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Introduction: Feeding is an interactive process between a child and a caregiver, and its early and chronic problems can affect the stress and quality of life of parents. Since the health and support of caregivers can affect the child's disability and performance, it is important to consider the impact of feeding and swallowing disorders on caregivers. Hence, the present study aimed to translate and investigate the validity and reliability of the Feeding/Swallowing Impact Survey (FS-IS) in Persian. Methods: This methodological study consisted of two phases: translating the test to Persian (P-FS-IS) and evaluating psychometric properties including face and content validity (through experts' opinions and cognitive interviews), construct validity (by known-group validity and exploratory factor analysis), and reliability of the questionnaire (by internal consistency and test-retest reliability). The present study was performed on 97 Iranian mothers of children with cerebral palsy aged 2–18 years with swallowing impairments. Results: Exploratory factor analysis rendered two factors with a cumulative variance of 59.71%. When evaluating known-group validity, the questionnaire scores were significantly different across the groups with different severity of the disorder (F(2, 94) = 57.1, p ≤ 0.001). P-FS-IS had a high internal consistency with Cronbach's alpha of 0.95, and there was an appropriate intra-class correlation coefficient of 0.97 for the total questionnaire. Conclusion: P-FS-IS has good validity and reliability and is a suitable questionnaire for assessing the impact of pediatric feeding and swallowing disorders on Persian language mothers. This scale can be used in research and clinical settings to evaluate and determine therapeutic goals. [ABSTRACT FROM AUTHOR]

Background: The patient's fear of social reactions, the disease stigma, and being a transmission agent is a psychological and social consequence of contracting some diseases, especially infectious ones, in any society. The present study aimed to design and psychometrically evaluate a COVID-19 social stigma questionnaire in nurses. Methods: This mixed-method study was conducted using a sequential exploratory approach according to the Creswell method in Mazandaran Province (Iran) during 2021-22. The study was performed in three phases: (1) a qualitative phase to explain the key concept, (2) designing the scale items, and (3) an experimental phase with the scale psychometric evaluation. In the first phase, nurses' experiences regarding the concept of COVID-19 social stigma were evaluated using a qualitative method with an inductive qualitative content analysis approach. In this phase, the lived experiences of 12 nurses working at hospitals of Babol University of Medical Sciences were extracted through in-depth interviews with semi-structured questions and analyzed by conventional content analysis. The main classes are contradictory feelings, rejection, and adaptation strategies. In the second phase, the designed items were validated by determining face validity, content validity, and construct validity using exploratory factor analysis (EFA). In addition, the scale's reliability was determined through internal consistency and stability. Results: Following the study's first phase, a pool of questions with 64 initial items was formed. After evaluating face and content validity, the number of items was reduced to 24 cases. An excellent total content validity (S-CVI/Ave) of 0.93 was calculated for the scale. According to EFA outputs, three factors accounted for the most variance (52.82%), and four items were excluded in this phase. The Kaiser-Meyer-Olkin (KMO) statistic and Bartlett's test of sphericity were calculated at 0.776 and P < 0.001, respectively. The results of Cronbach's alpha (0.796) and intraclass correlation (0.793) indicated the correlation and internal consistency of the scale. Conclusion: This scale can help healthcare managers and policymakers apply necessary protective measures by evaluating the social stigma of COVID-19 in nurses and emerging infectious diseases that may occur in the future. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this small-scale study was to assess the content validity of a modified subset of 10 items from the Speech, Spatial and Qualities of Hearing Scale for Parents (SSQ-P) via a survey of expert opinion. Material and methods: An online survey was used to obtain opinions from 10 experts in the field of children's hearing and hearing assessment. Experts were asked to rate the relevance and representativeness of each SSQ-P item to deaf and hard of hearing children aged 5 years and over. Content validity was assessed by the item content validity index (ICVI), with excellent content validity identified as an ICVI above 0.8. Experts were also asked to suggest where they felt the wording of items could be improved. Results: For all items, ICVIs > 0.8 were obtained for both relevance and representativeness, indicating excellent content validity. Some minor rewording suggestions were made. Conclusions: The 10 items tested are candidates for inclusion in an abbreviated version of SSQ-P. Some minor rewording of items may be required, along with assessment of internal consistency and test--retest stability. [ABSTRACT FROM AUTHOR]

A self-report tool called the Subjective Mental Effort Questionnaire (SMEQ) was used to evaluate a person's mental workload function. Mental workload is also a widely used concept in cognitive ergonomics. Currently, assessment tools to measure cognitive ergonomic status have not been developed based on studies in Malaysian population. The study's objectives were to translate, validate, and test the reliability of the SMEQ Malay version among Melaka-based allied health practitioners. Phases of translation, content validation, face validation, cognitive interviewing, and test-retest of the SMEQ Malay version were all included in the development process. The Malay version of the SMEQ had perfect content validity index (CVI) and Kappa scores for content validation. Face validity and cognitive interviews confirmed that the questionnaires had appropriate grammar, clarity, correct word spelling, accurate sentence structure, appropriate font size, and was a clear instrument structure for the target population. Further validation and reliability testing indicated that the SMEQ Malay version had good test-retest reliability, with an intraclass correlation coefficient (ICC) = 0.961 and an standard error of measurement (SEM) = 2.725. According to this study, the SMEQ Malay version was proven to be a viable and reliable instrument for evaluating mental workload function in the Malaysian population. Future studies are recommended to compare the SMEQ Malay version among different types of jobs in Malaysia using a larger sample size and investigate complete psychometric testing among various occupations and tasks. [ABSTRACT FROM AUTHOR]

Purpose Knowledge advancement exposes the pharmacists to new ethical and professional challenges in providing pharmaceutical care. The pharmacist's attitude towards the ethical challenges of pharmacy practice could be of great help in assessing pharmacist's ethical sensitivity. This study aimed to design a valid and reliable questionnaire for measuring pharmacists' attitudes. Methods The present study is the second phase of a sequential exploratory mixed-method study for designing and psychometric evaluation of the questionnaire. In the first phase the questionnaire was developed using semi-structured interviews followed by content analysis. The psychometric evaluation of the questionnaire was performed examining the validity (face, content, and construct), and reliability (internal consistency and Intraclass Correlation Coefficient and Standard Error of Measurement) in a sample of pharmacists practicing in community pharmacies in Tehran and Tabriz, Iran (n = 504). The construct validity of the questionnaire was determined using exploratory and confirmatory factor analysis. Results The Scale-Content Validity Index/Average (S-CVI/AVE) was calculated at 0.84. The results of exploratory factor analysis supported 22 items in four factors including regulations and rules, professional communications, providing and supplying medicine, and consultation and providing pharmaceutical care that are explained by a total of 49.50% of the variance. Also, confirmatory factor analysis confirmed goodness of fit indices and model fit. Cronbach's alpha Coefficient was 0.919 and ICC was 0.914. Conclusions The psychometric evaluation of the present questionnaire shows a native, valid and reliable instrument to assess pharmacists' attitudes toward ethical challenges which could be a mirror of pharmacists ethical sensitivity. [ABSTRACT FROM AUTHOR]

In 2019, Health Canada released a new iteration of Canada's Food Guide (2019-CFG), which, for the first time, highlighted recommendations regarding eating practices, i.e., guidance on where, when, why, and how to eat. The objective of this study was to develop a brief self-administered screener to assess eating practices recommended in the 2019-CFG among adults aged 18–65 years. Development of the screener items was informed by a review of existing tools and mapping of items onto 2019-CFG recommendations. Face and content validity were assessed with experts in public health nutrition and/or dietary assessment (n = 16) and individuals from Government of Canada (n = 14). Cognitive interviews were conducted with English-speaking (n = 16) and French-speaking (n = 16) adults living in Canada to assess face validity and understanding of the screener items. While some modifications were identified to improve relevance or clarity, overall, the screener items were found to be relevant, well-constructed, and clearly worded. This comprehensive process resulted in the Canadian Eating Practices Screener/Questionnaire court canadien sur les pratiques alimentaires, which includes 21 items that assess eating practices recommended in the 2019-CFG. This screener can facilitate monitoring and surveillance efforts of the 2019-CFG eating practices as well as research exploring how these practices are associated with various health outcomes. [ABSTRACT FROM AUTHOR]

Background: The new Knee Society Knee Scoring System (KSS) has been widely used to assess the symptoms, satisfaction, expectations, and physical activities of patients who undergo total knee arthroplasty (TKA). KSS has been translated and validated into many languages but not Persian. The aim of this study was to translate and evaluate the validity and reliability of the Persian version of the new KSS. Methods: The Persian version of the new KSS was translated and culturally adapted according to international guidelines, including translation, back-translation, pre-testing, and expert committee review. A total of 142 patients scheduled to undergo TKA were included in this study and were asked to complete the Persian-KSS, Oxford Knee Score (OKS), and the Visual Analogue Scale (VAS) index both two weeks before the surgery and 6 months after the surgery. Face, content, and construct validity were evaluated to assess the validity of Persian-KSS. Results: The Persian-KSS was comprehensive, indicating that the Persian version of KSS was clear and easy to understand for Persian-speaking patients undergoing TKA. The reliability of the Persian-KSS, assessed by Cronbach's alpha, was 0.894 and 0.800 for the pre- and post-operative stages, respectively. The intraclass correlation coefficient (ICC) assessed the test–retest reliability, which was 0.766 and 0.796 for the pre- and post-operative stages, respectively. The construct validity analysis of Persian-KSS demonstrated a statistically significant correlation between Persian-KSS and the OKS (r = − 0.935, p-value = 0.000 for the pre-operative stage, and r = − 0.809, p-value = 0.000 for the post-operative stage) and VAS index (r = − 0.401, p-value = 0.001 for the pre-operative stage and r = − 0.259, p-value = 0.029 for the post-operative stage). Conclusion: The Persian-KSS, developed after the translation and cross-cultural adaptation process, was proven to be a reliable and valid assessment measure for those who undergo TKA. [ABSTRACT FROM AUTHOR]

