Relação entre fatores socioeconômicos e a pandemia da covid-19 / Correlation between socioeconomic factors and the COVID-19 pandemic

Resumo Este artigo objetivou verificar a relação entre os fatores socioeconômicos e a pandemia da covid-19 nos municípios de médio porte mineiros. O procedimento de análise de dados foi a modelagem de equações estruturais de mínimos quadrados parciais. As variáveis utilizadas foram vulnerabilidade, saneamento, renda, agravantes, vacinação, casos de covid-19, mortalidade por covid-19, hospitalização e doenças crônicas não transmissíveis. Os dados foram coletados no Índice Mineiro de Responsabilidade Social, no painel de monitoramento dos casos de covid-19 e no painel de monitoramento de vacinação contra covid-19. O recorte temporal foi determinado pelo início da pandemia e a disponibilidade de dados (março de 2020 a setembro de 2021). Os resultados evidenciaram que melhores condições de saneamento estão negativamente relacionadas aos casos de covid-19, a renda está positivamente relacionada com os casos de covid-19 e a taxa de mortalidade por doenças crônicas não transmissíveis está relacionada de forma positiva com a mortalidade por covid-19. Os casos de covid-19 têm impacto negativo na hospitalização e a hospitalização tem impacto positivo na mortalidade. Os casos moderados pela vacinação estão negativamente relacionados à mortalidade por covid-19. Os resultados confirmam que condições socioeconômicas menos favoráveis tornam a sociedade mais vulnerável a covid-19.

Abstract This study investigated the correlation between socioeconomic factors and the COVID-19 pandemic in medium-sized Minas Gerais municipalities. Data were analyzed by partial least squares structural equation modeling, using the following variables: vulnerability, sanitation, income, aggravating factors, vaccination, COVID-19 cases, COVID-19 mortality, hospitalization and non-communicable chronic diseases. Data were obtained from the Minas Gerais Social Responsibility Index, the COVID-19 cases monitoring panel and the COVID-19 vaccination monitoring panel. Data collection time frame was determined by the onset of the pandemic and data availability (March 2020 to September 2021). Results showed that better sanitation conditions are negatively related to COVID-19 cases, income is positively related to COVID-19 cases, and higher mortality from chronic noncommunicable diseases are positively related to COVID-19 mortality. COVID-19 cases have a negative impact on hospitalization and hospitalization has a positive impact on mortality. Cases, moderated by vaccination, are negatively related to COVID-19 mortality. These findings confirm that less favorable socioeconomic conditions make society more vulnerable to COVID-19.

Ergonomia en actividades académicas desde casa

Introducción: A consecuencia de la emergencia sanitaria por el virus SARS-CoV2, las actividades académicas migraron de forma repentina a un entorno de trabajo remoto; esto provocó que los hogares de todo el mundo se convirtieran en el asentamiento urgente de las estaciones de trabajo académico. La ergonomia como disciplina científica cobra relevancia al ser un aliado subsanador para mitigar los riesgos asociados con la aparición de lesiones musculoesqueléticas. De acuerdo con la memoria estadística del Instituto Mexicano de Seguridad Social, IMSS1, en el primer año de pandemia de COVID-19 se registraron 30 860 atenciones por lesiones en la región de manos y muñecas, 9696 en la zona de cabeza y cuello, 6251 dorsopatías y 1673 atenciones por astenopia a jóvenes de entre 18 a 29 años que desarrollaban actividades escolares. Objetivo: En este sentido, se aborda la presente investigación para conocer la composición de los espacios de trabajo académico en casa y analizar si existen factores o elementos que incidan en el riesgo de lesiones musculoesqueléticas en los estudiantes del nivel superior. Metodología: A través de un modelo de ecuaciones estructurales que cuenta con el constructo latente de las posibles lesiones (PL) en manos, espalda, piernas, cabeza, vista, oído, agotamiento físico y la respiración, las variables observables se atribuyen a los espacios utilizados para las actividades académicas en casa, muebles y equipos, Condiciones y Medio Ambiente (CyMAT). Resultados y discusión: Se encontró que un mal diseño de la estación de trabajo académico en casa, aunado a la utilización inadecuada de los muebles y equipos, aumenta la posibilidad de presentar síntomas asociados con las LMEs y, por tanto, daños en la salud del estudiante. Conclusión: La mediación de las estaciones de trabajo a través de la implementación de elementos ergonómicos mejora de forma sustancial la calidad de trabajo académico en casa, y hace evidente la importancia de la ergonomía como disciplina científica.

Introduction: As a result of the health emergency of the SARS-CoV2 virus, academic activities suddenly migrated to a remote work environment, causing homes around the world to become the urgent settlement of academic workstations. Ergonomics as a scientific discipline becomes relevant as it is a healing ally to mitigate the risks associated with the appearance of musculoskeletal injuries. According to the statistical report of the Mexican Institute of Social Security, IMSS1, in the first year of the COVID 19 pandemic, 30,860 care for injuries in the hands and wrists region, 9,696 in the head and neck area, 6,251 dorsopathies and 1,673 care for asthenopia were registered to young people between 18 and 29 years old who develop school activities. Objective: In this sense, this research is addressed to know the composition of academic workspaces at home and analyze if some factors or elements affect the risk of musculoskeletal injuries in students of the higher level. Methodology: Through a structural equations model that has the latent construct of possible injuries (PL) in the hands, back, legs, head, eyesight, hearing, physical exhaustion, and breathing; the observable variables are attributed to the spaces used for academic activities at home, furniture and equipment, conditions and environment (CyMAT) Results and discussion: It is explored that a bad design of the academic workstation at home coupled with the inappropriate use of furniture and equipment increases the possibility of presenting symptoms associated with SCI and therefore, damage to the student's health. Conclusion: The mediation of workstations through the implementation of ergonomic elements substantially improves the quality of academic work at home, making evident the importance of ergonomics as a scientific discipline

Green Products Purchase Intention in Chilean Consumers: Comparing Three Models Using Structural Equations / Intención de Compra de Productos Ecológicos en Consumidores Chilenos: Comparación de Tres Modelos por Ecuaciones Estructurales

Abstract The objective of this study was to compare three models: the theory of reasoned action (TRA), the theory of planned behavior (TPB), and its extended form (ETPB), to predict the intention of Chilean consumers for purchasing green products. Five hundred people were surveyed, establishing an inter-rater reliability analysis, and a discriminant, convergent and construct validity using three structural equation models (SEM). The results showed that the ETPB model is useful to explain the consumption behavior intention for green products based on a triple bottom line, whose main contribution is the indirect effect of EC on the model. The study found that of the three variables, PBC was the strongest predictor of purchase intention, followed by attitude. In conclusion, both the ETPB model and the green products purchase intention instrument contribute to broaden the studies about consumer behavior in sustainable marketing in Chile.

