Previous Cross-sectional Analyses Research Articles

A Longitudinal Investigation of Lower-Risk Gambling Limits in the Canadian National Study.

Recent years have seen increased attention given to identifying and describing the levels of gambling participation that confer a risk of harm in order to generate public health advice regarding lower-risk gambling. However, most of the existing literature has failed to explicitly assess these limits in a prospective manner. The purpose of this study is to employ a methodology consistent with prior investigations to evaluate the level of gambling participation associated with an increased risk of future gambling-related harm. Using data from the Alberta Gambling Research Institute's National Project Online Panel Survey, risk ratios and Receiver Operating Characteristic (ROC) analyses were used to determine the relative risk of gambling-related harm associated with participating in a greater number of gambling formats, gambling more days per month, and spending a greater proportion of income gambling. Prospective lower-risk limits were largely consistent with those identified in previous cross-sectional analyses (e.g., no more than two gambling formats, no more than once a week), with the exception that higher limits were found for the percent of household income spent gambling (3.4-6.4% vs. 1%). We advise that future research on lower-risk gambling limits consider the use of more granular assessment instruments and prospective methods to more closely evaluate the association between gambling participation and gambling harm.

Postnatal methylmercury exposure and neurodevelopmental outcomes at 7 years of age in the Seychelles Child Development Study Nutrition Cohort 2

BackgroundConsumption of fish yields many nutritional benefits, but also results in exposure to methylmercury (MeHg). The developing brain is known to be particularly susceptible to MeHg toxicity in high doses. However, the potential impact of low-level environmental exposure from fish consumption on children’s neurodevelopment remains unclear. MethodsWe investigated postnatal MeHg exposure at 7 years and its association with a battery of 17 neurodevelopmental outcomes in a subset of children (n = 376) from 1535 enrolled mother-child pairs in Nutrition Cohort 2 of the Seychelles Child Development Study (SCDS NC2). Each outcome was modeled in relation to postnatal MeHg exposure using linear regression, adjusting for prenatal MeHg exposure, levels of maternal polyunsaturated fatty acids (PUFA), and several other covariates known to be associated with neurodevelopmental outcomes. ResultsMedian postnatal MeHg exposure at 7 years was 2.5 ppm, while the median prenatal MeHg exposure was 3.5 ppm. We found no statistically significant associations between postnatal MeHg exposure and any of the 17 neurodevelopmental outcomes after adjusting for prenatal MeHg exposure and other covariates. ConclusionsThese findings are consistent with previous cross-sectional analyses of the SCDS Main Cohort. Continued follow-up of the entire NC2 cohort at later ages with repeated exposure measures is needed to further confirm these findings.

Do women's empowerment and self-expression values change adolescents' gendered occupational expectations? Longitudinal evidence against the gender-equality paradox from 26 European countries.

Despite the increases in women's educational attainment in recent decades, female labor market participation and labor market returns are still lower than those of their male counterparts. Among the main factors explaining this persistence of economic inequality is the persistently gendered nature of occupational expectations, which results in gender segregation of labor. In this paper, we describe how gender-specific adolescents' occupational expectations change over time (2006-2018) and how women's empowerment and cultural norms might influence gender-specific occupational expectations. Against the backdrop of the research on the gender-equality paradox and from a comparative perspective, we focus on national and institutional characteristics to investigate how individual and national factors explain gendered occupational expectations. We answer our research questions by applying a two-step multilevel model with fixed effects. For this, we used PISA data and merged them with state-level information from 26 European countries. We add to existing research by making three contributions. First, we describe the changes in occupational expectations over time within European countries by looking at the gender composition of the desired occupation and distinguishing three categories (gender-typical, gender-balanced, and gender-atypical). Second, we investigate the relationship between national characteristics and the evolution of gendered occupational expectations separately by gender to reveal gender-specific mechanisms. Third, by using data from two-time points, we explore which national-level changes lead to changes in students' occupational expectations. Our first descriptive results show that the patterns of how students' occupational expectations change over time differ remarkably between countries. In 2018 in some countries, students' occupational expectations became more segregated while in others the number of students with gender-balanced or gender-atypical expectations increased. Our fixed effects models show that women's empowerment and self-expression value explained variance over time. For example, women's empowerment measured via an increase in women's employment and participation in parliament led to less gender-typical occupational expectations among girls and boys. Similarly, a rise in self-expression values led to less gender-typical occupational expectations, again for both boys and girls. Remarkably, our results do not verify the gender-equality paradox for occupational expectations, as is the case in previous cross-sectional analyses.

