Floor Effects Research Articles

Spanish Cross-Cultural Adaptation and Validation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score.

There are no available questionnaires in Spanish that assess the function and performance of shoulder and elbow in overhead sports. The Kerlan-Jobe Orthopaedic Clinic (KJOC) score is a reference tool for this purpose. We aimed to cross-culturally adapt and investigate its measurement properties in Spanish overhead athletes. Cross-cultural adaptation followed the steps of direct translation, back translation, comprehensibility analysis, and review by the Committee of Experts. Then, symptomatic and asymptomatic overhead athletes were invited to complete an electronic version of the Spanish adaptation (KJOC-Sp). The structural validity was evaluated through an exploratory factor analysis with principal axis factoring. Hypotheses were tested for known-groups and convergent validity, studying the correlation with the Shoulder Pain and Disability Index and the Disabilities of the Arm, Shoulder, and Hand Sports Module questionnaires in symptomatic athletes. Cronbach alpha was calculated for internal consistency and intraclass correlation coefficient (ICC)2,1 for test-retest reliability. Floor and ceiling effects and time to completion were also calculated. The KJOC-Sp maintained the content of the original version and was adapted to the new population. One hundred participants (41 females and 59 males) with a mean age of 22.4 (5.9)years participated in the study of measurement properties. The factor analysis revealed a 1-factor solution. Symptomatic participants scored significantly lower than asymptomatic, with a large effect size (P < .001; r = .67). Correlations were of -.60 (P < .05) with the Shoulder and Pain Disability Index questionnaire and -0.66 (P < .05) with the Disabilities of the Arm, Shoulder, and Hand Sports Module questionnaire. Cronbach alpha was .98 (95% confidence interval, .97-.98) and the ICC2,1 was .96 (95% confidence interval .93-.98). No floor or ceiling effects were observed among the symptomatic athletes, while mean time to completion was 121seconds. The KJOC-Sp is equivalent to the original score, aside from valid and reliable, without floor or ceiling effects in symptomatic athletes and with a low time consumption.

PID-5-SRF online administration: psychometric indicators and measurement invariance between different formats of data collection.

The PID-5 is a tool used to assess maladaptive personality traits according to the DSM-5 Alternative Model. Objective: The objective is to seek evidence of the validity and reliability of the Personality Inventory for DMS-5 (PID-5-SRF) admin-istered online and assess its measurement invariance compared to the paper-and-pencil administration. A sample of 274 individuals from the general population (73.4% of women; 34.76 years old ±11.6) completed the instrument online after the study was dissemi-nated on social media and among the authors' contacts. Internal consistency (facets α≥0.70; domains α≥0.89) and test-retest reliability (15 to 30 days: facets ICC≥0.63; domains ICC≥0.82) were satisfactory, but a floor effect was found in almost all the items. A large number of facets (N=9) showed better fit to a bifactorial structure, and the Exploratory Factor Analysis suggested that a six-factor model better fits the data. Measurement invariance between the online and paper-and-pencil administrations was not attested at a configural level. The results revealed satisfactory psychometric indicators when the instrument was applied online, confirming its feasibility in collecting data. However, the in-strument's structure is not invariant, and caution must be adopted when compar-ing and interpreting data collected through different formats.

Assessing a cut-off point for the diagnosis of abnormal uterine bleeding using the Menstrual Bleeding Questionnaire (MBQ): a validation and cultural translation study with Brazilian women.

