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Since lack of culture-specific foods in dietary assessment methods may bias reported dietary intake, we identified foods and dishes consumed by residents not born in Sweden and describe consequences for reported foods and nutrient intake using a culturally adapted dietary assessment method. Design consisted of cross-sectional data collection using (semi-)qualitative methods of dietary assessment (and national diet survey instrument RiksmatenFlex) with subsequent longitudinal data collection using quantitative methods for method comparison (December 2020–January 2023). Three community-based research groups were recruited that consisted of mothers born in Sweden, Syria/Iraq, and Somalia, with a median age of 34, 37, and 36 years, respectively. Women born in Syria/Iraq and Somalia who had lived in Sweden for approximately 10 years, reported 78 foods to be added to RiksmatenFlex. In a subsequent study phase, 69% of these foods were reported by around 90% of the ethnic minority groups and contributed to 17% of their reported energy intake. However, differences between the three study groups in median self-reported energy intake remained (Sweden 7.19 MJ, Syria/Iraq 5.54 MJ, and Somalia 5.69 MJ). The groups also showed differences in relative energy contribution from fats and carbohydrates, as well as differences in energy intake from food groups such as bread and sweet snacks. We conclude that a dietary assessment instrument containing culture-specific foods could not resolve group differences in reported energy intake, although these foods provided content validity and contributed 17% of energy intake. The dietary habits collected in this study serve to develop new dietary assessment instruments.
Otology training solely using cadavers is challenging because of scarcity and high costs. The use of additive manufacturing technology is a promising alternative. This study aimed to qualitatively validate new additive manufacturing temporal bone specimens for their realism and ability to train surgical skills.
Methods
Three additive manufacturing models generated using cadaveric temporal bones were evaluated. Three otologists with experience as trainers dissected and evaluated each specimen.
Results
The additive manufacturing specimens scored an average of 4.26 ± 0.72 (out of 5) points and received positive feedback. The agreement between the three expert raters was high (intra-class correlation coefficient of 0.745).
Conclusion
The results suggested that the additive manufacturing temporal bones were able to faithfully reproduce a training experience similar to that on cadaveric temporal bones. Further studies that investigate the effectiveness of these specimens in training surgical skills are needed before integrating them into surgical training curricula.
The costs of low back pain (LBP) are complex and difficult to estimate. This study aims to adapt the Cost for Patients Questionnaire (CoPaQ) for use in LBP populations.
Materials and methods
In a cross-sectional qualitative study, we conducted cognitive interviews to assess the CoPaQ’s suitability for addressing costs related to LBP. Three groups of participants were included (n = 5 each): (i) persons with a history of LBP or primary caregiver, (ii) researchers with expertise in LBP, and (iii) primary care providers specialized in treating LBP. The interpretation, analysis, and summary of results used Knafl et al.’s qualitative content analysis method.
Results
Persons with a history of LBP (n = 5), had a median age of 60 years (Interquartile Range (IQR): 26–71.5), and varying durations of LBP, the median duration of LBP 7 years (IQR: 4–32.5). Researchers (n = 5) had a median age of 33 years (IQR: 29–45). Primary care providers (n = 5) had a median age of 40 years (IQR: 37.5–65), and a background in chiropractic care (n = 3) and physiotherapy (n = 2). Content analysis of the interviews revealed sources of error with five pre-determined themes (clarity/comprehension, relevance, inadequate response definition, reference point, perspective modifiers) and one developed theme (organization). We modified the questionnaire for LBP populations based on the feedback.
Conclusion
Our study evaluated the content validity of a questionnaire that assesses the direct and indirect costs associated with LBP. Future studies should pilot this questionnaire with persons of varying LBP severity and compare it with cost diaries.
