The Altman Self-Rating Mania Scale (ASRM) has been recommended as a brief and psychometrically promising tool for the self-reporting of (hypo)manic symptoms. However, there is a shortage of validation in clinical samples, and none for the newly developed 11-item version. Thus, this study aimed to test the reliability and validity of the ASRM-11 in comparison with the ASRM-5. Through a retrospective chart review, self-reported data on the Korean ASRM (K-ASRM) were collected from 122 patients diagnosed with either bipolar or depressive disorder via a (semi)structured diagnostic interview. They were interviewed individually using the Korean Young Mania Rating Scale (K-YMRS). The reliability, construct, convergent, and diagnostic validity were also examined. The reliability of both versions of the K-ASRM ranged from good to excellent. Factor analyses revealed a unifactorial solution for K-ASRM-5, while a dual-factor structure emerged for K-ASRM-11, corresponding to the bright and dark sides of (hypo)mania. Moreover, both versions demonstrated a significant positive correlation with the total K-YMRS score. In the receiver operating curve analysis, the discriminating ability of both versions was fair when distinguishing manic from non-manic patients. Both the K-ASRM-5 and K-ASRM-11 demonstrated comparable levels of sound psychometric properties, which supports their continued usage in research and clinical practice. It is necessary to test potential utility of the K-ASRM-11 for symptom monitoring and treatment response because of its additional coverage of dark-side (hypo)manic symptoms, including irritability and impulsivity, which are considered important for the quality of life of patients with bipolar disorder.

BackgroundChallenges in accessing comprehensive sexual and reproductive health (SRH) information and care leave many individuals with spina bifida (SB) vulnerable to unmet SRH needs, risking unfulfilling sexual experiences and increasing susceptibility to coercion and abuse. Accurate tools are essential to measure SRH knowledge and self-efficacy in adults with SB.ObjectiveThis study aimed to evaluate the internal consistency and construct validity of domains of a newly developed survey that assesses SRH knowledge and self-efficacy in partner and provider discussions among adults with SB.MethodsThe SRH survey, recently validated for content, was distributed via REDCap with support from the National Spina Bifida Association (SBA) through social media, including SBA's Facebook, and the Adult Advisory Committee. Responses were de-identified, and each participant received a unique survey ID. Internal consistency of the self-efficacy subscales was assessed using Cronbach's alpha and Kuder-Richardson Formula 20 (KR-20) was used for the knowledge scale. Principal component analysis (PCA) evaluated scale structures. Analyses were conducted using SPSS.ResultsNinety participants completed the SRH survey. Most respondents were female (75.5%). Participants' ages ranged from 18 to 77 years (mean = 40.47, SD = 12.897) and 85.6% identified as non-Hispanic White. Both the self-efficacy scale for partner discussions (α = 0.914, five items) and provider communication (α = 0.958, eight items) had excellent internal consistency. PCA supported construct validity, with a single-factor structure explaining 75.3% of variance for partner communication and 78.0% for provider communication, indicating that each set of items measures a cohesive underlying construct of self-efficacy within its respective communication domain. KR-20 indicated low internal consistency for the SRH knowledge scale (KR-20 = 0.426, 11 items), likely due to limited response variability.ConclusionThe SRH self-efficacy scales for partner and provider communication demonstrated excellent internal consistency (reliability) and construct validity among adults with SB. In contrast, limited variability in knowledge responses suggests that the current knowledge scale may require refinement to better capture differences in SRH knowledge across individuals.

To evaluate construct validity of five concern for falling (CFF) outcome measures: 1) Locomotor Capability Index (LCI); 2) Prosthetic Limb Users Survey-Mobility (PLUS-M); 3) Consequences of Falling (COF) Scale; 4) Perceived Ability to Manage a Fall (PAMF) Scale; and 5) Perceived Control Over Falling (PCOF) Scale in people with lower limb loss (PWLLL). Two coders independently linked ICF codes to measures using established linking rules. Consensus was achieved through discussion and consultation with an additional author. Inter-rater reliability was assessed using Cohen's kappa. ICF codes were compared with established CFF construct codes using descriptive statistics, and codes from limb loss-specific measures (PLUS-M, LCI) were compared against concepts identified in generic measures (COF, PAMF, PCOF). Inter-rater reliability ranged from moderate to very good (kappa values = 0.52-0.91, p < 0.001); values could not be calculated for the PCOF due to limited items. Forty-seven items were linked; the most common codes were d4602 (n = 11) ('Moving around outside the home/buildings') and d4551 (n = 9) ('Climbing/going up/down steps/hills'), concentrated within the Activities and Participation ICF component. While the ICF offers a standardized framework, greater specificity for limb loss-related mobility demands may enhance its clinical utility for PWLLL.

