Sufficient Validity Research Articles

A systematic review and mapping exercise to assess the content validity of patient-reported outcome measures for adults having reconstructive surgery of the lower limb.

Lower limb reconstruction (LLR) has a profound impact on patients, affecting multiple areas of their lives. Many patient-reported outcome measures (PROMs) are employed to assess these impacts; however, there are concerns that they do not adequately capture all outcomes important to patients, and may lack content validity in this context. This review explored whether PROMs used with adults requiring, undergoing, or after undergoing LLR exhibited content validity and adequately captured outcomes considered relevant and important to patients. A total of 37 PROMs were identified. Systematic searches were performed to retrieve content validity studies in the adult LLR population, and hand-searches used to find PROM development studies. Content validity assessments for each measure were performed following Consensus-based Standards for the selection of health measurement Instruments (COSMIN) guidelines. A mapping exercise compared all PROMs to a conceptual framework previously developed by the study team ('the PROLLIT framework') to explore whether each PROM covered important and relevant concepts. The systematic searches found 13 studies, while hand searches found 50 PROM development studies, and copies of all 37 measures. Although several studies discussed content validity, none were found which formally assessed this measurement property in the adult LLR population. Development of many PROMs was rated as inadequate, no PROM had sufficient content validity in the study population, and none covered all areas of the PROLLIT framework. The LIMB-Q was the most promising and comprehensive measure assessed, although further validation in a wider sample of LLR patients was recommended. Current PROMs used in adults requiring, undergoing, or after undergoing LLR lack content validity and do not assess all important and relevant outcomes. There is an urgent need for improved outcome measurement in this population. This can be achieved through development of a new PROM, or through validation of existing measures in representative samples.

Spatiotemporal Monitoring of Cropland Soil Organic Carbon Changes From Space.

Soil monitoring requires accurate and spatially explicit information on soil organic carbon (SOC) trends and changes over time. Spatiotemporal SOC models based on Earth Observation (EO) satellite data can support large-scale SOC monitoring but often lack sufficient temporal validation based on long-term soil data. In this study, we used repeated SOC samples from 1986 to 2022 and a time series of multispectral bare soil observations (Landsat and Sentinel-2) to model high-resolution cropland SOC trends for almost four decades. An in-depth validation of the temporal model uncertainty and accuracy of the derived SOC trends was conducted based on a network of 100 long-term monitoring sites that were continuously resampled every 5 years. While the general SOC prediction accuracy was high (R2 = 0.61; RMSE = 5.6 g kg-1), the direct validation of the derived SOC trends revealed a significantly greater uncertainty (R2 = 0.16; p < 0.0001), even though predicted and measured values showed similar distributions. Classifying the results into declining and increasing SOC trends, we found that 95% of all sites were either correctly identified or predicted as stable (p < 0.001), highlighting the potential of our findings. Increased accuracies for SOC trends were found in soils with higher SOC contents (R2 = 0.4) and sites with reduced tillage (R2 = 0.26). Based on the signal-to-noise ratio and temporal model uncertainty, we were able to show that the necessary time frame to detect SOC trends strongly depends on the absolute SOC changes present in the soils. Our findings highlight the potential to generate significant cropland SOC trend maps based on EO data and underline the necessity for direct validation with repeated soil samples and long-term SOC measurements. This study marks an important step toward the usability and integration of EO-based SOC maps for large-scale soil carbon monitoring.

Lifestyle Profile Scale for Gravida with Urinary Incontinence: scale development and psychometric testing in Chinese Mainland

ObjectivesA significant number of women may experience urinary incontinence (UI) during pregnancy. While lifestyle modifications are recommended as important measures for preventing and treating UI, little is known about the...

