Translation and Cross-Cultural Adaptation of the Brazilian Version of the International Knee Documentation Committee Subjective Knee Form Validity and Reproducibility

Background: The perception of improvement by a patient has assumed a central role in functional evaluation after a variety of knee problems. One of the instruments most used in clinical research is the International Knee Documentation Committee (IKDC) Subjective Knee Form because its psychometric properties are considered to be excellent. Nonetheless, this questionnaire was originally developed for use in the English language. Therefore, to use this questionnaire in the Brazilian population, it is essential to translate and validate it. Purpose: The aim of this study was to translate the IKDC Subjective Knee Form into a Brazilian version and to test its validity and reproducibility. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The translation of the original IKDC Subjective Knee Form into a Brazilian version was accomplished in accordance with the American Orthopaedic Society for Sports Medicine guidelines and was tested in 32 patients with knee pathologic conditions to develop the first Brazilian version. To test validity and reproducibility, 117 patients with several knee complaints completed the Brazilian IKDC Subjective Knee Form, the Short Form 36 (SF-36), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Lysholm score. From these patients, 85 were retested within a week to achieve reproducibility. The validation was addressed by correlating the Brazilian IKDC Subjective Knee Form to the other outcome measures. The reproducibility was tested by measuring internal consistency, test-retest reliability, and agreement. Results: The Brazilian IKDC Subjective Knee Form was highly related to the physical component summary of the SF-36, the Lysholm score, and the WOMAC, and weakly related to the mental component summary of SF-36 (r=.79, .89, .85, and .51, respectively). The internal consistency was strong, with a Cronbach a value of .928 and .935 in the test and retest assessment, respectively. The test-retest reliability proved to be excellent, with a high value of the intraclass correlation coefficient (.988), as well as the agreement, demonstrated by the low differences between the means of the test and retest, and the short limit of agreement, observed in the Altman-Bland and survival-agreement plots. Conclusion: The results of this study provide evidence that the Brazilian IKDC Subjective Knee Form has psychometric properties similar to the original version. In addition, it was a reliable evaluation instrument for patients with knee-related problems.

Cultural adaptation and psychometric properties of Brazilian Need for Recovery Scale

OBJECTIVE: To translate the Need for Recovery Scale (NFR) into Brazilian Portuguese and culturally adapt it and assess the stability, internal consistency and convergent validity of the Brazilian scale among industrial workers. METHODS: The translation process followed the guidelines for cultural adaptation of questionnaires including the steps of translation, synthesis, back translation, expert committee review, and pre-testing. The Brazilian Portuguese NFR, final version (Br-NFR) was assessed for stability (n=52) and internal consistency (n=192) and for convergent validity through simultaneous assessment with other instruments: the Borg Scale (n=59); the Chalder Fatigue Questionnaire (n=57) and 3 subscales of the SF-36 (n=56). RESULTS: Stability and internal consistency met the criterion for a reliable measure (ICC=0.80 and Cronbach's alpha =0.87, respectively). The convergent validity between Br-NFR and other instruments also showed good results: Borg Scale (r= 0.64); Chalder Questionnaire (r= 0.67); SF-36 subscales: vitality (r= -0.84), physical functioning (r= -0.54), and role-physical (r= -0.47). CONCLUSIONS: The Br-NFR proved to be a reliable instrument to evaluate work-related fatigue symptoms in industrial workers. Furthermore, it showed significant and good correlations with well-established instruments such as the Borg Scale, the Chalder Questionnaire and SF-36 vitality subscale, supporting the validity of the Br-NFR.

