Uso da adaptação transcultural nos cursos de pós-graduação em Enfermagem / Use of cross-cultural adaptation in Postgraduate Nursing courses / Uso de la adaptación transcultural en las carreras de grado en Enfermería

Objetivo: analisar a produção científica brasileira, na Pós-Graduação em Enfermagem, que utilizou o método de adaptação transcultural. Método: estudo documental, com busca realizada na Biblioteca Digital de Teses e Dissertações, que resultou em 140 dissertações e 72 teses para análise, oriundas de Programas de Pós-Graduação da região Sudeste, seguida das regiões Nordeste, Sul e Centro-Oeste, sem representação da região Norte. Resultados: os instrumentos adaptados foram, em sua maioria, procedentes do idioma inglês. Prevaleceram as pesquisas na área/campo Assistencial, destacando-se a linha de pesquisa Processo de Cuidar em Saúde e Enfermagem. Identificou-se descompasso entre o que é produzido na área e o que é recomendado internacionalmente. Conclusão: verificou-se aumento na utilização da adaptação transcultural como método de pesquisa, com persistência das assimetrias acadêmicas regionais e sem consenso sobre o referencial metodológico.

Objective: to analyze the Brazilian scientific production in Postgraduate Nursing education using the cross-cultural adaptation method. Method: documentary study with searches carried out in the Digital Library of Theses and Dissertations resulting in 140 Master's theses and 72 Doctoral dissertations for analysis originated from Postgraduate Programs carried out in the Southeast region of Brazil, followed by the Northeast, South and Midwest regions ­ there was no representation of the North region. Results: the adapted instruments were, mostly, originally written in English. Research in the Care area/field prevailed, highlighting the line of research called Health and Nursing Care Process. A gap between what is produced in the area and what is recommended internationally was identified. Conclusion: an increase in the use of cross-cultural adaptation as a research method was noticed, with the persistence of regional academic asymmetries and lack of consensus on the methodological framework.

Objetivo: analizar la producción científica brasileña, en el Postgrado en Enfermería, que utilizó el método de adaptación transcultural. Método: estudio documental, la búsqueda se realizó en la Biblioteca Digital de Tesis y Disertaciones, se obtuvieron 140 tesis de maestría y 72 tesis de doctorado para análisis, provenientes de Programas de Posgrado de la región Sudeste, seguida de las regiones Nordeste, Sur y Centro-Oeste, no se encontraron documentos de la región Norte. Resultados: los instrumentos adaptados fueron, en su mayoría, del idioma inglés. Predominaron las investigaciones en el área/campo Asistencial, se destacó la línea de investigación Proceso de Atención en Salud y Enfermería. Se identificó que lo que se produce en el área no coincide con lo que se recomienda a nivel internacional. Conclusión: se comprobó que aumentó el uso de la adaptación transcultural como método de investigación, que persisten las disparidades académicas regionales y que no hay consenso sobre el marco metodológico.

The Ubiquitous External Ejaculation: Examining Perceptions of Sexual Images Across Cultures.

The persistent debates over pornography have often focused on differences between males and females, not only in the frequency of consumption or the type of material consumed, but also on the different ways that individuals may perceive sexually explicit images and respond to them. Some of these differences may be due to sex differences in a number of factors including sexual strategies, pathogen or sexual disgust, and own mate value as well as within sex differences in these factors. Previous studies have demonstrated that perceptions of sexually explicit images are influenced by the sex of the target in the image and the target's emotional affect, as well as sex of the respondent, their sexual orientation, short-term mating orientation, and disgust measures. However, these previous studies were conducted with participants from the United States alone. This study compared the findings from these US samples to those from non-Western ones (Philippines and Brazil) in order to examine the replicability across cultures of the US results as well as whether some variables (religiosity, for example) account for more or less of the variance in perceptions in different populations. Results indicated that there were some differences in terms of the amount of variance in perceptions explained by different variables across populations. Participant and stimuli related variables explained more variance in the Philippines while individual difference variables accounted for more variance in Brazil.

Nursing outcome "Knowledge: Wound management" for surgical incision wound care: Update, translate, and culturally adapt.

