Satisfactory Validity Research Articles

Development of a Japanese version of the patient perceptions of deprescribing – Short form

AbstractBackgroundDeprescribing is a critical component of clinical practice, especially in geriatric medicine. Nevertheless, the attributes of patients who are prepared for, interested in, and could potentially benefit from deprescribing have not been well examined. The Patient Perceptions of Deprescribing (PPoD) evaluates patients' overall readiness for deprescribing and is complemented by an 11‐item validated short form (SF‐PPoD). The objective of this study was to develop a Japanese version of the SF‐PPoD and assess its reliability and validity within Japanese older adults with polypharmacy.MethodsThe SF‐PPoD was translated, back‐translated, and assessed in a cognitive interview. We conducted a cross‐sectional survey with 196 patients aged 65 years or older with five or more medications using the Japanese version to test for reliability and validity. We examined internal consistency and construct validity to determine if the Japanese sample responses reproduce the two subscales in the original SF‐PPoD. Finally, we examined intra‐person replicability using the intraclass correlation coefficient, in which 100 participants were invited and 93 participated.Results118 males and 78 females, with a mean age of 79.2 [SD 6.5] years, completed the survey. Confirmatory factor analysis of the Japanese version of SF‐PPoD revealed satisfactory structural validity with two‐dimensional structure, “Motivation for Deprescribing” and “Primary Care Physician Relationship.” Cronbach's alpha showed good internal consistency, and test–retest demonstrated acceptable intra‐rater reliability.ConclusionsWe developed and validated a Japanese version of SF‐PPoD with an 11‐item, two‐dimensional structure consistent with the original SF‐PPoD. This scale may facilitate shared decision‐making for medication optimization among older adults living with multimorbidity.

A Psychometric Development and Evaluation of the Flow State Scale for Caregiving Tasks Among Clinical Nurses.

The extensive research already conducted in numerous non-healthcare disciplines has consistently demonstrated the effectiveness of flow in alleviating work-related stress and boosting employee engagement in the workplace. Despite the potential benefits to nursing of improving flow, no valid instrument is currently available to measure the work-related flow experience of clinical nurses. This study was designed to develop the Flow State Scale for Caregiving Tasks (FSS-CT) and to evaluate its psychometric properties in the context of clinical nurses. This study, guided by the flow theory of Mihaly Csikszentmihalyi (1975), employed a three-phase approach to developing and evaluating the psychometric properties of the FSS-CT. Five hundred thirty-six full-time clinical nurses working in hospitals of various levels in Taiwan were recruited via cluster random sampling to participate in an anonymous online survey. The content validity of the developed scale was established through expert panel verification, criterion-related validity was assessed by correlating the scale with the Work-related Flow Inventory, and construct validity was evaluated via explanatory and confirmatory factor analyses. Scale reliability was determined using Cronbach's α coefficient. The FSS-CT, a 12-item Likert scale comprising four domains, was developed. These domains capture the elements of nurses' work-related flow, including professional confidence, merging of action and awareness, balance between skill and challenge, and autotelic experience. The FSS-CT demonstrated high content validity (content validity index > .90) and satisfactory criterion-related validity (coefficient = .55, p < .001). Furthermore, the scale was found to have excellent internal consistency (Cronbach's α = .91). Factor analyses yielded a four-factor structure accounting for 69.34% of the total variance, indicating a good fit for the final model based on recommended goodness-of-fit indices. The FSS-CT is a viable and dependable instrument for assessing the work-related flow experiences of nurses, with the measured outcomes offering to nursing administrators valuable insights into or directions for personnel development and work allocation initiatives.

Psychometric properties evaluation of the Persian version of the self-report outcome scale for lupus disease Lupus_PRO version 1.7.

