Preliminary psychometric evaluation of the Vancouver Index of Acculturation (VIA) in a UK-based East-Asian sample

This study aimed to evaluate the psychometric properties and acceptability of the Vancouver Index of Acculturation (VIA) in a sample of UK-based East-Asian adults. Although widely used in cross-cultural research, relatively few studies have assessed the factor structure, validity, and user acceptability of the VIA in non-North American samples. A total of 236 East-Asian participants (mean age = 26.8, 47.06% female) completed the 20-item VIA and demographic questions. Confirmatory factor analysis (CFA) was conducted using AMOS with maximum likelihood estimation and robust standard errors. Exploratory factor analysis (EFA) using principal axis factoring and varimax rotation was also performed. Internal consistency, convergent and discriminant validity, and acceptability were evaluated. CFA showed poor model fit for the original two-factor VIA structure: χ 2(169) = 367.12, p &lt; 0.001; CFI = 0.84; RMSEA = 0.089. The Mainstream factor showed weak and mostly nonsignificant loadings, while the Heritage factor demonstrated strong loadings. Internal consistency was high for Heritage (α = 0.91) and acceptable for Mainstream (α = 0.81). EFA supported a refined 17-item two-factor model, excluding three low-loading Mainstream items. Discriminant validity was supported, but convergent validity was only partially established. Acceptability data indicated that while most items were well received, several were perceived as culturally ambiguous. Findings support the VIA's bidimensional structure but suggest that cross-cultural adaptation may be needed to improve measurement accuracy in UK-based East Asian populations. The study highlights the importance of further validation in culturally diverse samples.</p

The process of translation and cross-cultural adaptation of functional assessment tools for dementia:A systematized review

Background and AimsA decline in function related to impairment in cognitive abilities is required for diagnosing dementia. Cultural diversity influences everyday functioning, suggesting that functional assessment tools need to be culturally dependent. Therefore, this systematized review aimed to explore the translation and cross-cultural adaptation of functional assessment tools designed to support dementia diagnosis.MethodsA systematic search of five electronic databases (CINAHL Plus, EMBASE, PubMed/MEDLINE, PsycINFO) was conducted from inception until September 2023. Quality assessment criteria were then utilized to evaluate the process of cross-cultural adaptation and psychometric properties of identified functional assessment tools.ResultsFifteen studies relating to adapted functional assessment tools in 11 languages were identified. It was found that less than half of these studies fully adhered to established guidelines for the translation and cross-cultural adaptation of instruments. Regarding psychometric properties, while the internal consistency and reliability of included measures were generally strong, there was variability in evaluating other psychometric properties, notably structural validity, measurement error, and cross-cultural validity.ConclusionsThis review underscores the need for researchers and clinicians to follow standardized guidelines for translating and cross-culturally adapting functional assessment tools for dementia and ensuring the comprehensive evaluation of psychometric properties in cross-cultural settings. Researchers and clinicians should consider whether the psychometric properties and characteristics of an adapted functional activity measure are suitable for use in their population of interest

Cross-Cultural Paediatric Neuropsychological Assessment:Key Considerations

Background and Aims: Cross-cultural paediatric neuropsychology faces important challenges in ensuring assessments are fair and valid across diverse cultural, linguistic, and socioeconomic backgrounds. This article aims to highlight key considerations and gaps in current practice, with a focus on supporting equitable neuropsychological assessment practices in increasingly diverse populations. Methods: This perspective article draws on a structured narrative review of key literature and explores core themes in the cross-cultural neuropsychological assessment of children, including test adaptation, developmental considerations, and interpreter-mediated assessment. Results: Three main areas are discussed: (1) the inconsistent adaptation of paediatric-specific cognitive assessment tools across cultures, (2) the influence of cultural and educational factors on child development and test performance, and (3) the complexities of interpreter-mediated neuropsychological assessment in paediatric settings. Although there are established tools and emerging guidance in adult neuropsychology, systematic, child-focused cross-cultural assessment frameworks remain underdeveloped.Conclusion: Further research is needed to develop culturally responsive, developmentally appropriate, and standardised frameworks for paediatric neuropsychological assessment. This includes improving normative data sets, refining cross-cultural adaptation processes, and developing interpreter protocols tailored to child assessments. These efforts are essential to ensure that assessments are equitable, accurate, and clinically useful across diverse populations.</p