Abnormal uterine bleeding (AUB) is a common condition, and the Menstrual Bleeding Questionnaire (MBQ) is used for its assessment. To translate, assess the cut-off point for diagnosis, and explore psychometric properties of the MBQ for use in Brazilian Portuguese. Prospective cohort study including 200 women (100 with and 100 without AUB) at a tertiary referral center. MBQ translation involved a pilot-testing phase, instrument adjustment, data collection, and back-translation. Cut-off point was obtained using receiver operating curve analysis. Menstrual patterns, impact on quality of life due to AUB, internal consistency, test-retest, responsiveness, and discriminant validity were assessed. For construct validity, the Pictorial Blood Assessment Chart (PBAC) and World Health Organization Quality of Life - abbreviated version (WHOQOL-BREF) were applied. Women with AUB were older, had higher body mass indices, and had a worse quality of life during menstruation. Regarding the MBQ's psychometric variables, Cronbach's alpha coefficient was > 0.70 in all analyses, high intraclass correlation coefficient was found in both groups; no ceiling and floor effects were observed, and construct validity was demonstrated (correlation between MBQ score, PBAC score, and clinical menstrual cycle data). No difference between MBQ and PBAC scores were perceived after the test-retest. Significant differences were found between MBQ and PBAC scores before and after treatment. An MBQ score ≥ 24 was associated with a high probability of AUB; accuracy of 98%. The MBQ is a reliable questionnaire for Brazilian women. The cut-off ≥ 24 shows high accuracy to discriminate AUB.

Reliability and validity of the Japanese version of the Pediatric Epilepsy Medication Self-Management Questionnaire Caregiver Version

The objectives of this study were to develop a Japanese version of the Pediatric Epilepsy Medication Self-Management Questionnaire Caregiver Version (PEMSQ-J) and to examine its reliability and validity. A quantitative cross-sectional study was conducted among primary caregivers (N=309) of children under the age of 18 taking epilepsy medication. The PEMSQ-J was the main instrument used to collect information such as basic demographics.Cronbach's α was calculated to determine internal consistency, and the intraclass correlation coefficient was calculated to assess reproducibility. In addition, confirmatory factor analysis with covariance structure analysis was performed to confirm the goodness of fit of the model. Finally, criterion-related validity was confirmed. Analysis of responses to items on the PEMSQ-J revealed no ceiling or floor effects, and there was no marked bias in distributions in terms of skewness or kurtosis. Internal consistency assessed with Cronbach's α ranged from 0.847 to 0.935. A test of reproducibility revealed that the intraclass correlation for the total score was 0.730. Exploratory factor analysis identified two factors, which differed from the four factors in the original version. When their details and structure were examined, however, the two were interpreted as having a similar structure. Similarly to those of the original version, the goodness-of-fit indices for the four factors according to confirmatory factor analysis were close to the standard values. The PEMSQ-J, which consists of 27 items with a four-factor structure, was statistically acceptable, and it was found to have a certain degree of reliability and validity.

Translation, cross-cultural adaptation, and validation of health and self-management in diabetes questionnaire (HASMID-10) into Brazilian Portuguese

Considering the ability of the health and self-management in diabetes questionnaire (HASMID-10) to verify the impact of self-management on diabetes, we highlight its relevance to scientific research and clinical applicability. However, to date, no study has been conducted to scientifically support its use in other languages.To translate, cross-culturally adapt, and validate the HASMID-10 into the Brazilian Portuguese.A translation, cross-cultural adaptation, and validation study conducted at Ceuma University.Study was conducted in accordance with the Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures and Consensus-based Standards for the Selection of Health Measurement Instruments. We included participants of both sexes diagnosed with diabetes, aged between 18 and 64 years, and without cognitive deficits or any other limitations that would prevent them from answering the questionnaire. We assessed participants using the problem areas in diabetes (PAID) scale and HASMID-10. We assessed reliability using a test-retest model with a 7-day interval between assessments. We used intraclass correlation coefficient (ICC), 95% confidence interval (CI), standard error of measurement (SEM), minimum detectable difference (MDD), Spearman correlation coefficient, and floor and ceiling effects.Sample comprised 116 participants, most of whom were women, overweight, non-practitioners of physical activity, and nonsmokers. We observed significant correlations (P = 0.006; rho = -0.256) between the HASMID-10 and PAID, adequate reliability (ICC = 0.780) and internal consistency (Cronbach's alpha = 0.796). No ceiling or floor effects were observed.HASMID-10 has adequate measurement properties and may be used for Brazilians.

Cross-cultural adaptation and reliability of the European Portuguese version of the Musculoskeletal Health Questionnaire: A methodological study.

