights into driving sustainable change. MAD statement This integrative literature review on sustainability-oriented HRM (SOHRM) is vital for understanding organizational change towards sustainability. By critically analysing 220 articles, this study not only bridges gaps in the current SOHRM research but also pioneers a multilevel perspective, providing comprehensive lens to examine how SOHRM both impacts and is affected by different stakeholders. Our findings offer a novel multilevel model that aligns HRM strategies with Sustainable Development Goals, guiding both scholars and practitioners towards sustainable organizational transformations. This paper is a call to action for embracing multilevel thinking in HRM, a crucial step for organizations committed to sustainable development.

Socioeconomic inequality and determinants of low birth weight in Kenya: a multilevel analysis using 2022 demographic and health survey.

Socioeconomic inequality remains a critical determinant of health outcomes worldwide, particularly in low- and middle-income countries. In Kenya, one of the most pressing maternal and child health challenges is the high prevalence of low birth weight (LBW), which is a key indicator of infant health and a strong predictor of neonatal and child morbidity and mortality. Therefore, exploring socioeconomic inequality and the determinants of LBW in Kenya is essential for developing effective policies and interventions. A cross-sectional study was conducted using secondary data from the 2022 Kenyan Demographic and Health Survey. A weighted total sample of 4717 live births in the two years prior to the survey was included in the study. The concentration index and concentration curve were used to investigate socioeconomic inequality in LBW among newborns. In addition, a multilevel regression model was used to identify the determinants, and the adjusted odds ratio with a 95% confidence interval was used to determine statistical significance. The prevalence of low birth weight among live births in Kenya was 8.71%. It was inequitably distributed across socioeconomic groups, with a concentration index of (-0.0295), with a higher concentration of LBW infants among mothers living in the lowest socioeconomic quintile. Mothers without formal education, poor wealth index, female sex, multiple births, and antenatal care visits were all significant predictors of LBW. This study highlights that LBW remains a significant issue in Kenya, disproportionately concentrated in households in the lowest socioeconomic quintile. Factors such as lack of maternal education, poverty, being female, being a twin, and inadequate antenatal care visits were significant predictors. To address these issues, it is important to improve maternal education, economic prosperity, healthcare accessibility, gender-sensitive approaches, and specialized care for multiple pregnancies, and encourage regular antenatal care visits for better birth outcomes and to reduce LBW prevalence. Hence, Kenyan governments and non-governmental organizations should address the complex factors to improve birth outcomes and reduce LBW.

Expression of Concern: Exploring the determinants of exclusive breastfeeding among infants under-six months in Ethiopia using multilevel analysis

Expression of Concern: Exploring the determinants of exclusive breastfeeding among infants under-six months in Ethiopia using multilevel analysis

긍정심리자본이 대학생의 삶의 만족도에 미치는 영향: 학업소진의 매개효과와 질적 경험 분석

Objectives This study aims to analyze the impact of positive psychological capital on life satisfaction among university students and to verify the mediating effect of academic burnout in this relationship. In addition, it seeks to explore students’ subjective experiences of academic burnout through qualitative analysis to gain deeper insight into its underlying causes. Specifically, it investigates various factors that contribute to decreased life satisfaction due to academic burnout, thereby proposing educational intervention strategies to help alleviate it. Methods A mixed-methods approach was employed, incorporating both quantitative and qualitative analyses. For the quantitative component, a survey was administered to 1,779 students enrolled at D University in Seoul. Validated scales were used to measure positive psychological capital (PsyCap), life satisfaction, and academic burnout. Analytical methods included descriptive statistics, correlation analysis, and hierarchical multiple regression analysis (HMR). Results The analysis revealed that positive psychological capital had a significant positive effect on life satisfaction, whereas academic burnout was found to have a negative impact on life satisfaction. Furthermore, academic burnout was shown to partially mediate the relationship between certain subcomponents of positive psychological capital—hope, resilience, and self-efficacy—and life satisfaction. In the qualitative analysis, the major factors contributing to academic burnout were categorized into: ① academic and achievement-related factors, ② mental and emotional factors, ③ future and career anxiety factors, ④ environmental and interpersonal relationship factors, ⑤ physical and lifestyle habit factors, and ⑥ time and self-management factors. In particular, emotional exhaustion, feelings of inefficacy, and cynicism were identified as the core subcomponents of academic burnout. Conclusions This study empirically demonstrates that academic burnout among university students stems not only from academic or career-related stress but also from a combination of emotional, environmental, and physical factors. Based on these findings, universities should consider developing psychological and emotional support systems aimed at strengthening students' positive psychological capital and reducing academic burnout. Future research should investigate concrete intervention strategies to prevent academic burnout and enhance life satisfaction.

