Original Scale Research Articles

Development and Validation of SCACOMS, a Composite Scale for Assessing Disease Progression and Treatment Effects in Spinocerebellar Ataxia.

Spinocerebellar ataxias (SCA) are rare inherited neurodegenerative disorders characterized by a progressive impairment of gait, balance, limb coordination, and speech. There is currently no composite scale that includes multiple aspects of the SCA experience to assess disease progression and treatment effects. Applying the method of partial least squares (PLS) regression, we developed the Spinocerebellar Ataxia Composite Scale (SCACOMS) from two SCA natural history datasets (NCT01060371, NCT02440763). PLS regression selected items based on their ability to detect clinical decline, with optimized weights based on the item's degree of progression. Following model validation, SCACOMS was leveraged to examine disease progression and treatment effects in a 48-week SCA clinical trial cohort (NCT03701399). Items from the Clinical Global Impression-Global Improvement Scale (CGI-I), the Friedreich Ataxia Rating Scale (FARS) - functional stage, and the Modified Functional Scale for the Assessment and Rating of Ataxia (f-SARA) were objectively selected with weightings based on their sensitivity to clinical decline. The resulting SCACOMS exhibited improved sensitivity to disease progression and greater treatment effects (compared to the original scales from which they were derived) in a 48-week clinical trial of a novel therapeutic agent. The trial analyses also provided a SCACOMS-derived estimate of the temporal delay in SCA disease progression. SCACOMS is a useful composite measure, effectively capturing disease progression and highlighting treatment effects in patients with SCA. SCACOMS will be a powerful tool in future studies given its sensitivity to clinical decline and ability to detect a meaningful clinical impact of disease-modifying treatments.

Assessing basic/fundamental psychological need fulfillment: systematic mapping and review of existing scales to foster cumulative science.

Because the fulfillment of basic/fundamental psychological needs affects people's motivation and well-being, measuring the degree to which these needs are met is of interest to researchers across various domains. Although numerous self-assessment tools have been developed, no recent comprehensive reviews exist, hindering cumulative scientific progress. The present systematic review aimed to identify and analyze the main approaches to developing self-report scales for assessing basic/fundamental psychological need fulfillment. The objective is to inform readers interested in selecting instruments for their studies and those intending to develop new scales. Following PRISMA, we conducted a search of Scopus, Web of Science, PubMed, and ProQuest in August 2023. The following information was extracted from eligible studies: Scale name, abbreviation, theoretical basis, application domain, final scale construction, scale development and validation methodology, and citation count. Our search identified 32 primary studies, in which 31 original scales were developed and validated, and 89 secondary studies that aimed to modify these original scales. The predominant theoretical basis was Self-Determination Theory, although eight scales were based on alternative need typologies. The scales were either domain-general or specific to contexts such as work, education, or exercise/sports contexts. While most were designed to measure need satisfaction, some also addressed need support, frustration, and thwarting. Despite significant efforts in developing, adapting, and applying scales to measure need fulfillment, we found several issues resulting from diverse perspectives on conceptualizing psychological needs and need typologies, discordant approaches in developing and validating measures, and other inconsistencies that should be acknowledged and addressed in future research.

Validation of the Teachers AI-TPACK Scale for the Indian Educational Setting

Educators work in extremely dynamic and complex classroom environments where they must continuously alter and update their understanding. Specifically, possession of rich, organised, and integrated knowledge from various domains including knowledge on subject-matter, knowledge of students' thinking and learning, and, increasingly, knowledge of technology is essential. By integrating these three aspects, Mishra and Koehler developed the Technological Pedagogical and Content Knowledge (TPACK) framework in 2006 which offers a thorough and comprehensive method for incorporating technology into the education setting. On the parallel, use of information technology has rapidly increased in the field of education, especially with the introduction of Artificial Intelligence (AI). Thus, the Technological Pedagogical Content Knowledge (TPACK) framework needed to be updated to reflect the growing incorporation of AI into educational standards. Hence, investigator Ning and colleagues in the year 2024 built a framework for incorporating AI into TPACK and developed a robust scale titled Teachers AI-TPACK Scale that measures the teachers competencies in incorporating AI into their teaching environment. The objective of this work was to test the validity of the scale in the Indian educational setting. With a sample size of 660 teaching faculties in universities and colleges across India, this study followed the routine stages such as construct validity analysis in the form of Exploratory Factor Analysis using SPSS V27, followed by Confirmatory Factor Analysis in AMOS software. The original scale with 39 items across seven dimensions were retained throughout the validation process and resulted in a high reliability score of 0.907. This provides compelling evidence for the validity and reliability of the teachers AI-TPACK scale in measuring Indian educators' knowledge and skills at the juncture of AI with pedagogy, technology and content. This is currently the only scale available to measure this construct in India.

