Search Results (821)

Background: The Operating Room Management Attitudes Questionnaire (ORMAQ) is widely used to assess operating room (OR) staff attitudes toward patient safety and teamwork across diverse contexts. However, no validated French version currently exists, limiting its use in francophone settings. This study aimed to translate and culturally adapt the ORMAQ into French and to evaluate its psychometric properties, while also reporting OR professionals’ attitudes explored during the validation process. Methods: A cross-sectional methodological study was conducted among OR professionals, including surgeons, anesthetists, anesthesia nurses, operating room nurses, and residents. The original ORMAQ was translated into French using a standardized forward–backward translation procedure and pretested with 20 OR professionals. Content and concurrent validity were examined. Reliability was assessed through internal consistency, test–retest reproducibility, and dimension-level consistency. Construct validity was examined using both exploratory and confirmatory factor analyses (CFA). Results: The overall response rate to the survey was 76.5% (n = 303). The French ORMAQ demonstrated good internal consistency, as evidenced by both Cronbach’s alpha (α = 0.842) and McDonald’s Omega (ω = 0.98). For the individual dimensions, reliability values ranged from 0.597 to 0.891 for alpha and from 0.75 to 0.89 for Omega. Test–retest analysis showed excellent reproducibility (ICC = 0.96; 95% CI: 0.92–0.98). Factor analyses supported the eight-factor structure, with the CFA confirming good model fit and meaningful item loadings across dimensions, with standardized loadings ranging from 0.40 to 0.83. Conclusions: The French version of the ORMAQ showed satisfactory psychometric properties. It represents a robust tool for assessing safety and teamwork attitudes among OR professionals in francophone countries. Full article

Climate change poses accelerating and intensifying threats to cultural heritage worldwide, necessitating urgent and coordinated state-level responses. This study critically examines China’s governance framework for climate adaptation of cultural heritage, identifying a critical policy misalignment: although relevant legal and governance instruments—spanning cultural heritage protection, environmental governance, disaster risk reduction, territorial spatial planning, and climate action systems—are nominally in place, they remain profoundly fragmented in practice, resulting in operational inefficiency that severely constrains effective adaptation. To address this, the paper argues for a fundamental paradigm shift from static preservation to dynamic adaptation. It proposes a reform pathway centered on three pillars: reconceptualizing heritage from static preservation to dynamic adaptation, institutionalizing cross-departmental cooperation, and integrating systemic adaptation tools into planning and decision-making. The ultimate objective is to establish an adaptive governance system capable of responding flexibly to climate impacts through interdisciplinary coordination. This transformation is framed as a critical strategic imperative, essential for ensuring the long-term resilience of cultural heritage and civilizational continuity in a warming world. Full article

Building healthy communities requires organizational arrangements that center on resident and community assets while using data to guide decisions. This study examines how the Evidence2Success framework was implemented in three communities, Kearns, UT, Mobile, AL, and Memphis, TN, to understand how citizen-led asset mapping, coalition processes, and funding strategies shape youth well-being efforts. Using an interpretive case-study design, we analyzed process-evaluation interviews, implementation milestones and benchmarks, strengths-and-concerns reports, and community case materials to trace how coalitions mobilized assets, reoriented institutional resources, and adapted evidence-based programs. The results show that broad, cross-sector Community Boards completed most implementation tasks, increased participation by people of color, and developed more inclusive decision-making structures that addressed historical inequities. Coalitions also strengthened data-use capacities, employing youth survey results and local qualitative input to select priorities, braid funding, and make culturally responsive adaptations while maintaining program fidelity. Overall, the findings suggest that when evidence-based planning frameworks are embedded within asset-based, resident-governed structures, communities can build sustainable organizational arrangements that support youth well-being and advance more equitable local systems. Full article