Development of a Japanese version of the Fresno test for family physicians to measure evidence‐based medicine competence

Development of a Japanese version of the Fresno test for family physicians to measure evidence‐based medicine competence

Household chaos, emotion regulation and social adjustment in preschool children

Social adjustment is critical to preschool children’s overall development and well-being. Household chaos and emotion regulation are important influencing factors that affect young children’s social adjustment. Our study examines the interplay between household chaos and social adjustment among preschool children and investigates the mediating function of emotion regulation. Three parent report scales with sufficient reliability and validity were completed by parents from six kindergartens: the Confusion, Hubbub and Order Scale (CHAOS), Emotion Regulation Checklist (ERC), and Social Competence and Behavior Evaluation (SCBE-30). The results showed that household chaos can directly and indirectly predict social adjustment via the intermediary effect of emotion regulation. Understanding and addressing household chaos, as well as supporting children in developing emotion regulation skills, can play a significant role in promoting social adjustment and mental health in preschool children.

Objective Structured Clinical Examination to Assess Patient Safety Competencies of Japanese Medical Students: Development and Validation Argument.

Background The growing emphasis on improving patient safety over the past two decades has received more focus in the undergraduate curricula, and the appropriate assessment of patient safety competencies at graduation is crucial in competency-based medical education. However, there is no valid method for assessing patient safety competencies because current assessment methods in medical education focus less on behavior. The objective structured clinical examination (OSCE) is a method to assess clinical performance and has been implemented by medical schools in Japan for summative assessment at graduation. However, stations with sufficient validity to assess patient safety competencies have not yet been developed. Thus, this study aimed to evaluate, under a contemporary validity framework, an OSCE station for assessing patient safety competencies that students are expected to achieve at graduation from medical schools in Japan. Methods A validity argument was conducted using Messick's validity framework, which includes content, response process, relations to other variables, internal structure, and consequences. First, we applied a modified Delphi study to develop OSCE stations for assessing patient safety competencies based on the national model core curriculum at graduation. The panel survey recruited members who have expertise in clinical education and patient safety. The draft stations simulated various situations associated with patient safety. Final-year medical students then took the OSCE. We analyzed the results of the OSCE, compared the scores with those of the clinical reasoning examination, and evaluated its reliability. Results Out of 30 panelists, 22 (73.3%) fully participated in the Delphi rounds. After two Delphi rounds, we established four stations to assess patient safety competencies. They met the content dimension of the validity framework. The OSCE results showed low correlation with clinical reasoning, suggesting that patient competencies cannot be inferred from clinical reasoning. Each station had satisfactory reliability. The entire process minimized possible assessment bias. Conclusions The OSCE scenario designed through the modified Delphi study met the five criteria of Messick's validity framework. The results show that it is a valid strategy for assessing patient safety competencies at graduation.

Advancing Precision Oncology with Digital and Virtual Twins: A Scoping Review.

Digital twins (DTHs) and virtual twins (VTHs) in healthcare represent emerging technologies towards precision medicine, providing opportunities for patient-centric healthcare. Our scoping review aimed to map the current DTH and VTH technologies in oncology, summarize their technical solutions, and assess their credibility. A systematic search was conducted in the main bibliographic databases, identifying 441 records, of which 30 were included. The studies covered a wide range of cancers, including breast, lung, colorectal, and gastrointestinal malignancies, with DTH and VTH applications focusing on diagnosis, therapy, and monitoring. The results revealed heterogeneity in targeted topics, technical approaches, and outcomes. Most twining solutions use synthetic or limited real-world data, raising concerns regarding their reliability. Few studies have integrated real-time data and machine learning for predictive modeling. Technical challenges include data integration, scalability, and ethical considerations, such as data privacy and security. Moreover, the evidence lacks sufficient clinical validation, with only partial credibility in most cases. Our findings underscore the need for multidisciplinary collaboration among end-users and developers to address the technical and ethical challenges of DTH and VTH systems. Although promising for the future of personalized oncology, substantial steps are required to move beyond experimental frameworks and to achieve clinical implementation.

Reliability and Validity of the Turkish Version of the Deglutition Handicap Index.