Beyond Empathy: Analyzing Compassion Fatigue Among Counselor

Compassion fatigue is an emotional response characterized by a diminished capacity or interest in empathizing with others. This phenomenon often results from continuous exposure to traumatic narratives recounted by clients, leading to negative behavioral and emotional outcomes in counselors. Compassion fatigue can impair the ability to support others and hinder overall productivity. Counselors are particularly vulnerable to experiencing compassion fatigue. Given the increasing number of counselors, it is imperative to investigate the prevalence and characteristics of compassion fatigue. This study aims to delineate the features of compassion fatigue among 45 counselors at East & Central Java. The research employs a quantitative descriptive methodology. The Professional Quality of Life Scale (ProQOL) was adapted for this study, encompassing three subscales that assess compassion fatigue, compassion satisfaction, and burnout. This instrument represents an advanced iteration of the original compassion fatigue scale.

Nursing Principles Practice Basic Competencies Scale – Turkish Adaptation Study

Objective: The main objectives of clinical education in nursing education are to develop the student’s competences in cognitive, affective and psychomotor areas. Reliable measurement tools are needed for the evaluation of these competences that begin to be gained with the first clinical practice. This methodological study investigated the cultural and Turkish validity of the Core Competence in Basic Nursing Practice Scale (CCFNPS) for undergraduate nursing students. Methods: A methodological research has been carried out on the cultural validation and adaptation of the scale. The construct’s validity was examined using both exploratory and confirmatory factor analysis in a sample of 466 students. The scale’s internal consistency reliability was evaluated using Cronbach’s alpha. Test-retest reliability was assessed using a dependent sample t-test and intraclass correlation with a sample of 30 students. Results: The scale’s content validity index was 0.98. The results of exploratory factor analysis revealed a five-factor structure similar to the original scale, the variance explained was 69.62%, but four items were removed from the scale due to low factor loading. Confirmatory factor analysis results (fit indices values) applied to the twenty – one items and five sub-dimensional structure were found to be acceptable. Scale Cronbach’s alpha values were above 0.70. Conclusion: The 21-item Turkish version of CCFNPS was found to be a valid and reliable scale for measuring the competencies acquired by students after their first clinical training.

Abstract A033: Metabolomics reveals racial differences in metabolites among women

Abstract Background: Non-Hispanic Black (NHB) women experience disparities in cancer outcomes and mortality compared with non-Hispanic White (NHW) women. While social determinants of health contribute to these differences, investigating potential biological factors behind the observed racial differences is essential for developing effective health interventions. Therefore, we performed a comprehensive analysis comparing the metabolomic profiles of NHB and NHW women to identify whether differences exist in metabolites. Methods: We performed metabolomic profiling on 674 women recruited at Washington University School of Medicine, St. Louis, MO. A total of 1074 metabolites were profiled at Metabolon. We excluded 246 metabolites with missing values in ≥300 women from the analyses. We used the 10-nearest neighbor method for imputing missing data. We investigated the associations between metabolites and race using linear regression models, adjusting for age, body mass index, alcohol consumption, and education level. Metabolites were log-transformed before regression analyses, and linear coefficients were back-transformed to the original scale. A Bonferroni-adjusted p-value<10-5 was considered statistically significant. Pathway enrichment analyses were conducted for differential metabolites within each super-pathway. Results: Twenty-five (3.0%) of the 828 metabolites differed significantly between NHW and NHB women at the Bonferroni-adjusted p- value<10-5 level, with 19 metabolites higher in NHW women and 6 metabolites higher in NHB women. These metabolites belong to amino acid (n=12), xenobiotics (n=9), lipid (n=2), cofactors and vitamins (n=1), and partially characterized molecules (n=1) super-pathways. In NHB women, the top 3 metabolites with the highest percentage differences compared with NHW women were 2-naphthol sulfate (89.7%, p=3.6×10-6)[chemical], 2-hydroxyfluorene sulfate (71.6%, p=5.9×10-8)[tobacco metabolite], and carotene diol (3) (35.6%, p=1.1×10-6)[vitamin A metabolism]. Conversely, the top 3 metabolites with the highest percentage differences in NHW women compared with NHB women were N6-methyllysine (59.0%, p=1.2×10-26)[lysine metabolism], tryptophan betaine (57.7%, p=2.1×10-11)[tryptophan metabolism], and theophylline (52.8%, p=2.2×10-7)[xanthine metabolism]. Conclusions: We identified racial differences in several functional metabolites among women that may contribute to the observed cancer disparities and have implications for cancer prevention. Citation Format: Ghazaleh Pourali, Liang Li, Kayla R. Getz, Myung Sik Jeon, Jingqin Luo, Chongliang Luo, Adetunji T. Toriola. Metabolomics reveals racial differences in metabolites among women [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A033.