Resumen El objetivo del presente estudio fue comparar los modelos de teoría de acción razonada (TAR), teoría de comportamiento planificado (TCP) y su forma extendida (TCPE), para predecir la intención de compra de productos ecológicos en consumidores chilenos. Se encuestaron 500 personas y se estableció un análisis de fiabilidad interjuez, validez discriminante, convergente y de constructo a través de modelos de ecuaciones estructurales (SEM). Los resultados señalan que el modelo TCPE es útil para explicar la intención de comportamiento de consumo ante productos verdes con base en una triple línea de fondo, cuya principal contribución es el efecto indirecto de PA sobre el modelo. De las tres variables, se evidencia que el CCP era la predictora más fuerte de la intención de compra, seguida de la actitud. En conclusión, tanto el modelo TCPE como el instrumento de intención de compra de productos verdes contribuyen a la ampliación de estudios sobre el comportamiento del consumidor en marketing sustentable en Chile.

Analysis of influencing factors of caregiver preparedness at discharge of patients with chronic heart failure based on the individual and family self-management theory / 中国实用护理杂志

Objective:A structural equation model of the influencing factors on caregiver preparedness at discharge of patients with chronic heart failure was constructed based on the individual and family self-management theory, and the main paths influencing caregiver preparedness were explored.Methods:This study was a cross-sectional survey. A total of 345 caregivers of patients with chronic heart failure who were hospitalized in the Fourth Affiliated Hospital of China Medical University from October 2020 to August 2021 were selected as research objects by convenience sampling method, and they were investigated by Caregiver Preparedness Scale, Family APGAR Index, Herth Hope Index, Social Support-Rating Scale, Simplified Coping Style Questionnaire. The influencing factors on caregiver preparedness at discharge of patients with chronic heart failure were analyzed.Results:The total score of Caregiver Preparedness Scale, Family APGAR Index, Herth Hope Index, Social Support-Rating Scale, and Positive and Negative Coping Subscale of Simplified Coping Style Questionnaire in patients with chronic heart failure was (20.79 ± 4.92), (8.05 ± 1.43), (35.34 ± 4.47), (43.89 ± 6.56), (24.38 ± 5.21), (11.21 ± 4.26) points. Caregiver preparedness in patients with chronic heart failure was positively correlated with family function, hope, positive coping and social support ( r values were 0.213-0.383, all P<0.01), and negatively correlated with negative coping ( r=-0.546, P<0.01). Family function and social support in patients with chronic heart failure could directly or indirectly affect caregiver preparedness (total effect value: 0.380, 0.212), hope and negative coping directly affected caregiver preparedness (total effect value: 0.200, -0.433), and could account for 39% of the total variation in caregiver preparedness. Conclusions:Caregiver preparedness of patients with chronic heart failure needs further improvement. The effective ways to improve caregiver preparedness are to pay attention to family function, improve hope level, increase social support and reduce negative coping.

Experiencia del síntoma en el Síndrome Coronario Agudo: comprobación de un modelo conceptual / Symptom Experience in Acute Coronary Syndrome: Testing a Conceptual Model / Experiência de sintomas nas Síndromes Coronarianas Agudas: verificação de um modelo conceitual

Introducción: el síndrome coronario agudo (SCA) se caracteriza por diferentes síntomas, por lo cual la experiencia varía de persona a persona. El Modelo conceptual del manejo de los síntomas (MCMS) de Dodd aborda este aspecto que requiere ser comprobado dentro de la práctica de enfermería. Objetivo: comprobar los postulados de la dimensión de la experiencia de los síntomas del Modelo conceptual de Dodd en personas con síndrome coronario agudo. Métodos: comprobación teórica por medio de ecuaciones estructurales. Participaron 256 individuos con diagnóstico de síndrome coronario agudo, seleccionados por muestreo probabilístico estratificado. Se recolectaron datos clínicos, sociodemográficos y se midió la evaluación y respuesta a los síntomas con cinco instrumentos válidos. Se realizó un análisis estadístico con ajuste absoluto, ajuste incremental y ajuste de parsimonia del cual derivó un modelo de ecuaciones estructurales. Resultados: se comprobó la relación bidireccional entre la severidad del síntoma (evaluación) y la toma de decisiones (respuesta al síntoma). Se conformó un modelo que explica el 44 % de la varianza sobre la toma de decisiones. Sobre esta variable también influyen otras variables como la evaluación cognitiva y el control personal. Conclusión: este modelo conceptual permitió comprender la dimensión de la experiencia del síntoma en pacientes con síndrome coronario agudo, comprobando sus postulados en la práctica.

Introduction: acute coronary syndrome (ACS) is characterized by different symptoms, so the experience varies from person to person. Dodd's Conceptual Model of Symptom Management addresses this aspect that requires testing within nursing practice. Objective: to test the postulates of the symptom experience dimension of Dodd's Conceptual Model of Symptom Management in persons with acute coronary syndrome. Methods: theoretical testing by means of structural equations. A total of 256 individuals with a diagnosis of acute coronary syndrome, selected by stratified probability sampling, participated. Clinical and sociodemographic data were collected, and symptom assessment and response were measured with five valid instruments. Statistical analysis was performed with absolute adjustment, incremental adjustment and parsimony adjustment from which a structural equation model was derived. Results: the bidirectional relationship between symptom severity (assessment) and decision making (symptom response) was tested. A model was formed that explains 44% of the variance on decision making. This variable is also influenced by other variables such as cognitive evaluation and personal control. Conclusion: this conceptual model allowed us to understand the dimension of symptom experience in patients with acute coronary syndrome, proving its postulates in practice.

