Search Results (1,065)

Background: The Psychache Scale (PS) is the most widely used scale to measure psychological pain due to its ease of application, favorable evidence of predictive validity, and adequate psychometric properties from the CTT (Classical Test Theory) approach. This paper aims to contribute to the improvement of the Spanish version of the PS by analyzing its psychometric properties using a Rasch model. Methods: Using quota sampling, 905 young adults completed an online questionnaire with the PS. Results: The items and response categories showed an acceptable fit to the model and good performance. The separation index indicated three strata for persons. The item-person map showed that persons were placed lower on the psychological pain continuum than item, and some item pairs presented small difference in their severity. The study of men-women DIF (differential item functioning) showed a slight differential functioning only for item 6. Conclusions: This study provides new evidence that supports the use of the PS to measure psychological pain. Full article

Coordinate measuring techniques are essential for determining the diameter and roundness of circular features, yet measurements based on short arc segments remain highly sensitive to form deviations, sampling strategy, and instrument error. With the increasing demands placed on metrology, the choice of suitable data calculation and analysis methods becomes crucial for reliable interpretation of results. This study presents a simulation-based analysis of diameter evaluation for an oval-shaped profile, considering different levels of form deviation, three orientations of the contour peak, and the presence of random measurement error. The analysis includes both complete contours and partial arc segments and evaluates four reference-circle-fitting methods (LSCI, MZCI, MICI, MCCI). The results show that shortening the measured arc increases the influence of local geometric irregularities and random error on the obtained diameter values. The fitting methods behave differently under these conditions: LSCI is strongly affected by the orientation of the deformation peak, while MICI and MCCI provide reliable results only for sufficiently long arcs. MZCI consistently delivers the most stable performance when only fragmentary data are available. These findings indicate that both the choice of reference method and the selection of an adequate arc length are crucial for ensuring reliable and meaningful diameter assessment. Full article

Background/Objectives: The cancer experience has a significant affective impact on patients, often causing anxiety and depression. Given the importance of this condition, there is a true need for psychometrically valid and culturally appropriate assessment tools for anxiety and depression in this condition. This is also true for Arabic-speaking populations. This study evaluates the measurement properties of the PROMIS Depression in Cancer (PROMIS-Ca-D) and Anxiety in Cancer (PROMIS-Ca-A) questionnaires, part of the Patient-Reported Outcomes Measurement Information System^® (PROMIS^®), for assessing depression and anxiety in Saudi Arabian cancer patients. Methods: The PROMIS-Ca-D was translated into Arabic and subsequently tested with 30 participants from five Arabic-speaking countries. The PROMIS-Ca-A had been previously translated into Arabic. The second phase recruited 213 cancer patients in Riyadh, Saudi Arabia, who completed the PROMIS-Ca-D and PROMIS-Ca-A. Rasch analysis (rating scale model) was used to assess category functioning, item fit, unidimensionality, differential item functioning, and measures reliability. Results: The translation process confirmed the cultural appropriateness of the Arabic PROMIS-Ca-D. In the validation cohort (N = 213), Rasch analysis indicated excellent reliability for both scales. Although disordered modal thresholds and signs of multidimensionality were observed, control analyses confirmed that these features did not compromise the item calibrations or the person’s measures. Item fit was adequate, and Differential Item Functioning was negligible. However, suboptimal item-person targeting was noted. Conclusions: The Arabic PROMIS-Ca-D and PROMIS-Ca-A are psychometrically sound instruments for evaluating psychological distress in Arabic-speaking cancer patients. Future research should focus on assessing responsiveness and evaluating metric equivalence with legacy measures. Full article

