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The oral communicative demand increases daily in the exercise of work functions in which the voice is necessary for the performance of daily work. Teachers, singers, actors, teleoperators, communicators, ticket-takers, health workers, among other professions, are subjected to a very high vocal load as they use their voice at high intensity for long periods of time, presenting a greater predisposition and incidence of developing vocal pathology. The aim of the present study is to analyse the differences in vocal difficulties between an Arts Education group (GE-A) and a Non-Arts Education group (GE-NA) using a screening procedure based on biomechanical voice analysis combined with the VHI-10 vocal disability questionnaire. The hypothesis suggests that participants in the GE-A group present a greater degree of functional alteration than those in the GE-NA group, due to the daily overload generated due to the high vocal demand inherent to the speciality. A total of 182 participants, 80 men and 102 women, were studied. The data from the screening by biomechanical analysis of the vocal folds reveal a profile with a greater imbalance in the dynamics of the vocal folds during phonation in the GE-A. These results could be associated with a higher vocal demand in GE-A and would justify the implementation of periodic diagnostic and preventive measures, as well as specific speech therapy rehabilitation treatments in this group., La demanda comunicativa oral aumenta diariamente en el ejercicio de funciones laborales en las que la voz es necesaria para el desempeño del trabajo diario. Profesores, cantantes, actores, teleoperadores, comunicadores, taquilleros, sanitarios, entre otras profesiones, se encuentran sometidos a una carga vocal muy elevada ya que utilizan su voz en alta intensidad durante amplios periodos de tiempo, presentando una mayor predisposición e incidencia de desarrollar patología vocal. El objetivo del presente estudio es analizar las diferencias en cuanto a dificultades vocales entre un grupo de Educación Artística (GE-A) y un grupo de Educación no Artística (GE-NA) mediante un procedimiento de cribado basado del análisis biomecánico de la voz junto con el cuestionario discapacidad vocal del VHI-10. La hipótesis sugiere que los integrantes del grupo GE-A presentan mayor grado de alteración funcional que el GE-NA motivado por la sobrecarga diaria que genera la alta demanda vocal propia de la especialidad. Se recogieron muestras de 182 participantes, 80 hombres y 102 mujeres. Los datos del cribado por análisis biomecánico de las cuerdas vocales revelan un perfil con mayor desequilibrio en la dinámica de los pliegues vocales durante la fonación en el GE-A. Estos resultados podrían estar asociados a una mayor demanda vocal en los GE-A y justificaría implementar medidas periódicas de diagnóstico y prevención, así como tratamientos específicos de rehabilitación logopédica en el presente grupo.

Objective. To evaluate sleep disturbances and to verify the accuracy of three screening tests to detect them in patients at the end-of-life admitted in a hospital palliative care unit. Method. The level of sleep disturbances was evaluated through the Pittsburgh Sleep Quality Index (PSQI) in 150 palliative patients. This questionnaire was the criterion variable for testing the three screening tests used: Edmonton Symptom Assessment System (ESAS-Sleep subscale); the single question “How much do you worry about your sleep problems?” which is answered on a scale of 0–10 (Sleep-Worry-Q) and another single question: “Do you think you have sleep problems?” with two response categories, Yes/No (Sleep-Problem-Q). Results. According to the PSQI (cut-off point: 8), 87% of patients presented sleep disturbances. The ESAS-Sleep (cut-off point: 3) showed a sensitivity of 0.87, a specificity of 0.58, and an AUC of 0.729; the Sleep-Worry-Q (cut-off point: 4) showed a sensitivity of 0.95, a specificity of 0.68, and an AUC of 0.854; the Sleep-Problem-Q obtained a sensitivity of 0.92 and a specificity of 0.65. Significance of results. Patients at the end-of-life, near the time of death, have high levels of sleep disturbances that can be detected early, with better diagnostic accuracy, with the Sleep-Worry-Q. Although from a clinical point of view, the application of the Sleep- Problem-Q may be more advantageous, as it presents good diagnostic accuracy, greater simplicity, and brevity., Depto. de Personalidad, Evaluación y Psicología Clínica, Fac. de Psicología, TRUE, pub

