Scale Questions Research Articles

Suicidal thoughts and behaviors among gender-minority adolescents in the emergency department.

Gender-minority youth, whose gender identity differs from their sex assigned at birth, have elevated suicide risk compared to cisgender youth, yet few studies examine their suicide risk in the emergency department (ED). Our objectives were to determine the prevalence of and assess risk and protective factors associated with prior suicide attempt (SA) and recent suicide ideation (SI) among gender-minority adolescents in the ED. We conducted a secondary analysis of gender-minority adolescents in the Emergency Department Screening for Teens at Risk for Suicide (ED-STARS) multicenter, random-series prospective cohort study. Prior SA and recent SI were based on the Columbia Suicide Severity Rating Scale and Ask Suicide-Screening Questions, respectively. We conducted Firth's logistic regressions to assess risk and protective factors associated with prior SA and recent SI. Of 6641 adolescent participants in ED-STARS, 280 (4.2%) identified as gender minority. Of the gender minorities, 72% presented with a nonpsychiatric complaint, 37% admitted to a prior SA, and 25% reported recent SI. Prior SA was associated with the number of self-harm methods in the prior 12 months (adjusted odds ratio [aOR] 1.5, 95% confidence interval [CI] 1.3-1.9), sexual minority (aOR 5.0, 95% CI 2.5-10.6), and mother's history of prior SA (aOR 3.6, 95% CI 1.5-9.2). Recent SI was associated with hopelessness (aOR 4.2, 95% CI 1.5-13.9), lower positive affect (aOR 0.9, 95% CI 0.8-1.0), sexual minority (aOR 8.3, 95% CI 2.5-37.8), five or more self-harm events in the prior 12 months (aOR 4.9, 95% CI 2.1-11.6), and number of illicit drug classes (aOR 1.9, 95% CI 1.2-3.2). Among gender-minority ED adolescent patients, one in three experienced a SA prior to the ED visit. One in four endorsed SI within 2 weeks of the ED visit. The identified risk and protective factors among gender-minority adolescents may inform future ED-based efforts to detect and reduce suicide risk.

Роль социальной активности молодежи в выраженности идентичностей и их согласованности

<p style="text-align: justify;"><strong>Objective.</strong> To identify the role of commitment to various forms of social activity in the expression of student youth identities and their consistency. <br><strong>Background.</strong> Social activity is the sphere of socialization of young people. Therefore, in the process of its implementation, various socio-psychological formations of the individual are formed. One of the most important is social and personal identity, considered in this study as the effects of social activity. The most important task is to study the role of involvement in various forms of activity in the formation of social identity and the stability of the personal role identity of young people. Such scientific knowledge will allow to establish the potential of social activity in the formation of youth identity. <br><strong>Study design.</strong> The factor structure of social identity and the relationship between types of identity and forms of social activity were studied. To establish the types of identity, factor analysis was used, the presence and nature of the relationship were recorded through correlation and regression analyses. <br><strong>Participants.</strong> 442 residents of Russia (average age 21,8; 33,5% men, 66,5% women). <br><strong>Measurements. </strong>Questionnaire, including 18 scale questions, meaningfully describing the forms of social activity (R.M. Shamionov, etc.); 17 categories of social identity, identified on the basis of preliminary piloting; methodology of stability of personal-role identity (E.A. Petrash, V.B. Nikishina). <br><strong>Results. </strong>Various categories of social identity form 4 enlarged groups (types) based on factor analysis. Various forms of social activity of young people form 4 enlarged groups (types) based on factor analysis: identity – personal, Internet-user, political and civil-family identity. The effects of combinations of different forms of social activity is the formation of a particular type of social identity. Forms of social activity explain from 21% to 36% of variations in social identity. The most pronounced relationship between the stability of personal-role identity was found with civic identity. <br><strong>C</strong><strong>onclusions.</strong> The inclusion of students in certain forms of social activity can contribute to the formation of various types of identity and achieve a certain level of them. It is also established that the consistency of personal-role identity is positively conditioned by religious and family-household activity, and protest, spiritual and leisure forms contribute to its decrease.</p>