To culturally adapt the Musculoskeletal Health Questionnaire (MSK-HQ) to European Portuguese and evaluate its reliability in individuals with musculoskeletal conditions. The study was carried out in two phases. In the first phase, the MSK-HQ was translated and culturally adapted. In the second phase, a longitudinal observational study was carried out with a convenience sample of participants with musculoskeletal conditions. Data collection began at the start of physiotherapy treatments by filling in the MSK-HQ and Numeric Pain Rating Scale (NPRS). After 4-7 days, the participants were asked to fill out the MSK-HQ once again, as well as the Patient Global Improvement Change (PGIC) scale. The data collected was used to study internal consistency, test-retest reliability, and measurement error. Floor and ceiling effects were also analysed. The MSK-HQ was successfully translated and adapted into European Portuguese. The second phase of the study had a sample of 191 participants. This study demonstrated high internal consistency (Cronbach's α = 0.885) and excellent test-retest reliability (ICC(2,1) = 0.908). The analysis of measurement error resulted in an SEM of 2.818 and an SDC at 7.811. No floor or ceiling effect was observed. The MSK-HQ-PT is a reliable instrument for measuring musculoskeletal health. Further studies on its validity and responsiveness are needed.

The Malnutrition Awareness Scale for community-dwelling older adults: Development and psychometric properties

Background & AimsQualitative studies suggest that malnutrition awareness is poor in older adults. The aim of this study was to develop a questionnaire to quantitatively assess malnutrition awareness in community-dwelling older adults aged 60+ years. MethodsThe Malnutrition Awareness Scale (MAS) was developed based on the awareness phase of the Integrated-Change model, and included four domains: knowledge, perceived cues, risk perceptions, and cognizance. Twenty-six scale items were developed using results from mainly qualitative research and the expertise of the authors. Items were piloted in 10 Dutch older adults using the Thinking Aloud method to optimize wording. In a feasibility study, annoyance, difficulty and time to complete the MAS and its comprehensibility were tested. After final revisions, the MAS was applied to a large sample to test its psychometric properties (i.e., inter-item correlations, Cronbach’s alpha, score distribution) and relevance of the items was rated on a 5-point scale by 12 experts to determine content validity. ResultsThe feasibility study (n=42, 55% women, 19% 80+ y) showed that the MAS took 12±6 min to complete. Most participants found it not (at all) annoying (81%) and not (at all) difficult (79%) to complete the MAS, and found it (very) comprehensible (83%). Psychometric analyses (n=216, 63% women, 28% 80+ y) showed no redundant items, but two items correlated negatively with other items, and one correlated very low. After removal, the final MAS consists of 23 items with a min-max scoring range from 0 to 22 (with higher scores indicating higher awareness) and an overall Cronbach’s alpha of 0.67. The mean MAS score in our sample (n=216) was 14.8±3.2. The lowest obtained score was 6 (n=3) and the highest 22 (n=1), indicating no floor or ceiling effects. Based on the relevance rating, the overall median across all 22 items was 4.0 with IQR 4.0-5.0. ConclusionThe Malnutrition Awareness Scale is a novel, feasible and reliable tool with good content validity to quantitively assess malnutrition awareness in community-dwelling older adults. The scale is now ready to identify groups with poor malnutrition awareness, as a basis to start interventions to increase malnutrition knowledge and awareness.

Validating Athletes’ Subjective Performance Scale: A Rasch Model Analysis

This study aimed to validate the athletes’ subjective performance scale (ASPS) and examine its optimal categorization measuring Korean university athletes using the Rasch model. A six-item ASPS with ten response categories was administered to 201 Korean university athletes participating in team sport events. The Rash measurement program, Winsteps (version 4.6.2.1), was used to perform Rasch analysis. The results showed that the model was a good fit for the data. The Wright-Andrich map indicated ceiling and floor effects, as ASPS items were unable to measure individuals with logits beyond 3 or below -2.5. Furthermore, the reliability of item separation and person separation demonstrated acceptable confidence. Lastly, the findings indicated that the ASPS, which utilized a 10-category rating scale, was problematic due to disordered thresholds. The exploratory analysis revealed that both six and seven-category rating scales appeared to comply with the effective classification criteria, but further research is needed for confirmatory analysis. Previous research has explored the relationships between psychometric factors and subjective performance; however, this study offers valuable insights into optimal categorization and introduces an innovative approach to measuring athletes’ subjective performance. To assess subjective sport performance satisfaction, the authors propose employing a six-category rating scale, which this study found to be reliable and valid in relation to construct.

