Operational Equivalence Research Articles

Conversion of Sewage Sludge to combined heat and power: Modeling and optimization

Combined Heat and Power (CHP) generation from Sewage Sludge (SS) offers two simultaneous advantages: greenhouse gas emission reduction and increase of renewable energy generation as promoted by the European Union Green Deal 2021. In this work, a numerical model has been developed via Aspen Plus for the evaluation of CHP generation potentiality from SS through gasification integrated with an internal combustion engine system. The model is applied to the case of Italy and eight other European countries for the first time. The gasification model has been developed based on the experimental data on syngas generation from SS in a bench-scale rotary kiln reactor under laboratory conditions available in the literature. Sensitivity analysis revealed optimal operating temperature and equivalence ratios for gasification were 900 °C and 0.2 respectively. The CHP generation potentiality of SS resulted to be 2.73 kWh per kg SS as dry solid.According to the statistical analysis used in the present study, SS generation will reach 680 kt per year as dry solid by 2030 based on the current sludge generation rate as well as improvement in the wastewater collection and treatment expected for the future in Italy. Within this time, the projected electrical and thermal energy generation rate per year can reach 714 GWh and 1142 GWh respectively. Electrical and thermal energy generation rates from sewage sludge have been estimated for eight EU countries in 2015 and compared with the Italian scenario, founding the highest one in Spain and the lowest in Luxembourg.

EHEALS as a predictive factor of digital health information seeking behavior among Brazilian undergraduate students.

This study aimed to perform the cross-cultural adaptation and validation of the eHealth Literacy Scale (eHEALS) for Brazilian Portuguese. The cross-cultural adaptation was conducted through conceptual equivalence, verbatim translation, semantic, item and operational equivalence, and back-translation. Subsequently, 521 undergraduate students answered the adapted version of the eHEALS, the General Perceived Self-Efficacy Scale (GSES), the Oral Health Impact Profile-14 (OHIP-14) and sociodemographic and health-related questions. Statistical analysis was performed to determine the dimensionality, internal consistency, stability and concurrent/convergent/discriminant/predictive validities of the eHEALS (p < 0.05). The adequacy of sample size was confirmed by a non-identity correlation matrix (Bartlett's test of sphericity, p < 0.001), without influence of multicollinearity (determinant = 0.026). The confirmatory factor analysis identified four factors in agreement to the constructs namely as online searching self-efficacy, awareness of available sources, information usage ability, and critical analysis of useful information. The eHEALS displayed an excellent internal consistency (Cronbach's alpha = 0.88), a good stability (ICC = 0.71, 95% CI: 0.49-0.84), and it was significantly correlated with GSES (concurrent validity). Higher eHEALS scores were identified among (i) white and (ii) younger students, (iii) from health sciences courses, (iv) with more years of graduation, (v) who their fathers were working in specialized functions (discriminant validity), and (vi) among those who were frequently interested in digital health information (convergent validity). The students with higher eHealth literacy levels were more likely to seek health information in the last 24 h (predictive validity). In conclusion, the eHEALS demonstrated adequate psychometric properties to be applied for the Brazilian population.

Translation, transcultural adaptation and validation to Brazilian Portuguese of tools for adverse drug reaction assessment in children