Bakgrund: Sepsis är ett akut sjukdomstillstånd med en hög mortalitet världen över.Tidig identifiering och snabb behandling är viktig för patientens överlevnad.Sjuksköterskan har i sitt patientnära arbete en unik position att snabbt identifierasepsis och initiera behandling. För att möjliggöra en säker vård för patient, kollegoroch vårdansvarig sjuksköterska ska sjuksköterskan arbeta förebyggande ochpatientsäkert. Syfte: Att kartlägga åtgärder som främjar sjuksköterskans förmåga attidentifiera sepsis på sjukhus. Metod: En litteraturöversikt har genomförts för attskapa en överblick av det aktuella kunskapsläget. För att besvara syftet användesartiklar med en kvantitativ metod. Med hjälp av Polit och Becks niostegsmodellanalyserades artiklar som sedan presenterades i resultatet. Resultat: Resultatetvisade att sjuksköterskorna använde sig utav utbildning, riktlinjer samtscreeningverktyg för att främja identifieringen utav sepsis. Signifikanta skillnader sågsi relation till de olika åtgärderna. Skillnaderna visade bland annat en minskadmortalitet och minskad vårdtid. Slutsats: Sjuksköterskan har en central roll i attidentifiera sepsis. Resultatet förväntas identifiera åtgärder som i den kliniskavardagen kan hjälpa framtida sjuksköterskor eller annan vårdpersonal. Genom attsjuksköterskan är ödmjuk för den egna kompetensen, tar hjälp av screeningverktygoch vidhåller de riktlinjer som finns kan en grund för säker vård byggas., Background: Sepsis is an acute illness with a high mortality rate worldwide. It istherefore important to act quickly as rapid identification and treatment can be crucialfor the patient's survival. The nurse has, with her close work with the patient a uniqueposition to quickly identify sepsis and initiate treatment. In order to enable safe carefor both the patient, colleagues and healthcare providing nurse, the nurse must workpreventively and in a patient safe manner. Aim: To map interventions that promotethe nurse's identification of sepsis in a hospital setting. Method: A literature reviewhas been carried out to create an overview of the current state of knowledge. To answerthe purpose, articles with a quantitative methodology were chosen. Using Polit andBeck's nine-step model articles were analyzed and then presented in the results.Results: The results showed that the nurses used training, protocols and screeningtools to promote the identification of sepsis. Significant differences were seen inrelation to the various interventions. The differences showed for instance a decreasedmortality and abbreviated the hospital stay. Conclusion: The nurse has a central rolein identifying sepsis. The results are expected to identify measures that can help futurenurses or other healthcare professionals in the clinic. By the nurse being humble abouther own competence, using screening tools and maintaining the existing protocols, afoundation for safe care can be built.

A referral to genetic counseling is commonly made for patients with many types of cancer, given that cancers are hereditary in 5-10% of cases (National Institutes of Health, 2017). However, patients with myeloid malignancies are not often provided with genetic services despite emerging evidence that these cancers are hereditary about 13% of the time (Yang et al., 2022). This study explored the use of somatic genetic testing as a screening tool for hereditary cancer predisposition in patients diagnosed with myeloid malignancies, in the hopes of providing more evidence that this is an appropriate way to identify patients in need of genetics services. The study involved 110 participants whose medical records and somatic genetic test results were analyzed for criteria that indicate a need for genetic counseling and germline genetic testing. Furthermore, this study investigated the current landscape of genetics professionals’ involvement in the care of patients with myeloid malignancies at a single institution. Results from this study showed that 62 out of 110 patients (56%) met criteria for germline genetic testing to assess hereditary cancer risk based on the National Comprehensive Cancer Network 2023 guidelines for AML/MDS and the 2022 European LeukemiaNet guidelines (Döhner et al., 2022; National Comprehensive Cancer Network, 2023). However, none were referred for genetics services on the basis of their diagnosis of myeloid malignancy. Additionally, of those 62 patients, 9 (15%) would not have met those criteria without considering the results of their somatic genetic testing, all of which included genetic variants that could be germline in origin, and as such, would be clinically relevant. This indicates a need for greater awareness among providers (hematologic oncologists, genetic counselors, molecular pathologists, and molecular geneticists) concerning the current recommendations for germline genetic testing for patients with myeloid malignancies and somatic genet

Aim: To investigate cognitive impairment and psychopathology in out-of-hospital cardiac arrest (OHCA) survivors using a screening procedure during hospitalisation and examine the evolution of these parameters at three-month follow-up. Methods: This multicentre cohort study screened for cognitive impairment using the Montreal Cognitive Assessment (MoCA), for symptoms of anxiety, depression and traumatic distress using the Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale–revised (IES-R) during hospitalisation. At three-month follow-up, we evaluated cognitive impairment with a neuropsychological test battery and symptoms of psychopathology were re-assessed using HADS and IES-R. Logistic regression models were applied to examine associations between screening results and outcomes. Results: This study included 297 OHCA survivors. During hospitalisation, 65% presented with cognitive impairment, 25% reported symptoms of anxiety, 20% symptoms of depression and 21% symptoms of traumatic distress. At follow-up, 53% reported cognitive impairment, 17% symptoms of anxiety, 15% symptoms of depression and 19% symptoms of traumatic distress. Cognitive impairment during hospitalisation was associated with higher odds (OR (95% CI) 2.55 (1.36–4.75), p = .02) of an unfavorable cognitive outcome at follow-up, and symptoms of psychopathology during hospitalisation were associated with higher odds of psychopathology at follow-up across all three symptom groups; anxiety (6.70 (2.40–18.72), p < .001), depression (4.69 (1.69–13.02), p < .001) and traumatic distress (7.07 (2.67–18.73), p < .001). Conclusion: OHCA survivors exhibited both cognitive impairment and symptoms of psychopathology during hospitalisation comparable to previous studies, which were associated with unfavorable mental health outcomes at three-month follow-up.

