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Toward an explanatory model of nursing performance.

This article suggests a general substantive framework which may be used to integrate conceptually the numerous strands of research conducted in the area of nursing performance. A model which employs the variable-blocking technique discussed by Blalock is presented. Examples--in terms of the model--are given of aspects of nursing performance which have been intensively researched as well as areas which have received limited attention but hold promise. The issue of methodologies used in performance research is addressed. Three multivariate analytical techniques (factor mapping, canonical correlation, and structural equation models), which could be brought to bear on relatively complex performance data and which could prove useful for a wide range of substantive problems, are discussed.

Achievement

Peer and parental influences on adolescent tobacco use.

Longitudinal models of the development of adolescent smoking and smokeless tobacco (ST) use were tested for a sample of 643 adolescents, age 14 to 17. The sample was assessed at three time points. Smoking, smokeless tobacco, and other problem behaviors formed a single problem behavior factor. Structural equation modeling indicated that inadequate parental monitoring and association with deviant peers at Time 2 predicted tobacco use at Time 3. When parental and peer smoking at Time 2 were added to the model, each accounted for significant variance in predicting Time 3 smoking, but inadequate parental monitoring and association with deviant peers still accounted for some of the variance in Time 3 smoking. In predicting boys' smokeless tobacco use, monitoring at Time 2 predicted smokeless tobacco use, but only when parental approval of ST use was not included. Fathers approval of ST use at Time 2 predicted ST use at Time 3, while maternal disapproval predicted its use.

Adolescent

Elevated water levels drive greenhouse gas mitigation in the riparian zone profile.

Wetlands are critical for climate regulation, with their hyporheic zone serving as sensitive interfaces for groundwater-soil-atmosphere exchange. These zones are active hotspots for carbon-nitrogen cycling and greenhouse gas (GHG) emissions (CO2, CH4, N2O), yet the impact of water level fluctuations on these emissions and their microbial drivers in freshwater wetlands remains poorly understood. This study investigated the spatiotemporal dynamics of GHG emissions and carbon-nitrogen coupling processes along riparian soil profiles of Baiyangdian Lake during water level fluctuations. Employing static chamber measurements, microcosms, quantitative PCR, Metagenome-Assembled genome (MAG) analyses, and Structural Equation Modeling (SEM), we observed that GHG emissions were significantly affected by water level fluctuations. Specifically, CO2 and N2O fluxes, as well as CO2 production potential were significantly lower at high-water-level conditions. Water level also emerged as a key driver of microbial community structure, with Methylococcaceae and Methanosarcinaceae as key regulators of CH4 emission, and Anaeromyxobacteraceae as central to N2O dynamics. A high-quality Methylomirabilales-like MAG, possessing the complete pathway for coupled nitrate reduction and methane oxidation, was identified. Its abundance negatively correlated with water level, suggesting that these C-N coupling bacteria contribute to reducing GHG emissions. This study provides crucial theoretical insights and identifies microbial targets for mitigating wetland GHG emission through hydrological management.

Greenhouse Gases

Parents' attachment histories and children's externalizing and internalizing behaviors: exploring family systems models of linkage.

Twenty-seven mothers and 27 fathers were given the Adult Attachment Interview (M. Main & R. Goldwyn, in press) when their children were 3.5 years old. Continuous ratings of narrative coherence, probable experience quality (parents perceived as loving), and state of mind (current anger at parents) were entered as latent variables in partial least squares structural equation models that included observational measures of marital quality and parenting style. Models that include fathers' attachment histories predicted more variance in kindergarten teachers' descriptions of children's externalizing behavior, whereas models that include mothers' attachment histories predicted more variance in children's internalizing behavior. Marital data added predictive power to the equations. Discussion is focused on the importance of integrating attachment and family systems approaches, and of parents' gender and marital quality, in understanding specific links between parents' attachment histories and their young children's externalizing and internalizing behaviors.

Adult

Modeling causal relations between academic and social competence and depression: a multitrait-multimethod longitudinal study of children.

