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 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.

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.

Cross-cultural variations in climate for autonomy, stress and organizational productivity relationships:A comparison of Chinese and UK manufacturing organizations

Cross-cultural researchers have questioned the extent to which European–American management practices can be transported to major markets in Asia, such as the People's Republic of China. Applying employee involvement theory, we examined the relationships between climate for autonomy, work demands climate, employee stress and organizational productivity in a cross-national study of 51 UK and 104 Chinese manufacturing organizations. We predicted and found that climate for autonomy was positively and negatively related to stress in the Chinese and UK contexts, respectively. The interaction of climate for autonomy and work demands climate was significant: climate for autonomy was positively related to organizational productivity only when work demands climate was low.

Cross-cultural confirmatory factor analysis of the CES-D in Spanish and Mexican dementia caregivers

The Center for Epidemiologic Studies-Depression Scale (CES-D) is the most frequently used scale for measuring depressive symptomatology in caregiving research. The aim of this study is to test its construct structure and measurement equivalence between caregivers from two Spanish-speaking countries. Face-to-face interviews were carried out with 595 female dementia caregivers from Madrid, Spain, and from Coahuila, Mexico. The structure of the CES-D was analyzed using exploratory and confirmatory factor analysis (EFA and CFA, respectively). Measurement invariance across samples was analyzed comparing a baseline model with a more restrictive model. Significant differences between means were found for 7 items. The results of the EFA clearly supported a four-factor solution. The CFA for the whole sample with the four factors revealed high and statistically significant loading coefficients for all items (except item number 4). When equality constraints were imposed to test for the invariance between countries, the change in chi-square was significant, indicating that complete invariance could not be assumed. Significant between-countries differences were found for three of the four latent factor mean scores. Although the results provide general support for the original four-factor structure, caution should be exercised on reporting comparisons of depression scores between Spanish-speaking countries.

The effect of consumer risk perceptions and information search on willingness to buy GM food products: A cross cultural analysis

This paper seeks to address the widespread call in the literature for the cross-cultural examination ( and validation) of accepted concepts within consumer behaviour, such as consumer risk perceptions and information search. The findings of the study provide support for a number of accepted relationships, whilst identifying distinct cross cultural differences in external information search and willingness to buy genetically modified (GM) food products by consumers.

Cross-cultural consumer/consumption research : dealing with issues emerging from globalization and fragmentation

To understand the effects of globalization and fragmentation, macromarketing scholars need insights about links between individual consumer behavior and societal outcomes. The challenge in this regard is to create a program of macrooriented cross-cultural research. This article offers a crosscultural consumer behavior research framework for this purpose. The framework encompasses four key areas of consumer behavior that are related to the forces of globalization and fragmentation, including the environment, identity, wellbeing,and market structure and policy. A discussion of these substantive areas is followed by a suggested macro-microoriented research agenda and a call for paradigm plurality in pursuing this agenda.

An investigation of cross-cultural differences in binge-drinking perceptions and behaviours

This paper examines the variance in binge-drinking attitudes and behaviours between university student cohorts from Western and Eastern countries who reside in Australia. In particular, we investigate the impact of social influence on these consumer responses. An online survey resulted in 190 useable responses from university students at three different Australian universities. The results show that students from Western countries consume alcohol at higher levels and demonstrate more ‘approach’ behaviours towards binge-drinking, whereas students from Eastern countries demonstrate more ‘avoid’ behaviours. Social distancing from drunk or story-telling people is evident as students from Eastern countries while students from Western countries were more likely to indulge in story-telling and either ignored or encouraged surrounding people who were drunk.

Cross-cultural differences in self-reported decision-making style and confidence

The Melbourne Decision Making Questionnaire (Mann, Burnett, Radford, & Ford, 1997) measures selfreported decision-making coping patterns. The questionnaire was administered to samples of University students in the US (N = 475), Australia (N = 262), New Zealand (N = 260), Japan (N = 359), Hong Kong (N = 281), and Taiwan (N = 414). As predicted, students from the three Western, individualistic cultures (US, Australia, and New Zealand) were more con® dent of their decision-making ability than students from the three East Asian, group-oriented cultures (Japan, Hong Kong, Taiwan). No cross-cultural differences were found in scores on decision vigilance (a careful decision-making style). However, compared with Western students, the Asian students tended to score higher on buck-passing and procrastination (avoidant styles of decision making) as well as hypervigilance (a panicky style of decision making). Japanese students scored lowest on decision self-esteem and highest on procrastination and hypervigilance. It was argued that the con¯ ict model and its attendant coping patterns is relevant for describing and comparing decision making in both Western and Asian cultures.