Nomogram for predicting nutritional risk of cognitive impairment

Background Cognitive impairment patients are prone to malnutrition, which further promotes cognitive decline. Cognitive impairment patients are unable to accurately answer subjective questions in the nutrition screening scale. Therefore, it is crucial to establish a nutritional risk prediction model using objective evaluation indicators to evaluate the nutritional status of cognitive impairment patients during hospitalization. Objective To develop a nomogram for prediction of the nutritional risk in cognitive impairment patients. Methods The least absolute shrinkage and selection operator (LASSO) was used for regression analysis, and predictive factors were selected based on 10-fold cross validation. Then, using the selected predictive factors, multivariable logistic regression analysis was performed to obtain the final clinical prediction model. Moreover, the performance of the model was evaluated from receiver operating characteristic curve, calibration curve, and decision curve analysis. Further assessment was conducted through internal validation. Results Six predictive factors were selected from 20 variables through LASSO, including body mass index, age, triglyceride, taking cognitive-improving drugs, controlling nutritional status, and geriatric nutritional risk index. The area under the receiver operating characteristic curve of the training cohort was 0.91, while the validation cohort was 0.88, indicating that the model constructed with 6 predictors had moderate predictive ability. The decision curve analysis showed that the threshold range for both groups was 0.00–0.80, with the highest net benefit 0.76 for training cohort, while 0.77 for validation cohort. Conclusions Introducing six predictive factors, the risk nomogram is useful for predicting nutritional risk of cognitive impairment.

“With a Little Help from my Friends”: Exploring Pseudo-Social Music Listening Experiences

Contemporary research highlights intimate connections between music and social bonding, such that even modern music listening behaviors, including listening when alone, may be social experiences; in some cases, music may behave as a social “agent” with which interpersonal or social experiences can occur for listeners. However, these types of experiences, labeled here as pseudo-social music listening ( P-SML) experiences, have rarely been investigated directly. This paper outlines a preliminary study of P-SML experiences, exploring six conceptual types of experience identified in existing literature ( Company, Consolation, Empathy, Personas and Narratives, Identification, and Feeling One with music). Through a questionnaire containing rating scale and open-ended questions, participants ( N = 117) highlighted how relatable these six proposed P-SML types were to their own listening experiences, by ranking vignette statements describing the experiences of other listeners. Participants then recalled a P-SML experience of their own, describing their subjective feelings, qualities of the music involved, and whether this experience is consistent or situation-dependent. Results suggest that participants often described P-SML experiences as emotional experiences that involve a felt sense of connection or resonance between listener and music. Factors considered important for P-SML experiences include the emotional expression of the music, melodies and harmonies, and rhythm. Extra-musical knowledge, such as knowledge of the composer, songwriter, or performer, was considered less important. Findings are discussed in terms of links between music, emotion and social bonding, conceptualizing connection and resonance when listening to music in relation to parasocial interactions, and refining a conceptual foundation of P-SML experiences for future work.

Livestock farmer-reported knowledge and attitudes regarding agroforestry planning and management

This study aimed to explore the knowledge and attitudes of livestock farmers from the United Kingdom regarding agroforestry planning and management issues. The farmers (n = 48) answered an online survey with demographic, open, closed and Likert scale questions. Almost half of the participants said they need more information to successfully plan and manage an agroforestry system, and self-reported low knowledge on management practices related to trees. Participants stated they did not expect to receive technical support from governmental agencies to maintain the agroforestry area. However, they would like to improve their knowledge through field days, courses, and Internet sources. Benefits to the environment, animals and farm profitability were considered central to successful agroforestry systems. In conclusion, participants cannot successfully plan and manage agroforestry, but they are willing to improve their knowledge and skills.