Posttraumatic stress symptoms and posttraumatic growth in Chinese adolescents after tornado: Cross-lagged panel network analysis.

Existing literature has yielded mixed results regarding the relationships between posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG). The recent network analysis provided opportunities to investigate the associations between PTSS and PTG on a more fine-grained level. Previous cross-sectional network analyses were unable to address the directionality of the temporal relationships between components of PTSS and PTG. Therefore, the current study aimed to model cross-lagged network of components of PTSS and PTG with longitudinal data to unveil the direction of their relationships. A sample of 202 adolescents (Mage = 14.36, 38% boys) who survived the Yancheng tornado were assessed with the Child PTSD Symptom Scale (CPSS) and Posttraumatic Growth Inventory (PTGI) at 9, 12, and 18 months following the tornado. Two cross-lagged panel networks were examined to model the temporal associations between components of PTSS and PTG. The T1-T2 Network was much denser than the T2-T3 Network. The majority of cross-cluster edges were directed from PTSS to PTG. Interestingly, two major components of PTSS, Avoidance and Intrusion shared vastly different relationships with PTG. While Intrusion positively predicted components of PTG, Avoidance exhibited negative predictive value on PTG. The study highlighted the differential relationships that Intrusion and Avoidance shared with the PTG components, suggesting that interventions could benefit from mitigating avoidance and incorporating intrusion into positive change. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Predictors of adolescents’ change in reading literacy: the role of reading strategies, reading motivation, and declarative metacognition

Declarative metacognition, use of reading strategies and reading motivation are important predictors of reading literacy. Moreover, reading motivation’s strong links with reading strategy use and declarative metacognition raise questions about whether motivation moderates the effects of the latter on reading literacy and its development during secondary school. Whereas most previous research implemented cross-sectional analyses focusing on one or more of the aforementioned variables, this study takes a longitudinal perspective to examine how reading motivation (reading for enjoyment versus interest), declarative metacognition and reading strategy use – directly or in interaction – concurrently predict reading literacy in Grade 7 and subsequent changes until Grade 9. Applying structural equation models to a sample of 4,037 secondary school students from the German National Educational Panel Study, the results revealed that reading for enjoyment and declarative metacognition had strong effects on reading literacy in Grade 7. In contrast, reading for interest exhibited a small negative effect and the effects of strategy use were negligible. Longitudinal analyses replicated the cross-sectional pattern with more modest effect sizes. Contrary to our hypotheses, the effects of declarative metacognition and reading strategy use on reading literacy at Grade 7 as well as changes in reading literacy until Grade 9 were not moderated by aspects of reading motivation. Finally, regarding the trajectory of reading literacy, our results challenge previous assumptions on the importance of reading for interest and reading strategies use, but also confirm earlier findings on the relevance of declarative metacognition and reading for enjoyment.

Inequities in ambient fine particulate matter: A spatiotemporal analysis in Canadian communities

BackgroundExposure to fine particulate matter (PM2.5) is associated with adverse health outcomes but communities are not randomly exposed to PM2.5. Previous cross-sectional environmental injustice analyses in Canada found disproportionately higher exposure to PM2.5 in low-income populations, visible minorities and immigrants. Beyond static surveillance, it is also important to evaluate how changes in PM2.5 exposure over time may differentially impact disadvantaged communities. We examine whether communities with different sociodemographic characteristics benefited equitably from the overall decreases in ambient concentrations of PM2.5 from 2001 to 2016 in Canada. MethodsWe derived census tract level estimates of average annual PM2.5 using validated satellite-based estimations of annual average PM2.5 concentration surfaces. We investigated how the spatial distribution of PM2.5 has evolved over 15 years (2001–2016) by comparing absolute values and rank percentiles of census tract level annual average PM2.5 concentrations in 2001 and 2016. Using decennial census data and multivariable linear regression, we determined if sociodemographic characteristics are associated with changes in exposure to PM2.5, accounting for geographic boundary changes between census periods. ResultsOverall, ambient PM2.5 concentrations decreased from 2001 (median of 9.1 μg/m3) to 2016 (median of 6.4 μg/m3), with varying provincial patterns. Across communities, ranked census tract specific PM2.5 in 2001 and in 2016 are highly correlated (Spearman's rho = 0.75). We found that, on average and accounting for provincial differences and baseline PM2.5, communities with greater density of aboriginal population, lower education, higher shelter-cost-to-income ratio, unemployment or lower income experienced smaller absolute decreases in PM2.5 from 2001 to 2016. ConclusionsIdentifying sociodemographic groups that benefit least from decreasing exposure to PM2.5 highlights the need to consider environmental injustice when designing or revising air pollution policies.