Introdução: Síndromes coronarianas agudas (SCA) caracterizam-se por diferentes sintomas, pelo que a experiência muda de pessoa para pessoa. O Modelo conceitual do manejo dos sintomas (MCMS) de Dodd aborda esse aspecto que precisa testes na prática de enfermagem. Objetivo: verificar os postulados da dimensão da experiência dos sintomas do Modelo conceitual de Dodd em pacientes com síndrome coronariana aguda. Métodos: verificação teórica por meio de equações estruturais. Participaram 256 indivíduos com diagnóstico de síndrome coronariana aguda, selecionados por amostragem probabilística estratificada. Dados clínicos e sociodemográficos foram coletados e a avaliação e resposta aos sintomas foi medida com cinco instrumentos válidos. Foi realizada análise estatística com ajuste absoluto, ajuste incremental e ajuste de parcimônia que derivou num modelo de equaciones estruturais. Resultados: verificou-se o relacionamento bidirecional entre a gravidade do sintoma (avaliação) e a tomada de decisão (resposta ao sintoma). Um modelo que explica 44% da variância sobre a tomada de decisão foi conformado. Sobre essa variável também influem outras variáveis como a avaliação cognitiva e o controlo pessoal. Conclusão: este modelo conceitual permitiu compreender a dimensão da experiência do sintoma em doentes com síndrome coronariana aguda, verificando seus postulados na prática.

Exploring factors associated with obesity in Argentinian children using structural equation modeling / Explorando factores asociados a la obesidad en niños argentinos usando un modelo de ecuaciones estructurales / Explorando fatores associados à obesidade em crianças argentinas utilizando a modelagem de equações estruturais

Abstract: Habits and behaviors related to obesity risk are strongly associated with the family environment and are affected by socioeconomic factors. Structural equation modeling (SEM) allows us to hypothesize on how the relationships between these factors occur and measure their impact. This study aimed to explore the relationship between family socioeconomic indicators and childhood obesity, mediated by habits linked to energy balance, applying a SEM. A cross sectional study was performed on 861 Argentinian schoolchildren aged 6-12 years, from 2015 to 2016. The model included three latent variables: socioeconomic status, healthy habits, and obesity. Socioeconomic status indicators and healthy habits were surveyed by self-administered parental questionnaires, whereas obesity indicators were evaluated with anthropometry. The applied model showed an acceptable fit (NFI = 0.966; CFI = 0.979; RMSEA = 0.048). Socioeconomic status positively influenced parental education, health insurance, and car possession, while negatively influenced crowding (p < 0.001). Healthy habits significantly influenced physical activity, meals frequency, and sleep hours, while negatively influenced sedentary hours and mother's nutritional status (p < 0.001). Obesity factor positively influenced body mass index, body fat, and waist-to-height ratio (p < 0.001). Finally, socioeconomic status positively influenced health habits, which in turn negatively influenced obesity factor. Healthy habits (especially physical activity and mother's nutritional status) mediated the relationship between socioeconomic status and child obesity. Further research should include other indicators related to diet, eating habits, and physical activity like neighborhood characteristics.

Resumen: Los hábitos y comportamientos relacionados con el riesgo de obesidad están fuertemente asociados al entorno familiar y se ven afectados por factores socioeconómicos. El modelo de ecuaciones estructurales (MEE) permite plantear hipótesis sobre cómo se dan las relaciones entre estos factores y medir su impacto. El objetivo del presente estudio fue explorar la relación entre los indicadores socioeconómicos familiares y la obesidad infantil, mediada por hábitos relacionados con el balance energético, aplicando un MEE. Se realizó un estudio transversal con 861 escolares argentinos de 6 a 12 años entre 2015 y 2016. El modelo incluyó tres variables latentes: nivel socioeconómico, hábitos saludables y obesidad. Los indicadores nivel socioeconómico y hábitos saludables se midieron mediante cuestionarios autoadministrados a los padres, mientras que los indicadores de obesidad se obtuvieron mediante antropometría. El modelo aplicado presentó un ajuste aceptable (NFI = 0,966; CFI = 0,979; RMSEA = 0,048). El nivel socioeconómico influyó positivamente en la escolaridad de los padres, en el plan de salud y en el hecho de tener automóvil, mientras que influyó negativamente en el hacinamiento (p < 0,001). La variable hábitos saludables influyó significativamente en la actividad física, en la frecuencia de las comidas y en las horas de sueño, pero influyó negativamente en las horas sedentarias y en el estado nutricional materno (p < 0,001). El factor obesidad influyó positivamente en el índice de masa corporal, en la grasa corporal y en la razón cintura/talla (p < 0,001). Finalmente, el nivel socioeconómico influyó positivamente en los hábitos saludables, que, a su vez, influyeron negativamente en la obesidad. Los hábitos saludables, en especial la actividad física y el estado nutricional materno, moderan la relación entre el nivel socioeconómico y la obesidad infantil. Las nuevas investigaciones deberían incluir otros indicadores relacionados con la dieta, con los hábitos alimentarios y con la actividad física, así como con las características del vecindario.

Resumo: Hábitos e comportamentos relacionados ao risco de obesidade estão fortemente associados ao ambiente familiar e afetados por fatores socioeconômicos. A modelagem de equações estruturais (MEE) permite levantar hipóteses sobre como ocorrem as relações entre esses fatores e medir seu impacto. O objetivo do presente estudo foi explorar a relação entre os indicadores socioeconômicos familiares e a obesidade infantil, mediada por hábitos ligados ao balanço energético, aplicando uma MEE. Um estudo transversal foi realizado com 861 escolares argentinos de 6 a 12 anos entre 2015 e 2016. O modelo incluiu três variáveis latentes: nível socioeconômico, hábitos saudáveis e obesidade. Os indicadores do nível socioeconômico e de hábitos saudáveis foram medidos por meio de questionários autoaplicáveis aos pais, enquanto os indicadores de obesidade foram obtidos por meio de antropometria. O modelo aplicado apresentou um ajuste aceitável (NFI = 0,966; CFI = 0,979; RMSEA = 0,048). O nível socioeconômico influenciou positivamente a escolaridade dos pais, o plano de saúde e a posse de automóvel, enquanto influenciou negativamente a aglomeração (p < 0,001). A variável hábitso saudáveis influenciou significativamente a atividade física, a frequência das refeições e as horas de sono, mas influenciou negativamente as horas sedentárias e o estado nutricional materno (p < 0,001). O fator obesidade influenciou positivamente o índice de massa corporal, a gordura corporal e a relação cintura/estatura (p < 0,001). Finalmente, o nível socioeconômico influenciou positivamente os hábitso saudáveis, que por sua vez influenciou negativamente a obesidade. Hábitos saudáveis, especialmente atividade física e estado nutricional materno, mediam a relação entre nível socioeconômico e obesidade infantil. Novas pesquisas devem incluir outros indicadores relacionados à dieta, hábitos alimentares e atividade física, como características da vizinhança.