We report the results of a mapping exercise by the European Federation of Nurses (EFN) on challenges and solutions related to violence against nurses. This is an issue of growing international concern, with the problem accentuated during and following the COVID-19 pandemic. Following a cross-sectional observational design, an online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. Face validity was achieved through an expert panel. Descriptive statistics were used for data analysis, including counts, percentages, and tabulation. Qualitative data analysis followed thematic synthesis techniques. Three main findings are noted. First, violent incidents against nurses are under-reported due to fear of victimization, employer discouragement, and the perception that reporting will not make any difference. Second, perpetrators of violent acts extend beyond patients and families to include health professionals of different ranks. Third, violent incidences have a significant adverse effect on nurses' health and retention, leading to nurses reducing their working hours or opting for part-time work. Violence against nurses is an expression of a broader problem that is rooted in the failure to recognize and manage violence at the level of the healthcare organization, and the absence of appropriate legislation to maintain minimum standards of safe working environments. This is partly the result of inadequate European Union-wide legislation targeting workplace violence in the health professions. Nurses need more institutional support through dedicated funding aimed at targeted interventions, more legislative commitment to ratify policies against discrimination, and an opportunity to voice the needs to the appropriate policymakers with the ability to bring significant change to existing conditions. Given the severity of the situation, inaction could lead to irreplaceable damage to the nursing workforce, compounding pressures resulting from the COVID-19 pandemic. Ultimately, this situation can further drive existing nurses out of the profession, weakening health systems worldwide. [ABSTRACT FROM AUTHOR]

Background: This study examined the impacts of an educational intervention based on the Progressively Lowered Stress Threshold (PLST) extended model on caregiving for people with dementia (PWD). Method: This study was conducted in Isfahan, Iran, from May 2016 to June 2018, with 38 caregivers of PWD as participants assigned to an intervention group. Data were collected using a multi‐sectional, researcher‐developed questionnaire that recorded the demographic characteristics, and measured the dementia‐related knowledge and caregiving practices of the participants. The questionnaire and an educational program were designed in three parts according to the educational needs of caregivers to enhance their practice, skills, and ability to handle challenging behaviours in PWD. The questionnaire's face validity was confirmed by expert review, and its reliability was assessed with Cronbach's alpha coefficient (knowledge section, 0.838; practice section, 0.802). The sampling method used was convenience sampling, and none of the caregivers refused to receive the educational content. Therefore, the evaluation of the program lacks a randomized controlled group. To tailor the intervention program to the participants' needs, the educational content was based on the PLST extended model. Results: The mean scores for knowledge and practice increased following the intervention (P < 0.05). An educational intervention, using the PLST extended care model, thus produced positive impacts in improving the knowledge and practice of caregivers of PWD. Conclusion: Educating caregivers with the PLST extended model, with a specific focus on the cultural and religious backgrounds of societies, is recommended. [ABSTRACT FROM AUTHOR]

Background and Aim: Evidence-based practice improves the quality of clinical performance. Attitude affects the implementation of research findings into practice. The Evidence-Based Practice Attitude Scale (EBPAS-36) evaluates the attitude of therapists toward evidence-based practice. The present study aimed to provide a validated Persian translation of the EBPAS-36 for audiologists. Methods: The original EBPAS-36 was translated by using the international quality of life assessment protocol. The validity of translated version was surveyed by an expert panel and the Persian version with 35 questions was yielded. A demographic questionnaire and EBPAS P-35 were given to 182 audiologists to evaluate the psychometric properties. The reliability was evaluated by completing the EBPAS P-35 after 2 weeks by 30 of the participants and Cronbach's alpha and Intra-Class Correlation (ICC) were calculated. Confirmatory Factor Analyses (CFA) were also conducted. Results: The content validity ratio was above 0.33 for all except item 10 which was removed from the Persian version. The mean(SD) total score was 2.38(0.46). A significant relationship was observed between the total score and all subscales (p<0.05). The original factor structure showed an acceptable model fit (CMIN/DF=1.39, GFI=0.84, CFI=0.94, IFI=0.94, RMSEA=0.04) confirming the 12-factor structure of the EBPAS-36. The internal consistency was very good for the total score (α=0.88) and adequate to very good for the subscales (0.65--0.84), indicating high reliability. The ICC showed good agreement in the score of test-retest (total ICC=0.65). Conclusion: This study confirms good psychometric properties and validity of the EBPAS P-35 in a sample of audiologists. [ABSTRACT FROM AUTHOR]

Introduction: Radiation therapy (RT) can benefit approximately 50% of cancer patients and contribute to 40% of all cancer cures, yet its utilisation in cancer is low globally. Several factors contribute to this including perceived inconvenience related to accessing and utilising RT. To quantitatively assess the latter, a new tool – the Radiation therapy‐related Inconvenience Questionnaire (RIQ) – was developed. This study aimed to pre‐test the RIQ and explore barriers and facilitators to implementing it in routine clinical practice and clinical trials. Methods: Semi‐structured cognitive interviews were conducted with patients undertaking RT, recruited via three hospitals to examine content validity, acceptability, and comprehensibility of the RIQ. Interviews identified inconsistencies, relevance, and clarity of items. Semi‐structured interviews with healthcare professionals involved in the delivery of care to individuals undertaking RT explored barriers and facilitators to routine usage. Thematic analysis was used to identify themes. Results: Patients (N = 15) identified problems in content, instructions, layout, length, and response options; consequently, 25 items were revised and eight removed, resulting in a final 29‐item questionnaire. Clinicians identified staff‐ and patient‐specific barriers to implementing RIQ in clinical practice. Perceived facilitators included the following: (a) workplace factors, (b) mode of administration, and (c) imparting knowledge. Conclusion: This study demonstrated acceptability and comprehensibility of the 29‐item RIQ amongst cancer patients undertaking RT and treating clinicians. The next phase will evaluate the RIQ's measurement properties in a larger clinical study. The barriers and facilitators identified can guide future implementation of RIQ in clinical practice and clinical trials. [ABSTRACT FROM AUTHOR]

Presently, child-specific tools and instruments related to active school travel (AST) are lacking. This methodological shortcoming often contributes to suboptimal AST behaviour evaluations and intervention programming. The aim of this paper was to develop and validate a theoretically informed child-specific scale regarding multiple perceived barriers and enablers known to impact children's participation in AST. Mixed methods. A mixed-methods and multistudy scale development approach featuring the application of social-ecological theory, a validation pilot study (n = 80), and test-retest study (n = 96) was conducted in collaboration with children in Ontario, Canada. In tandem with completing cognitive interviews and online surveys, multiple analyses, including a qualitative thematic analysis, along with weighted Cohen's kappa, Cronbach's alpha, and confirmatory factor analysis were undertaken. Qualitative analyses of the developed tool addressed face validity concerns related to the response options and definitions of terms used. Following the reliability analyses of 40 items, two confirmatory factor analyses were run to assess the construct validation of perceived AST barriers and enablers, and resulted in the development of the 24-item Perceived Active School Travel Enablers and Barriers – Child (PASTEB-C) questionnaire. The developed PASTEB-C questionnaire may be used to inform the programming and development of AST interventions, as well as conduct child-specific AST research. [ABSTRACT FROM AUTHOR]

Health literacy is a crucial factor in determining one's health outcomes. Individuals with high health literacy possess the ability to access, comprehend, evaluate, and utilize health information to maintain, enhance, and advocate for good health. This study aimed to develop and validate a tool called the Health Literacy Questionnaire for Older Adults (HLQ-OA) specifically designed to assess the health literacy of community-dwelling older adults in Taiwan. The development of the HLQ-OA occurred in two phases. Firstly, a systematic literature review was conducted, followed by the evaluation of content validity and face validity through expert and older adult assessments. Subsequently, a cross-sectional study was carried out, involving a convenient sample of 481 older adults from community-dwelling long-term care stations. The final version of the HLQ-OA comprised 16 items that assessed four competencies associated with accessing, understanding, appraising, and applying health-related information. The HLQ-OA demonstrated excellent internal consistency, with an overall Cronbach's α coefficient of 0.94. Additionally, the model fit indices indicated an acceptable fit: RMSEA = 0.046, GFI = 0.909, CFI = 0.945, TLI = 0.939. Furthermore, a high correlation was observed between the HLQ-OA and the HL-SF12 (r  = 0.832). These findings support the reliability and validity of the HLQ-OA as a tool for assessing the health literacy of older adults. In conclusion, the HLQ-OA is a reliable and valid instrument that can be effectively utilized to measure the health literacy levels of older adults. [ABSTRACT FROM AUTHOR]