Although there is a plethora of tools available to assess children's movement competence (MC), the literature suggests that many have significant limitations (e.g. not practical for use in ‘real-world’ settings). The FMS 2 assessment tool has recently emerged as a valid and feasible alternative to existing measures. The aim of this study was to examine the construct validity of the FMS 2 among 10- to 13-year-old children in primary school in Ireland. As part of this study, 246 children (50% boys, M age = 11.25 years) were assessed using the FMS 2 assessment tool at two time points, eight weeks apart. Structural validity was assessed using confirmatory factor analysis. Results indicated acceptable model fit for each individual factor (locomotor, object manipulation, and stability) at both time points, although stronger fit statistics were observed at the second time point. Further, each factor demonstrated measurement invariance between the two time points. When combined into a single model, model fit was inadequate, suggesting that the individual components, while related, are distinct constructs. Boys demonstrated significantly higher MC scores than girls at both time points, while no significant age-related differences were observed. The findings of this study suggest that the FMS 2 assessment tool has good structural validity, and is consistent when measuring children's MC proficiency over time.

This study was conducted to estimate the reliability and validity of the translated and culturally adapted Polish version of the Trunk Impairment Scale in post-stroke patients and to determine the strength of the relationship between trunk and upper limb physical function after stroke. The Polish version of the Trunk Impairment Scale was developed through cultural adaptation. Internal consistency, test-retest reliability, and inter-rater reliability were determined, and construct validity was evaluated by analysing the Polish version of the Trunk Impairment Scale, the Polish version of the Fugl-Meyer Assessment Scale, and the Polish version of the Action Research Arm Test. Eighty patients with diagnosed stroke in the subacute and chronic stages. The internal consistency for the Polish version of the Trunk Impairment Scale was excellent (α = 0.85-0.91). Test-retest and inter-rater reliability were almost perfect (ICC = 0.94-1.0, κ = 0.92-1.0). Construct validity was moderate (rho = 0.71-0.76). A moderate correlation was also found between the Polish version of the Trunk Impairment Scale and Polish version of the Action Research Arm Test total scores (rho = 0.60). The Polish version of the Trunk Impairment Scale is a reliable and moderately valid outcome measure to assess trunk impairment in Polish stroke survivors. Trunk function is moderately related to gross and fine motor skills of the arm, hand, and fingers among individuals with stroke.

CONTEXT:Sedation and pain management are core strategies used to manage discomfort, anxiety, and pain in intensive care; however, strategies to improve this practice are inconsistently implemented with differential effect.OBJECTIVES:We describe the development and psychometric testing of the Optimizing ContExt in Assessing sedatioN in ICU (OCEAN-ICU) instrument intended for use in intensive care to guide development of change strategies to optimize sedation. We also provide descriptive results.METHODS AND MODELS:A prospective instrument development study was undertaken in the United Kingdom. Clinical staff who self-identified as responsible for prescribing, administering, and/or advising on sedation to invasively mechanically ventilated intensive care patients participated. Developed from previous interviews and refined during pilot testing, the draft instrument incorporated 68 statements aligned with the theoretical domains framework. Interested clinicians completed an online survey. Item responses were summed descriptively. Congruence between rankings of agreement and importance were assessed descriptively. Construct validity was assessed using confirmatory factor analysis.RESULTS:252 usable responses were received from U.K.-based critical care clinicians (53 medical doctors, 149 nurses, 25 pharmacists, 16 physiotherapists, and nine other healthcare professionals). After refining, 39 items were retained with an overall internal consistency of 0.81 and construct validity of χ2/degrees of freedom = 1.86, comparative fit index = 0.73, and root mean square error of approximation = 0.058.INTERPRETATION:Areas of practice with high levels of agreement and perceived importance focused on the value of light sedation and the lack of progress in sedation minimization. Conflict between importance and agreement was reported in the effective assessment and management of pain, delirium, and agitation.CONCLUSIONS:The OCEAN-ICU instrument has been developed to determine barriers and facilitators to improving sedation practice in local intensive care contexts. Further validation is required before testing whether the development of change strategies based on identified barriers and facilitators are effective in optimizing sedation practice.