Background/Objectives: Urinary incontinence (UI) is common among women and is often underreported and undertreated, partly due to limited health literacy and persistent misconceptions regarding its causes and management. Instruments that reliably assess knowledge about UI are important for identifying educational needs and evaluating the impact of educational interventions. Although the Incontinence Quiz (IQ) has been validated in other languages, no psychometrically tested French version was previously available. This study aimed to translate, culturally adapt, and evaluate the measurement properties of the French version of the Incontinence Quiz (IQ-Fr) in adult women, following internationally recommended procedures for cross-cultural adaptation. Methods: A methodological validation study with a two-sample design was conducted. An extended sample (n = 289) was used to examine internal consistency and convergent validity, while a validation subsample (n = 40) was used to assess divergent validity and reproducibility. The translation process included forward translation, synthesis, back-translation, expert committee review, and pretesting. The internal consistency of the IQ-Fr was assessed using Cronbach’s Alpha. The convergent validity of the IQ-Fr was assessed by both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). The divergent validity of the IQ-Fr was evaluated by Pearson’s correlation IQ-Fr and Ditrovie quality-of-life scores. Finally, the reproducibility of the IQ-Fr was evaluated by Intraclass Correlation (ICC) between the IQ-Fr scores obtained at two different time points (T0 and T1) over a one-week interval. Results: The IQ-Fr showed acceptable internal consistency (Cronbach’s Alpha = 0.654) comparable to other translations/cultural adaptations made for the same instrument. The EFA and CFA suggest the same four-dimension structure (IQ-Fr) found in the original instrument (IQ), although the factorial model fit would benefit from the additional removal of item 6 from the questionnaire, as already suggested by the increase in the instrument’s Cronbach’s Alpha (from 0.646 to 0.659). The IQ-Fr also showed good divergent validity, as assessed by the absence of a statistically significant Pearson correlation between the scores of the IQ-Fr and the scores of a non-related construct—the Ditrovie scale (r_p = 0.097, p-value = 0.552). Lastly, the IQ-Fr showed good reproducibility, as demonstrated by the high ICC coefficient (ICC = 0.752) between the instrument’s overall scores at T0 and T1. Conclusions: The French version of the Incontinence Quiz (IQ-Fr) presents good indicators of internal consistency, convergent validity, divergent validity, and reproducibility for it to be used in research and educational contexts in French-speaking populations. Full article

Background: Nutritional literacy is a core competency for promoting healthy dietary behaviors and preventing nutrition-related chronic diseases. Standardized scales are essential for rigorous measurement and evaluation, yet the field exhibits substantial heterogeneity in concepts and measurement approaches. Methods: We systematically searched five major databases, namely Web of Science, PubMed, Scopus, Embase, and CINAHL, from their inception to October 2025. Evidence was compiled on the conceptual evolution, domain structure, scoring logic, population-specific applicability, and application scenarios of nutritional literacy scales. Results: A total of 14 nutritional literacy scales developed between 2005 and 2025 were included in the review. The structure and measurement content of these scales have progressively expanded, evolving from an early focus on basic reading and numeracy skills to become multidimensional assessment tools encompassing knowledge, skills, and behavioral practices. The target population has broadened from the general adult population to include multiple special groups, while application regions have extended from high-income Western countries to developing regions, including China and Turkey, and assessment methodologies have progressively shifted from single tests to blended objective–subjective approaches, with most scales demonstrating sound reliability and validity. These instruments are now employed for screening, intervention evaluation, dietary behavior mechanism research, and analysis of chronic disease risk. The reviewed studies indicate that nutritional literacy is generally positively correlated with healthy dietary behaviors, nutrition labeling utilization, and related health outcomes. Conclusions: Although nutritional literacy scale research has advanced with regard to conceptualization, measurement design, and applications, major gaps remain, including fragmented dimensional structures, insufficient standardization, inadequate cultural adaptation, and limited longitudinal evidence. Future work should prioritize a unified assessment framework, stronger tools for special and vulnerable populations, digital innovations for scalable measurement, and interdisciplinary and cross-national collaboration to enhance quality, practicality, and comparability and to support global nutrition promotion and public health policy. Full article

International students in Saudi universities face academic and adaptation challenges shaped by emotional, cognitive, linguistic, and sociocultural factors. This study examined whether emotional intelligence and cognitive flexibility predicted academic success and adaptation outcomes among international students in Saudi public universities. A quantitative cross-sectional survey was conducted with 410 international students using structured measures of emotional intelligence, cognitive flexibility, academic success, adaptation outcomes, Arabic proficiency, and sociodemographic characteristics. Data were analysed using descriptive statistics, chi-square tests, Kendall’s tau-b correlations, hierarchical regression, and observed-variable path analysis. Duration of residence was significantly associated with Arabic proficiency, χ²(8) = 82.40, p < .001. Arabic proficiency was positively associated with GPA, τ = 0.62, p < .001, and adaptation outcomes, τ = 0.48, p < .001. In hierarchical regression, sociocultural covariates and psychological predictors explained substantial variance in academic success, R² = 0.53, and adaptation outcomes, R² = 0.53. Emotional intelligence and cognitive flexibility remained positive predictors of both outcomes after accounting for Arabic proficiency, duration of residence, region of origin, and language of instruction. Findings suggest that international student success in Saudi universities reflects an interaction of emotional, cognitive, linguistic, and contextual resources. Universities should strengthen integrated support for emotional regulation, adaptive thinking, Arabic-language development, and culturally responsive academic guidance. Full article

