Valid Assessment Research Articles

The Safety, Feasibility, and Efficacy of a Structured Individual Exercise Program for Community-Dwelling Stroke Patients

Introduction: Stroke is a leading cause of mortality and long-term disability worldwide, often resulting in low levels of physical activity post-discharge. A comprehensive exercise program could be a safe method to increase stroke patients’ physical activity and exercise volume. This pilot study examines the effectiveness, safety, and feasibility of a comprehensive exercise regimen for stroke patients residing in the community after discharge. Methods: This single-group pilot study included patients who received inpatient rehabilitation for motor impairment following a stroke. Community-dwelling participants engaged in a comprehensive exercise program, which was structured and individualized, consisting of stretching, aerobic exercise, strength training, and balance exercises, conducted under the supervision of a health exercise specialist in a dedicated living lab within the hospital. The program involved 20 sessions, each lasting 50 min, conducted three to five times weekly. The pre- and post-intervention evaluations were comprehensive, including safety and validity assessments, along with physical function tests such as cardiopulmonary exercise testing and various fitness tests (6 min walk test, timed up and go test, chair stand test, figure-of-8 walk test, grip strength test, and sit-and-reach test). Depression levels were assessed using the Geriatric Depression Scale (GDS). Results: A total of 22 subjects were recruited, with 21 completing the study after one dropout due to fatigue and visiting distance. Among the 21 completers, one subject experienced a mild adverse event (hypoglycemia), which was not serious, confirming the program’s safety. The exercise participation rate was 95.5%, and the adherence rate averaged 95.2%, with all completers achieving over 80% adherence. Significant improvements were observed in VO2 peak (p = 0.000), 6 min walk test (p = 0.000), timed up and go test (p = 0.000), chair stand test (p = 0.000), figure-of-8 walk test (p = 0.000), and grip strength (p = 0.001). However, changes in the peak respiratory exchange ratio (p = 0.078), sit-and-reach test (p = 0.228) and GDS scores (p = 0.275) were not significant. Conclusion: This study demonstrates that the comprehensive exercise program is sufficiently safe and valid for stroke rehabilitation patients. The program significantly enhances cardiopulmonary endurance, walking ability, balance, muscle strength, muscle endurance, and coordination. Further research with larger sample sizes and control groups is needed to confirm these findings and explore additional benefits.

Reliability and Validity of Measuring the Strength of the Chin-Tuck Maneuver in Community-Dwelling Older Adults as a Means of Evaluating Swallowing-Related Muscle Strength

Background: The chin-tuck maneuver has been suggested to increase suprahyoid muscle activation, but a method to measure the strength of the chin-tuck maneuver has not been established. We developed a method to measure the strength of the chin-tuck maneuver (chin-tuck strength) and examined the reliability and validity of chin-tuck-strength measurement in community-dwelling older adults. Participants and Methods: The participants were 233 older adults aged ≥65 years without dysphagia or physical disability. Chin-tuck strength was measured twice consecutively using the developed device, and reproducibility was analyzed using intraclass correlation coefficients (ICCs). In addition, maximum tongue pressure, oral diadochokinesis, grip strength, knee extension strength, and the timed up and go test (TUGT) were measured as indices of swallowing-related muscle function and appendicular muscle function. The associations of chin-tuck strength with swallowing-related muscle function and appendicular muscle function were analyzed statistically. Results: The ICCs for chin-tuck strength were 0.82 (95% confidence interval [CI]: 0.73–0.88) in males and 0.87 (95% CI: 0.70–0.93) in females. Chin-tuck strength was significantly associated with maximum tongue pressure, grip strength, knee extension strength, and TUGT. Conclusions: This study suggests that chin-tuck strength is a reliable and valid assessment of swallowing-related muscle strength.