PURPOSE: This study has two objectives: (1) to identify the indicators of the nursing outcome "Knowledge: Wound management (3209)" related to the evaluation of knowledge about the care of surgical wounds; (2) to translate and culturally adapt the nursing outcome "Knowledge: Wound management (3209)" into Brazilian Portuguese and Colombian Spanish. METHODS: This is a methodological study with two steps. Initially, a scoping review was conducted based on the methodology of the Joanna Briggs Institute. Subsequently, the translation and cultural adaptation of the outcome were performed by adapting Beaton's recommendations, which included the label, definition, indicators, and measurement scale. FINDINGS: The review identified 31 indicators to evaluate knowledge about surgical wound care. Of these, 16 are described in the original outcome, and 15 new indicators are proposed to be included in the classification. Following this, the label, definition, indicators, and outcome measurement scale were reviewed, translated, and adapted with appropriate terminology for the cultural contexts of Brazil and Colombia. CONCLUSION: The outcome "Knowledge: Wound management (3209)" for evaluating the knowledge of surgical wounds consists of 31 indicators, all supported by scientific literature. The translated and adapted versions into Brazilian Portuguese and Colombian Spanish were found to be equivalent to the original. It is inferred that the identified indicators and the translated versions of the outcome will provide nursing professionals with an accurate assessment of knowledge about surgical incision wound care in daily practice. IMPLICATIONS FOR NURSING PRACTICE: This study reviews the scientific literature on the outcome "Knowledge: Wound management (3209)," facilitating the comprehensive measurement of specific knowledge about the care of surgical wounds in practice, education, or research. Additionally, it makes available the translated and adapted versions of the outcome in Brazilian Portuguese and Colombian Spanish. PROPÓSITO: Este estudio tiene dos objetivos: (1) Identificar los indicadores del resultado de enfermería "Knowledge: Wound Management (3209)" relacionados a la evaluación del conocimiento sobre el cuidado de las heridas quirúrgica; (2) traducir y adaptar culturalmente el resultado de enfermería "Knowledge: Wound Management (3209)" al portugués de Brasil y al español de Colombia. MÉTODOS: Estudio metodológico de dos pasos. Inicialmente, fue realizada una revisión de alcance orientados en la metodología de la Joanna Briggs Institute. Posteriormente, se realizó la traducción y adaptación cultural del resultado adaptando las recomendaciones de Beaton e incluyó la etiqueta, definición, indicadores y escala de medición. HALLAZGOS: En la revisión fueron identificados 31 indicadores para evaluar el conocimiento sobre el cuidado de las heridas quirúrgicas. De los 31 indicadores, 16 son descritos en el resultado y 15 nuevos indicadores propuestos para ser incluidos en la clasificación. A continuación, la etiqueta, definición, indicadores y escala de medición del resultado fueron revisados, traducidas y adaptados con la terminología adecuada para los entornos culturales de Brasil y Colombia. CONCLUSIÓN: El resultado "Knowledge: Wound Management (3209)" para el cuidado de las heridas quirúrgicas está compuesto por 31 indicadores todos sustentados con la literatura científica. Las versiones traducidas y adaptadas al portugués de Brasil y al español de Colombia del resultado fueron equivalentes al original. Se infiere que los indicadores identificados y las versiones traducidas del resultado le proporcionaran al profesional de enfermería una evaluación precisa del conocimiento sobre el cuidado de las heridas quirúrgicas en la práctica diaria. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA: Este estudio revisa la literatura científica del resultado "Knowledge: Wound Management (3209)" favoreciendo la medición integral del conocimiento específico sobre el cuidado de las heridas quirúrgicas en la práctica, educación o investigación. Además, pone a disposición la versión traducida y adaptada del resultado en portugués de Brasil y en español de Colombia.

Evaluation of the psychometric properties of the health care providers' pain and impairment relationship scale (HC-PAIRS) in health professionals and university students from Chile and Colombia.