Examining the cognitive underpinnings of functional decline in prodromal Alzheimer’s disease:Insights from the Details of Functions of Everyday Life (DoFEL) Scale

Available assessments for early-stage Alzheimer's disease (AD) identify neuropsychological and functional impairments, which rarely correlate in the early disease stages. The ability to bind information in memory declines in preclinical AD stages. However, it is unclear whether such cognitive deficits underlie functional impairment in prodromal AD stages. This study investigates whether incorporating memory binding, a function that is a sensitive cognitive marker for early-stage AD, into a functional assessment tool can reveal the cognitive underpinnings of daily activities. The Details of Function of Everyday Life (DoFEL) scale was revised, and its latent structure was explored through principal axis factoring in a nonclinical sample ( n  = 559). Dementia professionals subsequently reviewed the revised DoFEL for content validity, followed by confirmatory factor analysis in another nonclinical sample ( n  = 135). Additionally, 49 participants with mild cognitive impairment (MCI) and 33 healthy controls completed the DoFEL, Addenbrooke's Cognitive Examination-Revised (ACE-R) and a Visual Short-Term Memory Binding Task (VSTMBT). Correlation analysis and binomial regression were used to examine the relationship between DoFEL scores and cognitive measures and to assess its ability to differentiate between healthy controls and MCI patients. The revised DoFEL showed satisfactory structural and construct validity, although some items lacked content validity. Significant negative associations were found between DoFEL scores and ACE-R ( r  = -0.66, p &lt; 0.001) as well as VSTMBT ( r  = -0.52, p=0.003) performances. Binomial regression demonstrated the DoFEL's effectiveness in distinguishing healthy controls from MCI patients (AUC = 0.95). These findings suggest that linking memory binding with functional performance could enhance functional assessment in early-stage AD. </p

Functional assessment of cognitively impaired older adults : are we asking the right questions?

Background: Recent attention has turned to the development of preventative treatments for Alzheimer’s disease (AD) by targeting the early stages of impairment. However, current neuropsychological and functional assessments are not ideally suited to identify early deviations from healthy ageing (HA). The Details of Functions of Everyday Life (DoFEL; Parra & Kaplan, 2019) is a theory-driven scale that incorporates cognitive constructs sensitive to the preclinical stages of dementia (memory binding). DoFEL can help assess the extent to which instrumental functions of daily living are supported by such cognitive abilities and if so, whether by asking the right questions through such a scale we could unveil subtle and still undetected impairments. We predict this would increase the sensitivity of scales to detect older adults with cognitive impairment who are at a high risk of dementia.   Methods: Twenty-five MCI and 21 HA controls (ACE-R score ≥ 88) (Mioshi et al., 2006) underwent an extensive baseline neuropsychological assessment followed by yearly follow-up assessments. The DoFEL is an informant-based neuropsychological assessment that measures a range of functional abilities which rely on different forms of binding functions. This measure includes 82 statements subdivided into 7 functional domains that comprehensively assess different aspects of daily living. Higher DoFEL score indicate greater impairment.   Results: Five key findings from this study were: (1) The total DoFEL score differentiates MCI from HA U=406.00, p=0.002. Higher scores were detected in individuals with MCI (Mdn= 0.41, Mean rank= 29.24) than in the HA (Mdn= 0.35, Mean rank= 16.67). (2) Individuals with MCI showed domain-specific impairments on DoFEL such as Objects and People, Technology and Communication, Work and Social Life. (3) Relative to HA, MCI patients presented with impaired functional abilities that rely on relational (i.e., forming associations, p=0.001) and conjunctive (i.e., forming object identity, p=0.004). (4) DoFEL scores correlate with (r= -0.62, p=0.000), and predicts cognitive performance on the ACE-R (β= -128.68, t(44)= -6.97, p=0.000).   Conclusion: DoFEL can detect differences between individuals with MCI and HA in overall and specific functional abilities seemingly supported by binding functions and therefore may be a useful tool to identify individuals at risk of developing AD