Construction of women's empowerment index for Bangladesh

IntroductionThis study is dedicated to refining and enhancing the measurement model of women's empowerment in Bangladesh. Women's empowerment, a crucial and multifaceted aspect of societal growth, is often hindered by gender disparities. This is particularly evident in societies like Bangladesh, where women face inequalities in education, economic opportunities, and decision-making power. To address these disparities effectively, it is essential to have a comprehensive understanding of women's empowerment. Therefore, this study aims to refine and enhance the measurement model to capture the multifaceted nature of women's empowerment accurately.MethodsTo gather data for this study, a structured questionnaire was administered to married women of reproductive age (15–49) in eight Mouza/Mohalla in Dhaka, Bangladesh. This unique approach allowed us to capture a diverse range of perspectives. We used thirty-three indicators across economic, socio-cultural, household, and psychological dimensions to measure women's empowerment. The sample data were then randomly divided for exploratory factor analysis (EFA) and Confirmatory Factor Analysis (CFA) to identify and validate a comprehensive multidimensional framework.ResultsOut of 625 respondents, only 36% of women worked, and ~39% married before age 18. Employing thirty-three items in EFA led to identifying eight critical factors (economic independence, control over household financial decisions, household decision-making, reproductive decision-making, freedom of movement, media exposure, positive self-esteem, and negative self-esteem). These factors, which explained 72.661% of the total variance in the data, provide a practical framework for understanding and addressing women's empowerment. Each component was then divided into two sub-dimensions to acquire a better understanding. The CFA indicated a good model fit for each dimension, and convergent and discriminant validity assessments were used to establish reliability and validity, further enhancing the practical implications of our findings.ConclusionsThe results of our rigorous exploratory and confirmatory factor analyses not only confirmed the sample structures and internal consistency but also provided significant insights. The findings suggested an adequate fit for all CFA models, indicating the robustness of our measurement model. According to the CFA results, each dimension's variables are satisfactory, and all the dimensions can be combined to create a single index measuring women's empowerment. This comprehensive understanding of women's empowerment, with its specific dimensions and factors, equips policymakers and practitioners with the knowledge to develop a wide range of interventions appropriate to particular facets of empowerment, thereby fostering societal growth and gender equality.

Professionalism assessment of students in clinical education through Situational Judgment Test (SJT).

The study aims to assess the situational judgment capability of students in various professions, including medicine, surgical nursing, anesthesia nursing, and emergency medical technology, using a validated and adapted Situational Judgment Test (SJT). The cross-sectional study was conducted at Qom University of Medical Sciences in 2023-2024. The study consisted of two steps: (1) adaptation and validity assessment of the SJT in various health professions, and (2) evaluation of students' situational judgment capability using the adapted SJT. Participants included 207 students from surgical nursing, anesthesia nursing, medicine, and emergency medical technology departments, selected through stratified random sampling. The SJT included 10 constructed-response scenarios developed by Alkhuzaee and colleagues in 2022. The validation and adaptation process utilized consensus methods, and the SJT was modified to a selected response format based on a knowledge-based approach. Scores ranged from 0 to 30. Cohen's method and norm-referencing standard deviation were used to calculate a cut-off score. Data were analyzed using descriptive statistics (frequency, mean, standard deviation) and inferential statistics (independent t-test, ANOVA, and ANCOVA). The face and content validity of the adapted SJT with a selected-response format was confirmed by expert agreement. The reliability of the SJT was approved, with a Cronbach's Alpha of 0.81. The mean score of students' situational judgment in professionalism was 11.90 (SD 4.54). Students' professions significantly impacted their situational judgment scores (F (3.201) = 3.67, p = 0.01, Partial Eta Squared = 0.052). The adaption and validation of SJT with a selected response format were confirmed by experts who evaluated the situational judgment capabilities of students in different clinical professions. The reliability of the SJT was acceptable-Cohen's method as a standard-setting approach assisted in identifying students needing support and training. The moderate level of situational judgment capacity confirmed the development of the educational program for the improvement of non-cognitive and non-technical skills such as judgment and decision-making in the field of professionalism.

Evidence pointing toward invalidity of the SF-8 physical and mental scales: a fusion validity assessment.

The SF-8™ Short Form Health Survey creates physical and mental health scale scores from responses to eight survey questions. These widely used scales demonstrate reasonable reliablity, and some forms of validity but have not been assessed for fusion validity. We assess the fusion validity of the SF-8 physical and mental health scales, and provide comments assisting fusion validity assessment of other scales. Checking the fusion validity of a scale requires including the scale and its constituent indicators in a structural equation model that has at least one variable causally downstream from the scale. We assessed fusion validity of the SF-8 physical and mental health scales in the context of work-related variables for care aides working in Canadian long-term care homes. Variables causally downstream from physical and mental health, such as work burnout, permit checking whether the SF-8 indicator items fuse to form cogent physical and mental scales, irrespective of whether those indicators share common-factor foundations. We found that the SF-8 physical and mental health scales did not function appropriately. The scales inappropriately claimed effects for several items that had no effects and provided biased estimates of other effects. These deficiencies seem grounded in the scales' developmental history, which implicitly bolstered selection of some causally ambiguous items and paid insufficient attention to component factor model testing. Our observations of causal incongruities question whether the SF-8 can provide valid assessments of physical and mental health. However, it would be imprudent to discontinue SF-8 use on the basis of a single study suggesting invalidity. This uncomfortable conclusion can be rechecked by re-analyzing data from any project that employed the SF-8 and recorded even one causal consequence of physical or mental health. The power of fusion validity assessment comes from connecting the recorded consequences simultaneously to both the scale and the items from which that scale is calculated.