Real-time visual recognition systems integrated with culturally adaptive reasoning are urgently demanded in globalized culinary scenarios. An agent-oriented framework, Agent-based Gastronomy Recommender Enhanced Engine with YOLO (AGREE-YOLO), is proposed in this study, which integrates an optimized lightweight YOLOv13 detector and vision language model (VLM)-driven agents for cross-cultural seafood recipe recommendation. The improved YOLOv13 is equipped with group shuffle convolution (GSConv) modules and Wise-IoU (WIoU) loss, which is validated on a refined underwater seafood dataset targeting sea cucumbers, sea urchins and scallops. It achieves 91.2% precision and 87.3% recall, with 3.9% and 4.2% increments over the baseline model, and maintains 2.0 ms inference speed. Detection outputs are structured and stored in a MySQL database, and a novel ChatFlow pipeline is constructed in the Dify platform to support natural language database querying. VLM-powered agents retrieve structured data and generate culturally tailored recipes and dish images automatically. Operational validation verifies that the end-to-end pipeline realizes seamless conversion from seafood images to personalized cross-cultural recommendations. This work provides an integrated solution for intelligent, culturally adaptive gastronomy in food informatics. Full article

Generating culturally coherent multimodal folktales presents unique challenges, particularly for underrepresented cultures facing data scarcity and cultural bias. Existing approaches predominantly rely on Western-centric corpora, limit outputs to text–image modalities, and reduce culture to a superficial stylistic layer rather than a core narrative structure. In this paper, we propose MELT (Multimodal Engine for Localized Tales) a unified framework for culturally adaptive story generation across text, illustration, and audio. To achieve this, MELT embeds cultural context as a foundational generative constraint and integrates three modules: (1) a localized folktale generation module leveraging structured prompting and contextual reasoning to preserve the narrative flow and cultural identity of traditional folktales; (2) an illustration generation module that ensures cultural style and character consistency using a Tri-Stage LoRA (Low-Rank Adaptation) pipeline; (3) a storytelling audio component tailored to cultural prosody and oral storytelling conventions. Case studies on Korean and Bengali folktales demonstrate MELT’s ability to generate culturally coherent outputs using lightweight, data-efficient adaptation techniques. Human evaluation results demonstrated that MELT consistently outperformed the baseline across both case studies, showing a substantial improvement in cultural adaptation, nearly doubling the score in the Korean folktale evaluation. By positioning culture as a core generative principle, MELT provides a pathway for culturally coherent AI storytelling, particularly for underrepresented traditions. Full article

Background: Parents of children with disabilities often experience reduced quality of life (QoL), yet validated Arabic instruments remain limited. This study aimed to translate and validate the Arabic version of the Multicultural Quality of Life Index (MQLI-Ar). Methods: A cross-sectional study was conducted among 132 parents and caregivers in Saudi Arabia. The MQLI was translated using forward–backward translation and culturally adapted. Reliability and validity were assessed using Cronbach’s alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA). Results: The MQLI-Ar demonstrated high internal consistency (Cronbach’s alpha = 0.948). EFA supported a unidimensional structure explaining 68.3% of the variance. CFA indicated acceptable model fit (CFI = 0.934, TLI = 0.915, SRMR = 0.0397), although RMSEA was elevated. Factor loadings ranged from 0.642 to 0.919, confirming strong item–factor relationships. Conclusions: The MQLI-Ar is a reliable and valid tool for assessing QoL among Arabic-speaking caregivers of children with disabilities, supporting its use in research and clinical practice. Full article

The aim of the present study was to explore differences in fair play attitudes among university students in Hungary and Kenya using the Fair Play Attitude Scale (EAF). The questionnaire was culturally adapted for the Kenyan context and administered in both countries. A total of 2090 university students participated in the survey (1278 from Kenya and 812 from Hungary). The scale measures three dimensions of fair play attitudes: gamesmanship and the importance of winning, acceptance of rough play and cheating, and fair play and enjoyment of the game. Principal component analysis confirmed the three-factor structure of the instrument, and reliability indices indicated satisfactory internal consistency in both samples. Due to the non-normal distribution of the variables, non-parametric statistical procedures were applied to examine differences between groups. The results revealed significant cross-cultural differences in fair play attitudes. Kenyan students, particularly men, showed higher acceptance of competition-oriented behaviour and gamesmanship, whereas Hungarian students placed greater emphasis on enjoyment and adherence to fair play principles. The findings highlight the role of cultural and social contexts in shaping ethical attitudes in sport and underline the importance of fair play education in sport pedagogy and educational practice. Full article

