Standardized Path Coefficients Research Articles

Contributing to sustainable smallholder agriculture through optimizing key agricultural inputs in China

Smallholder agriculture contributes substantially to global food production, yet often does not follow the most sustainable practices. Different agricultural inputs result in variegated and unpredictable economic and environmental outcomes. Here, we developed a generalizable approach to promote multi-objective coordination by optimizing smallholder agricultural inputs, and then applied it in winter wheat-summer maize rotation systems in the North China Plain. We found that smallholder farmers used a large range of agricultural inputs, with maximum and minimum values differing by a factor of 2.4–14. Using a structural equation model, we determined that pesticide, working hours, irrigating water, and chemical N fertilizer were the key inputs influencing food security, economic sustainability, resource sustainability, and environmental sustainability, respectively, with standardized path coefficients of −0.224, −0.436, −0.643, and −0.901. Lastly, we calculated that optimizing agricultural inputs can potentially improve food security, economic sustainability, resource sustainability, and environmental sustainability by 9–27%, 15–61%, 8–20%, and 5–14%, respectively. Our framework provides a generalizable approach for smallholder agriculture-dominated areas to achieve multi-objective sustainability.

Mechanistic insight into enhanced methyl orange degradation by Raoultella planticola/MoS2 biohybrid: Implication for electron transfer and microbial metabolism

The biodecolorization of traditional azo dyes is typically hindered by low electron transfer rate, a challenge that can be addressed by incorporating nanoparticles with redox properties to establish a stable biohybrid system. Here, a surface precipitated R. planticola/MoS2 biohybrid characterized by excellent biocompatibility was developed. The findings revealed that hybrid molybdic sulfide (MoS2) at concentrations ranging from 0.1 to 0.7 mM facilitated the biodecolorization of methyl orange (MO), with the R. planticola/MoS2(0.5mM) exhibiting the highest decolorization efficiency. The levels of nicotinamide adenine dinucleotide (NADH), adenosine triphosphate (ATP) in the R. planticola/MoS2 biohybrid increased by 92.08%, 42.61%, respectively, indicating a significant enhancement in microbial metabolic activity. Moreover, the electron transfer system activity (ETSA) of the biohybrid increased by 85.89%, accompanied by a decrease in charge transfer resistance, while MoS2 may involved in and contributed to a notable improvement in the electron transfer capability of the system. Structural equation modeling analysis showed a significant correlation between the R.planticola/MoS2 with extracellular polymeric substances (EPS) and antioxidant stress capacity, with standardized path coefficients of 0.837 and 0.999, respectively, indicating enhanced environmental adaptability of R. planticola. Even after 4 cycles of decolorization, the efficiency remained above 90%, demonstrating good stability. This study comprehensively elucidated the synergistic promotion mechanism of the R. planticola/MoS2 in enhancing MO biodegradation through enhancements in microbial metabolic activity and electron transfer capacity. The findings present a novel strategy for accelerating the biodecolorization of azo dyes and deepening the understanding of the interactions between nanomaterials and microorganisms.

Structural equation model analysis of the effect of visceral fat on osteoporosis

BackgroundOsteoporosis is a considerable public health challenge in Moyu County, Xinjiang. Here, we evaluated the influencing factors of osteoporosis in this region.MethodsWe recruited 7,761 participants and randomized them into normal and osteoporotic populations based on T-score. The effects of general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet on osteoporosis were analyzed. Furthermore, a structural equation model was constructed to uncover the direct and indirect influencing factors of osteoporosis.ResultsAmong the participants, 1,803 (23.23%) had normal bone mass while 1,496 (19.28%) had osteoporosis. The univariate analysis showed significant differences in the general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet. Stratification based on age (45 years) and body mass index (BMI) (18.5 kg/m2) showed variations in the body composition between the two groups; however, the visceral fat differed significantly. Logistic regression analysis affirmed the association of visceral fat index as it was included in all equations, except for age and female menopause. The structural equation exhibited that the general conditions, body composition, and, calcium sources, and exercise were direct factors of osteoporosis, while respiratory exposure and daily diet were indirect factors. The standardized path coefficient was highest in general conditions, followed by body composition, and lastly, calcium sources and exercise.ConclusionObesity, besides age and female menopause, is also an influencing factor of osteoporosis. The visceral fat index plays a vital role in osteoporosis. Our findings may provide experimental evidence for early prevention and treatment of osteoporosis.