Assessing the psychometric properties of Connor-Davidson Resilience Scale 25 (CD-RISC 25) in pharmacy students and academics in the Eastern Mediterranean Region

BackgroundResilience is a complex concept that is defined and influenced by the context of individuals, organisations, societies and cultures. The Connor-Davidson Resilience Scale (CD-RISC) is a widely used validated tool to evaluate psychological resilience. CD-RISC is a self-administered scale of twenty-five items, each rated by a 5-point Likert scale. The scale evaluates overall personal resilience through assessing five main resilience-related constructs; personal competence, trust in one's instincts, positive acceptance of change, control and spiritual influences. As per the scale's developers, higher scores reflecting greater level of resilience. This particular tool has not previously been tested with a pharmacy student or academic population sample. ObjectiveThis study aims to assess the factor structure, validity, and reliability of the CD-RISC-25 in a sample of pharmacy students and academics from faculties drawn across the Eastern Mediterranean Region (EMR). MethodsA cross-sectional study was carried out between October 2020 and January 2021 sampling pharmacy students and academics across the EMR who were invited to complete the self-administered CD-RISC 25 questionnaire. Confirmatory factor analysis using principal components analysis with oblique rotation was conducted on sample responses (n = 616). The internal consistency and reliability for each identified factor and from the CD-RISC scale was evaluated by using Cronbach's alpha coefficient. ResultsFive factors were isolated accounting for 51.5 % total cumulative model variance. Identification of factors showed high convergence with previous work on the CD-RISC resilience tool. The current study in our sample found a five–factor structure which differed from the original scale reliabilities. This study did identify a five-factor solution with differing item factor loadings. The reliability analysis on the CD-RISC-25 items in our study sample revealed an overall Cronbach Alpha value of 0.89; however, three items showed corrected Item-total correlations of <0.3. Our analysis, in this respondent sample, suggested a re-adjustment of the scale inclusions to improve overall scale stability and performance. ConclusionsThe current research findings propose a modified five-factor structure to resilience, with a 22-item unidimensional model of CD-RISC scale.

Turkish Validity and Reliability of The Mini Service User Recovery Evaluation Scale

Objective: The aim of this research is to adapt the MiniService User Recovery Evaluation (MiniSeRvE) Scale to Turkish culture and establish its psychometric properties. Materials and Methods: This methodological study included 150 patients who applied to psychiatry outpatient clinics between March 2020 and January 2021. "The Personal Information Form," "The MiniService User Recovery Evaluation (MiniSeRvE) Scale," "The Subjective Recovery Assessment Scale," and "The Spiritual Well-Being Scale" were used to collect the data. Results: The CFA of the MiniSeRvE Scale determined that the three sub-dimensions and factor loadings were between 0.50 and 0.91, consistent with the original scale. The Cronbach's alpha coefficient was found to be 0.864 for the total scale and between 0.77 and 0.95 for the sub-dimensions. Conclusions: The MiniSeRvE Scale is a valid and reliable measurement tool.

Joint meta-analysis of two diagnostic tests accounting for within and between studies dependence.