BackgroundChildren are more vulnerable to adverse drug reactions (ADRs) due to complex changes in the body during the growth process and lack specific pharmacoepidemiologic studies. Causality and Avoidability assessment of ADRs are relevant to clinical guidelines development and pharmacovigilance. This study aimed to translate and transcultural adapt two new tools—Liverpool Causality Assessment Tool (LCAT) and the Liverpool Avoidability Assessment Tool (LAAT)—to Brazilian-Portuguese and evaluate the psychometric properties of these tools to analyse ADRs in Brazilian children.MethodsThe validation of the cross-cultural adaptation of tools was obtained by the functional (conceptual, semantic, operational, and measurement) equivalence between the original and translated versions of each instrument. The translated version of LCAT and LAAT was applied to assessing the twenty-six case reports of suspected adverse drug reactions in a Brazilian teaching paediatric hospital. The inter-rater reliability (a pharmacist and a physician) was evaluated using Cronbach’s alpha. The exact agreement percentages (%EA) and extreme disagreement (%ED) were computed. Overall Kappa index was calculated with a 95% confidence interval.ResultsThere was a need to modify some terms translated into Portuguese for semantic and conceptual equivalence. The Cronbach’s alpha coefficient values obtained were 0.95 and 0.85, and the weighted Kappa (95% confidence interval) were 0.82 (0.67–0.97) and 0.68 (0.45–0.91) for LCAT and LAAT, respectively. The Brazilian-Portuguese versions of the LCAT and LAAT showed reliable and valid tools for the diagnosis and follow-up of ADRs in children.ConclusionThe methodological approach allowed the translation, transcultural adaptation, and validation to Brazilian-Portuguese of two easy and quick to perform tools for causality and avoidability of ADRs in children by a multidisciplinary expert specialist committee, including the authors of original tools. We believe these versions may be applied by professionals (patient safety teams) and researchers in Brazil in groups or by a single reviewer.Trial registrationThis study was evaluated and approved by the Research Ethics Committee (Instituto de Pediatria e Puericultura Martagão Gesteira – Federal University of Rio de Janeiro – Number: 3.264.238.

Adapting the Trauma History Questionnaire for use in a population of homeless people with severe mental illness in Tamil Nadu, India: qualitative study.

The Trauma History Questionnaire (THQ) is one of the most widely used traumatic event inventories, but its lack of validation makes it unsuitable for the millions of homeless people with severe mental illness in India, who are particularly vulnerable to trauma exposure. To translate and culturally adapt the THQ for use in a population of homeless people with severe mental illness in Tamil Nadu, India. We used Herdman et al's model of cultural equivalence to conduct an in-depth qualitative assessment of the cultural validity of the THQ. Following several translations, conceptual, item, semantic and operational equivalence of the THQ was assessed through four focus groups with user-survivors (n = 20) and two focus groups with mental health professionals (n = 11). Several adaptations, including the addition of 18 items about relationships, homelessness and mental illness, were necessary to improve cultural validity. Three items, such as rape, were removed for reasons of irrelevance or cultural insensitivity. Items like 'adultery' and 'mental illness' were reworded to 'extramarital affair' and 'mental health problem', respectively, to capture the cultural nuances of the Tamil language. Findings revealed a divergence in views on tool acceptability between user-survivors, who felt empowered to voice their experiences, and mental health professionals, who were concerned for patient well-being. Providing a sense of pride and autonomy, user-survivors preferred self-administration, whereas mental health professionals preferred rater administration. Culture significantly affects what types of events are considered traumatic, highlighting the importance of cultural validation of instruments for use in novel populations and settings.

How was the cooking skills and healthy eating evaluation questionnaire culturally adapted to Brazil?

Abstract The study described the cross-cultural adaptation process of the American Cooking Skills and Healthy Eating questionnaire to Brazil. Six stages were followed: Translation; Synthesis of translations; Back-translations; Expert Committee; Synthesis of final version; and the Pretest (self-administered online questionnaire in a Brazilian University). Participants responded to the translated questionnaire twice for test-retest. Conceptual, item, semantic, operational and measurement equivalences were evaluated between original and translated questionnaires, as well as the internal consistency and test-retest reliability. Item, conceptual, semantic equivalences between original and Brazilian questionnaires were reached before the Expert Committee stage. Specific cooking techniques and terms were adapted. Forty-eight students answered the questionnaire in the pre-test stage, achieving the operational and measurement equivalences with kappa’s agreement from moderate to substantial, and satisfactory to excellent correlations between measures. Only two measures showed low internal consistency. The combination of stages and equivalences approaches used in this cross cultural adaptation study provided lessons for further Nutrition’s researches, disclosing the complexity of cooking skills concepts.