A Preliminary Evaluation of the Psychometric Properties of the ARTIC-10 in Dental Settings:A Cross-Sectional Study

Background and Aims: Trauma-informed care (TIC) is increasingly recognized in healthcare, including dentistry, for its potential to improve patient outcomes. However, there are currently no validated tools for assessing TIC attitudes among dental professionals. This study aimed to evaluate the psychometric properties of the 10-item Attitudes Related to Trauma-Informed Care (ARTIC-10) scale within a UK dental hospital setting and explore its ability to distinguish between staff with and without prior TIC training. Methods: A cross-sectional study was conducted with 43 staff members from a UK dental hospital, including dentists, dental nurses, administrative staff, and technicians. Participants completed the ARTIC-10 and the Beliefs About Trauma and Trauma-Informed Care (BAT-TIC) scale. A subset of participants (n = 13) completed the ARTIC-10 again after 1 month to assess test–retest reliability. Internal consistency, construct validity, test–retest reliability, and group differences were examined. Results: The ARTIC-10 demonstrated strong test–retest reliability (intraclass correlation coefficient = 0.891) and moderate construct validity through a significant positive correlation with the BAT-TIC (r = 0.493, p = 0.005). TIC-trained staff scored significantly higher on the ARTIC-10 (M = 5.30, SD = 0.73) than untrained staff (M = 4.84, SD = 0.73), t(41) = 2.03, p = 0.04, with a moderate effect size (d = 0.62). However, internal consistency was low (Cronbach's α = 0.420), suggesting limitations in scale reliability within this sample. Conclusion: The ARTIC-10 shows preliminary promise as a measure of trauma-informed attitudes among dental staff and may be useful in evaluating training interventions. However, further research with larger, stratified samples is needed to improve internal consistency and assess the scale's broader applicability in dental settings.</p

A preliminary validation of the details of function of everyday life scale for the detection of early‐stage Alzheimer’s disease

Background: Assessments for early‐stage Alzheimer’s disease (AD) aim to identify neuropsychological and functional impairments, which rarely correlate with early disease stages. We need to enhance our understanding of the cognitive aspects contributing to functional decline to improve sensitivity in functional assessment. The ability to bind information in memory declines in preclinical AD stages. However, it is unclear whether such cognitive deficits underlie functional impairment in prodromal AD stages. To explore this, the Details of Function of Everyday Life (DoFEL) has been developed, aiming to link the cognitive constructs of memory‐binding to specific impairments in activities of daily living. Method: The DoFEL underwent revision and latent structure exploration through Exploratory Factor Analysis in a non‐clinical sample (N = 559). This revised DoFEL was subjected to content validity review by eight dementia professionals, and factor structure was reassessed with Confirmatory Factor Analysis in a different sample (N = 135). Forty‐nine participants with MCI and thirty‐three healthy controls completed the DoFEL, Addenbrookes Cognitive Examination‐Revised (ACE‐R), and a Visual Short‐Term Memory Binding Task (VSTMBT). The correlation of revised DoFEL scores was examined in relation to ACE‐R and VSTMBT. Binomial regression was used to establish whether the revised DoFEL could differentiate healthy controls from MCI. Result: (1) Conjunctive and relational binding appeared to be represented as dimensions within DoFEL subscales. However, the factor structure was not replicated across all subscales, suggesting further scale revision would be of benefit. (2) Dementia professionals considered the revised DoFEL useful for detecting functional impairment in early‐stage AD. However, the relevance of some items to binding was questionable due to their broad nature. (3) Performance on the revised DoFEL (higher score indicating impairment) strongly correlated with performance on the ACE‐R, r(82) = ‐0.663, p < .001, and moderately correlated with performance on the VSTMBT, r(82) = ‐0.518, p = 0.003. (4) The revised DoFEL differentiated those on a healthy ageing trajectory from individuals diagnosed with MCI, demonstrating comparability with the ACE‐R. Conclusion: These findings offer initial evidence for the validity of the DoFEL. It indicates that the connection between binding and performance in functional activities could offer a valuable avenue for improving functional assessment during early‐stage AD