Brazilian version of the Quality of Care Scale: the perspective of people with disabilities

OBJECTIVE To analyze evidence of the validity and reliability of a Brazilian Portuguese version of the Quality of Care Scale from the perspective of people with physical and intellectual disabilities.METHODS There were 162 people with physical disabilities and 156 with intellectual disabilities from Porto Alegre and metropolitan region, who participated in the study in 2008. Classical psychometrics was used to independently analyze the two samples. Hypotheses for evidence of criterion validity (concurrent type) were tested with the Mann-Whitney test for non-normal distributions. Principal components analysis was used to explore factorial models. Evidence of reliability was calculated with Cronbach alpha for the scales and subscales. Test-retest reliability was analyzed for individuals with intellectual disabilities through intra-class correlation coefficient and the Willcoxon test.RESULTS The principal components in the group with physical disabilities replicated the original model presented as a solution to the international project data. Evidence of discriminant validity and test-retest reliability was found.CONCLUSIONS The transcultural factor model found within the international sample project seems appropriate for the samples investigated in this study, especially the physical disabilities group. Depression, pain, satisfaction with life and disability may play a mediating role in the evaluation of quality of care. Additional research is needed to add to evidence of the validity of the instruments.

Homograph ambiguity resolution in front-end design for portuguese TTS systems

In this paper, a module for homograph disambiguation in Portuguese Text-to-Speech (TTS) is proposed. This module works with a part-of-speech (POS) parser, used to disambiguate homographs that belong to different parts-of-speech, and a semantic analyzer, used to disambiguate homographs which belong to the same part-of-speech. The proposed algorithms are meant to solve a significant part of homograph ambiguity in European Portuguese (EP) (106 homograph pairs so far). This system is ready to be integrated in a Letter-to-Sound (LTS) converter. The algorithms were trained and tested with different corpora. The obtained experimental results gave rise to 97.8% of accuracy rate. This methodology is also valid for Brazilian Portuguese (BP), since 95 homographs pairs are exactly the same as in EP. A comparison with a probabilistic approach was also done and results were discussed.

A Brazilian version of the "Children's Interview for Psychiatric Syndromes" (ChIPS)

OBJETIVE: The advance of research in child and adolescent psychiatry in Brazil heavily depends on the existence of instruments for the investigation of psychiatric syndromes adapted to Brazilian Portuguese. METHODS: This article describes a careful process of translation of the Children's Interview for Psychiatric Syndromes for the purpose of use in research in Brazil. The Children's Interview for Psychiatric Syndromes has a version for parents (P-ChIPs) and a version for children (ChIPS). In this article, the sections of P-ChIPS referring to attention-deficit hyperactivity disorder, oppositional-defiant disorder, conduct disorder, mania/hypomania, anorexia nervosa, bulimia nervosa and psychotic disorders were translated to Brazilian Portuguese. The sections of the ChIPS referring to substance use disorders, social anxiety disorder, specific phobias, obsessive-compulsive disorder, generalized anxiety disoder, separation anxiety disorder, post-traumatic disorders and depression/dysthimia were also adapted. Each section was translated by two independent translators and later discussed in a committee composed of experts in the field of Psychiatry and a professional of the field of linguistics. RESULT: A final version containing an interview for the main psychiatric syndromes was defined. CONCLUSION: The translated P-ChIPS is a helpful instrument in children and adolescent clinical evaluation.

Translation and Cross-Cultural Adaptation of the Lymphoedema Functioning, Disability and Health Questionnaire for Lower Limb Lymphoedema into Portuguese Language

Objective The objective of the study is to describe the process of translation and cross-cultural adaptation of the Lymphoedema Functioning, Disability, and Health Questionnaire for Lower Limb Lymphoedema (Lymph-ICF-LL) into (Brazilian) Portuguese. Methods The process was comprised of five steps - translation, back translation, revision by an expert panel, pretest, and final translation. The first translation was performed by two professionals of the healthcare area, and the back translation was performed by two translators. An expert panel assessed the questions for semantics and idiomatic, cultural, and conceptual equivalence. The pretest was conducted on 10 patients with lymphedema. Results Small differences were identified between the translated and back-translated versions, which were revised by the expert panel. The patients included in the pretest found 10 questions difficult to understand; these questions were reassessed by the same expert panel. Conclusion The results of the translation and cross-cultural adaptation of the Lymph- ICF-LL resulted in a Brazilian Portuguese version, which still requires validation with various samples of the local population.