Assessing laboratory animals' welfare - their current and/or past subjective affective states - is essential for ethical and regulatory reasons (and central to biomedical research into, for example, pain, nausea or anxiety). But this is challenging; and in the quest for quantification (and perhaps simplicity), it can be tempting to overlook construct validity. Nevertheless, that our indicators have good construct validity - that is, they accurately reflect the construct or concept of interest - is essential. This is true whether we are interested in short-term emotions like fear, longer-term mood-like states such as malaise, or markers of cumulative stress over a project or even a lifespan. Without it, welfare assessments risk being incorrect: inaccurate and unhelpful for the animals they aim to evaluate and assist. Here (summarising text from a forthcoming edited book), I introduce five validatory tests, as well as highlighting the importance of considering indicators' responsiveness/sensitivity and selectivity/specificity. I also outline how these principles could help improve the construct validation of both humane endpoints and retrospective severity assessments. Careful construct validation can never fully solve the 'Other Minds' problem: that animals' subjective experiences are private (such that we can never measure them, only infer them). However, done well, construct validation would add additional logical rigour to laboratory animal welfare assessment, increase its accuracy, and make benchmarking (e.g. severity classification) more transparent.

This work presents the design, construction, and experimental validation of a low-cost CMOS-based spectrometer built using a 3D-printed structure, a general-purpose webcam, and a low-cost diffraction grating. The system was calibrated using LED light sources and validated against a commercial Ocean HR4000CG-UV-NIR spectrometer. Results show that the CMOS-based spectrometer achieves wavelength detection accuracy within ±7 nm and is capable of resolving emission spectra with ~1 nm resolution spacing in the visible range (440–620 nm). The device was also applied to measure fluorescence in vitamin-enriched beverages and to analyze the absorbance properties of colored filters, demonstrating its utility in both chemical and optoelectronic applications. These findings confirm the feasibility of implementing low-cost spectroscopic tools for educational and scientific use.

Organoids revolutionizing precancer research.

Thailand's transition to a super-aged society requires innovative management frameworks to support technology-enabled healthcare for older adults. Smartwatches offer significant potential for continuous health monitoring. However, a validated management model suitable for Thailand's healthcare context remains underdeveloped. Therefore, this study developed and validated a second-order confirmatory factor analysis (CFA) of smartwatch innovation management factors for holistic older adult care, grounded in stakeholder perspectives. A cross-sectional survey was conducted with 260 stakeholders involved in a smartwatch-based elderly care pilot project in Thailand's northern Chiang Rai Province. Participants included physicians, nurses, village health volunteers, and caregivers. Data were collected using a five-point Likert-scale questionnaire comprising 13 observed variables across four proposed components. These included Health Data Management (HMS1), Holistic Health Integration (HMS2), Connection with Healthcare Services (HMS3), and Technology Design Suitability for Older Adults (HMS4). LISREL was used to conduct the CFA, which assessed construct validity. The second-order model demonstrated excellent fit (χ² = 2.54, df = 6, p = 0.952, χ²/df = 0.42, RMSEA = 0.00, CFI = 0.99, GFI = 0.98). All first- and second-order factor loadings were statistically significant (p &lt; .01). HMS4 (β = 0.95) and HMS3 (β = 0.94) emerged as the most influential dimensions. Construct reliability and convergent validity were confirmed (CR ≥ 0.75; AVE ≥ 0.50). The findings indicate that effective smartwatch innovation management for older adults must prioritize age-appropriate technology design and integration with formal healthcare systems. The validated framework provides policy and implementation guidance grounded in professional stakeholder assessment.