The authors obtained self-reports, peer nominations, teacher ratings, and parent reports of depression and social and academic competence on 490 3rd graders and 455 6th graders near the beginning and end of the school year. Confirmatory factor analysis and structural equation modeling revealed that (a) measures showed significant convergent and discriminant validity; (b) within-wave correlations between constructs were large and significant, although the depression-social competence correlation was larger than the depression-academic competence correlation; (c) the cross-wave stability of all constructs was remarkably high; and (d) social competence at Wave 1 predicted depression at Wave 2 for 6th graders after controlling for depression at Wave 1. Depression did not predict change in either academic or social competence over time. Implications for competence-based and failure-based models of child depression are discussed.

Achievement

Antecedents and consequences of victimization of lesbian, gay, and bisexual young people: a structural model comparing rural university and urban samples.

Research indicates that antigay victimization is widespread and that lesbian, gay, and bisexual young people may be very vulnerable to such victimization. The current study builds upon previous work by Hershberger and D'Augelli (1995), who studied the consequences of sexual orientation-based victimization in 194 urban lesbian, gay, and bisexual youths. Using structural equation modeling, the present study models both antecedents and consequences (including psychological distress, self-esteem, and suicidality) of victimization via a secondary analysis of their data set. In addition, a second sample of 54 lesbian, gay, and bisexual youths from a rural university setting was examined to cross-validate and generalize the relationships found in urban settings. Results indicated that a revised model of victimization exhibited sufficient fit to the urban sample data and provided preliminary support for the generalizability of the model beyond the initial sample. Additional similarities were found between the urban and rural university community samples, including a high prevalence of reported suicide attempts: 42% of the urban sample and 32% of the rural university sample had attempted suicide at least once. Results indicated that victimization based on sexual orientation has similar correlates for young people in different community settings.

Bisexuality

On testing the face validity of planning/problem-solving tasks in a normal population.

Clinically, tests of executive functions tend to be chosen on face validity. If such tests are to be used to evaluate a clinical population, their ability to measure executive functions should be reliably demonstrated in a normal population. In order to investigate the reliability of such tests, a sample of 130 normal adults (74 women, 56 men) ages 17 to 55 years were administered 4 tests purporting to measure planning/problem-solving: the Tower of London Test, the Six Element Test, the Twenty Questions Test, and the Rey Complex Figure Test. A structural equation modeling approach provided by the LISREL 8 program was used to evaluate three models hypothesized to explain the relationship among the test variables and the latent construct of planning/problem-solving. An adequate model was unable to be estimated, thus raising questions about the meaning of the latent construct planning/problem-solving and the psychometric structure of the Tower of London Test.

Adolescent

Causal modeling of epidemiological data on psychiatric disorders.

This paper reviews the logic of causal inference from epidemiological data. I maintain that the clearest causal statements can be made when the philosophical causal principles of association, direction and isolation are upheld in epidemiological research. After reviewing the argument by Holland that only experimental manipulation affords clear causal claims, I examine the utility of structural equation models and longitudinal methods for making causal claims from non-experimental data. This examination leads to the conclusion that mental health epidemiologists should begin to incorporate intervention trials into the last phases of their research programmes when they want to make strong causal claims.

Humans

Analyzing the development of individual differences in terms of Matthew effects in reading: results from a Dutch Longitudinal study.

The Matthew effect hypothesis provides a theoretical framework to describe the development of individual differences in reading ability. The model predicts an increase of individual differences in reading. Reciprocal relationships between reading and other factors seem to cause these increasing differences. This longitudinal study of 3 years was concerned with uncovering the existence and causes of increasing individual differences in reading in the early elementary grades. Data were analyzed within a structural equation modeling framework. The results clearly indicate increasing individual differences for word recognition skills. For reading comprehension, no such effects could be established for this limited time period. More important, some evidence for interactive relationships between reading and other cognitive skills, behaviors, and motivational factors, hypothesized to cause increasing differences between readers, was found.

Child

A bi-directional theory of addiction: examining coping and the factors related to substance relapse.

The results from this study supported a bi-directional theory of addiction for a sample of Black, inner-city, working-class, male substance abusers. Using structural equations modeling, at 6 months posttreatment we found that (a) the reciprocal effect emotional and psychological distress and substance relapse had on one another existed within the context of their bi-directional relationship with social instability, and (b) effective coping skills and resources moderated the negative effects that emotional and psychological distress, social structure, and substance relapse had on one another. These findings led us to three suggestions treatment professionals can use to counteract recidivism.