Human papillomavirus vaccination behaviors among gynecological outpatients based on extended unified theory of acceptance and use of technology / 预防医学

Objective@#To investigate the factors affecting human papillomavirus (HPV) vaccination behaviors among gynecological outpatients based on extended unified theory of acceptance and use of technology (UTAUT2), so as to provide insights into the development of HPV vaccination behavioral interventions.@*Methods@# Patients at ages of 45 years and younger that were admitted to the outpatient department of gynecological of Shanxi Provincial People's Hospital from October 2021 to August 2022 were recruited, and the factors affecting HPV vaccination behaviors were identified using UTAUT2.@*Results@#A total of 431 female outpatients were enrolled, including 163 patients at ages of 36 to 45 years (37.82%), 272 cases with an educational level of college degree and above (63.11%) and 253 patients with per capita monthly household income of more than 3 000 Yuan (58.70%). The coverage of HPV vaccination was 24.36%, and the main cause of non-vaccination was difficulty in high-valent HPV vaccine appointment. Price value, social impact and efficacy expectation posed a positive impact on HPV vaccination behaviors via intention of vaccination (β=0.11, 0.08, 0.07, all P<0.05) and intention of vaccination and effort expectancy (β=0.10, 0.07, 0.06, all P<0.05), and effort expectancy played a mediating effect between intention of vaccination and vaccination behaviors (β=0.28, P<0.05).@*Conclusion@#Efficacy expectation, social impact, price value, intention of vaccination and effort expectancy may positively affect HPV vaccination behaviors.

Main and moderated effects of multimorbidity and depressive symptoms on cognition

Objective: Multimorbidity, or the occurrence of two or more chronic conditions, is a global challenge, with implications for mortality, morbidity, disability, and life quality. Psychiatric disorders are common among the chronic diseases that affect patients with multimorbidity. It is still not well understood whether psychiatric symptoms, especially depressive symptoms, moderate the effect of multimorbidity on cognition. Methods: We used a large (n=2,681) dataset to assess whether depressive symptomatology moderates the effect of multimorbidity on cognition using structural equation modelling. Results: It was found that the more depressive symptoms and chronic conditions, the worse the cognitive performance, and the higher the educational level, the better the cognitive performance. We found a significant but weak (0.009; p = 0.04) moderating effect. Conclusion: We have provided the first estimate of the moderating effect of depression on the relation between multimorbidity and cognition, which was small. Although this moderation has been implied by many previous studies, it was never previously estimated.

Effectiveness Comparison of Polysaccharides, Proteins, and Lipids as Composite Edible Coatings on the Quality of Food Products / Comparación de la Efectividad de Polisacáridos, Proteínas y Lípidos como Recubrimientos Compuestos Comestibles en la Calidad de los Productos Alimenticios

Background: This research was motivated by the complaints of tomato farmers about their crops that quickly rotted before being sold, as well as the many research results (raw materials and methods) that edible coating films could not be applied optimally. Objectives: The research was a practical recommendation by comparing the effectiveness of raw materials (polysaccharides, proteins, and lipids) with the dipping and spray methods. Materials and methods used in the comparison process were the application of Structural Equation Modeling (SEM) with the Partial Least Square (PLS) approach. Results: Dipping has a strong effect (f2 ≥ 0.35; p<0.05), while spray had a moderate effect (f2: 0.15-0.35; p<0.05). Thus, the role of dipping as a mediator was more dominant than spray. Compared to proteins and lipids, polysaccharides had the best effectiveness (ß:0.460-0.584; f2: 0.15-0.35; p<0.05). Conclusion: the three ingredients improved the quality of tomatoes, and the dipping method was easier to apply by farmers than the spray method, which had many obstacles in its application

Antecedentes: esta investigación está motivada por las quejas de los productores de tomate sobre sus cultivos que se pudren rápidamente antes de ser vendidos, así como por los muchos resultados de la investigación (materias primas y métodos) de que las películas de recubrimiento comestibles no se pudieron aplicar de manera óptima. Objetivos: La investigación consiste en recomendaciones prácticas mediante la comparación de la eficacia de las materias primas (polisacáridos, proteínas y lípidos) con los métodos de inmersión y aspersión. Métodos: El método utilizado en el proceso de comparación es la aplicación del modelo de ecuaciones estructurales (SEM) con el enfoque de mínimos cuadrados parciales (PLS). Resultados: La inmersión tiene un efecto fuerte (f2 ≥ 0,35; p<0,05), mientras que la pulverización tiene un efecto moderado (f2: 0,15-0,35; p<0,05). Por lo tanto, el papel de la inmersión como mediador es más dominante que el del rociado. Los polisacáridos tienen la mejor eficacia (ß:0,460-0,584; f2: 0,15-0,35; p<0,05) en comparación con las proteínas y los lípidos. Conclusión: es que los tres ingredientes pueden mejorar la calidad de los tomates, y el método de inmersión es más fácil de aplicar por los agricultores que el método de aspersión, que tiene muchos obstáculos en su aplicación

Soledad y ansiedad durante el confinamiento por COVID-19. El efecto mediador de la regulación emocional / Loneliness and anxiety during COVID-19 lockdown. The mediating effect of emotion regulation