Inequities in exposure to ambient fine particulate matter in Canada

BACKGROUND AND AIM: Exposure to fine particulate matter (PM2.5) is associated with various adverse health outcomes. Previous cross-sectional analyses of environmental injustice in Canada found inequitable exposure to PM2.5 in low-income populations, visible minorities and immigrants. We expand on this literature by investigating if communities with different demographic characteristics benefit equitably from changes in ambient concentrations of PM2.5 from 2001 to 2016 in Canada. METHODS: We use census tract level estimates of average annual PM2.5 derived from satellite-based observations to investigate how the spatial distribution of PM2.5 has evolved over time. We use decennial census data to determine if demographic characteristics are associated with changes in exposure to PM2.5, accounting for geographic boundary changes between census periods. RESULTS:Ambient PM2.5 concentrations have decreased from 2001 (median of 9.1 μg/m³ across tracts) to 2016 (median of 6.4 μg/m³ across tracts), with varying provincial patterns. Across census tracts, ranked estimates of PM2.5 in 2001 and in 2016 are correlated (Spearman correlation coefficient = 0.75). Tracts with higher concentrations of PM2.5 in 2001 tend to remain among the most polluted tracts in 2016. Accounting for provincial differences and baseline PM2.5, census tracts with greater proportions of individuals with lower education, unemployed individuals or individuals who have lower income experience smaller absolute decreases in PM2.5 from 2001 to 2016. CONCLUSIONS:Identifying demographic groups that benefit least from changes in ambient concentrations of PM2.5 provides direction for research on reducing environmental injustice due to differential exposure. KEYWORDS: Environmental justice, Particulate matter, Socio-economic factors

Analysis of the association between serum PFAS levels measured in NHANES and subsequent development of stroke or myocardial infarction as assessed through linked Medicare claims data

Background/Aim: Per- and polyfluoroalkyl substances (PFAS) are persistent chemicals used in many products and manufacturing processes. Human exposure to some PFAS has been associated with serum cholesterol concentrations, but observed cardiovascular disease (CVD) associations have been inconsistent. Previous cross-sectional analyses of PFAS-CVD associations used U.S. National Health and Nutrition Examination Survey (NHANES) data. We prospectively examined associations between NHANES serum PFAS concentrations and subsequent myocardial infarction (MI), ischemic stroke (IS) or any stroke (AS), using linked National Death Index and Medicare claims data, for participants aged ≥65 years with PFAS measurements and Medicare fee-for-service enrollment (study population).Methods: NHANES (1999-2000, 2003-2012) serum PFAS concentrations [perfluorooctane sulfonate, perfluorooctanoic acid (PFOA), perfluorononanoic acid, perfluorohexane sulfonate] were analyzed using quartile (among cases) indicator variables and the natural log of quartile geometric means (continuous variable, trend test). CVD outcomes occurring after serum collection were identified, among participants reporting no prior history of the outcome, using linked (through 2013) Medicare claims ICD-9-CM codes and underlying cause-of-death ICD-10 codes. Survival analysis models with an age time scale; weighted to account for survey design and Medicare matching; and stratified on body mass index; controlled for survey cycle, age, gender, race/ethnicity, smoking, alcohol consumption, physical activity, education, and income-to-poverty ratio.Results: Among 1248 in the study population, 1078 reported no prior MI (72 developed MI) and 1102 reported no prior stroke (67 developed IS; 78 developed AS). Quartile-specific hazard ratios (HRs) and trends for all PFAS-outcome combinations were not statistically significant, but some elevated HRs were observed [e.g., IS HRs (95% confidence intervals) for PFOA quartiles 2-4 vs. 1: 2.04 (0.79-5.28), 1.98 (0.75-5.19), 1.63 (0.61-4.36)].Conclusions: This analysis did not provide clear evidence of an association between serum PFAS concentrations and MI, IS, or AS. Results should be interpreted considering study limitations (e.g., limited power, single exposure measurement).

