Alpha Omega Research Articles

Analyses of Orthopaedic Surgery Residency Interviews.

We retrospectively reviewed the 2020-2021 and 2021-2022 residency interview cycles, both conducted virtually due to the COVID-19 pandemic. Residency application (i.e., applicant demographic and academic backgrounds) and interview data (i.e., faculty interviewer scores) were recorded. Interobserver reliability among faculty interviewers was calculated. Statistical analysis was performed to determine factors associated with ranking of applicants. There were 195 included applicants from the 2020 and 2021 interview cycles. There was no true agreement of interviewers' scoring of shared applicants (kappa intraclass coefficient range 0-0.2). Applicant factors associated with being ranked include applying to the match for the first time, USMLE Step 1 and 2 scores, educational break (vs. consecutive completion of college and medical school in 4 years each), higher class rank, and greater interviewer scores. Factors associated with better rank included additional degrees (i.e., PhD or MBA), couples match, AOA designation, educational break, underrepresented minority status, and notable attributes (i.e., collegiate athletics or Eagle Scout participation). Factors associated with worse rank included male sex, international medical graduate, prior match history, science major, extended research (i.e., >1 year spent in a research role), and home medical school students. There was significant variability and no reliability at our institution among faculty interviewers' applicant ratings. Being ranked was based more on academic record and interview performance while final rank number seemed based on applicant qualities. The removal of merit-based objective applicant measurements offers challenges to optimal residency applicant and program match. III (retrospective cohort study).

Differences in the Academic Attributes of Matched and Unmatched Orthopaedic Surgery Residency Applicants are Narrowing.

Applicant data from the National Resident Matching Program from 2016 to 2022 were analyzed. The number of matched and unmatched US allopathic senior orthopaedic applicants relative to the number of available positions was used to determine respective match rates. Performance metrics and applicant characteristics were compared by match status. Trends were compared with those of previous analysis from 2006 to 2014. The number of applicants increased from 863 in 2016 to 1,068 in 2022. The match rate decreased from 75% in 2016 to 66% in 2022 (p < 0.0001). Matched applicants had a higher number of contiguous ranks (12.3 vs. 6.5; p < 0.001), United States Medical Licensing Examination (USMLE) Step-1 score (248 vs. 240; p < 0.001), USMLE Step-2 score (255 vs. 247; p < 0.001), Alpha Omega Alpha (AOA) membership (38% vs. 13%; p < 0.001), and enrollment at a top 40 National Institutes of Health (NIH)-funded medical school (34% vs. 24%, p < 0.001). Compared with 2006 to 2014 data, a smaller percentage of matched applicants were enrolled in a top 40 NIH-funded medical school (34% vs. 37%, p = 0.013). The mean differences in USMLE Step-1 score (16 vs. 8.25 points, p < 0.001) and USMLE Step-2 score (16 vs. 8.25 points, p = 0.002) in favor of matched applicants nearly halved compared with that in 2006 to 2014. In addition, there was no longer a significant difference in the number of research products (abstracts, presentations, posters, and publications) between matched and unmatched applicants (p = 0.309). Differences in the academic attributes of matched and unmatched orthopaedic surgery applicants have become less profound over time, making it increasingly difficult to predict a successful match based on USMLE Step scores, AOA membership, research productivity, and medical school research reputation. Future studies should evaluate differences in subjective metrics (e.g., away rotation and interview performance and letters of recommendation) by match status.

"Educational Material on HIV": validity of health educational technology for people living with HIV.

to validate the educational technology "Educational Material on HIV" (INPI - BR 10 2020 003765 0). a methodological study with 39 expert judges in HIV/AIDS, using a 5-point Likert scale for assessment. Data were tabulated, processed and analyzed through descriptive analysis. Cronbach's alpha and McDonald's omega tests were performed to analyze internal consistency, and the Intraclass Correlation Coefficient, for reliability. Agreement was established by a Level Content Validity Index greater than 0.90. the assessment instrument showed high internal consistency (Cronbach's alpha of 0.89; McDonald's omega of 0.91) with reliable values. Based on the Intraclass Correlation Coefficient, judges' answers showed acceptable reliability, mean score 0.89 (p<0.001). Agreement among judges was greater than 0.90 in the three assessed dimensions (objectives, presentation and relevance). the technology was considered a qualified and adequate tool by the judges regarding its objectives, presentation and relevance.