Coronavirus anxiety is defined as a psychological contrast characterized by excessive fear, obsessive thoughts, and reassurance-seeking behaviors associated with COVID-19. As current scales have been tested primarily in North American populations, we aimed to translate and culturally adapt three measures of dysfunctional coronavirus anxiety—the Coronavirus Anxiety Scale (CAS), the Obsession with COVID-19 Scale (OCS), and the Coronavirus Reassurance-Seeking Behaviors Scale (CRBS)—for the first time in Greek-speaking populations. To translate existing scales, we followed best practices for cross-cultural comparisons using forward translation (English to Greek) and backward translation (Greek to English) with expert translation review, prior to conducting pilot testing and confirmatory factor analysis in a bespoke survey population. A total of 405 adults from Cyprus participated in this study. The results indicated that the Greek versions of these measures demonstrated adequate reliability (Cronbach’s alphas > 0.70) and strong factor structure, as supported through confirmatory factor analysis. However, only the CAS exhibited evidence of both convergent and divergent validity. Our study makes several innovative contributions which have broad implications for crisis preparedness, including providing a framework for mental health interventions in future pandemics or Black Swan events. Full article

Background/Objectives: Pediatric pain management remains a significant clinical challenge, with contemporary biopsychosocial models increasingly emphasizing humanized care and non-pharmacological strategies. This study aimed to culturally adapt and evaluate the psychometric properties of the Polish version of the HUPEDCARE-Q (Humanisation of Pediatric Care in Pain Management with a Non-Pharmacological Approach) questionnaire among healthcare professionals and students. An additional objective was to explore differences in knowledge, attitudes, and self-reported practices across different age groups and stages of professional development. Methods: An observational, cross-sectional study was conducted. The cross-cultural adaptation process included independent forward translations, reconciliation, back-translation, and an expert panel review. Data were collected using online surveys. Construct validity was evaluated through confirmatory factor analysis (CFA), while internal consistency reliability was assessed using McDonald’s omega coefficient and the Kuder–Richardson Formula 20 (KR-20). Group differences were analyzed utilizing the Mann–Whitney U test. Results: Because the original factor structure exhibited a suboptimal fit to the data, a revised and reduced Polish version was proposed, which demonstrated significantly improved fit indices (CFI = 0.91 for the attitudes and knowledge domains; CFI = 0.99 for the pain management domain). Exploratory bivariate analyses showed higher knowledge and attitudes scores among older participants and working professionals, whereas no statistically significant differences were observed in self-reported pediatric pain management practices. Conclusions: The revised Polish short-form adaptation of the HUPEDCARE-Q showed improved model fit and domain-specific psychometric performance, with strong internal consistency for the pediatric pain management domain, acceptable reliability for the knowledge domain, and moderate reliability for the attitudes domain. Therefore, the instrument should be interpreted as a preliminary screening and assessment tool rather than as a fully established measure with uniformly strong reliability across all domains. The observed discrepancy between higher knowledge and attitude scores and the absence of significant differences in self-reported practices may suggest that knowledge and attitudes alone are not sufficient to explain differences in self-reported pediatric pain management practices. Full article

Background/Objectives: The increasing use of home mechanical ventilation in Poland highlights the need for reliable and culturally appropriate tools to assess caregiver quality of life. This study aimed to translate, culturally adapt, and evaluate the initial psychometric properties of the Polish version of the Adult Carer Quality of Life Questionnaire (AC-QoL) among informal caregivers of adults receiving home mechanical ventilation. Methods: A total of 203 informal caregivers participated. The cross-cultural adaptation followed standard procedures. Confirmatory Factor Analysis was conducted to assess the factor structure. Reliability and validity were assessed using Cronbach’s alpha, McDonald’s omega, Composite Reliability, Average Variance Extracted, and correlations with caregiver burden, perceived stress, and life satisfaction. Results: Confirmatory Factor Analysis supported the original eight-factor structure, demonstrating good model fit (CFI = 0.954; TLI = 0.950; RMSEA = 0.069; SRMR = 0.078), with factor loadings ranging from 0.64 to 0.96. The Polish version of the AC-QoL demonstrated high internal consistency (Cronbach’s α = 0.95). Convergent validity was confirmed by significant correlations with caregiver burden, perceived stress, and life satisfaction. Conclusions: The Polish version of the AC-QoL demonstrates promising psychometric properties and may support clinical assessment and research in home-based long-term care. Full article