Urinary mycoestrogens and age and height at menarche in New Jersey girls

BackgroundDespite evidence of the endocrine disrupting properties of zearalenone (ZEN) and alpha-zearalanol (zeranol, α-ZAL), they have been minimally studied in human populations. In previous cross-sectional analyses, we demonstrated that 9–10 years old girls with detectable urinary ZEN were of shorter stature and less likely to have reached the onset of breast development than girls with undetectable urinary ZEN. The aim of this study was to examine baseline concentrations of ZEN, (α-ZAL), and their phase-1 metabolites in relation to subsequent growth and timing of menarche using 10 years of longitudinal data.MethodsUrine samples were collected from participants in the Jersey Girl Study at age 9–10 (n = 163). Unconjugated ZEN, (α-ZAL), and their metabolites were analyzed using high performance liquid chromatography and tandem mass spectrometry. Information on height, weight, and pubertal development was collected at a baseline visit with annual follow-up by mail thereafter. Cox regression was used to evaluate time to menarche in relation to baseline ZEN, (α-ZAL), and total mycoestrogen exposure. Z-scores for height and weight were used in mixed models to assess growth.ResultsMycoestrogens were detectable in urine in 78.5% of the girls (median ZEN: 1.02 ng/ml, range 0–22.3). Girls with detectable urinary concentrations of (α-ZAL) and total mycoestrogens (sum of ZEN, (α-ZAL) and their metabolites) at baseline were significantly shorter at menarche than girls with levels below detection (p = 0.04). ZEN and total mycoestrogen concentrations were inversely associated with height- and weight-z-scores at menarche (adjusted β = − 0.18, 95% CI: -0.29, − 0.08, and adjusted β = − 0.10, 95% CI: -0.21, 0.01, respectively).ConclusionThis study supports and extends our previous results suggesting that exposure to ZEN, (α-ZAL), and their metabolites is associated with slower growth and pubertal development in adolescent girls.

The nature of the platyceratid–crinoid association as revealed by cross-sectional data from the Carboniferous of Alabama (USA)

The association of Paleozoic crinoids and platyceratid gastropods has drawn the attention of paleontologists for nearly 200 years. It has been variably interpreted as predatory, commensalistic, mutualistic or parasitic. Previous cross-sectional analyses of large populations of crinoids and platyceratids have favored the parasitic explanation for the interaction because of data suggesting that the average size of infested crinoids is less than that of their uninfested conspecifics. In this study, we examine a population of Dizygocrinus from the Carboniferous (Early Visean) Monteagle Limestone of Madison County, Alabama, USA. Of the 198 specimens examined from a single lens, 37 showed evidence of infestation by way of attached gastropods or drillholes at the base of their anal tubes—slender, cylindrical extensions of the tegmen with the periproct at the distal end. In contrast to the results of previous studies, the average size of the infested Dizygocrinus in this study was greater than that of the uninfested subset. Using conceptual and numerical models, we demonstrate that despite the slightly larger average size of the infested crinoids, the gastropods diminished the growth rates of their hosts. Thus, parasitism is the best explanation for this biotic interaction. The presence of an anal tube among the Monteagle Limestone Dizygocrinus may have diminished the negative impact of their parasites by increasing the length of the hindgut, and as a consequence, increased crinoids’ ability to absorb nutrients.

Does Physical Activity Mediate the Effect of Residential Greenness on Mental Health and Subjective Well-Being? Findings from the Sister Study