The quiet quitting scale: Development and initial validation.

COVID-19 pandemic causes drastic changes in workplaces that are likely to increase quite quitting among employees. Although quiet quitting is not a new phenomenon, there is no instrument to measure it. To develop and validate an instrument assessing quiet quitting among employees. We identified and generated items through an extensive literature review and interviews with employees. We carried out the content validity by content experts and we calculated the content validity ratio. We checked face validity by conducting cognitive interviews with employees and calculating the item-level face validity index. We conducted exploratory and confirmatory factor analysis to investigate the quiet quitting scale (QQS) factorial structure. We checked the concurrent validity of the QQS using four other scales, i.e., Copenhagen burnout inventory (CBI), single item burnout (SIB) measure, job satisfaction survey (JSS) and a single item to measure turnover intention. We estimated the reliability of the QQS measuring Cronbach's alpha, McDonald's omega, Cohen's kappa and intraclass correlation coefficient. After expert panel review and item analysis, nine items with acceptable corrected item-total correlations, inter-item correlations, floor and ceiling effects, skewness and kurtosis were retained. Exploratory factor analysis extracted three factors, namely detachment, lack of initiative and lack of motivation, with a total of nine items. Confirmatory factor analysis confirmed this factorial structure for QQS. We found statistically significant correlations between QQS and CBI, SIB, JSS and turnover intention confirming that the concurrent validity of the QQS was great. Cronbach's alpha and McDonald's omega of the QQS were 0.803 and 0.806 respectively. QQS, a three-factor nine-item scale, has robust psychometric properties. QQS is an easy-to-administer, brief, reliable and valid tool to measure employees' quiet quitting. We recommend the use of the QQS in different societies and cultures to assess the validity of the instrument.

Development, validation & pilot testing of a questionnaire to assess healthcare seeking behaviour, healthcare service utilization & out-of-pocket expenditure of Particularly Vulnerable Tribal Groups of Odisha, India.

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. 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. 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. 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.

Confirmatory Factor Analysis (CFA) and Psychometric Validation of Healthy Lifestyle and Personal Control Questionnaire (HLPCQ) in India.

The silent epidemic of chronic illness has become a significant public health challenge worldwide. The prevention and management of these deadliest health conditions primarily require empowering the individual to make healthy choices every day, e.g., healthy eating, physical exercise, etc., The first step in designing an intervention for this comprises measuring the health empowerment-related factor. However, severe scarcity of practical tools is noted. The present study aimed at the evaluation of psychometric properties of a healthy lifestyle and personal control questionnaire (HLPCQ)'s English Version in the Indian population. For this, a cross-sectional study was conducted on 618 people enlisted from the Northern state of India with the help of convenience sampling strategy. Data is collected by sharing the google form of HLPCQ through various online platforms. The value of Cronbach alpha and MacDonald's Omega, was >.70, suggesting HLPCQ has good reliability in the Indian population. While confirmatory factor analysis result shows that the final model with 24 items has a good fit to the data (RMSEA = 0.04, CFI = 0.97, TLI = 0.96, SRMR = 0.03) which implies that HLPCQ has acceptable structural and cultural validity. While the value of average variance extracted (AVE) and composite reliability (CR) for each factor were found to be more than .50 and .70 respectively, indicating the presence of convergent and discriminant validity for HLPCQ. These findings indicate that the HLPCQ has sound psychometric properties and can be used in the Indian population.

Desarrollo y propiedades psicométricas de un cuestionario sobre alfabetización ambiental en la escuela secundaria de indonesia

Concurrently, the amount of research dedicated to mitigating the effects of environmental issues is increasing. Environmental Education has emerged as one of the most promising research fields in preventing and addressing environmental problems. Nevertheless, it is important to note that environmental literacy is not limited by age, education level, or occupation, particularly in the Indonesian context. Therefore, this study aimed to evaluate the psychometric properties of an environmental literacy questionnaire for secondary school students. The sample consisted of 1,021 students from both public and private schools in Indonesia, ranging from grades 7-9. A three-factor model, including environmental consciousness, environmental anxiety, and environmental awareness, was validated using confirmatory factor analysis (CFA). Model fit was assessed using a variety of fit indices, such as the chi-squared test, comparative fit index (CFI), Tucker-Lewis Index (TLI), Good-Fit Index (GFI), root mean square approximation error (RMSEA), standardized root mean square residual (SRMR), and KMO index. Cronbach Alpha and McDonald's Omega were used to evaluate the reliability of the three factors, with values ranging from 0.66 to 0.78 and 0.68 to 0.79, respectively. The results indicate that the environmental literacy questionnaire is a reliable and valid tool for assessing the environmental literacy of secondary school students in the Indonesian context.