Sexual and reproductive health interventions' effectiveness should be evaluated using a valid instrument. This study aimed to validate a questionnaire on sexual and reproductive health in adolescents and young adults from São Tomé and Príncipe who voluntarily enrolled in a vocational school in Portugal to complete their 12th school year and obtain a professional card. A questionnaire consisting of perception and knowledge sections was adapted from previous questionnaires. We followed the steps of psychometric analysis. Firstly, we assessed face validity and content validity. We used factorial analysis to validate the perceptions section (which included Likert-type questions). For the knowledge section (which consisted of multiple-choice questions), we used the key check, discrimination index, and difficulty index. We evaluated internal consistency through Cronbach's alpha for the perceptions section and the Kuder-Richardson score for the knowledge section. Out of 105 invited students, a total of ninety students were enrolled in this study, of whom 88 completed most of the questions. The exploratory analysis showed that most students agreed with the right to refuse intercourse. However, while approximately 23% disagreed that consensual sex among adult women or men is always wrong, around the same proportion agreed. A considerable number of students recognized condoms and pills as effective methods of contraception. However, most students were unfamiliar with other methods. Most knowledge questions showed acceptable difficulty levels, and the discrimination index varied among questions. The knowledge questions demonstrated good consistency levels. This study enabled us to develop an appropriate instrument for evaluating the effectiveness of public health interventions and identifying specific knowledge gaps in migrant populations from low-income countries. This will help prioritise topics to be addressed in sexual health education sessions. [ABSTRACT FROM AUTHOR]

The QUAlity of Life Assessment in Spina bifida (QUALAS) for adults (QUALAS-A) evaluates the health-related quality of life (HRQOL), reflecting the condition specificity of adults with spina bifida (SB). The study's purpose was to translate and cross-culturally adapt the QUALAS-A into Korean and validate a Korean-modified version of the QUALAS for Young Adults (QUALAS-YA-Km). Face and content validity were evaluated in the pilot study. Internal consistency and test-retest reliability were confirmed in the main study. Factor analysis was performed, and convergent and divergent validity was verified using the World Health Organization Quality of Life assessment instrument abbreviated version (WHOQOL-BREF). Forty-seven adults had myelomeningocele. Five items with low communality were deleted through the factor analysis, and the domains were renamed. The QUALAS-YA-Km showed good internal consistency (Cronbach's alpha 0.73–0.83) and excellent test-retest reliability (intraclass correlation coefficient 0.84–0.89). The QUALAS-YA-Km showed good convergent and divergent validity, with weak to strong correlations with the WHOQOL-BREF. Developed with consideration of Korea's cultural characteristics, the QUALAS-YA-Km is a convenient and reliable instrument, with good internal consistency, stability, and construct validity. This can be a useful tool in clinical and research settings for HRQOL optimization in young adults with SB. Optimizing health-related quality of life (HRQOL) is one of the goals of people with spina bifida (SB), which requires HRQOL measurements that reflect the condition specificity of SB The QUAlity of Life Assessment of Spina bifida for Adults (QUALAS-A) is a self-reported HRQOL questionnaire for adults with SB developed in the United States, which is used in research and clinical practice The present study revealed that the Korean modified version of the QUAlity of Life Assessment of Spina bifida for Young Adults (QUALAS-YA-Km), developed in consideration of the cultural characteristics of Korea, is a valid, convenient, and reliable tool The QUALAS-YA-Km, is a useful tool that can be used in clinical and research settings for HRQOL optimization in adults with SB [ABSTRACT FROM AUTHOR]

Background Staff training in organizations is a measure for developing human capital. The pathology of this process needs to be assessed to understand the current situation and solve the challenges and limitations. Objective This study aims to assess the pathology of the training process for the incident command system (ICS) staff of hospitals in Guilan Province using the three-pronged approach. Methods This is a qualitative-quantitative study. The study population in the qualitative phase included experts in the hospital ICS. In the quantitative phase, the study population included all ICS managers and staff in the Guilan Province hospitals (n= 548). The data collection tool was a semi-structured interview in the qualitative phase and a researcher-made questionnaire in the quantitative phase. For data analysis, MAXQDA software, version 2020 was used in the qualitative phase and SPSS software, version 26 was used in the quantitative phase. Results The results in the qualitative phase showed the extraction of 55 open codes, 25 axial codes, and 6 selective codes in the form of three domains of processes, context, and structure. The results in the quantitative phase showed that among all the domains, the process domain-related factors with a percentage of variance (impact) of 0.262 were more harmful than context- and structure-related factors in the training process. Conclusion The pathology assessment based on the three-pronged model is an effective method for determining the training priorities for the hospital ICS staff. The use of this model during a crisis can be an effective step for identifying shortcomings to solve them and take appropriate measures for the ICS staff training. [ABSTRACT FROM AUTHOR]

Misophonia is characterized by intense emotional reactions to specific sounds or visual stimuli and typically onsets during childhood. An obstacle for research and clinical practice is that no comprehensively evaluated measures for pediatric misophonia exist. In a sample of 102 youth meeting the proposed diagnostic criteria of misophonia, we evaluated the child and parent-proxy versions of the self-reported Misophonia Assessment Questionnaire (MAQ; assessing broad aspects of misophonia) and the child version of the Amsterdam Misophonia Scale (A-MISO-S; assessing misophonia severity). Confirmatory and exploratory factor analysis were used to examine factor structures of the measures. Further, child-parent agreement on the MAQ and associations between both measures and misophonia-related impairment, quality of life, and misophonia-related school interference were examined to evaluate aspects of convergent validity. For both youth- and parent-ratings, four MAQ factors emerged: pessimism, distress, interference, and non-recognition. A-MISO-S showed a unidimensional structure, but the item 'effort to resist' did not load significantly onto the unidimensional factor. Good child-parent agreement on the MAQ scales were found and both MAQ and A-MISO-S were moderately to strongly associated with misophonia-related impairment, quality of life (inverse association), and misophonia-related school interference. MAQ and A-MISO-S assess sensitivity to auditory but not visual stimuli, the sample size was modest, and repeated assessments were not conducted. The combination of MAQ and A-MISO-S shows promise as a multidimensional assessment approach for pediatric misophonia. Future evaluations should include known-groups validity, screening performance, and sensitivity to change in symptom severity. • Misophonia typically onsets during childhood or adolescence. • No validated measures for pediatric misophonia exist • The MAQ and A-MISO-S were evaluated in a sample of 102 youth with misophonia. • The measures show promising psychometric properties. • MAQ and A-MISO-S provide a broad measurement approach to pediatric misophonia. [ABSTRACT FROM AUTHOR]

Background: Tobacco usage has been identified as a leading preventable cause of mortality and is responsible for six million fatalities per year globally. India had enacted COTPA in 2003. Tobacco vendors are one of the key stakeholders for Cigarettes and Other Tobacco Products Act (COTPA) implementation. Objective: To assess the knowledge gap on COTPA and to explore the perceived factors influencing implementation of COTPA among tobacco vendors in Puducherry. Materials and Methods: A mixed-method study was conducted among tobacco vendors from Point of Sale (PoS) around 230 educational institutions (schools and degree colleges) in Puducherry for three months. Simple random sampling was applied to select educational institutions and the tobacco vendors from PoS located around these institutions were included. Data capture was done using a pretested, face-validated questionnaire incorporated in Epicollect software 5 and data analysis by SPSSv24. Purposive sampling was employed to conduct in-depth interviews among tobacco vendors till the point of saturation and manual content analysis performed. Written informed consents were sought. Institutional Ethical Committee approval was obtained. Results: Majority (95.7%) reported that they were aware of tobacco control legislation, but only one person had heard of COTPA. Awareness about the display of signage boards at PoS was observed in 75.7% vendors. Around 41.7% reported that they should not advertise any kind of tobacco products. Three major themes were identified: facilitators, barriers, and suggested measures for COTPA implementation. Conclusion: Tobacco vendors in Puducherry were aware of tobacco control legislations but not familiar with the COTPA and its provisions. It is necessary to put forth efforts to educate these important stakeholders to be more cognizant of COTPA and to effectively include them in anti-tobacco programs. [ABSTRACT FROM AUTHOR]

Background: The aim of the study was to investigate the psychometric properties of the Persian version of the 20-item Fear of Self Questionnaire (FSQ) in Iranian samples. Methods: A cross-sectional, descriptive survey design was used. Students in universities of Tehran were invited to participate. Participants were asked to complete the Persian versions of the FSQ, Vancouver Obsessional Compulsive Inventory (VOCI), Depression, Anxiety and Stress Scale (DASS-21), Ego Strength Scale (ESS), and Rosenberg's Self-Esteem Scale (RES). Face, content, and construct validity, internal consistency (Cronbach's alpha), and test-retest reliability of the FSQ were assessed. Results: Face and content validity of the FSQ were confirmed. Analysis of the principal components using the inclined rotation method showed that there were two factors with an eigenvalue >1, which explained 80.5% of the total variance. The first factor had 12 items and the second factor had 8 items. The internal consistency was 0.975, 0.981, and 0.941 for the total score and the first and second factor, respectively, whereas the test-retest reliability was 0.732, 0.729, and 0.714, respectively (all p ≤ 0.01). For convergent validity of the FSQ, correlations of the total score and the two factors of the FSQ with the scores of VOCI, RES, ESS, and DASS-21 were all significant (p ≤ 0.01). Conclusion: The FSQ can be used in Iranian samples for clinical practice and research. [ABSTRACT FROM AUTHOR]