The Deglutition Handicap Index (DHI) is a self-reported questionnaire focus on dysphagia related quality of life of patients. The present study was aimed to translate the DHI into Turkish, and investigate the reliability and validity of the Turkish version of the DHI (T-DHI). A total of 100 patients with different diagnoses participated. The study was carried out in 3 phases including translation, reliability and validation phases. The translation phase was performed by the forward-backward-forward translation methodology. The internal consistency and test-retest reliability were used for reliability phase. The criterion validity of the T-DHI was investigated for validation phase. The Cronbach's alpha value of the T-DHI was 0.93 of which indicates excellent internal consistency. The Intraclass Correlation Coefficient ranged from 0.96 to 0.99 for test-retest reliability. There was negative and weak correlation between functional subscale score from the T-DHI and the Functional Oral Intake Scale (r=-0.29, p = 0.004), and positive and moderate to strong correlations between total and subscale scores from the T-DHI and the Turkish version of the Eating Assessment Tool (r = 0.67-0.78, p < 0.001) indicating sufficient criterion validity. The T-DHI is a reliable and valid questionnaire to define dysphagia related quality of life of patients. Clinicians could be used the T-DHI during swallowing evaluation part during the management process of deglutition disorders to plan patient centered rehabilitation, improve care and follow up.

A beginner's guide to supervised analysis for mass cytometry data in cancer biology.

Mass cytometry enables deep profiling of biological samples at single-cell resolution. This technology is more than relevant in cancer research due to high cellular heterogeneity and complexity. Downstream analysis of high-dimensional datasets increasingly relies on machine learning (ML) to extract clinically relevant information, including supervised algorithms for classification and regression purposes. In cancer research, they are used to develop predictive models that will guide clinical decision making. However, the development of supervised algorithms faces major challenges, such as sufficient validation, before being translated into the clinics. In this work, we provide a framework for the analysis of mass cytometry data with a specific focus on supervised algorithms and practical examples of their applications. We also raise awareness on key issues regarding good practices for researchers curious to implement supervised ML on their mass cytometry data. Finally, we discuss the challenges of supervised ML application to cancer research.

Ferroptosis and Intrinsic Drug-induced Liver Injury by Acetaminophen and Other Drugs: A Critical Evaluation and Historical Perspective.

Drug-induced hepatotoxicity is a significant clinical issue worldwide. Given the limited treatment options for these liver injuries, understanding the mechanisms and modes of cell death is crucial for identifying novel therapeutic targets. For the past 60 years, reactive oxygen species and iron-dependent lipid peroxidation (LPO) have been hypothesized to be involved in many models of acute drug-induced liver injury. However, this mechanism of toxicity was largely abandoned when apoptosis became the primary focus of cell death research. More recently, ferroptosis-a novel, non-apoptotic form of cell death-was identified in NRAS-mutant HT-1080 fibrosarcoma cells exposed to erastin and other NRLs. Ferroptosis is characterized by glutathione depletion and the impairment of glutathione peroxidase 4 activity, which hinders the detoxification of lipid hydroperoxides. These hydroperoxides then serve as substrates for iron-dependent LPO propagation. This cell death mechanism is now receiving widespread attention, extending well beyond its original identification in cancer research, including in the field of drug-induced liver injury. However, concerns arise when such mechanisms are applied across different cell types and disease states without sufficient validation. This review critically evaluated the historical evidence for iron-dependent LPO as a mechanism of drug-induced hepatotoxicity and explored how these earlier findings have led to the current concept of ferroptosis. Overall, the published data support the idea that multi-layered endogenous antioxidant defense mechanisms in the liver limit the occurrence of pathophysiologically relevant LPO under normal conditions. Only when these defense mechanisms are severely compromised does ferroptosis become a significant mode of drug-induced cell death.

Measurement properties of the Brazilian-Portuguese version of the PROMIS-29 questionnaire and the Impact Score in patients with chronic low back pain

