A delimitação da escuta psicanalítica com referências a Aristófanes / Determination of psychoanalytic listening based on Aristophanes / La Delimitación de la escucha psicoanalítica con referencias a Aristófanes

Apresentamos, neste texto, alguns elementos específicos da escuta psicanalítica para caracterizar, segundo modelo estrutural, sua posição a respeito da linguagem. Considerando indicações técnicas em diferentes momentos da obra de Freud e também os aportes de Lacan, descrevemos aspectos fundamentais da escuta clínica, assim como seus princípios linguísticos norteadores. Observamos a importância da reserva do analista - a abstinência de críticas -, avaliamos o papel da temporalidade no uso da língua e as duas figuras retóricas que são representantes fundamentais operadoras do psiquismo. Após esta delimitação, situamos a perspectiva da escuta numa dimensão histórica a partir da qual interrogamos o lugar do saber na maiêutica socrática segundo texto Teeteto de Platão. Posteriormente, abordamos aspectos antigos da escuta a partir das descrições feitas na comédia de Aristófanes, o que nos permite comprovar que elementos fundamentais da maiêutica ainda estão presentes na escuta clínica contemporânea, operando no discurso do analista, como um fator sincrônico possibilitado pela linguagem...(AU)

This text presents some specific elements of psychoanalytic listening to characterize its position regarding the language according to the structural model. Considering the technical indications at different moments in Freud's work and in Lacan's contributions, we describe the fundamental aspects of clinical listening, as well as its guiding linguistic principles. We observe the importance of the analyst's reserve ─ the abstinence of criticism ─ and evaluated the role of temporality in the use of language and the two rhetorical figures that are fundamental representatives of psychism. After having established this, we situate the perspective of listening in a historical dimension from which we question the role of knowledge in the Socratic maieutic method according to Plato's Theaetetus text. We then approach old aspects of listening based on descriptions made in Aristophanes' comedy, which allowed to prove how fundamental elements of maieutics are still present in contemporary clinical listening, operating in the discourse of the analyst as a synchronic factor that was made possible by language...(AU)

En este texto mostramos algunos elementos específicos de la escucha psicoanalítica para caracterizar, según el modelo estructural, su posición respecto al lenguaje. Considerando las indicaciones técnicas en diferentes momentos de la obra de Freud, y también los aportes de Lacan, describimos sus aspectos fundamentales, destacando la importancia de la reserva del analista y los principios lingüísticos orientadores de la escucha. Observamos la importancia de la reserva del analista - la abstinencia de críticas -, evaluamos el papel de la temporalidad en el uso del lenguaje y las dos figuras retóricas que son representantes fundamentales operadoras del psiquismo. Hecha esta delimitación, situamos la perspectiva de la escucha en una dimensión histórica y desde ella interrogamos el lugar del saber en la mayéutica socrática según la obra Teeteto de Platón. Posteriormente, abordamos los aspectos antiguos de la escucha a partir de las descripciones hechas en la comedia de Aristófanes, lo que nos permite comprobar qué elementos fundamentales de la mayéutica aún están presentes en la escucha clínica contemporánea, operando en el discurso del analista como un factor sincrónico del lenguaje...(AU)

The Structural Analysis of Variables Related to Posttraumatic Growth among Psychiatric Nurses

PURPOSE: The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.METHODS: Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.RESULTS: The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.CONCLUSION: A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses' hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.

Contrastación de un modelo confirmatorio para el estudio del acoso laboral en climas y redes profesionales de servicios públicos de salud / Contrasting a confirmatory model for the study of workplace harassment in public health professional networks and environments

A menudo, el acoso laboral ha sido observado como parte de un proceso de violencia al interior de las organizaciones que se internaliza en ellas hasta formar perpetradores y víctimas, pero desde la óptica del clima y la red formativa laboral el presente trabajo se propuso especificar un modelo con la finalidad de estudiar el fenómeno en comento en instituciones de salud pública de alta especialidad y dedicadas a la creación del conocimiento, ya que en éstas prevalecen asimetrías entre investigadores y asistentes, así como por su condición de género o área de especialización. De este modo, se llevó a cabo un estudio no experimental con una selección no probabilística de 218 empleados de una institución de salud pública en el centro de México. A partir de un modelo estructural fue posible apreciar que, ante las consecuencias somáticas del acoso laboral, la intervención de la organización fue determinante para su reducción, aunque el porcentaje de la varianza total explicada sugiere la inclusión de otros factores en el modelo, se recomienda una línea de investigación relativa a la formación de redes institucionales para la prevención o atención inmediata de la problemática(AU)