A cluster-randomized controlled trial of a teacher-coaching intervention: a pilot study aimed at supporting classroom climate and student development

ABSTRACT This pilot study examined the utility of a practice-based coaching (PBC) intervention in Swedish elementary schools designed to support the classroom climate and benefit students. The intervention involved activities, self-assessment, observation, and coaching to the teachers, with the aim of improving the classroom climate and students’ self-concept, prosocial behavior, well-being, and academic achievement. The design was a cluster randomized trial with the school as the assignment unit. Participants in the intervention were 66 students in four classes, and in the control, four classes with 77 students. The duration of the intervention was five months. An autoregressive structural equation model was estimated. The correlations between the latent variables at pre-test ranged from low to high. There were significant standardized path coefficients concerning all the latent variables pre- and post-test. The estimates of the intervention at the post-test were non-significant. The results suggested a longer duration of the intervention with more frequent coaching sessions, which may enhance its effect.

Association of self-leadership and epidemic risk perception on quality of life in post-pandemic mainland of China: a cross-sectional study.

Self-leadership has proven to adjust individual psychological states and promote active behaviors to mitigate stress perception and negative lifestyle. This study aims to investigate the relationship between self-leadership, epidemic risk perception, and quality of life among the general public in post-pandemic mainland of China. Two online self-reported questionnaire surveys were carried out with 3,098 and 469 people in the Chinese mainland in February 2021 and December 2022, respectively. The univariate analysis, structural equation modeling, and fuzzy-set qualitative comparative analysis were used to analyze the data which was collected by Revised Self-Leadership Questionnaire, Perceived Risk of COVID-19 Pandemic Scale and World Health Organization Quality of Life Brief Scale. The Self-leadership was directly, moderately, and positively correlated with quality of life (Standardized path coefficients: 0.383 and 0.491, respectively; p < 0.05), and epidemic risk perception was negatively correlated with quality of life (Standardized path: 0.068 and 0.120, respectively; p < 0.05). The structural equation model for self-leadership, epidemic risk perception, and quality of life had a good fit (CFI = 0.957, 0.939 > 0.9; RSMEA = 0.058, 0.064 < 0.08, respectively) and was consistent across genders, educational levels, and types of occupations (Delata-CFI < 0.01). The core condition for achieving a high quality of life lies in maintaining a low level of self-punishment and a high level of self-cueing or a high level of self-punishment and a low level of self-cueing. In the post-epidemic era, the public can adjust their attitude toward stress by enhancing their self-leadership skills. Among various self-leadership skills, self-punishment or self-cueing may have the most significant impact on the quality of life.

Associations of vegetable and fruit intake, physical activity, and school bullying with depressive symptoms in secondary school students: the mediating role of internet addiction

BackgroundFew studies have simultaneously focused on the associations of vegetable and fruit intake, physical activity, school bullying, and Internet addiction (IA) with depressive symptoms. This study aimed to explore the direct and indirect effects of the above factors on depressive symptoms in adolescents by constructing a structural equation model (SEM).MethodsThis study was conducted in Qingdao from September to November 2021. A total of 6195 secondary school students aged 10–19 years were included in the analysis. Information on all variables was assessed using a self-administered questionnaire. An SEM was constructed with depressive symptoms as the endogenous latent variable, IA as the mediating variable, and vegetable and fruit intake, physical activity, and school bullying as the exogenous latent variables. The standardized path coefficients (β) were the direct effects between the latent variables, and the indirect effects were obtained by the product of direct effects between relevant latent variables.ResultsThe median value with the interquartile range of depressive symptom scores was 7 (3,12). Vegetable and fruit intake (β=-0.100, P<0.001) and physical activity (β=-0.140, P<0.001) were directly negatively related to depressive symptoms. While school bullying (β=0.138, P<0.001) and IA (β=0.452, P<0.001) were directly positively related to depressive symptoms. IA had the greatest impact on depressive symptoms. Vegetable and fruit intake, physical activity, and school bullying could not only directly affect depressive symptoms, but also indirectly affect depressive symptoms through the mediating effect of IA, the indirect effects and 95% confidence intervals (CIs) were -0.028 (-0.051, -0.007), -0.114 (-0.148, -0.089) and 0.095 (0.060, 0.157), respectively. The results of the multi-group analysis showed that the SEM we constructed still fit in boy and girl groups.ConclusionsThe results indicated that vegetable and fruit intake, physical activity, school bullying, and IA had a significant direct impact on depressive symptoms, among which IA had the greatest impact. In addition, both vegetable and fruit intake, school bullying, and physical activity indirectly affected depressive symptoms through the mediating effect of IA. The impact of IA on depressive symptoms should be given extra attention by schools and parents. This study provides a scientific and effective basis for the prevention and control of adolescent depressive symptoms.