Although a growing body of research shows that exposure to natural environments benefits physical and mental health and well-being, there remain significant gaps in our understanding of the factors that influence the association between exposure and health and well-being outcomes. Addressing these gaps, we present results from two projects using health data from NIEHS’ Sister Study and residential greenness derived from the US National Land Cover Database. The Sister Study collects various measures from over 50,000 women aged 35-74 years across the United States. The cohort covers broad geographic distribution and demographics that help us understand the potential mechanisms between exposures to nature and health outcomes. Previous cross-sectional analyses of the Sister Study by Villeneuve and colleagues found reduced risks of obesity (body mass index ≥ 30) for women who lived in areas with the highest tertile of greenness within a 500m residential buffer (odds ratio (OR) = 0.83, 95% CI = 0.79–0.87) relative to those in the lowest tertile. Further, mediation analyses showed that physical activity attenuated the association between greenness and obesity by 32%. In this presentation, we analyze the associations between residential greenness within 250m, 500m, and 1250m buffers, and self-reported health, perceived stress, depressive symptoms and quality of life, controlling for sociodemographic factors, lifestyle, and environmental stressors. Then, we discuss how levels of physical activity mediate the association between mental health and residential greenness. Additionally, we extend previous analyses that investigated the association between overall physical activity and nearby greenness to examine associations with specific types of recreational physical activities, particularly those more likely influenced by proximal greenness. Finally, we discuss the impact of using different metrics for exposure assessment and propose future directions for this research.

NP36 - Using the Child as Change Agent for Preventing Childhood Obesity in Rural Georgia: Home Environment Results

Objective: The objective of this study was to determine if the Action Pack Families child as change agent intervention resulted in changes in the home food and physical activity environment of children over the course of a 3-year intervention. Description: This study was a group-randomized intervention that included all 10 elementary schools in a county in rural Georgia. Action Pack Families was a child as change agent nutrition and physical activity intervention with school, home, and community based components. The intervention was delivered by trained family nutrition educators in partnership with University of Georgia Extension. The school curriculum was designed to be physically active and experiential. Students were taught strategies for sharing what they learned with their families. In addition to the school-to-home activities that engaged families in intervention activities at home, the family component of the intervention included community events, family fun nights, and communication via Facebook. Community recognition and support of the program was enhanced by participation in local events. Evaluation: Child height and weight were collected at school by the research team; diet, physical activity, and home environment factors were self-reported by parents using a paper-pencil survey. Anthropometric data were collected at the beginning and end of each school year from 3rd through 5th grade. Parent survey data were collected at the beginning of each school year as well as at the end of 5th grade. Conclusions and Implications: Previous cross-sectional analyses of baseline data from this study suggested that the home environment does not necessarily influence the dietary behavior of children in the same way across all racial/ethnic groups. An analysis of intervention effects on home environment, dietary, and activity variables showed that the intervention impacted key variables for positive changes in the home environment with the effect varying across racial/ethnic groups. Using children as change agents might be effective in altering some home environment variables that could aid in preventing childhood obesity. Funding: 2012-68001-19625. The following is the supplementary data to this article: Download .pdf (.86 MB) Help with pdf files Poster

Seroadaptive Strategies of Vancouver Gay and Bisexual Men in a Treatment as Prevention Environment

ABSTRACTBritish Columbia’s treatment as prevention policy has provided free access to highly active antiretroviral therapy (HAART) to all HIV-positive provincial residents since 1996. One outcome is an increase in HIV-positive gay and bisexual men (GBM) with suppressed viral loads. Previous cross-sectional analyses indicated that some Vancouver GBM now recognize condomless anal sex with men on HAART who report a suppressed viral load as a seroadaptive strategy. To test the hypothesis that this new strategy, termed viral load sorting (VLS), is recognized and used among by GBM in the Momentum Health Study, we analyzed longitudinal data for HIV-negative/unknown (n = 556) and HIV-positive (n = 218) serostatus participants. Analyses indicated that both groups reported VLS, and that serostatus and Treatment Optimism Scale scores were significant determinants in frequency and use. Results exemplify the medicalization of sex and Rogers’ Diffusion Of Preventative Innovations Model, and they have important implications for HIV research and GBM sexual decision-making.