Concrete-filled steel tube (CFST) columns are composite structural elements preferred in various engineering structures due to their superior properties compared to those of traditional structural elements. However, fire resistance analyses are complex due to CFST columns consisting of two components with different thermal and mechanical properties. Significant challenges arise because current design codes and guidelines do not provide clear guidance for determining the time-dependent fire performance of these composite elements. This study aimed to address the existing design gap by investigating the fire behavior of circular long CFST columns under axial compressive load and developing robust, accurate, and reliable design models to predict their fire performance. To this end, an up-to-date database consisting of 62 data-points obtained from experimental studies involving variable material properties, dimensions, and load ratios was created. Analytical design models were meticulously developed using two advanced soft computing techniques: artificial neural networks (ANNs) and genetic expression programming (GEP). The model inputs were determined as six main independent parameters: steel tube diameter (D), wall thickness (t_s), concrete compressive strength (f_c), steel yield strength (f_sy), the slenderness ratio (L/D), and the load ratio (μ). The performance of the developed models was comprehensively compared with experimental data and existing design models. While existing design formulas could not predict time-based fire performance, the developed models demonstrated superior prediction accuracy. The GEP-based model performed well with an R-squared value of 0.937, while the ANN-based model achieved the highest prediction performance with an R-squared value of 0.972. Furthermore, the ANN model demonstrated its excellent prediction capability with a minimal mean absolute percentage error (MAPE = 4.41). Based on the nRMSE classification, the GEP-based model proved to be in the good performance category with an nRMSE value of 0.15, whereas the ANN model was in the excellent performance category with a value of 0.10. Fitness function (f) and performance index (PI) values were used to assess the models’ accuracy; the ANN (f = 1.13; PI = 0.05) and GEP (f = 1.19; PI = 0.08) models demonstrated statistical reliability by offering values appropriate for the expected targets (f ≈ 1; PI ≈ 0). Consequently, it was concluded that these statistically convincing and reliable design models can be used to consistently and accurately predict the time-dependent fire resistance of axially loaded, circular, long CFST columns when adequate design formulas are not available in existing codes. Full article

In the United States, although the gaps in health insurance coverage by sexual orientation have been closing since the implementation of the Affordable Care Act and legalization of same-sex marriage, the LGB group (i.e., lesbian, gay, bisexual) continues to report healthcare utilization and access inequities such as more delayed or unmet care. The extant research has often examined healthcare utilization and access inequities due to affordability (e.g., out-of-pocket costs). However, healthcare utilization and access inequities are only partially explained by cost reasons; there are non-cost reasons that have not been adequately empirically examined. The present study innovatively includes discrimination structural variables to understand how social structure is associated with healthcare utilization and access inequities of LGB people. It focuses on two routine health services—regular check-ups and prescription medications—for LGB people who have chronic diseases. Additionally, sexual orientation may intersect with sex assigned at birth (sex, hereafter, i.e., male, female) to impact healthcare utilization and access inequities. The current study applies quantitative intersectional analysis to understand healthcare utilization and access inequities from a sexual orientation and sex intersectional lens and for easier and clearer interpretations of intersectional results and more actionable policy implications for inter-categorical groups. Using the 2023 National Health Interview Survey (weighted N = 136,231,053), we conducted quantitative intersectional analysis for logistic regression using complex survey data. First, we fit a series of logistic regression models with sexual orientation–sex interactions for routine healthcare utilization and access outcomes, adjusting for covariates. Second, we calculated average marginal predictions for inter-categorical groups by interacting sexual orientation and sex and other covariates. Third, we computed risk ratios of average marginal predictions for all the covariates. Lastly, we examined the interaction of inter-categorical groups/sexual orientation and structural variables. Our results show that experiencing a higher level of discrimination is positively associated with underutilization of regular check-ups and lower access to prescription medications, and this effect is stronger for LGB people. Further, LGB women are least likely to utilize regular check-ups and LGB men are least likely to access prescription medications among the inter-categorical groups. Highlighting structural issues of healthcare utilization and access offers new evidence on healthcare utilization and access inequities that can inform policies for raising awareness of and addressing structural issues. The intersectional analyses suggest that relevant policies target LGB women and LGB men. Full article