Behavior Rating Inventory of Executive Function in Preschool (BRIEF-P) and Attention-Deficit and Hyperactivity Disorders (ADHD): A Systematic Review and Meta-Analysis of Floor and Ceiling Effects.

ADHD is a neurodevelopmental disorder that is accompanied by executive challenges. To obtain evidence of the usefulness of the BRIEF-P and to analyze the possible ceiling and floor effect of its scores in the assessment of executive function in preschoolers with signs compatible with a possible diagnosis of ADHD. A search was performed in Science Direct, NCBI (PubMed), and ProQuest Education Journals during the period 2012-2022. We included studies that evaluated samples of individuals with symptomatology compatible with ADHD, with an age range between 2 and 6 years, published in English or Spanish. Of a total of 2538 articles, only seven met the inclusion criteria. The risk of bias was assessed using the QUADAS-2 questionnaire. The main variables were age and executive functioning. Executive deficits in early-age individuals with symptoms compatible with ADHD are more extensive than just deficits in working memory. A floor effect has been found in tests associated with hot executive functions and a ceiling effect in cold executive functions. This makes it necessary to use different tests to assess executive performance in preschoolers with ADHD-compatible symptomatology and to design intervention proposals accordingly. The BRIEF-P is an instrument that facilitates obtaining a sensitive and discriminative executive profile, although it should be used in combination with other neuropsychological performance tests.

Speech-in-Noise Recognition in School-Aged Children with Hearing Loss: Evidence of a Critical Condition

Previous research findings demonstrated that cochlear implants (CIs) users have essential challenges with speech recognition in the presence of background noise. Therefore, this study aimed to determine speech-in-noise (SiN) perception in Persian school-aged children with CIs/hearing aids (HAs) compared to their peers with normal hearing (NH). The research was administered as a cross-sectional study. Speech-in-noise performance in thirty-three school-aged children with hearing loss (19 unilateral CIs users and 14 bilateral HAs users) was compared to twenty school-aged children with normal hearing by using the Persian Lexical Neighborhood Tests (PLNTs). To make sure that floor or ceiling effects would not affect the children’s performance, the PLNTs were performed by the sound field at different levels of signal-to-noise ratio (SNR). The SiN performance on all four subscales of the PLNTs was significantly poorer in Persian school-aged CIs/HAs users than their peers with NH for all stepwise increases in the SNR (P &lt; 0.001). The Persian school-aged CIs users experience a critical condition related to listening spectrally degraded speech in noisy environments such as home, school, and classroom due to SiN perception insufficiency.

Cross-Cultural Adaptation and Validation of the Russian-Language Version of the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS)

Background. Developed in 1994 by H. Kitaoka et al. the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale (AOFAS-AHS) allows to assess pain, function, deformity and alignment of the foot and ankle. There is no Russian-language AOFAS-AHS questionnaire adapted according to current standards in the scientific literature.&#x0D; The aim of this paper is to perform the cross-cultural adaptation and to assess the validity of the Russian-language version of the AOFAS-AHS scale, including the evaluation of its psychometric properties.&#x0D; Methods. The original English version of the AOFAS-AHS scale was translated from English into Russian by a native Russian speaker. Then the questionnaire was back-translated into English by another translator whose native language is English. The next stage was the comparison of the original and back-translated versions, followed by the presentation of a pre-final cross-culturally adapted version, which was tested on 10 patients to ensure that the questions were comprehensible. The next step was the approval of the final version and its completion by patients to be operated on the hindfoot or ankle. The printed copy of the final version of the questionnaire was completed by the patients with an interval of 3 days. Total of 44 consecutive patients were enrolled, including 18 women (41%) and 26 men (59%), with a mean age of 61.7 (32-78) years. The psychometric properties of the Russian-language version of the AOFAS-AHS questionnaire (internal consistency, retest reliability, measurement error, responsiveness, and construct validity) were assessed based on the COSMIN (COnsensus-based Standards for the selection of health status Measurement INstruments) principles.&#x0D; Results. The mean score according to the AOFAS-AHS scale was 49.6 (min 2; max 82) out of a possible 100. The average time to complete the questionnaire was 4.2 minutes. All hypotheses formulated showed correlations of varying moderate to strong degrees. The Cronbach’s alpha coefficient was 0.76, which indicates a high level of internal consistency of the elements of the validated questionnaire. A good intra-class consistency of 0.83 was obtained, which shows a high degree of reliability of the questionnaire’s reproducibility. The ceiling and floor effects for the primary results of the questionnaires did not exceed 15%. The mean value of the Russian-language version of the AOFAS-AHS increased to 86.6 after surgical treatment. The values of standardized effect size (ES) and standardized response mean (SRM) were 5.56 and 4.83, respectively.&#x0D; Conclusion. The adapted Russian-language version of the AOFAS-AHS scale showed good psychometric properties and can be recommended for assessment of the physical activity in patients with ankle and hindfoot-related pathology and can also be used for monitoring the changes during the treatment.