Longitudinal effects of religious involvement on religious coping and health behaviors in a national sample of African Americans

Many studies have examined associations between religious involvement and health, linking various dimensions of religion with a range of physical health outcomes and often hypothesizing influences on health behaviors. However, far fewer studies have examined explanatory mechanisms of the religion-health connection, and most have overwhelmingly relied on cross-sectional analyses. Given the relatively high levels of religious involvement among African Americans and the important role that religious coping styles may play in health, the present study tested a longitudinal model of religious coping as a potential mediator of a multidimensional religious involvement construct (beliefs; behaviors) on multiple health behaviors (e.g., diet, physical activity, alcohol use, cancer screening). A national probability sample of African Americans was enrolled in the RHIAA (Religion and Health In African Americans) study and three waves of telephone interviews were conducted over a 5-year period (N = 565). Measurement models were fit followed by longitudinal structural models. Positive religious coping decreased modestly over time in the sample, but these reductions were attenuated for participants with stronger religious beliefs and behaviors. Decreases in negative religious coping were negligible and were not associated with either religious beliefs or religious behaviors. Religious coping was not associated with change in any of the health behaviors over time, precluding the possibility of a longitudinal mediational effect. Thus, mediation observed in previous cross-sectional analyses was not confirmed in this more rigorous longitudinal model over a 5-year period. However, findings do point to the role that religious beliefs have in protecting against declines in positive religious coping over time, which may have implications for pastoral counseling and other faith-based interventions.

A marginal structural modeling strategy investigating short and long-term exposure to neighborhood poverty on BMI among U.S. black and white adults

We apply a marginal structural modeling (MSM) strategy to investigate the relationship between neighborhood poverty and BMI level among U.S. black and white adults. This strategy appropriately adjusts for factors that may be simultaneously mediators and confounders (e.g., income, health behavior), strengthening causal inference and providing the total (direct and indirect) neighborhood effect estimate. Short and long-term neighborhood poverty were positively associated with being overweight for both black and white women. No link was found for either black or white men. Socioeconomic and behavioral factors do not appear to be strong mediators. Sensitivity analyses suggest that the direction of point estimates is robust to unobserved confounding, though 95% confidence intervals sometimes included the null, particularly for white women. Compared to previous cross-sectional and longitudinal analyses, MSM results provide stronger evidence for a causal link between neighborhood poverty and body weight among women.

Determinants of annual change in physical activity in COPD.

Daily physical activity (PA) is reduced in patients with COPD. Previous cross-sectional analyses indicate various predictors for a low level of PA including airway obstruction, exacerbations and co-morbidities. However, information from longitudinal studies evaluating PA in the context of disease progression, survival and co-morbidities is scant. In a heterogeneous cohort of COPD patients, we annually assessed the number of steps per day over 1 week and potential determinants including lung function, exacerbations and co-morbidities. Univariable and multivariable mixed effect models were used to investigate associations between the change in steps per day (dependent variable) and possible predictors and their annual changes. A total of 177 COPD patients (46% GOLD (Global Initiative for Chronic Obstructive Lung Disease) stage 1/2, 38% stage 3 and 16% stage 4) with a mean (min/max) follow-up time of 2.7 (1/5) years were annually assessed. The number of steps per day decreased significantly over time (P < 0.001) with a mean annual change of -508 steps. The decrease in activity was significantly associated with forced expiratory volume in 1 s (FEV1 ) % predicted (P = 0.020) but not with annual changes in FEV1 . Hyperinflation, exacerbations, co-morbidities and their annual changes, and survival did not significantly affect change in PA. COPD patients have a substantial decrease of PA over time. This decrease seems to be determined by the degree of airflow limitation. However, patients with a greater annual decline in lung function did not show a greater decrease in PA. The rate of decline in PA did not differ between survivors and non-survivors in this cohort.

Nursing Skill Mix, Nurse Staffing Level, and Physical Restraint Use in US Hospitals: a Longitudinal Study

BackgroundAlthough it is plausible that nurse staffing is associated with use of physical restraints in hospitals, this has not been well established. This may be due to limitations in previous cross-sectional analyses lacking adequate control for unmeasured differences in patient-level variables among nursing units.ObjectiveTo conduct a longitudinal study, with units serving as their own control, examining whether nurse staffing relative to a unit’s long-term average is associated with restraint use.DesignWe analyzed 17 quarters of longitudinal data using mixed logistic regression, modeling quarterly odds of unit restraint use as a function of quarterly staffing relative to the unit’s average staffing across study quarters.Subjects3101 medical, surgical, and medical-surgical units in US hospitals participating in the National Database of Nursing Quality Indicators during 2006–2010. Units had to report at least one quarter with restraint use and one quarter without.Main MeasuresWe studied two nurse staffing variables: staffing level (total nursing hours per patient day) and nursing skill mix (proportion of nursing hours provided by RNs). Outcomes were any use of restraint, regardless of reason, and use of restraint for fall prevention.Key ResultsNursing skill mix was inversely correlated with restraint use for fall prevention and for any reason. Compared to average quarters, odds of fall prevention restraint and of any restraint were respectively 16 % (95 % CI: 3–29 %) and 18 % (95 % CI: 8–29 %) higher for quarters with very low skill mix.ConclusionsIn this longitudinal study there was a strong negative correlation between nursing skill mix and physical restraint use. Ensuring that skill mix is consistently adequate should reduce use of restraint.

