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The main problem of interpreting alpha as a measure of internal consistency is that alpha tends to increase with the number of items, a problem that was already discussed by (Cronbach 1951, p. 323).
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The other thing is making them realize that the big-ticket items are a problem, because most of the ones our younger clients tend to purchase are a depreciating asset".
In the OHIP-14, each subscale is represented by two items describing a problem.
Each of the 23 items states a problem, for example "difficulty walking".
Respondents were asked whether each in a series of items was a problem in getting the health care they needed.
Each of the 23 items states a problem, for example 'it is hard for me to run' and refers to the past week (acute version).
Examples of personal stigma items are: "A problem like 'Jenny's' is a sign of personal weakness", "People with a problem like 'Jenny's' are dangerous", and "If I had a problem like 'Jenny's', I would not tell anyone".
The instrument consists of an intensity scale that indicates the frequency of conduct problems (7-point Likert-scale items) and a problem scale that indicates whether the reporting parent experiences the behaviors of the child as problematic (scored as 1) or not problematic (scored as 0).
*Frequency of study participants reporting item as a problem (maximum = 1.0) +Mean importance assigned to item if reported as a problem (maximum = 5.0) ++Frequency importance product (frequency × mean importance) (maximum = 5.0) NB: The twenty highest ranking items are in bold font and were included in the final questionnaire and calculation of the ESTI score.
Also, parents were asked to indicate whether a specific sleep item is a problem by circling yes, no, or not applicable for each item.
Following Jenkinson et al. [ 21], we conceptualized the questionnaire in terms of each item as a problem (Table 1).
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com