Divergent changes in particulate and mineral-associated organic carbon under natural revegetation along a soil texture gradient in temperate grasslands of China

The natural revegetation of grasslands can stimulate belowground carbon inputs and facilitate the storage of soil organic carbon (SOC), which is conducive to the restoration of grassland ecosystems. Previous studies have investigated the dynamics of organic carbon (OC) in bulk soil, but paid little attention to OC fractions within aggregates. This study explored the response of OC changes in functionally distinct fractions, namely particulate organic matter (POM) and mineral-associated organic matter (MAOM), to natural restoration through systematic measurements of two grassland vegetation species at three study sites along a soil texture gradient in the Loess Plateau. In naturally restored grasslands, the SOC and OC contents of POM (POM_C) and MAOM (MAOM_C) within bulk soil and aggregates were significantly (p < 0.05) higher relative to bare land, with more effective improvement of POM_C (1.01−6.55 times) than MAOM_C (0.88−4.26 times). Compared to cover type (6.01 %−26.04 %), soil texture explained the variance of OC fractions to a greater extent (56.39 %−88.16 %). Soil texture had a larger contribution to MAOM_C in bulk soil with standardized path coefficients for total effect of 0.78 than POM_C, which had a coefficient of 0.67 (p < 0.05). Moreover, the growth rate of the MAOM_C pool exhibited a gradual decline (p < 0.001), which subsequently approached saturation level despite a persistent increase in total SOC in both bulk soil and aggregates. During soil carbon sequestration, aggregate fractions with relatively smaller particle size reached the MAOM_C saturation more easily than fractions with larger size. The findings of this study highlight the important role of soil texture in determining the saturation level of the MAOM_C pool at the regional scale. In the development of soil carbon sequestration strategies, more attention should be paid to the divergent behaviors of different SOM fractions and their distinct responses to natural restoration at larger spatiotemporal scales.

Development, validation and reliability testing of the hospice care environment scale

BackgroundWHO stated the environment is an important factor affecting the development of hospice care. The environment is the sum of factors affecting behavior besides the individual factors. Currently, a scale to comprehensively assess the hospice environment of nurse is still lacking. This study aimed to develop an instrument to investigate the environmental factors affecting hospice care of nurses.MethodsLiterature review and a semi-structured interview were conducted to form the items pool of the Hospice Care Environment Scale. Two rounds of Delphi expert consultation were conducted by 16 experts to revise the scale dimensions and entries to form the Hospice Care Environment Scale. A psychometric evaluation was then performed among 530 oncology nurses in a large tertiary oncology hospital in Hubei Province. The 500 valid questionnaires were randomly divided into two groups in a 1:1 ratio, sample 1 (n1 = 250) for item screening and sample 2 (n2 = 250) for quality evaluation of the resulting scale. Item analysis, reliability analysis, validity analysis and acceptability analysis were performed.ResultThe Hospice Care Environment Scale consists of two dimensions and 13 entries. The Cronbach’s α coefficient of the Hospice Care Environment Scale was 0.970, and the Cronbach’s α coefficient of the two dimensions were 0.952 and 0.969, respectively, with the Item-content validity index and average Scale- content validity index of the scale was both 1.000. The validation factor analysis showed the standardized path coefficients of each item were basically above 0.5, and the factor structure model was stable and suitable. The average completion time of the scale was about 3 min, which had good feasibility.ConclusionThe Hospice Care Environment Scale to assess the environment of hospice care services, has good content and construct validity and reliability. This scale can provide guidance to evaluate the hospice care environment.