Resumen El confinamiento ocasionado por la pandemia del COVID-19 ha impactado en la vida de los estudiantes universitarios en todo el mundo. Conocer sus efectos en la salud mental y el comportamiento será una prioridad en los siguientes años. En este contexto, el objetivo de la presente investigación fue analizar por primera vez las relaciones directas e indirectas entre la experiencia de soledad, las estrategias de regulación emocional desadaptativas (rumiación, evitación, supresión, catastrofización y autoculpa) y la ansiedad en una muestra de universitarios mexicanos. Con base en él, se hipotetizó que las estrategias de regulación emocional desadaptativas mediarían la relación entre la soledad y la ansiedad. Para lograr este propósito se especificó un modelo de ecuaciones estructurales. Un total de 824 estudiantes universitarios participaron en la presente investigación. Los resultados mostraron que los datos se ajustaron de manera adecuada al modelo estructural especificado. Por otra parte, también se encontró que la soledad tuvo un efecto directo que no fue estadísticamente significativo con la ansiedad. En conclusión, estos hallazgos revelan la presencia de un efecto de mediación al mostrar que la soledad estuvo relacionada indirectamente con la ansiedad por su relación con las estrategias de regulación emocional desadaptativas. Con ello, al analizar la función mediadora de las estrategias de regulación emocional desadaptativas se aportaron, por primera vez en México, nuevos elementos que permiten conocer con mayor profundidad los efectos directos e indirectos de estos tres constructos.

Abstract The lockdown caused by the COVID-19 pandemic has impacted the lives of undergraduate students around the world. Knowing its effects on mental health and behavior will be a priority for years to come. Due to the multiple negative effects that confinement by the COVID-19 pandemic has brought, this study aims to provide new scientific evidence that will allow a better understanding of the effects of the experience of loneliness caused by this pandemic. Based on the procedural model of emotion regulation created by Gross, the objective of this research was to analyze the direct and indirect relations between the experience of loneliness, maladaptive emotion regulation strategies (rumination, avoidance, suppression, catastrophizing, and self-blame) and anxiety in a sample of Mexican undergraduate students. Based on this goal, it was hypothesized that maladaptive emotion regulation strategies would mediate the relation between loneliness and anxiety. To achieve this purpose, a total of 824 undergraduate students participated in the present research. In addition to providing their sociodemographic data, they answered the De Jong Gierveld Loneliness Scale, the Emotion Regulation Questionnaire, the Cognitive-Behavioral Avoidance Scale, the Cognitive Emotion Regulation Questionnaire, and the Beck Anxiety Inventory. In order to carry out the mediating analysis, a structural equation model was created which included three latent variables (loneliness, maladaptive emotion regulation strategies and anxiety). This model was tested using the Lavaan software. The indirect effects were analyzed using the bootstrapping method. The results showed that maladaptive emotional regulation strategies had a mediating role which was positive and significant in the relation between loneliness and anxiety. Regarding the measurement model, confirmatory factor analysis was used to test the measurement model comprising the three latent variables. Results showed that the measurement model fit the observed data appropriately. Furthermore, with the purpose of examining the validity of the measurement model, the average variance extracted and square root of the average variance extracted were calculated. Findings indicated that the average variance extracted for each construct was higher than all the squared correlations involving that construct. This confirmed the discriminant validity of all variables of study. Regarding the structural model, results showed acceptable data fit. The model explained 48 % of the variance in anxiety. The structural equation analysis revealed that loneliness was related positively with maladaptive emotion regulation strategies. Similarly, maladaptive emotion regulation strategies were associated positively with anxiety. Likewise, it was possible to confirm the main hypothesis of this study which stated that maladaptive emotion regulation strategies would mediate the influence of loneliness on anxiety among Mexican university students. Finally, it was confirmed that loneliness had a nonsignificant direct effect on anxiety. Regarding the contribution of each of the five maladaptive emotion regulation strategies, rumination had a significant function in the mediating process showing that loneliness had an impact on anxiety via the continuous thoughts that participants had about their own emotions. In turn, because of the strategy of catastrophizing, participants intensified their thoughts and emotions waiting for the worse scenario which in turn increased their levels of anxiety. Likewise, the strategies of avoidance and suppression had also a significant contribution on the mediating role of maladaptive strategies. Finally, the strategy of self-blame was a significant contribution to the mediating function. Therefore, with the purpose of controlling emotions associated with loneliness, it was possible that participants could blame themselves as a mechanism to regulate their emotions. In conclusion, these findings reveal the presence of a mediating effect by showing that loneliness was indirectly related to anxiety via its relation with maladaptive emotion regulation strategies.

Self-esteem and Suicidal Ideation in Pakistani Undergraduates / Autoestima e ideación suicida en estudiantes universitarios paquistaníes

Abstract The main purpose of the study was to assess the relationship between self-esteem and suicidal ideation in Pakistani undergraduates (N = 600). Participants' ages ranged from 17 to 25 years (M =20.26, SD = 1.6) with 50% males and 50% females. A Structural Equation Modeling approach was used to analyse the data. All fit indices were examined on measurement level. Relationships between three latent variables: positive self-esteem, negative self-esteem, and suicidal ideation were assessed on structural level. Results revealed that students with negative self-esteem were more prone towards suicidal ideation (β = .15, p < .001). Moreover, those students who were having positive self-esteem were less likely indicating suicide ideation which suggested that positive self-esteem is a protective factor against suicidal ideation (β = -.10, p < .05) among undergraduates.

Resumen El objetivo principal del estudio fue evaluar la relación entre la autoestima y la ideación suicida en estudiantes universitarios paquistaníes (N = 600). Las edades de los participantes variaron de 17 a 25 años (M = 20.26, SD = 1.6) con un 50% de hombres y un 50% de mujeres. Se utilizó un enfoque de modelado de ecuaciones estructurales para analizar los datos. Todos los índices de ajuste se examinaron a nivel de medición. Se evaluaron a nivel estructural las relaciones entre tres variables latentes: autoestima positiva, autoestima negativa e ideación suicida. Los resultados revelaron que los estudiantes con autoestima negativa eran más propensos a la ideación suicida (β = .15, p < .001). Además, los estudiantes que tenían una autoestima positiva tenían menos probabilidades de indicar una ideación suicida, lo que sugirió que la autoestima positiva es un factor protector contra la ideación suicida (β = -.10, p < .05) entre los estudiantes de pregrado.