Psychometric evaluation and cross-cultural adaptation of the Australian Pelvic Floor Questionnaire (APFQ-IR) in Iranian reproductive age women

Pelvic floor disorders (PFDs), as a silent alert, is one of the pervasive debilitating health concerns among women all over the world, such that in developed countries, one in four women, suffers from PFDs. Validity and reliability of the Australian Pelvic Floor Questionnaire (APFQ) has not been determined in Iran, so to determine APFQ’s psychometric characteristics, we decided to conduct this study on women of reproductive age in Tabriz city, Iran. This methodological cross-sectional study was intended to determine the psychometric properties of the Persian version of the APFQ-IR in 5 steps including “translation process, content validity, face validity, construct validity (exploratory and confirmatory factor analyses and examination of ceiling and floor effects) and reliability” on 400 reproductive age women referring to health centers in Tabriz city, Iran, with cluster random sampling method in the period between May 2022 to September 2022. The translation process was done based on two approaches, Dual panel, and Beaton et al.’s five steps. Then, in order to evaluate content validity, face validity, and construct validity, 10 instrument and PFDs experts, 10 women from the target group investigated the instrument's items, and 400 eligible women completed the instrument. Finally, to determine the reliability, two internal consistency methods, (Cronbach's alpha and McDonald's omega) and test–retest method (ICC) were used. In the present study, content validity assessment of APFQ-IR, showed a good level of validity (CVR = 0.96, CVI = 0.94). To assess construct validity, exploratory factor analysis results on 36 items, led to the identification of 4 factors including bladder function, bowel function, prolapse symptom and sexual function, which explained 45.53% of the cumulative variance and indicated the sufficiency of the sample size (Kaiser–Meyer–Olkin = 0.750). Implementing confirmatory factor analysis, (RMSEA = 0.08, SRMR = 0.08, TLI = 0.90, CFI = 0.93, χ2/df = 3.52) confirmed the model fit indices. Finally the internal consistency and reliability was high for the entire instrument (Cronbach’s alpha = 0.85; McDonald's omega (95% CI) = 0.85 (0.83–0.87) and Intraclass Correlation Coefficient (95% CI) = 0.88 (0.74–0.94)). The Persian version of the APFQ-IR, has a good validity and reliability and has acceptable psychometric properties, thus can be used both for research purposes and for clinical evaluation of pelvic floor disorders symptoms in health centers.

A Preliminary Comparison of the Katrak Hand Movement Scale With the Upper Extremity Fugl Meyer Assessment Shows a Strong Correlation After Stroke

ObjectiveTo investigate the concurrent validity of the KHMS with the FMA-UE. DesignThe FMA-UE and the KHMS were administered to 50 adults with stroke to evaluate their concurrent validity. SettingThree tertiary rehabilitation hospitals. ParticipantsParticipants were aged ≥18 years, receiving stroke or rehabilitation services from a participating hospital, and had a confirmed diagnosis of stroke (ischemic or hemorrhagic) with upper limb involvement. Fifty patients were recruited to the study (20 women, 30 men, N=50) with a mean age of 71 (SD 13.4, range 35-90) years. Time since stroke varied from 2 days to 187 months, with a median of 0.8 months. InterventionsNot applicable. Main Outcome MeasuresConcurrent validity of the KHMS with the FMA-UE. ResultsA correlation of r=0.948 was found between the 2 scales (P=.0001). Moderate floor effects were noted in our sample (16%); however, significant ceiling effects were recorded (44%). ConclusionThe KHMS demonstrated a statistically strong correlation with the FMA-UE and holds promise for use, particularly in the clinical setting, to evaluate upper limb motor impairment after stroke.