Validity study of the Three-Dimensional Work Fatigue Inventory among higher education nursing faculty.

to adapt and validate the Three-Dimensional Work Fatigue Inventory (3D-WFI) for Brazil's cultural reality and assess the psychometric properties. a methodological study developed in six stages: initial translation; synthesis of translations; back translation; review by expert committee; pretest; and review of the adaptation process by the researchers. For validity, the instrument was applied to a sample of 318 nursing professors from Brazilian federal and state public universities. Data were analyzed using exploratory and confirmatory factor analysis, composite reliability and instrument reliability (Cronbach's alpha and McDonald's omega). the 3D-WFI instrument showed excellent internal consistency (α=0.95 and ω=0.97), three dimensions and explained variance of 62.77%. the Brazilian version of the instrument showed excellent psychometric properties for assessing fatigue among Brazilian workers.

Predictive Value of Preresidency Academic Metrics on Resident Publication Potential.

Otolaryngology residency is highly competitive, and applicant academic metrics are scrutinized. The predictive value of preresidency academic metrics on applicants' future research productivity and career aspirations remains largely undefined. Retrospective cohort study. Academic otolaryngology department, 2014 to 2015. Applicant demographics, publication history, and United States Medical Licensing Examination (USMLE) scores were downloaded from Electronic Residency Application Service archives. Publications during residency were tallied from all PubMed articles indexed between July 1, 2015 and June 30, 2020. Postresidency career paths were examined by 2 investigators (D.J.C. and L.X.Y.) using Google searches with an emphasis on program websites, Doximity, and LinkedIn profiles. Associations with publication potential and postresidency positions were evaluated with Spearman rank correlation coefficients and Kruskal-Wallis, Wilcoxon rank sum, and χ 2 tests. Of 321 applicants, 226 (70%) matched, and 205 (64%) completed residency by June 2020. Matched residents published a median of 4 (range: 0-41) manuscripts during residency. USMLE scores, Alpha Omega Alpha status, and the number of preresidency publications did not significantly correlate with publication potential during residency. The number of research experiences had a significant positive correlation with publications during residency (p < 0.001). Asian race (p = 0.002) and geographical region of residency (p < 0.001) also had significant associations with publication potential. Of the 205 graduates, 118 (58%) enrolled in fellowship. Age and female sex (74% vs 48%; p = 0.002) were the only factors significantly associated with pursuing a fellowship. In otolaryngology, not all preresidency academic metrics are associated with publication potential during residency or propensity for fellowship training. Programs should not use academic metrics alone to predict an applicant's future research productivity or career trajectory.

Gov➔Value: How to combine reported quality experiences and patient-reported outcome measures. First results on vulvar cancer patients in an Italian Research Hospital.

Vulvar cancer (VC) accounts for <1% of cancers affecting the female gender. Clinical Pathways (CP) and Clinical Outcomes Monitoring are useful for providing high-quality care to these patients. However, it is essential to integrate them with the patient's perspective according to Value-Based Healthcare paradigms. Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are tools for assessing outcomes and experiences with health care from the patient's perspective. The aim of this paper is to collect and synthesize PROMs and main stakeholders' experience on the VC CP, according to a value-based approach. To select the most appropriate instrument, a review was conducted on the main databases and official websites of specific institutions and organizations. In the second phase, a 2-round Delphi survey was conducted to assess the Reported Experience Measures (REMs) tool. Questions were evaluated according to four criteria (general relevance, evidence-based, measurability, actionability) and included if strong agreement was reached. A Principal Component Analysis (PCA) was executed. Cronbach's alpha and McDonald's omega were computed. Fisher's exact test and Wilcoxon rank sum test were used to compare ratings between groups. Descriptive statistics were performed for both PROMs and REMs instruments. For PROMs assessment, EORTC QLQ-C30 questionnaire was selected and administered to 28 patients. Global Health Status/Quality of Life and Functional Scales Scores were high or very high, while symptoms scale reported low or medium scores. The final REMs consists of 22 questions for professionals and 16 for patients and caregivers. It was administered to 22 patients, 11 caregivers, 5 physicians, 2 nurses and 1 clinical senior manager. PCA identified 4 components. Scale reliability was acceptable (α = 0.75 95% CI: 0.61-0.85; ω = 0.69; 95% CI: 0.54, 0.82). A statistically significant difference between the patient/caregiver group and the professionals was found for items 8 (follow-up), 10 (perceived quality), 12 (safety), and 16 (climate) (p = 0.02; p = 0.03; p < 0.001; p < 0.001, respectively). PROMs could provide new ways of intercepting patients' needs and feedback, thus acting on them. The proposed REMs tool would allow to detect information not available elsewhere, which, through Audit and feedback strategies, could lead to enhancement of healthcare experience, according to a value-based approach.