Resident water conservation behaviors among different age groups in rural areas of the Weibei arid belt, China

Understanding water conservation behaviors across various age groups is crucial for developing effective water resource management strategies particularly in arid and semiarid zones. Based on a semi-structural questionnaire survey of 445 households in China's Weibei arid belt and extended Theory of Planned Behavior Model, a Structural Equation Model (SEM) was constructed to elucidate the age-related impact of water conservation knowledge, attitudes, subjective norms, and perceived control on water-saving behaviors. The results show that (1) youth group prioritizes personal hygiene and laundry activities whereas the elderly exhibit lower such requirements. (2) Water consumption varies significantly by age, with the elderly group consumes the least, averaging 62.26 L per capita per day (Lpcd), followed by the middle-aged group at 73.95 Lpcd, and the youth at the highest consumption rate of 84.60 Lpcd. (3) Influential factors on water conservation behavior differ substantially by age: Among the youth, water conservation behavior is strongly influenced by attitude in this domain (standardized path coefficient [SPC] = 0.32). The middle-aged group is influenced by subjective norms (SPC = 0.27) and attitudes toward water conservation (SPC = 0.27). Conversely, the elder group's behavior is dominated by knowledge (SPC = 0.35) and perceived control (SPC = 0.32). Given such distinct perceptions and behaviors of household water consumption, tailored water conservation strategies are essential of water conservation education through social media for youth, tiered pricing for the middle-aged, and water-saving subsidies to the elderly in the case areas.

미용인의 NCS화장품 능력단위인지와 현장활용성 및 화장품학 교과만족도 관계 연구

Objectives The purspose of this study is to analyze the effect of cosmetics National Competency Standards recognition on cosmetics subject necessity and subject satisfaction through field usability.&#x0D; Methods A survey was conducted on 304 cosmetologists who had experience in cosmetic course. To verify the research hypothesis, the structural equation model was establised and analyzed using AMOS, and bootstrapping was used to verify the mediation effect. The significance of the mediation effect was verified again through the Sobel Test.&#x0D; Results Recognition of cosmetics NCS had a positive (+) effect on field usability. Field usability had a positive (+) significant effect on the cosmetics subject necessity and had a positive (+) effect on cosmetics subject satisfaction. It was confirmed that the recognition of cosmetics NCS did not have a direct effect on the cosmetics subject necessity, and only the indirect path was significant, confirming that field usability had a complete mediation effect. In the relationship between whether it is an cosmetics NCS recognition, field usability, and cosmetics sbject satisfaction, the indirect path generates a standardized path coefficient that greatly exceeds 1.0, and the direct path was an inconsistent mediation effect with opposite sign values, confirming that the direct path had a spurious effect. This means that in the relationship between cosmetics NCS recognition and cosmetics subject satisfaction, field usability has a complete mediation effect.&#x0D; Conclusions Cosmetics NCS recognition does not have a direct effect on the necessity of cosmetics subject and satisfaction of cosmetics subject, but field usability plays a complete mediation role and has an effect. This can be said to be a result that corresponds to the characteristics of the practical-oriented beauty occupation. The cosmetics NCS should be reorganized according to the beauty occupations so that cosmetics can be used more safely and appropriately in the field of beauty work by major that utilizes cosmetics.&#x0D;

Childhood Gender Nonconformity and Sexual Orientation Disparities in Depressive Symptoms: The Role of Parental Attitudes.

Purpose: This study tested whether sexual orientation disparities in depressive symptoms are partially explained by recalled childhood gender nonconformity and whether the proportion of this association explained by childhood gender nonconformity is moderated by recalled parental attitudes toward childhood gender nonconformity. Methods: A convenience sample of young adults was recruited from two Chinese online survey platforms (272 heterosexual males, 272 bisexual males, 272 gay males, 272 heterosexual females, 272 bisexual females, and 272 lesbian females). Both mediation and moderated mediation models were conducted. Results: For both sexes, bisexual and gay/lesbian individuals reported significantly higher levels of depressive symptoms than heterosexual individuals, with total effects (standardized path coefficients) ranging from 0.25 to 0.38, all ps < 0.01. These sexual orientation disparities in depressive symptoms were partially explained by childhood gender nonconformity, with indirect effects ranging from 0.08 to 0.17, all ps < 0.001. The effect of childhood gender nonconformity on depressive symptoms was significantly moderated by parental attitudes. The mediating effect of childhood gender nonconformity on sexual orientation disparities in depressive symptoms was strongest at the more negative levels (one standard deviation [SD] above the mean) of parental attitudes and weakest at more tolerant levels (one SD below the mean) of parental attitudes. Conclusions: Childhood gender nonconformity may be a partial contributor to sexual orientation disparities in depressive symptoms and this indirect effect may be moderated by parental attitudes toward childhood gender nonconformity, with the indirect effect decreasing when parental attitudes move from negative toward more tolerant levels.