QOL-10. AN ASSESSMENT TOOL FOR MEASURING CAREGIVERS’ DEATH ANXIETY IN PRIMARY BRAIN TUMOR: A CONFIRMATORY FACTOR ANALYSIS

Abstract BACKGROUND Caregivers of patients with primary brain tumor describe significant emotional distress regarding their loved one’s impending trajectory and eventual mortality—a construct known as death anxiety. Our team adapted a pre-existing, validated scale for patients with advanced cancer (the Death and Dying Distress Scale; DADDS) to measure this latent variable in caregivers of patients with primary brain tumors. Our adapted scale (DADDS-CG) demonstrated preliminarily strong internal consistency and construct validity. We now seek to confirm the factor structure, internal consistency, and convergent validity of the DADDS-CG in a second sample of neuro-oncology caregivers in accordance with best practices of measure development. METHODS Caregivers of those with primary brain tumors (N=221) completed an online battery of self-report questionnaires, including the 15-item Death and Dying Distress Scale-Caregiving (DADDS-CG), the Generalized Anxiety Disorder (GAD-7), and the Patient Health Questionnaire (PHQ-9). To verify the two-factor structure of the DADDS-CG, we used confirmatory factor analysis. Cronbach’s alpha measured internal consistency, Pearson correlations assessed convergent validity, and descriptive statistics determined the prevalence of death anxiety. RESULTS Caregivers (Mage=46.2) were primarily White (85.5%) female (72.4%) spouses (75.6%). The two-factor model demonstrated adequate fit (X2/df=4.24; CFI-.89; NFI=.87; RMSEA=.06), suggesting two correlated subscales of death anxiety: Finitude and Dying (r=.80). The DADDS-CG demonstrated strong internal consistency (a=.95) and was moderately correlated with the GAD-7 (r=.73) and PHQ-9 (r=.68), suggesting adequate convergent validity. Mean scores fell within the moderate range (M=40.5, SD=18.7), with 20.8%, 36.2%, and 43.0% of caregivers reporting low, moderate, and severe death anxiety, respectively. CONCLUSION The DADDS-CG is a valid and reliable assessment tool for measuring death anxiety in caregivers of those with primary brain tumors. Given the high prevalence of death anxiety, future investigations are needed to understand caregiver’s death anxiety throughout the disease trajectory and to inform intervention development for neuro-oncology caregivers.

Assessment of validity of local neoclassical transport theory for studies of electric-field root-transitions in the W7-X stellarator

Abstract The neoclassical ambipolarity condition governing the radial electric field in stellarators can have several solutions, and sudden transitions (in radius) between these can then take place. The radial position and structure of such a transition cannot be determined from local transport theory, and instead a non-rigorous model based on a diffusion equation for the electric field is usually employed for this purpose [1]. We compare global (full plasma volume) drift-kinetic simulations of neoclassical transport in the Wendelstein 7-X stellarator with this model and find significant discrepancies. The position r0 of the transition is not predicted correctly by the diffusion model, but the radial structure of the transition layer is in reasonable agreement if the diffusion coefficient is chosen appropriately. In particular, it should depend on the plasma temperature in the same way as the plateau-regime coefficient of neoclassical transport theory or the gyro-Bohm diffusion coefficient. In the small-gyroradius limit, the prediction of r0 by the diffusion model simplifies to the so-called Maxwell construction [2, 3]. However, this property also emerges from a wide range of other mathematical models in the appropriate limit. The basic assumption underlying these models is that the diffusion, or generalisations thereof, is independent of the radial electric field, which is however unlikely to be the case in practice. Presumably this fact explains the discrepancy between the diffusion model and the drift-kinetic simulations. Finally, it is found that global simulations replicate the phenomenon of spontaneous root transitions driven by variations in the electron-to-ion temperature ratio, as predicted by local theory in the small-gyroradius limit.