Use of benzodiazepine and Z-drugs and mortality in older adults after myocardial infarction.

The adverse cardiovascular effects of benzodiazepines and Z-drugs (jointly referred as BZDRs) have been of concern. Yet, little is known about the use of BZDRs in relation to mortality risk among older adults with myocardial infarction history (post-MI). This study is a secondary analysis of the Alpha Omega Cohort study, comprising post-MI patients aged 40-60years. Self-reported information on the use of BZDRs, including types and dose, was collected at baseline. Four categories of mortality were examined, namely all-cause mortality, cardiovascular (CVD) mortality, cancer mortality, and non-CVD/non-cancer mortality. Associations between BZDRs use, by types and doses, and mortality were estimated with Cox regression models, adjusted for demographic and classic cardiovascular risk factors. A total of 433 (8.9%) out of 4837 (21.8% females) patients reported BZDRs use at baseline. During a median follow-up of 12.4years, 2287 deaths were documented, of which 825 (36.1%) were due to CVD. BZDRs use was related to a statistically significantly higher risk of all-cause and CVD mortality; adjusted hazard ratios [95% CI] were (1.31 [1.41, 1.52]) and (1.43 [1.14, 1.81]), respectively. These relationships were dose-dependent-patients using BZDRs on an as-needed basis had similar risks compared to the non-uses, whereas patients with a daily use schedule and increasing doses had higher risks (p-value for trend: <0.001). BZDRs use was independently associated with a higher risk of all-cause and cardiovascular mortality in older post-MI patients, and there was evidence for a dose-dependent relationship. NCT00127452 (www. gov).

Psychometric properties of the Smartphone Addiction Inventory - Short Form (SPAI-SF) in Brazilian adolescents

The Smartphone Addiction Inventory - Short Form (SPAI-SF) is shorter version (10 items) of the original version of SPAI (26 items). In this study, we aimed to: (i) adapt and test the internal structure of the SPAI-SF, using confirmatory factor analysis (CFA), multigroup confirmatory factor analysis (MGCFA), and network analysis; (ii) analyze the internal consistency, temporal stability, criterion, predictive and construct validities of the SPAI-SF. A total of 392 adolescents (M = 12.76; SD = 1.00) completed the following measures: demographic questionnaire, SPAI-SF, Smartphone Addiction Scale - Short Version (SAS-SV), and the Internet Addiction Test (IAT). The CFA showed good fit indices with the original four factors, and MGCFA indicated measurement invariance for gender. Network analysis provided an understanding of the core symptoms of problematic smartphone use (PSU) for both boys and girls. The intraclass correlation coefficient (ICC) was 0.865 (95% CI: 0.841 - 0.887) and indicated a robust temporal stability. The instrument demonstrated acceptable overall reliability measured by Cronbach's alpha and McDonald's Omega criteria (α = 0.722; ω = 0.725) and did not show floor and ceiling effects. The scale's significant correlations demonstrated convergent and criterion validities of the SPAI-SF with SAS-SV, IAT, and Smartphone usage data. The SPAI-SF is a reliable instrument to detect PSU in adolescents.