Background: Delirium is characterized by an acute disturbance in cognition and attention. It is common and disproportionately effects elderly hospitalized adults. It is associated with increased risk of dementia, increased mortality, and increased healthcare costs. Early detection and identification of those at highest risk for delirium is crucial to mitigate these adverse effects. The current study seeks to determine the validity of a novel screening tool: the Neurological Orientation, Verbal response Assessment of Delirium (NOVAD) to detect delirium utilizing Electronic Medical Record (EMR) data. Methods: This is a retrospective observational study of EMR data extracted from hospitalized patients at a large multi-state hospital system. Data for the NOVAD score was documented by nurses as part of routine assessments and extracted from the patient's EMR. This was then compared to the patient’s Confusion Assessment Method (CAM) score as recorded by nursing as well as whether a physician had documented the patient as having Delirium or Encephalopathy by International Classification of Disease version 10 (ICD-10) code. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated by comparing NOVAD detection of delirium to CAM and delirium or encephalopathy ICD-10 code. Results: 464,395 participants were included in this study. The mean age of study participants was 56.18 years (SD 20.82) and the sample was 56.17% female (n = 260,856). The prevalence of participants in the study with a positive NOVAD score was 29.23% (n = 135,776; 95% CI: 0.2911, 0.2937). Nursing administered modified CAM score was documented positive in 2.41% (n = 11,183; 95% CI: 2.31%, 2.45%) of participants. NOVAD was found to be 86.63% sensitive (95% CI 86.53, 86.73) and 78.08% specific (95% CI: 77.96 ,78.20) based on ICD-10 code diagnosis of delirium or encephalopathy as being truly positive for delirium. Conclusion: The current study’s results suggest that NOV

Bakgrund: Sepsis är ett allvarligt tillstånd som obehandlat kan leda till organsvikt och död. Infektioner kan utvecklas till sepsis hos såväl tidigare fullt friska som multisjuka personer, i alla åldersgrupper och samhällsskikt. Kombinationen av diffusa symtom och ett snabbt sjukdomsförlopp ställer krav på sjuksköterskors kompetens, eftersom tidig identifiering och behandling är avgörande för patienternas överlevnad. Syfte: Syftet med studien är att kartlägga olika interventioners effekt på sjuksköterskors tidiga identifiering och omvårdnad av patienter med sepsis. Metod: Litteraturöversikt baserad på 12 kvantitativa interventionsstudier från PubMed och Cinahl. Artiklarna kvalitetsgranskades och analyserades därefter med kvantitativ ansats. Resultatet presenteras i text samt med deskriptiv statistik. Resultat: Studiens resultat presenteras i tre kategorier; Identifiering, Åtgärder och Patientutfall. Statistiskt signifikanta förbättringar identifierades i samtliga tre kategorier i form av bland annat minskad dödlighet och LOS samt förbättrad identifiering och följsamhet för sepsis bundles. Konklusion: Studien indikerar att testade interventioner har potential att förbättra identifiering, omvårdnad och utfall för sepsispatienter. Litteraturstudien betonar behovet av screeningverktyg och omvårdnadsåtgärder med högre evidensgrad, mer tydliga riktlinjer och en arbetsmiljö som ger sjuksköterskor möjlighet att arbeta med hela sin kompetens., Background: Sepsis is a serious condition that untreated may cause organ failure and death. Infections can develop into sepsis in previously healthy people as well as multimorbid patients, in all ages and social strata. The combination of diffuse symptoms and quick progression of disease make demands on nurses’ competence, thus early identification and treatment is crucial for patients’ survival. Aim: The aim of the study was to examine the effect of different interventions on nurses’ early identification and care of patients with sepsis. Methods: Literature review of 12 quantitative intervention studies from PubMed and Cinahl. The articles were quality checked and analyzed with a quantitative approach. Results are presented in written text and descriptive statistics. Results: The results are presented in three categories; Identification, Nursing interventions and Patient outcomes. This study demonstrated statistically significant improvements in all three categories including reduced mortality and LOS, improved identification and compliance to sepsis bundles. Conclusion: This study indicates that examined interventions have potential to improve identification, care and outcome for septic patients. It further emphasizes the need for higher evidence screening tools and nursing interventions, clearer guidelines and a working environment which gives nurses the opportunity to carry out their competencies.