BackgroundA task force from the US National Institute of Health aimed to establish parameters for surveys with patients with chronic low back pain (LBP) by recommending the use of the Patient-Reported Outcome Measurement Information System 29-item (PROMIS-29) questionnaire and the stratification according to the Impact Score. We aimed to assess the internal consistency, reliability, measurement error, construct validity and responsiveness of the Brazilian-Portuguese version of the PROMIS-29 questionnaire (version 2.1) and the Impact Score in patients with chronic LBP.MethodsA prospective cohort study was carried out with patients with chronic LBP who were receiving physiotherapy treatment in clinics in São Paulo and Vitória cities, Brazil. The sample included 102 patients with chronic LBP, aged between 18 and 80 years, and with the ability to read and write in the Brazilian-Portuguese language. Exclusion criteria were patients with serious spinal conditions, cognitive impairment, pregnant women, and patients who had undergone lumbar surgery within the past six months. The PROMIS-29 questionnaire, the 12-item Short-Form Health Survey and the Roland-Morris Disability Questionnaire were applied. The PROMIS-29 questionnaire was reapplied after 24 hours and 4 weeks.ResultsThe PROMIS-29 questionnaire showed Cronbach’s Alpha values between 0.81 (anxiety) and 0.91 (depression). The ICC2.1 ranged from 0.85 (95% CI: 0.77 to 0.89) to 0,97 (CI 95%: 0.95 to 0.98). The SEM values ranged between 0.85 (physical function) and 2.62 (ability to participate in social roles and activities). The Impact Score showed Cronbach’s Alpha, ICC2.1 and SEM values of 0.91, 0.97 (95% CI: 0.95 to 0.98) and 0.56, respectively. The PROMIS-29 questionnaire and the Impact Score showed sufficient construct validity. The PROMIS-29 questionnaire showed moderate responsiveness, while the Impact Score showed sufficient responsiveness.ConclusionsBoth the Brazilian-Portuguese version of the PROMIS-29 questionnaire and the Impact Score showed sufficient internal consistency, reliability, construct validity and responsiveness in Brazilian patients with chronic LBP. The results support the US National Institutes of Health’s recommendation to use the PROMIS-29 questionnaire and the Impact Score in patients with chronic LBP. We suggest that future studies evaluate the structural validity of the Brazilian-Portuguese version of the PROMIS-29 questionnaire.Clinical trial numberNot applicable.

Validation of the Polish version of an Ageism Scale for Dental Students (ASDS-PL).

Ageism is one of the common forms of discrimination and prejudice. It has also been shown to be present in health professionals, including doctors, nurses, and medical students. The aim of this study was to translate the Ageism Scale For Dental Students (ASDS) into Polish, perform a culture adaptation, and conduct a preliminary validation analysis. The survey was administered to 202 third-, fourth-, and fifth-year students at the Jagiellonian University (No. 1072.6120.283.2020). Data were analyzed using principal components analysis (PCA) with an oblique, Promax rotation, and confirmatory factor analysis (CFA). Cronbach's alpha (α) was calculated to check the internal consistency reliability. Discriminant validity was analyzed using the Mann-Whitney and Kruskal-Wallis test. PCA produced a 10-item scale distributed into three factors, which explains 59.52% of the total variance. Factor 1 ("preconceived notions about dental treatment") contained four items (α=0.703), Factor 2 ("cost-benefit of providing care for older patients")-four items (α=0.660) and Factor 3 ("dentist-older patient interaction")-two items (α=0.662). CFA confirmed that the model is a good fit (RMSE=0.058, 90% CI from 0.014 to 0.092, CFI=0.950, and TLI=0.926). The discriminant validity showed statistically significant differences in factors or individual items related to the year of the study, gender, and having a history of living with an older person(s) or an older patient(s) treated. The validation of the ASDS conducted in Poland identified 10 items with sufficient validity and reliability.

Validity and Reliability of a Simplified Chinese Version of Cancer Survivors' Unmet Needs Scale (CaSUN).