Hypothesis Testing and Identification Systems

We study hypothesis testing problems with fixed compression mappings and with user-dependent compression mappings to decide whether or not an observation sequence is related to one of the users in a database, which contains compressed versions of previously enrolled users' data. We first provide the optimal characterization of the exponent of the probability of the second type of error for the fixed compression mappings scenario when the number of users in the database grows exponentially. We then establish operational equivalence relations between the Wyner-Ahlswede-Körner network, the single-user hypothesis testing problem, the multi-user hypothesis testing problem with user-dependent compression mappings and the identification systems with user-dependent compression mappings. These equivalence relations imply the strong converse and exponentially strong converse for the multi-user hypothesis testing and the identification systems both with user-dependent compression mappings. Finally they also show how an identification scheme can be turned into a multi-user hypothesis testing scheme with an explicit transfer of rate and error probability conditions and vice versa.

Cross-cultural adaptation of a quality of life questionnaire for individuals with oral potentially malignant disorders in the Brazilian context.

The aim of this article is to describe the cross-cultural adaptation of a quality of life (QoL) questionnaire for individuals with potentially malignant oral diseases (OPMD) in the Brazilian context. This methodological study consisted of the following stages of content validation process: (1) Conceptual and item equivalence: stage during which a comprehensive literature review on the construct was performed; (2) Semantic equivalence. The extensive literature review showed that the questionnaire enables evaluation of QoL, and that domains and items are also considered and relevant to the Brazilian context. Semantic equivalence was evaluated as satisfactory by a committee of judges. The scope of the domains was analyzed according to the agreement rate and presented results equal to or greater than 84%. The general Content Validity Calculation (CVC) was 0.84 for clarity and 0.92 for representativeness. Of the 20 items, 18 presented CVC values above 0.8. The indicators for content validation, pre-test and operational equivalence indicate that the Brazilian version of the OPMD QoL questionnaire is a promising instrument and a tool that seems valid to evaluate the quality of life of people with oral potentially malignant disorders. As a next step, it is important to measure equivalences to evaluate the psychometric properties of this instrument.

Unitary equivalence of multiplication operators on the Bergman spaces of polygons

AbstractIn this paper, we will show that the unitary equivalence of two multiplication operators on the Bergman spaces on polygons depends on the geometry of the polygon.

Characterization of Noncontextuality in the Framework of Generalized Probabilistic Theories

To make precise the sense in which the operational predictions of quantum theory conflict with a classical worldview, it is necessary to articulate a notion of classicality within an operational framework. A widely applicable notion of classicality of this sort is whether or not the predictions of a given operational theory can be explained by a generalized-noncontextual ontological model. We here explore what notion of classicality this implies for the generalized probabilistic theory (GPT) that arises from a given operational theory, focusing on prepare-measure scenarios. We first show that, when mapping an operational theory to a GPT by quotienting relative to operational equivalences, the constraint of explainability by a generalized-noncontextual ontological model is mapped to the constraint of explainability by an ontological model. We then show that, under the additional assumption that the ontic state space is of finite cardinality, this constraint on the GPT can be expressed as a geometric condition which we term simplex-embeddability. Whereas the traditional notion of classicality for a GPT is that its state space be a simplex and its effect space be the dual of this simplex, simplex-embeddability merely requires that its state space be embeddable in a simplex and its effect space in the dual of that simplex. We argue that simplex-embeddability constitutes an intuitive and freestanding notion of classicality for GPTs. Our result also has applications to witnessing nonclassicality in prepare-measure experiments.