Systemic Lupus Erythematosus (SLE) significantly affects both the quality of life related to health and non-health aspects. This study aims to evaluate the psychometric properties of the Persian version of the Lupus_PRO questionnaire, version 1.7. The questionnaire serves as a specific self-report outcome scale for assessing the treatment outcomes of Lupus disease. The Lupus_PRO questionnaire, version 1.7, was translated into Persian using the standard forward-backward method. After being completed by 218 patients with Lupus, the psychometric properties of the instrument were examined. The Convergent and Discriminant Validity of the scale were assessed using Average Variance Extracted and Cross Loadings, respectively. The construct validity of the questionnaire was also evaluated through Confirmatory Factor Analysis (CFA). Cronbach's alpha was calculated to assess the reliability of the questionnaire dimensions. Out of the 218 patients with lupus who participated in the current study, 13 (6%) were male, and 205 (94%) were female. The mean (SD) age of participants was 40.29 (10.94) years. The Average Variance Extracted (AVE) for HRQOL and Non-HRQOL constructs, except for the Coping and Cognition dimension, was greater than 0.50, indicating satisfactory convergent validity. The interdimensional correlation coefficient (Discriminant Validity) for each dimension with other questionnaire dimensions was less than 0.10, indicating that the questionnaire has good convergent and discriminant validity. Additionally, the results of the Confirmatory Factor Analysis (CFA) indicated that the questionnaire was a suitable fit. In terms of reliability, Cronbach's alpha for the various questionnaire dimensions ranged from 0.51 to 0.91, indicating good internal consistency. The Persian version of the Lupus_PRO questionnaire, version 1.7, demonstrates acceptable validity and reliability in the Iranian population. This instrument can effectively measure various aspects of the quality of life in patients with lupus.

Development and initial validation of the online risk-taking scale

This study aims to develop and validate the Online Risk-Taking Scale. Based on the results of expert opinions and a trial application, a 20-item draft form was created. This scale includes 20 questions about behaviors that are considered risky and have been performed in the last six months. The scale was administered to 214 secondary school students as an online questionnaire, and data were collected. Validity and reliability studies were conducted using these final data. Exploratory factor analysis and confirmatory factor analysis were performed to determine the validity levels of the scale. Cronbach's α coefficient and McDonald's Omega (ω) coefficient were analyzed to assess the reliability levels. The scale demonstrated satisfactory validity and reliability. As a result, a valid and reliable measurement tool that will contribute to the literature by determining the online risk-taking levels of secondary school students has been obtained.

The Walsh Family Resilience Questionnaire: Validity evidence from Portugal

AbstractBackgroundFamily resilience refers to a family's capacity to face and manage adversities, emerging as a stronger and more resourceful unit. A family system approach enlarges the lens to the broad relational network, identifying potential resources for resilience within the immediate and extended family. This approach emphasizes a family's innate ability to adapt in the face of adversities.ObjectiveThis study aims to test the psychometric properties of the Walsh Family Resilience Questionnaire (WFRQ) using a sample of Portuguese caregivers with children aged between 10 and 15 years.MethodA total of 267 caregivers of children aged 10 to 15 years completed a sociodemographic questionnaire and the WFRQ. Analyses were performed to evaluate the WFRQ's validity evidence based on the internal structure (i.e., dimensionality and reliability) and on its relationship to other variables.ResultsThe findings supported a 31‐item version of the WFRQ with one third‐order latent factor, three second‐order factors, and nine first‐order factors for the Portuguese population. The WFRQ exhibited satisfactory validity evidence based on the internal structure and relation to other variables.ConclusionOverall, the results of this study demonstrate the suitability of the WFRQ as a holistic measure to gauge resilience at the family level, going beyond individual assessments.ImplicationsThis instrument holds significant utility in family resilience research and clinical interventions involving families.

Intimate Partner Violence Victimization and Perpetration among Lesbians, Gays, and Bisexuals

Intimate partner violence (IPV) is a global health concern that profoundly affects not only heterosexual but also lesbian, gay, and bisexual (LGB) populations. Although studies conducted outside Norway have reported similar prevalence rates of IPV in heterosexual and LGB relationships, no published studies from Norway, whether academic or from nongovernmental organizations, have focused specifically on IPV prevalence rates in the LGB population. One reason might be the absence of a standardized tool to measure IPV. In this study, as researchers with backgrounds in social psychology, violence and minority studies, we firstly aim to evaluate the validity of the Revised Conflict Tactics Scale (CTS-R) in understanding the intimate partner violence experiences of LGB individuals. Secondly, we investigate how common various forms of perpetration and victimization are within the LGB community, specifically looking at psychological aggression, physical assault, and sexual coercion. We are also interested in whether there are any differences in the experiences of these forms of violence based on sexual orientation. To conduct this research, we studied 285 LGB individuals in Norway, aged between 18 and 64 (mean age = 31.80 years). The results of a correlation analysis revealed that all types of victimization from and perpetration of violence are positively and strongly associated. Chi-square tests indicated that there was no significant difference among LGB individuals in psychological and physical victimization or perpetration. However, gay individuals reported significantly higher sexual IPV victimization and perpetration than lesbian and bisexual individuals. Overall, we suggest that the CTS-R has satisfactory construct validity and effectively helps gauge psychological, physical, and sexual IPV in the LGB population. Moreover, we conclude that psychological, physical, and sexual IPV perpetration and victimization are prevalent in LGB relationships in Norway, and thus, that LGB IPV warrants further investigation into its antecedents and consequences.