Adaptation, Psychological

Promoting wellness by delaying age of cardiovascular disease onset: development of a model.

Studies promoting wellness and prevention of cardiovascular disease have primarily dealt with identifying risk factors rather than factors that influence the age at which the cardiovascular disease develops. The purpose of this study was to determine whether selected risk factors affect the age when cardiovascular disease develops. Using a nonexperimental design, all 800 subjects who developed cardiovascular disease were selected from the Framingham Heart Study. A structural equation model for age of cardiovascular disease development was tested. Gender, smoking, entry age, antihypertensive medication use, hemoglobin, body mass index, systolic blood pressure, and diastolic blood pressure were significant determinants of the age at which cardiovascular disease develops. The model accounted for 72% of the variance in age of cardiovascular disease development. The results of this study suggest that in assisting individuals to modify cardiovascular disease risk, cardiovascular nurses and other professionals must address smoking, body mass index, and blood pressure as a package to delay onset of cardiovascular disease symptoms.

Age Factors

Social disconnection integrates genetic and proteomic risks in suicidal ideation and depression.

Suicidal ideation (SI) and major depressive disorder (MDD) are complex psychiatric conditions arising from the interplay of genetic liability, molecular processes, and psychosocial factors. While these dimensions have been extensively studied in isolation, their joint contribution to SI and MDD remains unclear. This study integrates multi-modal data to elucidate these synergistic effects and develop robust models for individual-level risk stratification. Leveraging longitudinal multi-modal data from 13,085 UK Biobank participants, we integrated genomic, proteomic, and social connection profiles. We developed interpretable risk scores using a rigorous supervised machine learning framework encompassing diverse linear and ensemble classifiers. Permutation importance was employed to quantify feature contributions and derive transparent, weighted risk metrics across diverse classifiers. These scores were validated through association, interaction, and mediation analyses. Social connection-based risk scores significantly differentiated cases and controls across the two suicidal ideation phenotypes at 2017 and 2023 with cross-sectional analyses (AUCs: 0.70 - 0.73), outperforming proteomic-only models. Functional dimensions of social connection emerged as the most informative predictors. Longitudinal analyses revealed that social risk scores at baseline predicted suicidal ideation onset six years later, independent of demographic covariates. Interaction analyses demonstrated that polygenic risk for suicide attempt significantly interacted with both social and proteomic risk features in relation to depression. Structural equation models further confirmed that social disconnection acts as a key mediator linking genetic predisposition to MDD and SI. Social disconnection is a critical risk factor mediating the impact of genetic vulnerability on psychiatric outcomes. Integrating social, genetic, and molecular data supports a multilevel framework for risk stratification and highlights the potential of socially oriented interventions to mitigate biological risk.

Humans

Psychosocial correlates of substance use: comparing high school students with incarcerated offenders in Hong Kong.

Drug use prevalence data were obtained from 969 adolescents, high school students and imprisoned offenders who reported use of cough medicine, organic solvents, cannabis, heroin, tranquilizers, and narcotics over the past six months. Incarcerated youths, in particular girls, had higher prevalence rates than students. Drug use frequencies were associated with psychosocial variables such as disinhibition, peer drug use, susceptibility to peer pressure, attitudes, encouragement by peers, and perceived availability of drugs. The psychosocial process of the initiation and maintenance of substance use was specified as a path model that considered 1) personality and social environment as distal precursors and 2) a drug-use predisposition and perceived availability as proximal precursors of three kinds of outcome variables: drug use, the intention to try illicit drugs if they were legal, and adverse outcomes of drug use. It was found that the same structural equation model fit the data of both samples of offenders and students, however, with very different weights assigned to the paths.

Adolescent

Construct validity of heroin abuse estimators.