Bifidobacterium animalis subsp. lactis Bi-07 supports lactose digestion in vitro and in randomized, placebo- and lactase-controlled clinical trials

Probiotics may alleviate lactose maldigestion. The objective was to select a probiotic with high lactase activity and compare it with lactase and placebo in clinical trials. Bacterial cultures were screened for lactase activity in a model of the upper gastrointestinal (GI) tract. Bifidobacterium animalis subsp. lactis Bi-07 (Bi-07) counts were adjusted in subsequent experiments to correspond to 4500 Food Chemicals Codex (FCC) units of lactase, the amount in the European Food Safety Authority (EFSA)-approved health claim. Two crossover clinical trials, Booster Alpha and Booster Omega, were performed in participants with lactose intolerance, where 2×1012 CFUs Bi-07, 4662 FCC lactase, or placebo was consumed simultaneously with a lactose challenge, with 1-wk washouts between challenges. The trial designs were identical except for the source of lactose. Breath hydrogen concentration (BHC) was measured to assess the effect of the investigational products on lactose digestion, for which incremental area under the curve (iAUC) was the primary outcome. Peak BHC, cumulative BHC, and GI symptoms were secondary outcomes. Bi-07 was superior to placebo in reducing BHC [iAUC, parts per million (ppm) ∙ h] in both trials (Booster Alpha: geometric least square mean ratio: 0.462; 95% CI: 0.249, 0.859; P=0.016; Booster Omega: 0.227; 95% CI: 0.095, 0.543; P=0.001). Lactase was superior to placebo in Booster Alpha (0.190; 95% CI: 0.102, 0.365; P<0.001) but not Booster Omega (0.493; 95% CI: 0.210, 1.156; P=0.102). Noninferiority of Bi-07 compared with lactase was observed in Booster Omega (0.460; 95% CI: 0.193, 1.096; P=0.079; CI upper limit<1.25 noninferiority margin). Odds of abdominal pain (compared with placebo: 0.32, P=0.036) and flatulence (compared with placebo: 0.25, P=0.007) were lower with lactase in Booster Alpha. Increased odds of nausea were seen with Bi-07 (compared with placebo: 4.0, P=0.005) in Booster Omega. Bi-07 has high lactase activity, and in 2 clinical trials, it supported lactose digestion in individuals with lactose intolerance.These trials were registered at clinicaltrials.gov as NCT03659747 (Booster Alpha) and NCT03814668 (Booster Omega).

Examining the Psychometric Properties of the Farsi Version of the Body Image Scale for Breast Cancer Survivors.

Mastectomy as a surgical treatment in women with breast cancer causes a change in their body image due to the loss of femininity and body integrity, decreased sense of sexual attractiveness, and dissatisfaction with the presence of surgical scars. The present study was conducted to evaluate the psychometric properties of the Farsi version of the body image scale for breast cancer survivors. This cross-sectional study was conducted on 204 women with a mastectomy referred to Kermanshah's surgery and oncology office in 2021. Face and content validity were evaluated qualitatively. Construct validity was evaluated by exploratory factor analysis (with maximum likelihood and Promax rotation) and confirmatory factor analysis. Cronbach's alpha and McDonald's omega coefficients were used to verify internal consistency. The mean age of the participants was 46.57 (SD = 9.47). One factor was extracted that explained 46.56% of the total variance of body image. The factor load of the items varied between 0.561 and 0.801. The results of CFA also showed that the final model has a perfect fit: CMIN = 20.931; DF = 13; CMIN/FD = 1.610; p = 0.074; GFI = 0.972; AGFI = 0.939; IFI = 0.985; CFI = 0.985; TLI = 0.975; PNFI = 0.595; PCFI = 0.610; RMSEA = 0.055. internal consistency based on Cronbach's alpha and McDonald's omega coefficients was 0.856 and 0.861, respectively. The Farsi version of the body image scale for breast cancer survivors has good construct validity and may be used in various studies in clinical and research settings.

Call to Action: Disaggregating the Asian American Medical Student Experience.