Comprehensive sexuality education (CSE) is instrumental in ensuring that young people have the knowledge and skills to make informed decisions and practice safer sex. Worryingly, CSE is often not available to adolescents and young with disabilities. The Breaking the Silence (BtS) approach to CSE was developed to address this gap and help equip educators to teach CSE to adolescents and young people with disabilities. The TSE-Q was designed to evaluate the effectiveness of the BtS approach and monitor changes in educators' knowledge, skills, attitudes, self-confidence, and preparedness to teach CSE to young people with disabilities. The TSE-Q is aligned with an adapted version of the theory of planned behavior. This is a second validation study of the TSE-Q embedded within a feasibility study for the BtS approach. Fifty educators and support staff from two South African special schools for people with disability participated in a BtS training workshop and completed the TSE-Q before and after the workshop. Additionally, participants were asked to complete an adapted version of Rowe, Oxman, and O'Brien's validity questionnaire probing content validity, face validity, and ease of use. Baseline data from the TSE-Q was evaluated for reliability, while the validity questionnaire and verbal feedback were used to assess validity. Most scales show good reliability, but knowledge-based scales have lower reliability due to their multidimensionality. The TSE-Q shows good face validity, content validity, and ease of use, but should be done on different days to any intervention/training. Overall, the TSE-Q is a robust questionnaire with good content coverage. [ABSTRACT FROM AUTHOR]

In the field of mental health and armed conflict, its characterization using reliable psychometric instruments has become a key strategy to assess its exposure. In long-time and low-intensity armed conflicts such as Colombian, evaluation of these events through reliable and validated questionnaires is less frequent. Some approaches have explored exposure to the conflict based on ecological measures, for example, scores assigned according to geographic location and according to the history of the presence of armed groups. However, current implies a difficulty in determining the level of exposure. For that, the same authors applied spatial and temporary criteria to generate typologies based on the level of exposure of armed conflict. The use of valid tools, scales, or instruments in the field of armed conflict is recent. The Questionnaire of Exposure or Armed Conflict (CECA in Spanish) has been developed in this study as a useful alternative to assess exposure to armed conflict from exposes individuals. This Questionnaire characterizes direct and indirect exposure to events related to armed conflict and the effects of this experience in their actors. Based on previous approaches such as the Extreme Experiences Scale (EX2) were developed CECA questionnaire, for that, a panel of experts was convened to evaluate each item in terms of clarity, relevance, sufficiency, coherence, based on the Delphi method. Using this method, several successive rounds were carried out with the experts, with the experts, guaranteeing the blinding of the participants. The strategy involved sending each expert the proposed instrument and an excel template where they would rate each item according to the criteria set out. The whole process was online and blind. In the event of disagreement between experts, the following Delphi round was carried out until the best agreement was found against the proposed items. For each item, the Content Validity Index (CVI) > .70 and modified Kappa coefficient > .60 were calculated to evaluate the agreement of the experts. Six items were eliminated from the original questionnaire of 38 items. The final version of CECA contained 33 items classified in 3 dimensions: direct experiences (11 items), indirect experiences (14 items), and outcomes in mental health (8 items). The content validation of CECA provides valuable information for researchers and specialized professionals in the area to make interventions in populations exposed to armed conflict events. This type of tool is an important and necessary advance for the area of mental health and the study of the impact of the armed conflict. Future research should address another type of validation of the CECA instrument. Among these, inquire about structural validity, criterion validity, internal consistency. [ABSTRACT FROM AUTHOR]

Objective: Describe the development and validation of the Subjective Habitability & Acceptability Questionnaire (SHAQ). Background: Habitat area size, layout, and design may impact individual and team behavioral health and performance (BHP) outcomes in operational environments. However, there are no standardized measures of these relationships. Method: SHAQ is a modular survey consisting of two 6-item scales: BHP Outcomes (Performance of Individual Activities, Performance of Group Activities, Mood, Psychological Stress, Sleep, and Social Interactions) and Habitability Moderators (Privacy, Social Density, Efficiency, Control, Comfort, and Convenience). We collected SHAQ data from NASA's Human Exploration Research Analog (HERA) crews (n = 19) in reference to multiple habitat areas (Sleep/Bedroom, Hygiene/Bathroom, Work/Office/Workshop, and Food Preparation/Kitchen/Galley) in the HERA operational environment, private hotel rooms, and individual home habitats. Results: SHAQ has high construct validity (single factor solutions, mean item factor loading = 0.760, mean % variance = 60.37), internal consistency and reliability (item mean α = 0.880, mean ω=0.894, mean ICC = 0.430), concurrent validity (mean item r with System Usability Scale = 0.42), and discriminant validity (e.g., significantly higher facilitation of group activities in HERA Work/Office/Workshop and Food Preparation/Kitchen/Galley areas vs. Hygiene/Bathroom and Sleep/Bedroom areas; significantly higher ratings of privacy, comfort, and convenience in hotel vs. HERA). Conclusion: SHAQ is a reliable, valid, and sensitive measure of BHP impacts of habitat size and layout. Application: SHAQ can be used to inform evidence-based recommendations and thresholds for habitat area size, layout, and design options to support individual and team BHP in operational environments. [ABSTRACT FROM AUTHOR]

Aims: Improving hospital nutrition and mealtime care is complex and often requires multifaceted interventions and implementation strategies to change how staff, wards and systems operate. This study aimed to develop and validate a staff questionnaire to identify multilevel barriers and enablers to optimal nutrition and mealtime care on hospital wards, to inform and evaluate local quality improvement. Methods: Literature review, multidisciplinary focus groups and end‐user testing informed questionnaire development and establishment of content and face validity. To determine the construct validity, the questionnaire was administered to ward staff working in five wards across two facilities (acute hospital, rehabilitation unit). Exploratory factor analysis was used to estimate the number of factors and to guide decisions about whether to retain or reject individual items. Scale reliability was assessed using Cronbach's alpha. Results: The questionnaire was completed by 138 staff, with most respondents being nurses (57%) and working in the acute care facility (76%). Exploratory factor analysis supported construct validity of four of the original seven subscales. The final questionnaire consisted of 17 items and 4 sub sub‐scales related to (1) Personal Staff Role; (2) Food Service; (3) Organisational Support, and (4) Family Involvement; each sub‐scale demonstrated good reliability with Cronbach's alpha values all >0.70. Conclusion: This novel and brief questionnaire shows good reliability and preliminary evidence of construct validity in this small sample. It provides a potentially useful instrument to identify barriers and enablers to nutrition and mealtime care from the staff perspective and inform where improvement efforts should be focused. [ABSTRACT FROM AUTHOR]

Purpose: Hyperacusis is an uncommon hearing disorder, known as increased sensitivity to daily surrounding sounds. This disorder can profoundly affect people's daily activities. The studies conducted about hyperacusis are very limited in Iran. The purposes of this study are the psychometric evaluation of the Persian version of the Hyperacusis Questionnaire (PHQ) and the investigation of its prevalence. Method: This cross-sectional study was accomplished on 203 young university students with normal hearing sensitivity. After translating the questionnaire, the psychometric properties of the PHQ were evaluated by content validity ratio (CVR) and index (CVI) and exploratory factor analysis (EFA). Students were evaluated by clinical audiology tests, the loudness discomfort level (LDL) measurement, and answering the PHQ. The research data collection was done from April to November 2022. Otoscopy, clinical and speech audiometry, and LDL were all executed, respectively. The participants directly answered the PHQ. All statistical analyses were performed using SPSS software Version 26. Results: The PHQ demonstrated acceptable validity and reliability, Cronbach's alpha (.81), CVI (> 0.88), and CVR (> 0.98). EFA revealed four dimensions of the questionnaire. Of the participants, four (2%) were identified as suffering from hyperacusis. The PHQ showed the possibility of differences between genders. Conclusions: The psychometric evaluations of the PHQ were found to be acceptable and can be used in future studies. The prevalence of hyperacusis in our sample was 2%, and estimated to be higher in females. These findings suggest the need for further research on hyperacusis in Iranian population and specified studies to compare the two genders. [ABSTRACT FROM AUTHOR]

Introduction: The number of Italian citizens unaware of their risk of cardiovascular disease it is still very high. Aim: This study aimed to translate and preliminarily validate a brief Italian version of the Perception of Risk of Heart Disease Scale (PRHDS). Methods: PRHDS was culturally adapted to the Italian context. Then, the scale was administered to 772 healthy adults. By randomly dividing the sample into two subsamples, we tested the scale dimensionality through Exploratory Factor Analysis (EFA) followed by Confirmatory Factor Analysis (CFA). Finally, we evaluated internal consistency. Results: Psychometric properties of the scale were appropriate. EFA and CFA evidenced a unidimensional structure of a brief version of the scale, composed of six items. Internal consistency was adequate. Conclusions: Italian version of the brief PRHDS is a promising self-report questionnaire to measure cardiovascular risk perception among Italian adults. [ABSTRACT FROM AUTHOR]