대학생 공공성 척도 개발에 따른 타당화 연구

Objectives Based on positive organizational theory, this study developed and validated a scale to measure the degree of publicness focusing on college students' school life. Methods Questions were developed from the perspective of university students focusing on the main elements of the concept of publicness in positive organizational scholarship, and the main survey was conducted with a draft finalized through a Delphi survey and group interviews with experts. Afterwards, the validity and reliability of the scale were verified based on the data of 251 people in the main survey. Results First, as a result of developing the scale draft, 49 questions in the initial draft were extracted into 38 questions after a Delphi survey, and 40 questions were confirmed as the final draft through item modification in a group interview with experts. Second, as a result of the descriptive statistical analysis of the questions after the main survey, an exploratory factor analysis was conducted assuming normal distribution of the item response distribution and item discrimination at an appropriate level. When one heterogeneous factor item was deleted and the factor loadings of a total of 39 items were considered, The appropriateness of the four-factor structure was confirmed. Lastly, as a verification of the goodness of the finalized scale, a normal distribution was assumed in the item response distribution, and a significant difference was confirmed in the item differentiation between the upper and lower groups(p=.000). The overall reliability, which is the internal fit of the scale, was .982, and a significant correlation between sub-domains was confirmed in construct validity (p<.01), so a total of 39 questions of the college student publicness scale were verified as a reliable and valid scale. Conclusions Based on the concept of positive organizational research, a scale was completed to examine the concept of publicness among university students through validation.

Student Engagement and Perceptions in College English Writing Classes Based on Sustainable Development Goals (SDGs)

The purpose of this study is to examine Korean college students’ engagement with the Sustainable Development Goals (SDGs) in English academic writing classes and their perceptions of this integration. A total of 47 students participated in the study during the spring semester of 2024. The primary data source was a survey questionnaire that included multiple-choice questions, five-Likert scale questions, and open-ended questions. Quantitative data were analyzed using descriptive statistics, while qualitative responses were examined through thematic analysis. The findings reveal that many students tended to focus on a single SDG within the social or environmental domain throughout the semester, generally selecting topics based on their interests and/or familiarity. They also placed greater value on the individual writing process compared to the interactive writing process. These results suggest areas where students’ engagement with the SDGs and related writing activities could be improved. Regarding their perceptions, most students viewed the integration of the SDGs as appropriate, emphasizing their relevance as writing topics and their educational value. SDG-focused writing activities were perceived as beneficial for enhancing students’ learning in both cognitive and social-emotional domains, particularly by deepening their awareness and understanding of SDG-related issues and improving their experience with English academic writing. However, students reported relatively less growth in their social-emotional development compared to cognitive development and exhibited limited intrinsic interest in the SDGs and English academic writing. Based on these findings, implications are proposed for instructors seeking to integrate the SDGs into English academic writing classes.

Participation of Clients in the E-Banking Practices of Nepalese Commercial Banks

The aim of present research was to analyze the different e-banking services provided by Nepalese commercial bank in terms of customers’ participation. Nowadays, almost all commercial banks and financial intermediaries provide internet banking services for their customers in order to reduce cost and time. This study conducted to understand the different technological advancement used by the Nepalese commercial bank in their day-to-day operation. Data for this research came from both primary and secondary sources: responses from a questionnaire and many secondary sources. Present investigation was conducted utilizing a survey technique using a questionnaire as the data collecting tool. To get understanding of consumers' involvement in the Nepalese banking sector, structured sets of questions including Likert scale questions, yes/no questions, multiple choice questions were asked. According to the findings of this study, decision-makers should take into consideration the importance of centering their attention on the alertness, and faith of clients. This can be accomplished by enhancing safety measures, implementing proper e-legislation, and offering electronic bills or assurance for each and every transaction. The ultimate goal is to instill a greater sense of confidence in those who use such services and to encourage a culture of internet banking usage throughout Nepal. The findings of this study indicate that both the environment in which the application for online banking is used and the program itself are in need of further enhancement. The bank should always place a strong emphasis on encouraging consumer participation in the use of online banking services, rather than only focusing on the implementation of latest technological advancements.