IntroductionRepresentation of Mexican Americans in Alzheimer's disease (AD) clinical research has been extremely poor.MethodsData were examined from the ongoing community-based, multi-ethnic Health & Aging Brain among Latino Elders (HABLE) study. Participants underwent functional exams, clinical labs, neuropsychological testing, and 3T magnetic resonance imaging of the brain. Fasting proteomic markers were examined for predicting mild cognitive impairment (MCI) and AD using support vector machine models.ResultsData were examined from n = 1649 participants (Mexican American n = 866; non-Hispanic White n = 783). Proteomic profiles were highly accurate in detecting MCI (area under the curve [AUC] = 0.91) and dementia (AUC = 0.95). The proteomic profiles varied significantly between ethnic groups and disease state. Negative predictive value was excellent for ruling out MCI and dementia across ethnic groups.DiscussionA blood-based screening tool can serve as a method for increasing access to state-of-the-art AD clinical research by bridging between community-based and clinic-based settings.

Food frequency questionnaires (FFQ) are commonly used dietary assessment tools. The aim was to assess the relative validity of a 15-item FFQ, designed for the screening of poor dietary patterns with a validated diet history (DH). The study population was derived from the Gothenburg H70 Birth Cohort Studies. The DH registrations were harmonized in accordance with the FFQ frequencies. The agreement was assessed by Cohen’s kappa with corresponding confidence intervals (CI) for the frequency and categorical variables. Bland–Altman plots were used for the numeric variables. The study comprised data from 848 individuals (55.2% women). Overall, there was high agreement between the methods, with the exact and adjacent level of agreement over 80% for eight variables. The proportion attributed to the opposite frequency was fairly low for most of the frequency variables. Most of the kappa values were in fair or moderate agreement. The highest kappa values were calculated for the type of cooking fat (k = 0.68, CI = 0.63–0.72) and sandwich spread (k = 0.55, CI = 0.49–0.53), and the lowest for type of bread (0.13, CI = 0.07–0.20) and sweets (0.22 CI = 0.18–0.27). In conclusion, the FFQ showed overall good agreement compared with the DH. We, therefore, think it, with some improvements, could serve as a simple screening tool for poor dietary patterns., (This article belongs to the Special Issue Health Promotion in a Life Span Perspective)

Children from food insecure households are more likely to have substandard food and nutritional intakes, and experience developmental delays, behaviour issues and increased use of health services. In Australia, screening for household food insecurity (HFI) within health services is not undertaken routinely, limiting opportunities to optimise nutrition and healthcare. This research aimed to (a) identify the prevalence, potential determinants and outcomes of HFI among paediatric outpatients in two Queensland hospitals; and (b) identify questions suitable for screening households at risk of HFI. A cross-sectional survey collected data from caregivers of children attending paediatric appointments at two hospitals in Brisbane, Australia (n = 148). Sociodemographic, health and household-related characteristics were collected, and food security status was assessed using four HFI measures. Chi-square, independent t-tests, ANOVA and logistic regression explored associations between HFI and health-related characteristics. A potential HFI screener was identified based on the most frequently endorsed questions from any HFI measure, and its validity was assessed through calculation of sensitivity and specificity. Prevalence of HFI was 41%, with 16% experiencing very low food security. Households with a child of ‘fair/poor’ health had 5.59 times greater odds of being food insecure than being food secure, compared to households with a child of ‘excellent/good’ health (aOR 5.59, 95% CI: 1.3–23.5). HFI was also positively associated with household chaos (p =.006). A combination of two questions was identified as a possible screening tool, with a sensitivity of 96% and a specificity of 90%. This study demonstrated HFI may be highly prevalent in a paediatric outpatient population, which may result in difficulties in being able to follow nutrition prescriptions. A highly sensitive and specific two-question screening tool was identified and may assist practitioners in paediatric heal

