Title. Translation of scales in cross-cultural research: issues and techniques Aims. This paper is a report of a study designed to: (i) describe issues and techniques of translation of standard measures for use in international research; (ii) identify a user-friendly and valid translation method when researchers have limited resources during translation procedure; and (iii) discuss translation issues using data from a pilot study as an example. Background. The process of translation is an important part of cross-cultural studies. Cross-cultural researchers are often confronted by the need to translate scales from one language to another and to do this with limited resources. Method. The lessons learned from our experience in a pilot study are presented to underline the importance of using appropriate translation procedures. The issues of the back-translation method are discussed to identify strategies to ensure success when translating measures. Findings. A combined technique is an appropriate method to maintain the content equivalences between the original and translated instruments in international research. There are several possible combinations of translation techniques. However, there is no gold standard of translation techniques because the research environment (e.g. accessibility and availability of bilingual people) and the research questions are different. Conclusions. It is important to use appropriate translation procedures and to employ a combined translation technique based on the research environment and questions.

Nonadherence to treatmeot regimen is a prevalent problem of patients with chronic disorders. Approximately half of the patients with a chronic disease have problems following their prescribed regimen to the extent that they are unable to obtain optimum clinical benefit. This chapter reviews the state of knowledge regarding adherence to chronic disease regimens across the life span and demonstrates that the extent and nature of the adherence problems are similar across diseases, across regimens, and across age groups. Adherence to the commonly prescribed regimens is addressed, including pharmacological therapies, therapeutic diets, and therapeutic exercise. Randomized, controlled studies focusing on various educational, behavioral, cognitive, and affective interventions to improve adherence are included. Based on this review, further work is needed to better understand and improve adherence. New strategies for analysis and measurement will support these needed advances in the field of adherence.

Problem drinking is associated with decreased medication adherence, particularly with taking medications off schedule during the previous week. Clinicians should assess for alcohol problems, link alcohol use severity to potential adherence problems, and monitor outcomes in both alcohol consumption and medication adherence.

Clinicians who disclose diagnoses of mild cognitive impairment need to be mindful of the potential for varying interpretations of the information that is conveyed. Future research needs to include systematic, longitudinal investigations of illness representation and its impact on health behaviors among individuals with mild cognitive impairment.

OBJECTIVE:To examine the relation between problem drinking and medication adherence among persons with HIV infection. DESIGN:Cross-sectional survey.SETTING/PARTICIPANTS: Two hundred twelve persons with HIV infection who visited 2 outpatient clinics between December 1997 and February 1998. MEASUREMENTS AND MAIN RESULTS:Nineteen percent of subjects reported problem drinking during the previous month, 14% missed at least 1 dose of medication within the previous 24 hours, and 30% did not take their medications as scheduled during the previous week. Problem drinkers were slightly more likely to report a missed dose (17% vs 12 %, P = .38) and significantly more likely to report taking medicines off schedule (45% vs 26%, P = .02). Among drinking subtypes, taking medications off schedule was significantly associated with both heavy drinking (high quantity/frequency) (adjusted odds ratio [OR], 4.70; 95% confidence interval [95% CI], 1.49 to 14.84; P < .05) and hazardous drinking (adjusted OR, 2.64; 95% CI, 1.07 to 6.53; P < .05). Problem drinkers were more likely to report missing medications because of forgetting (48% vs 35%, P = .10), running out of medications (15% vs 8%, P = .16), and consuming alcohol or drugs (26 % vs 3 %, P < .001).CONCLUSION: Problem drinking is associated with decreased medication adherence, particularly with taking medications off schedule during the previous week. Clinicians should assess for alcohol problems, link alcohol use severity to potential adherence problems, and monitor outcomes in both alcohol consumption and medication adherence.