Evaluation of a training programme for interpreters in the field of trauma-focused cognitive behavioural therapy – one year follow-up

ABSTRACT Background: If the patient does not speak the national language, access to the healthcare system is usually only possible via an interpreter. The need for evaluated training for interpreters working in this field is emphasized in the literature, particularly in the context of psychotherapeutic treatment. This study evaluates a TF-CBT-specific training course for interpreters over a period of one year. Methods: The TF-CBT-specific training was conducted in the form of webinars via the online communication provider Zoom in 10 sessions with 10–15 participants each. The content of the training included the topics of trauma and PTSD, how to establish a constructive working relationship with the therapist, and the modules of TF-CBT with an explanation of the therapeutic principles. In a previous study knowledge gain and a change of an attitude that is more conductive to good cooperation was archived by the workshop in prä-post-tests. In this study the training was evaluated at the 6-month and 12-month follow-up using hierarchical linear regression. Results: Results show that attitude change remained stable over the one-year period. Knowledge and psychotherapy support were statistically significant predictors. Knowledge gained during training decreased over time. Attitude and psychotherapy support were identified as statistically significant predictors. Discussion: The evaluated training for interpreters, who were willing to interpret in a TF-CBT for children and adolescents, showed a stable improvement in attitudes regarding good cooperation with the therapist. Knowledge about PTSD and TF-CBT, did not remain stable over the period of one year after the training. In other comparable training courses, this could be compensated for by consolidation in supervision meetings.

Association Between Body Image and Quality of Life of Women Who Underwent Breast Cancer Surgery

Breast cancer is a condition characterized by the uncontrolled growth of breast cancer cells. The treatment for the disease, such as surgery, chemotherapy, radiotherapy, and systemic therapy, can significantly impact patients’ body image and overall quality of life. This study aimed to evaluate body image perceptions and cancer-related quality of life in women who underwent surgical treatment for breast cancer at a reference hospital in southern Brazil. One hundred six women with breast cancer, aged 21 to 93 years (M = 55.3; SD = 12.9), participated in this cross-sectional study. They responded to the Body Image and Relationships Scale (BIRS), Functional Assessment of Cancer Therapy for Breast Cancer scale (FACT-B), and a questionnaire on clinical and sociodemographic variables. Multiple linear regression analyses revealed that general perceived body image, as measured by BIRS, was significantly predicted by younger age and chemotherapy (F(2, 99) = 7.376, p = 0.003). These predictors accounted for 11.2% of the variance in BIRS (adjusted R2 = 0.112). Hierarchical multiple regression analysis indicated that cancer-related quality of life was significantly predicted by younger age, use of psychiatric medication, and body image domains, including strength and health, social barriers, and appearance and sexuality. The complete model, encompassing all predictors, was significant (F(5, 96) = 15.970, p &lt; 0.001) and explained 42.6% of the variance in FACT-B (adjusted R2 = 0.426). Clinicians should be aware that younger patients who have undergone chemotherapy for breast cancer may experience changes in body image perception following surgery. Contributing factors such as younger age, use of psychiatric medications, and negative postoperative body image may be associated with a diminished quality of life related to cancer.