Study on the status of mental workload and its relationship with work engagement and fatigue among clinical nurses / 中国实用护理杂志

Objective:To explore the current status of mental workload and its relationship with work engagement and fatigue, as well as the impact path among the three.Methods:Clinical nurses from six tertiary hospitals including Shanghai Traditional Chinese Medicine Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, etc. were selected to conduct a cross-sectional survey using convenience sampling method from February to March 2020. They were investigated by general information questionnaire, NASA Task Load Index (NASA-TLX), Utrecht Work Engagement Scale (UWES), and Fatigue Scale-14 (FS-14).Results:The total mental workload score of 776 clinical nurses was 76.50(69.00, 84.00). Single factor analysis showed that clinical nurses of different ages, marriage and childbirth status, education level, professional title and working years had different mental workload ( Z = -2.61, H values were 10.22-22.41, all P<0.01). Bivariate analysis revealed that the mental workload of clinical nurses was positively correlated with work engagement ( r = 0.27, P<0.01) and fatigue ( r = 0.23, P<0.01), and work engagement and fatigue were negatively correlated ( r = -0.23, P<0.01). Mediation effect analysis demonstrated that mental workload had a positive predictive effect on fatigue ( β = 0.39, P<0.01) and work engagement ( β = 0.35, P<0.01); the suppressing effect of work engagement between mental workload and fatigue, the absolute value of the ratio of the suppressing effect to the direct effect was |-0.17/0.39|. Conclusions:The mental workload of clinical nurses is at relatively high level. Hospital administrators can partially improve the fatigue state of clinical nurses with high mental load through the adjustment effect of work engagement.

Uso de serviços de saúde bucal entre idosos brasileiros: mediação pela perda dentária / Use of oral health services among elderly Brazilians: mediation by tooth loss

Resumo Analisaram-se fatores associados ao uso de serviços de saúde bucal (USSB) entre idosos brasileiros. Estudo transversal, que considerou a amostra de 7.619 idosos (65-74 anos) do SB Brasil 2010. Utilizou-se modelagem com equações estruturais (MEE), investigando associação entre variáveis latentes ou observadas, de forma direta ou mediada, em relação ao USSB. Utilizaram-se estimadores de mínimos quadrados ajustados pela média e variância, por meio de coeficientes padronizados, erro padrão e intervalos de confiança, com o método bootstrapping com 1.500 iterações. Idosos com melhor condição socioeconômica, menor número de dentes perdidos e presença de impactos das condições de saúde bucal em sua vida foram associados de forma direta ao desfecho. Ainda estiveram associados ao USSB de forma mediada, a condição socioeconômica, sexo e idade; bem como o uso de próteses; além de se encontrar correlação entre uso de próteses e dentes perdidos. A perda dentária exerceu papel de destaque, apontando para a necessidade de ampliação do acesso às próteses dentárias na atenção básica.

Abstract The present study analyzed factors associated with the use of oral health services among elderly Brazilians. This was a cross-sectional study with data from the latest National Oral Health Survey (SB Brazil 2010), which considered a sample of 7,619 elderly individuals (65-74 years) for analysis. Structural Equation Modeling (SEM) was used, investigating the association between latent or observed variables, directly or mediated, in relation to the use of oral health services. Least squares estimators adjusted by mean and variance, were used by means of standardized coefficients, and standard error and confidence intervals, by applying the bootstrapping method with 1,500 iterations. Elderly individuals with a higher socioeconomic status, fewer missing teeth, and the presence of impacts of oral health conditions on their lives were directly associated with the outcome. Other factors associated with the mediated use of oral health services among elderly Brazilians included socioeconomic status, gender, age, and the use of prostheses, in addition to finding a correlation between prosthesis use and missing teeth. Tooth loss, along with other factors, played a prominent role in this study regarding the use of oral health services among elderly Brazilians, pointing to the need to expand access to dental prostheses in primary care.

Characteristics of the cognitive domains of the montreal cognitive assessment scale in the elderly from the perspective of structural equation modeling / 中华老年医学杂志

Objective:To analyzed the characteristics of the cognitive domains of the montreal cognitive assessment(MOCA)scale in cognitively impaired or normal elderly people from the perspective of structural equation modeling(SEM).Methods:There were 335 old individuals in this study, including 166 cognitively normal individuals, 130 patients with mild cognitive impairment(MCI)and 39 individuals with dementia.The average age of the individuals was 81.5±9.0.Data on the Montreal cognitive assessment(MoCA, Beijing version)were gathered.Following exploratory factor analysis and selection of latent and manifest variables, a structural equation model was established.After assessment of data from the domains of the scale in the elderly, participants were divided into a normal group and a patient group, which formed the basis of the model.Results:The KMO value of the data calculated by exploratory factor analysis was 0.762.The dimensions measured by the scale were divided into four main latent variables: memory, visuospatial execution, language ability and attention.The CMIN value of the overall model was 44.039 and the P value was 0.168.The parameters of the overall model and individual dimensions all indicated a good fit.The model showed that visuospatial execution had the largest impact on cognitive function, with a path coefficient of 0.742, and language ability had the least impact, with a path coefficient of only 0.091.As a latent variable, attention had path coefficients of 0.372 and 0.236 for memory, 1.663 and 1.102 for visuospatial execution, and 1.090 and 0.798 for language ability, respectively, for the two groups, with clear statistically significant differences between the groups(all P<0.05). Conclusions:SEM can improve researchers' overall understanding of the impacts of the individual components of the scale and their use and interpretation of the scale.

Evidências desfavoráveis ao postulado de cargas fatoriais simples do Exame Nacional do Ensino Médio (ENEM) / Evidence contrary to the assumption of simple Factor loadings of the National High School Education Exam (ENEM) / Evidencias desfavorables al postulado de cargas factoriales Simples del Examen Nacional de Enseñanza Secundaria (ENEM)

O Exame Nacional do Ensino Médio (ENEM) possui um modelo de medida restrito, caracterizado pelo postulado de que os itens marcadores de cada domínio se vinculam exclusivamente ao seus domínios-alvo. Estudos pregressos sugerem, por meio de evidências indiretas, que esse modelo não seria válido. No entanto, esse postulado ainda não foi diretamente avaliado. Neste estudo, investiga-se esse pressuposto por meio de análises fatoriais dos itens do ENEM de 2011. Dois modelos foram testados. O primeiro, chamado de estrutura simples de Thurstone, representa o modelo de medida do ENEM. O segundo, de cargas cruzadas, refuta esse modelo. O modelo das cargas cruzadas foi o único que apresentou bom ajuste aos dados de acordo com todos os índices empregados. As evidências encontradas são desfavoráveis ao postulado de cargas fatoriais simples do modelo de medida do ENEM, indicando problemas de validade e na qualidade dos escores produzidos. (AU)

