Comparison of Model Fit Indices Used in Structural Equation Modeling Under Multivariate Normality

The purpose of this study is to investigate the impact of estimation techniques and sample sizes on model fit indices in structural equation models constructed according to the number of exogenous latent variables under multivariate normality. The performances of fit indices are compared by considering effects of related factors. The Ratio Chi-square Test Statistic to Degree of Freedom, Root Mean Square Error of Approximation, and Comparative Fit Index are the least affected indices by estimation technique and sample size under multivariate normality, especially with large sample size

Co-Plot Method: A Research on Tobacco Control in the European Region

BACKGROUND: The aim of this study is to introduce the uncommonly used Co-Plot method which is called the multivariate graphical analysis and to apply this method to a data set including tobacco control in European region.METHODS: This study uses the data from the World Health Organization database according to Human Development Index of European countries. It takes into account variables such as smoking prevalence in young people and adults, the proportion of smoking-related deaths and domestic legislations casespertaining to tobacco products and analyses the data using the Co-Plot method.RESULTS: Results of the study demonstrated that smoking prevalence and restrictions on advertising of tobacco products were highly negatively correlated. The proportion of deaths associated with smoking-related diseases increased parallel to the increase in the smoking prevalence in young people and adults. Norway, France and Finland have enforced legal limitations on direct and indirect advertising, and thus there has been a decline in smoking prevalence among young people andadults. In some countries, including Ireland, Italy and Serbia, the prevalence of smoking among the young has decreased due to the new or increased legal restrictions on the sale distribution of tobacco products. The governments in the Czech Republic, Kazakhstan, Estonia, Croatia, the Netherlands,Belgium, and Poland have placed restrictions on direct and indirect advertising. The distribution of other causes-related deaths and lung cancer-related deaths are high.CONCLUSION: The restrictions on tobacco products were tightened in time with the increased prevalence of smoking and proportion of smoking-related deaths. It can be said that the significantrelationships identified in this study have even more pertinence in developed countries. Consequently, Co-Plot method has enabled deeper data interpretations of the relationships between the countries and the variables in this study

Evaluation of the functional status of patients with chronic obstructive pulmonary disease via the modeling approach

Background: Chronic obstructive pulmonary disease (COPD) is common worldwide. COPD has negative effects on the quality of life of the patient due to restrictions on daily activities. It can cause a major healthcare burden according to the stage and grade of disease.Objective: The purpose of this study was to determine the physical and psychological functional capacity factors affecting patients’ functional performance and to develop a COPD-specific functional status model using these factors.Methods: A group of randomly selected patients (n=183) diagnosed with COPD at a university hospital in Turkey comprised the study sample. Physical examinations were carried out on all patients and they completed questionnaires that included socio demographic and disease characteristics, the Hospital Anxiety and Depression Scale, Functional Performance Inventory and Short Form-36 Survey. The proposed theoretical model was analyzed in the LISREL program using the structural equation modeling approach.Results: We found that the independent latent variable of the physiological functional capacity yielded a significant positive effect on the dependent latent variable of functional performance, while the psychological functional capacity produced no significant effect.Conclusions: The COPD-specific functional status model should prove to be an effective and beneficial tool for issues such as treatment maintenance and for the preservation or improvement of patients’ quality of life. [Ethiop.J. Health Dev. 2019; 33(2):81-87]Keywords: Chronic obstructive pulmonary disease, functional status, functional performance, functional capacity, structural equation modelin

Examining the Probabilities of Type I Error for Unadjusted All Pairwise Comparisons and Bonferroni Adjustment Approaches in Hypothesis Testing for Proportions

The aim of this study is to examine the association among the probabilities of Type I error obtained by Unadjusted All Pairwise Comparisons (UAPC) and Bonferroni-adjustment approaches, the sample size and the frequency of occurrence of an event (prevalence, proportion) in hypothesis testing of difference among the proportions in studies. In the simulation experiment planned for this purpose, 4 groups were formed and the proportions in each group were chosen between 0.10 and 0.90 so that they will be equal at each experiment. Furthermore, the sample sizes were chosen from 20 to 1000. In accordance with these scenarios, the probabilities of Type I error were calculated by both of approaches. In each approach, a significant S-curve relationship was found between the probability of Type I error and sample size. However, a significant quadratic relationship was found between the probabilities of Type I error and the proportions in each group. Nonlinear functional relations were put forward in order to estimate the observed Type I error rates obtained by the two different approaches where sample size and the proportion in each group are known. Furthermore, it was founded that Bonferroni-adjustment approach cannot always protect Type I error level. It was observed that the probability of Type I error estimated by the functional relation on Type I error rate for UAPC approach is lower than the values calculated using the formula in the literature