Selective Exhaust Gas Recycling in Gas Turbines with CO2 capture: A comprehensive technology assessment

Modern gas turbines operate with large amounts of excess air for cooling and dilution of the combustion gases, in order to maintain gas turbine blade integrity. Selective recycling of CO2 into the gas turbine compressor inlet, also referred as Selective Exhaust Gas Recirculation (SEGR), can reduce the large volumetric flow rate through a CO2 capture system caused by the gas turbine excess air requirements, by 70 - 77%. It also increases CO2 concentrations to 14-18 vol% from 3-4% vol, increasing the driving force for post-combustion capture systems. This paper provides a comprehensive assessment of the concept and presents research outcomes from the UK-funded SELECT project, including power plant and process modelling, techno-economic assessments, pilot-scale gas turbine experimental work and experimental combustion tests on a representative combustor. Using an integrated model of turbomachinery, power cycles and a generic post-combustion CO2 capture technology with a 30%wt MEA solvent, we show that a reduction of up to 50% of the absorber of the capture plant – the most capital intensive part of the process – can be achieved. The compressor and gas turbine operate without any significant deviation from their design point, and a marginal increase of 0.5% point in the net electrical efficiency can be achieved. Pilot-scale testing - conducted at the Pilot Scale Advanced Capture Technologies (PACT) facilities at the University of Sheffield - show that CO2 injection at the compressor inlet of a 100 kW micro gas turbine (mGT) connected to a 1 tonne per day CO2 capture plant reduces net electrical efficiency by 1-2 %point. This is caused by lower flame temperatures, and, unlike in larger gas turbines, the control system of the micro gas turbine. Combustion tests at Cardiff University’s Gas Turbine Research Centre (GTRC) in a pilot-scale high-pressure generic premixed swirl burner, representative of modern dry-low emissions (DLR) gas turbine burners, show the effect of CO2 as diluent on the operational premixed CH4/air flame stability, chemical kinetics and measured exhaust gas composition. CO2 acts as a combustor inhibitor, causing downstream migration of the premixed flame zone, leading to eventual blow-off, instability and extinction, requiring a change in the operation equivalence ratio. The effect of adding CO2 leads to a reduction in the adiabatic flame temperature due to thermal quenching, which results in higher CO emissions and smaller thermal NOx emissions. Increasing pressure has a significant reducing effect on CO emissions, yet it results in higher NOx production, which may require mitigation if this trend is found to continue towards pressures approaching that of the F-class gas turbine. Finally, a conceptual design assessment of a regenerative adsorption wheel with structured adsorbents is proposed for the selective recycling of CO2 in combined cycle gas turbine (CCGT) power plants. It has the advantage of a relatively small pressure drop to reduce the derating of the gas turbine compared to selective CO2 membrane systems. An equilibrium model of a rotary adsorber with commercially available activated carbon adsorbents shows that four rotary wheels of 24 m diameter and 2 m length would be required in an 820MW CCGT plant. A reduction of 50% in the mass of adsorbent would be possible with an adsorbent with a higher capacity, such as Zeolite X13, with upstream dehydration of the flue gases.

Cross-Cultural Adaptation and Evaluation of the Participation and Environment Measure for Children and Youth to the Indian Context-A Mixed-Methods Study.

Culturally appropriate measures enable knowledge transfer and quality improvement of rehabilitation services in diverse contexts. The Applied Cultural Equivalence Framework (ACEF) was used in a two-phased mixed methods study to adapt and evaluate the Participation and Environment Measure-Children and Youth (PEM-CY) in India. Cognitive interviews with caregivers of children with disabilities (n = 15) aged 5–17 years established conceptual, item, semantic, and operational equivalence of the Indian PEM-CY. Construct validity was assessed by comparing PEM-CY scores of children with and without disabilities (n = 130) using a case-control design. Cognitive interviews resulted in operational (60.3%), semantic (26.4%), and item-level (13.2%) modifications in the PEM-CY with no changes at the conceptual level. Internal consistency (n = 130) was acceptable to excellent (0.61–0.87) on most scales. Test–retest reliability (n = 30) was good to excellent (ICC ≥ 0.75, Kappa 0.6–1.0) for most scales. Significant differences in all PEM-CY summary scores were found between children with and without disabilities, except for environmental supports. Children with disabilities had lower scores on frequency and involvement in activities across all settings; their caregivers desired greater change in participation and reported experiencing more environmental barriers across settings. Findings suggest the adapted PEM-CY is a valid and reliable measure for assessing the participation of Indian children.