Brazilian version of the Berg balance scale

The purpose of the present study was to translate and adapt the Berg balance scale, an instrument for functional balance assessment, to Brazilian-Portuguese and to determine the reliability of scores obtained with the Brazilian adaptation. Two persons proficient in English independently translated the original scale into Brazilian-Portuguese and a consensus version was generated. Two translators performed a back translation. Discrepancies were discussed and solved by a panel. Forty patients older than 65 years and 40 therapists were included in the cultural adaptation phase. If more than 15% of therapists or patients reported difficulty in understanding an item, that item was reformulated and reapplied. The final Brazilian version was then tested on 36 elderly patients (over age 65). The average age was 72 years. Reliability of the measure was assessed twice by one physical therapist (1-week interval between assessments) and once by one independent physical therapist. Descriptive analysis was used to characterize the patients. The intraclass correlation coefficient (ICC) and Pearson's correlation coefficient were computed to assess intra- and interobserver reliability. Six questions were modified during the translation stage and cultural adaptation phase. The ICC for intra- and interobserver reliability was 0.99 (P < 0.001) and 0.98 (P < 0.001), respectively. The Pearson correlation coefficient for intra- and interobserver reliability was 0.98 (P < 0.001) and 0.97 (P < 0.001), respectively. We conclude that the Brazilian version of the Berg balance scale is a reliable instrument to be used in balance assessment of elderly Brazilian patients.

L1 acquisition across Portuguese dialects: modular and interdisciplinary interfaces as sources of explanation

This study investigates the child (L1) acquisition of properties at the interfaces of morpho-syntax, syntax-semantics and syntax-pragmatics, by focusing on inflected infinitives in European Portuguese (EP). Three child groups were tested, 6–7-year-olds, 9–10-year-olds and 11–12-year-olds, as well as an adult control group. The data demonstrate that children as young as 6 have knowledge of the morpho-syntactic properties of inflected infinitives, although they seem at first glance to show partially insufficient knowledge of their syntax–semantic interface properties (i.e. non-obligatory control properties), differently from children aged 9 and older, who show clearer evidence of knowledge of both types of properties. However, in general, both morpho-syntactic and syntax–semantics interface properties are also accessible to 6–7-year-old children, although these children give preference to a range of interpretations partially different from the adults; in certain cases, they may not appeal to certain pragmatic inferences that permit additional interpretations to adults and older children. Crucially, our data demonstrate that EP children master the two types of properties of inflected infinitives years before Brazilian Portuguese children do (Pires and Rothman, 2009a and Pires and Rothman, 2009b), reasons for and implications of which we discuss in detail.

Knowledge of A/A'-dependencies on subject extraction with two types of infinitives in non-native Portuguese adult bilingualism

Within generative L2 acquisition research there is a longstanding debate as to what underlies observable differences in L1/L2 knowledge/ performance. On the one hand, Full Accessibility approaches maintain that target L2 syntactic representations (new functional categories and features) are acquirable (e.g., Schwartz & Sprouse, 1996). Conversely, Partial Accessibility approaches claim that L2 variability and/or optionality, even at advanced levels, obtains as a result of inevitable deficits in L2 narrow syntax and is conditioned upon a maturational failure in adulthood to acquire (some) new functional features (e.g., Beck, 1998; Hawkins & Chan, 1997; Hawkins & Hattori, 2006; Tsimpli & Dimitrakopoulou, 2007). The present study tests the predictions of these two sets of approaches with advanced English learners of L2 Brazilian Portuguese (n = 21) in the domain of inflected infinitives. These advanced L2 learners reliably differentiate syntactically between finite verbs, uninflected and inflected infinitives, which, as argued, only supports Full Accessibility approaches. Moreover, we will discuss how testing the domain of inflected infinitives is especially interesting in light of recent proposals that Brazilian Portuguese colloquial dialects no longer actively instantiate them (Lightfoot, 1991; Pires, 2002, 2006; Pires & Rothman, 2009; Rothman, 2007).

