Journal impact factors: implications for the nursing profession

Background: The journal impact factor (IF) has become widely used as an absolute measure of the quality of professional journals. It is also increasingly used as a tool for measuring the academic performance of researchers and to inform decisions concerning the appointment and tenure of academic staff as well as the viability of their departments/schools. In keeping with these IF-related trends, nurse researchers and faculty the world over are being increasingly expected to publish only in journals that have a high IF and to abandon all other forms of publishing (including books and book chapters) that do not attract IF rankings.

Issues: The IF obsession is placing in jeopardy the sustainability and hence viability of nursing journals and academic nursing publication lists (academic texts). If nurse authors abandon their publishing agenda and publish only in 'elite' journals (many of which may be outside nursing), the capacity of the nursing profession to develop and control the cutting edge of its disciplinary knowledge could be placed at risk.

Actions: Other means for assessing the quality and impact of nursing journals need to be devised. In addition, other works (such as books and book chapters) need also to be included in quality metrics. Nurse authors and journal editors must work together and devise ways to ensure the sustainability and viability of nursing publications.

Using choquet integrals for evaluating citation indices in journal ranking

The use of citation-based indices to evaluate the quality of journals is becoming increasingly widespread. Recently, ISI Web of Knowledge has begun to include three new indices in their journal statistics, including a 5-year impact factor. Here, we continue our earlier research which modeled the behavior of journal assessors based on some of these indices and the Choquet integral. We interpret the obtained fuzzy measures of many new datasets toward understanding the importance of these newly published indices and how indicative they may be of a journal's quality. The problem is one of ordinal classification, and the values of the best-fitting fuzzy measures can be obtained using the FMtools software package.

Discovering implicit criteria preferences reflected in tourism journal ranking lists using the Choquet Integral

Variations between journal rankings may cause confusion. As such, prior attempts were made to compare and evaluate journal ranking criteria for obtaining insightful knowledge on how different research communities have ranked journals. However, existing approaches are unable to model the journal ranking process closely enough as they are incapable of considering the relationship between multiple criteria simultaneously. In this paper, we address the challenges by introducing the Choquet Integral (CI) for evaluating journal ranking criteria. The new approach is able to account for interactions between criteria in relation to overall ranking score, using a fuzzy measure in its computation. Its properties, the Shapley value and the Interaction index, allow for good representations of importance and interactions between criteria. We demonstrate the efficiency of the CI through a case study of journal ranking lists in tourism and service journals.

The projected impact of population and high-risk strategies for risk-factor control on coronary heart disease and stroke events

Objective: To model the impact of both population and high-risk strategies on cardiovascular disease (CVD) outcomes.

Design, setting and participants: A CVD risk-factor survey was carried out in rural south-eastern Australia from 2004 to 2006. Using a stratified random sample, data for 1116 participants aged 35–74 years were analysed. Applying the Framingham risk equations to risk-factor data, 5-year probabilities of a coronary heart disease event, stroke and cardiovascular event were calculated. The effect of different changes in risk factors were modelled to assess the extent to which cardiovascular diseases can be prevented by changing the risk factors at a population level (population strategy), among the high-risk individuals (high-risk strategy) or both.

Results: Among men, a population strategy could reduce cardiovascular events by 19.3% (193 per 1000 per 5 years), the high-risk strategy by 12.6% (126 per 1000) and a combined strategy by 24.1% (241 per 1000); and among women, by 21.9% (219 per 1000), 19.0% (190 per 1000) and 28.7% (287 per 1000), respectively.

Conclusions: For prevention of CVD in Australia, it is important both to treat high-risk individuals and to reduce the mean risk-factor levels in the population. We show how risk-factor survey data can be used to set targets for prevention and to monitor progress in line with the recommendations of the National Preventative Health Taskforce.

Impact of positively- versus negatively-worded items on the factor structure of three psychological measures: W-BQ22, W-BQ12 & SF-36

Background: The 22-item Well-being Questionnaire (W-BQ22) (Bradley, 1994) includes Anxiety, Depression, Energy and Positive Well-being subscales. However, the constructs of anxiety and depression could not be easily distinguished from each other. Consequently, the W-BQ12 was designed to include just three subscales, Negative Well-being (including only negatively-worded anxiety and depression items), Energy (2 positively- and 2 negativelyworded items) and Positive Well-being (all positively-worded items). The SF-36 (Ware & Sherbourne, 1983), a widely used health status measure, includes a 4-item vitality subscale (2 positively- and 2 negatively-worded items) and a 5-item mental health scale (2 positively worded and 3 negatively-worded items).

Method: Factor structures of W-BQ22, W-BQ12 and SF-36 were compared using data from 789 outpatients with diabetes.

Results: W-BQ22 factor analysis showed negatively-worded anxiety and depression items loading together, while positively-worded depression items loaded with positive well-being items and separately from positively-worded anxiety items. W-BQ12 loaded as intended on 3 factors, with negatively-worded anxiety and depression items loading together on one factor: negative well-being. The four energy items (2 positively- and 2 negatively-worded) loaded together (factor 3) and the four positive well-being items loaded together (factor 1). Unforced factor analysis of the SF-36 produced 5 factors and split the mental health and vitality items into two components, which could only be defined in terms of positive and negative wording. A forced 8-factor solution produced similar results, with the mental health and vitality items being split into two components according to their positive or negative wording. A forced 2-factor solution brought mental health/vitality items together, separate from physical health items.