To translate Cancer Survivors' Unmet Needs scale (CaSUN) into Simplified Chinese, and to assess the validity and reliability of this translated version among Chinese cancer survivors. Following the cross-cultural adaptation guidelines, the original CaSUN scale was translated from English into Simplified Chinese. To enhance the readability and comprehension of each item, a pilot study involving 40 cancer patients was carried out. Subsequently, 324 cancer survivors participating in follow-up appointments at a cancer hospital in Beijing, China completed the Simplified Chinese version of the CaSUN. The scale's validity was assessed through factor analysis. Indices including Satorra-Bentler scaled chi-square to degree of freedom ratio (χ2/df), comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean squared residual (SRMR) were employed for construct validity. Average variance extracted (AVE) of each category reflected the convergent validity. Reliability was confirmed with both Cronbach's α and Guttman split-half coefficient. Factor analysis suggested that a three-level hierarchical structure of the CaSUN with four first-order factors, nine second-order factors and all the 35 items assessing unmet need could fit our data well (χ2/df=2.833, CFI=0.902, RMSEA=0.076, SRMR=0.066), indicating sufficient construct validity for this model. For convergent validity, AVE of each second-order category were greater than 0.5. Regarding reliability, Cronbach's α of the 35 items was 0.968, and the Guttman split-half coefficient was 0.984. Both of these coefficients were higher than 0.8. The present Simplified Chinese version of CaSUN had good cultural adaptability, appropriate validity and reliability for assessing unmet needs in different cancer survivor groups in Chinese mainland. This Simplified Chinese version of CaSUN can assist health professionals in addressing individual survivor needs and bridge the gap between patients' experiences and their expectations, thereby improving the quality of cancer survivorship care.

Hepatocellular carcinoma risk scores for non-viral liver disease: A systematic review and meta-analysis

BackgroundHepatocellular carcinoma (HCC) risk prediction models may provide a more personalised approach to surveillance for HCC among patients with cirrhosis. This systematic review aims to summarise the performance of HCC prediction models in patients with non-viral chronic liver disease. MethodThe study was prospectively registered with PROSPERO (ID: CRD42022370078) and reported in accordance with PRISMA guidelines. MEDLINE and EMBASE databases were searched using a validated search filter for prediction model studies. Two reviewers independently assessed studies for inclusion and risk of bias. Model performance (discrimination and calibration) were identified to assess the risk of HCC at specified time points. A random effects meta-analysis was done on a subset of studies that reported performance of the same model. Results7,854 studies were identified. After review, 14 studies with a total of 94,014 participants were included. 45% of patients had viral hepatitis, 27% alcohol related liver disease (ArLD) and 19% metabolic associated steatotic liver disease (MASLD). Follow-up ranged from 15.1 - 138 months. Only one model was developed using a competing risk approach. Age (7 models) and sex (6 models) were the most frequently included predictors. Model discrimination (AUROC or c-statistic) ranged from 0.61 - 0.947. Only the ‘aMAP’ score (age, male sex, albumin,bilirubin, and platelets) had sufficient external validation for quantitative analysis, with a pooled c-statistic of 0.81 (95% CI 0.80-0.83). Calibration was reported in only 9 of 14 studies. All studies were rated high risk of bias. ConclusionStudies describing risk prediction of HCC in non-viral chronic liver disease are poorly reported, have a high risk of bias and do not account for competing risk events. Patients with ArLD and MASLD are underrepresented in development and validation cohorts. These factors remain barriers to the clinical utility and uptake of HCC risk models in persons with the commonest liver diseases. Impact and implicationsThe recent EASL policy statement emphasises the potential of risk-based surveillance to reduce both HCC-related deaths and surveillance costs. This study addresses the gap in understanding the performance of current HCC risk models in patients with non-viral liver diseases, reflecting the epidemiological landscape of liver disease in Western countries.In our review of these models, we identified several key concerns regarding reporting standards and risk of bias and confirmed that patients with alcohol-related liver disease (ArLD) and metabolic-associated steatotic liver disease (MASLD) are underrepresented in model development and validation cohorts. Additionally, most models fail to account for the significant risk of competing events, leading to potential overestimation of true HCC risk.This study highlights these critical issues that may hinder the implementation of risk models in clinical practice and offers key recommendations for future model development studies.

Assessing Chest Tube Insertion Skills Using a Porcine Rib Model-A Validity Study.