Responding to AI

The influence of artificial intelligence “has enormous implications for higher education” (Bearman, Ryan & Ajjawi, 2023, p. 369). Those of us teaching in the higher education sector have felt this profoundly: after the rapid uplift in digital teaching and learning practices in response to COVID 19 we are required, yet again, to respond to a new set of challenges brought about by the impact of AI. As an example, chatbot technology is calling into question the reliability of the traditional essay as a valid assessment tool (Stokel-Walker, 2022), requiring significant critical reflection and reevaluation of assessments from teaching academics to ensure course learning outcomes are met. This presentation outlines how a teaching specialist academic working in an initial teacher education (ITE) programme at a South Australian university carried out one such redesign. The focus of the re-design was a ‘unit/year plan’ assessment task for a final year curriculum specialization topic. The redesign aligned with the two guiding principles from TEQSA’s Assessment reform for the age of artificial intelligence (Lodge et al., 2023). The first of these guiding principles: ‘Assessment and learning experiences equip students to participate in a world where AI is ubiquitous’ (p. 2) points to the importance of educating students around AI use relevant to their learning. The second guiding principle: ‘Forming trustworthy judgements about student learning in a time of AI requires multiple, inclusive and contextualised approaches to assessment’ (p. 3) underscores the ongoing necessity for universities to have effective means by which to measure student learning outcomes, especially in accredited courses. The redesign of the assessment task both acknowledged the potential of AI for use in the professional space, and simultaneously sought to ensure assessment validity through the inclusion of an interview with the pre-service teachers. Overall, the redesign of the assessment task incorporated three components. Firstly, a brief introductory module about discipline-specific uses of AI was incorporated into the online course content. Secondly, pre-service teachers were ‘permitted’ to utilise available AI platforms in the creation of their planning task. Thirdly, the assessment process was adapted to include an oral presentation (Gulikers, Bastiaens & Kirschner, 2004) conducted as a panel interview in which each pre-service teacher could provide evidence of the pedagogical perspectives underpinning their plan and subsequently demonstrate the successful achievement of topic learning outcomes. The purpose of the panel interview was to assist assessors in forming a judgement about pre-service teachers’ pedagogical understanding and application, in line with relevant criteria from Matheis and John’s Comprehensive Authentic Assessment Model (CAAM) (Matheis & John, 2024). Autoethnographic reflections on the first delivery of the redesigned assessment are provided, including alternative approaches for future iterations. The learnings from the teaching initiative outlined in this presentation contribute to the growing discussion about how we can develop the capacity of our pre-service teachers as skilled and critical practitioners who can utilize AI as a valuable tool for their ongoing professional practice.

The Italian version of the Majeed pelvic score: translation, cross-cultural adaptation and validation.

The assessment of functional outcomes after pelvic ring fracture remains a controversial topic. The Majeed pelvic score (MPS) is the most commonly used pelvic-specific questionnaire in the literature. The aim of this study is translation, cross-cultural adaptation and validation of the Italian version of MPS. The study was articulated in two phases. Phase 1 consisted in translation and cross-cultural adaptation of MPS, from English into Italian. The psychometric properties were tested on 52 Italian patients (Phase 2). Construct validity was assessed by correlation with Short-Form 12 (SF-12). 33 patients repeated the questionnaire after 14days to assess its reproducibility. All data were subsequently analyzed (descriptive statistics, multitrait analysis, reliability and construct validity assessment). The questionnaire was clear and easily understood (no missing data). A ceiling effect was detected for all items of the scale. Multitrait analysis showed good results for each outcome measure, except for the item "walking distance" that showed poor item discriminant validity. A significant correlation between the MPS and the physical component summary (PCS) of the SF-12 was found, while there was a weak correlation with the mental component summary (MCS). The questionnaire showed high internal consistency (Cronbach's alpha: 0.91-0.99) and very good test-retest reliability (intraclass correlation coefficients: 0.92-0.96). The Italian version of the MPS has demonstrated to be reliable and valid in the evaluation of patients with pelvic ring fractures. There is still however a need for an instrument capable of evaluating the mental component in these types of injuries.

Combining Sentinel-2 and diverse environmental data largely improved aboveground biomass estimation in China's boreal forests.