EFL Learners' View on the Use of Flip for Oral Practice

Flip, a free video-based app, offers the potential for creating interactive discussion spaces and promoting much-needed oral practice for English as a Foreign Language (EFL) learners. This study aimed to discover A1 learners' perceptions of Flip's usability, effectiveness for oral practice, and perceived advantages and disadvantages. Thirty university beginner students voluntarily participated in an online questionnaire comprising closed-ended questions using the Likert scale and open-ended questions aiming for qualitative data. Findings revealed that the app was overwhelmingly well-received by students who found it easy to use, practical, dynamic, and useful for oral practice. Cited advantages included utility, accessibility, and the ability to view and learn from classmates' videos. A few disadvantages were also mentioned, such as the need for a steady internet connection and some anxiety about sharing videos publicly. The study concluded that learners hold a positive view of Flip Flip and that it should be more widely utilized by English teachers in their classrooms, given its potential for facilitating oral practice and interactive discussions among EFL students.

The scale question as an urban question: The making of homo urbanicus amid state entrepreneurialism

This research bridges two influential strands of literature on urban China—state entrepreneurialism and homo urbanicus (城市人). By revisiting how China’s post-reform urban transformation has unfolded and connecting it to current development strategies, this research provides a fresh perspective on the country’s urbanization processes and their implications for future governance. The analysis proposes an alternative periodization of three phases: anti-migration urbanism, anti-settlement urbanism, and anti-civitas urbanism. Beyond understanding urbanization as a crisis-driven, state-rescaling phenomenon pivoting around the blending of state and market forces, this research repositions the concept of homo urbanicus, or the urban citizen, as central to understanding the urban question in China’s governance strategies. The study urges scholars to reconsider urbanization not only as a structural transformation but as a transformative redefinition of citizenship critical to understanding China’s ongoing drive to “people-centered urbanzation”.

ANALYSIS OF DETERMINANTS INFLUENCING GENDER DISPARITIES IN LEADERSHIP POSITIONS WITHIN THE HIGHER EDUCATION SECTOR OF SRI LANKA: EVIDENCE OF GLASS CEILING

The term 'Glass Ceiling' refers to invisible yet impenetrable barriers that prevent women and minorities from climbing to top positions, regardless of their accomplishments. To address the existing gap in this particular field of research, the study highlights the urgent need to prioritize diversity, acknowledge the leadership potential of women, and foster inclusive environments that support women in reaching senior academic roles in the Sri Lankan context. The analysis utilized a web-based structured questionnaire with five-point Likert scale questions to gather data from 290 female academics in Sri Lankan state universities through purposive sampling. The study deployed Partial Least Squares - Structural Equation Modeling (PLS-SEM) to identify the relationship and magnitude between variables. The analysis revealed significant inverse correlations between Cultural Barriers (r = -0.108, p = 0.000), Family Barriers (r = -0.095, p = 0.000), and Perceived Discrimination (r = -0.266, p = 0.000) with women's career progression, while Organizational Environment (r = 0.086, p = 0.000) and Motivation and Satisfaction (r = 0.566, p = 0.000) positively impacted their career progression. Hence the findings of the research strongly suggest reducing the gender-based disparities in leadership roles within academia. The study provides valuable implications to empower women for leadership roles while highlighting the role of the higher education system and relevant authorities in Sri Lanka. Keywords: , , , ,

Prevalence of Primary Dysmenorrhea and Its Associated Risk Factors among Adolescent Girls in Selected Schools of Lusaka District, Zambia

Background: Dysmenorrhea is a common gynecological issue among young females. However, no studies in Zambia have examined the prevalence and associated factors of primary dysmenorrhea among adolescent girls. This study aimed to determine the prevalence and associated factors of primary dysmenorrhea among adolescents in selected schools in the Lusaka District. Methods: A cross-sectional study was conducted in eight randomly selected schools in Lusaka, including 400 post-menarche girls aged 10–19 years. Participants were selected via random sampling, and data were collected using a researcher-designed questionnaire informed by literature. The tool included closed-ended and Likert scale questions, piloted for reliability (Cronbach's alpha: 0.8–0.9). Analysis was performed using STATA version 14.2, with variables having p < 0.05 in multivariate logistic regression considered statistically significant. Results: All 400 participants responded (response rate: 100%). The prevalence of primary dysmenorrhea was 78% (312/400; 95% CI: 73.6%–82.0%). Major risk factors included a positive family history (p < 0.001) and symptoms like breast tenderness (p = 0.008), diarrhea (p < 0.001), headache (p = 0.002), and nausea (p = 0.015). Menstrual cycles lasting 31–35 days (p = 0.034) and moderate menstrual flow (p = 0.011) were also significant. Conclusion: Primary dysmenorrhea is highly prevalent among adolescents in Lusaka. Determinants included family history, long cycles, moderate flow intensity, and menstrual discomfort.