Assessments require sufficient validity evidence before their use. The Assessment for Competence in Chest Tube Insertion (ACTION) tool evaluates proficiency in chest tube insertion (CTI), combining a rating scale and an error checklist. The aim of this study was to collect validity evidence for the ACTION tool on a porcine rib model according to the Messick framework. A rib model, consisting of a porcine hemithorax that was placed in a wooden frame, was used as simulator. Participants were recruited from the departments of surgery, pulmonology, and emergency medicine. After familiarization with the rib model and the equipment, standardized instructions and clinical context were provided. They performed 2 CTIs while being scored with the ACTION tool. All performances were assessed live by 1 rater and by 3 blinded raters using video recordings. Generalizability-analysis was performed and mean scores and errors of both groups on the first performance were compared. A pass/fail score was established using the contrasting groups' method. Nine novice and 8 experienced participants completed the study. Generalizability coefficients where high for the rating scale (0.92) and the error checklist (0.87). In the first CTI, novices scored lower than the experienced group (38.1/68 vs. 47.1/68, P = 0.042), but no difference was observed on the error checklist. A pass/fail score of 44/68 was established. A solid validity argument for the ACTION tool's rating scale on a porcine rib model is presented, allowing formative and summative assessment of procedural skills during training before patient contact.

РАЗРАБОТКА И ВАЛИДАЦИЯ ЭЛЕКТРОННОЙ АНКЕТЫ ПО ОЦЕНКЕ ПРОФЕССИОНАЛЬНОЙ ИНФОРМИРОВАННОСТИ ВРАЧЕЙ О ПОРЯДКЕ СООБЩЕНИЙ О НЕЖЕЛАТЕЛЬНЫХ РЕАКЦИЯХ НА ЛЕКАРСТВЕННЫЕ ПРЕПАРАТЫ

Drug safety is one of the priority areas of modern medicine and pharmacy. The statistics and accounting of adverse drug reactions represent a complex problem due to the fact that many adverse reactions remain unrecognized and also depend on the willingness of healthcare professionals to inform regulatory authorities about the occurred adverse reactions. The objective of this study was to create and assess the reliability of an electronic questionnaire aimed at evaluating healthcare professionals' understanding of the procedures for reporting adverse drug reactions. The study consisted of two phases: the first phase focused on the development of the questionnaire and evaluation of a draft version by an expert committee, while the second phase included pilot testing with 30 respondents. The final version of the electronic questionnaire consists of 23 questions. As a result of the two phases of development and validation, the electronic questionnaire demonstrates sufficient reliability and validity, suggesting its potential for future use.

The Affective Neuroscience Personality Scales (ANPS) in Slovenia: Validation of the Six Primary Scales Across Three ANPS Versions

Abstract To assess primary emotions in subcortical brain regions across all mammals, the affective neuroscience personality scales (ANPS) were created for use in research involving human subjects. Later revisions of the scales have been validated across many countries and are used in diverse fields of psychology. The ANPS revisions culminated in the most recent ANPS 3.1. In this study, we evaluated the psychometric properties of the ANPS 3.1 and its two abbreviated versions (affective neuroscience personality scales – brief (BANPS) and affective neuroscience personality scales – short version (ANPS-S)) in a Slovenian community sample of 502 young adults. We simultaneously examined several kinds of validity evidence across the three versions: construct validity, internal reliability, and convergent validity. Our findings revealed acceptable construct validity of the six-factor model of the BANPS that was superior to the ANPS-S and particularly to the ANPS 3.1. The latter exhibited incremental fit issues noted in previous versions. However, we revealed sufficient internal reliability and convergent validity of the scale scores against the Big Five personality traits, and the frequency of the participants’ recently felt positive and negative emotions across all three ANPS versions. Testing the measurement invariance of BANPS across sex suggested full metric invariance and partial scalar invariance which allows direct score comparisons between males and females.

German mHealth App Usability Questionnaire (G-MAUQ) and short version (G-MAUQ-S): Translation and validation study