Multilevel Investigation of Higher Tourism Education Service Quality in the Digital Era

Digital transformation poses significant challenges for higher education institutions in tourism education, where technological integration is crucial. Leveraging the technology affordance theory lens, a multilevel framework posits the concepts of substitution, augmentation, modification, and redefinition (SAMR) as key principles. This model represents a progressive and transformative approach that educators can utilize through digital tools to enhance the quality of educational services by making strategic investments aligned with the needs of digital transformation. Data was collected from 209 faculty members and 2,466 corresponding students across seven Egyptian tourism colleges. Multilevel structural equation modelling results revealed that digital transformation requirements have a positive influence on the enhancement and transformation stages of SAMR, thereby improving educational service quality. Findings demonstrate how institutional requirements shape faculty members' actualization of technological affordances across the SAMR stages, progressing from essential substitution to transformative redefinition.

Speech-in-Noise Ability and Signal to Noise Ratio Predict the Timing of Hearing-Impaired Listeners' Intertalker Saccades When Observing Conversational Turn-Taking: An Explorative Investigation.

We explored the hypothesis that, when listeners visually follow the turn-taking of talkers engaged in a conversation, the timing of their eye movements is related to their ability to follow the conversation. We made use of a re-purposed dataset where adults with hearing impairment (N = 17), assisted by hearing aids, observed audiovisual recordings of dyadic conversations presented via a television screen and loudspeakers. The recordings were presented with multitalker babble noise at four signal to noise ratios (SNRs), in 4-dB steps ranging from -4 to 8 dB, to modulate the participants' ability to follow the conversation. We extracted time windows around conversation floor transfers (FTs) in the stimulus where participants reacted by moving their gaze from one talker to the next, termed FT-intertalker saccades (ITS). We recorded the timing of this eye movement relative to the onset of the new talker's speech. In addition, participants completed a separate word-recognition test to measure their speech perception in noise (SPIN) ability at the same SNRs as used for the conversation stimuli. We predicted that the timing of FT-ITS would be delayed with difficult SNR levels and for listeners with low SPIN ability. The effect of SPIN ability was tested first as a continuous variable, and subsequently with participants divided into high and low SPIN-ability groups. Multilevel linear modeling showed that the timing of FT-ITS was predicted by SNR condition and SPIN group, but no effect was found for SPIN ability as a continuous variable. Post hoc comparisons (uncorrected for multiple comparisons) indicated that delayed FT-ITS were associated with low SPIN ability, and both the hardest and easiest SNR conditions. The full model accounted for 34.5% of the variance in the data, but the fixed effects of SPIN and SNR together accounted for only 2.3%. Although the results should be interpreted with caution due to limitations in the experiment design, they provide preliminary support that FT-ITS timing can be used as a measure of hearing-impaired listeners' ability to follow a conversation. This first exploration of this question can serve future studies on this topic, providing guidance on the range of perceptual difficulty where this measure may be sensitive, and recommending a modeling approach that takes into account differences between stimuli.

Multi-level phenotypic models of cardiovascular disease and obstructive sleep apnea comorbidities: A longitudinal Wisconsin sleep cohort study

Cardiovascular diseases (CVDs) are prevalent among obstructive sleep apnea (OSA) patients, presenting significant challenges in predictive modeling due to the complex interplay of these comorbidities. Current methodologies predominantly lack the dynamic and longitudinal perspective necessary to accurately predict CVD progression in the presence of OSA. This study addresses these limitations by proposing a novel multi-level phenotypic model that analyzes the progression and interaction of these comorbidities over time. Our study utilizes a longitudinal cohort from the Wisconsin sleep cohort, consisting of 1,123 participants, tracked over several decades. The methodology consists of three advanced steps to capture the relationships between these comorbid conditions: (1) performing feature importance analysis using tree-based models to highlight the predominant role of variables in predicting CVD outcomes. (2) developing a logistic mixed-effects model (LGMM) to identify longitudinal transitions and their significant factors, enabling detailed tracking of individual trajectories; (3) and utilizing t-distributed stochastic neighbor embedding (t-SNE) combined with Gaussian mixture models (GMM) to classify patient data into distinct phenotypic clusters. In the analysis of feature importance, clinical indicators such as total cholesterol, low-density lipoprotein, and diabetes emerged as the top predictors, highlighting their significant roles in CVD onset and progression. The LGMM predictive models exhibited a high diagnostic accuracy with an aggregate accuracy of 0.9556. The phenotypic analysis yielded two distinct clusters, each corresponding to unique risk profiles and disease progression pathways. One cluster notably carried a higher risk for major adverse cardiovascular events (MACEs), attributed to key factors like nocturnal hypoxia and sympathetic activation. Analysis using t-SNE and GMM confirmed these phenotypes, which marked differences in progression rates between the clusters. In conclusion, our study provides a profound understanding of the dynamic OSA-CVD interactions, offering robust tools for predicting CVD onset and informing personalized treatment strategies.