Air-gasification of pine sawdust using dolomite as in-bed material: Effects of gasification conditions on product characteristics

Air-gasification has emerged as preferred means of converting biomass to valuable synthesis gas (syngas). In present work, the gasification characteristics of pine sawdust were studied in a small-scale fluidized bed using calcined dolomite as in-bed material. Dolomite is characterized by higher tar conversion and H2 production during biomass gasification. Different operation conditions, equivalence ratios, reaction temperatures and dolomite contents, are studied for their influence on the gas compositions, gas yields, tar yields and higher heating values of producer gas. The results show that increasing either temperature or dolomite content enhances the tar conversion, where the latter accounts for the syngas with the lowest tar content. At 850 °C, the addition of 50 wt% dolomite can increase the gas yield from 1.48 to 1.85 Nm3/kg, and lowering the tar yield from 11.5 to 4.6 g/Nm3. Furthermore, the addition of more dolomite enhances the quality of the product gas, as indicated by increased values of the higher heating values of producer gas. Increasing the dolomite content within the 0–50% range resulted in higher H2 and CO contents, whereas the CH4 content declined. A slight change in CO2 content was observed with increasing dolomite content, which might cause by the limited carbonation. In contrast, the H2 content enhances non-linearly with the increase of dolomite content, which indicates that the catalytic activity of dolomite improves with the increase of dolomite share in the feedstock, due to the reforming of tar over dolomite. Increasing the ER from 0.14 to 0.3 elevates the gas yield, but decreases the tar yield and increases the H2 content in the product gas.

Instruments to assess children’s language and speech translated and adapted into Brazilian Portuguese: an integrative literature review

ABSTRACT Purpose: to analyze the content and translation guidelines of instruments meant to assess language, speech sound production, and communicative skills of children, adapted to Brazilian Portuguese. Methods: a search was conducted in national and international databases to select articles on the assessment of language, speech, and communicative skills in children, considering the descriptors “translation”, “adaptation”, “cultural adaptation”, “cross-cultural adaptation”, “language”, “speech”, and “pragmatic”. The search was conducted in the SciELO, Virtual Health Library, PubMed/MEDLINE, and Latin American and Caribbean Health Sciences Literature. Results: eight assessment instruments compatible with the inclusion criteria were found. Conclusion: of the instruments found, four approached specific investigations, such as syntax, narrative, pragmatic skills, and speech sound organization, while the other four had a more encompassing profile, verifying form, content, and/or use (pragmatics). Concerning the guidelines, the most recurrent stages between the translation proposals were translation, conciliation of the previous stage or synthesis version, back-translation, reviewing committee, pretest, and final version. The conceptual, item and operational equivalences were frequently cited for verification.

Cross-cultural adaptation of the Fat Talk Questionnaire for Brazilian Portuguese language.

To perform the cross-cultural adaptation of the Fat Talk Questionnaire into Brazilian Portuguese with focus on adolescent girls. The steps taken in this research were: conceptual and item equivalence, semantics, operational. The conceptual and item equivalence was performed by researchers in the field of Nutrition and body image; semantics involved translators fluent in English and Portuguese (n=3) and experts (n=19) in body image and eating behavior. Step 3 included 32 female adolescents (15 and 18 years), who answered the translated and adapted version to assess comprehension by the target audience. Of the 14 items, six were considered adequate by the experts and 3 items required minimal language adjustments. Five items needed broader changes for cultural and idiomatic adaptation. The back-translation was approved by the original authors. The average response time by the adolescents was 3.5 minutes, with no queries. The scale was translated and adapted to Brazilian Portuguese aimed at female adolescents, showing satisfactory results in the translation process, conceptual, semantic and operational equivalence. Analyses of external validity, measurement equivalence and reproducibility were also required.

Cross-cultural adaptation of the Recovery Self-Assessment RSA-R Family/Brazil: Validity evidence based on test content.