Cognitive activity questionnaires could provide insight into neurocognitive reserve. The Lifetime Cognitive Activities Questionnaire (LCAQ) assesses cognitive activities at four stages of life. The Modified Current Cognitive Activities Questionnaire (CCAQ) assesses current cognitive activities. We examined the construct validity, internal consistency, test-retest reliability, and stability of these questionnaires throughout the Brain in Motion (BIM) study and their relationship with cognitive performance. The LCAQ, Montreal Cognitive Assessment (MoCA), and neuropsychological battery were administered at the initial pre-intervention and six-year follow-up. The CCAQ was administered at five timepoints. Construct validity of the CCAQ/LCAQ was assessed using proxies of cognitive engagement (educational attainment and the North American Adult Reading Test [NAART]). Cronbach alpha analysis determined internal consistency. LCAQ reliability was established by comparing the pre-intervention and six-year follow-up. CCAQ reliability was determined by comparing both pre-intervention assessments, correlations throughout BIM determined stability. A multiple linear regression investigated the associations between cognitive engagement and cognitive domains derived from a principal component analysis. MoCA scores at the initial pre-intervention (27.49 ± 1.46) and six-year follow up (26.53 ± 2.08). The LCAQ and CCAQ correlated with educational attainment and the NAART. The LCAQ (n = 266) produced an alpha of 0.90 (20 items). The CCAQ (n = 261) resulted in an alpha of 0.71 (25 items). LCAQ scores (n = 94) at the initial pre-intervention and six-year follow-up were correlated. CCAQ (n = 94) scores at the initial pre-intervention correlated with scores at all five other timepoints. The multiple linear regression revealed associations between the CCAQ and verbal memory/attention. The NAART was associated with processing speed, concept formation, and verbal memory/attention. In the absence of cognitive decline, these questionnaires exhibit significant construct validity, internal consistency, test-retest reliability, and the CCAQ displayed stability. The NAART and CCAQ were associated with neuropsychological performance. Our findings support future use of these questionnaires and exemplify the neuroprotective role of cognitive engagement. [ABSTRACT FROM AUTHOR]

Background: The evaluation of spiritual requirements in patients can facilitate the delivery of spiritual care as an essential element of holistic healthcare. The objective of this research was to develop and evaluate the psychometric properties of a questionnaire on patients' spiritual needs in medical-surgical hospital settings. Methods: This research utilized an exploratory sequential design, involving the creation of a pool of items through both inductive and deductive methods. The questionnaire's psychometric properties were then assessed using various techniques, such as face and content validity, item analysis, construct validity, internal consistency, stability, confirmatory factor analysis, and the Gradual Response Model of Samejima. The data analysis was conducted using MPLUS software, version 5.1. Results: The study's results showed that a four-factor structure (interpersonal connectedness, relationship with God, transcendence, and peaceful environment) with 43 items was successfully extracted through exploratory factor analysis. The confirmatory factor analysis supported the findings of the exploratory factor analysis. The Cronbach's alpha coefficients for the scale and factors ranged between 0.83 and 0.95. Furthermore, the interclass correlation coefficients for the scale and factors were between 0.89 and 0.96. Conclusions: The questionnaire designed in this study is a reliable and valid instrument that can be utilized by healthcare, educational, and research institutions to evaluate the spiritual needs of patients in medical-surgical hospital settings. [ABSTRACT FROM AUTHOR]

Background: The Cluster Headache Impact Questionnaire (CHIQ) is a specific and easy-to-use questionnaire to assess the current impact of cluster headache (CH). The aim of this study was to validate the Italian version of the CHIQ. Methods: We included patients diagnosed with episodic CH (eCH) or chronic CH (cCH) according to the ICHD-3 criteria and included in the "Italian Headache Registry" (RICe). The questionnaire was administered to patients through an electronic form in two sessions: at first visit for validation, and after 7 days for test-retest reliability. For internal consistency, Cronbach's alpha was calculated. Convergent validity of the CHIQ with CH features and the results of questionnaires assessing anxiety, depression, stress, and quality of life was evaluated using Spearman's correlation coefficient. Results: We included 181 patients subdivided in 96 patients with active eCH, 14 with cCH, and 71 with eCH in remission. The 110 patients with either active eCH or cCH were included in the validation cohort; only 24 patients with CH were characterized by a stable attack frequency after 7 days, and were included in the test-retest cohort. Internal consistency of the CHIQ was good with a Cronbach alpha value of 0.891. The CHIQ score showed a significant positive correlation with anxiety, depression, and stress scores, while showing a significant negative correlation with quality-of-life scale scores. Conclusion: Our data show the validity of the Italian version of the CHIQ, which represents a suitable tool for evaluating the social and psychological impact of CH in clinical practice and research. [ABSTRACT FROM AUTHOR]

The Clinical Assessment of Modes questionnaires (CAMQs) determine clients' preferential modes for therapy (CAM-C1), clients' perception of modes used by the occupational therapist (OTs) during therapy (CAM-C2), or modes the OTs believed to have used (CAM-T). Access to valid CAMQs for Danish OTs and clients required a rigorous translation and cultural adaptation process. To translate and culturally adapt the CAMQs into Danish, examining face validity in a Danish context. A 10-step guideline for the process of translating and culturally adapting questionnaires was followed. Steps 1–6 included translation into Danish, steps 7–8 involved cognitive debriefing interviews and validation based on the Content Validity Index (CVI) analyzed using Kappa statistics. Steps 9–10 finalized the process. CAMQs were translated into Danish. Based on cognitive debriefing interviews and CVIs involving 15 clients and 7 OTs, modifications regarding titles, layouts, instructions, wording and response categories were performed in all Danish CAMQs. The Item CVI and the modified kappa revealed that most participants had a high level of agreement on the cultural relevance. Translated versions of the CAMQs have been culturally adapted into Danish. The current Danish versions seem culturally relevant and useable in Danish occupational therapy. [ABSTRACT FROM AUTHOR]

This study aimed to face validate an adolescent ovulatory menstrual (OM) health literacy questionnaire and to measure reliability by test–retest. Draft questions from an earlier content validation were adjusted following face validity assessment with 28 adolescents. Test–retest reliability was assessed by 89 adolescents aged 14–18 years over a two‐week period across four school sites. The mean levels of agreement recorded from the critical, interactive and functional health literacy domains were 83%, 74% and 68%, respectively. There were 44 out of 74 items with Kappa statistics >0.40. The questionnaire has confirmed face validity and adequate test–retest reliability for assessing adolescent OM health literacy. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Much research has been conducted on the relationship between recovery orientation and people diagnosed with mental illnesses such as schizophrenia and mood disorders. A recovery‐oriented approach by mental health professionals can reduce hospital stays and medical costs for people diagnosed with mental illness.There are similarities and differences between recovery‐oriented approaches for individuals diagnosed with dementia and those diagnosed with mental illness. This reflects the characteristics of irreversible dementia.Although dementia courses at recovery colleges are increasing, dementia recovery is in its infancy and course content varies. The core of the recovery framework for individuals diagnosed with dementia is 'Continue to be me'.Recovery‐oriented approaches and programmes have been developed by mental health workers for older adults, including those with dementia, but there are no outcome measures that reflect the characteristics of dementia care. What the paper adds to existing knowledge?: We developed a scale to assess nurses' recovery orientation in dementia care, which has been found to be reliable, and although some validity issues remain, it is the first scale to objectively assess recovery orientation in dementia care.The emphasis is on helping people diagnosed with dementia maintain their identity, which is not adequately covered by existing measures of recovery. What are the implications for practice?: The ability to objectively assess recovery orientation in dementia care allows us to identify areas of inadequacy.It can be used to reduce variation in the content of recovery college courses and as an indicator for evaluating training in recovery‐oriented approaches to dementia care. Introduction: Programmes regarding recovery‐oriented approaches for older people, including those with dementia, have been developed, but there are no clear indicators, and the process is still in its infancy. Purpose: We developed a scale to assess nurses' recovery orientation in dementia care. Methods: A draft of a 28‐item scale was developed based on interviews with 10 nurses, skilled in dementia care with a Japanese mental health perspective, and a literature review. A self‐administered questionnaire was developed for nurses working in a dementia ward, and an exploratory factor analysis was conducted. A confirmatory factor analysis was conducted to test for convergent and discriminant validity. The Recovery Attitude Questionnaire was used to examine criterion‐related validity. Results: An exploratory factor analysis produced a 19‐item scale and identified five factors (KMO value: 0.854). The Cronbach's alpha for the overall scale was.856, with each subfactor showing a range of.742–.792, validating its reliability. Discussion: The results of confirmatory factor analysis supported the five‐factor construct. Reliability was verified, but some issues remained in convergent and discriminant validity. Implications for Practice: This scale can be used to objectively assess nurses' recovery orientation in dementia care and as a measure of training in recovery‐oriented approaches. [ABSTRACT FROM AUTHOR]

The objective of this project was to develop a brief self-administered dietary screener, in English and French, to rapidly assess alignment of adults' dietary intake with the 2019 Canada's Food Guide healthy food choices recommendations. In consultation with Health Canada and external advisors (n = 15), guiding principles were defined. Existing screeners were scanned, and the healthy food choices recommendations were mapped to inform questions and response options. Cognitive interviews were conducted in English (n = 17) and French (n = 16) with adults aged 18–65 years from April to June 2021 to assess understanding of questions and face validity; recruitment emphasized variation in sociodemographic characteristics. Face and content validity were assessed with experts in nutrition, surveillance, and public health (n = 13 English, 3 French) from April to May 2021. The testing indicated that the screener was well understood overall but informed refinements to improve comprehension of the questions and their alignment with the healthy food choices recommendations. The resulting Canadian Food Intake Screener/Questionnaire court canadien sur les apports alimentaires includes 16 questions to rapidly assess alignment of intake with the 2019 Canada's Food Guide healthy food choices recommendations, including healthy foods and foods to limit, in situations in which comprehensive dietary assessment is not feasible. The Canadian Food Intake Screener was developed to rapidly assess alignment of adults' dietary intake over the past month with the Food Guide's healthy food choices recommendations. The screener was developed and evaluated through an iterative process that included three rounds of cognitive interviews in each of English and French, along with ongoing feedback from external advisors and face and content validity testing with a separate panel of content experts. The 16-question screener is intended for use with adults, aged 18–65 years, with marginal and higher health literacy in research and surveillance contexts in which comprehensive dietary assessment is not possible. [ABSTRACT FROM AUTHOR]

