Cross-cultural adaptation and assessment of the reliability and validity of the Core Outcome Measures Index (COMI) for the Brazilian-Portuguese language

The use of patient-orientated questionnaires is of utmost importance in assessing the outcome of spine surgery. Standardisation, using a common set of outcome measures, is essential to aid comparisons across studies/in registries. The Core Outcome Measures Index (COMI) is a short, multidimensional outcome instrument validated for patients with spinal disorders. This study aimed to produce a Brazilian-Portuguese version of the COMI. A cross-cultural adaptation of the COMI into Brazilian-Portuguese was carried out using established guidelines. 104 outpatients with chronic LBP (> 3 months) were recruited from a Public Health Spine Medical Care Centre. They completed a questionnaire booklet containing the newly translated COMI, and other validated symptom-specific questionnaires: Oswestry Disability Index (ODI) and Roland Morris disability scale (RM), and a pain visual analogue scale. All patients completed a second questionnaire within 7-10 days to assess reproducibility. The COMI summary score displayed minimal floor and ceiling effects. On re-test, the responses for each individual domain of the COMI were within 1 category in 98% patients for the domain 'function', 96% for 'symptom-specific well-being', 97% for 'general quality of life', 99% for 'social disability' and 100% for 'work disability'. The intraclass correlation coefficients (ICC2,1) for COMI pain and COMI summary scores were 0.91-0.96, which compared favourably with the corresponding values for the RM (ICC, 0.99) and ODI (ICC, 0.98). The standard error of measurement for the COMI was 0.6, giving a "minimum detectable change" (MDC95%) of approximately 1.7 points i.e., the minimum change to be considered "real change" beyond measurement error. The COMI scores correlated as hypothesised (Rho, 0.4-0.8) with the other symptom-specific questionnaires. The reproducibility of the Brazilian-Portuguese version of the COMI was comparable to that of other language versions. The COMI scores correlated in the expected manner with existing but longer symptom-specific questionnaires suggesting good convergent validity for the COMI. The Brazilian-Portuguese COMI represents a valuable tool for Brazilian study-centres in future multicentre clinical studies and surgical registries.

Cross-cultural adaptation of the Work Disability Diagnosis Interview (WoDDI) for the Brazilian context

The Work Disability Diagnosis Interview (WoDDI) is a structured interview guide developed by the University of Sherbrooke, Canada to help clinicians detect the most important work-related disability predictors and to identify one or more causes of prolonged absenteeism. This methodological study aims for the cross-cultural adaptation of the WoDDI for the Brazilian context. The method followed international guidelines for studies of this kind, including the following steps: initial translation, synthesis of translations, back translation, evaluation by an expert committee and testing of the penultimate version. These steps allowed obtaining conceptual, semantic, idiomatic, experiential and operational equivalences, in addition to content validity. The results showed that the translated WoDDI is adapted to the Brazilian context and can be used after training.

Cross-cultural adaptation and psychometric properties of the Brazilian version of the scale of oral health outcomes for 5-year-old children (SOHO-5)

Abstract Background Most of the instruments available to measure the oral health-related quality of life (OHRQoL) in paediatric populations focus on older children, whereas parental reports are used for very young children. The scale of oral health outcomes for 5-year-old children (SOHO-5) assesses the OHRQoL of very young children through self-reports and parental proxy reports. We aimed to cross-culturally adapt the SOHO-5 to the Brazilian Portuguese language and to assess its reliability and validity. Findings We tested the quality of the cross-cultural adaptation in 2 pilot studies with 40 children aged 5–6 years and their parents. The measurement was tested for reliability and validity on 193 children that attended the paediatric dental screening program at the University of São Paulo. The children were also clinically examined for dental caries. The internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.90 for the children’s self-reports and 0.77 for the parental proxy reports. The test-retest reliability results, which were based on repeated administrations on 159 children, were excellent; the intraclass correlation coefficient was 0.98 for parental and 0.92 for child reports. In general, the construct validity was satisfactory and demonstrated consistent and strong associations between the SOHO-5 and different subjective global ratings of oral health, perceived dental treatment need and overall well-being in both the parental and children’s versions (p < 0.001). The SOHO-5 was also able to clearly discriminate between children with and without a history of dental caries (mean scores: 5.8 and 1.1, respectively; p < 0.001). Conclusion The present study demonstrated that the SOHO-5 exhibits satisfactory psychometric properties and is applicable to 5- to 6-year-old children in Brazil.

Cross-cultural adaptation of the Safety Attitudes Questionnaire - Short Form 2006 for Brazil

The objective of this study was to perform a cross-cultural adaptation of the Safety Attitudes Questionnaire - Short Form 2006 for Brazil. The instrument was applied in six hospitals in three regions of Brazil. Content, face, and construct validity was performed. Analysis of the instrument's reliability was performed by verifying the items' internal consistency through Cronbach's alpha. The sample was composed of 1301 professionals working in clinical and surgical wards of six hospitals. Confirmatory analysis showed that the model including 41 items was satisfactory. The Portuguese version presented an alpha of 0.89. The item-total correlations among the domains were moderate to strong, except for the domain Stress Recognition. We concluded that the instrument's version adapted to Portuguese and applied in our sample is valid and reliable.