In the cross-cultural adaptation of instruments, the qualitative component of adaptation is generally poorly reported, sometimes being superficially addressed. In this study we aimed to describe the qualitative component of the cross-cultural adaptation process and to demonstrate validity evidence based on test content of the Recovery Self-Assessment-RSA-R Family/Brazil. We conducted a qualitative study that included the steps of preparation, translation, back-translation, expert's assessment, workshop with a researcher from Yale University, and two pilot studies involving family members of patients attended at mental health services. Among the results, we found considerable validity evidence based on test content with a percentage of agreement above 80%. Pilot studies contributed to accentuating this evidence, assisting in the cultural adequacy of the statements and in the operational equivalence of the instrument. The adaptation process of the RSA-R Family/Brazil proved to be complex. From this experience, we concluded that presenting validity evidence based on test content is important to ensure the applicability tools to the target culture. The instrument will still be evaluated as for psychometric characteristics through statistical techniques.

Cross-cultural adaptation of the Richmond Agitation-Sedation Scale to Brazilian Portuguese for the evaluation of sedation in pediatric intensive care.

ObjectiveTo perform a cross-cultural adaptation of the Richmond Agitation-Sedation Scale (RASS) to Brazilian Portuguese for the evaluation of sedation in pediatric intensive care.MethodsCross-cultural adaptation process including the conceptual, item, semantic and operational equivalence stages according to current recommendations.ResultsPretests, divided into two stages, included 30 professionals from the pediatric intensive care unit of a university hospital, who administered the translated RASS to patients aged 29 days to 18 years. The pretests showed a content validity index above 0.90 for all items: 0.97 in the first stage of pretests and 0.99 in the second.ConclusionThe cross-cultural adaptation of RASS to Brazilian Portuguese resulted in a version with excellent comprehensibility and acceptability in a pediatric intensive care setting. Reliability and validity studies should be performed to evaluate the psychometric properties of the Brazilian Portuguese version of the RASS.

Utility of Equivalence and Cognition Models in Enhancing Validity of Translated Questionnaires: A Methodological Example Using the Heart Quality-of-Life Questionnaire.

ABSTRACTBackgroundThe cross-cultural adaptation of questionnaires has tenuous theoretical underpinnings that limit the rigor of data collection and the meaningful analysis of cognitive interview data. An adaptation of existing models of equivalence and cognition provides structure to the comprehensive investigation of various equivalence types in enhancing the validity of translated questionnaires.PurposeIn this study, a framework comprising equivalence and cognition models was used to assess and finalize the Heart Quality-of-Life (HeartQoL)-Bahasa Malaysia (BM) questionnaire, which was derived from both forward–backward (FB) and dual-panel (DP) translation methods.MethodsInvestigation and finalization of two initial versions of the questionnaire were conducted based on findings from an expert assessment (n = 3 sociolinguists blinded to translation methods) and cognitive interviews with purposively sampled patients (FB: n = 11; DP: n = 11). The equivalence model of Herdman et al. and the question-and-answer model of Collins were adapted to form a “cognition-and-equivalence” model to guide data collection and analysis through modified cognitive interviews. The final HeartQoL-BM was completed by 373 patients with ischemic heart disease from two medical centers, and the data were analyzed using confirmatory factor analysis to assess the evidence of equivalence.ResultsFindings from the expert assessment and cognitive interview showed the existence of semantic and item equivalence on almost all of the FB and DP items, identified some subtle potential equivalence gaps, and guided the process of item finalization. Confirmatory factor analysis, including tests of factorial invariance on the final two-factor model of HeartQoL-BM, confirmed conceptual, item, measurement, and operational equivalence, which supports functional equivalence.ConclusionsThe potential use of the cognition-and-equivalence model for modified cognitive interviewing and the application of the six equivalence types of Herdman et al. were supported by the HeartQoL-BM showing functional equivalence with its source. HeartQoL-BM is a potentially valid measure of health-related quality of life for patients with ischemic heart disease independent of conditions such as angina, myocardial infarction, and heart failure.