Accurately mapping aboveground biomass (AGB) in China's boreal forests is crucial for assessing global carbon stock and formulating forest management strategies but remains challenging as the environmental heterogeneity complicates AGB estimation. Here, we investigated the relative gains of integrating Sentinel-2 and environmental data, as well as synthetic aperture radar (SAR) images to map AGB in China's boreal forests. We used two machine learning algorithms, random forest and gradient boosting regression (GBR), and four dataset combinations to develop the AGB models, then evaluated the AGB map by carrying on uncertainty analysis and comparing it with existing AGB products. Results showed that the GBR model based on Sentinel-2 and environmental data presented the best AGB estimation capability (R2: 0.75, RMSE: 23.60 Mg/ha), while further adding SAR images had negative effects on the model improvement. The Tasseled Cap Distance, short-wave infrared from Sentinel-2, Black dragon fire disturbance, Elevation, and Geographic locations were found to be significant contributors to AGB prediction. Our AGB estimates exhibited moderate to low uncertainty and outperformed other existing AGB maps in China's boreal forests based on independent validation assessment. The AGB distribution presented a noticeable south-north gradient difference, ranging from 3.23 to 346.37 Mg/ha. This study provides new insight into AGB estimation through the integration of Sentinel-2 imagery and multiple environmental data and offers a basis for sustainable management in China's boreal forests.

Examination of the relationship between dimensions of sexual perfectionism and female sexual function and sexual performance anxiety among Iranian married women of reproductive age: a cross-sectional study

BackgroundPerfectionism is a multidimensional personality trait that manifests itself through various aspects of life as well as sexuality. Yet, the specific nexus between perfectionism and women’s sexual experiences continues to remain unaddressed. Hence, this research aimed to investigate the relationship between the dimensions of sexual perfectionism, sexual function, and sexual performance anxiety (SPA) among Iranian married women of reproductive age in Gonabad, Iran.MethodA cross-sectional study was conducted in Gonabad City in 2021, involving 450 women of reproductive age. Stratified sampling was used to select public healthcare centers, and participants were chosen via simple random sampling. Data were collected online through platforms like WhatsApp and Telegram, using the Multidimensional Sexual Perfectionism Questionnaire (MSPQ), Female Sexual Function Index (FSFI), and Brief Sexual Performance Anxiety Scale (BSPAS). The validity and reliability of these instruments were confirmed through content validity assessments and Cronbach’s α. Hierarchical linear regression was performed using SPSS version 26, with the significance level set at p < 0.05.ResultsLinear regression analysis indicated that self-oriented sexual perfectionism was positively associated with all FSFI domains, including desire, arousal, lubrication, orgasm, satisfaction, total FSFI (p < 0.001), and pain (p < 0.01). Partner-oriented sexual perfectionism was positively associated with satisfaction (p < 0.05). In contrast, partner-prescribed sexual perfectionism was negatively associated with all domains of FSFI, including desire, pain (p < 0.05), arousal, lubrication, total FSFI (p < 0.001), orgasm, and satisfaction (p < 0.01). Socially-prescribed sexual perfectionism was positively associated with desire and negatively associated with pain (p < 0.05). In particular, only partner-prescribed and socially-prescribed sexual perfectionism were positively associated with SPA (p < 0.01).ConclusionThe association found between dimensions of sexual perfectionism, sexual function, and SPA in Iranian women underscores the necessity for educational initiatives tailored to psychologists, psychiatrists, counselors, sexologists, and other healthcare practitioners. These programs would help to build a deeper insight into the origins of women’s sexual complaints and identify and manage them within the context of marital relationships.

Experience of Service Questionnaire (ESQ) in children and adolescents: factor structure, reliability, validity, item parameters and interpretability of the parent version for practical use in Greece