From an organizational climate and workplace training network perspective, this study proposes a model for the purpose of studying workplace harassment in highly specialized public health institutions dedicated to the generation of knowledge because, in these settings, there are asymmetries between researchers and their staff, as well as by gender and area of expertise. We conducted a non-experimental study in a convenience sample of 218 employees at a public health institution in central Mexico. Based on a structural model, we found that, in the presence of somatic consequences of workplace harassment, organizational interventions were decisive in reducing this form of workplace violence, although the percentage of the total variance explained by the model suggests there are other factors playing a role as well To prevent or immediately respond to workplace harassment, we recommend future research that examines the role of institutional networks in relation to this problem(AU)

Métodos actuales para asegurar la validez de los estudios de causalidad en Medicina / Current methods to assure the validity of the causality studies in Medicine

RESUMEN Fundamento: Los estudios de causalidad deben aportar resultados certeros, lo cual depende de la adecuación de los mismos, de ahí la necesidad de conocer los métodos que aseguren la validez de estas investigaciones. Objetivo: Sistematizar los métodos actuales para el estudio de causalidad en Medicina que incluye el diseño, los requerimientos que aseguran su validez y los métodos para el cumplimiento de estos requerimientos. Desarrollo: Se realizó una revisión bibliográfica en bases de datos biomédicas, se seleccionó la literatura de mayor actualidad, integralidad y cientificidad con la cual se organizó una síntesis crítica, a la que se le agregó la experiencia de las autoras. Se presentan técnicas para la detección y tratamiento de la confusión y la interacción y para garantizar la comparabilidad entre grupos. Entre las técnicas se destacan la aleatorización mendeliana, el puntaje de susceptibilidad, los G-métodos, los modelos estructurales marginales y anidados, la lógica difusa y el análisis estadístico implicativo. Conclusiones: A pesar del avance en los métodos estadísticos es el investigador el encargado de garantizar la no confusión residual y discernir entre lo estadísticamente significativo y lo clínicamente aceptable.

ABSTRACT Background: Causality studies must provide accurate results, which depends on their adequacy, therefore the need of knowing the methods that ensure the validity of these investigations. Objective: To systematize the current methods for the study of causality in Medicine that includes the design, the requirements that ensure its validity and the methods for complying with these requirements. Development: It was carried out a bibliographic review in biomedical databases and selected the most current, comprehensive, scientific literature, with this, a critical synthesis was organized, with the experience of the authors. Techniques for the detection and treatment of confusion and interaction were presented, also to ensure comparability between groups. Among the techniques, Mendelian randomization, susceptibility score, G-methods, marginal and nested structural models, fuzzy logic and implicative statistical analysis stand out. Conclusions: Despite the progress in statistical methods, the researcher is responsible for guaranteeing residual non-confusion and distinguishing between statistically significant and clinically acceptable.

Encuesta BIARE 2012: Análisis del bienestar subjetivo de los mexicanos y modelamiento estructural / BIARE survey 2012: subjective analysis related to mexican people well-being and structural modeling

Resumen Objetivo: El bienestar de una sociedad es un constructo considerado como multidimensional (componentes objetivos y subjetivos). La encuesta nacional de Bienestar Autorreportado (BIARE) se diseñó para evaluar el bienestar de la población mexicana. No obstante, no se ha explorado la estructura y relación que tienen los módulos (sub-escalas) para explicar el bienestar de los mexicanos. Así, el objetivo del estudio es explorar la estructura y relación que tienen los módulos en la encuesta BIARE, 2012 (Instituto Nacional de Estadística y Geografía [INEGI], 2012) mediante modelamiento estructural. Método: Se realizó análisis de datos secundarios de la base BIARE, la cual es aleatoria y representativa a nivel nacional. Participaron 10.654 ciudadanos con un rango de edad entre 18 y 70 años; 5.967 eran mujeres y 4.687 hombres. Resultados: Se encontraron tres modelos. En un primer modelo se concibió la variable latente Bienestar general asociada con variables empíricas Solvencia, Felicidad, Satisfacción y Autodeterminación. En un segundo modelo se proponen dos variables latentes: 1) Bienestar percibido, asociada a tres variables empíricas; a) Satisfacción con la vida, b) Autodeterminación y c) Felicidad; 2) Socio-cultura, relacionada también con tres variables empíricas: a) Altruismo, b) Cultivado y c) Relaciones virtuales. Un tercer modelo de trayectorias para variables latentes mostró ajustes satisfactorios que explican relaciones entre la variable Felicidad con Solvencia, Satisfacción y Autodeterminación, consecutivamente. Conclusiones: La información que se puede obtener del cuestionario BIARE es relevante para evaluar la percepción de los ciudadanos y el entorno inmediato, como la familia. Pero no permite una evaluación precisa sobre la contribución de los factores meso y macro-sociales en el bienestar de los mexicanos. Es necesario que BIARE integre un modelo multidimensional de bienestar.