Психометрические показатели шкалы «Проактивные аттитюды» в подростковом возрасте: проверка факторной структуры и внутренней согласованности

&lt;p&gt;This study was carried out as part of the development of psychodiagnostics tools for studying the proactive coping behavior in adolescents. Currently, there are few studies on proactive coping in adolescence, given the variety of studies on general coping behavior in adolescents. The aim of the study was to identify the psychometric properties of R. Schwarzer&amp;rsquo;s &amp;ldquo;Proactive Attitudes&amp;rdquo; scale, including its factor structure, internal consistency and validity, among adolescents. A total sample of 237 participants (117 girls and 120 boys) aged 11&amp;ndash;15 years old (M=13.2; SD=1.41), was used. The scale consists of 8 questions and was designed to assess the level of proactive attitudes towards future events. The scale showed acceptable internal reliability (Cronbach's alpha coefficient &amp;alpha;=0.78). Exploratory factor analysis revealed a one-factor structure for the scale (&amp;ldquo;Responsibility and independent choice&amp;rdquo;), using confirmatory factor analysis the one-factor structure of the scale was confirmed (&amp;chi;&amp;sup2;=34.17; CFI=0.959 acceptable, SRMR=0.041; SMSEA=0.069 with 90% confidence interval 0.032&amp;ndash;0.104). The scale demonstrated satisfactory convergent validity. Average scores on the scale are presented, gender differences were not found. The &amp;ldquo;Proactive Attitudes&amp;rdquo; scale can be used as an effective tool for assessing a person&amp;rsquo;s proactive orientation in adolescence, and has acceptable psychometric indicators. The prospect of work should focus on standardizing of the scale for other age groups with different professional and social status, including clinical sample.&lt;/p&gt;

The Illusory Health Beliefs Scale: preliminary validation using exploratory factor and Rasch analysis.

Illusory health beliefs are ill-founded, erroneous notions about well-being. They are important as they can influence allied attitudes, actions, and behaviors to the detriment of personal and societal welfare. Noting this, and the prevalence of paranormal beliefs in contemporary Western society, researchers developed the Paranormal Health Beliefs Scale (PHBS). Modification of the PHBS for use with a United Kingdom-based sample resulted in the instrument broadening to incorporate illusory rather than merely paranormal health beliefs. The present study psychometrically assessed the emergent Illusory Health Beliefs Scale (IHBS). The principal objective was to validate the IHBS using a large, representative sample. Eight hundred and fifty participants (360 males, 482 females, eight non-binary) completed the IHBS alongside instruments assessing theoretically associated constructs (i.e., magical thinking, faith in scientifically unsubstantiated notions, and forms of self-referential, intuitive causation). Exploratory factor analysis revealed the existence of six meaningful IHBS dimensions: Religious/Spiritual, Superstition, Precognitive, Health Myths, Skepticism, and Health Pseudoscience. The IHBS demonstrated satisfactory reliability and convergent validity with theoretically aligned constructs. Rasch analysis at the subscale level revealed good item/person fit and item/person reliability, unidimensionality, and equivalency of items across subgroups (gender and religious affiliation). Analysis confirmed the IHBS was an effective measure of illusory health beliefs. However, researchers should undertake further work to refine the scale and evaluate its performance across different samples and time points.

Development of the West China Tinnitus Impact Inventory and Analysis of Its Reliability and Validity.