Background: Chronic back pain is a frequent and disabling health problem. There is evidence that ignorance and erroneous beliefs about chronic low back pain among health professionals interfere in the treatment of people who suffer from it. The Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) has been one of the most used scale to assess these misbeliefs, but no studies have been reported in Latin America. Method: We studied the factorial structure of the HC-PAIRS in health personnel and health sciences university students in two Latin American countries: Colombia (n = 930) and Chile (n = 190). Spain's data was taken of the original study of the Spanish version of the HC-PAIRS (171 Physiotherapy students). Additionally, the measurement invariance of this scale among Chile, Colombia and Spain was evaluated by calculating three nested models: configural, metric and scalar. We used a Confirmatory Factor Analysis (CFA) in both Latin American samples, with Maximum Likelihood Robust (MLR) estimation to estimate the parameters. For the final model in each sample, reliability was assessed with the Composite Reliability (CR) index, and to obtain the proportion of variance explained by the scale the Average Variance Extracted (AVE) was calculated. Results: The one-factor solution shows an acceptable fit in both countries after deleting items 1, 6, and 14. For the resulting scale, the CR value is adequate, but the AVE is low. There is scalar invariance between Chile and Colombia, but not between these two countries and Spain. Conclusions: HC-PAIRS is useful for detecting misconceptions about the relationship between chronic low back pain that would cause health personnel to give wrong recommendations to patients. However, it has psychometric weaknesses, and it is advisable to obtain other evidence of validity.

What attributes of digital devices are important to clinicians in rehabilitation? A cross-cultural best-worst scaling study.

BACKGROUND: Digital interventions are becoming increasingly popular in rehabilitation. Understanding of device features which impact clinician adoption and satisfaction is limited. Research in the field should be conducted across diverse settings to ensure digital interventions do not exacerbate healthcare inequities. OBJECTIVE: This study aimed to understand rehabilitation clinicians' preferences regarding device attributes and included a cross-cultural comparison. MATERIALS AND METHODS: Choice experiment methodology (best-worst scaling) was used to survey rehabilitation clinicians across Australia and Brazil. Participants completed 10 best-worst questions, choosing the most and least important device attributes from subsets of 31 attributes in a partially balanced block design. Results were analysed using multinomial models by country and latent class. Attribute preference scores (PS) were scaled to 0-100 (least to most important). RESULTS: A total of 122 clinicians from Brazil and 104 clinicians from Australia completed the survey. Most respondents were physiotherapists (83%) working with neurological populations (51%) in the private/self-employed sector (51%) who had experience using rehabilitation devices (87%). Despite preference heterogeneity across country and work sector (public/not-for-profit versus private/self-employed/other), clinicians consistently prioritised patient outcomes (PS 100.0, 95%CI: 86.2-100.0), patient engagement (PS 93.9, 95%CI: 80.6-94.2), usability (PS 81.3, 95%CI: 68.8-82.5), research evidence (PS 80.4, 95%CI: 68.1-81.7) and risk (PS 75.7, 95%CI: 63.8-77.3). In Australia, clinicians favoured device attributes which facilitate increased therapy dosage (PS 79.2, 95%CI: 62.6-81.1) and encourage patient independent practice (PS 66.8, 95%CI: 52.0-69.2). In Brazil, clinicians preferred attributes enabling device use for providing clinical data (PS 67.6, 95%CI: 51.8-70.9) and conducting clinical assessments (PS 65.6, 95%CI: 50.2-68.8). CONCLUSION: Clinicians prioritise patients' needs and practical application over technical aspects of digital rehabilitation devices. Contextual factors shape clinician preferences rather than individual clinician characteristics. Future device design and research should consider preferences and influences, involving diverse stakeholders to account for context-driven variations across cultures and healthcare settings.

German translation, cultural adaptation for Austria and validation of the Neurological Sleep Index - Multiple Sclerosis (NSI-MS).

STUDY OBJECTIVES: To translate, culturally adapt, and validate the Neurological Sleep Index - Multiple Sclerosis (NSI-MS) for use in Austrian German-speaking populations with multiple sclerosis (pwMS). METHODS: Following established guidelines, the NSI-MS diurnal sleepiness (DS), non-restorative nocturnal sleep (NRNS), and fragmented nocturnal sleep (FNS) scales underwent forward-backward translation, with content and face validity, and cultural adaptation to Austria established. Construct validity was evaluated using Rasch analysis. Known-groups validity was examined, and comparisons were made with scales measuring MS fatigue, daytime sleepiness, sleep quality, anxiety, and depression. Reliability was assessed through Cronbach's alpha, Person Separation Index, Lin's concordance correlation coefficient, measurement error, and floor and ceiling effects. Data were merged with a historic English dataset for comparison between English/German language versions. RESULTS: The translation and cultural adaptation of the NSI-MS-G were successful. Pretesting involved 30 pwMS, while the validation included 400 pwMS with mild-to-severe disability. The DS, NRNS, and FNS scales exhibited good fit parameters, were unidimensional, and invariant. NSI-MS-G scales demonstrated excellent convergent and known-groups validity, internal consistency, person separation reliability, test-retest reliability, adequate measurement error, and low floor and ceiling effects. Pooling English and German datasets revealed that person estimates for the NRNS and FNS scales are equivalent across versions, unlike the DS scale. CONCLUSIONS: The NSI-MS-G demonstrates validity, reliability, and responsiveness in assessing DS, NRNS, and FNS in pwMS, generating interval-level data, and shows equivalence between its English and German versions. CLINICAL TRIAL REGISTRATION: Register: German Clinical Trials Register (DRKS); URL: https://drks.de/search/en/trial/DRKS00025573; Identifier: DRKS00025573.