Objective: Appetitive traits influence obesity risk, yet no validated Danish tool exists to assess these traits in adults. We translated the Adult Eating Behavior Questionnaire (AEBQ) into Danish and evaluated reliability and validity. Methods: Adults (n = 1257) from the South Danish Obesity Initiative completed the Danish AEBQ; a subsample took part in test–retest analysis (n = 256). Content validity was assessed via Three-Step Test Interviews (n = 5). Test–retest reliability was examined by intraclass correlation (ICC). Confirmatory factor analysis (CFA) tested structural validity (with an ancillary eight- vs. seven-factor comparison). Internal consistency was evaluated by Cronbach’s α and McDonald’s ω. Pearson correlations and regression models (adjusted for age, sex, and education) related subscales to BMI, waist-to-hip ratio (WHR), and body fat percentage (fat%). Results: Three-Step Test Interviews supported content validity. Test–retest reliability was good for most subscales (ICCs ≈ 0.80–0.88) and moderate for Emotional Undereating (ICC = 0.640). Both CFA models showed acceptable fit; information criteria favored the seven-factor solution, with small differences on other indices. Internal consistency was acceptable for most subscales (α and ω ≥ 0.70), borderline for Hunger (α = 0.70; ω = 0.71), and below threshold for Satiety Responsiveness (α = 0.69; ω = 0.69). Food Responsiveness and Emotional Overeating were positively associated with BMI/WHR/fat%, while Emotional Undereating showed inverse associations; other subscales showed no associations. Conclusions: The Danish AEBQ shows adequate psychometric performance, and both seven- and eight-factor structures appear applicable in a Danish setting, with the caveat that internal consistency for Hunger and Satiety Responsiveness fell just below conventional cut-offs. Full article

The use of chemically assisted performance enhancement (CAPE) substances has become a prominent trend in today’s competitive societies. Although evidence suggests that CAPE behaviors across different life domains share common characteristics, no consistent theoretical framework exists for understanding the decision to engage in such behaviors. The aim of the present study was to examine a unified conceptualization of CAPE behaviors in four life domains. A total of 254 participants (64 competitive athletes, 40 recreational exercisers, 67 students, and 83 professionals) completed a survey assessing distal and proximal associations of CAPE behaviors (adapted for each domain). Path analysis used to evaluate the proposed model demonstrated an adequate fit. Results indicated that proximal associations of intentions (i.e., attitudes, norms, and situational temptation) were predicted by distal variables (i.e., social norms and cultural values). Intentions to engage in CAPE behaviors were predicted by attitudes and situational temptation. Goal commitment predicted only the mean of working, studying, or training. Finally, the mean of supplement use was predicted by norms. These findings provide preliminary evidence for a conceptual framework to understand CAPE behaviors across life domains, which may serve as a basis for designing intervention programs aimed at helping individuals make informed decisions about CAPE. Full article

Background/Objectives: Delayed motherhood is becoming increasingly common, yet limited evidence exists on birth satisfaction and breastfeeding attitudes among women aged ≥35. In this study, the hypothesis was tested whether higher birth satisfaction and stronger social support are associated with more positive breastfeeding attitudes and if previous childbirth experience moderates these relationships. Methods: A cross-sectional online survey was conducted among 148 Polish women up to 12 months postpartum. Participants were recruited via social media and parenting-related online communities; the survey was disseminated across multiple online channels to enhance representativeness and reduce potential sampling bias. Eligibility included age ≥35 at childbirth and informed consent. The sample size was considered adequate based on recommendations for regression models with the number of included predictors. Validated tools were used (MSPSS, IIFAS-Pol, BSS-R PL). Assumptions for Pearson’s correlation coefficients and linear regression (normality, homoscedasticity, absence of multicollinearity) were checked prior to analyses. The analysis was performed using IBM SPSS Statistics 29 (IBM Corp., Armonk, New York, NY, USA). Results: Women aged ≥35 reported high birth satisfaction and generally positive breastfeeding attitudes. Among multiparous women, birth satisfaction was moderately positively associated with breastfeeding attitudes (BSS-R PL; r = 0.396, p < 0.01), and perceived social support showed a small but significant association (MSPSS; r = 0.249, p < 0.05). Hierarchical regression analyses indicated that, in women over 35 with a subsequent child, psychosocial variables significantly predicted breastfeeding attitudes, whereas the control model—including education, socioeconomic status, and delivery mode—was not significant. Adding birth satisfaction and perceived social support improved model fit (R² = 0.194), with birth satisfaction emerging as the only significant predictor (β = 0.31). The corresponding effect size (f² = 0.143) indicated a near-medium effect. In contrast, neither the control nor the extended model was significant among primiparous women, suggesting no meaningful associations in this group. Conclusions: Higher birth satisfaction and perceived social support may promote more favorable breastfeeding attitudes in women becoming mothers at ≥35, with stronger effects among multiparous mothers. These findings highlight the need for individualized prenatal education, enhanced psychosocial support, partner involvement and efforts to improve childbirth experiences. Interventions tailored to women entering motherhood at an advanced maternal age are warranted. Full article