Numerical Analysis of the Effect of Floor Depression on the Extent of Thermal Interaction with the Ground and Energy Management Using a Vegetable Cold Store as an Example

The thermal interaction between cooling facilities and the ground is most often discussed in terms of the appropriate insulation of building partitions. Unfortunately, there is little information about the potential of using ground thermal accumulation to support the shaping of the microclimate in cooling facilities by embedding them in the ground. This problem is particularly important in the context of striving to reduce the energy demand of buildings. The article discusses a new scientific problem related to the effect of vegetable cold storage floors being recessed into the ground on the surrounding land’s impact range and on its energy management. Validation of the numerical model was performed based on actual year-round field surveys. These surveys were conducted in a free-standing vegetable cold storage facility located in southern Poland. The results of the study allowed us to determine the contribution of the land to the energy balance of the cold storage. A floor recessed into the ground doubled the ground’s contribution to the energy balance. The most important research results showed that the range of thermal impact on the surrounding ground also increased by 2.0 m more than that of a building with the floor located at ground level. An evaluation of the heat flow between the cold storage and the ground in the cases analyzed was also carried out. The analysis of the ground heat exchange balance on an annual basis showed high energy gains of 2055 kWh. The total energy demand for cooling was 1723 kWh, while it was 1204 kWh for heating. The results of the analysis of the heat exchange intensity between the indoor air and the ground showed that the ground contribution accounted for 16.6% of the total energy balance of the cold storage. The highest energy gains from the ground were found in October and amounted to 478 kWh. Due to the summer shutdown, there was an intense heat flow to the ground in July, which amounted to 588 kWh.

Vortioxetine Reverses Impairment of Visuospatial Memory and Cognitive Flexibility Induced by Degarelix as a Model of Androgen Deprivation Therapy in Rats

Introduction: Androgen deprivation therapy (ADT) is a mainstay treatment for prostate cancer, but many patients experience cognitive impairment in domains mediated by the medial prefrontal cortex (mPFC) and hippocampus. Prostate cancer typically occurs in older patients (>65 years). As age is often accompanied by cognitive decline, it may impact the efficacy of any treatment aimed at restoring cognitive impairment induced by ADT. Vortioxetine, a multimodal antidepressant that improves cognition in depression, has been shown to be efficacious in elderly patients. Therefore, vortioxetine may improve cognition in older patients who experience cognitive decline after ADT. Methods: Young (3 months) and middle-aged (13 months) rats were used to investigate the influence of age on treating ADT-induced cognitive decline. As our previous studies used surgical castration, we tested if vortioxetine would reverse cognitive deficits associated with more translationally relevant chemical castration using degarelix. Vortioxetine was given in the diet for 21 days. Animals underwent behavioral testing to assess visuospatial memory mediated by the hippocampus and cognitive flexibility mediated by the mPFC. We also investigated changes in afferent-evoked responses in these regions in middle-aged rats. Results: Degarelix induced impairments in both visuospatial memory and cognitive flexibility that were reversed by vortioxetine. Vortioxetine also rescued afferent-evoked responses in the mPFC and hippocampus. However, modest age-related reductions in baseline visuospatial memory limited our ability to detect further decreases induced by degarelix in middle-aged rats due to a floor effect. Conclusion: These results suggest that vortioxetine may be a treatment option for older prostate cancer patients who experience cognitive decline after ADT.