Eventful analysis employs the most unfrozen and hence the most exploratory strand of CHA. It employs historical comparisons and explores transformation patterns, that is, patterns of qualitative change. It uses two key tools: historical description and conceptualization. The aim of historical description is to figure out what is going on, to gain a basic understand of a phenomenon before proceeding to explain it. Often this involves de-redescribing a phenomena that has qualitatively changed over time. Historical description, in turn, involves six concrete steps: fact gathering, chronicling, concatenation, periodizing, looking for intercurrence patterns, and rethinking research questions. Conceptualization serves to make historical description more comparativist and to explore broader patterns. The chapter discusses how to replace proper names with broader concepts by defining both the positive and the negative pole of concepts. It lists criteria for assessing the content and temporcal validity of concepts.
Recently, the Health of the Nation Outcome Scales 65+ (HoNOS65+) were revised. Twenty-five experts from Australia and New Zealand completed an anonymous web-based survey about the content validity of the revised measure, the HoNOS Older Adults (HoNOS OA).
Results
All 12 HoNOS OA scales were rated by most (≥75%) experts as ‘important’ or ‘very important’ for determining overall clinical severity among older adults. Ratings of sensitivity to change, comprehensibility and comprehensiveness were more variable, but mostly positive. Experts’ comments provided possible explanations. For example, some experts suggested modifying or expanding the glossary examples for some scales (e.g. those measuring problems with relationships and problems with activities of daily living) to be more older adult-specific.
Clinical implications
Experts agreed that the HoNOS OA measures important constructs. Training may need to orient experienced raters to the rationale for some revisions. Further psychometric testing of the HoNOS OA is recommended.
Reliable and valid assessment of sports nutrition knowledge can inform athlete nutrition education to address knowledge gaps. This study aimed to test the reliability and validity of an electronically administered sports nutrition knowledge tool – Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire (PEAKS-NQ). A 94-item PEAKS-NQ was piloted to 149 developmental athletes (DA) in New Zealand, with a subset invited to complete the PEAKS-NQ again to assess reliability. Reliability was evaluated using sign test, intraclass correlation and Cronbach’s α. Accredited sports dietitians (ASD; n 255) completed the PEAKS-NQ to establish construct validity via known-groups methodology and provided relevance scores to determine the scale content validity index (S-CVI). Rasch analysis was conducted to identify potentially problematic items and test reliability. Score differences between DA and ASD were analysed using independent t or non-parametric tests. DA (n 88) were 17·8 (sd 1·4) years, 61·4 % female and mostly in high school (94·3 %). ASD (n 45) were 37·8 (sd 7·6) years, 82·2 % female, with >5 years of dietetic experience (59·1 %). ASD scored higher than DA in all sections and overall (91·5 (sd 3·4) v. 67·1 (sd 10·5) %) (P < 0·001). There were no differences between retests (n 18; P = 0·14). Cronbach’s α was 0·86. S-CVI indicated good content validity (0·88). Rasch analysis resulted in a fifty-item PEAKS-NQ with high item (0·91) and person (0·92) reliability. The PEAKS-NQ is reliable and valid for assessing sports nutrition knowledge which could assist practitioners effectively tailor and evaluate nutrition education.
This study investigated the efficacy of a live theater performance intervention for enhancing the attitudes of pre-service rehabilitation students toward people with disabilities. A convenience sample of 54 undergraduate students of Latino/a descent (females = 33 and males = 21), age range 18 - 24 completed a pre-post design attitude change intervention. Data were collected on the students’ attitudes toward persons with disabilities, using the scale of attitudes towards disabled persons, and gladness, using a liker scale. Multivariate analysis of covariance was used to analyze the data. Results indicated the live theater performance intervention was more effective in providing positive emotion of gladness and in improving the attitudes of the students towards PWDs compared to simple print media.
There are a number of scales intended to measure workplace attitudes toward people with disabilities. However, there is limited demonstration of validity evidence, especially theoretical validity. This article reports on the development of the Co-Worker Acceptance of Disabled Employees (CADE) Scale, including an examination of theoretical and empirical validity evidences. Theoretical validity is supported by screening each scale item through the difference model of disability. Empirical validity evidence is generated through a content validity study and an initial validity study. Exploratory factor analysis reveals that workplace attitudes toward employees with disabilities are based on perceived differences between those with disabilities and others. The CADE Scale will support workplace training and provide evidence of attitude change subsequent to workplace disability-related interventions.