A Study on Factors Influencing Designers’ Behavioral Intention in Using AI-Generated Content for Assisted Design: Perceived Anxiety, Perceived Risk, and UTAUT

This study aims to comprehensively understand the intention to use Artificial Intelligence Generated Assistance in Design Tools (AIGC) among design students and practitioners, along with its influencing factors. Utilizing Smart-PLS software and Partial Least Squares Structural Equation Modeling (PLS-SEM) technique, we constructed a comprehensive research model. Based on 404 valid questionnaire responses, we systematically analyzed the underlying mechanisms of designers’ attitudes towards AIGC tools. The sample encompasses diverse schools and levels of professional experience, ensuring the wide applicability of research outcomes. In the data analysis process, professional statistical analysis methods, including path analysis and standardized path coefficients, were employed to ensure a profound exploration of research questions. The results indicate that performance expectancy, effort expectancy, social influence, and facilitating conditions significantly positively influence the willingness to use AIGC tools, while perceived anxiety and perceived risk exert negative impacts. This study, by integrating traditional and novel factors, provides crucial theoretical and practical guidance for the actual application of AIGC technology in the design field, offering profound insights for the future development and education of design technology.

Longitudinal relationship between grip strength and cognitive function in a European population older than 50 years: A cross-lagged panel model

ObjectivesThe aim of this study was to investigate the dynamic longitudinal relationship between grip strength and cognitive function. Methods6175 participants aged ≥50 years were included in the study using three waves of follow-up data from the Survey of Health, Ageing, and Retirement in Europe in 2015 (T1), 2017 (T2) and 2019 (T3). Cognitive function was assessed using numeracy, verbal fluency, immediate recall, delayed recall and total. The cross-lagged panel model was used for analysis. ResultsThere was a correlation between grip strength and cognitive function. Standardized path coefficient from numeracy T1 to grip strength T2 was 0.017 (p = 0.003), and from numeracy T2 to grip strength T3 was 0.014 (p = 0.012). Standardized path coefficient from grip strength T1 to numeracy T2 was 0.096 (p < 0.001), and from grip strength T2 to numeracy T3 was 0.113 (p < 0.001). Other indicators of cognitive function had similar relationships with grip strength. ConclusionsThe study found a statistically significant longitudinal and bidirectional relationship between grip strength and cognitive function in a sample of people aged ≥50 years from several European countries.

Body Part Pain Affects Subjective and Objective Handball Performance in Japanese Male National Athletes-Results of Short-Term Practical Monitoring of Athletes' Conditions.

This short-term survey examined the effect of body part pain on subjective and objective handball performance in Japanese male national handball athletes. Fourteen athletes participated in this study. Assessments of pain in 10 body parts and subjective performance (concentration and satisfaction with body movement) were performed using a visual analog scale from 0 to 10 over four consecutive training days. Monitoring of heart rate and body acceleration during training was also performed to quantify the objective performance. Path analysis and linear mixed modeling were employed to assess the relationship between body pain scores and subjective/objective handball performance. Over the four days of the study period, the body part in which most athletes reported pain was the dominant shoulder (6 of 14 athletes), followed by the dominant knee, the dominant elbow, the dominant ankle joint, and the non-dominant ankle joint (3 of 14 athletes). The path analysis revealed that pain in the dominant elbow negatively correlated with concentration (standardized path coefficient = -0.644, p = 0.00), which was associated with satisfaction with body movement (standardized path coefficient = 0.704, p = 0.00). No significant effect of body pain on objective performance (heart rate and body acceleration) was found among the athletes in this study. The results suggested that the elite athletes were practicing with pain. Even if pain does not physically affect athletes' objective performance, pain in the upper extremities, associated with the primary handball movement of throwing, may reduce the quality of practice by lowering athletes' subjective performance.