Exploring the Mediating Role of Self-Regulation in Bullying Victimization and Depressive Symptoms among Adolescents: A Cross-Regional and Gender Analysis.

This study explores the mediating role of self-regulation in the relationship between bullying victimization and depressive symptoms among adolescents, considering the moderating effects of gender and region. A cross-sectional analysis was conducted with 3984 adolescents aged 12-18 from the United Kingdom, Hong Kong, Taiwan, and the Netherlands. Data were collected via an online survey administered through Qualtrics. The survey included validated measures such as the Illinois Bullying Scale (IBS) to measure bullying victimization, the Adolescent Self-Regulatory Inventory (ASRI) to measure self-regulation, and the Patient Health Questionnaire (PHQ) to measure depression. The SPSS macro PROCESS was employed for data analysis, with model 4 used for testing the mediating effects of self-regulation and model 1 for assessing the moderating effects of gender and region. The results demonstrated significant associations between bullying victimization, self-regulation, and depressive symptoms. Self-regulation mediated the positive association between bullying victimization and depression, with notable variations across genders and regions. Specifically, male students in Hong Kong exhibited an increased susceptibility to depression when subjected to bullying. These findings underscore the protective role of self-regulation in mitigating the adverse effects of bullying victimization on adolescent mental health. Implications for interventions and prevention strategies targeting adolescent depression are discussed.

Psychometric properties of the chinese version of the value-based stigma inventory (VASI): a translation and validation study.

OBJECTIVE: This study aimed to develop a culturally adapted Chinese version of the Value-based Stigma Inventory (VASI) and to evaluate its psychometric properties, including reliability and validity, among the general Chinese population. METHODS: This study is a cross-sectional study. Convenience sampling was used to recruit 708 general citizens from Shenyang City, Liaoning Province, China. The VASI's internal consistency, split-half reliability, and test-retest reliability were tested to assess the translated scale's reliability. Several validity tests were performed, including expert consultation, exploratory factor analysis, and confirmatory factor analysis. Data were analyzed using SPSS 25.0 (IBM Corp., Armonk, NY, United States) and AMOS 23.0 (IBM Corp., Armonk, NY, United States). RESULTS: The Chinese version of the VASI showed good reliability, with a Cronbach's α value of 0.808, and the dimensions ranged from 0.812 to 0.850. Test-retest reliability showed good temporal stability with a value of 0.855, and the split-half reliability value was 0.845, indicating a high degree of consistency. The scale also demonstrated good content validity with a content validity index of 0.952. After conducting exploratory factor analysis, a five-factor structure was identified, including factors of self-realization, personal enrichment, reputation, meritocratic values, and security. In the confirmatory factor analysis, all recommended fit indicators were found to be within the acceptable range, including χ2/DF = 1.338, GFI = 0.960, AGFI = 0.940, RMSEA = 0.031, TLI = 0.985, CFI = 0.989, IFI = 0.989, PGFI = 0.640, and PNFI = 0.729. CONCLUSION: The Chinese version of the VASI is valid and reliable among the Chinese general public. The five-factor structured scale effectively assessed public stigma against mental illness, including the value orientations associated with personal stigma. Given the harsh and widespread public stigma against mental illness, the findings from the questionnaire may inform the development of future public health education programs. Public health education is needed to reduce the stigma of mental illness, increase public awareness of mental health issues, and mitigate the continued stigmatization of mental illness.

The imperative for cross-cultural medical education in globalized healthcare.