The construct validity of two methodologically unrelated procedures for estimating the prevalence of heroin abuse was studied using a covariance structure model-fitting approach. A factor analytic estimation procedure and a log-linear-based capture-recapture method of estimation were simultaneously applied to 24 major metropolitan areas of the nation. A test of the construct validity of these procedures for estimating the prevalence of heroin abuse was carried out in the context of structural equation models where the results of the two methods were compared directly.

Data Collection

A longitudinal model of maternal self-efficacy, depression, and difficult temperament during toddlerhood.

The purpose of this study was to test a model of maternal self-efficacy during toddlerhood using a longitudinal sequential design. Participants were 126 mothers of 1-year olds (Cohort 1) and 126 mothers of 2-year olds (Cohort 2) who completed questionnaires measuring maternal self-efficacy, depression, and perceived difficult toddler temperament three times over 1 year. Data were analyzed using structural equation modeling and maximum likelihood estimation. Findings support a model whereby (a) the more depressed the mother feels, the more likely she is to rate her toddler's temperament as difficult, (b) the more difficult the child's temperament is perceived to be, the lower the mother's estimates of her parenting self-efficacy, (c) the lower the mother's self-efficacy, the greater her depression, and (d) the more depressed the mother feels at one point in time, the more likely she is to remain depressed 6 months later. Implications of the findings are discussed as they relate to self-efficacy theory and nursing intervention with parents of difficult toddlers.

Adult

Factors promoting cigarette smoking among black youth: a causal modeling approach.

A longitudinal model of Black adolescent smoking was tested using 223 seventh-grade students attending public schools in northern New Jersey. Interpersonal and intrapersonal factors were hypothesized to have an impact on Black seventh graders' decision to smoke. After conducting an exploratory Principal Factor Analysis (PFA) using a varimax rotation with the Time 1 data, a structural equation model was developed and refined through successive iterations. The final model revealed friends' smoking to be the most significant predictor of Black adolescent smoking at Time 1, but perceived smoking norms and intrapersonal factors such as decision making, self-efficacy, and self-esteem at home and at school exerted an important influence on smoking at Time 2. These results suggest that social influence factors may be important early in the smoking initiation process, but factors such as perceived smoking norms and intrapersonal factors may play an important role in maintaining the smoking habit in Black adolescents.

Adolescent

A longitudinal causal model of cardiac invalidism following myocardial infarction.

BACKGROUND: Invalidism has been discussed in the cardiovascular literature for decades. Researchers have studied health perceptions, emotional distress, and dependency in patients after acute myocardial infarction in an attempt to understand the phenomenon. However, no theory of the manner in which these variables interact has been proposed. OBJECTIVES: Using previous research, a model of invalidism was specified in which individuals' perceptions that their health is poor lead to emotional distress and increased dependency. As health perceptions improve over time, emotional distress and dependency decrease. METHOD: Survey data were collected from 111 men and women 1 and 4 months after a first myocardial infarction and were tested using structural equation modeling. RESULTS: The model was rejected using a confirmatory approach (chi2(89) = 141.40; p= .00034). The fit indices, however, suggested an adequate fit of the model to the data (CFI = .96; NNFI = .94). CONCLUSION: The conclusion is that the model is reasonable and serves as a starting point for a theory-based empirical exploration of the invalidism process.

Adult

Structural factor analyses for medically unexplained somatic symptoms of somatization disorder in the Epidemiologic Catchment Area study.

BACKGROUND: Assess the latent structure of the DSM-III somatization symptoms and the stability of symptom patterns over time. METHODS: Cross-sectional and longitudinal covariation of symptoms of somatization disorder were investigated using structural equation models in a population-based data set from the Epidemiologic Catchment Area study. RESULTS: Medically unexplained physical complaints were discovered to cluster into three separate factors, consistent with the DSM-IV definition of somatization disorder, but one dominant general factor was defined, consistent with the DSM-III conceptualization. Individual symptom prevalences and factor structures were different for men and women. The factor structures remained stable at 1 year follow-up. Variations in the threshold of number of somatization symptoms required for diagnosis affected prevalence, sex ratio and temporal stability of the diagnosis. CONCLUSIONS: These population-based results support dimensional models of somatization. Implications for changing the threshold of the categorical diagnosis of somatization disorder and providing better care for these patients are given.

Adult