This study aimed to translate the Mental Health Knowledge Schedule (MAKS) to Brazilian Portuguese, adapt it to the Brazilian primary health care context, and evaluate its psychometric properties. The adaptation process involved three stages: translation, back-translation, and peer-group evaluation. To achieve a valid and reliable instrument, the Brazilian Portuguese version of the questionnaire (MAKS-BR) was administered through an anonymous, online self-administered questionnaire to a convenience sample of 289 primary care professionals with a mean age of 39.6 years (SD = 9.6 years), 90% of whom were women. The instrument, in its final 11-item model, presented satisfactory fit and comparative indices with a two-factor model. The first factor aggregates items related to mental health knowledge, while the second included items related to recognition and familiarity with various mental health conditions. The network findings support the discriminant validity of the two dimensions, while also underscoring the integrative nature of mental health literacy, in which knowledge and recognition processes are interconnected yet functionally distinct. Our findings suggest that the MAKS is an adequate instrument for assessing mental health knowledge, considering the linguistic and cultural contexts of Brazil. Full article

Competing risks modeling plays a pivotal role in both reliability analysis for scientific and engineering fields and survival analysis within medical research. In real-world scenarios, failure or death (from a biological perspective) often arises from multiple risk factors that compete with one another. To adequately capture these complexities, it is essential to employ a flexible probabilistic framework, such as the competing risks model, which ensures suitability for intricate risk scenarios (e.g., analyzing data from aggressive diseases where treatment response and disease progression are closely interwoven). This study introduces Stacy’s competing risks model, built upon Stacy’s generalized gamma distribution, offering enhanced robustness and flexibility over existing models. The paper first develops the mathematical properties of the proposed model, followed by a detailed exploration of parameter estimation through various estimation methods. A key focus is accurately estimating shape parameters to gain deeper insights into the survival and failure mechanisms associated with the underlying phenomenon. The performance of different estimation approaches is assessed using Monte Carlo simulations, with results indicating that the least square, Cramér–von Mises, Anderson–Darling, right Anderson–Darling, and weighted least square had better performance and stable estimation accuracy compared with maximum likelihood maximum product of spacings methods. The model is applied to two real-world blood cancer datasets to demonstrate practical applicability, showing the superior performance and outstanding fit of the Anderson–Darling method among the other methods. The findings highlight the superior performance of Stacy’s competing risks model, supported by low Kolmogorov–Smirnov statistics and high p-values, affirming its suitability and robustness in modeling blood cancer data compared to other standard models. Full article

Background/Objectives: The Test of Gross Motor Development (TGMD-2) totals assume equal weighting of the 12 locomotor (LOC) and object control (OC) skills, yet validation studies indicate differential contributions. The study compared equal- and differential-weighted scores for LOC and OC skills, with three fitness and two physical activity (PA) outputs during guided active play (GAP). Methods: Children’s (n = 82; 7.6 ± 1.5 years) TGMD-2 LOC and OC differential factor weights were estimated with Exploratory Factor Analysis (EFA) and compared to equal weights with multiple linear regression (two, five, and eight predictors) and Chi-square analyses. Predictor variables included fitness, BMI, sex, age stages, and PA assessed by energy expenditure (PAEE) and intensity (MVPA) estimated using accelerometry during 1 h GAP. Results: EFA supported a two-factor structure (variance explained = 51.1%) with ≥0.500 loadings for 9/12 skills. Differential- and equal-weighted LOC and OC scores showed varied contributions from individual skills. Multiple linear regression analysis showed similar explained variances (R²) of 53% (PAEE), 40% (MVPA), 31% (OC), and 14% (LOC) for equal or differential scores with eight predictors. Although β coefficients varied, going from two, five, and eight predictors, the impact of equal and differential weights was comparable. Chi-square analysis indicated high OC associated with MVPA (X² (4) = 9.42, p ≤ 0.05), LP, and STR with PAEE. Conclusions: TGMD-2 outputs with equal- and differential-weighted scores are adequate for clinical/educational use, which show similar relationships with PA and HRF variables. Differential-weighted TGMD-2 scores comprise different contributions of movement skills and may hold promise for intervention studies focused on varied or target tasks and movement abilities. Full article