The Global Leadership Initiative on Malnutrition (GLIM) criteria are consensus criteria for the diagnosis of malnutrition. This study aimed to investigate and compare the prevalence of malnutrition using the GLIM, European Society for Clinical Nutrition and Metabolism (ESPEN) and International Statistical Classification of Diseases version 10 (ICD-10) criteria; compare the level of agreement between these criteria; and identify the predictive validity of each set of criteria with respect to 30-day outcomes in a large cancer cohort. GLIM, ESPEN and ICD-10 were applied to determine the prevalence of malnutrition in 2794 participants from two cancer malnutrition point prevalence studies. Agreement between the criteria was analysed using the Cohen’s Kappa statistic. Binary logistic regression models were used to determine the ability of each set of criteria to predict 30-day mortality and unplanned admission or readmission. GLIM, ESPEN and ICD-10 criteria identified 23.0%, 5.5% and 12.6% of the cohort as malnourished, respectively. Slight-to-fair agreement was reported between the criteria. All three criteria were predictive of mortality, but only the GLIM and ICD-10 criteria were predictive of unplanned admission or readmission at 30 days. The GLIM criteria identified the highest prevalence of malnutrition and had the greatest predictive ability for mortality and unplanned admission or readmission in an oncology population.

Since parental burnout can have detrimental consequences for parents, couples, and children, easy-to-use, reliable, and valid practical tools for the early detection of parental burnout are required. We developed and validated a brief scale to identify burned-out parents and parents at burnout risk. In Study 1, we developed the 5-item Brief Parental Burnout scale (BPBs) based on the gold standard measure of parental burnout, the Parental Burnout Assessment (PBA). We applied Item Response Theory Graded Response Model (GRM) analyses on the data of 1,725 Finnish parents. Compared against the PBA total score, the five selected items showed both high sensitivity and specificity in screening parental burnout. As expected, burned-out parents and those at burnout risk according to the BPBs displayed higher depressive symptoms, lower self-esteem, and more frequent sleep disruptions than non-burned-out parents. In Study 2, we tested the sensitivity and specificity of the BPBs by using both the BPBs and the PBA as independent assessment tools in a sample of 1,088 Finnish parents. In Study 3, the high sensitivity and specificity of the BPBs found in Study 2 were replicated in an independent sample of 104 Belgian parents. We further demonstrated the concurrent validity of the BPBs test score interpretations by showing that burned-out parents, or those at burnout risk, reported higher child neglect and parental violence than non-burned-out parents. Because of its user-friendliness and the strong psychometric properties of its test score, the BPBs is a good candidate to use as a screening tool for parental burnout.

Background: By the year 2030 the prognosis is that one fourth of the Swedish population will be 65 years or older. An age group that today stands for 40 percent of all the daily visits in the Swedish emergency departments. Nearly half of them are 80 years or older. The frail older adults are often low prioritized due to their diffuse symptoms whereby long waiting times and healthcare-related injuries may occur. As a complement to the standard prioritizing procedure, that triage stands for, some emergency departments have introduced screening tools for detecting those individuals that are older adults and frail. Unfortunately, the introduction of new guidelines, do not always imply that the implementation comes easy because there are factors that facilitate and inhibit their intended use. Aim: To illustrate factors that affect the nurses use of the screening tool Clinical Frailty Scale (CFS) which identifies frailty in elders during triage in the emergency department. Method: A descriptive quantitative cross-sectional study where data was collected through a web-based questionnaire. The data of the study was analyzed through descriptive and analytical statistics. Results: When it came to influencing factors regarding the use of CFS in the selected emergency department, CFS as a method with its practicalities constituted as facilitators, whilst the organizational and working cultural aspects constituted as barriers. The differences in the nurses' experience and education effected the perception of CFS in different ways. Conclusion: There is a need of a working culture where responsibility is shared between stakeholders to facilitate a guideline. Advanced nurse practitioners can have a crucial role in educating, motivating and creating space for discussion relating to organizational, theoretical and practical components of the process in identifying the frail older adults., Bakgrund: Prognosen är att år 2030 kommer en fjärdedel av den svenska populationen vara 65 år eller äldre. Åldersgruppen utgör idag cirka 40 procent av alla besök på Sveriges akutmottagningar där nästan hälften av dem är 80 år eller äldre. De sköra äldre erhåller ofta låg prioritering på grund av sina diffusa symtom, där långa väntetider och vårdrelaterade skador kan uppstå som följd. Som komplement i den vanliga prioriteringsrutinen som triagering innebär har akutmottagningar infört screeningverktyg för att upptäcka de individer som är sköra äldre. Dessvärre innebär införandet av nya rutiner att de inte alltid lätt implementeras i verksamheten eftersom det finns faktorer som främjar och hindrar dess avsedda användning. Syfte: Att belysa faktorer som påverkar sjuksköterskors användning av screeningverktyget Clinical Frailty Scale (CFS) för att identifiera sköra äldre vid triagering på akutmottagningen. Metod: En kvantitativ tvärsnittsstudie där data samlades in genom en webbenkät. Studiens data analyserades deskriptivt samt med analytisk statistisk. Resultat: När det kom till faktorer som påverkade användningen av CFS på den valda akutmottagningen utgjorde CFS som metod med dess praktiska delar en främjande faktor, medan organisatoriska och arbetskulturella aspekter utgjorde hindrande faktorer. Skillnaderna i erfarenhet och utbildning hos sjuksköterskorna påverkade uppfattningen om CFS på olika sätt. Slutsats: Det behövs en arbetskultur med ett delat ansvar mellan organisation och medarbetare för att främja följsamheten till en rutin. Specialistsjuksköterskor kan ha en betydande roll i att utbilda, motivera och skapa forum för diskussion gällande organisatoriska, teoretiska och praktiska delar i processen av att identifiera sköra äldre.