Nutrient profiling (NP) is a method for evaluating the healthfulness of foods. Although many NP models exist, most have not been validated. This study aimed to examine the content and construct/convergent validity of five models from different regions: Australia/New Zealand (FSANZ), France (Nutri-Score), Canada (HCST), Europe (EURO) and Americas (PAHO). Using data from the 2013 UofT Food Label Information Program (n15342 foods/beverages), construct/convergent validity was assessed by comparing the classifications of foods determined by each model to a previously validated model, which served as the reference (Ofcom). The parameters assessed included associations (Cochran–Armitage trend test), agreement (κ statistic) and discordant classifications (McNemar’s test). Analyses were conducted across all foods and by food category. On the basis of the nutrients/components considered by each model, all models exhibited moderate content validity. Although positive associations were observed between each model and Ofcom (all Ptrend<0·001), agreement with Ofcom was ‘near perfect’ for FSANZ (κ=0·89) and Nutri-Score (κ=0·83), ‘moderate’ for EURO (κ=0·54) and ‘fair’ for PAHO (κ=0·28) and HCST (κ=0·26). There were discordant classifications with Ofcom for 5·3 % (FSANZ), 8·3 % (Nutri-Score), 22·0 % (EURO), 33·4 % (PAHO) and 37·0 % (HCST) of foods (all P<0·001). Construct/convergent validity was confirmed between FSANZ and Nutri-Score v. Ofcom, and to a lesser extent between EURO v. Ofcom. Numerous incongruencies with Ofcom were identified for HCST and PAHO, which highlights the importance of examining classifications across food categories, the level at which differences between models become apparent. These results may be informative for regulators seeking to adapt and validate existing models for use in country-specific applications.
To develop a measure of food and nutrition security for use among an Australian population that measures all pillars of food security and to establish its content validity.
Design
The study consisted of two phases. Phase 1 involved focus groups with experts working in the area of food security. Data were assessed using content analysis and results informed the development of a draft tool. Phase 2 consisted of a series of three online surveys using the Delphi technique. Findings from each survey were used to establish content validity and progressively modify the tool until consensus was reached for all items.
Setting
Australia.
Subjects
Phase 1 focus groups involved twenty-five experts working in the field of food security, who were attending the Dietitians Association of Australia National Conference, 2013. Phase 2 included twenty-five experts working in food security, who were recruited via email.
Results
Findings from Phase 1 supported the need for an Australian-specific tool and highlighted the failure of current tools to measure across all pillars of food security. Participants encouraged the inclusion of items to measure barriers to food acquisition and the previous single item to enable comparisons with previous data. Phase 2 findings informed the selection and modification of items for inclusion in the final tool.
Conclusions
The results led to the development of a draft tool to measure food and nutrition security, and supported its content validity. Further research is needed to validate the tool among the Australian population and to establish inter- and intra-rater reliability.
The Camberwell Assessment of Need for the Elderly (CANE) was developed for the assessment of physical-, psychological-, and environment-related needs in the elderly. The aim of this study was to revise and adapt the German version of the CANE with regard to the content validity of the instrument.
Methods:
Following a multistage approach, face-to-face interviews using the CANE, an expert survey and a multidisciplinary consensus conference were conducted in order to evaluate the frequency and relevance of met and unmet needs in the German elderly population, and to modify the content of the CANE for the German-speaking countries.
Results:
In Germany, unmet physical needs including physical health, medication, eyesight/hearing/communication, mobility/falls, self-care, and continence were found to have top priority closely followed by social needs (company, intimate relationships, daytime activities, information, and abuse/neglect). Psychological needs were the lowest ranked care category. Experts’ proposals for the improvement of the German version of the CANE were collected. All findings were discussed and integrated in the multidisciplinary consensus conference with the result of a revised and adapted CANE that is applicable in the German-speaking context.