Background/Objectives: Childhood is a critical stage for consolidating health-related habits that shape physical, cognitive, and socio-emotional development. Regular physical activity has been linked to fitness and academic outcomes, while high body mass index (BMI) may hinder school performance. This study examined associations between BMI, perceived school competence, academic performance, and weekly physical activity volume in Portuguese elementary students, addressing a gap in national evidence compared with international studies. Methods: A cross-sectional correlational design was adopted with 531 children (M = 9.13 years) from 10 public schools. BMI was calculated from anthropometric measures, weekly physical activity was self-reported, perceived competence was assessed with Harter’s Self-Concept Scale (Cronbach’s α = 0.797), and academic performance was obtained from school records. Analyses included Pearson correlations, ANOVA with Scheffé post hoc, and multiple regression, with exact significance values reported. Results: Higher BMI was negatively associated with perceived competence and academic achievement, while regular physical activity, particularly 4–6 h per week, was linked to better results in Portuguese and mathematics. Associations were modest (r = 0.18–0.32; R² = 0.12). Regression showed physical activity (β = 0.093, p = 0.033) and perceived competence (β = 0.126, p = 0.004) predicted academic performance, whereas BMI was not (β = −0.028, p = 0.524). The near-zero correlation with environmental studies suggests subject-specific influences. Conclusions: Adequate BMI and regular physical activity are associated with better academic performance. The role of perceived competence is theoretically inferred as a potential mediator, but not formally tested. Findings highlight the interplay of physical, cognitive, and psychosocial factors. Structured school-based activity programs of 4–6 h weekly may promote both health and learning. Full article

A UAV LiDAR dataset offers unparalleled possibilities for accurate topographic modeling and land suitability analysis in spatial planning. This study uses UAV LiDAR for high-resolution DSM and DTM modeling of the Goranci area in Bosnia and Herzegovina—a typical karst region with a complex topographic pattern of sinkholes and varying solar access. Based on the dataset obtained with a UAV LiDAR system, this analysis encompasses a multidimensional spatial analysis that considers a set of topographic–morphometric, hydrological, and solar radiation criteria. A set of topographic derivatives, namely, slope layers; topographic position index layers (TPI); layers of terrain ruggedness index (TRI); layers of topographic wetness index (TWI), sky view factors (SVF), and layers of potential incoming solar radiation (PISR), was obtained for the DTM/DSM datasets and normalized for standard scales. The obtained criteria layers were then assigned specific values based on their relative importance using a multi-criteria decision analysis technique with a weighted linear combination procedure. A suitability index pinpointing gently sloping lands with adequate solar access and avoidance of moisture accumulation sinks can be recognized as the best-qualifying loci for habitation. The results show that about 30% of the area is highly or very highly suitable, primarily representing gently sloping, well-drained, and optimally solar-exposed plateau surfaces, potential locations with high ground elevation, and larger area sizes. Another 14% is moderately suited, and more than 50% is classified as unsuitable or excluded, primarily due to steep slopes, depressions, and/or missing coverage by LiDAR points, thereby underlining the decisive role of slope, solar conditions, and drainage conditions in determining land suitability for settlements. This study has proved that a UAV LiDAR dataset can be successfully paired with Open-Source GIS for a methodologically sound location of settlement zones that fit into the local environment while being environmentally friendly. This solution promotes informed spatial decision-making by utilizing topographic accuracy of a 3D landscape with a procedure of quantitative spatial reasoning for a more informed spatial planning. Full article