This study aimed to translate the Lymphedema Quality of Life Questionnaire-leg into Korean (K-LYMQOL-leg) and test its reliability and validity. The LYMQOL-leg was translated forward and backward from English to Korean. Fifty-five patients with lower limb lymphedema completed the K-LYMQOL-leg and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC-QLQ-C30) at the first visit, and the K-LYMQOL-leg was re-administered within a week. Reliability was tested by calculating the intraclass correlation coefficient (ICC) and the Cronbach's alpha for each domain. Face validity was evaluated, and concurrent validity was verified by comparing the K-LYMQOL-leg domain scores with the corresponding EORTC-QLQ-C30 and limb volume scales. The known-group construct validity was then assessed. Excellent reliability was confirmed by internal consistency (Cronbach's alpha coefficient, 0.851–0.878) and test-retest reliability (ICC, 0.901–0.936) in the four domains. A significant correlation was confirmed in the appearance domain with limb volume (r = 0.424) and in the other domains [function, symptom, and mood], with the EORTC-QLQ-C30 scales (r = −0.779, 0.712, and −0.783). Known-group validity was confirmed in all four domains. The K-LYMQOL-leg verified in this study can be used in clinical practice to evaluate the Quality of Life (QOL) of patients with lymphedema or in research as an outcome. Among cancer treatment-related complications, lymphedema of the lower extremities severely and persistently reduces the health-related quality of life of cancer survivors. The Korean version of the Lymphedema Quality of Life Questionnaire-leg (K-LYMQOL-leg) is an easy, reliable and valid questionnaire for patients with lower limb lymphedema. K-LYMQOL-leg will be useful in assessing the quality of life of patients with lower limb lymphedema in a clinical setting or for research purposes. [ABSTRACT FROM AUTHOR]

The Patient Health Questionnaire (PHQ-9) and the Major Depression Inventory (MDI) are psychometric instruments frequently used for depression diagnosis and monitoring in primary care settings. The goal of this study was to assess and compare the construct validity of the PHQ-9 and the MDI using Rasch analysis. The PHQ-9 and the MDI were distributed in random ordering (first or last) to a waiting room sample of Danish primary care patients. Analysis of fit to the Rasch model, ordering of response categories, dimensionality-testing, test for differential item functioning, test for local dependency, and calculation of reliability indices were used to evaluate the psychometric characteristics of the instruments. A sample of 281 persons (18–87 years, 72 % females) responded to both instruments. Reliability was acceptable for PHQ-9 (PSI 0.80) and excellent for MDI (PSI 0.88). Both instruments demonstrated fit to the Rasch model after rescoring of all items. Dimensionality testing supports that both instruments are unidimensional. Indication of local dependency was observed for PHQ-9 item 2&6 and MDI item 1&4. No indication of differential item functioning regarding age, gender or ordering of instruments was found. The PHQ-9 and the MDI both demonstrate measurement problems. Modifying individual items and reducing the number of response categories in both instruments could potentially improve their measurement capabilities. Study findings do not provide a conclusive indication of which instrument has superior operating characteristics. • The PHQ-9 and the MDI are psychometric instruments frequently used for depression diagnosis and monitoring. • The construct validity of the PHQ-9 and MDI was compared head to head using Rasch analysis. • Reliability was excellent for MDI and acceptable for PHQ. • Both instruments demonstrated measurement problems in terms of local dependency of item pairs. • Both instruments may improve by reducing the number of response categories. [ABSTRACT FROM AUTHOR]

The Vancouver Obsessional Compulsive Inventory–Mental Contamination scale (VOCI-MC) and the Contamination Thought–Action Fusion scale (CTAF) are two self-report instruments that assess symptoms of mental contamination and fusion between thoughts, and feelings and behaviours associated with contamination, respectively. The aim of this study was to investigate the psychometric properties of the French version of these two scales in non-clinical and clinical samples. We included 79 participants diagnosed with obsessive-compulsive disorder (OCD), 31 diagnosed with anxiety disorders, who were recruited from the University Department of Adult Psychiatry in Montpellier, and 320 non-clinical participants recruited from the general population. Psychometric properties of the French VOCI-MC and CTAF were investigated. Results showed that the French versions of the VOCI-MC and the CTAF had high internal consistency, good convergent and divergent validity, as well as good temporal stability. Exploratory and confirmatory factor analyses showed a one-factor structure for the two scales in both non-clinical and OCD samples. Adequate discriminative validity was established by comparing OCD patients with contamination-related symptoms and OCD patients who did not report contamination-related symptoms. The French VOCI-MC and CTAF are valid and appropriate tools for measuring mental contamination in both clinical and research contexts. [ABSTRACT FROM AUTHOR]

Background: Personality traits are associated with pain‐related beliefs and coping strategies, and different chronic conditions are linked through specific personality profiles. This highlights the importance of having valid and reliable measures of personality traits for use in clinical and research settings when assessing patients in chronic pain. Purpose: To translate and cross‐culturally adapt the 10‐item Big Five Inventory (BFI‐10) into Danish. Methods: A bilingual expert panel (N = 4) and a panel of laymen (N = 8) translated and culturally adapted the questionnaire into Danish. Face validity was evaluated in a group of persons suffering from recurring or ongoing painful conditions (N = 9). Data were collected to evaluate the internal consistency, test–retest reliability and factor structure (N = 96). Results: Some of the participants in the lay panel considered the questionnaire too short, considering its aim of assessing personality. Acceptable internal consistency was found for two out of five subscales (0.78 for both Extraversion and Neuroticism), while the internal consistency was non‐acceptable for the remaining subscales (0.17–0.45). Test–retest reliability was acceptable for three subscales (0.80 for Neuroticism, 0.84 for Conscientiousness, and 0.85 for Extraversion). Assumptions for determining the factor structure were not met and therefore was this analysis omitted. Discussion: Although face valid, only two out of five subscales had acceptable internal consistency and only three subscales had acceptable test–retest reliability. These findings indicate that interpreting findings regarding personality using the Danish BFI‐10 should be done with caution. [ABSTRACT FROM AUTHOR]

Introduction: there is an emerging current necessity of valid questionnaires, encompassing most of food, beverages, diseases, signs and symptoms currently related to the pathogenesis of adverse reactions to foodstuffs (ARFS) in the Spanish population. Objectives: this study aimed to design and validate two questionnaires to assess ARFS in the Spanish population, Food and Beverages Frequency Consumption Questionnaire to Identify Adverse Reactions to Foodstuffs (FBFC-ARFSQ-18); and Pathologies and Symptomatology Questionnaire associated with Adverse Reactions to Foodstuffs (PSIMP-ARFSQ-10). Methods: both questionnaires were designed adapting questionnaires from the literature; and validated, using the expert judgment method, in five phases: questionnaires development, pilot test and reliability, content validity, face validity, and ethical considerations. Questionnaires were developed using the REDCap™ tool hosted at the Universidad Politécnica de Madrid. A total of 20 Spanish experts evaluated the questionnaires. Cronbach's alpha reliability coefficients were calculated using SPSS version 25.0 (IBM Corp., Armonk, NY-USA) and Aiken's V coefficient values were calculated using ICaiken.exe (Visual Basic 6.0, Lima-Perú). Results: a final construct of questions was designed, ensuring no overlap, for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10. Cronbach's alpha reliability coefficients were 0.93 and 0.94; and Aiken's V coefficient values were 0.90 (0.78-0.96 CI) and 0.93 (0.81-0.98 CI) for FBFC-ARFSQ-18 and PSIMP-ARFSQ-10, respectively. Conclusions: both validated questionnaires could be used to analyze the association between certain food and beverages consumption with ARFS, such as food allergies and food intolerances; also, to investigate the link between some specific diseases, signs and symptoms with ARFS. [ABSTRACT FROM AUTHOR]

We aimed to translate and cross-culturally adapt the Western Ontario Rotator Cuff index into Greek (WORC-GR) and evaluate its reliability and validity in a Greek speaking population with rotator cuff (RC) disorders. Translation and cross-cultural adaptation process followed published guidelines. Content and face validity were assessed by 9 experts and 16 patients with RC pathologies, respectively. Internal structure, reliability, measurement error, and convergent validity (correlation with the Disability of the Arm, Shoulder and Hand – DASH, Shoulder Pain and Disability Index – SPADI, and Short Form-36) of the index were evaluated in 104 participants (44.2% women, mean age ± SD: 44.9 ± 15.01 years) with RC related pain. The WORC-GR showed excellent item and scale content validity index (0.875–1.00 and 0.975, respectively), internal consistency (Cronbach's alpha range 0.749 − 0.903) and test-retest reliability (intraclass correlation coefficient: 0.942, 95% CI: 0.913–0.961). Factorial validity testing revealed a 4-factor structure explaining 69.7% of the total variance. High positive correlations were found with DASH (r = 0.806) and SPADI (r = 0.852). WORC-GR is a reliable and valid instrument to assess symptoms in patients with RC disorders. Further research on the content validity, internal structure, and responsiveness of the tool is required. The Greek version of WORC (WORC-GR) is a clear and comprehensible patient reported outcome measure. WORC-GR has excellent internal consistency, test-retest reliability and with no floor and ceiling effects. WORC-GR is a valid outcome measure for patients with rotator cuff disorders. [ABSTRACT FROM AUTHOR]