Health care professionals’ views on a new postpartum contraception audiovisual animation: a survey

BackgroundThe postpartum period is a high-risk time for unintended pregnancy. We developed a 2-minute audiovisual animation on postpartum contraception (PPC) including the return of fertility after birth for patients. The...

Chat GPT를 활용한 토의에 대한 예비교사 인식 연구: A 대학 교직실무 과목 수강생을 중심으로

Objectives The purpose of this study were to analyze pre-service teachers’ perceptions of the case of discussion practices using chat GPT in university teaching profession classes and to identify effective strategies for the discussion. Methods After designing and conducting the six discussions using chat GPT with 47 students in teaching practice classes at A University in Gyeonggi-do, a survey was conducted on the discussion process and the effectiveness, advantages, disadvantages, and implications of the successful discussion. The process and effects of the discussion were investigated using 5-point scale questions to derive the mean and standard deviation, and the advantages, disadvantages, and implications of the successful discussion were investigated using open-ended descriptive questions, and content analysis was conducted using the constant comparison method. Results The students were generally positive about the process and effectiveness of discussions using chat GPT. Improvement of the quality of discussion, progression of difficult topic discussion, checking of the contents of prior discussion, and development of thinking were recognized as advantages, and the decline in effort to think due to over-dependence, lack of time, errors and dissatisfaction of the answers were recognized as disadvantages. Conclusions Discussions using chat GPTs are generally expected to be useful, but to be effective, it was suggested that thorough pre-discussion, critical analysis with peers and follow-up questions and answers using chat GPTs sufficient time allocation, and instructor feedback to address errors and doubts are important.

Understanding Greenhouse Tomato (Solanum lycopersicum L.) Growers’ Perceptions for Optimal Phthorimaea absoluta (Meyrick) Management—A Survey in Greece

The tomato (Solanum lycopersicum L.) leafminer, Phthorimaea absoluta (Meyrick) (Lepidoptera: Gelechiidae), is an extremely invasive pest and is threatening tomato production worldwide. Several strategies have been developed and implemented for managing P. absoluta. Effective pest control strategies based on integrated pest management (IPM) schemes include different cultural practices and techniques. This study seeks to (a) examine the perspectives, attitudes, and opinions of greenhouse tomato producers in Greece regarding different methods of P. absoluta management and (b) to determine whether the perceived damage caused by P. absoluta could be predicted by the implementation of various control management strategies. A questionnaire was employed to ascertain the views and beliefs of the participants. The questionnaire comprised five-point Likert scale questions. Principal component analysis (PCA) and binary logistic regression analysis were applied to examine the relationship between the reported perceived insect damage and the utilization of control techniques. The study findings indicate that greater adoption of alternative control methods and higher levels of adherence to preventive measures against P. absoluta are associated with a perception of reduced levels of damage. Conversely, individuals with a strong reliance on pesticides use are more likely to perceive a higher level of damage. Ultimately, as tomato growers are trying to deal with P. absoluta, more education and research on other alternatives could help the reduction of chemical use, promoting more environmentally friendly practices. The findings highlight integrated pest management over pesticides for sustainable tomato production. This can guide future research and extension efforts to develop tailored P. absoluta management approaches for Greek greenhouse growers and similar environments.

Assessing Attitudes and Perceptions of Unconscious Bias Experienced by Surgical Oncology Fellows.