BackgroundHealth systems need tools to assess patient’s experience of service, but existing tools lack reliability and validity assessment. Our aim is to investigate the factor structure, reliability, validity, item parameters and interpretability of the parent version of the Experience of Service Questionnaire (ESQ) for practical use in Greece.MethodsA total of 265 caregivers that were using mental health services in Greece participated in this study as part of the Nationwide cross-sectional survey from the Child and Adolescent Mental Health Initiative (CAMHI). Confirmatory Factor Analysis was used to test factor structure. Reliability of all models were measured with omega coefficients. Tobit regression analysis was used to test for convergent and discriminant validity with specifically designed questions. Item parameters were assessed via Item Response Theory. Interpretability was assessed by means of IRT-based scores.ResultsWe found that ESQ is best represented and scored as a unidimensional construct, given potential subscales would not have enough reliability apart from a general factor. Convergent and discriminant validity was demonstrated, as caregivers who perceived that their child benefited from the received mental health care had 6.50 higher summed scores (SMD = 1.14, p < 0.001); while those who believed that their child needed additional help had 5.08 lower summed scores on the ESQ (SMD = −0.89, p < 0.001). Average z-scores provided five meaningful categories of services, in terms of user satisfaction, compared to the national average.ConclusionsOur study presents evidence for the reliability and validity of the ESQ and provides recommendations for its practical use in Greece. ESQ can be used to measure experience of service and might help drive improvements in service delivery in the Greek mental health sector.

A comprehensive instrument for evaluating advanced volleyball techniques in sport science students: design, reliability, and validity

Background: The enhancement of sports performance, particularly in volleyball, relies on the use of valid and well-developed measurement tests. Numerous studies have thus developed tests tailored to different skill levels to accurately assess athletes' abilities. However, the existing instruments for measuring volleyball techniques have yet to fully address the needs of advanced levels, especially in assessing technical skills among sports science students at the advanced stage. Purpose: This study aims to develop a comprehensive volleyball skill assessment instrument for advanced-level sports students, focusing on four key techniques: serving, underhand passing, overhand passing, and spiking. The instrument underwent rigorous testing to ensure its validity and reliability, with particular attention to construct validity across different phases and indicators. Methods: The study used a development research design based on the Plomp model, involving 51 male students from the Advanced Volleyball Course at Universitas Negeri Padang. Five expert judges assessed the instrument's feasibility before implementation. The research process included preliminary research, prototyping, and assessment phases. Expert opinions were collected using a Likert scale questionnaire via the Delphi technique. Validity and reliability were analyzed using SPSS version 25, focusing on internal and external validity coefficients and Cronbach's Alpha. Results: The instrument showed high reliability, with Cronbach's Alpha values consistently above 0.87. Construct validity tests confirmed the assessment's validity, with scores indicating a strong correlation between evaluated indicators and overall skill proficiency. Conclusion: The developed instrument is a reliable and valid tool for assessing advanced volleyball skills, offering a standardized method for educators and coaches to evaluate and enhance sports science students' performance. The study highlights the importance of phase-by-phase analysis in skill assessment for more effective volleyball training programs.

Energy Efficiency and Economic Survivance Appraisal of a 375 kWp Rooftop Solar PV System Under Hot and Dry Indian Climate

ABSTRACTIndia's rooftop solar photovoltaic (PV) installations are experiencing rapid growth due to favorable regulations. As climate change becomes a growing concern, researchers are turning their attention to the effects of weather patterns on the performance of rooftop solar panels, and also to optimize their efficiency in a changing environment. Consequently, industry players in the solar sector have been conducting performance validation and feasibility assessments of these plants. A 375 kWp rooftop PV plant is studied as a case example from April 1, 2022 to March 31, 2023, generating 543,666 kWh annually for the grid. The NMBE and MBE were assessed using simulation tools like PVGIS and PV Watts. In addition, a cost–benefit analysis of carbon credits was conducted with and without their inclusion. The energy payback time is calculated at 4.5 years post‐inclusion. Over a 25‐year lifespan, the embodied energy of the PV plant amounts to 2,552,265 kWh. This plant can mitigate CO2 emissions annually by 10,173.57 tons which is equivalent to INR 5,464,925. The current study highlights both environmental and economic benefits by incorporating carbon credits into the project. Further advancement in simulation tools, PV technologies, climate change adaptations are expected which will improve the rooftop system efficiency with shorten pay pabck periods and maximum reductions in CO2 emissions.

Validity and reliability of the short-form adolescent health promotion scale among adolescents and young adults in Ghana: methodological study