Background: The quality of triage in emergency department depends on regular evaluation of triage nurses' professional capabilities and development of programs to improve them. Flipped classrooms are a new approach to learning which can be employed to improve professional capabilities. The present study aims to compare the impact of lecturing to flipped classrooms in virtual learning on the knowledge and professional capabilities of triage nurses in the emergency departments of the state hospitals of Yazd province in south-western Iran in 2022. Methods: The present study is an experimental work of research. Seventy-four triage nurses participated in the study. Seventy-four triage nurses were randomly allocated to the two groups, including flipped classrooms (group B) and lecturing (group A). The data collection instruments were an emergency department triage nurses' professional capability questionnaire and a triage knowledge questionnaire. The collected data were analyzed in SPSS v.22 using independent t-test, chi-squared test, and repeated measures analysis of variance. Level of significance was set at p ≥ 0.05. Results: The participants' mean age was 33.1 ± 4.3 years. As measured one month after the education, the triage knowledge mean score of the nurses who were educated using the flipped classroom method (9.29 ± 1.73) was higher than that of the nurses who were educated via lecturing (8.45 ± 1.788), and the difference was statistically significant (p = 0.001). Also, measured one month after the education, the professional capability mean score of the nurses who were educated using the flipped classroom method (140.27 ± 11.744) was higher than that of the nurses who were educated via lecturing (132.84 ± 10.817), and the difference was statistically significant (p = 0.006). Conclusion: There was a significant difference between the pretest and posttest knowledge and professional capability mean scores of both groups immediately after the education. However, measured one month after the education, the mean and standard deviation of the knowledge and professional capability scores of the triage nurses who had been educated via flipped classrooms were higher than those of the nurses in the lecturing group. Thus, virtual learning using flipped classrooms is more effective than lecturing in improving triage nurses' knowledge and professional capability in the long run. [ABSTRACT FROM AUTHOR]

Face recognition assessments that use images of celebrities require not only face recognition ability but also pop-culture knowledge and successful recall of identifying information. Here, we introduce a task designed to measure face recognition more specifically: the Famous Faces Doppelgangers Test (FFDT). Participants (N = 57,407) identified 40 celebrities paired with lookalike doppelgangers, allowing face recognition ability to be assessed without requiring information recall. In addition, participants reported whether they were familiar with each celebrity, allowing poor face recognition ability to be differentiated from low pop-culture knowledge. FFDT performance was reliable (rxx =.80), similar across participants of different racial and ethnic groups, and more highly correlated with memory for faces (r =.50) and self-reported face recognition ability (r =.48) than processing speed ability (r =.10). Thus, the FFDT is a reliable, valid, and specific measure of the ability to identify familiar faces, making it a promising new tool for assessing face recognition ability. [ABSTRACT FROM AUTHOR]

Background & Aims Healthcare providers are responsible for providing services to mothers and infants during disasters. The purpose of this study is to determine their educational needs for maternal and newborn care during disasters in Iran. Materials & Methods This is a cross-sectional study that was conducted in 2017 on 208 healthcare providers (nurses, practical nurses, and midwives) from nine armed forces hospitals in Tehran, Iran who were selected by a census method. The data collection tool was a researcher-made questionnaire with acceptable face validity, content validity, and structure, with a Cronbach’s alpha of 0.94. The data were analyzed using descriptive and inferential statistics in SPSS software, version 16. Results The mean score on the educational needs assessment scale was higher in the fields of sexual violence management (4.30±0.01) and information management (4.28±0.01), indicating the high need for education in these areas. The lowest scores were in the fields of postpartum care in newborns (2.19±0.96) and responsiveness (2.98±0.89). In total, the educational needs of healthcare providers were high (3.3±0.43). Conclusion The readiness of healthcare providers in Iran to provide maternal and newborn care during disasters is low and needs more attention. Therefore, it is recommended to compile and revise university educational programs and implement continuous education programs based on the results of this study in the proposed areas (especially sexual violence management and information management) in a regular, periodic, and continuous manner. [ABSTRACT FROM AUTHOR]

Specific phobia is a subcategory of anxiety disorders that remains poor understanding due to inadequate screening tools. This study aimed to develop and validate a new Specific Phobia Questionnaire (SPQ). This SPQ was developed based on literature reviews and inputs from related experts for content validity. The SPQ questionnaire consisted of 14 items and after content validity and face validity testing procedure, 12 items were chosen for the final questionnaire. The questionnaire was then distributed via Google form to university students in Klang Valley. A total of 267 students participated in this study with 70.8% were female with mean age of 23.28 (Standard deviation of 4.98) years. Validity analysis using exploratory factor analysis from the final study indicated that the Kaiser-Meyer- Olkin value was 0.77 and extracted three domains; animals, blood injection injury and situational-environment. Reliability analysis showed that Cronbach's α values were 0.84, 0.86, 0.78 and 0.72 for the total items, animal, blood injection injury and situational-environment domains, respectively. The newly developed SPQ showed good reliability and validity for evaluating specific phobia. [ABSTRACT FROM AUTHOR]

Aims and objectives: To develop and evaluate the psychometric properties of an instrument that measures nurses' Attitudes Towards Recognising Early and Noticeable Deterioration (ATREND). Background: General ward nurses play an important role in recognising patient deterioration. However, their attitudes towards early recognition of clinical deterioration have not been adequately explored due to the lack of a valid and reliable scale. Design: An instrument development and validation study. Methods: A three‐phase structure that followed the STROBE checklist was used: (1) item generation, (2) content and face validity assessment and (3) psychometric properties evaluation. The scale items were developed based on a comprehensive literature review and content validity assessment by 15 international experts from five countries. The psychometric properties of the ATREND scale were tested on 434 registered nurses, with retest evaluations (n = 100) at two hospitals. Exploratory and confirmatory factor analyses were used to examine the factor structure of the scale. The scale was also evaluated for its internal consistency, test–retest reliability and convergent validity. Results: The scale's content validity was 0.95. A 3‐factor solution was identified from the final 11 items: (1) beliefs about importance of patient observation, (2) use of broader patient assessment skills and (3) confidence in recognising clinical deterioration. The internal consistency reliability of the scale was supported with an acceptable Cronbach's alpha value of 0.745. Test–retest reliability of the scale was excellent, with an intraclass correlation coefficient of 0.825. The ATREND scale shows evidence of good convergent validity. Conclusion: The final 11‐item ATREND scale demonstrates adequate initial evidence of reliability and validity for use in acute ward settings. Relevance to clinical practice: Nursing educators and clinicians may use this scale to assess ward nurses' attitudes and practices towards early recognition of clinical deterioration and then enhance their competencies and behaviours in the recognition of clinical deterioration. [ABSTRACT FROM AUTHOR]

To develop and test the psychometric properties of a responsive feeding questionnaire (RFQ) on the basis of Self-Determination Theory for caregivers of toddlers aged 12–24 months in China. Item generation, preliminary evaluation items, refinement questionnaire, and psychometric properties testing. Toddlers' caregivers from Shandong Province, China, were surveyed online between June 2021 and February 2022 (n = 616). Content, face, and construct validity and reliability of the RFQ. Content validity was performed on the basis of expert panel feedback and cognitive interviews among caregivers. Construct validity was evaluated using principal component analysis with varimax rotation. Test-retest reliability was conducted with a sample of 105 caregivers. Over 3 phases of testing, a new instrument was developed to measure responsive feeding in toddler caregivers. The instrument was reliable, with an internal consistency of 0.87 and an intraclass correlation of 0.92. The principal component analysis identified a 3-factor solution (autonomy support, positive involvement, appropriate response) aligning with a theoretical framework from Self-Determination Theory. The final version of the instrument included 23 items. The 23-item RFQ has been validated in a Chinese population. Future research needs to validate this instrument in other countries and with children of different ages. [ABSTRACT FROM AUTHOR]

Introduction: American Society of Anaesthesiologists (ASA) and Difficult Airway Society (DAS) have provided guidelines on management of difficult intubation and Cannot Intubate, Cannot Ventilate (CICV) situations. There have been many advances in equipment available to anaesthesiologist in difficult airway like Supraglottic Airway Devices (SGA), Video-Laryngoscope (VL) and optical stylet. The knowledge and practice of these guidelines are important for patient safety in difficult airway scenario. Aim: To validate the questionnaire to assess practice preferences in difficult intubation and CICV in Indian anaesthesiologist. Materials and Methods: This questionnaire-based observational survey was carried out between April 2021 to June 2021 at Department of Anaesthesia, DY Patil School of Medicine, Navi Mumbai, Maharashtra, India. Nineteen questions were framed based on the literature related to difficult intubation and CICV practices. This questionnaire sent to 20 experts to grade each question on relevance, clarity, simplicity and ambiguity on a likert scale of 4 as provided in information sheet. Sixteen out of 20 experts responded. Nineteen questions were framed based on the literature related to difficult intubation and CICV practices. The questionnaire was expanded to 22 questions after pilot testing with 10 senior expert anaesthesiologists suggestion of including the question on apneic oxygenation. The collected responses were used to calculate Item-wise Content Validity Index (I-CVI), Scale-wise Content Validity Index (S-CVI) and Modified Kappa Statistics (MKS) in Microsoft excel sheet. Results: S-CVI for relevance, simplicity, clarity and ambiguity was 0.77, 0.77, 0.77 and 0.73, respectively. S-CVI/average or Average Congruency Percentage (ACP) was 0.95, 0.95, 0.95 and 0.94 for relevance, simplicity, clarity and ambiguity, respectively. Question 4, 14, 20, 22 received I-CVI of 0.75 in terms of relevance, clarity, simplicity and ambiguity and modified as per experts instructions. Conclusion: The survey questionnaire developed to assess practice preferences in difficult intubation and CICV fulfilled the content validity criteria both by qualitative and quantitative analyses. [ABSTRACT FROM AUTHOR]