Purpose: The purpose of this pilot study was to determine the sensitivity and specificity of a newly developed Canadian Caries Risk Assessment Tool for children < 6 years to predict caries development in a cohort of individuals followed in community-based dental clinics. Methods: A prospective observational cohort study was conducted to test the Canadian Caries Risk Assessment Tool. Children were recruited over a 12-month period. The child’s parent/caregiver completed a baseline CRA via interview, and dmft/dmfs were recorded. Participants returned for a follow-up examination at which time a second interview and changes in oral health, including new dental caries activity and dmft/dmfs were recorded. Data was analyzed using standard, bivariate statistics (chi square, t test, McNemar). Odds ratios (OR), sensitivity, specificity and positive/negative predictive values were calculated. Data: Overall, 173 preschool children were initially enrolled. The average age was 39.9 ± 17 months. Baseline CRA enrollment and follow up occurred between January 2019 and October 2021 with an average time between assessments of 13 ± 4 months. 122 (70.5%) children were assigned a high CRA rating at their baseline appointment and 106 (61.3%) were found to have active caries or past evidence of dental treatment for caries. Baseline presence of visible caries and/or past evidence of dental treatment was found to be statistically significant (p <0.0001) with new caries noted at their follow up assessment (OR=7.39). Individuals assigned to a high risk CRA rating were found to be significantly associated (p 0.0001) with formation of new caries noted at their follow up assessment (OR= 4.9). Sensitivity and specificity for baseline CRA rating (high and low risk) and new caries noted at clinical follow-up was determined to be 86.1% and 44.2% with a positive predictive value of 59.1% and a negative predictive value of 77.3%. Conclusion: The current assessment of the Canadian Caries Risk Assessment

This paper reports on a multi-phased, mixed-method consensus-based study conducted with young carers in the UK aged 11–18, and health, social care and education professionals from the UK, USA and Canada, to identify priority items for inclusion in a short screening tool for use with young carers of a family member with a progressive or long-term illness or disability. Following ethical approval from University and local Research Ethics Committees, qualitative and quantitative data were collected between 2017 and 2019 from 267 people (107 young carers; 160 professionals), through interviews, a focus group, a Delphi survey, consensus group meetings and consultations. Qualitative data were analysed thematically, and quantitative data were analysed using measures of central tendency, frequency and levels of dispersion. The resulting Carers’ Alert Thermometer (CAT-YC) contains an identification question followed by ten areas of need across two themes of ‘current caring situation’ and ‘carer’s health and wellbeing,’ along with guidance for possible next steps and space for an action plan to be jointly agreed between the screener and young carer. Preliminary piloting of the CAT-YC provides evidence of identifying and monitoring needs, and is expected to be useful for young carers, a wide range of professionals, and organisations that support young carers.

Background. Developmental Language Disorder (DLD) is frequent in childhood and may have long-term sequelae. By employing an evidence-based approach, this scoping review aims at identifying (a) early predictors of DLD; (b) the optimal age range for the use of screening and diagnostic tools; (c) effective diagnostic tools in preschool children. Methods. We considered systematic reviews, meta-analyses, and primary observational studies with control groups on predictive, sensitivity and specificity values of screening and diagnostic tools and psycholinguistic measures for the assessment of DLD in preschool children. We identified 37 studies, consisting of 10 systematic reviews and 27 primary studies. Results. Delay in gesture production, receptive and/or expressive vocabulary, syntactic comprehension, or word combination up to 30 months emerged as early predictors of DLD, a family history of DLD appeared to be a major risk factor, and low socioeconomic status and environmental input were reported as risk factors with lower predictive power. Optimal time for screening is suggested between age 2 and 3, for diagnosis around age 4. Because of the high variability of sensitivity and specificity values, joint use of standardized and psycholinguistic measures is suggested to increase diagnostic accuracy. Conclusions. Monitoring risk situations and employing caregivers’ reports, clinical assessment and multiple linguistic measures are fundamental for an early identification of DLD and timely interventions.