Abstract Objective: The National Self-Reported Well-being Survey (BIARE) was designed to assess well-being in mexican population, considering well-being of a society as a multidimensional construct (objective and subjective components). However, the structure and relationship between modules (sub-scales) to explain mexican well-being has not been explored yet. Thus, this study aims to explore the structure and relationship among those sub-scales based on the BIARE survey 2012 (INEGI, 2012) through structural modeling. Method: BIARE, Secondary data analysis, which is random and representative of Mexican people was conducted; 10.654 citizens, who were between 18 and 70 years were sampled; 5.967 women and 4.687 men. Results: As a result, three models were found. In a first model, the latent variable related to general well-being associated with empirical variables such as: solvency, happiness, satisfaction and self-determination were considered. In a second model, two latent variables are proposed: 1) Perceived well-being, associated with three empirical variables as follows: a) life Satisfaction b) Self-determination and c) Happiness; 2) Socioculture, also related to three empirical variables, which are: a) Selflessness, b) Cultivated relationships and c) Virtual relationships. A third model of trajectories for latent variables showed adjustments that explain relations among variable Happiness with Solvency, Satisfaction and Self-determination. Conclusions: The information that can be obtained from BIARE questionnaire is relevant to evaluate citizens´s perception and immediate environment, like family. But it does not allow for an accurate assessment about contribution of meso and macro-social factors on mexican´s well-being. It is necessary that BIARE integrate a multidimensional model of well-being.

A Structural Equation Model of Happiness in Korean College Students / 정신간호학회지

PURPOSE: The aim of this study was to develop a structural model based on Bronfenbrenner's ecology of human development theory, that illustrates relationships of happiness and associated factors among Korean college students. METHODS: Study participants were 357 college students recruited from five universities throughout the convenience sampling. Self-reported data were collected from November, 2018 to January, 2019. The data were analyzed using descriptive statistics, Pearson's correlation coefficients, and a structural equation modeling in order to identify factors associated with college students' happiness. RESULTS: The tested model demonstrated the acceptable model fit compared to the hypothesized model, that explained college students' happiness with 68.7% accuracy. Positive family function, high self esteem and ego-resilience were significant factors associated with happiness for college students. However, positive friend support was not significant in our model. CONCLUSION: Our study findings suggest that both family and individual interventions are required to reduce negative emotions and increase happiness of college students. In particular, multicomponent interventions should include the concepts of self esteem, ego-resilience, and family function in terms of assessment and intervention contents tailored to Korean college students.

A Structural Model for Chemotherapy Related Cognitive Impairment and Quality of Life in Breast Cancer Patients

PURPOSE: This study aimed to develop and test a structural model for chemotherapy-related cognitive impairment of breast cancer patients based on a literature review and Hess and Insel's chemotherapy-related cognitive change model. METHODS: The Participants consisted of 250 patients who were ≥19 years of age. The assessment tools included the Menopause Rating Scale, Symptom Experience Scale, Hospital Anxiety and Depression Scale, Everyday Cognition, and Functional Assessment of Cancer Therapy-Breast Cancer. Data were analyzed using the SPSS 21.0 and AMOS 21.0 programs. RESULTS: The modified model was a good fit for the data. The model fit indices were χ2=423.18 (p<.001), χ2/df=3.38, CFI=.91, NFI=.91, TLI=.89, SRMR=.05, RMSEA=.09, and AIC=515.18. Chemotherapy-related cognitive impairment was directly influenced by menopausal symptoms (β=.38, p=.002), depression and anxiety (β=.25, p=.002), and symptom experiences (β=.19, p=.012). These predictors explained 47.7% of the variance in chemotherapy-related cognitive impairment. Depression and anxiety mediated the relations among menopausal symptoms, symptom experiences, and with chemotherapy related cognitive impairment. Depression and anxiety (β=−.51, p=.001), symptom experiences (β=−.27, p=.001), menopausal symptoms (β=−.22, p=.008), and chemotherapy-related cognitive impairment (β=−.15, p=.024) had direct effects on the quality of life and these variables explained 91.3%. CONCLUSION: These results suggest that chemotherapy-related toxicity is highly associated with cognitive decline and quality of life in women with breast cancer. Depression and anxiety increased vulnerability to cognitive impairment after chemotherapy. Nursing intervention is needed to relieve chemotherapy-related toxicity and psychological factor as well as cognitive decline for quality of life in patients undergoing chemotherapy.