Clinimetric properties of the Perme Intensive Care Unit Mobility Score

Background:The use of instruments in clinical practice with measurement properties tested is highly recommended, in order to provide adequate assessment and measurement of outcomes. Objective:To calculate the minimum clinically important difference (MCID) and responsiveness of the Perme Intensive Care Unit Mobility Score (Perme Score). Methods:This retrospective, multicentric study investigated the clinimetric properties of MCID, estimated by constructing the Receiver Operating Characteristic (ROC). Maximizing sensitivity and specificity by Youden's, the ROC curve calibration was performed by theHosmer and Lemeshow goodness-of-fit test. Additionally, we established the responsiveness, floor and ceiling effects, internal consistency, and predictive validity of the Perme Score. Results:A total of 1.200 adult patient records from four mixed general intensive care units (ICUs) were included. To analyze which difference clinically reflects a relevant evolution we calculated the area under the curve (AUC) of 0.96 (95% CI: 0.95-0.98), and the optimal cut-off value of 7.0 points was established. No substantial floor (8.8%) or ceiling effects (4.9%) were observed at ICU discharge. However, a moderate floor effect was observed at ICU admission (19.3%), in contrast to a very low incidence of ceiling effect (0.6%). The Perme Score at ICU admission was associated with hospital mortality, OR 0.86 (95% CI: 0.82-0.91), and the predictivevalidity for ICU stay presented a mean ratio of 0.97 (95% CI: 0.96-0.98). Conclusions:Our findings support the establishment of the minimum clinically important difference and responsiveness of the Perme Score as a measure of mobility status in the ICU.

Applicability of the Online Short Spatial Ability Battery to university students testing

Introduction. Multiple studies advocate an importance of spatial abilities (SA) for educational and occupational success, especially in STEM. Recently an Online Short Spatial Ability Battery (OSSAB) was developed and normed for SA testing in adolescents. The battery includes mechanical reasoning, paper folding, pattern assembly, and shape rotation tests. The battery has shown good psychometric characteristics (high reliability and validity, low redundancy, discriminative power), and is available in open access and free to use.Aim. The present research aims: 1) to examine the applicability of the OSSAB for university student testing; 2) to describe its psychometric properties and structure; and 3) to investigate links between SA and educational performance.Methods. A total of 772 university students (aged from 18 to 26, mean age (SD) = 19.55 (1.51), 63.1% females) participated in the study. Participants provided information about their age, gender, university major, and academic achievement, and completed a battery of tests that included the OSSAB tests.Results. The study reports psychometric norms for using the OSSAB in university students. Students’ performance in the OSSAB was similar to that shown in previous research in adolescents in terms of means and variance. The OSSAB showed adequate psychometric properties in this sample: no floor or ceiling effects; low redundancy; moderate to high internal consistency; high discriminative power across university majors; and high external validity. The results indicated that around 6% of the students showed very high levels of SA (higher than 1.5 SD above the mean), and around 8% of students showed very low levels of SA (lower than 1.5 SD below mean). In addition, the OSSAB scores were linked to educational profile choice and exam scores, with small-to-medium effect sizes.Scientific novelty. The study provides psychometric norms for a short online open measure of spatial ability in university students.Practical significance. The OSSAB can be used to provide individual recommendations to students (e.g. SA training), to identify spatially gifted students, and for research purposes in university contexts.

Regular Physical Exercise Adherence Scale (REPEAS): a new instrument to measure environmental and personal barriers to adherence to regular physical exercise