Statistical Properties of Sampling Distributions of Different Test Statistics for Different Measures of Change and a New Test: Simulation Study

The aim of this study is to analyse the distribution characteristics of four different test statistics, namely the Mean/Standard Error of Mean (Mean/SEmean), Median/Interquartile Range (Median/IQR), Trimmed Mean/Standard Error of Mean (TrMean/SEmean), and Trimmed Mean/Interquartile Range (TrMean/IQR), which can be used to test two measures of change, namely percent change (PC) and modified symmetrised percent change (MSPC). To ensure the selection of suitable test statistics using the two measures of change, the observed type-I errors and powers of the test statistics have been computed. Results demonstrate that the sampling distributions of the four different test statistics by using PC values exhibit skewness. The Mean/SEmean statistic for the MSPC measure exhibits a two-peak value and platykurtic distribution, while the TrMean/SEmean statistic shows a leptokurtic distribution. The Median/IQR test yields robust and powerful results, especially for large sample sizes. This new statistical measure is referred to as the HS test.WOS:00059204480000

Co-Plot Method: A Research on Tobacco Control in the European Region

BACKGROUND: The aim of this study is to introduce the uncommonly used Co-Plot method which is called the multivariate graphical analysis and to apply this method to a data set including tobacco control in European region.<br />METHODS: This study uses the data from the World Health Organization database according to Human Development Index of European countries. It takes into account variables such as smoking prevalence in young people and adults, the proportion of smoking-related deaths and domestic legislations cases<br />pertaining to tobacco products and analyses the data using the Co-Plot method.<br />RESULTS: Results of the study demonstrated that smoking prevalence and restrictions on advertising of tobacco products were highly negatively correlated. The proportion of deaths associated with smoking-related diseases increased parallel to the increase in the smoking prevalence in young people and adults. Norway, France and Finland have enforced legal limitations on direct and indirect advertising, and thus there has been a decline in smoking prevalence among young people and<br />adults. In some countries, including Ireland, Italy and Serbia, the prevalence of smoking among the young has decreased due to the new or increased legal restrictions on the sale distribution of tobacco products. The governments in the Czech Republic, Kazakhstan, Estonia, Croatia, the Netherlands,<br />Belgium, and Poland have placed restrictions on direct and indirect advertising. The distribution of other causes-related deaths and lung cancer-related deaths are high.<br />CONCLUSION: The restrictions on tobacco products were tightened in time with the increased prevalence of smoking and proportion of smoking-related deaths. It can be said that the significant<br />relationships identified in this study have even more pertinence in developed countries. Consequently, Co-Plot method has enabled deeper data interpretations of the relationships between the countries and the variables in this study

The validity and reliability of Pictorial Pediatric Symptom Checklist in children of 4-5 ages

Objective: The objective of this study is to carry out the validity and reliability of Pictorial Pediatric Symptom Checklist (PPSC), in preschool children of 4-5 ages. Methods: This methodological study was carried out by permission of ethics committee from Marmara University Institute of Health Sciences Ethics Committee and permission of Duzce Provincial National Education Directorate. The population of the study consists of 1.512 parents with children of 4-5 ages studying in 26 preschool education institutions in Duzce. The sample of the study is composed of 759 parents who accept to participate in the study and meet the admission criteria. MINRES Factor Analysis and Confirmatory Factor Analysis (CFA) were used to identify and support of the validity of PPSC. The Cronbach's alpha internal consistency, test-retest and Spearman-Brown reliability coefficients were calculated in order to assess the reliability of the checklist. Findings: It was observed that the dataset of the checklist meet multivariate normal distribution and multicollinearity assumptions. According to Cronbach's alpha internal consistency and test-retest validity coefficients, the overall reliability of the checklist is at an acceptable level. As a result of factor analysis, the construct validity of PPSC with five-factor structure was investigated with CFA. Although the suggested model was not considered as meaningful (chi(2)=460.02, df=365, p=0.001), the model has a good fit because it is RMSEA<0.05 and chi(2)/df<2, when other model fit indexes were analyzed. The model has an acceptable fit as indexes SRMR<0.07, CFI, NFI, GFI, and AGFI are close to the values 0.90 or 0.95. Conclusion: The findings show that the PPSC is a valid and reliable screening tool offering the opportunity of identifying psychosocial and behavioral problems in preschool children