Current healthcare systems are like living creatures. They are highly complex, multi-faceted, and dynamic. They must constantly change and adapt; they are like a melting pot, brimming with both rich and diverse cultures from all corners of the world. Beyond just nationality, these systems can include many languages, religious beliefs, socioeconomic backgrounds, and unique health practices. The tides of globalization, multicultural societies, migration, and international collaboration are continuously reshaping how healthcare providers are educated and how healthcare is delivered in an equitable, inclusive, and fair manner. To keep pace with, and within, these highly vibrant socio-cultural frameworks, Cross-Cultural Medical Education is needed to educate healthcare professionals. This education is essential to create professionals who are not just skilled, but who are also culturally savvy and able provide fair and equal care to patients from all sorts of backgrounds. It provides professionals with foundational knowledge to navigate the complex landscape of diverse patient populations. Cross-Cultural Medical Education is thus of paramount importance to satisfy the need for effective cross-cultural communication and understanding in patient care preferences, ultimately leading to improved health outcomes.

Measurement invariance of the Intuitive Eating Scale-2 across country, ethnicity, sex, and sexual orientation: A cross-cultural study between Brazil and the U.S.

Intuitive eating is defined as being connected to internal hunger, satiety, and appetitive cues and flexibly using these cues to determine when, what, and how much to eat. The Intuitive Eating Scale-2 (IES-2) is a widely used measure of facets of intuitive eating. However, the scale has shown unstable factor structure in several validation studies and there is a lack of studies investigating the measurement invariance of the IES-2 beyond sex. We aimed to evaluate the psychometric properties of the IES-2, testing several factor structures among Brazilian and U.S. samples of men and women; to test measurement invariance across country of origin, ethnicity, sex, and sexual orientation; and to evaluate its internal consistency. Three models of the latent structure of the IES-2 were tested using confirmatory factor analyses (CFA) in a total of 1072 young adults (452 Brazilians and 620 Americans), aged 18-35 years. Results demonstrated that only a 3-factor solution with 11 items of the IES-2 showed adequate fit to the data for both countries. This model demonstrated scalar invariance across sex and sexual orientation, but only configural invariance was found across country of origin and ethnicity. Good internal consistencies were found for both the Brazilian and American samples. The present study provides support for a 3-factor solution with 11 items of the IES-2, to Brazilian and American samples. The study also offers evidence of internal consistency, and invariance between sex (i.e., male and female) and sexual orientation (i.e., heterosexual participants and sexual minority participants).

Validación transcultural al idioma español de la escala RosaQoL.

INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea.

The impact of gender, psychology, and cultural dimensions on leadership development in distance education.

The research purpose is to evaluate the effectiveness of leadership in the process of distance learning from the perspective of the psychological theories of leadership, gender, and cross-cultural issues. The present research is based on such methods as surveys, testing, quantitative and qualitative analysis, and statistical data processing. The subjective (the experience of the respondents) and objective (machine calculation of clusters) assessments allowed the scholars to generate more arguments on leadership in the learning process. The sample consisted of 600 female and male students (300 from each sex, respectively) aged 18-20 years from Abu Dhabi University, American University in The Emirates, and the United Arab Emirates University. The research stated that the majority of students, regardless of gender, suppose that both sexes can develop similar leadership traits (80%). The research claims that female leaders have to be more dynamic and demonstrate higher intelligence (26% vs. 20%) and confidence (20% vs. 15%) than male leaders. Cultural and socio-demographic characteristics do not play a significant role in leadership development (10%). The main cause for the choice of a leader is behavioural and communication characteristics (50%) as well as personal qualities (35%). These results can be used for the online design of distance learning courses in universities (both group and individual), as well as for psychologists to study the aspect of individuals' predisposition to leadership. It makes sense for further research to explore the issue of differences in the perception of educational leadership in Asian and Western European countries based on the cross-cultural aspect, that is, the influence of national culture on the choice of leader in the educational environment.

Measurement invariance of the Facebook intrusion questionnaire across 25 countries.