Dysphagia is a common and disabling consequence of head and neck cancer treatment. Patient-reported outcome measures provide critical insight into swallowing-related quality of life. The M. D. Anderson Dysphagia Inventory is the most widely used disease-specific questionnaire for this purpose. This study aimed to translate, culturally adapt, and validate a Hebrew version of the M. D. Anderson Dysphagia Inventory for use among individuals with head and neck conditions. This single-center psychometric validation study was conducted in the Department of Otolaryngology-Head and Neck Surgery at Sheba Medical Center. The translation followed the Principles of Good Practice of the International Society for Pharmacoeconomics and Outcomes Research. Adult Hebrew-speaking participants completed the translated inventory. Internal consistency, test-retest reliability, and construct validity were evaluated using Cronbach's alpha, intraclass correlation coefficients, correlation analyses, and known-groups comparisons against established quality-of-life instruments. Statistical analyses were performed in R using standardized psychometric methods. Four hundred participants completed 416 questionnaires. Internal consistency was excellent across domains (Cronbach's alpha 0.87-0.95), and test-retest reliability showed strong temporal stability (intraclass correlation 0.82-0.90). Correlations among domains supported the original three-factor structure. Scores demonstrated expected clinical gradients across surgical exposure groups. Convergent validity was confirmed through strong correlations with established voice and quality-of-life measures. The Hebrew version of the M. D. Anderson Dysphagia Inventory demonstrates excellent reliability and validity consistent with international adaptations. It enables standardized, patient-centered assessment of swallowing-related quality of life in Hebrew-speaking populations and facilitates cross-cultural research in head and neck oncology.

PurposeChronic kidney disease (CKD) is a global public health priority. Adherence to complex therapeutic regimens is crucial for non-dialysis patients. However, the absence of multidimensional assessment instruments has impeded precise adherence evaluation and targeted interventions. This study aimed to develop and validate a disease-specific Treatment Adherence Scale for Non-Dialysis CKD Patients (TAS-NCKD).MethodsA cross-sectional mixed-methods study was conducted in China. Preliminary items were developed by a scoping review and two Delphi expert rounds. Three rounds of surveys (n=160, 350, and 370) were conducted for the construction and psychometric validation of the scale. Feasibility, reliability, validity, discrimination and difficulty, and optimal cutoff determination was verified.ResultsThe third validation cohort consisted of 181 patients with CKD stage 1, 49 with stage 2, 59 with stage 3, 38 with stage 4, and 43 with stage 5. The final TAS-NCKD comprises 45 items across 5 dimensions. The scale demonstrated high feasibility with a completion rate of 92.5%, and a completion time within 18 minutes. The Cronbach’s α, split-half reliability, test-retest reliability for the scale were 0.955, 0.968, and 0.836. The scale-level content validity index (CVI) and item-level CVI were 0.992 and 0.875–1. Confirmatory factor analysis showed a good model fit. Convergent and discriminant validity both met the standards. Item characteristic curves were ideal and the optimal cutoff was established at 179 points.ConclusionThe TAS-NCKD is a valid and reliable instrument for assessing treatment adherence in Chinese non-dialysis CKD patients. This study provides targeted insights for improving patient self-management and may help slow disease progression.

Type of the article: Research ArticleAbstractIn the context of Vietnam’s rapidly expanding digital ecosystem, understanding how psychological differences shape brand cognition among Generation Z has become increasingly important. This study aims to examine the influence of the Big Five personality traits on brand awareness across major digital touchpoints, addressing the limited empirical evidence from emerging markets. A quantitative survey was conducted in January 2025 with 898 Gen Z consumers residing in Hanoi and Ho Chi Minh City. Using Cronbach’s Alpha, Exploratory Factor Analysis, and multiple regression, the study assessed the reliability of measurement scales and the effects of personality traits on brand awareness indicators derived from Aaker’s (1991) framework. The findings show that four personality traits – openness, conscientiousness, extraversion, and neuroticism – positively and significantly predict brand awareness on digital platforms (β = 0.171–0.250; p &amp;amp;lt; 0.001). Conscientiousness exhibits the strongest impact (β = 0.250), followed by neuroticism (β = 0.240), extraversion (β = 0.224), and openness (β = 0.171). Agreeableness does not demonstrate adequate construct validity and is excluded from the final model. Additional analyses using ANOVA reveal significant differences in brand awareness across regions but not across genders. These results illustrate that personality-driven tendencies, such as exploratory behavior, systematic information processing, social interaction, and risk-avoidance, play a substantial role in determining how frequently and effectively young consumers encode brand cues in digital environments. The study concludes that integrating personality insights into digital brand communication strategies can enhance relevance, memorability, and consumer-brand alignment, especially within dynamic Gen Z segments.Acknowledgment(s)The researchers express sincere gratitude to all the participants who generously participated in this study.