L1 Acquisition of interface properties across Portuguese dialects: modular and interdisciplinary interfaces as sources of explanation

This study investigates the child (L1) acquisition of properties at the interfaces of morphosyntax, syntax-semantics and syntax-pragmatics, by focusing on inflected infinitives in European Portuguese (EP). Three child groups were tested, 6–7-year-olds, 9–10-year-olds and 11–12-year-olds, as well as an adult control group. The data demonstrate that children as young as 6 have knowledge of the morpho-syntactic properties of inflected infinitives, although they seem at first glance to show partially insufficient knowledge of their syntax–semantic interface properties (i.e. non-obligatory control properties), differently from children aged 9 and older, who show clearer evidence of knowledge of both types of properties. However, in general, both morpho-syntactic and syntax–semantics interface properties are also accessible to 6–7-year-old children, although these children give preference to a range of interpretations partially different from the adults; in certain cases, they may not appeal to certain pragmatic inferences that permit additional interpretations to adults and older children. Crucially, our data demonstrate that EP children master the two types of properties of inflected infinitives years before Brazilian Portuguese children do (Pires and Rothman, 2009a,b), reasons for and implications of which we discuss in detail.

English-Spanish bilingual learners of Portuguese as a third language: non-redundant acquisition and its typological nature

This chapter has two goals: (a) to discuss the Spanish-Portuguese interface in current formal language acquisition research and (b) to highlight the contributions of this language pairing in the emerging field of formal third language acquisition. The authors discuss two L3 acquisition studies (Montrul, Dias, & Santos, 2011; Giancaspro, Halloran, & Iverson, in press) examining Differential Object Marking, a morphological case marker present in Spanish but not in Portuguese, arguing that the results show how data from Spanish-English bilinguals learning Brazilian Portuguese as an L3 illuminate the deterministic role of structural and typological similarity in linguistic transfer. The data provide supportive evidence for only one of three existing L3 transfer models: the Typological Proximity Model (Rothman, 2010, 2011, 2013).

OpenWordNet-PT: an open brazilian wordnet for reasoning

Brazilian Portuguese needs a Wordnet that is open access, downloadable and changeable, so that it can be improved by the community interested in using it for knowledge representation and automated deduction. This kind of resource is also very valuable to linguists and computer scientists interested in extracting and representing knowledge obtained from texts. We discuss briefly the reasons for a Brazilian Portuguese Wordnet and the process we used to get a preliminary version of such a resource. Then we discuss possible steps to improving our preliminary version.

Oldenburg Burnout Inventory - student version: cultural adaptation and validation into Portuguese

Realizou-se adaptação cultural do Inventário de Oldenburg para estudantes (OLBI-S) em português e estimou-se sua confiabilidade e validade. O OLBI-S foi preenchido por 958 estudantes universitários brasileiros e 602 portugueses. O modelo fatorial original apresentou ajustamento adequado mas foram removidos dois itens com confiabilidade individual baixa (λ<0,5). A nova estrutura apresentou bom ajustamento a 2/3 da amostra total sendo invariante no 1/3 restante da amostra. Verificou-se baixa consistência interna e validade convergente, confiabilidade compósita aceitável, boa validade discriminante, concorrente e divergente. O OLBI-S não foi invariante nas amostras de Brasil e Portugal. O OLBI-S apresentou limitações e ausência de validade transcultural nas amostras estudadas.

The Brazilian version of the Childhood Health Assessment Questionnaire (CHAQ) and the Child Health Questionnaire (CHQ)

We report the cross-cultural adaptation and validation into Brazilian-Portuguese of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children regardless the underlying disease. The Brazilian CHAQ was revalidated, while the CHQ has been derived from the Portuguese version. A total of 471 subjects were enrolled: 157 patients with JIA (27% systemic onset, 38% polyarticular onset, 9% extended oligoarticular subtype, and 26% persistent oligoarticular subtype) and 314 healthy children. The CHAQ discriminated clinically healthy subjects from JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and lower overall well-being scores when compared to their healthy peers. Also the CHQ discriminated clinically healthy subjects from JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being score when compared to their healthy peers. In conclusion the Brazilian versions of the CHAQ-CHQ are reliable and valid tools for the combined physical and psychosocial assessment of children with JIA. © Copyright Clinical and Experimental Rheumatology 2001.

Characteristics of the acquisition of sonorant consonants orthography in Brazilian children from a São Paulo municipality

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)