The National High School Examination (ENEM) has a restricted measurement model characterized by the assumption that the marker items in each domain are exclusively linked to their target domain. Previous studies suggest, through indirect evidence, that this model may not be valid. However, this postulate has not yet been directly assessed. In this study, this assumption was investigated through factor analysis of the items of the ENEM 2011 edition. Two models were tested. The first, called Thurstone's simple structure, represents the measurement model of the ENEM. The second, of crossed loadings, refute this model. The crossed loadings model was the only one that presented a good fit to the data according to all the indices employed. The evidence found is unfavorable for the assumption of simple factor loadings of the measurement model of the ENEM, indicating issues of validity and in the quality of the scores produced. (AU)

El Examen Nacional de Enseñanza Secundaria (ENEM) tiene un modelo de medición restringido, caracterizado por el postulado de que los ítems marcadores en cada dominio están vinculados exclusivamente a su dominio objetivo. Estudios previos sugieren, a través de evidencia indirecta, que este modelo no sería válido. Sin embargo, este postulado aún no ha sido evaluado directamente. En este estudio se investiga este supuesto a través del análisis factorial de los ítems del ENEM 2011. Se probaron dos modelos. El primero, llamado estructura simple de Thurstone, representa el modelo de medición ENEM. El segundo, de cargas cruzadas, refuta este modelo. El modelo de carga cruzada fue el único que presentó un buen ajuste a los datos de acuerdo con todos los índices empleados. Las evidencias encontradas son desfavorables al supuesto de cargas factoriales simples del modelo de medición del ENEM, lo que indica problemas de validez y en la calidad de las puntuaciones producidas. (AU)

The mediating role of emotion regulation strategies in the relationship between family of origin violence and intimate partner violence

Abstract The effects of family of origin violence and intimate partner violence have been extensively documented; however, very few studies have examined the interaction with emotion regulation strategies. Thus, the objective of this research was to analyze whether different types of emotion regulation strategies, both adaptive and maladaptive, mediate the relationship between family of origin violence and intimate partner violence in the Mexican population. A total of 838 participants (45.9% men and 54.1% women) responded to instruments addressing family of origin violence, emotion regulation strategies, and intimate partner violence. The results revealed that both structural models were significant. For women, the model showed an adequate fit X 2 (11, N = 838) = 22.75, p = .288, GFI = .95, AGFI = .91, NFI = .98, CFI = .97, RMSEA = .05. Likewise, we found similar indexes for men X2 (11, N = 838) = 28.20, p = .348, GFI = .97, AGFI = .93, NFI = .97, CFI = .95, RMSEA = .04. Specifically, the direct effects of adaptive strategies on intimate partner violence were statistically significant. Meanwhile, the direct effects of family of origin violence on maladaptive emotion regulation strategies were significant, as were the direct effects of maladaptive strategies on intimate partner violence. In turn, the indirect effects of family of-origin violence were significantly related to intimate partner violence via maladaptive emotion regulation strategies. In addition, the results clearly showed that men reported higher levels of aggression against women. Finally, regarding the selection of emotion regulation strategies, while women employed more adaptive emotion regulation, men showed a more definite tendency to use maladaptive emotion regulation.

Conversion to organic farming: a dynamic opportunity for Pakistani smallholders of fresh fruit / Conversão para a agricultura orgânica: uma oportunidade dinâmica para pequenos produtores de frutas frescas do Paquistão

ABSTRACT: Exporting the organic fresh fruit (FF) to Europe and America could be regarded as great opportunity for smallholders and suppliers of Gilgit Baltistan, Pakistan. Yet, the global organic farmland and the number of organic producers are continued to grow. To date, little is known about the behavior of Pakistani farmers towards organic fresh fruit production. This study examined the factors that influence the decision-making of fresh fruit smallholders concerning the conversion to organic farming (COF). This study uses Ajzen's theory of planned behavior (TPB) to predict the behavior of Pakistani smallholders of fresh fruit. Path analysis examined the utility of the extended version of the TPB model to anticipate 277 small-scale farmers' behavioral intentions towards the adoption of organic farming (AOF) and their prospect of converting their farm to organic produce within the next three years. The present study reported that the smallholders' attitude (ATT), subjective norms (SN), perceived behavior control (PBC), and farmer's group participation (FGP) were positively correlated with farmer's intention to adopt organic farming, while group participation of farmers has significant correlation with their behavior regarding production of organic fruits. The present study justifies using the model of farmers' group participation in policies that deliberately cheer up smallholders of fresh fruit to adopt organic farming, to raise farm incomes and to alleviate poverty.

RESUMO: Exportar a fruta fresca orgânica (FF) para a Europa e América pode ser considerada uma grande oportunidade para pequenos proprietários e fornecedores de Gilgit Baltistan, Paquistão. No entanto, as terras agrícolas orgânicas globais e o número de produtores orgânicos continuam a crescer. Até o momento, pouco se sabe sobre o comportamento dos agricultores paquistaneses em relação à produção de frutas frescas orgânicas. O objetivo deste estudo, portanto, foi examinar e determinar os fatores que influenciam a tomada de decisão dos pequenos produtores de frutas frescas sobre a conversão para a agricultura orgânica (COF). Este estudo usa a teoria do comportamento planejado de Ajzen (TPB) para prever o comportamento dos pequenos produtores de frutas frescas do Paquistão. A análise de caminho examinou a utilidade da versão estendida do modelo TPB para antecipar as intenções comportamentais de 277 agricultores de pequena escala em relação à adoção da agricultura orgânica (AOF) e sua perspectiva de converter sua fazenda em produtos orgânicos nos próximos três anos. O presente estudo descobriu que a atitude dos pequenos proprietários (ATT), as normas subjetivas (SN), o controle do comportamento percebido (PBC) e a participação do grupo de agricultores (FGP) foram positivamente correlacionadas com a intenção do agricultor de adotar a agricultura orgânica, enquanto a participação do grupo de agricultores correlação significativa com seu comportamento em relação à produção de frutas orgânicas. O presente estudo justifica o uso do modelo de participação de grupos de agricultores em políticas que encorajam deliberadamente os pequenos produtores de frutas frescas a adotar a agricultura orgânica, para aumentar a renda agrícola e diminuir a pobreza.