Facebook is one of the most popular social networking sites. However, Facebook intrusion or addiction is a growing concern as it involves an excessive attachment to Facebook, which disrupts daily functioning. To date, few studies have examined whether cross-cultural differences in the measurement of Facebook addiction exist. The aim of this study was to investigate the cross-cultural validity and measurement invariance of the Facebook Intrusion Questionnaire (FIQ), one of the most widely used measures of Facebook addiction, across 25 countries (N = 12,204, 62.3% female; mean age = 25 years). Multigroup confirmatory factor analyses (MGCFA) assessed cross-cultural validity as well as invariance. Additionally, individual confirmatory factor analyses evaluated the factorial structure and measurement invariance across genders in each country. The FIQ demonstrated partial metric invariance across countries and metric (13 countries), scalar (11 countries) or residual (10 countries) invariance across genders within individual countries. A one-factor model indicated a good fit in 18 countries. Cronbach's alpha for the entire sample was .85. Our findings suggest that the FIQ may provide an adequate assessment of Facebook addiction that is psychometrically equivalent across cultures. Moreover, the questionnaire seems to be universal and suitable for studying different social media in distinct cultural environments. Consequently, this robust tool can be used to explore behaviours related to specific media that are particularly popular in any given country.

"To be culturally competent is to be willing to learn about the differences and to acknowledge them"- a qualitative study on Polish medical students' attitudes towards cross-cultural competence development.

BACKGROUND: Changes in Polish demographic data with a growing number of culturally and linguistically diverse patients stipulate new directions in medical education to prepare future physicians to work effectively across cultures. However, little is known about Polish medical students' willingness to gain cross-cultural knowledge and skills, desire to get engaged in interactions with patients from diverse cultural backgrounds, expectations and needs concerning cross-cultural training as well as challenges they face in the path to cultural competence. METHODS: Therefore, in this study, we conducted and thematically analysed fifteen semi-structured interviews with medical students to broaden our understanding of medical students' perception of cross-cultural competence enhancement. RESULTS: The conducted thematic analysis allowed for the development of four themes, which showed that Polish medical students perceived skills and knowledge necessary to facilitate culturally congruent care as indispensable to form quality patient-doctor relations, believed that lack of cultural sensitivity may lead to dangerous stereotype formation and insufficient competence may be the source of stress and anxiety resulting in confusion and lack of confidence. Finally, numerous suggestions have been made by participants on how to improve their cross-cultural competence. Students emphasized, however, the role of medical education with active and experiential learning methods, including simulation-based training, in the process of equipping them with the knowledge and skills necessary to provide best quality care to culturally diverse patients. CONCLUSIONS: Our analysis indicated that Polish medical students seem to hold positive attitudes towards cultural competence development and view it as an important component of physician professionalism.

Piagetian Theory and the Psychogenetic Development of Humankind Throughout History. Towards a General Theory of the Human Being.

J. Piaget wanted to study children to find a key to understanding history of mind, culture, science, and philosophy. The new theory program, called the structural-genetic theory program, developed by the author of this article, is an off-spring of Piagetian theory and follows Piaget's main idea concerning the study of parallels between ontogenetic and historical developments. It maintains the full identity of the child's psyche and that of the adult archaic human being concerning traits and features of the preoperational stage and partially the concrete operational stage, thereby evidencing the total sally of the formal operational stage in the minds of archaic people. The identity of the stage structures is not partially given but rather entirely and implies even the smallest details. The article exemplifies this identity concerning several central issues, such as logic, physical understanding, categories such as causality and chance, animism, personification of plants and animals, belief in magic, metamorphosis, ghosts, and understanding of dreams and myths. Accordingly, there is no difference between ontogenetic stages and the psychogenetic development of humankind throughout history. Historically, humankind has gone through the same stages as children do. The new theory program presents the fundamental theory of the human being as he or she existed in history and peopled archaic, ancient, and medieval societies. Consequently, the world history of culture, mind, worldview, politics, law, science, philosophy, morals, religion, and arts must be reconstructed in terms of stages, a task already accomplished by the new program, at least to a certain extent.

BMI and explicit-implicit cues on food choice: The fake food buffet in the United Kingdom and Indonesia.

We examined whether people with high BMI sampled from two different countries were more susceptible to behavioural change via an implicit, rather than explicit, intervention. We measured BMI and used three types of cue interventions (implicit vs explicit healthy lifestyle cue vs neutral cue) to examine their impact on our participants' food choice using the Fake Food Buffet. Healthiness of the meal chosen was measured by the percentage of healthy food items in the meal. Portion size of their chosen meal was operationalised by the total number of food items chosen and its total calorie content was also estimated. Participants were recruited from the United Kingdom (N = 264) and Indonesia (N = 264). Our results indicated that while explicit food cues were overall more effective, implicit cues were a more effective strategy to change food choice behaviours among individuals with high BMI. Participants with high BMI were more likely to regulate the healthiness of their meal and less likely to regulate its portion size or calorie content. The efficacy of our healthy eating interventions was cross-culturally generalizable. Our study supports previous research that implicit cues of a healthy lifestyle might be a more effective behavioural change strategy for individuals with high BMI.