Association between Eating Alone and Metabolic Syndrome: A Structural Equation Modeling Approach

The aim of this study was to construct and test a structural equation model for the risk factors of metabolic syndrome in Korean adults. The structural equation model hypothesizes that eating alone and feeling depressed is a risk factor for metabolic syndrome. The data of this study were obtained from the Sixth Korea National Health and Nutrition Examination Survey which was cross-sectional data from the representative national survey. A total of 4,013 subjects replied to the survey item of lifestyle and completed the physical examinations among adults aged 19 years or older in South Korea was in 2015. The structural model in this study was composed of four latent variables: eating alone, depression, negative health behavior, and metabolic syndrome. Two variables, the rate of eating alone and depression, were exogenous variables. Negative health behavior was both a mediating variable and endogenous variable, and metabolic syndrome was the final endogenous variable. The data were analyzed using the Maximum Likelihood method and bootstrapping. The structural model was appropriate for the data based on the model fit indices. The results of this study can be summarized as follows: Eating alone is a direct risk factor of metabolic syndrome in Korean women. Depression can mediate metabolic syndrome through negative health behaviors. Negative health behavior had a direct impact on metabolic syndrome in both men and women. This study may be a guideline for interventions and strategies to reduce the incidence of metabolic syndrome in Korean adults.

Construction of a Model of Aggression in the Upper Grades of Elementary School

PURPOSE: The purpose of this study was to construct a structural model that explains the factors affecting aggression among elementary school students and to verify their suitability.METHODS: The study period was from June to August 2018. The study subjects were fifth- and sixth- graders at an elementary school. In total, 291 surveys were collected, of which 259 were analyzed. Data were analyzed using SPSS version 24.0 and AMOS version 24.0.RESULTS: The fit of the final model was acceptable (χ2=160.08 [p<.001], GFI=.921, AGFI=.869, CFI=.919, SRMR=.057, and RMSEA=.086). Thus, eight of the 10 hypotheses were shown to be statistically significant.CONCLUSION: The results of this study indicate that positive and open parenting behaviors and training children to engage in self-control are needed to reduce their aggression. In addition, considerable attention and education are required in the home, school, and society so that children can learn to properly recognize and express their emotions and establish suitable beliefs regarding aggressive behavior.

Patient Safety Management Activities of Clinical Nurse: A Modified Theory of Planned Behavior / 간호행정학회지

PURPOSE: The purpose of this study was to develop a structural model for patient safety management activities and to identify the influencing factors of organizational and individual dimensions that promote patient safety management activities and to suggest effective intervention plans.METHODS: A structured self-report questionnaire was used to measure organizational factor, attitude, subjective norm, perceived behavior control, and patient safety management activities. The questionnaires were distributed to 300 nurses and 275 were included in the analysis. SPSS 25.0 and AMOS 21.0 were used to analyze the model fitness, indirect effect, and direct effect of the model.RESULTS: The hypothetical model for patient safety management activities was appropriate. Among the 8 pathways, 6 direct pathways were significant. Organizational factor affected individual attitudes, subjective norms, and perceived behavior control. Perceived behavior control, and subjective norm affected behavioral intention. Behavioral intention affected patient safety management activities. Perceived behavior control did not affect patient safety management activities.CONCLUSION: Organizations and individuals must change together to promote patient safety management activities. The organization should establish practical education and training, systems and regulations. Individuals should increase behavioral intention by strengthening perceived behavioral control and subjective norm.