Components of the Collaboration between Hospital and Community Pharmacists in Municipal Hospitals: Findings from the Municipal Hospital Pharmacist Perspective Using Structural Equation Modeling / 社会薬学

Objective: The study aimed to identify potential components of the collaboration between hospital and community pharmacists from the perspective of pharmacists in municipal hospitals. Methods: Following a preliminary study, an online survey was conducted among pharmacy directors and those on an equivalent managerial level in municipal hospital pharmacies. The survey used a 5-point Likert scale with 32 items about the components of collaboration between hospital and community pharmacists. We performed an exploratory analysis and structural equation modeling of the data. Results: The analysis proposed a five-factor model (“Organizational climate,” “Information sharing system,” “Community support system,” “Interest in healthcare policy,” and “Understanding of healthcare policy”), which consisted of 17 items. Subsequent confirmation with structural equation modeling created a model with good fit (in terms of partial evaluation and overall goodness of fit) with a chi-square of 86.218, P-value of 0.564, goodness of fit index of 0.907, adjusted goodness of fit index of 0.857, and other good model fit indices (comparative fit index of 1.000 and root mean square error of approximation of 0.000). Discussion: This study identified two core universal concepts and three concepts adhering to the current medical context, that seem to guide the behavior of municipal hospital pharmacists─who are major players in community healthcare─in their collaboration with community pharmacists.

Factors influencing protective behavior in the post-COVID-19 period in China: a cross-sectional study

BACKGROUND@#The study aimed to explore the factors influencing protective behavior and its association with factors during the post-COVID-19 period in China based on the risk perception emotion model and the protective action decision model (PADM).@*METHODS@#A total of 2830 valid questionnaires were collected as data for empirical analysis via network sampling in China. Structural equation modeling (SEM) was performed to explore the relationships between the latent variables.@*RESULTS@#SEM indicated that social emotion significantly positively affected protective behavior and intention. Protective behavioral intention had significant direct effects on protective behavior, and the direct effects were also the largest. Government trust did not have a significant effect on protective behavior but did have a significant indirect effect. Moreover, it was found that government trust had the greatest direct effect on social emotion. In addition, we found that excessive risk perception level may directly reduce people's intention and frequency of engaging in protective behavior, which was not conducive to positive, protective behavior.@*CONCLUSION@#In the post-COVID-19 period, theoretical framework constructed in this study can be used to evaluate people's protective behavior. The government should strengthen its information-sharing and interaction with the public, enhance people's trust in the government, create a positive social mood, appropriately regulate people's risk perception, and, finally, maintain a positive attitude and intent of protection.

Adaptação e validação da escala de perfeccionismo Almost Perfect Scale-Revised para o português brasileiro / Adaptation and validation for Brazilian Portuguese of the Revised Almost Perfect Scale / Adaptación y validación de la escala de perfeccionismo Almost Perfect Scale-Revised para el portugués brasileño

O perfeccionismo é um construto multidimensional cujo estudo vem aumentando desde os anos de 1990. Uma das escalas mais utilizadas para sua mensuração é a Almost Perfect Scale - Revised (APS-R), composta por três dimensões: Padrões, Discrepância e Ordem. Devido à ausência de medidas como essa no Brasil, este estudo objetivou adaptar e analisar as propriedades psicométricas da APS-R em uma amostra brasileira, por meio da análise de sua estrutura interna e levantamento de sua confiabilidade. Participaram 787 universitários (79,3% do sexo feminino), idade média de 25,98 anos (DP = 7,29) que responderam à APS-R e a um questionário sociodemográfico. Os itens adaptados mostraram IVC adequados: equivalência semântica (0,99), cultural (0,94) e conceitual (0,94). Dentre os modelos estruturais testados, o bifatorial mostrou-se superior aos demais (χ2 = 452,371; TLI = 0,94; CFI = 0,96; RMSEA = 0,047). Assim, a escala apresentou propriedades psicométricas satisfatórias para uso no Brasil, tanto no que se refere à sua validade quanto confiabilidade. São discutidas limitações e implicações do estudo. (AU)

The study of perfectionism as a multidimensional construct has increased since the 1990's. The Almost Perfect Scale (APS-R) is widely used across studies to measure perfectionism; it is composed by three dimensions: High Standards, Discrepancy, and Order. However, despite increasing interest in the measurement of perfectionism, there were no scales available for Brazilian-Portuguese. Accordingly, we aimed to adapt the APS-R and to analyze the psychometric properties and test confirmatory models for the Brazilian version of the Almost Perfect Scale (APS-R Brasil). A sample of university students (n=787) with a mean age 25.98 years (SD=7.29), 79.3% women, completed the APS-RB. The adapted items demonstrated semantic, cultural and conceptual adequacy (all CVI <90). The ESEM two factor model, showed the better fit index (χ²= 452.371; TLI=0.94; CFI=0.96; RMSEA=0.047). The Brazilian version of APS-R was shown to be valid and reliable. Limitations and implications of the study are discussed. (AU)

El estudio del perfeccionismo como un constructo multidimensional ha aumentado desde los años 90. La escala Almost Perfect Scale-Revised (APS-R), que se usa ampliamente en los estudios del perfeccionismo, está compuesta por tres factores: altos estándares, la percepción de la discrepancia y el orden. Sin embargo, a pesar del creciente interés en la medición del perfeccionismo, todavía no hay escalas disponibles para el portugués brasileño. Por lo tanto, el objetivo de esta investigación fue adaptar y analizar las propiedades psicométricas, y probar modelos confirmatorios para la APS-R en una muestra brasileña. Dicha muestra se compuso por estudiantes universitarios (n = 787) con una edad media de 25,98 años (DE = 7,29) y 79,3% mujeres. Los ítems adaptados demostraron adecuación semántica, cultural y conceptual (todos los IVC <90). El modelo ESEM Bifactor mostró el mejor índice de ajuste (χ2 = 452,371; TLI = 0,94; CFI = 0,96; RMSEA = 0,047). La versión brasileña de APS-R demostró ser válida y fiable. Aparte, se discute las limitaciones e implicaciones del estudio. (AU)