A cancer diagnosis can impose a financial burden on patients and their families, defined as socio-economic impact (SEI) within a framework of the Organization of European Cancer Institutes (OECI). The Socio-Economic Consequences of Cancer (SEC) study assessed SEI in 25 European countries using the Canadian Financial Index of Toxicity (FIT) instrument, showing substantial variation and supporting the need for a validated Europe-specific instrument. We examined the FIT instrument's validity and reliability in a secondary analysis of the SEC study, exploring whether the SEI framework supported its validation. Factor analyses were performed on the largest subgroup sharing cancer type, language, and country. The aim was to test whether the Canadian model could be replicated or a SEI-based model fit better. Reliability and construct validity were analyzed, followed by configural invariance and Differential Item Functioning (DIF) analysis for cross-country comparability. We used data from Bulgaria, France, Germany, the Netherlands, Norway, and Spain. The original FIT-instrument failed to replicate in the Spanish sample, leading to an SEI-based model with better fit (CFI = 0.975, RMSEA (90% CI) = 0.104 (0-0.278), χ2 = 18, p = .60). The instrument was reliable. Construct validity was partly confirmed. Configural invariance testing suggested that the SEI-based model's factor structure fits better in Europe, while DIF was identified, implying that direct score comparisons across countries should be done with care. In conclusion, the original FIT-instrument could not be fully validated in Europe whereas the SEI-framework improved score interpretation, supporting its use in developing a validated instrument tailored to the European context.

Abstract This paper reports on a pre-registered systematic review (PROSPERO; REF: CRD42023472339) of the role of therapists’ mentalizing capacity in psychotherapy processes. Studies were reviewed to address the following research questions: (i) what are the characteristics of studies that have investigated therapists’ mentalizing; (ii) what measurement tools are used to assess therapists’ mentalizing; (iii) what is the evidence of construct validity of these assessment tools; and (iv) what is the evidence of association between therapists’ mentalizing and patient outcome following psychotherapy. Studies conducted after 1991 that employed a quantitative design and measured therapists’ mentalizing were included. Three databases were searched on 14th February 2025: MEDLINE ® , PsychINFO and EMBASE. The identified studies were appraised for quality and data was extracted for narrative synthesis. Fourteen articles were included in this review. There was large heterogeneity across studies in terms of design, measurement of mentalizing and treatment modalities employed. Preliminary evidence suggested therapist mentalizing may both influence psychotherapy outcome across different therapeutic approaches and be associated with therapist wellbeing. Despite numerous limitations observed in this exploratory research, therapist mentalizing may play an important role in psychotherapy change processes. Implications for how therapist mentalizing could be optimised to improve therapeutic effectiveness and to mitigate against the impacts of stressful working environments are considered, along with recommendations for future research.

Personality, as a stable and coherent set of behavioral and cognitive patterns, significantly influences linguistic expression, emotional regulation, and cognitive functioning. The Big Five personality traits-neuroticism, extraversion, openness, agreeableness, and conscientiousness- are especially relevant for understanding to language use and social interaction, making them foundational for developing of personality-informed natural language processing (NLP) systems. Despite this, existing personality lexicons often lacks rigorous validation, show weak alignment with linguistic features and personality traits, and fail to adapt to dynamic language environments such as social media. This study presents the construction and empirical validation of a personality lexicon derived from established psychological scales, dictionaries, and literature. Validation using real-world participant data yielded high hit rates across all Big Five dimensions (all > 0.70; mean = 0.787) and their 30 corresponding facets (all > 0.60; mean = 0.768). This lexicon provides a robust foundation for advancing computational personality assessment and supports applications in personalized NLP, large language models, and mental health prediction.