Conclusion: The previously unrecognised influence of positive and negative wording on factor structure is clearly shown here to be of importance in conceptualising and designing measures of psychological well-being to be used with people with diabetes and may be of relevance for other populations.

Stage of perinatal development regulates skeletal muscle mitochondrial biogenesis and myogenic regulatory factor genes with little impact of growth restriction or cross-fostering

Foetal growth restriction impairs skeletal muscle development and adult muscle mitochondrial biogenesis. We hypothesized that key genes involved in muscle development and mitochondrial biogenesis would be altered following uteroplacental insufficiency in rat pups, and improving postnatal nutrition by cross-fostering would ameliorate these deficits. Bilateral uterine vessel ligation (Restricted) or sham (Control) surgery was performed on day 18 of gestation. Males and females were investigated at day 20 of gestation (E20), 1 (PN1), 7 (PN7) and 35 (PN35) days postnatally. A separate cohort of Control and Restricted pups were cross-fostered onto a different Control or Restricted mother and examined at PN7. In both sexes, peroxisome proliferator-activated receptor (PPAR)-γ coactivator-1α (PGC-1α), cytochrome c oxidase subunits 3 and 4 (COX III and IV) and myogenic regulatory factor 4 expression increased from late gestation to postnatal life, whereas mitochondrial transcription factor A, myogenic differentiation 1 (MyoD), myogenin and insulin-like growth factor I (IGF-I) decreased. Foetal growth restriction increased MyoD mRNA in females at PN7, whereas in males IGF-I mRNA was higher at E20 and PN1. Cross-fostering Restricted pups onto a Control mother significantly increased COX III mRNA in males and COX IV mRNA in both sexes above controls with little effect on other genes. Developmental age appears to be a major factor regulating skeletal muscle mitochondrial and developmental genes, with growth restriction and cross-fostering having only subtle effects. It therefore appears that reductions in adult mitochondrial biogenesis markers likely develop after weaning.

The impact of a team-based intervention on the lifestyle risk factor management practices of community nurses: outcomes of the community nursing SNAP trial

Background
Lifestyle risk factors like smoking, nutrition, alcohol consumption, and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care is an appropriate setting to address these risk factors in individuals. Generalist community health nurses (GCHNs) are uniquely placed to provide lifestyle interventions as they see clients in their homes over a period of time. The aim of the paper is to examine the impact of a service-level intervention on the risk factor management practices of GCHNs.

Methods
The trial used a quasi-experimental design involving four generalist community nursing services in NSW, Australia. The services were randomly allocated to either an intervention group or control group. Nurses in the intervention group were provided with training and support in the provision of brief lifestyle assessments and interventions. The control group provided usual care. A sample of 129 GCHNs completed surveys at baseline, 6 and 12 months to examine changes in their practices and levels of confidence related to the management of SNAP risk factors. Six semi-structured interviews and four focus groups were conducted among the intervention group to explore the feasibility of incorporating the intervention into everyday practice.

Results
Nurses in the intervention group became more confident in assessment and intervention over the three time points compared to their control group peers. Nurses in the intervention group reported assessing physical activity, weight and nutrition more frequently, as well as providing more brief interventions for physical activity, weight management and smoking cessation. There was little change in referral rates except for an improvement in weight management related referrals. Nurses’ perception of the importance of ‘client and system-related’ barriers to risk factor management diminished over time.

Conclusions
This study shows that the intervention was associated with positive changes in self-reported lifestyle risk factor management practices of GCHNs. Barriers to referral remained. The service model needs to be adapted to sustain these changes and enhance referral.

Factor structure and measurement invariance of the Health Education Impact Questionnaire: does the subjectivity of the response perspective threaten the contextual validity of inferences?

Objective:
On-going evidence is required to support the validity of inferences about change and group differences in the
evaluation of health programs, particularly when self-report scales requiring substantial subjectivity in response generation are used as outcome measures. Following this reasoning, the aim of this study was to replicate the factor structure and investigate the measurement invariance of the latest version of the Health Education Impact Questionnaire, a widely used health program evaluation measure.
Methods:
An archived dataset of responses to the most recent version of the English-language Health Education Impact
Questionnaire that uses four rather than six response options (N=3221) was analysed using exploratory structural equation
modelling and confirmatory factor analysis appropriate for ordered categorical data. Metric and scalar invariance were
studied following recent recommendations in the literature to apply fully invariant unconditional models with minimum
constraints necessary for model identification.
Results:
The original eight-factor structure was replicated and all but one of the scales (Self Monitoring and Insight) was
found to consist of unifactorial items with reliability of ⩾0.8 and satisfactory discriminant validity. Configural, metric and scalar
invariance were established across pre-test to post-test and population sub-groups (sex, age, education, ethnic background).
Conclusion:
The results support the high level of interest in the Health Education Impact Questionnaire, particularly for use as a pre-test/post-test measure in experimental studies, other pre–post evaluation designs and system-level monitoring and evaluation.