Owing to differences in cultural background, education level, and lifestyle, certain items of existing tinnitus evaluation scales are difficult for Chinese patients to understand, despite being translated. However, few independently developed scales have been developed specifically for Chinese patients. Therefore, with this study, we aimed to construct a tinnitus scale, the West China Tinnitus Impact Inventory (WCTII), suitable for the accurate reflection of the impact and severity of the disease in this population. Basic items were obtained through semistructured interviews with patients with tinnitus. We invited 23 domestic experts on tinnitus to form an expert group. The basic items were modified using the Delphi method. Cronbach's α values for the scale scores and correlation coefficients between the items and the scale scores were calculated. Items with correlation coefficients <0.5 were deleted. Exploratory factor analysis was conducted to determine the scale structure of the items remaining after item deletion. The intragroup correlation coefficient was used to assess the scale's test-retest reliability. The Pearson correlation coefficient between the scale scores and the scores for the Chinese-Mandarin version of the Tinnitus Handicap Inventory was used to evaluate concurrent validity. After five rounds of expert correspondence and exploratory factor analysis, we determined the content and structure of the scale. The WCTII consists of 19 items in 4 subscales, namely, F1: the impact of tinnitus on emotion (items 1 to 9); F2: the impact of tinnitus on sleep (items 10 to 12); F3: patients' beliefs about their tinnitus (items 13 to 16, 19); and F4: the impact of tinnitus on auditory processing ability (items 17 to 18). The overall Cronbach's α was 0.934. The Cronbach's α values for F1 to F4 were 0.912, 0.843, 0.829, and 0.838, respectively. The intragroup correlation coefficient (95% confidence interval) of the total scale and F1 to F4 were 0.779 (0.549 to 0.886), 0.738 (0.496 to 0.860), 0.826 (0.713 to 0.897), 0.720 (0.536 to 0.836), and 0.715 (0.532 to 0.832), respectively. The correlation between the WCTII and Chinese-Mandarin version of the Tinnitus Handicap Inventory scores was 0.849 (p < 0.001). The WCTII yielded satisfactory reliability and validity, indicating that it can be used to assess the severity of tinnitus in Chinese patients.

Development and validation of Tamil version of CARIES-QC questionnaire among socially marginalized school children in Chennai City.

The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), which was developed to assess dental caries-specific Child Oral Health Related Quality of Life (COHRQoL), has been translated into few world languages. To develop and validate the Tamil version of Caries Impacts and Experience Questionnaire for Children (CARIES-QC). This cross-sectional study was conducted among socially marginalized school children in Chennai City. The initial translation of the English CARIES-QC questionnaire to Tamil was made by two independent translators followed by an expert committee discussion to derive a prefinal version of the Tamil questionnaire. Subsequently, content validation was performed by bilingual subject experts followed by preliminary pilot testing among 30 school children aged 8-10 years studying in Adidravidar Welfare High School, Chennai, to produce the final version of the questionnaire. Convergent validity, discriminant validity, and test-retest reliability of the translated questionnaire were tested among 191 children. The content validation process revealed that the translated version had relevant questions and content coverage (Scale-wise Content Validity Index score = .91). The children with and without dental caries had mean CARIES-QC scores of 5.39 + 3.7 and 3.71 + 5.1, respectively, and their statistically significant difference (p-value = .04) between them indicates the scale's satisfactory discriminant validity. The Cronbach's alpha was .87 indicating the questionnaire's good internal consistency. The newly developed Tamil CARIES-QC questionnaire is a valid and reliable tool for assessing COHRQoL among Tamil-speaking school children.

Patient-reported outcome measures for medication treatment satisfaction: a systematic review of measure development and measurement properties

BackgroundMedication Treatment Satisfaction (M-TS) from the patients’ perspective is important for comprehensively evaluating the effect of medicines. The extent to which current patient-reported outcome measures (PROMs) for M-TS are valid, reliable, responsive, and interpretable remains unclear. To assess the measurement properties of existing PROMs for M-TS and to highlight research gaps.MethodsUsing PubMed, Embase (Ovid), Cochrane library (Ovid), IPA (Ovid), PsycINFO, Patient-Reported Outcome and Quality of Life Questionnaires biomedical databases, and four Chinese databases, we performed a systematic search for studies addressing the development and validation of PROMs for M-TS. Based on the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guideline, pairs of reviewers independently assessed the measurement properties of the PROMs and rated the quality of evidence on the measurement properties of each PROM. (The Open Science Framework registration: https://doi.org/10.17605/OSF.IO/8S5ZM).ResultsThis review identified 69 PROMs for M-TS in 114 studies (four generic, 32 disease-specific, and 33 drug-specific) of which 60 were intended for adults. All provided limited or no information regarding interpretability. Most demonstrated appropriate construct validity including convergent validity (39/69) and discriminative or known-groups validity (40/69) (high to moderate quality of evidence). Only a few provided evidence of sufficient content validity (8/69), structural validity (13/69), and internal consistency (11/69). Of 38 PROMs reporting test–retest reliability, results in 24 provided evidence of satisfactory test–retest reliability (18 with high to moderate, 6 with low to very low quality of evidence). Few PROMs reported responsiveness (16/69). Two generic PROMs (Treatment Satisfaction Questionnaire for Medication initial Version 1.4, TSQM-1.4; Treatment Satisfaction with Medicines Questionnaire, SATMED-Q) and one drug-specific PROM (Insulin Treatment Satisfaction Questionnaire, ITSQ) demonstrated both satisfactory validity and reliability.ConclusionsMost existing PROMs for M-TS require further exploration of measurement properties. Reporting guidelines are needed to enhance the reporting quality of the development and validation of PROMs for M-TS.