There is an extensive literature on methods for meta-analysis of diagnostic test accuracy, but it mainly focuses on a single test. A multinomial generalised linear mixed model was recently proposed for the joint meta-analysis of studies comparing two tests on the same participants in a paired tests design with a gold standard. In this setting, we propose a novel model for joint meta-analysis of studies comparing two diagnostic tests which assumes independent multinomial distributions for the counts of each combination of test results in diseased and non-diseased patients, conditional on the latent vector of probabilities of each combination of test results in diseased and non-diseased patients. For the random effects distribution of the latent proportions, we employ a one-truncated D-vine copula that can provide tail dependence or asymmetry. The proposed model includes the multinomial generalised linear mixed model as a special case, accounts for the within-study dependence induced because the tests are applied to the same participants, allows for between-studies dependence, and can also operate on the original scale of the latent proportions. The latter enables the derivation of summary receiver operating characteristic curves. Our methodology is demonstrated with simulation studies and a meta-analysis of screening for Down's syndrome with two tests: shortened humerus and shortened femur.

The validation of short eating disorder, body dysmorphia, and Weight Bias Internalisation Scales among UK adults

BackgroundWhen collecting data from human participants, it is often important to minimise the length of questionnaire-based measures. This makes it possible to ensure that the data collection is as engaging as possible, while it also reduces response burden, which may protect data quality. Brevity is especially important when assessing eating disorders and related phenomena, as minimising questions pertaining to shame-ridden, unpleasant experiences may in turn minimise any negative affect experienced whilst responding.MethodsWe relied on item response theory to shorten three eating disorder and body dysmorphia measures, while aiming to ensure that the information assessed by the scales remained as close to that assessed by the original scales as possible. We further tested measurement invariance, correlations among different versions of the same scales as well as different measures, and explored additional properties of each scale, including their internal consistency. Additionally, we explored the performance of the 3-item version of the modified Weight Bias Internalisation Scale and compared it to that of the 11-item version of the scale.ResultsWe introduce a 5-item version of the Eating Disorder Examination Questionnaire, a 3-item version of the SCOFF questionnaire, and a 3-item version of the Dysmorphic Concern Questionnaire. The results revealed that, across a sample of UK adults (N = 987, ages 18–86, M = 45.21), the short scales had a reasonably good fit. Significant positive correlations between the longer and shorter versions of the scales and their significant positive, albeit somewhat weaker correlations to other, related measures support their convergent and discriminant validity. The results followed a similar pattern across the young adult subsample (N = 375, ages 18–39, M = 28.56).ConclusionsThese results indicate that the short forms of the tested scales may perform similarly to the full versions.

Early Hotspot Detection in Photovoltaic Modules using Deep Learning Methods

Photovoltaic (PV) energy systems have been widely used in energy production especially in recent years due to their clean, reliable, environmentally friendly and resource continuity. The electrical energy to be obtained must be uninterrupted and of high quality. For this reason, faults that may cause production losses in PV power plants should be detected quickly and accurately. In this study, an approach that can automatically detect hotspot fault in solar PV modules is presented. In the proposed approach, firstly, Jet colormap based colored image transformation process is applied to gray scale infrared image data. Then, using three different deep learning models such as MobilNetV2, ResNet-18, InceptionV3, both original grey scale data and Jet colormap data are detected and evaluation metric values are obtained. The importance of this research lies in the potential of deep learning-based effective detection, especially in the early and rapid diagnosis of PV hotspot faults.

Career Insecurity Scale Short Form (CI-S): Construction and Validation

To facilitate research on career insecurity, we develop and validate an eight-item short form of the 32-item original scale across three studies, namely the CI-S. In all studies, CI-S consistently showed high internal reliabilities and correlations with the full scale. Specifically, Study 1 finishes the preliminary item selection and makes an initial validation. Study 2 demonstrates that CI-S has a comparable criterion-related validity with the full scale. Study 3 examines a moderated mediation model of the relationship between career insecurity and workplace deviance and shows that using CI-S or the full scale does not change the results. Taken together, these studies demonstrate that CI-S is a psychometrically satisfying and practically useful measure of career insecurity that can be used with confidence in research and practice.