Design a Data Analytics Training System to Explore Behavioral Intention and Immersion for Internal Enterprise Education

This research delves into the integration of the CDIO framework and gamified learning into a web crawling system, aiming to elevate the innovation and practical skills of corporate trainees. The study examines the effects on learning achievement, immersion, and behavioral intentions among corporate trainees. Results indicate that those utilizing the gamified web crawling learning system exhibit enhanced learning achievement. HMSAM analysis unveils notable standardized path coefficients, wherein perceived ease of use positively influences perceived usefulness, curiosity, joy, and control. Perceived usefulness and joy significantly impact behavioral intention to use, prompting corporate trainees to express a continued willingness to use the system. These findings deepen our comprehension of CDIO and gamified learning applications in corporate education and training, emphasizing the importance of aligning educational tools with the interests and preferences of corporate trainees.

The green mindset: how consumers’ attitudes, intentions, and concerns shape their purchase decisions

Purpose. The goal of the present investigation is to find out what effect environmental concern has as a moderator between green brand positioning, green brand knowledge, social value, and perspective on the green brand among young consumers. Design/methodology/approach. Information was gathered from 407 Bangladeshi university students, both public and private. The suggested model was evaluated with the assistance of SPSS version AMOS-24, using the Structural equation Modeling (SEM) method. Findings. According to the standardized path coefficients of the SEM, the findings suggest that environmental concerns have a great deal to do with young people’s green purchasing intentions. According to the results, ‘green brand positioning’ (GBP) and ‘green brand knowledge’ (GBK), directly and indirectly via ‘Attitude towards Green Brand’ (ATGB) affect ‘Green Purchasing Intention’ (GPI). But ‘social value’ (SV) and ATGB are indirectly important factors in determining intent to buy environmentally friendly products and have no direct effect on GPI. Here, as a moderator, ‘environmental concern’ (EC) plays a vital role. Practical implications. These insights may help companies better comprehend how customers view environmentally responsible products as well as what factors influence their purchase decisions. Additionally, it is essential for businesses to appreciate the significance of educating people about environmental issues in order to increase consumer awareness and encourage more sustainable consumption habits. Originality and value. The study’s findings might be quite instructive to firms and businesses and motivate young people to make environmentally friendly purchases. One of the first studies of its kind, its findings are extremely valuable for companies seeking to understand their customers’ perspectives on green brands because they may shed light on how environmental concerns can moderate consumer behavior when it comes to purchasing environmentally friendly products.

Women's status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling.

Skilled birth attendants (SBA) facilitate identifying and overcoming labor problems and saving lives. With one of the highest maternal death rates in the Asia-Pacific area, SBA utilization during childbirth among Papua New Guinea (PNG) women remains low. Women's status and empowerment are important factors in maternal and child health services and critical to maternal and child health development. This study is intended to apply structural equation modeling based on data from the Demographic and Health Survey (DHS) to evaluate the causal relationship between women's status, empowerment, and SBA utilization in PNG and the mechanisms of their influence. This study employed data from the 2016-2018 Papua New Guinea Demographic Health Survey (PNG DHS), which recruited 18,175 women aged 15-49 years. A multi-stage sample and a structured questionnaire were used to collect information on maternal health, women's empowerment, and related topics. STATA 17.0 was used to describe the data, while MPLUS 8.2 was employed for structural equation modeling and pathway analysis. The two empowerment dimensions of household decision-making (standardized path coefficient, β = 0.049, p < 0.05) and access to health services (β = 0.069, p < 0.01) were positively associated with SBA utilization, while the association between attitudes toward partner violence and SBA utilization was not statistically significant. In addition, mediation analysis revealed that education indirectly influenced SBA utilization through access to health services (β = 0.011, 95% CI: 0.002, 0.022). The findings confirmed the direct and indirect effects of women's status and empowerment on SBA utilization in PNG. Therefore, a call for further evidence-based interventions in PNG and possibly Pacific Small Island Developing States (PSIDS) is needed to improve women's educational attainment, household decision-making, and access to health services to enhance maternal and newborn health and well-being.

Analysis of Prescription Compliance and Influencing Factors in Cardiac Rehabilitation after Surgery in Children with Congenital Heart Disease Based on Generalized Trust Theory.