Purpose: This project aimed to evaluate anesthesia provider attitudes surrounding the clinical topic of perioperative peripheral nerve injury. Additionally, the project sought to introduce anesthesia providers to a novel risk assessment device that may help identify patients at high risk for perioperative peripheral nerve injury while assessing its potential utility in anesthesia practice.Background: Perioperative peripheral nerve injury is a significant cause of patient morbidity and medical litigation. Anesthesia-related lawsuits involving perioperative nerve injury are the second most common type of intraoperative malpractice lawsuit, consistently representing 15-18% of claims (Grant et al., 2019). Research shows that nerve injury is more common in patients with specific comorbidities, predisposing them to nerve damage (Welch et al., 2009). These patients have physiologic characteristics that may be easily identifiable during a preoperative assessment (ASA, 2018). Methods: The project utilized a descriptive design with quantitative evaluation by an electronic survey created by Qualtrics. The survey was distributed to participants following a medicolegal analysis presentation about perioperative peripheral nerve injury and the introduction of a peripheral nerve injury risk assessment tool created by the author. The study's survey gathered data in two main areas, the providers’ opinions and attitudes towards the problem of a perioperative peripheral nerve injury and their view of the presented screening tool’s usefulness. Results: The strongest metrics resulting from the survey showed that anesthesia providers have an increased interest in improving documentation, improving patient assessment efforts, improving patient communication, and perioperative team communication, with the highest metric showing interest in reducing legal risk. When asked if the anesthesia providers could see themselves using the presented screening tool in their clinical practice, 69% of an

Early literacy development is an indicator of a child’s overall cognitive-linguistic development and affects their academic, social, emotional and behavioural skills. Research suggests that early detection in preschool years can have an important role in the prevention of academic failure. There is a lack of early literacy screening tools for Portuguese preschool children. This study aims to present preliminary data results of the development and validation of the Preschool Early Literacy Screening Tool (Rastreio de Literacia Emergente Pré-escolar- RaLEPE). A pilot study was carried out with a sample of 128 screenings, answered by the parents/caregivers of the Portuguese children in the target age groups. The analysis of results shown the reliability of the tool, with a very good internal consistency for RaLEPE total scale and the different sections. Therefore, preliminary results of this study indicate internal validity of the RaLEPE and confirm this as screening tool usefulness for early intervention childhood, to provide early diagnosis and contribute to early intervention for children with language and learning disorders., El desarrollo temprano de la alfabetización es un indicador del desarrollo cognitivo-lingüístico general de los niños y afecta a sus habilidades académicas, sociales, emocionales y conductuales. La investigación sugiere hasta el momento que la detección temprana en los años preescolares puede tener un papel importante en la prevención del fracaso académico. Carecemos, no obstante, de una falta de herramientas de evaluación de la alfabetización temprana para los niños preescolares portugueses. Este estudio tiene como objetivo presentar los resultados de los datos preliminares del desarrollo y validación de la Herramienta de detección de alfabetización temprana en edad preescolar (Rastreio de Literacia Emergente Pré-escolar; RaLEPE). Se realizó un estudio piloto con una muestra de 128 encuestas, respondidas por los padres / cuidadores de los niños portugueses de 3 a 6 años. El análisis de resultados muestra la fiabilidad de la herramienta, con una muy buena consistencia interna para la escala total RaLEPE y los diferentes tramos. Por lo tanto, los resultados preliminares de este estudio indican una alta validez interna del RaLEPE y lo confirman como una herramienta de utilidad para la intervención temprana en la infancia de cara a brindar un diagnóstico e intervención temprana en niños con trastornos del lenguaje y el aprendizaje.

Objectives: The First-time Injurious Fall (FIF) screening tool was created to identify fall risk in communityliving older adults who may benefit from primary preventive interventions. The aim of this study was to evaluate the predictive performance of the FIF tool in 2 cohorts of older adults. Design: Longitudinal cohort study. Setting and Participants: The Swedish National Study on Aging and Care in Skane (SNAC-S) and Blekinge (SNAC-B), Sweden. Community-living people aged >= 60 years (n = 2766). Methods: Nurses and physicians collected data in the 2 cohorts through interviews and testing. Data on injurious falls were collected from register data and were defined as receipt of care after a fall. The FIF tool, consisting of 3 questions and 1 balance test, was examined in relation to injurious falls for up to 5 years of follow-up using Cox proportional hazards models. The predictive performance of the FIF tool was further explored using Harrell C statistic and Youden cut-off for sensitivity and specificity. Results: The hazard ratios (HRs) of an injurious fall in the high-risk group for women and men were 3.80 (95% confidence interval [CI] 2.53, 5.73) and 5.10 (95% CI 2.57, 10.12) in SNAC-S and 4.45 (95% CI 1.86, 10.61) and 32.58 (95% CI 4.30, 247.05) in SNAC-B compared with those in the low risk group. The sensitivity and specificity of the Youden cut-off point (3 or higher for high-risk) were 0.64 and 0.69 for women and 0.68 and 0.69 for men in SNAC-S, and 0.64 and 0.74 for women and 0.94 and 0.68 for men in SNAC-B. The predictive values (Harrell C statistic) for the scores for women and men were 0.73 and 0.74 in SNAC-S and 0.72 and 0.89 in SNAC-B. Conclusions and Implications: Our results suggest that the FIF tool is a valid tool to use for prediction of first-time injurious falls in community-living older adults. (C) 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