BackgroundThe use of mobile health applications is increasingly common among the general public and in healthcare systems. With such apps percolating into the classic healthcare sector, the necessity of sound and standardized evaluation grows. The mHealth App Usability Questionnaire (MAUQ) provides a novel and custom-tailored psychometrically validated instrument to capture users’ perception of the usefulness and usability of an mHealth application. So far, this questionnaire is only available in English, Malay and Chinese. The aim of this study was to translate and validate a German version of the MAUQ (G-MAUQ). Further, we developed a short scale with 6 items (G-MAUQ-S) in German. MethodsWe used the Translation, Review, Adjudication, Pretest and Documentation (TRAPD) method to translate the MAUQ. Subsequently, we assessed content validity with 15 expert ratings and face validity with 15 German speaking mHealth users. To further validate the questionnaire, we used data from 148 participants of an RCT examining symptom checkers in the Emergency Department to assess convergent validity by correlating the G-MAUQ with the German version of the System Usability Scale and discriminant validity by correlating the G-MAUQ with other unrelated questionnaires. Lastly, we developed a short version by assessing item discrimination, factor loadings, correlation with the full scale and construct validity. ResultsAll but one item showed sufficient content validity with item-level content validity index values between CVI-I = 0.8 and 1.0. Face validity was excellent with item-level face validity index values ranging from FVI-I = 0.87 to 1. Convergent validity was sufficient with r = 0.769, and discriminant validity was sufficient with values between r = −0.014 and r = 0.220. An internal consistency of Cronbach's α = 0.93 demonstrated high reliability. The short scale showed sufficient convergent validity (r = 0.762) and discriminant validity (r between −0.012 and 0.201). ConclusionsA validated and reliable G-MAUQ can be used by researchers and practitioners to assess the usability of mHealth interventions. We also provide the German mHealth App Usability Questionnaire – Short Version (G-MAUQ-S) with six questions to quickly assess the usability of an intervention.

Development and validation of the Japanese version of the Auckland individualism and collectivism scale: relationship between individualism/collectivism and mental health.

This study developed the Japanese version of the Auckland Individualism and Collectivism Scale (J-AICS), examined its reliability and validity, and explored the associations between its factors (compete, unique, responsibility, advice, and harmony) along with variables related to mental health in the Japanese population. We recruited 476 Japanese participants from the general population. Participants completed the J-AICS along with questionnaires pertaining to culture and mental health. Confirmatory factor analysis indicated the correlated five-factor model showed a good fit to the data. The Cronbach's α and McDonald's ω coefficients were high for the individualism, collectivism, compete, unique, and advice factors, but low for the responsibility and harmony factors. Convergent validity was supported by significant relationships between culture-related variables. A one-way analysis of variance revealed the low individualism/collectivism cluster had higher loneliness and lower satisfaction with life than the high individualism and collectivism clusters. The multiple regression analyses showed that the responsibility factor was significantly and negatively associated with mental health concerning anxiety and depressive symptoms, loneliness, and satisfaction with life. In addition, the harmony factor was significantly and positively associated with the mental health. These findings demonstrate sufficient validity of the J-AICS; however, reliability was insufficient for responsibility and harmony. Further, responsibility was positively associated with mental health and harmony was negatively associated with mental health.

The External and Internal Shame Scale (EISS): Turkish Adaptation Study

The aim of this research is to carry out the Turkish adaptation, validity and reliability studies of the "External and Internal Shame Scale”, which was developed to measure the two sub-dimensions of shame, internal and external shame, at once. The sample of the research consists of 434 university students studying at Mersin University and other state universities. In order to provide evidence for the construct validity of the scale, confirmatory factor analysis (CFA) and criterion-related validity studies were conducted and the correlation values between the sub-factors were examined. When the correlation values between CFA and sub-factors and the results of the criterion-related validity study were examined, it was seen that the scale had sufficient construct validity. In order to determine the reliability of the scale, Cronbach's alpha internal consistency reliability coefficient, item-total test correlation (ITTC) coefficient and test-retest correlation coefficient were calculated. Cronbach's alpha internal consistency coefficients were calculated as .77 for internal shame sub-factor, .76 for external shame sub-factor and .87 for total shame. Similarly, ITTC coefficients were found to be between .49 and .64 for the internal shame sub-factor, between .49 and .62 for the external shame sub-factor, and between .56 and .71 for the total shame. In addition, the test-retest reliability coefficients were calculated as .79 for the internal shame subscale and .78 for the external shame subscale. The data obtained showed that the adapted External and Internal Shame Scale (EISS) is a valid and reliable measurement tool for measuring the internal, external and total shame of university students.