Variation in the structure of the ichthyoplankton community in the lower Paraíba do Sul River

The Paraíba do Sul River is affected by extensive water collection for supply, organic and industrial pollution, and dams. Nonetheless, the ichthyofauna maintains biodiversity and sustains artisanal fisheries. This study analyzes the composition, abundance and distribution of fish larvae, an important approach to determine the reproductive period and spawning sites. The sampling occurred from August 2011 through February 2013 in five sites at a transect between the banks on the lower reach of the Paraíba do Sul River. A total of 5,412 larvae belonging to 20 taxa was captured. The predominant order was Characiformes. Larvae of Prochilodus spp. and Leporinus spp. were the most abundant; larvae of Brycon insignis, an endangered species, were present. Fewer larvae were collected in the second reproductive cycle during a severe drought. The absence of eggs indicates that the study area is not used for spawning, and highlights the need for studies in the main channel and in the tributaries of the Paraíba do Sul River. Fish larvae need to have access to the marginal lagoons along the lower stretch of the river, an area which is the object of disputes between fishermen and farmers.(AU)

O rio Paraíba do Sul é afetado por retirada de água para abastecimento, poluição orgânica e industrial e barramentos, mas mantém a biodiversidade de peixes e sustenta a pesca artesanal. Este estudo apresenta a composição, abundância e distribuição de larvas de peixes, abordagem importante para determinar o período de reprodução e locais de desova. A amostragem ocorreu entre agosto de 2011 e fevereiro de 2013 em cinco pontos de um transecto de 500 m entre as margens no trecho inferior do rio Paraíba do Sul. Um total de 5.412 larvas de 20 táxons foi capturado. Predominaram Characiformes, sendo que larvas de Prochilodus spp. e Leporinus spp. foram as mais abundantes. Larvas de Brycon insignis, espécie em extinção, foram registradas. Larvas foram menos abundantes no segundo ciclo reprodutivo, coincidindo com o início de uma seca severa na região. A ausência de ovos nas amostras indica que a área estudada não é utilizada para desova e aponta a necessidade de estudos no canal principal a montante e nos afluentes. Ressaltamos a necessidade de acesso das larvas às lagoas marginais no trecho inferior do rio Paraíba do Sul, área objeto de desentendimentos entre pescadores e agricultores.(AU)

A Structural Model for the Risk Factors of Metabolic Syndrome in Rural Women

PURPOSE: The purpose of this study was to construct and test a structural equation model to investigate the risk factors of metabolic syndrome in rural women. METHODS: The raw data in this study was collected from the Korean Genome and Epidemiology Study supervised by the Korea Centers for Disease Control and Prevention from 2005 to 2010. The data included physical examinations and surveys of 1,125 women, who resided in three rural areas of South Korea. The structural model in this study was composed of five latent variables: depression, stress, social support, health behavior, and metabolic syndrome. The structural equation model was used to assess the relationships among the variables. RESULTS: The results of the study showed that depression and stress had direct effects on metabolic syndrome. Social support had a direct effect on health behavior and metabolic syndrome. Also, health behavior had a direct effect on metabolic syndrome. CONCLUSION: This study may serve as a guideline for interventions and strategies used to reduce metabolic syndrome in rural women.

Testing an Explanatory Model for Preventing College Students' Problem Gambling

PURPOSE: A mediated model of Korean college students' problem gambling based on Blaszczynski and Nower's pathway model is developed and tested to explore mediating roles of self-control and irrational gambling beliefs in the association between emotionally vulnerable variables and problem gambling. METHODS: 273 student participants recruited from 4 universities in Seoul and Gyeonggi, Korea responded. Data were collected with a structured self-report questionnaire comprising measures of problem gambling, depression, anxiety, coping styles, irrational gambling belief, and self-control. RESULTS: The modified research model provides a reasonable fit to the data. Depression, anxiety, reflective coping, irrational beliefs, and self-control turned out to have direct effects on problem gambling, while indirect effects were reported in some suppressive and reactive styles. These predictors account for 38% of the college students' problem gambling. CONCLUSION: The findings suggest that developing intervention programs for reducing depression, anxiety, irrational gambling beliefs, and increasing reflective coping and self-control are needed to prevent Korean college students' problem gambling.

Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study / 한국역학회지

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

Seasonality of tuberculosis in the Republic of Korea, 2006–2016 / 한국역학회지

OBJECTIVES: While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016.METHODS: Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages.RESULTS: While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016.CONCLUSION: Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.

Testing a Model to Predict Problem Gambling in Speculative Game Users

PURPOSE: The purpose of the study was to develop and test a model for predicting problem gambling in speculative game users based on Blaszczynski and Nower's pathways model of problem and pathological gambling. METHODS: The participants were 262 speculative game users recruited from seven speculative gambling places located in Seoul, Gangwon, and Gyeonggi, Korea. They completed a structured self-report questionnaire comprising measures of problem gambling, negative emotions, attentional impulsivity, motor impulsivity, non-planning impulsivity, gambler's fallacy, and gambling self-efficacy. Structural Equation Modeling was used to test the hypothesized model and to examine the direct and indirect effects on problem gambling in speculative game users using SPSS 22.0 and AMOS 20.0 programs. RESULTS: The hypothetical research model provided a reasonable fit to the data. Negative emotions, motor impulsivity, gambler's fallacy, and gambling self-efficacy had direct effects on problem gambling in speculative game users, while indirect effects were reported for negative emotions, motor impulsivity, and gambler's fallacy. These predictors explained 75.2% problem gambling in speculative game users. CONCLUSION: The findings suggest that developing intervention programs to reduce negative emotions, motor impulsivity, and gambler's fallacy, and to increase gambling self-efficacy in speculative game users are needed to prevent their problem gambling.

A Structural Equation Model on Korean Adolescents' Excessive Use of Smartphones

PURPOSE: Authors develop a unified structural model that defines multirelationships between systematic factors causing excessive use of smartphones and the corresponding results. METHODS: A survey was conducted with adolescents who live in Seoul, Pusan, Gangneung, Donghae, and Samcheok from February to March 2016. Authors used SPSS, version 22.0, and AMOS, version 22.0, to analyze the survey results at a .05 significance level. To investigate demographic characteristics of the participants and their variations, descriptive analysis was used. The maximum likelihood estimate method was adopted to verify the fitness of the hypothetical model and the hypotheses therein. Authors used χ² statistics, goodness-of-fit index, adjusted goodness-of-fit index, comparative fit index, normed fit index, incremental fit index, root mean square residual, and root mean square error of approximation to verify the fitness of our structural model. RESULTS: (1) The proposed structural model demonstrated a fine fitness level. (2) The proposed structural model could describe the excessive use of a smartphone with 88.6% accuracy. (3) The absence of the family function and relationship between friends, impulsiveness, and low self-esteem were confirmed as key factors that cause an excessive use of smartphones. (4) Furthermore, impulsiveness and low self-esteem are closely related to the absence of family functions and relations between friends by 68.3% and 54.4%, respectively. CONCLUSION: Authors suggest that nursing intervention programs from various angles are required to reduce adolescents' excessive use of smartphones. For example, family communication programs would be helpful for both parents and children. Consultant programs about relationships with friends would also be helpful.

Pre-hypertension and the risk of diabetes mellitus incidence using a marginal structural model in an Iranian prospective cohort study / 한국역학회지

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

A Structural Model on the Nursing Competencies of Nursing Simulation Learners

PURPOSE: The purpose of this study was to test a model of nursing competencies of nursing simulation learners. The conceptual model was based on the theory of Jeffries's simulaton theory. METHODS: Data collection was conducted in October 2017 for 310 students from two nursing universities in Kyungbuk area for 20 days. Data analysis methods were covariance structure analysis using SPSS 21.0 and AMOS 22.0 statistical programs. RESULTS: The hypothetical model was a good fit for the data. The model fit indices were comparative fit index=.97, normed fit index=.94, Tucker-Lewis Index=.97, root mean square error of approximation=.44, and standardized root mean square residual=.04. Teacher factors were directly related to simulation design characteristics, and it was confirmed that the curriculum, classroom operation and teaching method of the instructors were important factors. Learner factors were found to have a direct effect on nursing competence, self-confidence, and clinical performance that belong to nursing capacity. In particular, the results of this study indicate that the simulation design characteristics have a partial mediating effect on learner factors and clinical performance, and a complete mediating effect on learner factors and clinical judgment ability. CONCLUSION: In order to improve the learner's clinical performance and clinical judgment ability, it is necessary to conduct practical training through nursing simulation besides preparing the learner and the educator.