Evaluation of the Psychometric Properties of the Translated Physical Self-Perception Profile Among Chinese Breast Cancer Survivor

PurposeTo translate the original English version of Physical Self-Perception Profile into Cantonese Chinese, while considering linguistic and socio-cultural characteristics, and evaluate its psychometric properties among Chinese breast cancer survivors in Hong Kong, China, thus providing a valid, culturally relevant tool for assessing of the physical self-esteem among this population. MethodsThe 30-item Physical Self-Perception Profile was translated into Chinese by the combined translation technique. The psychometric properties of the Cantonese version of the Physical Self-Perception Profile were examined in 292 Hong Kong Chinese breast cancer survivors for internal consistency and test-retest reliability. A confirmatory factor analysis was conducted to evaluate the structural validity. A panel of 5 experts examined its content validity. The concurrent validity was examined by correlating the Physical Self-Perception Profile and a validated global self-esteem measure. ResultsThe Cantonese version of the Physical Self-Perception Profile demonstrated satisfactory content validity, also satisfactory internal consistency with Cronbach’s α ranging from 0.64 to 0.80, as well as good test-retest reliability, with an intra-class correlation coefficient ranging from 0.77 to 0.81. The confirmatory factor analysis showed a fairly good fit of the four-factor subdomain structure, namely, physical condition, physical strength, body attractiveness and sports competence. The concurrent validity of the Chinese-version Physical Self-Perception Profile was demonstrated by a significant positive correlation between the physical self-worth domain and four subdomains with global self-esteem. In addition, the four subdomains had statistically significant positive correlations with the physical self-worth domain indicating the instrument’s hierarchical structure. ConclusionsThe study translated the Physical Self-Perception Profile from English to Cantonese and demonstrated its desirable psychometric properties among Chinese Hong Kong breast cancer survivors. The linguistical and cultural adaptation of this instrument can serve as a valid and reliable tool for assessing physical self-esteem among breast cancer survivors in Hong Kong, China.

Development and validation of a higher-order thinking skills (HOTS) scale for major students in the interior design discipline for blended learning

Assessing and cultivating students’ HOTS are crucial for interior design education in a blended learning environment. However, current research has focused primarily on the impact of blended learning instructional strategies, learning tasks, and activities on the development of HOTS, whereas few studies have specifically addressed the assessment of these skills through dedicated scales in the context of blended learning. This study aimed to develop a comprehensive scale for assessing HOTS in interior design major students within the context of blended learning. Employing a mixed methods design, the research involved in-depth interviews with 10 education stakeholders to gather qualitative data, which informed the development of a 66-item soft skills assessment scale. The scale was administered to a purposive sample of 359 undergraduate students enrolled in an interior design program at a university in China. Exploratory and confirmatory factor analyses were also conducted to evaluate the underlying factor structure of the scale. The findings revealed a robust four-factor model encompassing critical thinking skills, problem-solving skills, teamwork skills, and practical innovation skills. The scale demonstrated high internal consistency (Cronbach's alpha = 0.948–0.966) and satisfactory convergent and discriminant validity. This scale provides a valuable instrument for assessing and cultivating HOTS among interior design major students in blended learning environments. Future research can utilize a scale to examine the factors influencing the development of these skills and inform instructional practices in the field.