Accuracy of non-physician health workers in respiratory rate measurement to identify paediatric pneumonia in low- and middle-income countries: a systematic review and meta-analysis

BACKGROUND: Non-physician health workers play an important role in identifying and treating pneumonia in children in low- and middle-income countries (LMICs). In this systematic review, we summarized the evidence on whether health workers can accurately measure respiratory rate (RR) and identify fast breathing to diagnose pneumonia in children under five years of age. METHODS: We searched MEDLINE, EMBASE, Web of Science, and Scopus from January 1990 to August 2020 without any language restrictions. Reference lists of included studies were also screened for additional records. Studies evaluating the performance of health workers in measuring RR and/or identifying fast breathing compared to a reference standard were included. The methodological quality of the included studies was assessed using the QUADAS-2 tool. A meta-analysis was conducted to report pooled estimates of sensitivity and specificity. Hierarchical summary receiver operating characteristic curve (HSROC) models were fitted, and subgroup and sensitivity analyses were performed to examine the effects of study variables. RESULTS: We included 16 studies, eight of which reported the agreement in RR count between health workers and a reference standard. The median agreements were 39%, 47%, and 67% within ±2, ±3, and ±5 breaths per minute, respectively. Among the 16 included studies, we identified 15 studies that reported the accuracy of a health worker classifying breathing into either fast or normal categories compared to a reference standard. The median sensitivity, specificity, accuracy, and kappa value were 77%, 86%, 81%, and 0.75, respectively. Seven studies reporting the accuracy of identifying fast breathing were included in the meta-analysis. The pooled estimates of sensitivity and specificity were 78% (95% CI = 72-82) and 86% (95% CI = 78-91), respectively. CONCLUSIONS: Despite the problematic nature of reference standards and their variability across studies, our review suggests that the health worker performance in accurately counting RR is relatively poor. However, their performance shows reasonable specificity and moderate sensitivity in identifying fast breathing. Improving the detection of fast breathing in children with suspected pneumonia among health workers is an important child health programme objective and should be given appropriate priority

The classical case of character release: Darwin's finches ( Geospiza ) on Isla Daphne Major, GalÁpagos

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75575/1/j.1095-8312.1984.tb01679.x.pd

A Model for Damage Load and Its Implications for the Evolution of Bacterial Aging

Deleterious mutations appearing in a population increase in frequency until stopped by natural selection. The ensuing equilibrium creates a stable frequency of deleterious mutations or the mutational load. Here I develop the comparable concept of a damage load, which is caused by harmful non-heritable changes to the phenotype. A damage load also ensues when the increase of damage is opposed by selection. The presence of a damage load favors the evolution of asymmetrical transmission of damage by a mother to her daughters. The asymmetry is beneficial because it increases fitness variance, but it also leads to aging or senescence. A mathematical model based on microbes reveals that a cell lineage dividing symmetrically is immortal if lifetime damage rates do not exceed a threshold. The evolution of asymmetry allows the lineage to persist above the threshold, but the lineage becomes mortal. In microbes with low genomic mutation rates, it is likely that the damage load is much greater than the mutational load. In metazoans with higher genomic mutation rates, the damage and the mutational load could be of the same magnitude. A fit of the model to experimental data shows that Escherichia coli cells experience a damage rate that is below the threshold and are immortal under the conditions examined. The model estimates the asymmetry level of E. coli to be low but sufficient for persisting at higher damage rates. The model also predicts that increasing asymmetry results in diminishing fitness returns, which may explain why the bacterium has not evolved higher asymmetry