ObjectiveTo create, develop, and validate a scale that identifies the environmental and personal barriers that make it difficult to adhere to the practice of physical exercise on a regular basis in a population of Brazilian adults.MethodsWe include adult individuals, aged 18–59 years, practitioners or former practitioners of physical exercise, with Brazilian Portuguese as their mother tongue. In the development and validation phases of the process, 6 specialists in the field of the health assessed the content validity: firstly, the specialists were asked to freely list the questions they would ask to investigate the barriers to adherence to regulating physical activity. Secondly, after compiling all the suggestions listed and eliminating suggestions with similar content, the items suggested in the first round were sent to the specialists so that an evaluation of all questions using a 5-point Likert scale and the content validity coefficient was calculated. We then evaluated the structural validity, construct validity, reliability, internal consistency, and ceiling and floor effects of the Regular Physical Exercise Adherence Scale (REPEAS).ResultsSixteen items were proposed to measure the factors that make it difficult to adhere to the regular practice of physical exercise. The internal structure of the REPEAS initially tested was based on the theoretical proposal of creating the instrument with two domains. After the structural analysis, we used the modification indices to identify the redundant items of the instrument. Consequently, the final version of the REPEAS after factor analysis had 12 items. Thus, the structure with 2 domains and 12 items presented adequate fit indices. With regard to construct validity, the REPEAS scores were compared in two distinct groups: irregular practitioners/ex-practitioners versus regular practitioners of physical exercise, in which a significant difference could be observed between groups (p < 0.001) for both the domains. Acceptable reliability was observed for the environment and personal domains, with ICC values of 0.86 and 0.94, in the same order. For internal consistency, Cronbach's alpha value was 0.908 (environmental domain) and 0.915 (personal domain), these values being adequate for the REPEAS.ConclusionThe REPEAS is a scale with a valid two-dimensional internal structure, consisting of 12 items, reliable and with a valid construct, which supports its use in the clinical, epidemiological, and research contexts in Brazil.

Psychometric Properties of the Persian Version of the Comfort Questionnaire for Hand tools (CQH)

Objectives: The comfort questionnaire for hand tools (CQH) is a subjective measure for exploring the starting points for improving hand tool design. This study aimed to investigate the psychometric properties of the Farsi version of the CQH.&#x0D; Methods: In this cross-sectional study, which was conducted among 163 university students, the 17-question CQH was translated into Farsi with a translation back-translation procedure. Content validity was assessed by a panel of 10 experts. Exploratory Factor Analysis (EFA) was applied for determining construct validity. Cronbach’s alpha and Intraclass Correlation Coefficient (ICC) were used for assessing internal consistency and test-retest reliability, respectively. Ceiling and floor effects were also estimated for evaluating the feasibility of the measure.&#x0D; Results: The CQH showed good content validity. Content validity index (CVI) ranged from 0.80 to 1.00 and Content Validity Ratio (CVR) ranged 0.62-1.00. EFA led to extraction of two factors from the data. The first one was mostly related to functionality and physical interaction and the second one, was generally about adverse body effects. The Cronbach’s alpha was 0.74 and test-retest reliability was 0.74 (95% CI = 0.58 to 0.86) which both were satisfactory. There were no (0%) ceiling and floor effects.&#x0D; Conclusion: The Farsi version of CQH is an acceptable and useful instrument for evaluating hand tools comfort.

Beyond 10-year lead-times in EQ-5D-5L: leveraging alternative lead-times in willingness-to-accept questions to capture preferences for worse-than-dead states and their implication.

A fixed 10-year lead-time in composite time-trade-off (C-TTO) tasks might compromise the precision of utility values below -1. This study explored how alternative lead-times (ALTs) influence EQ-5D-5L value sets and their implications in economic evaluations. Leveraging data from Taiwan's EQ-5D-5L valuation and capitalizing on its exploratory willingness-to-accept question, we explored participants' quantification of "worse-than-dead (WTD)" health states with ALTs up to 50years. We then derived alternative value sets incorporating these ALTs through interval regression and compared them against those from conventional models. To evaluate their impact on health change valuation, we simulated utility differences for all possible EQ-5D-5L health-state-pairs using each value set. With a salient floor effect observed in the C-TTO values, the model with ALT led to a wider range of predicted utilities ( - 2.3897 ~ 1), compared with those of conventional models (generalized least squares (GLS): - 0.7773 ~ 1; Tobit-GLS: - 0.9583 ~ 1). Compared to the Tobit-GLS model, the model with ALT increased the numerical distance in 80% of health-state-pairs, with 11% decreasing and 9% altering direction (e.g., positive to negative) in utility differences. While ALTs offer insights into patient preferences, their integration into economic evaluations might require rescaling. Future research should prioritize advanced rescaling methods or enhanced elicitation strategies for populations with substantial censoring. This is pivotal for improving the elicitation of extreme WTD states and accurately discerning the relative distances between health states. Countries developing EQ-5D-5L value sets should consider pilot studies and incorporating region-specific questions on social determinants, especially where pronounced floor effects are suspected.