The development and validation of the impact of multiple sclerosis scale and the symptoms of multiple sclerosis scale

Objective

To develop and validate the Impact of Multiple Sclerosis Scale (IMSS) and the Symptoms of Multiple Sclerosis Scale (SMSS) using the Extended Disability Status Scale (EDSS) for construct validity.
Design

Panel design involving test-retest over 4 months.
Setting

A mailed survey.
Participants

Volunteers with a diagnosis of multiple sclerosis (MS) recruited from an MS support service in Australia: 193 people (mean age, 39y) and 150 people participated at time 1 and time 2, respectively.
Interventions

Not applicable.
Main Outcome Measures

Principal components analyses, the Cronbach α, and descriptive statistics for the 2 scales; correlations for construct validity with the EDSS and retest; and confirmatory factor analysis to test the stability of IMSS and SMSS components over time.
Results

The IMSS yielded 5 independent and reliable components; the SMSS yielded 3 components; both component structures were stable over time. These scales showed convergent validity with the EDSS.
Conclusions

The IMSS and SMSS are psychometrically sound scales suitable for clinical and research purposes to assess the symptoms and impact of MS.

Student satisfaction : impact of age and gender on satisfaction among international postgraduate students from Asia

Customer satisfaction is a core-marketing concept. It is considered as a major outcome of marketing activity and serves to link processes, culminating in purchase and consumption with post-purchase phenomena such as attitudinal change, customer retention, repeat purchase, brand loyalty, positive word-of-mouth communication. Student satisfaction is a strategic factor in developing a competitive advantage in the highly attractive and globally competitive international education market. Market forecasts indicate a seven-fold increase in the number of students seeking higher education overseas by 2025 and given the competitiveness of the industry, universities will need to focus on variables influencing student satisfaction in order to address areas where improvements in service quality are required.

A sample of 371 postgraduate students from China, India, Indonesia and Thailand, is investigated. The study highlights the development of a scale to measure international postgraduate student satisfaction. The scale demonstrates the importance of four predominant factors influencing university choices - Education Resources; Communication and Guidance; Customer Value and Study Outcomes; and Image, Prestige and Recognition. Using logistic regression and chi square testing, this paper investigates the impact of age and gender on satisfaction among international postgraduate students from four Asian countries studying in universities in Victoria, Australia, on theses factors. The results indicate that age has a positive relationship with satisfaction among postgraduate students while the influence of gender has no effect on influencing satisfaction among postgraduate students from Asia.

Exercise and calcium combined results in a Greater osteogenic effect than either factor alone: a blinded randomized placebo-controlled trial in boys

We examined the combined effects of exercise and calcium on BMC accrual in pre- and early-pubertal boys. Exercise and calcium together resulted in a 2% greater increase in femur BMC than either factor alone and a 3% greater increase in BMC at the tibia–fibula compared with the placebo group. Increasing dietary calcium seems to be important for optimizing the osteogenic effects of exercise.

Introduction: Understanding the relationship between exercise and calcium during growth is important given that the greatest benefits derived from these factors are achieved during the first two decades of life. We conducted a blinded randomized-controlled exercise–calcium intervention in pre- and early-pubertal boys to test the following hypotheses. (1) At the loaded sites (femur and tibia–fibula), exercise and calcium will produce greater skeletal benefits than either exercise or calcium alone. (2) At nonloaded sites (humerus and radius–ulna), there will be an effect of calcium supplementation.

Materials and Methods: Eighty-eight pre- and early-pubertal boys were randomly assigned to one of four study groups: moderate impact exercise with or without calcium (Ca) (Ex + Ca and Ex + placebo, respectively) or low impact exercise with or without Ca (No-Ex + Ca and No-Ex + Placebo, respectively). The intervention involved 20 minutes of either moderate- or low-impact exercise performed three times a week and/or the addition of Ca-fortified foods using milk minerals (392 ± 29 mg/day) or nonfortified foods over 8.5 months. Analysis of covariance was used to determine the main and combined effects of exercise and calcium on BMC after adjusting for baseline BMC.

Results: At baseline, no differences were reported between the groups for height, weight, BMC, or bone length. The increase in femur BMC in the Ex + Ca group was 2% greater than the increase in the Ex + placebo, No-Ex + Ca, or No-Ex + Placebo groups (all p < 0.03). At the tibia–fibula, the increase in BMC in the Ex + Ca group was 3% greater than the No-Ex + placebo group (p < 0.02) and 2% greater than the Ex + Placebo and the No-Ex + Ca groups (not significant). No effect of any group was detected at the humerus, ulna–radius, or lumbar spine for BMC, height, bone area, or volume.

Conclusions: In this group of normally active boys with adequate calcium intakes, additional exercise and calcium supplementation resulted in a 2–3% greater increase in BMC than controls at the loaded sites. These findings strengthen the evidence base for public health campaigns to address both exercise and dietary changes in children for optimizing the attainment of peak BMC.