Testing the structural and cross-cultural validity of the KIDSCREEN-27 quality of life questionnaire

OBJECTIVES: The aim of this study is to assess the structural and cross-cultural validity of the KIDSCREEN-27 questionnaire. METHODS: The 27-item version of the KIDSCREEN instrument was derived from a longer 52-item version and was administered to young people aged 8-18 years in 13 European countries in a cross-sectional survey. Structural and cross-cultural validity were tested using multitrait multi-item analysis, exploratory and confirmatory factor analysis, and Rasch analyses. Zumbo's logistic regression method was applied to assess differential item functioning (DIF) across countries. Reliability was assessed using Cronbach's alpha. RESULTS: Responses were obtained from n = 22,827 respondents (response rate 68.9%). For the combined sample from all countries, exploratory factor analysis with procrustean rotations revealed a five-factor structure which explained 56.9% of the variance. Confirmatory factor analysis indicated an acceptable model fit (RMSEA = 0.068, CFI = 0.960). The unidimensionality of all dimensions was confirmed (INFIT: 0.81-1.15). Differential item functioning (DIF) results across the 13 countries showed that 5 items presented uniform DIF whereas 10 displayed non-uniform DIF. Reliability was acceptable (Cronbach's alpha = 0.78-0.84 for individual dimensions). CONCLUSIONS: There was substantial evidence for the cross-cultural equivalence of the KIDSCREEN-27 across the countries studied and the factor structure was highly replicable in individual countries. Further research is needed to correct scores based on DIF results. The KIDSCREEN-27 is a new short and promising tool for use in clinical and epidemiological studies.

Cross-cultural equivalence and associations among food insecurity and parental influences of children's fruit and vegetable consumption

Over the past several decades, the prevalence of obesity has dramatically increased. Cause for concern has increased because overweight and obesity are major contributors to morbidity and mortality. Intervention research aimed at reducing the prevalence of obesity has identified the family, specifically the parent, as a key component of the home environment. However, findings from dietary behavior change interventions have been disheartening because few studies have reported meaningful change, suggesting methodological and/or measurement issues within the intervention process. A lack of appropriate mediators and cross-cultural equivalence may partially explain the reason for little change.^ The study aims were to (1) evaluate the psychometric properties and assess the cross cultural equivalence of the Food Insecurity Scale (paper 1) and the modified Parent Feeding Practices Questionnaire (paper 2) and to assess the overall relationships among food insecurity, parent mediators, and parent behaviors towards children's dietary behavior (paper 3) through structural equation modeling and tests of invariance. The study aims were accomplished through conducting secondary analyses using baseline data from English- and Spanish-speaking Hispanic women who participated in the Healthy Families: Step by Step (BHF) study.^ Results indicated that although the FIS and the mPFPQ exhibited sound psychometric properties, the instruments exhibited a lack of invariance across language spoken groups. The lack of invariance was more pronounced in the FIS. Results also supported the theoretical framework identifying parent's perceived barriers and self-efficacy as mediators of parent's behaviors toward improving children's health eating. Results did not suggest that the relationships were moderated by food insecurity.^ In conclusion, the identification of differential item functioning in food insecurity and parent feeding practices may be beneficial in enhancing tailored interventions through the incorporation of cultural differences into the change mechanisms. However, future research needs to be conducted to determine if the lack of invariance demonstrates the existence of item bias or if it is a reflection of true difference among the language spoken groups. Additionally, obesity intervention studies targeting parent/family barriers and parent self-efficacy to provide/encourage healthy diets may result in an increase in parent behaviors which promote healthy eating behaviors among children. Future research should also examine a more complete causal pathway to determine whether parental changes in the mediators ultimately lead to an increase in healthy dietary behavior among children.^

Negotiating cross-cultural difference in electronic discussion

Although a good deal of research exists both on computer-mediated communication(CMC) and on cross-cultural communication, rarely are the two areas brought together. In practice, however, extrapolation from one context to the other is common, with the internet and email being increasingly used to teach cross-cultural communication. What assumptions about the transfer of culture into cyberspace inform these practices? And are these assumptions well-founded? This paper explores practices of discussion on French and British internet media sites to determine the extent to which they reflect communicative practices elsewhere in those cultures. The case studies underline the importance of attending to the interaction between culture and genre, and have pedagogical implications for the use of such sites in the teaching of cross-cultural communication.