Background and aimAssessing health promotion among adolescents and young adults is vital to identify healthy and unhealthy behaviours as well as to evaluate health promotion interventions. However, there is no valid and reliable scale to assess health promotion among Ghanaians. For the first time, this study determined the validity and reliability of the original version of the Short‐Form Adolescent Health Promotion (AHP) scale among adolescents and young adults in Ghana.MethodThis cross-sectional methodological study included 617 adolescents and young adults within Kwame Nkrumah University of Science and Technology (KNUST) in Kumasi, Ghana. A well-structured questionnaire was used to collect sociodemographic data from study participants. The AHP-Scale was also used to collect data on participants health promoting behaviors. The scale’s validity was evaluated using Kaiser-Meyer-Olkin (KMO), Bartlett’s test of sphericity and Exploratory Factor Analysis (EFA), whilst the reliability was assessed using the Cronbach’s ɑ coefficient. Statistical analysis was performed using SPSS software version 26.ResultsThe KMO and the Bartlett’s test of sphericity were reported to be 0.899 and χ2 (276) = 6682.338 respectively, allowing for EFA with orthogonal rotation. The EFA revealed five factors covering 54.62% of the total variance. The factor loading order of the items did not exactly correspond to the order obtained in the original version of the scale’s validity analysis as the original scale had six factors. This six-factor loading scale was valid in regards to construct validity. The obtained factors included: life appreciation, exercise, stress management, nutrition, and social support. In this current study, Cronbach’s ɑ was calculated at 0.87 for the whole scale and between 0.71 and 0.92 for its subscales. Thus, indicating the current scale reliable.ConclusionThe six-factor loading scale of the Adolescent Health Promotion scale developed in the present study is acceptable for the validity and reliability assessment. However, the construct validity of this scale should be checked in other samples as it did not cover a large variance of the population. Large population wide studies are also needed to augment the current study findings with additional modifications for the adopted AHP scale.

Measuring cultural friction in cross-border mergers and acquisitions using a microfoundation-based approach

Purpose Cultural friction (CF) was introduced by researchers to overcome the issues and challenges of cultural distance measurement in the context of cross-border mergers and acquisitions (CBMAs). However, this construct has proved itself to be problematic to operationalize. To address this challenge, this paper aims to elaborate on a CF measurement instrument based on individual perceptions in CBMAs. This study used a microfoundation approach to measure CF, relying on managers’ interactions in CBMA settings. Design/methodology/approach To develop and validate a CF measurement in the context of CBMAs, this study followed a classical procedure including items development, lab tests and one field-study and an assessment of the construct validity. Findings The final instrument developed for measuring CF is composed of six critical incidents with three associated items each. The factor analysis revealed that the scale used in the field-test measures two factors of CF: internal and external. Reliability and discriminant validity are tested, demonstrating a good discriminant validity of “external” CF. The final measurement can be used as a valid and reliable scale in further studies to assess CF in the context of CBMAs. Originality/value This paper’s originality lies in developing and validating a CF measurement instrument that does not rely on cultural distance frameworks. The resulting scale shows the interest in considering micro-individual perceptions – the microfoundation level – for analyzing an organizational phenomenon as culture in CBMA contexts. Using a micro-founded approach, this study offers promising avenues for researchers who wish to study cultural interactions in international settings.

Quantity of delta-9-tetrahydrocannabinol consumption and cannabis use disorder among daily cannabis consumers.

Amid escalating cannabis legalization and daily consumption in the United States (US), determining the risk of cannabis use disorder (CUD) and relevant consequences among daily consumers has become a public health priority. Understanding these risks requires valid assessment of the daily quantity of delta-9-tetrahydrocannabinol (THC) consumed and its relation to consequences. This study characterized daily cannabis consumption using a new method for estimating milligrams of THC (mgTHC), and examined the relationship between daily mgTHC and CUD severity in a large national sample of daily consumers. US adult (aged 18+ years) daily cannabis consumers (n = 4134) completed a comprehensive online survey of cannabis consumption patterns (e.g. frequency, quantity, product types, potencies, administration methods) and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) CUD criteria. The primary exposure was past-week daily mgTHC consumption, calculated from survey responses to queries about product type, amount and potency consumed and including adjustments for puff size and loss of THC from specific methods of administration. The primary outcomes were (1) number of CUD criteria (range = 0-11) and (2) CUD severity categories: none, mild, moderate, severe. Median daily consumption was ~130 mgTHC, with substantial variability (25% ≤ 50 mg and 25% ≥ 290 mg). On average, participants endorsed 2.5 CUD criteria, and 65% met criteria for CUD (39% mild, 18% moderate, 8% severe). Greater daily mgTHC predicted higher CUD criteria count [betalog(mgTHC) = 0.50, 95% confidence interval (CI) = 0.267-0.734] and higher odds of mild [log odds ratio (logOR) = 0.238, 95% CI = 0.184-0.292], moderate (logOR = 0.303, 95% CI = 0.232-0.374) or severe (logOR = 0.335, 95% CI = 0.236-0.435) CUD. Among daily consumers of cannabis, there appears to be a positive relationship between the daily quantity of cannabis consumed (measured in milligrams of delta-9-tetrahydrocannabinol) and both the risk and severity of cannabis use disorder.