Background: Disordered eating behaviors (DEBs) among persons with schizophrenia (PwS) have been reported widely in the literature, with very few studies in India. Robust tools to assess DEB are needed in the vernacular language to capture symptoms of disordered eating accurately. No such tools are available in the Tamil language. Globally, the Eating Attitudes Test (EAT-26) is widely used to assess DEB among PwS. Aim: This study aimed to translate and study the factor structure and reliability of EAT-26 among Tamil-speaking PwS. Materials and Methods: EAT-26 was translated into Tamil following the Oxford linguistic validation process. Experts evaluated its face validity and content validity. One hundred and fifty PwS, aged between 18 and 65 years, who attended the outpatient department of a psychiatric facility, and consented to participate, completed the Tamil version of EAT-26. Test-retest reliability of EAT-26 was assessed by readministering the tool to 30 PwS after two weeks. Data were analyzed using Stata 16.1. Internal consistency and test-retest reliability were computed using Cronbach's alpha and intraclass coefficients, respectively. The factor structure of EAT-26 was explored using principal component analysis (PCA). Spearman's rho was calculated to understand the correlation between the factors. Results: EAT-26 had an internal consistency of 0.71 and test-retest reliability of 0.896. Factor analysis revealed nine latent factors consisting of 21 of the original 26 items on EAT-26. These 21 items could explain a variance of 63.63%. Conclusions: The Tamil version of the EAT-26 is a reliable tool to assess DEB among Tamil-speaking PwS. It can be used to screen PwS for eating disorder risk. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the predictors of Knowledge, Attitude and Practice (KAP) towards Family Planning (FP) among pregnant Fijian women. Methods: A cross-sectional study was conducted over two months in 2019 with adult pregnant women attending the Antenatal Clinic (ANC) at Ba Mission Hospital (BMH), Fiji. Data was collected using a self-administrated questionnaire. Statistical analysis included correlation tests and regression analysis in determining predictors of KAP. Results: 240 pregnant women participated in this study with a mean age of 26.02 (± SD = 4.13). The results showed a moderate level of knowledge (mean 14.95, SD ± 3.15), positive attitude (mean 20.56, SD ± 5.68), and good practice (mean 4.97, SD ± 1.73). Linear regression identified that women with more than seven children had a knowledge score of 3.65, lower than null parity (t value = -2.577, p = 0.011). Women aged 20 to 24 had a 6.47 lower attitude score than women aged 18 to 19 (t value = -2.142, p = 0.033). Women in defacto relationships had a 2.12 lower attitude score compared to the married category (t value = -2.128, p = 0.034). Fijian women of Indian descent had a 1.98 lower attitude score than the I Taukei women (t value = -2.639, p = 0.009). Women aged 30–34 had 2.41 lower practice scores than those aged 18–19 (t value = -2.462, p = 0.015). Conclusion: This study found a medium knowledge of FP among pregnant women. These findings support a recommendation for further research to implement effective strategies. [ABSTRACT FROM AUTHOR]

Background & objectives: Assessing healthcare seeking behaviour (HSB), healthcare utilization and related out-of-pocket expenditures of Particularly Vulnerable Tribal Groups (PVTGs) of India through a prism of the health system may help to achieve equitable health outcomes. Therefore, this comprehensive study was envisaged to examine these issues among PVTGs of Odisha, India. However, there exists no validated questionnaire to measure these variables among PVTGs. Therefore, a study questionnaire was developed for this purpose and validated. Methods: Questionnaire was constructed in four phases: questionnaire development, validity assessment, pilot testing and reliability assessment. Nine domain experts face validated questionnaire in two rounds, followed by a single round of quantitative content validity. Next, the questionnaire was pretested in three rounds using cognitive interviews and pilot-tested among 335 and 100 eligible individuals for the two sections healthcare seeking behaviour (HSB-Q) and maternal and child healthcare service utilization (MCHSU-Q). Internal consistency reliability was assessed for de novo HSB-Q. Results: On two rounds of expert-driven face validity, 55 items were eliminated from 200 items. Questionnaire showed moderate to high content validity (item-level content validity index range: 0.78 to 1, scale-level content validity index/universal agreement: 0.73; scale-level content validity index/average: 0.96 and multirater kappa statistics range: 0.6 to 1). During the pre-test, items were altered until saturation was achieved. Pilot testing helped to refine interview modalities. The Cronbach alpha and McDonald’s omega assessing internal consistency of HSB-Q were 0.8 and 0.85, respectively. Interpretation & conclusions: The questionnaire was found to be valid and reliable to explore healthcare seeking behaviour, maternal and child healthcare utilization and related out-of-pocket expenditure incurred by PVTGs of Odisha, India. [ABSTRACT FROM AUTHOR]

Background: The European Organisation for Research and Treatment of Cancer (EORTC) has developed the Spiritual Well-being Questionnaire (EORTC QLQ-SWB32), a measure of spiritual well-being validated with people receiving palliative care for cancer, although its usefulness is not restricted to that population. We aimed to translate and validate this tool in Finnish and to study the relationship between spiritual well-being (SWB) and quality of life (QOL). Methods: A Finnish translation was produced according to the guidelines of EORTC and included forward- and back-translations. Face, content, construct and convergence/divergence validity and reliability were studied in a prospective manner. QOL was assessed with EORTC QLQ-C30 and 15D questionnaires. Sixteen individuals participated in the pilot testing. 101 cancer patients drawn from oncology units, and 89 patients with other chronic diseases drawn from religious communities in different parts of the country participated in the validation stage. Retest was obtained from 16 individuals (8 cancer and 8 non-cancer patients). Inclusion criteria included patients with either a well-defined palliative care plan, or who would benefit from palliative care, as well as the capacity to understand and communicate in Finnish. Results: The translation appeared understandable and acceptable. Factorial analysis identified four scoring scales with high Cronbach alfa values: Relationship with Self (0.73), Relationship with Others (0.84), Relationship with Something Greater (0.82), Existential (0.81), and, additionally, a scale on Relationship with God (0.85). There was a significant correlation between SWB and QOL in all participants. Conclusions: The Finnish translation of EORTC QLQ-SWB32 is a valid and reliable measure both for research and clinical practice. SWB is correlated with QOL in cancer and non-cancer patients undergoing palliative care or who are eligible for it. [ABSTRACT FROM AUTHOR]

Objective: For a long time, it was held that narcissism had two aspects: narcissistic grandiosity and narcissistic fragility. The extraversion, neuroticism, and antagonism elements of the three-factor narcissism paradigm, on the other hand, have gained popularity in recent years. Based on the three-factor framework of narcissism, the Five-Factor Narcissism Inventory-short form (FFNI-SF) is a relatively recent invention. Therefore, this research aimed to assess the validity and reliability of the FFNI-SF in Persian among Iranians. Method: Ten specialists (with Ph.D.s in psychology) were enlisted in this research to translate and evaluate the reliability of the Persian version of the FFNI-SF. The Content Validity Index (CVI) and the Content Validity Ratio (CVR) were then used to assess face and content validity. It was given to 430 students at Azad University, Tehran Medical Branch, once the Persian form was completed. The available sampling technique was used to choose the participants. Cronbach's alpha and the test-retest correlation coefficient were used to assess the reliability of the FFNI-SF. In addition, concept validity was obtained using exploratory factor analysis. In addition, correlations with NEO Five-Factor Inventory (NEOFFI) and Pathological Narcissism Inventory (PNI) were employed to establish the convergent validity of the FFNI-SF. Results: According to professional opinions, the face and content validity indices met expectations. With Cronbach's alpha and test-retest reliability, the questionnaire's reliability was also established. Cronbach's alphas varied between 0.7 and 0.83 for the FFNI-SF components. According to test-retest reliability coefficients, the components' values varied from 0.7 to 0.86. Additionally, three factors (extraversion, neuroticism, and antagonism) were recovered using the principal components approach and a straight oblimin rotation. According to an analysis of the eigenvalues, the three-factor solution accounted for 49.01 of the variation in the FFNI-SF. The eigenvalues for the three variables were 2.95 (M = 1.39), 2.51 (M = 1.3), and 1.88 (M = 1.24) respectively. The FFNI-SF Persian form's convergent validity was further verified by the association between its results and those from the NEO-FFI and PNI tests and the FFNI-SF. There was a substantial positive association between FFNI-SF Extraversion and NEO Extraversion (r = 0.51, P ≤ 0.001), as well as a strong negative correlation between FFNI-SF antagonism and NEO agreeableness (r = -0.59, P ≤ 0.001). As well as this, PNI grandiose narcissism (r = 0.37, P ≤ 0.001) was shown to be significantly associated with FFNI-SF grandiose narcissism (r = 0.48, P ≤ 0.001), as it was with PNI vulnerable narcissism (r = 0.48, P < 0.001). Conclusion: with its solid psychometric qualities, we may utilize the Persian FFNI-SF to test the three-factor model of narcissism as an effective tool for research. [ABSTRACT FROM AUTHOR]