To understand the compliance, influencing factors, and action path of family cardiac rehabilitation exercise prescriptions for children after congenital heart disease surgery. A random sampling method was used to select 200 pediatric patients and their parents from a pediatric hospital in Shanghai. Among them, 57 cases (28.5%) of children's families followed the cardiac rehabilitation exercise prescription. Path analysis showed that peak oxygen uptake exerted a negative impact on the compliance of family cardiac-rehabilitation prescriptions for patients after congenital heart disease surgery through doctor-patient trust, with a standardized path coefficient of -0.246 (P = 0.001). Disease-related knowledge exerted a positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after congenital heart surgery through doctor-patient trust, with a standardized path coefficient of 0.353 (P < 0.001). The dimension of friend support in social support had a direct positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after cardiac surgery, with a standardized path coefficient of 0.641 (P = 0.006). The compliance of cardiac rehabilitation exercise prescription in children with congenital heart disease is not good and is affected by many factors, and there is a complex path relationship between various factors; the kilogram oxygen consumption of the child, the disease-related knowledge of the caregiver, and social support all play important roles in the compliance of the child's family's health prescription. SCMCIRB-K2021002-1.

Structural Equation Modelling to Identify Psychometric Determinants of Medication Adherence in a Survey of Kidney Dialysis Patients.

Medication non-adherence in dialysis patients is associated with increased mortality and higher healthcare costs. We assessed whether medication adherence is influenced by specific psychometric constructs measuring beliefs about the necessity for medication and concerns about them. We also tested whether medication knowledge, health literacy, and illness perceptions influenced this relationship. This study is based on data from a cross-sectional in-person questionnaire, administered to a random sample of all adult dialysis patients at a teaching hospital. The main outcome was self-assessed medication adherence (8-Item Morisky Medication Adherence Scale). The predictors were: concerns about medications and necessity for medication (Beliefs About Medication Questionnaire); health literacy; medication knowledge (Medication Knowledge Evaluation Tool); cognitive, emotional, and comprehensibility Illness perceptions (Brief Illness Perception Questionnaire). Path analysis was performed using structural equations in both covariance and variance-based models. Necessity for medication increased (standardized path coefficient [β] 0.30 [95% CI 0.05, 0.54]) and concerns about medication decreased (standardized β -0.33 [-0.57, -0.09]) medication adherence, explaining most of the variance in outcome (r2=0.95). Medication knowledge and cognitive illness perceptions had no effects on medication adherence, either directly or indirectly. Higher health literacy, greater illness comprehension, and a more positive emotional view of their illness had medium-to-large sized effects in increasing medication adherence. These were indirect rather and direct effects mediated by decreases in concerns about medications (standardized β respectively -0.40 [-0.63,-0.16], -0.60 [-0.85, -0.34], -0.33 [-0.52, -0.13]). Interventions that reduce patients' concerns about their medications are likely to improve adherence, rather than interventions that increase patients' perceived necessity for medication. Improving patients' general health literacy and facilitating a better understanding and more positive perception of the illness can probably achieve this. Our study is potentially limited by a lack of generalizability outside of the population and setting in which it was conducted.

The Impact of Digital Economy on Industrial Structure Upgrading under the Perspective of Political Economy

Abstract The rapid development of the new generation of digital technology and the increasing importance of the digital economy have brought new opportunities for China’s development and provided new ideas for the optimization of industrial structure as well as the improvement of industrial efficiency. In this paper, under the perspective of political economy, the evaluation index system of the comprehensive development level of the digital economy is constructed with the panel data of 30 Chinese provinces and municipalities from 2014 to 2023 as a sample, and the entropy weighting method is used to calculate the index of development. The rationalization and advanced upgrading of the industrial structure of the 30 provincial and municipal cities is studied by combining the Tel index and the added value of the tertiary/secondary industry. On this basis, the structural equation model was used to explore the role of the “digital economy” on “industrial structure upgrading”. The results of the study are as follows: the development level of China’s digital economy shows a stable growth trend from 2014 to 2023, with its average value increasing by 185.32%, and the average values of the advanced and rationalized levels of China’s industrial structure increasing and decreasing by 4.47% and 47.90%, respectively. The direct effect of the level of development on the improvement of industrial structure (i.e., Path 1) is significant, and the standardized path coefficient between the two is 0.162. The results of the study emphasize the need to comprehensively improve the level of development and to build an intermediary bridge between the digital economy and industrial structure upgrading by taking human capital, scientific and technological innovation, and consumption upgrading as important tools.