Racial and ethnic minorities remain underrepresented in the surgical workforce with well-documented barriers to diversity and inclusion, including financial support, lack of mentorship, and high attrition rates. Recent literature has documented race and sex discrimination in the training of surgical residents but little is known about the experience of discrimination at the surgical fellowship level. The goal of our study was to assess attitudes and perceptions of unconscious bias experienced during surgical oncology fellowship training at our institution. All graduates in the Department of Surgery at a single institution from 2016 to 2021 were eligible to participate. Graduates were contacted via their last known email address and asked to complete an electronic survey. The survey included de novo multiple choice, Likert scale, and free response questions developed by the authors to identify sociodemographic data and experiences related to unconscious bias. Overall, 271 graduates were contacted, with a response rate of 26% (n=72). The majority of responders were male (60%) and self-identified as White (72%). Twenty-five percent reported witnessing someone else being unfairly treated and 10% of responders felt their race affected patient interactions. Free-text responses demonstrated clear examples of macroaggressions and microaggressions related to ethnicity, particularly among international fellows.. In our survey of recent surgical oncology fellows, diversity of graduates was limited and reported experiences of discrimination were more common among international graduates. Assessment of institutional culture and the experience of trainees is a necessary step to ensure adequate support and active strides towards equity and inclusion.

Assessment of Ophthalmology Residency Training in Switzerland: A Trainee-Based Survey.

This study aimed to evaluate the current status of ophthalmology residency training in Switzerland and provide insights for enhancing training programs. The survey covered demographic data such as gender, age, workplace, and year of residency, as well as working conditions, current practical and diagnostic skills, interest in scientific work, and future plans. It consisted of 16 multiple choice questions (MCQ), 5 multiple select questions (MSQ), 8 free-text, 6 Net Promoter Score (NPS), and 4 Likert scale questions. All Young Swiss Ophthalmologists (YSO) members received an invitation to participate in the survey using an online form. All collected data were anonymized, and participants provided their consent for data collection, analysis, and publication. The survey assessed the perspectives of 63 Swiss ophthalmology residents on their training experiences. Respondents indicated the greatest interest in specializing in cataract and vitreoretinal surgery, followed by cornea, glaucoma, refractive surgery, and lid surgery. They also expressed a great need for improved supervision, structured curricula, and alignment of clinical and research duties. While pursuing additional surgical training and private practice autonomy, residents also expressed a preference for balanced workloads that emphasize patient care over full-time academic work. The survey indicates a need to standardize ophthalmology residency training in Switzerland to ensure comprehensive and uniform education. It also highlights specific areas for improvement, such as the absence of surgical training. Ongoing assessments are necessary to evaluate future developments.

Addressing code response challenges: Development of a pharmacist‐focused training program at an Academic Medical Center

AbstractIntroductionPharmacists are essential to the multidisciplinary team during code response. Commercially available basic and advanced‐life support training programs are not tailored for the depth of medication‐specific content essential for pharmacists to competently respond to codes. Opportunities exist to provide additional training to improve pharmacists' code response.ObjectiveTo develop pharmacist‐specific didactic education and hands‐on assessments for adult code response.MethodsAt our institution, acute care clinical staff pharmacists attend all adult codes. A mandatory pharmacist training program was designed to meet minimum institutional expectations for code response and address knowledge gaps. The program included three components: (1) online training module, (2) knowledge‐based assessment, and (3) hands‐on assessment. Pharmacists were surveyed pre‐ and post‐completion of the training program. The surveys consisted of 15 Likert scale questions and open‐ended questions. Chi‐square tests were used to compare a “positive” response to pre‐ and post‐survey questions. A “positive” response was defined as “Strongly Agree” or “Agree” on the Likert questions.ResultsSeventy‐three pharmacists completed the training program with 71 passing the hands‐on skills training on the first attempt. The pre‐ and post‐intervention survey was completed by 43/74 (58.1%) and 33/82 (40.2%) of pharmacists, respectively. A statistically significant increase in the number of “positive” survey responses was noted in 7 of the 15 Likert scale questions post‐intervention, with nominal improvements in the remaining 8. There were notable improvements in pharmacist perceived familiarity and comfort with medication locations (9% vs. 64%) and preparation (44% vs. 76%), and greater confidence in using available resources.ConclusionThe pharmacist‐specific code response training resulted in notable improvements in disclosed familiarity and comfort with code responsibilities. This training was transitioned into an annual competency module that may be used as a framework for other institutions implementing a similar process to maintain a standard level of competence in code response for pharmacists.