A cross-cultural study of the role of religion in consumers' ethical positions

Purpose - Previous studies have looked at how socio-economic and political factors play a role in consumers' ethical positions, but few have considered the role of religion which is a major driver of ethics. This paper seeks to address this. Design/methodology/approach - From a survey of over 700 consumers this paper explores the similarities and differences between consumers' ethical positions in three different religions namely; Christian (from three countries), Islam, and Buddhism. Findings - It was found that a reduced item scale measuring the two factors of Forsyth's idealism and relativism was applicable in all five religions, but variations were seen because of religious teachings. In particular, Austrian Christians were significantly less idealistic and relativistic than all other religions, even other Christians from the United States and Britain. Research limitations/implications - The results have implications for measuring ethical positions internationally and for developing ethically based marketing messages and products. Originality/value - The paper shows for the first time how ethical positions are affected by religions and should be of interest to marketers involved in ethics research and ethical marketing.

A cross-cultural investigation of the use of teaching styles

Teacher beliefs are a major influence on teacher actions. Because context influences beliefs, it was the purpose of this study to explore teachers' beliefs about Mosston's Spectrum of Teaching Styles from an international perspective. Over 1,400 teachers from 7 countries completed a survey related to their self-reported use of and beliefs about various teaching styles. Data suggested a shared core of reproduction teaching style use. The use of and beliefs about the production styles of teaching were more varied. Teachers' use of styles was significantly related to their beliefs about the styles. [PUBLICATION ABSTRACT]

Levinasian ethics and the representation of the other in international and cross-cultural management

In this paper, we seek to further the discussion, problematization and critique of west/east identity relations in ICM studies by considering the ethics of the relationship – an issue never far beneath the surface in discussions of Orientalism. In particular we seek to both examine and question the ethics of representation in relation to a critique of what has come to be known as international and cross-cultural management (ICM). To pursue such a discussion, we draw specifically on the ethical elaborations of Emmanuel Levinas as well as his chief interlocutors Jacques Derrida and Zygmunt Bauman. The value of this discussion, we propose, is that Levinas offers a philosophy that holds as its central concept the relationship between the self and Other as the primary ethical and pre-ontological relation. Levinas’ philosophy provides a means of extending the post-colonial critique of ICM, and ICM provides a context in which the Levinasian ethics can be brought to bear on a significant issue on contemporary business and management.

The language of business interviewing:a study in cross-cultural communication

The study examines the concept of cultural determinism in relation to the business interview, analysing differences in language use between English, French and West German native speakers. The approach is multi- and inter-disciplinary combining linguistic and business research methodologies. An analytical model based on pragmatic and speech act theory is developed to analyse language use in telephone market research interviews. The model aims to evaluate behavioural differences between English, French and West German respondents in the interview situation. The empirical research is based on a telephone survey of industrial managers, conducted in the three countries in the national language of each country. The telephone interviews are transcribed and compared across languages to discover how managers from each country use different language functions to reply to questions and requests. These differences are assessed in terms of specific cultural parameters: politeness, self-assuredness and fullness of response. Empirical and descriptive studies of national character are compared with the survey results, providing the basis for an evaluation of the relationship between management culture and national culture on a contrastive and comparative cross-cultural basis. The project conclusions focus on the implications of the findings both for business interviewing and for language teaching.

Leisure at work in Britain, West Germany, France and Japan : a cross-cultural comparative study

The aim of this thesis was to investigate the impact of changing values and attitudes toward work and the workplace in Britain, West Germany, France and Japan. A cross-national approach was adopted in order to gain a better understanding of differences and similarities in behaviour and to identify aspects specific to each society. Although the relationship between work and leisure has been thoroughly examined and there is a growing body of literature on changes in the values associated with these two phenomena, little research has been carried out into leisure at work. Studies of work time have tended to consider it as a homogeneous block, whereas recent research suggests that more attention should be devoted to unravelling the multiple uses of time at the workplace. The present study sought to review and analyse this new approach to the study of work time, and special attention is devoted to an examination of definitions of leisure, recreation, free time and work within the context of the workplace. The cross-cultural comparative approach gave rise to several problems due to the number of countries involved and the unusual combination of factors being investigated. The main difficulties were differences in the amount and quality of literature available, the non-comparability of existing data, definitions of concepts and socio-linguistic terms, and problems over access to organizations for fieldwork. Much of the literature generalizes about patterns of behaviour and few authors isolate factors specific to particular societies. In this thesis new empirical work is therefore used to ascertain the extent to which generalizations can be made from the literature and characteristics peculiar to each of the four countries identified. White-collar employees in large, broadly comparable companies were studied using identical questionnaires in the appropriate language. Respondents selected were men and women, aged between 20-65 years and either managers or non-managers. Patterns of leisure at work were found to be broadly similar in the national contexts, but with the Japanese and the West Germans experiencing the least leisure at work, and the British and the French perceiving the most. The general trend seems to be toward convergence of attitudes regarding leisure at work in the four countries. Explanations for variations in practice were sought within the wider societal contexts of each country.