Effects of climate and air pollution factors on outpatient visits for eczema: a time series analysis

Eczema resulting from external and internal factors accounts for the biggest global burden of disability owing to skin disease. This study aimed to determine an association between environmental factors and outpatient clinic visits for eczema. We collected data on dermatology clinic outpatient visits for eczema between January 2013 and July 2019. Data concerning environmental factors during this period were collated using national air quality network and air monitoring measurement parameters, namely barometric pressure, relative humidity, air temperature, and air pollutant concentrations, such as sulfur dioxide (SO2) and particulate matter (PM10). A distributed lag nonlinear model was used to investigate the relationship among eczema, environmental factors, and lagged effects. In total, 27,549 outpatient visits for eczema were recorded. In both single-factor and multiple-factor lag models, the effects of a 10-mu g/m(3)increase in PM(10)and SO(2)values had significantly positive effects on the number of daily outpatient visits over a total 5 days of lag after adjusting for temperature, the number of daily outpatient visits increased with 0.87%, 7.65% and 0.69%, 5.34%, respectively. Relative humidity (RR = 1.3870, 95% CI 1.3117-1.4665) and pressure (RR = 1.0394, 95% CI 1.0071-1.0727) had significantly positive effects on the number of daily outpatients in single-factor lag models. However temperature had a significantly negative effect on them in the number of daily outpatients (RR = 0.9686, 95% CI 0.9556-0.9819). Exposure to air pollution exacerbated eczema. Outpatient visits for eczema were found to have strong positive associations with changes in PM(10)levels.WOS:0005584179000022-s2.0-85089155390PubMed: 3277225

Exposure of Violence and its Effects on Health Care Workers

Objective: The aim of this study is to examine the frequency of violence that the healthcare workers of Duzce University Research and Practice Hospital encountered, situations that cause violence, post-violence attitude and the effects of violence on the personnel, and to evaluate the relationship between violence and the burnout levels of the healthcare workers. Methods: This descriptive cross-sectional study was conducted on the physicians and nurses working in different departments at Duzce University Research and Application Hospital, between October 2020 and February 2021. A questionnaire form consisted of 24 questions including demographic information and questions about working conditions and violence and Maslach Burnout Scale consisting of 22 questions were applied to the participants. Results: The frequency of the participants being exposed to violence throughout their professional life was found 74.4%. The most common type of violence was psychological violence (92.7%). Exposure to physical violence was more common among male healthcare workers (22.7%) (p <0.001). It was found that the rate of exposure to violence increased as the time spent in the profession, the average number of duty shifts, and the number of patients examined daily increased (p <0.05). Swearing and insult were the most common types of violence exposed (71.1%). In the comparison of the exposure to violence and sub-dimensions of burnout scale, it was found that Emotional exhaustion and Depersonalization subscale scores of those who were exposed to violence were significantly higher than those who were not (p = 0.005). Conclusions: Violence in the health sector is a serious problem that decreases the motivation of healthcare workers and causes mental, emotional and physical problems. In order to deal with this problem, instead of ignoring the problem, we need to reveal the violence and its destructive effects through more comprehensive studies.WOS:00068972950002

Assessment of the dissimilarities of totally 186 countries and regions according to COVID-19 indicators at the end of March 2020

BackgroundThis study is aimed at evaluating the relationship between the number of days elapsed since a country’s first case(s) of coronavirus disease 2019 (COVID-19), the total number of tests conducted, and outbreak indicators such as the total numbers of cases, deaths, and patients who recovered. The study compares COVID-19 indicators among countries and clusters them according to similarities in the indicators. MethodsDescriptive statistics of the indicators were computed and the results were presented in figures and tables. A fuzzy c-means clustering algorithm was used to cluster/group the countries according to the similarities in the total numbers of patients who recovered, deaths, and active cases. ResultsThe highest numbers of COVID-19 cases were found in Gibraltar, Spain, Switzerland, Liechtenstein and Italy were also of that order with about 1500 cases per million population. Spain and Italy had the highest total number of deaths, which were about 140 and 165 per million population, respectively. In Japan, where exposure to the causative virus was longer than in most other countries, the total number of deaths per million population was less than 0.5. According to cluster analysis, the total numbers of deaths, patients who recovered, and active cases were higher in Western countries, especially in central and southern European countries, which had the highest numbers when compared with other countries.ConclusionThere may be various reasons for the differences between the clusters obtained by fuzzy c-means clustering. These include quarantine measures, climatic conditions, economic levels, health policies, and the duration of the fight against the outbrea