Urdu translation and cross-cultural validation of the stroke self-efficacy questionnaire.

BACKGROUND: The Stroke Self-Efficacy Questionnaire (SSEQ) measures the self-confidence of the individual in functional activities after a stroke. The SSEQ is a self-report scale with 13 items that assess self-efficacy after a stroke in several functional domains. OBJECTIVE: The purpose was to translate the Stroke Self-Efficacy Questionnaire into Urdu Language and to find out the validity and reliability of Urdu SSEQ among stroke patients. METHODS: The cross-cultural validation study design was used. Following COSMIN guidelines, forward and backward translation protocols were adopted. After pilot testing on 10 stroke patients, the final Urdu version was drafted. A sample of 110 stroke patients was used to evaluate the validity and reliability of the SSEQ-U. Content and Concurrent validity were determined. The intraclass correlation coefficient and Cronbach's alpha were used to measure internal consistency and test-retest reliability. Data analysis was performed using SPSS 25. RESULTS: The final version was drafted after application on 10 stroke patients. Content validity was analyzed by a content validity index ranging from 0.87 to 1. The internal consistency was calculated by Cronbach's alpha (α > 0.80). Test-retest reliability was determined by the Intra-class correlation coefficient (ICC2,1=0.956). Concurrent validity was determined by correlations with other scales by using the Spearman correlation coefficient; moderate to strong correlations (positive and negative) were found with the Functional Independence Measure (r = 0.76), Beck Depression Inventory (r=-0.54), Short Form of 12-item Scale (r = 0.68) and Fall Efficacy Scale (r = 0.82) with p < 0.05. CONCLUSION: The Urdu version was linguistically acceptable and accurate for stroke survivors for determining self-efficacy. It showed good content and concurrent validity, internal consistency and test-retest reliability.

The cross-cultural adaptation of Chinese international students: an empirical study on sequential-mediated effects.

Using convenience sampling and snowball sampling methods, data from 432 Chinese international students in 10 countries, including the United Kingdom, South Korea, and the United States, were collected to construct a multivariate sequential-mediated mixed model for cross-cultural adaptation. SPSS 23.0 and AMOS 23.0 were employed for aggregated validity, discriminant validity, and sequential-mediated effects analysis. The study found that: Cultural adaptation stress is negatively correlated with positive coping and positively correlated with negative coping, with negative coping having a significant negative impact during the cross-cultural adaptation process. Positive coping is positively correlated with sports participation, while negative coping is negatively correlated with sports participation. Sports participation is positively associated with in-group identification and negatively associated with out-group bias. In-group identification has a positive impact on cross-cultural adaptation, whereas out-group bias cannot effectively predict cross-cultural adaptation.

Cultural adaptation of a self-review tool for health promoting universities in Bulgaria.

Introduction: The Health Promoting University initiative is unknown in Bulgaria, and the health promotion potential of Bulgarian universities has not been studied. In order to examine it, a suitable instrument is needed. The UK Healthy Universities Network provides an accessible Self-Review-Tool (SRT). Aim: To present the process of cultural adaptation of the SRT in Bulgarian language. Methods: The standardized WHO methodology for cultural adaptation of instruments was followed in four stages: (1) Two language translations of the instrument into Bulgarian were made; (2) An expert Delphi discussion reached a consensus on specific health promoting (HP) terms, followed by a backward translation; (3) Pilot testing of the tool among university community representatives was conducted through a survey among a small sample, with independent responses to the SRT questionnaire followed by cognitive interviews; (4) Final revision of the instrument. Results: Ten public health experts reached a consensus on the name of the initiative and various HP terms. Ten other respondents pre-tested the tool. Difficulties in responding the SRT concerned the meaning of some HP terms, complex words, the system of answers, limited applicability of some statements. Changes were made to 61 of the total 68 elements in the SRT. Conclusion: All stages of the cultural adaptation were important for the final result. The adapted Bulgarian version of the SRT would be useful to Bulgarian universities that want to make a clear commitment to improving the health of their university community and the wider society.