Pilot study of parental alienation items in the adverse childhood experiences scale

BackgroundAdverse Childhood Experiences (ACEs) and Parental Alienation (PA)are forms of adverse events negatively affecting children globally. The current study was to identify a revised ACEs measure that includes a screening item for PA. MethodsA total of 231 undergraduate students, ages 18 to 37, were surveyed for this analysis. A factor analyses was performed to identify what PA item, out of four, would correlate most strongly with existing ACEs scale items. Convergent and divergent validity was assessed. An exploratory factory analyses was conducted to identify factor structure of scale items and a confirmatory factory analysis of extracted factors was used to assess model fit. ResultsOver half (60 %) of the sampled population reported at least one ACEs item. All four PA items were significantly correlated with converging constructs (r = 0.68, p < .01). Out of four PA items, one PA item significantly outperformed the other three items in relation to convergent validity and was used to create a new ACEs-PA scale item (r = 0.33, p < .01). A two factor solution was identified with the new PA item loading, accounting for 35 % of the variance, explaining more variance in both outcomes (R2 = 0.43 and R2 = 0.16) than the original ACEs scale when comparing the adjusted R2 values (R2 = 0.35 and R2 = 0.13).Limitations This study used participant self-reporting methods subjecting it to retrospective bias. ConclusionWithin the population, the new PA item factored significantly with existing ACEs, suggesting the capture of an additional adverse childhood experience.

Psychometric Analysis of the Hip Disability and Osteoarthritis Outcome Score (HOOS).

Hip Disability and Osteoarthritis Outcome Survey (HOOS) was developed as a region- and disease-specific outcome to assess hip disability. Despite the use of the HOOS in clinical practice and research, psychometric analyses of the scale in a large dataset of patients have not been performed. As such, the purposes of this study were to assess the structural validity of the HOOS in patients who underwent a total hip arthroplasty. Data were obtained from the Surgical Outcome System (SOS) global registry. Confirmatory factor analysis (CFA) was conducted to assess the scale structure of the 40-item HOOS and exploratory factor analysis (EFA) was conducted to identify a parsimonious scale structure. The parsimonious model identified was subjected to multi-group and longitudinal invariance testing and LGC modeling. The original five-factor, 40-item HOOS did not meet recommended model fit indices values (CFI = 0.822, TLI = 0.809, IFI = 0.822, RMSEA = 0.085). Alternate model generation identified an alternative model (i.e., HOOS-9). Sound model fit was identified for the HOOS-9 (CFI = 0.974, TLI = 0.961, RMSEA = 0.046). Invariance testing criteria were also met between groups (i.e., age and sex) and across time. Lastly, a nonlinear growth trajectory was identified in responses pertaining to hip disability. The original scale structure of the 40-item HOOS was not supported. The HOOS-9 met contemporary model fit recommendations, along with multi-group and longitudinal invariance testing. Our findings support the preliminary use of the HOOS-9 to assess hip function and disability in research and clinical practice.

General and maladaptive traits as predictors of specific conspiracy beliefs related to COVID-19 and Russian-Ukrainian war: three-wave longitudinal study

AbstractThe aim of the study was to investigate how general personality traits (Big Five) and maladaptive traits (Personality Inventory for DSM-5) predict specific conspiracy beliefs related to COVID-19 and the Russian-Ukrainian war. 925 participants from Slovakia, recruited via an online panel of a research agency (50.6% women, mean age 50.9 years), were interviewed in October 2021 with the Big Five Inventory Short (BFI-S) and the Personality Inventory for DSM-5 Brief Form (PID-5-BF). Later (July-August 2022 and April-May 2023), they completed the original scales to measure COVID-19 and Russian-Ukrainian war conspiracies. The results showed that after controlling for demographic variables, belief in specific conspiracies was positively predicted by extraversion and negatively predicted by agreeableness. Of the maladaptive traits, only psychoticism was a positive predictor of specific conspiracies. Since the effects were consistent across all types of conspiracies, the results suggest that personality traits may play a role in how people come to believe in specific conspiracies.