Conclusions:
The provision of an adapted and improved German version of the CANE may substantially contribute to a comprehensive and valid assessment of needs in the elderly population. The results of this study represent an important basis for comprehensive needs assessment in the elderly in the theoretical and practical field of healthcare and health services research.
This research deals with assessing humor appreciation and highlights some of the strategies that can be used in two necessary stages in the construction of a test: the content validity study and the item analysis. First, we analyzed the content validity of a battery of 200 items developed to assess humor appreciation. Second, we analyzed the metric properties of the selected items by means of two studies. The first study was a pre-pilot analysis of the items in a sample of 212 participants, and the second study was a new item analysis in a sample of 344 Spanish people aged between 18 and 71 years. To determine content validity, we calculated interjudge agreement on item-facet theoretical match. Each item was assessed by seven judges, and the selection criterion used was a minimum agreement of 70%. This procedure led to eliminating 27 items.
Subsequent item analyses led to a preliminary proposal for a 40-item scale (Escala de Apreciación del Humor, EAHU [Humor Appreciation Scale]) with appropriate descriptive statistics as well as discrimination and homogeneity values. The internal empirical structure of the scale matched the operative definition of humor appreciation, and the Cronbach’s alpha of the EAHU scores ranged from .72 to .89.
During the latest decade, empirical research on the causes and consequences of the rule of law has expanded and, in the process, become extremely influential. However, we show that a number of widely used indices of the rule of law are not interchangeable. This lack of interchangeability is reflected in the fact that they are based on different defining attributes, to some extent cover distinct empirical scopes, do not correlate highly with each other, and support different explanatory factors. Until a consensus has been established with respect to the conceptualization of the rule of law, scholars are thus not free to opt for the measure that fits their data requirements best regarding spatial and/or temporal scope. Instead, they must carefully assess the content validity vis-à-vis their stipulated definition of the rule of law. Given the amount of money and time poured into the rule of law agenda, the problems identified reflect the lack of maturity of ‘good governance’ research.
The Motivational Interviewing Skill Code (MISC) is a coding system developed to measure adherence to motivational interviewing (MI). MI is an effective clinical style used in different treatment situations. Counsellors practising MI have to follow general principles and avoid certain traps. In the present study, the content of the MISC is compared with the general principles of MI and the traps to avoid in MI. Investigation of the content validity raises some questions. All general principles are represented but the traps to avoid in MI are not fully covered. The consequences of this under-representation are shown in transcripts of a selection of well-conducted MI training sessions. The reliability of the MISC was investigated by having five independent coders code 39 MI training sessions of different counsellors. The reliability of the MISC is reasonable. The five coders agreed to a large extent on the absolute ratings but the intraclass correlations were low. Although the MISC can be a useful research tool for process research of MI, it remains a labour-intensive instrument and for teaching and practice audit development of a more simple coding system is recommended.
Background: The present study aims to develop and validate a Chinese version of the Dementia Rating Scale (DRS) for use with Chinese populations in psychogeriatric settings.
Methods: The DRS was translated into Chinese and its content validity was evaluated by an 11-member expert panel. To assess reliability and concurrent validity, 52 subjects with dementia were recruited from medical and psycho-geriatric settings using purposive sampling.
Results: With percentage of agreement as an indicator, 28 out of 36 items (78%) had satisfactory content validity. Items with a percentage of agreement below 70% were reviewed and modified, based on the comments of the experts. The CDRS had excellent test-retest and inter-rater reliability, with intraclass correlation coefficient (ICC) at 0.94 and 0.93 respectively. Intraclass correlation coefficients ranged between 0.75 and 0.89 for the subscales. The internal consistency of the CDRS subscale, as measured by Cronbach's α, ranged from 0.57 to 0.82. The CDRS had high correlations with the Chinese Mini-mental State Examination (r=0.80 for total score, r=0.58 to 0.84 for subscales.
Conclusions: The CDRS is a valid instrument for the assessment of dementia in Chinese–speaking subjects.
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