To the Editor: There are general misconceptions that Asian American medical students do not experience racial discrimination and should therefore be excluded from diversity, equity, and inclusion (DEI) conversations. However, White medical students are 2 times more likely than Asian American students to enter the Alpha Omega Alpha Honor Medical Society, even after controlling for United States Medical Licensing Examination Step 1 scores and extracurricular activities. 1 White students are also significantly more likely to be described as “empathetic” and “compassionate” than Asian American students, 2 playing into the stereotype that Asian Americans are less warm than their White counterparts. Furthermore, there is significant underrepresentation among U.S. medical school leadership, with Asian American deans increasing from only 0 to 1 in the last 20 years. 3 There is also no public data on Asian subgroups in U.S. residency and beyond. Despite these examples of discrimination across the medical education continuum, Asian American medical students continue to be excluded from conversations of racism in medicine and, as a result, struggle to share their experiences with harassment and discrimination. 4 At the medical-school level, we believe the best ways to address discrimination issues faced by Asian American medical students are (1) to include mandatory coursework on the disaggregated Asian American racism and health disparities experiences, (2) to intentionally include Asian American students in DEI conversations, and (3) to conduct research on the Asian American medical student experience to better understand their specific needs. At the national level, we believe that (1) reporting disaggregated data in U.S. medical schools, residencies, and the physician working force and (2) comparing that data with U.S. census data could foster more nuanced DEI discussions.

Validation of the generalized anxiety disorder screener (GAD-7) in Cypriot pregnant and postpartum women

BackgroundAnxiety is increasingly acknowledged as a common mental health issue during the perinatal period. Its prevalence as well as the associated adverse effects constitute screening imperative. This study evaluates the psychometric properties and underlying factor structures of a Greek version of GAD-7 among pregnant and postpartum women (up to 6 months) in Cyprus.MethodsThis study was conducted from June to December 2020. A total of 457 Cypriot women in the perinatal period (222 pregnant and 235 postpartum) were surveyed. The assessment included anxiety (GAD-7) and depression (EPDS), and psychosocial factors related with anxiety. The internal consistency and factor structure of GAD-7 were evaluated using reliability coefficients, Cronbach’s Alpha and McDonald's Omega, and factor analysis, both Exploratory as well as Confirmatory.ResultsGAD-7 demonstrated good internal consistency (α = 0.907; Ω = 0.909). Horn's parallel analysis indicated a single factor as the most appropriate. CFA using the standard ML method indicated a good model fit, χ2 = 21.207, p = 0.096; CFI = 0.999; SRMR = 0.027. More studies are needed to determinate the cut-off point and the maximisation of the scale’s sensitivity and specificity in pregnant and postpartum Greek Cypriot women.ConclusionsGAD-7 is a valid and reliable measure and healthcare professionals should utilize GAD-7 as a standard instrument for the screening of anxiety symptoms in pregnant and postpartum Greek Cypriot women.

A psychometric evaluation of the International Trauma Questionnaire (ITQ) in a trauma-exposed college sample

IntroductionThe International Trauma Questionnaire (ITQ) is a well-validated measure of ICD-11 PTSD and CPTSD. However, further validation is needed in other samples and using external correlates representing a broader range of psychopathology. ObjectiveWe first examined the internal consistency of the ITQ, and then examined its convergent and discriminant validity with a wide variety of external correlates, including PTSD, childhood trauma, dissociation, somatization, anxiety, anxiety related disorders, depression, mania, paranoia, schizophrenia, borderline features, antisocial features, drug use, alcohol use, aggression, suicidal ideation, stress, interpersonal functioning, and treatment rejection. MethodUsing data from a trauma-exposed sample of college students (N = 246), we evaluated internal consistency via Cronbach's alpha and MacDonalad's omega, and convergent and discriminant validity via Pearson correlations and follow-up z tests using the Meng-Rosenthal-Rubin (1992) procedure to assess differences between the PTSD and DSO scales of the ITQ. ResultsThe ITQ has strong internal consistency reliability as indicated by Cronbach's alpha and MacDonald's omega. Patterns of convergent and discriminant validity fell broadly in hypothesized patterns, supporting the distinction between ICD-11 PTSD and CPTSD. All significant contrast analyses showed that correlations with external criterion variables were greater for ITQ DSO as compared to ITQ PTSD. ConclusionsOur results indicate that the ITQ is a psychometrically sound measure of ICD-11 PTSD and CPTSD. As indicated by the differential pattern in convergent and discriminant validity with a broad range of external correlates, the scale readily distinguishes PTSD and DSO as distinct constructs.

Development and Psychometric Properties of the Sexual Health Scale for Middle-Aged Married Women (SHIMA): a Mixed Methods Study.