Psychometric evaluation of the German version of the Questionnaire of Cognitive and Affective Empathy (QCAE)

Empathy as a central element of social cognition plays a decisive role in various psychosocial areas and interpersonal dynamics, especially within the context of psychotherapy. Despite the controversy surrounding a standardized definition, empathy is generally regarded as a multidimensional concept that encompasses both cognitive and affective dimensions. This differentiation between cognitive and affective facets is addressed by a widely used and internationally well-established self-report measure of empathy, the Questionnaire of Cognitive and Affective Empathy (QCAE). This study focuses on evaluating the psychometric properties of the German version of the QCAE. In a convenience sample (N=1300), the postulated confirmatory five-factor model showed an adequate fit to the underlying structure. The subscales of the QCAE exhibited satisfactory internal consistency and convergent validity with other instruments measuring empathy. Despite certain methodological limitations, our findings suggest that the German version of the QCAE is suitable as a reliable and valid instrument for measuring empathy. Further studies in population-representative samples and clinical populations are required before a clear recommendation regarding its utilization can be provided.

Design and validation of a simulated multitasking environment for assessing the cognitive load on the infantry squad leader.

The increasing cognitive load on infantry squad leaders is a common challenge in modern military operations. As this can increase health and safety risks, there is a need to study the factors responsible for the increase in cognitive load. Ecological situations inherently lack strong experimental controls; therefore, microworlds that simulate real tasks are the usual alternative to field studies. However, to the best of our knowledge, there are currently no microworlds that reproduce the main tasks of the squad leader during operations. This article adresses this gap by describing the design and validation of a new microworld: the Simulated Multitasking Environment for the Squad leader (SMES). Qualitative research was firstly conducted to highlight several squad leader's generic tasks (i.e., common to many situations in the field) that guided the design of the SMES. Psychometric validation of the SMES was then based on two experiments: (i) the first evaluated the microworld's psychometric qualities when tasks were performed individually; and (ii) the second explored concurrent tasks, reflecting real-world complexity. The results showed that the parameters manipulated for each task were relevant for inducing cognitive load, measured using a secondary detection response task and the NASA-TLX questionnaire. The SMES demonstrated satisfactory convergent and content validity in multitasking but not in single-task conditions. Performance in multitasking situations therefore does not seem to depend on task-specific skills, suggesting the existence of an independent factor-multitasking ability. Theoretical and practical implications of the SMES validation are discussed.

Development of a Questionnaire for Dental Utilization Based on the Andersen Model.

Background and aim Oral health is an integral part of overall general health. Understanding the variables that affect the use of dental services can help overcome the challenges and lessen disparities in oral health. There are no significant reliable questionnaires available for determining factors that influence dental care utilization.This study aimed to develop and validate a questionnaire based on the Andersen model of healthcare utilization to assess these factors. Materials and methods A preliminary questionnaire consisting of 34 items was developed based on the Andersen model of healthcare utilization.The questionnaire's final version consisted of24 items after five subject area experts analyzed its face validity and content validity. Content validity ratio (CVR) was used to evaluate the validity of the questionnaire. The Cronbach's alpha coefficient was then used to establish the internal consistency and test-retest for the reliability of the questionnaire. Results The final version of the questionnaire included 24 items based on CVR, and the data of the final version suited the model well. The internal consistency measured with Cronbach's alpha coefficient was above the threshold for each item. The Cronbach's alpha value for test-retest reliability was found to be 0.72, which was acceptable. Conclusions The current results show that the proposed questionnaire for dental utilization based on the Andersen model has satisfactory validity and reliability. This questionnaire can be used as an instrument to determine the various factors that affect the utilization of dental services.

Factor Structure and Psychometric Properties of the ED-15 in People With an Eating Disorder.

This study examines the factorial structure and psychometric properties of the Eating Disorder-15 questionnaire (ED-15) in a large clinical sample, as well as the instrument's sensitivity to early clinical change in therapy and ability to measure remission. Participants with eating disorders (N = 278) referred to the Flinders University Services for Eating Disorders in South Australia completed the ED-15 as well as other measures of eating disorder symptoms and co-occurring psychopathology, including depression, anxiety, and stress. Confirmatory factor analysis (CFA) revealed a two-factor model for the ED-15. The ED-15 had good internal consistency. It showed satisfactory concurrent validity with moderate correlations with the EDE-Q global score and contribution of unique variance to that score. Correlations indicated good convergent validity with clinical impairment and good divergent validity from depression, anxiety, and stress. The ED-15 showed a significant medium effect size change within the first four sessions of therapy. Good discriminant validity was indicated by cut-off scores used for remission, with significantly different levels of ED psychopathology and other impairments between the two groups. This study adds to the four previous psychometric studies of the ED-15, confirming robustness of the English version in a clinical sample. The brevity and psychometric robustness of the ED-15 makes it a preferable measure to the Eating Disorder Examination for sessional assessment of progress in treatment.