Tradução e adaptação transcultural da escala de atividade física para pessoas com deficiência física (PASIPD BR)

A prática de atividade física regular é importante para proporcionar à pessoa com deficiência física bem-estar e melhor qualidade de vida. Observa-se uma carência de instrumentos padronizados e específicos na língua portuguesa para avaliação do nível de atividade física direcionados a essa população. O estudo teve como objetivo traduzir e adequar culturalmente o instrumento Physical Activity Scale for Individuals with Physical Disabilities – PASIPD para o português do Brasil. Para o processo de tradução e adaptação transcultural da escala, foram realizadas cinco etapas: 1) tradução inicial; 2) síntese da tradução; 3) retrotradução; 4) equivalência semântica e operacional; e, 5) Pré-teste. Na equivalência semântica, 7 itens obtiveram índice de concordância abaixo de 70%. No pré-teste o instrumento foi testado com adultos com deficiência física, por seis profissionais especialistas na área de Reabilitação Física. Nessa etapa apenas um item teve índice de concordância abaixo de 70%. Após a adequação dos itens que apresentaram dificuldade a escala foi considerada adequada culturalmente para verificar o nível de atividade física em indivíduos com deficiência física no Brasil.

Measuring Stigma related to People with Albinism in Tanzania: A Cultural Validation Study of the EMIC-CSS and SDS among Adults

Purpose: People with albinism in Tanzania are severely stigmatised. A measurement tool to assess this stigmatisation among adults is lacking. This research aimed at the cultural validation of two Scales to measure stigma related to albinism: The Albinism Social Distance Scale (A-SDS) and the Albinism Explanatory Model Interview Catalogue Community Stigma Scale (A-EMIC-CSS). Method: Conceptual, item, semantic and operational equivalences were evaluated through focus groups and interviews. A pilot study among adults attending religious institutes, as a representation of Tanzanian society, was conducted to assess the measurement equivalence. There were 101 respondents for the test and 79 respondents for the re-test. Results: Conceptual, item, semantic and operational equivalences of the Scales are sufficient. In terms of measurement equivalence, the internal consistency of the A-SDS and A-EMIC-CSS are adequate. However, social desirability should be taken into account when interpreting the findings. Conclusion and Implications: The insights provided by this article can aid in the development of tools to measure stigma cross-culturally and across stigmatising conditions. The combination of the two Scales for short and long-term effect measurement is recommended.

Cross-cultural adaptation, validity and reproducibility of the Back Beliefs Questionnaire among older Brazilians with acute low back pain. A cross-sectional study.

Low back pain (LBP) has emerging as an epidemic, multifactorial and multidimensional condition in older age. Assessment of attitudes and beliefs of patients with back pain is necessary for understanding the impact of psychosocial factors on pain perception and management. To cross-culturally adapt and examine the validity and reproducibility (intra and interrater reliability and agreement) of the Back Beliefs Questionnaire (BBQ) in older Brazilians with acute LBP. Cross-sectional methodological report conducted at the Department of Physical Therapy of the Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. The present study was conducted for translating, adapting, and examining the psychometric properties of a questionnaire. Participants aged ≥ 60 years experiencing an acute episode of LBP were recruited. Coefficients of internal consistency, reliability and agreement were obtained using Cronbach's α, intraclass correlations, and standard error of measurement and the smallest detectable change, respectively. Twenty-six participants aged between 60-84 years and reporting a mean of 9.8 (4.3) years of schooling completed the study. The Brazilian Portuguese-language version of the BBQ (BBQ-Brazil) was proposed and presented with adequate conceptual, semantic, operational, and measurement equivalence from the original version. Intra and interrater evaluations showed moderate (0.74) and excellent (0.91) intraclass correlation coefficients, respectively, with small standard error of measurement for both evaluations. Internal consistency was considered adequate (0.70). BBQ-Brazil had consistent measurements of validity and reproducibility, and proved to be a valuable tool in clinical practice for addressing attitudes and beliefs of older patients with acute LBP.