This study aimed to develop and psychometrically validate the Sexual Health Scale for Middle-Aged sexually active women (SHIMA). This study was a sequential exploratory study consisting of two phases. In phase one, we interviewed 19 middle-aged women and reviewed the existing instruments to generate an item pool. Then, a panel of experts (n = 16) examined the items. In the second phase, the psychometric properties of the scale were assessed. For content and face validity, a panel of experts (n = 8) and a group of middle-aged women (n = 10) reviewed the items. For construct validity, a cross-sectional study was carried out on a sample of 427 married women. Finally, SHIMA's reliability was assessed. In the first phase, the sexual health concept was explored, and a provisional scale including 60 items was generated. Next, 21 items were removed based on content and face validity. Accordingly, the results obtained from the exploratory factor analysis (EFA) indicated acceptable loading for 34 items tapping into six factors that jointly explained 48.67% of the total variance observed. The internal consistency evaluation revealed that Cronbach's alpha and McDonald's omega were greater than 0.7, and the average inter-item correlation was greater than 0.4, except for one factor that showed borderline results. Test-retest reliability over a 2-weeks interval was 0.90, indicating its high stability. The SHIMA is a reliable and valid scale for measuring sexual health in middle-aged married women. It can be used as a sexual health screening scale by healthcare professionals and for research purposes.

Measuring working alliance and technical alliance from the perspective of healthcare professionals working with people with mild intellectual disabilities: adaptation, factor structure and reliability.

The establishment of a valuable and meaningful working alliance between people with mild intellectual disabilities (IDs) and healthcare professionals is critically important for improving both the quality of life and impact of therapy for people with mild IDs. Measuring the working alliance as a treatment or support component is therefore of utmost relevance. In light of the increased use of eHealth tools, it is also essential to measure the alliance using these tools, which is referred to as technical alliance. There was a lack of validation of these two measurements for healthcare professionals working with people with mild IDs, which this study sought to address. Both the validated Working Alliance Inventory - Short Form - MID (WAI-SF-MID) and Technical Alliance Inventory - Short Form - MID (TAI-SF-MID) for general patient populations were adapted for healthcare professionals working with people with mild IDs. A two-step approach was conducted to systematically adapt both measurements with an expert group of healthcare professionals. Confirmatory factor analysis was conducted to test a three-factor structure for both the WAI-SF-MID (N=199) and the TAI-SF-MID (N=139), and internal consistency was determined for both scales. An acceptable-to-good model fit was found for both the WAI-SF-MID and the TAI-SF-MID; confirmatory factor analysis confirmed a three-factor model for both measurements. Cronbach's alpha and McDonald's omega were excellent for both total scales (≥0.90) and acceptable to good for sub-scales of both versions. Both the WAI-SF-MID and the TAI-SF-MID are promising measurements for determining healthcare professionals' perspective on the (digital) working alliance with people with mild IDs.

Association of an Early Interest in Orthopedic Surgery with Match Rate into Orthopedic Surgery.

Orthopedic surgery residency is considered one of the most competitive specialties in which to match. Studies examining the factors associated with a successful match have neglected whether participation in an orthopedic interest group (OIG) improves the chances of orthopedic residency match. The goal of this study was to test the hypothesis that participation in the OIG would improve matching into an orthopedic surgery residency. We performed a retrospective cohort study between May 2017 and 2019 at one state-funded medical school. All of the applicants in orthopedic surgery from 2004 to 2019 were identified and contacted for OIG membership status. The Office of Student Affairs provided academic performance data (US Medical Licensing Examination scores and third-year clinical clerkship grades), Alpha Omega Alpha and Gold Humanism Honor Society status, and demographics (race and sex) of applicants. Between 2004 and 2019, 67 students (56 OIG and 11 non-OIG) applied for orthopedic surgery residency match. The match rate for the OIG was 86% compared with 64% for the non-OIG group, resulting in an adjusted odds ratio (adjusted for academic performance) of 10.23 (95% confidence interval 1.14-92.3, <i>P =</i> 0.038). OIG membership was associated with a significantly higher rate of orthopedic surgery residency matches. The higher rate of match associated with OIG membership may be the result of opportunities to diversify a residency application. Future studies are needed to further evaluate the potential association between OIG involvement and orthopedic surgery match.