Background/Objectives: Patients’ reports on their satisfaction with the care received often have been seen as a key quality indicator of hospital performance. However, the potential effect of different approaches to its measurement has not been adequately assessed in the health care setting. This study therefore aimed to methodologically compare two different response formats in patient satisfaction questionnaires—Likert scales and Item-Specific Response Options (ISRO)—within a Greek public hospital context. The aim was to comparatively explore resulting item- and scale-level score values, ceiling effects, acquiescence bias, and psychometric properties, including reliability and validity. Methods: An overall sample of 400 hospitalized patients at a National Health Service general university hospital was randomly assigned to two groups during February–March 2025. One group completed a Likert-scale questionnaire and the other a questionnaire, with the same content, that employed an ISRO format instead. The questionnaire items covered two aspects of the hospital experience, these being the satisfaction with doctors/nurses as well as the organization and planning of care. Statistical analysis involved Kolmogorov–Smirnov tests for normality, descriptive statistics, chi-square and Fisher’s exact test, t-tests, Mann–Whitney tests, ceiling effects, regressions, Cronbach’s alpha coefficients, and confirmatory factor analysis (CFA), with measures of composite reliability and average variance extracted and model fit indices. Results: Our analysis identified differences in the distributions of patient responses for many items, including variations in median values and the proportion of positive answers. ISRO items tended to produce higher ratings for nursing care and overall satisfaction, whereas Likert items yielded higher scores in organizational aspects. However, the magnitude of these differences was generally small. Regression analysis, adjusting for length of stay, confirmed statistically significant but modest differences in scale scores between formats. Neither format was superior in terms of ceiling effects, whereas no consistent evidence of acquiescence bias was found. Psychometric testing showed that Likert scales had somewhat higher internal consistency reliability and convergent validity, while ISRO exhibited a better model fit in CFA. Conclusions: The item response format seems to affect reported satisfaction scores, yet the impact is rather limited in practical terms for decision-making. Since neither format is consistently superior, the choice between them should depend on study aims, respondent burden, and the intended use of satisfaction scores by policy makers. Moreover, concerns about acquiescence bias may have been overstated in the health care context. Future research should extend these comparisons with other instruments and larger and more diverse samples, as well as employ complementary methods to clarify how response format affects patient satisfaction measurement. Full article

Coal sludge, a fine-grained by-product of hard coal benefit, comprises a mixture of coal particles and mineral and organic matter. Generated during sedimentation and dewatering processes in preparation plants, it is typically recovered as a semi-solid filter cake. The material has potential applications in energy production and, with appropriate processing and stabilization, could be utilized in geotechnical facilities. The strength properties defined by the internal friction angle and cohesion, as well as the deformation properties expressed by compressibility, are among the most important mechanical characteristics of soil. This article presents tests of coal sludge, for which the internal friction angle, cohesion, and oedometric primary and secondary moduli were determined. The material was prepared at its optimum moisture content and maximum dry density prior to testing. In the direct shear test, using a shear box of 6 × 6 cm, each sample was consolidated for 24 h under the applied vertical stress, under which it was subsequently sheared. The shear rate was constant at 0.01 mm/min, and the test was conducted up to 10% horizontal deformation. The vertical stresses applied ranged from 50 to 200 kPa. In the oedometer test, samples were prepared to fit the dimensions of the oedometer ring, and each subsequent load stage was applied after 24 h. The range of vertical stresses in this test was from 12.5 to 400 kPa. The results of the direct shear test (φ = 24°, c = 28 kPa) are similar to the strength parameters typically obtained for medium-cohesive soils, such as sandy silt (φ = 22°, c = 25 kPa. The results of the compressibility tests (0.89 MPa < M₀ < 6.35 MPa) correspond to values characteristic of organic soils, for example, organic silts (0.5 MPa < M₀ < 5 MPa). Moreover, analysis of the consolidation curves showed that up to a vertical stress of 100 kPa, coal sludge does not exhibit rheological behavior. The obtained results indicate that coal sludge, when compacted up to its optimum moisture content and to an adequate dry density, can be effectively utilized for geotechnical applications, such as the construction of isolation barriers, as a component of geotechnical mixtures, or as a sealing material for the reclamation of post-mining areas. Full article