Trusting the State, Trusting Each Other? The Effect of Institutional Trust on Social Trust

Trust in state institutions is a prominent explanation of social trust. However, previous—mainly cross-sectional—analyses provide limited causal evidence regarding the relationship between institutional trust and social trust and it is thus essentially unknown whether an observed relationship reflects reverse causality (social trust forming institutional trust), or both forms of trust reflecting deep-seated dispositions (common confounding). Against the backdrop of the shortcomings of previous cross-sectional analyses, this paper utilizes two Danish panel surveys containing measures of both types of trust for the same individuals surveyed at multiple points in time over a long time-span (up to 18 years) to address the potentially reverse and/or spurious relationship. Using individual fixed effects and cross-lagged panel models, the results provide strong evidence of trust in state institutions exercising a causal impact on social trust, whereas the evidence for a reverse relationship is limited.

Impact of Land Conservation Technologies on Agricultural Productivity in Tanzania

Land management and conservation have been considered the most important aspects of sustainable productivity in economically developing countries where land degradation is a major challenge. In Tanzania, both the government and international organizations have been promoting adoption of land management and conservation technologies (LMCTs) for a long time. This paper establishes the impact of three LMCTs – soil water conservation technologies and erosion control (SWCEC), organic and inorganic fertilizers – on maize crop yields in different rainfall zones, using national panel survey data. The study employs static panel models to analyse the two-period data sets for 2008-2009 and 2010-2011. The results indicate that adoption of LMCTs do contribute significantly to maize yield. The greatest effects of organic and SWCEC methods on crop yield were realized in low rainfall zones, while that of inorganic fertilizers was observed in high rainfall zones. These findings support previous cross-sectional data analyses, suggesting for policy makers that a blanket land management and conservation programme applied uniformly to all agro-ecological zones is not strategically beneficial. The advisability of a technology employed in a given zone should be supported by local knowledge and research findings culled from that particular area.

Antecedent predictors of children's initiation of sipping/tasting alcohol.

BackgroundSipping or tasting alcohol is one of the earliest alcohol-use behaviors in which young children engage, yet there is relatively little research on this behavior. Previous cross-sectional analyses determined that child sipping or tasting is associated with the child's attitude toward sipping and with a family environment supportive of alcohol use, but not with variables reflecting psychosocial proneness for problem behavior as formulated in Problem Behavior Theory (Jessor and Jessor, Problem Behavior and Psychosocial Development: A Longitudinal Study of Youth, 1977, Academic Press, New York). This study extended these analyses longitudinally to identify antecedent predictors of the childhood initiation of sipping or tasting alcohol in a multiwave study.MethodsA sample of 452 children (238 girls) aged 8 or 10 and their families was drawn from Allegheny County, PA, using targeted-age directory sampling and random digit dialing procedures. Children were interviewed using computer-assisted interviews. Antecedent variables collected at baseline (Wave 1) were examined as predictors of the initiation of sipping/tasting alcohol in childhood (before age 12) among Wave 1 abstainers (n = 286).ResultsNinety-four children initiated sipping/tasting alcohol in a nonreligious context between baseline and turning age 12. Initiation of sipping/tasting did not generally relate to baseline variables reflecting psychosocial proneness for problem behavior. Instead, as found in the previous cross-sectional analyses, the variables most predictive of initiating sipping/tasting were perceived parents' approval for child sipping, parents' reported approval for child sipping, parents' current drinking status, and children's attitudes toward sipping/tasting alcohol.ConclusionsThese longitudinal analyses replicate the earlier cross-sectional results. Young children's sipping/tasting of alcohol reflects parental modeling of drinking and parental approval of child sipping and does not represent a precocious manifestation of a psychosocial proneness to engage in problem behavior.