Utilisation of New Zealand Rugby's concussion management pathway: A mixed methods investigation.

Concerns around concussion highlight the need for strategies to improve the implementation and translation of concussion guidelines in community sports. This study assessed players' utilisation and compliance with New Zealand Rugby's Concussion Management Pathway (CMP). This pragmatic, mixed methods study comprised of concussion injury surveillance and mapping of players' healthcare touchpoints through the CMP. Semi-structured interviews were conducted to understand stakeholders' experiences. Over the season, 27 different healthcare pathways were identified with 28% of players progressing through all phases of the CMP (ideal pathway). Of the 206 suspected concussions reported over the season, 70% were logged in the CMP phone App, and 89% of these had an associated valid baseline concussion assessment. Prior to returning to contact training, 64% of players obtained a medical clearance. One theme, 'belief in the value of pathway' was identified as a facilitator across all CMP components. Themes such as 'concussion knowledge and the nature of concussion'; 'communication between stakeholders and sufficient information on the process'; and 'strong relationships and clarity around responsibilities' were identified as facilitators across several pathway components. Other facilitators included 'ease and timing of general practitioner access'; 'the phone App as facilitator to logging'; and 'spotting for concussion as a team'. Additionally, the findings signify baseline testing as a potential pre-cursor to overall CMP compliance. Strategies that support the facilitators identified in this study may further enhance compliance.

Emotion understanding among institutionalized preschool children in India: A visual-based approach.

The present study aimed to develop two visual tasks to assess the emotion understanding of institutionalized preschool children in India. To enhance the psychometric qualities of both tasks, content validity and inter-rater reliability assessments, translation-back translation and a rigorous peer review process were undertaken. In addition, the tool's components were mapped with institutionalized children's everyday experiences to help them better relate to the task. The tool development phase was followed by the assessment phase. Eighteen participants (nine males, nine females) aged 3-6 years were purposefully selected from three childcare institutions. The emotion identification task required children to identify the correct emotions from the cartoon characters' facial expressions and gestures, whereas, in the emotion situation task, children were asked to infer others' emotions from a vignette depicted by a picture card. Children's responses were videotaped, analysed and coded for both tasks. The study's key findings revealed that institutionalized children responded more accurately to emotion situation tasks yet struggled to identify sadness, anger and fear emotions compared to happiness. Furthermore, qualitative insights provided a comprehensive understanding and interpretation of the findings.

The limits of learning engagement and academic leadership within the higher education digitalization process - analysis by using PLS SEM.

There is convincing evidence that the learning environments digitalization of tools and equipment ultimately results in the speed and depth learning involvement of academia members, by raising attainment of each of the digital learning experiences. The majority of the research that was conducted on the topic of enhancing the digital skills of learners, which would ultimately lead to an increase in their active engagement, was conducted on students in primary and secondary education, leaving members of higher education outside of the scope of the study. Given the uninterrupted search for academic performance and innovation, the current research considers the technological changes that lead to the transformation of the traditional academic learning environments as previously known. The current paper considers the changes in the learners' engagement in the context of the dually digital transformation of the higher academic multi-institutional digitally-learning enhancements. An important factor to be considered regards the leadership evolution (in terms of teaching) that over time, led to a different speed contextual shift, according to its effectiveness, leading to higher or lower students learning (dis)engagement. The current manuscript aims to examine how the higher education digitalization levels could affect the student's learning engagement, under the close monitoring of the academia leadership styles practice. Data collection and analysis implied at first a qualitative approach by issuing an online-distributed survey that resulted in a number of 2272 valid responses. After performing structural equation modelling and proving a valid assessment tool, the analysis resulted into statistically proving the validity of two main hypotheses according to which students learning engagement has a positive effect on the practice of academic leadership. Additionally, results emphasized the fact that higher education digitalization has altogether a negative effect of students learning engagement. Consequently, the current study stresses on the importance of different peers' categories in the context of higher education institutions performance, with an emphasis on the different levels of students' engagement and the leadership styles evolution and practice, aspects uniformly developing within a continuously digitally transformation of the higher education environment.