Abstract Background Feedback on faculty teaching is essential for faculty development and education quality. Often in surgical training programs, this feedback is provided through resident evaluations of faculty. The content and quality of faculty teaching evaluations being used are, however, unknown as no standardized tool exists. The aim of this study was to identify the characteristics and evaluation domains of faculty teaching evaluation tools used in surgical residency programs. Methods Using convenience sampling, blank faculty teaching evaluation forms completed by residents were collected from university-based surgery residency programs across multiple U.S. geographic regions, including large public and private academic medical centers. A document analysis was performed using a mixed-methods approach to conduct a quantitative analysis to characterize the tools’ design features using descriptive statistics and perform a qualitative analysis of all question items using inductive content analysis to determine the evaluation domains. Results Fourteen faculty teaching evaluation forms from thirteen U.S. surgery departments met the sampling criteria and were included in the final analysis. Quantitative analysis showed that the mean number of questions per evaluation was 14.7 (median 13; range 4–23), composed of rating questions (median 10.5; range 0–20), free text comments (median 3; range 1–12), and checklist questions (median 0.5; range 0–2). The analysis also identified five styles of response anchors to each question including sequential, agreement, frequency, binary, and open-ended, and three performance levels for assessed faculty traits or behaviors including below expected performance, at expected performance, and above expected performance. Qualitative analysis of 206 question items revealed four major evaluation domains including teaching effectiveness (53.8% of codes), professionalism (25.5%), clinical performance (11.6%), and overall performance (9.1%) from the faculty teaching evaluation tools. Conclusions Surgical faculty teaching evaluations vary widely in design and frequently conflate teaching with professionalism and clinical performance. This domain mixing poses challenges for score interpretation and threatens construct validity if evaluations are used to assess teaching effectiveness exclusively. The findings suggest a consensus-based approach to defining core teaching domains and evidence-informed design principles, while allowing flexibility for local implementation. This study demonstrates the value of document analysis for critically examining assessment tools and provides empirical groundwork to inform future faculty evaluation efforts in surgical education.

Given the critical role of phonological vocabulary in second language (L2) listening proficiency, scholars have increasingly focused on measuring not only the form–meaning mapping aspects of vocabulary knowledge but also the extent to which learners can access this knowledge accurately and promptly in real-time contexts. To assess the automatized dimension of vocabulary knowledge, we built upon prior efforts to develop the lexicosemantic judgment task (LJT). Study 1 successfully replicated previous findings, showing that LJT outcomes could be distinguished from measures of declarative vocabulary knowledge (meaning recognition) and that LJT exhibited relatively strong associations with general L2 listening proficiency, even when controlling for other influencing factors. To further refine the construct validity of LJT as a measure of automatized L2 knowledge, Studies 2 and 3 developed and tested a timed version of the LJT. The results of the timed LJT, compared to the untimed version in Study 1, revealed similar links with listening proficiency, suggesting that the effect of time pressure on performance may be relatively minor. The test materials are provided in various formats to facilitate future research and pedagogical applications.

This study investigated the growth language mindset of undergraduate students in Thailand, focusing on their beliefs about intelligence, aptitude, and age sensitivity in English language learning. A total of 1,174 students from diverse academic disciplines participated in the survey, which employed the adapted Language Mindset Inventory (LMI). Descriptive statistics, multivariate analyses of variance (MANOVA), and confirmatory factor analysis (CFA) were conducted to address four research questions: (1) the overall level of growth mindset in English learning, (2) variations of mindset across disciplines, (3) differences based on the urban–rural divide, and (4) the construct validity of the proposed three-factor model. Results revealed that students generally hold strong growth-oriented beliefs, with the highest mean score for age sensitivity. MANOVA results indicated significant disciplinary differences in intelligence beliefs and age sensitivity beliefs, with students in telecommunication engineering, polymer engineering, manufacturing automation and robotics engineering, and mechanical engineering reporting the strongest growth mindsets. In contrast, bioscience and environmental engineering students showed weaker orientations. A separate MANOVA showed significant urban–rural differences across all three constructs, with urban students consistently reporting higher growth beliefs, particularly in age sensitivity. The CFA provided strong support for the three-factor model, and fit indices confirmed an excellent model fit. These findings highlight that while growth-oriented beliefs about language learning are widespread among Thai undergraduates, disciplinary and geographical disparities remain. The validated three-factor model confirms that intelligence, aptitude, and age sensitivity beliefs are distinct but interrelated dimensions of language mindset. The study highlights the need for tailored interventions to foster growth-oriented language learning environments.

This editorial argues that camouflaging, as developed in autism research, does not transfer coherently to attention-deficit hyperactivity disorder (ADHD). The executive functions required for sustained symptom concealment are precisely those impaired in ADHD. Current measures lack ADHD-specific validity, and compensatory behaviours should not be reclassified as camouflaging without dedicated theory, operational definitions and validated measurement.