Effects of the Enactive, Iconic, Symbolic (EIS) Intervention on Student Math Skills in Primary School

Abstract «Enactive, Iconic, Symbolic» (EIS) is a recently developed program modeled after instructional methodologies used in the Singapore math approach. The intervention emphasizes sequential mastery of math concepts, problem solving, and the use of the Concrete to Pictorial to Abstract approach (CPA). This quasi-experimental study evaluates the impact of EIS program on student math performance to explore the applicability of the Singapore approach in the Italian context and define the most appropriate methods for future large-scale evaluations. Eleven third- through fifth-grade treatment classes were matched comparison classes using propensity score matching, with mathematics performance measured before and after the intervention. A two-level random intercept hierarchical linear model was used to estimate treatment impact. We found no statistical significance effects of EIS after 16-20 weeks, ranging between 0.12 to 0.35 standard deviation units. The findings suggest the need for further investigations through largescale evaluations.

The association between depressive symptomatology and demographic characteristics, sexual minority identity, and discrimination experiences among lesbian and gay-identified South Korean adults

This study investigated predictors of depressive symptomatology among South Korean cisgender lesbians (N = 631) and gay adults (N = 1,181) using multiple hierarchical regression analysis. Group-specific differences emerged: LGBTQ+ community connectedness was a significant predictor only for gay men. Discrimination experiences varied; sexual minority identity-related family verbal violence was associated with depressive symptomatology in lesbians, while public discrimination was significant for gay adults. Both groups shared similarities in demographic factors affecting depressive symptomatology, including education, income, subjective class, and health status. The study revealed distinct predictors of depressive symptomatology for lesbians and gay adults in South Korea, emphasizing the need for tailored social work interventions that consider each group’s unique characteristics.

Professional quality of life of child welfare workers and psychotherapists working with traumatized young unaccompanied refugees in Germany: a cross-sectional study

Abstract Background Burnout symptoms and secondary traumatic stress are especially high among Child Welfare Workers (CWWs) and psychotherapists and might have increased since the recent increase in refugee numbers. Little is known about the wellbeing of CWW and psychotherapists working with unaccompanied young refugees (UYR), especially in German child and youth welfare facilities where they work closely together. This study aims to assess levels of compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) in German CWWs and psychotherapists, examining connections to demographic variables and group differences. Methods N = 198 CWW and N = 97 psychotherapists were assessed via the Professional Quality of Life Scale (ProQOL). Descriptive statistics, t-test for independent samples, correlations between the ProQOL scales and hierarchical regression analyses with demographic variables as predictors were computed. Results Both samples showed average to high levels of CS, and low to average levels of BO and STS. CWWs scored significantly higher than psychotherapists on BO and STS. In CWW, demographic variables were not associated with CS, BO or STS. Among psychotherapists, previous experiences in working with UYR (β = 0.38; p &lt;.001) were positively associated with CS. Factors such as weekly therapy sessions (β = − 0.35, p =.001) and the psychotherapist’s migration background (β = − 0.20, p =.048) were negatively associated with STS. The number of PTSD cases treated (β = 0.27, p =.018) and additional training (β = 0.31, p =.006) were positively associated with STS. Conclusion Among psychotherapists, prior experience in working with UYRs may contribute to elevated levels of CS, whereas a higher number of previously treated PTSD cases appears to be associated with increased STS. Further research on the influence of sociodemographic variables is needed for CWWs to identify protective and risk factors. Supporting and training CWWs and psychotherapists is crucial for quality treatment of traumatized UYRs.