Development and Validation of a Novel Tool to Measure Medication Adherence for Noncommunicable Diseases in India: Protocol for an Exploratory Sequential Mixed Methods Multicentric Study.

In high-income countries, only 50% of patients treated for chronic diseases adhere to the prescribed treatment. This issue is even more pronounced in resource-limited countries. Medication adherence scales are simple, low-cost approaches to identify nonadherence in clinical practice. In India, nonadherence to medication varies from 18.7% to 74%, assessed using scales validated in the Western population, as there is no validated medication adherence tool contextualized to the Indian setting. The phrasing of questions in scales validated elsewhere and its interpretations may vary when applied in Indian patients unless accounting for the unique cultural, social, and economic factors influencing medication adherence in India. This could result in inaccurate reports of adherence behavior. This study aims to develop and validate a novel medication adherence tool for select noncommunicable diseases (diabetes mellitus, hypertension, chronic obstructive pulmonary disease, bronchial asthma, and coronary artery disease) in the Indian population. An exploratory sequential mixed methods design will be used, beginning with a qualitative phase where the construct of the scale is defined and preliminary items are generated through a scoping review, focus group discussions, and in-depth interviews. This will be followed by the tool's development phase, including an expert panel review and item revision. Finally, a quantitative phase in 4 zones in India (North, South, East, and West) will be conducted to confirm and validate the newly developed scale. In the first phase, we will frame the construct definition and develop an inventory of potential items for the proposed medication adherence tool. In the second phase, item-level and scale-level content validity indices, along with content validity ratio, will be estimated. In the third phase, we will conduct an item reduction analysis and determine the scoring matrix and item weightage after expert review. We will assess the tool's psychometric properties, plot the receiver operating characteristic (ROC) curve to set an adherence cut-off score, and compute the construct validity and test-retest reliability from the quantitative survey. A medication adherence tool for noncommunicable diseases, developed after ensuring it is ethnically, culturally, and linguistically appropriate incorporating stakeholder perspectives and validated in community settings, would offer a real-world perspective of adherence. The tool will have 2 versions for clinical practice and research, aiding policy makers in adopting tailored adherence policies. PRR1-10.2196/60805.

Psychological distress does not predict decisional regret in patients undergoing spinal reconstruction for adult spinal deformity

PurposeThe study aimed to assess the link between preoperative psychological distress and postoperative decisional regret in adult spinal deformity (ASD) surgery patients. We hypothesized that greater pre-surgery distress would correlate with higher post-surgery regret. This evaluation was based on a retrospective case series from an institution with standardized surgical guidelines for ASD.MethodsThis IRB-approved retrospective study analyzed our institution’s ASD database from 2014 to 2020. Eligible patients had a minimum two-year post-op follow-up and preoperative psychological distress assessment. Patients were grouped based on psychological distress levels: green, yellow, and yellow minus. Regret post-surgery was assessed using the Decision Regret Scale and SRS-22 Question 22. Logistic regression evaluated the impact of distress levels on regret, controlling for age and sex.ResultsOut of 167 eligible patients, 112 responded and were analyzed. No significant demographic differences were observed between responders and non-responders. Using the Decision Regret Scale, 41% expressed no regret, while 63% expressed no regret with the SRS-22 questionnaire’s Single-Item scale. Only the yellow minus group showed significant regret difference based on osteotomy, with non-recipients more likely to express regret.ConclusionThis study found no significant link between psychological distress and post-operative regret in adult spinal deformity surgery after a minimum 2-year follow-up. Although nearly 60% exhibited some post-surgery regret, predicting regret based on psychological burden or demographics remains challenging. Further research is essential to identify factors contributing to post-operative regret in spinal deformity surgery patients.