Reproductive Autonomy Scale: Turkish Validity and Reliability Study

Objective: This study aims to determine the validity and reliability of the Turkish version of the Reproductive Autonomy Scale. Methods: A methodological study was conducted with 320 women who sought treatment in a Family Health Center between November 5, 2022, and February 1, 2023. Data were collected through the Personal Information Form and the Turkish version of the Reproductive Autonomy Scale. The content validity index (CVI-Lawshe technique) was used to analyze the agreement in expert opinions. While Pearson correlation analysis was used for the test-retest analysis of the scale and its sub-scales, Cronbach's alpha coefficient was utilized to analyze the internal consistency of the scale and its sub-scales. Exploratory factor analysis and confirmatory factor analysis were utilized to test the scale's construct validity. These factor analyses were conducted separately in two samples divided randomly. Results: The adequacy of the sample size was calculated using the Kaiser-Maier Oklin (KMO) value, which was found to be 0.704. The significance value of Bartlett's Test of Sphericity (χ91 196.033. p &amp;lt; .001) was below 0.05, indicating that a factor analysis may be useful with the data. A three-factor structure explaining %77.84 of the variance and having an eigenvalue above one was obtained due to the varimax axis rotation. All the items were included in the factors in the original scale, and a structure with factor loadings ranging between 0.589 and 0.917 emerged. The model was found to fit the data for the overall scale. Cronbach's alpha internal consistency coefficients of the scale were calculated as 0.903, 0.891, 0.928, and 0.918 for the total score, decision-making, freedom from coercion, and communication sub-scales, respectively. Conclusion: The Reproductive Autonomy Scale was found to be a valid and reliable measurement tool for the Turkish population.

Evaluation of Psychometric Proprieties of Mann Assessment of Swallowing Ability (MASA) in Italian Language: A Cross-Sectional Study.

The aim of this cross-sectional study was to translate, culturally adapt, and evaluate the psychometric properties of the Italian version of the Mann Assessment of Swallowing Ability (MASA) in post-stroke individuals. The original MASA scale was translated and culturally adapted from English to Italian following the international guidelines. The internal consistency and test-retest reliability of the MASA-IT were assessed, and its concurrent validity was examined through Pearson correlation coefficients with the Italian versions of two established gold standard scales for dysphagia assessment: the Dysphagia Outcome Severity Scale (DOSS) and the De Pippo Test-Three Oz Water Swallow. The MASA-IT was administered to 78 participants. The items demonstrated excellent internal consistency, with Cronbach's alpha ranging between 0.86 and 0.89. The interclass correlation coefficient was 0.98 for inter-rater reliability and 0.99 for intra-rater reliability, indicating high reproducibility. Regarding concurrent validity, the MASA-IT showed a strong direct correlation with the DOSS scale (r = 0.949, p = 0.01) and an inverse correlation with the De Pippo Test (r = -0.783, p = 0.01), confirming its good concurrent validity. The Italian version of the Mann Assessment of Swallowing Ability (MASA-IT) is a reliable and valid tool for assessing swallowing ability in post-stroke patients. Its strong psychometric properties make it well suited for clinical use in Italy.

Effectiveness of an unguided modular online intervention for highly anxious parents in preventing anxiety in their children: a parallel group randomised controlled trial