Background: Streptococcus pneumoniae, also referred to as pneumococcus, is of immense public health significance. In particular, it causes severe invasive diseases among children. This has led to the recommendation of anti-pneumococcal prophylaxis, including the administration of penicillin and pneumococcal conjugate vaccines (PCVs), which have become available in about 90% of the countries in sub-Saharan Africa. Nonetheless, breakthrough disease still occurs. Also, PCVs can cause a shift in the distribution of pneumococcal serotypes, usually towards non-vaccine types. However, in many sub-Saharan African countries where PCVs have been introduced, there are hardly any comprehensive post-vaccination surveillance data on pneumococcus. Aim: To describe the post-vaccination epidemiology of invasive pneumococcal disease (IPD) in Ghana, including the prevalence, serotype distribution and antibiotic resistance. Methods: The study was cross-sectional and involved 14,597 patients recruited at the Korle Bu Teaching Hospital, Greater Accra Regional Hospital, Princess Marie Louise Children’s Hospital, Ho Regional Hospital, Eastern Regional Hospital, and Zonal Public Health and Reference Laboratory, Tamale. Specimens of cerebrospinal fluid (obtained by lumbar puncture) and blood were collected routinely from meningitis patients, while blood specimens were taken from pneumonia patients. These were cultured for S. pneumoniae following standard microbiological methods and subjected to antimicrobial susceptibility testing. The isolates were serotyped by the pneumotest latex agglutination kit, and the results confirmed by Quellung reaction, using serotype-specific antisera. Results: The overall prevalence of IPD was 0.66% (n = 97), varying across syndromes: bloodstream infections (0.53%, n = 38), meningitis (2.45%, n = 43), and pneumonia (0.28%, n = 16). The majority of the cases (56.70%, n = 55) occurred in the 11–20-year-old group. Ten pneumococcal serotypes were identified, with Serotype 1 being predominant (58.76%), followed by Serotypes 23B (11.34%), 33F (9.28%), and 12F (8.24%). Vaccine serotypes accounted for 81.44% of the isolates, while 18.56% were non-vaccine serotypes (23A, 23B, and 38). Antimicrobial resistance was highest against sulphamethoxazole-trimethoprim (52%), ampicillin (51%), and penicillin (46%). No resistance was observed against ciprofloxacin, levofloxacin, and vancomycin. The multidrug resistance proportion was 42.3% (n = 41). Conclusions: Even in the post-vaccination era, vaccine-type IPD remains a significant public health issue in Ghana. The observed serotype distribution and antimicrobial resistance patterns warrant sustained surveillance, more adaptive vaccination policies, and rigorous antibiotic stewardship to effectively mitigate IPD burden. Full article

Background: Problematic smartphone use has been increasingly reported among university students, including nursing students, yet the availability of brief, culturally appropriate, and psychometrically sound assessment instruments in Greece remains limited. Aim: This study aimed to translate and culturally adapt the Greek version of the Smartphone Addiction Scale—Short Version (SAS-SV) and to evaluate its psychometric properties, including internal structure, reliability, and convergent validity with the Mobile Phone Problem Use Scale-10, among nursing students in Greece. Methods: In a cross-sectional study, nursing students from multiple departments across Greece (N = 331) completed the Greek SAS-SV, distributed online via official university forums, student groups, and institutional social media pages, between September 2025 and November 2025. We conducted exploratory and confirmatory factor analyses using polychoric correlations, examined convergent validity, performed exploratory comparisons across demographic characteristics, and estimated the reliability of the SAS-SV. Results: Confirmatory factor analysis was consistent with a one-factor structure and showed acceptable model fit. Internal consistency was high (Cronbach’s α was 0.862 and McDonald’s omega was 0.891), with supportive evidence of convergent validity through its correlation with the MPPUS-10 (Spearman’s ρ = 0.772, p < 0.001). Conclusions: The Greek SAS-SV showed acceptable psychometric properties among nursing students and seems appropriate for research purposes in Greece. Full article