The moral role models scale: Assessing connections to and functions of moral exemplars

ABSTRACT Recent accounts of character formation highlight the role of admiring and emulating moral role models or exemplars as a key facilitator of moral development. However, validated measures that assess the extent to which individuals affiliate with and are impacted by moral exemplars have not been developed. The present research fills this gap by developing and providing initial validity evidence for the Moral Role Models Scale (MRMS). Through exploratory and confirmatory analyses of data drawn from 456 participants, a single-factor version (10 items) of the MRMS was found to have both strong internal structure and satisfactory convergent and discriminant validity. The MRMS can be a useful tool to both researchers and practitioners of character education in exploring, clarifying, and evaluating the role of moral exemplars in moral formation.

Coconut Milk Consumption and Breast Cancer Risk in Thai Women: A Case-Control Study

Coconut milk contains plant-based saturated fat and phytochemicals with antioxidant activities. However, its role in breast cancer risk remains unclear. A case-control study was conducted on 244 participants to study the association. The Case group includes 61 newly diagnosed breast cancer patients receiving < 6 months of therapies. The Control group includes 183 healthy people with matched characteristics. A new questionnaire was developed, validated, and used in this study to estimate the frequency of coconut milk-containing food intake. Results show that the questionnaire has satisfactory content validity, test-retest reliability, and criterion-related validity. From the case-control study, either consuming 1–3 or 4–6 times/week of coconut-milk-containing curry or consuming 4–6 times/week of coconut milk-topped desserts are associated with increased risk of breast cancer (OR = 5.23, 5.6, and 2.6 respectively, p < 0.01). Consuming less than half of coconut milk liquid in desserts correlated with a reduced risk (OR = 0.43, p < 0.05). The findings suggest that moderate (less than half of a serving) and infrequent (less than once a week) consumption of coconut milk may be beneficial for breast cancer prevention. A larger scale study is warranted to confirm the findings and provide evidence for dietary recommendations.

Global Leadership Initiative on Malnutrition criteria using calf and upper arm circumference as phenotypic criteria for assessing muscle mass demonstrate satisfactory validity for diagnosing malnutrition in hospitalized patients: A prospective cohort study.

Hospitalized individuals present high rates of malnutrition and loss of muscle mass (MM). Imaging techniques for assessing MM are expensive and scarcely available in hospital practice. The Global Leadership Initiative on Malnutrition (GLIM) proposed a framework for malnutrition diagnosis that includes simple measurements to assess MM, such as calf circumference (CC) and mid-upper arm circumference (MUAC). This study aimed to analyze the validity of the GLIM criteria with CC and MUAC for malnutrition diagnosis, using Subjective Global Assessment (SGA) as the reference standard, in inpatients. A prospective cohort study was conducted on 453 inpatient adults in a university hospital. The presence of malnutrition was assessed within 48 h of hospital admission using SGA and GLIM criteria using CC and MUAC as phenotypic criteria for malnutrition diagnosis. Accuracy, agreement tests, and logistic regression analysis adjusted for confounders were performed to test the validity of the GLIM criteria for malnutrition diagnosis. The patients were aged 59 (46-68) years, 51.4% were male, and 67.8% had elective surgery. Compared with SGA, the GLIM criteria using the two MM assessment measures showed good accuracy (area under the curve > 0.80) and substantial agreement (κ > 0.60) for diagnosing malnutrition. The highest sensitivity was obtained with GLIMCC (89%), whereas GLIMMUAC showed high specificity (>90%). Also, malnutrition identified by GLIMCC and GLIMMUAC was significantly associated with prolonged hospitalization and in-hospital death. In the absence of imaging techniques to assess MM, the use of CC and MUAC measurements from the GLIM criteria demonstrated satisfactory validity for diagnosing malnutrition in hospitalized patients.