Children whose parents have anxiety problems are at increased risk of developing anxiety themselves. Parenting behaviors are a contributing factor to intergenerational transmission. Interventions which seek to limit anxiogenic parenting behaviors have shown potential in reducing anxiety in offspring but are not widely accessible. This prevention trial aimed to establish the effectiveness of an unguided modular online intervention for highly anxious parents in preventing anxiety in their children. A parallel group, block-randomised controlled trial of unblinded participants in a 1:1 ratio was conducted to compare efficacy of the online course compared to a no-intervention control. The intervention comprised 8 modules, of approximately 20min each, and participants progressed through the course at their own pace. The study was conducted entirely online with a self-referred UK-based community sample of parents (child 2-11 years) with substantial anxiety. The primary outcome measure was change in parent-reported child anxiety, as measured by the Spence Children's Anxiety Scale-Parent Report (SCAS-P) or Spence Pre-School Anxiety Scale-Parent Report (Preschool SCAS). Secondary outcomes were child internalising, externalising, and attentional symptoms (Pediatric Symptom Checklist), and parent anxiety (SCARED-Adult). Analyses using complete case analysis following intention to treat principles investigated intervention effects at 6 months (primary analysis) and additionally at 9 to 25-months' follow-up. Trial registration: ClinicalTrials.GovNCT04755933, https://clinicaltrials.gov/ct2/show/NCT04755933. 1811 participants (intervention=900; control=911; 92.7% (1677/1810) female; 85.3% (1535/1800) White-British; 66.8% (1201/1799) university educated). Participant retention (based on primary outcome completion) at T2 (6-months post consent) was 67.6% overall (n=1224) and substantially lower in the intervention arm 57.3% ((516/900) control=77.8% (708/910)). Child anxiety was lower in the intervention group compared to control at 6-month follow-up (adjusted effect size estimate-0.15 (95% CI:-0.23 to-0.08, p<0.001). There was very strong evidence that those in the intervention arm had lowered child anxiety (standardised SCAS score) compared to the control arm, with an effect size (Cohen's d) of-0.16 (95% CI:-0.23 to-0.08, p<0.001). The difference in standardised Spence Child Anxiety Scale score between the arms was-0.15 standard deviations. On the original scales for SCAS-P (0-114) and Preschool SCAS (0-112), this corresponds to a reduction of-2.38 (95% CI:-3.59 to-1.16) and-2.68 (95% CI:-4.05 to-1.31), respectively. No reported harms. A clinically unsupported online intervention designed for parents with high levels of anxiety is effective in reducing anxiety and internalising symptoms in their children, and also anxiety in parents. Given the low resource intensity of this intervention, and the positive effects reported here, these findings suggest it has promise in limiting the intergenerational transmission of severe anxiety. This work was supported by Kavli Trust (grant 38/19).

Assessing interactional competence through group discussion: A mixed methods validation

The purpose of this mixed methods study was to assess the validity and functionality of an analytic rating scale for the assessment of interactional competence (IC). The participants were 79 low- to high-proficiency Japanese university students who completed 10-minute small-group discussions. Video recordings of the discussions were assessed by raters using the rating scale. The rater scores were then analyzed using many-facet Rasch measurement (MFRM) which indicated a very good fit to the model. The data were subsequently analyzed using generalizability theory in the form of a G-study and d-study. Those studies showed that the rating scale could be used with fewer raters, therefore increasing practicality without a substantial decrease in reliability. In addition to quantitative data, qualitative data were also collected in the form of interviews with raters and comments they made during assessment. Several raters noted unexpected participant behaviors which were difficult to evaluate using the rating scale, as well as ambiguous language in some category descriptors. The qualitative data provided an invaluable supplement to the quantitative analyses which did not indicate major issues with the rubric. Both forms of data were used to revise the original rating scale and those changes are discussed. This study adds to the limited but growing number of mixed methods studies on IC assessment.

Limitations of Separating Athletes into High or Low-Risk Groups based on a Cut-Off. A Clinical Commentary.

Athlete injury risk assessment and management is an important, yet challenging task for sport and exercise medicine professionals. A common approach to injury risk screening is to stratify athletes into risk groups based on their performance on a test relative to a cut-off threshold. However, one potential reason for ineffective injury prevention efforts is the over-reliance on identifying these 'at-risk' groups using arbitrary cut-offs for these tests and measures. The purpose of this commentary is to discuss the conceptual and technical issues related to the use of a cut-off in both research and clinical practice. How can we better assess and interpret clinical tests or measures to enable a more effective injury risk assessment in athletes? Cut-offs typically lack strong biologic plausibility to support them; and are typically derived in a data-driven manner and thus not generalizable to other samples. When a cut-off is used in analyses, information is lost, leading to potentially misleading results and less accurate injury risk prediction. Dichotomizing a continuous variable using a cut-off should be avoided. Using continuous variables on its original scale is advantageous because information is not discarded, outcome prediction accuracy is not lost, and personalized medicine can be facilitated. Researchers and clinicians are encouraged to analyze and interpret the results of tests and measures using continuous variables and avoid relying on singular cut-offs to guide decisions. Injury risk can be predicted more accurately when using continuous variables in their natural form. A more accurate risk prediction will facilitate personalized approaches to injury risk mitigation and may lead to a decline in injury rates. 5.