Cone beam computed tomography (CBCT) usage has increased dramatically over the last couple of decades. The extent to which this tool can be accurately utilized, however, remains to be seen. The purpose of this investigation is to produce a systematic, reproducible calibration of structure and mineral density, from micro X-ray computed tomography (Micro XCT) to CBCT. Three scanners were calibrated to known mineral density phantoms. Calibration curves for each scanner were built from these phantoms and hydroxyapatite specimens, which were then applied to determine the mineral density of human jaws and teeth. Systematic calibration accounting for size of the phantom (ratio of surface area to volume), and mineral density (the amount of mineral in “mg” per cubic centimeter volume “cc”) revealed that each scanner has a size and density dependence and thereby threshold – detectable size and mineral density of a specimen. Inferior resolution, enhanced bleeding, large field of view, lower mineral density, and small size of specimens all contributed to reduced accuracy and consistency of CBCT images. Based on the current calibration and quality of CBCT systems, this research has shown the accuracy of these scanners needs improvement and that screening for prevention of disease is likely beyond the current scope of its intended use. It is likely that a lesion or pathology can only be diagnosed reliably when it is of a large enough density and size to actually utilize or if it imaged under a smaller field of view with enhanced resolution. Research is warranted to reliably use CBCT imaging as an effective screening tool to improve patient care.

Purpose: The purpose was to find out if screening for obstructive sleep apnea in the primary care setting using a questionnaire increases referrals for further sleep studies. The goal was to increase the number of referrals for follow-up sleep studies. Background: Sleep apnea is a sleep and respiratory disorder that causes frequent wakings in the night due to the throat muscles collapsing and causing the person to wake up to get needed oxygen. This disorder affects more than 22 million Americans and has a 2.47 increased morbidity and mortality risk if left untreated. Studies show that as many as 1 in 5 individuals struggle with sleep disordered breathing and 80% of these disorders go undiagnosed. Untreated sleep apnea has been linked to cardiovascular disease, hypertension, diabetes, strokes, and depression. There is currently no routine screening for sleep apnea in the primary care setting, but literature shows screening with the STOP-BANG Questionnaire increases follow-up for sleep studies and earlier treatment. The STOP-BANG Questionnaire has better sensitivity and specificity compared to other tools tested. Methods: The STOP-BANG Questionnaire was implemented to screen overweight patients with hypertension within one primary care practice for one month and referrals for follow-up were compared to the one month prior. A positive screen was a score of 4 or higher on the questionnaire. The post-intervention total was compared to the pre-intervention total and success was shown if the number of referrals increased by more than 10%. Results: Prior to the intervention, the clinic referred and set up four patients for follow-up sleep studies. Post intervention, the clinic referred and set up eight patients for follow-up sleep studies. There was a 100% increase in referrals in the post intervention group. Out of 12 participants, 2 screened negative, 10 screened positive, 2 refused referral while 8 accepted the referral for follow-up. Conclusion: The use of the STOP-BANG

Problematic drinking is a public health concern on college campuses. College students who do not have their risky drinking behaviors addressed are at greater risk for developing Alcohol Use Disorder (AUD). Despite known risks associated with drinking on college campuses, many college health centers miss an opportunity to address these behaviors because they lack a systematic process for identifying students at risk and referring them for treatment. This evidence-based project evaluated the effectiveness of using Screening, Brief Intervention, Referral to Treatment (SBIRT) to identify students with risky drinking behaviors and the impact the screening process had on facilitating a referral to treatment. Students (n=172) were screened using the Alcohol Use Disorders Identification Test- Consumption (AUDIT-C), as part of the check-in process when they presented for a wellness exam at a university student health center in the southeastern United States. Students’ drinking behaviors were categorized as low-risk, at-risk or high-risk based on their AUDIT-C scores. Outcome measurement results indicated that use of a systematic process for screening students for alcohol use was effective at identifying students with risky drinking behaviors, provided a structured process to giving students feedback about their drinking behaviors and facilitated a referral to treatment for those students who scored in the high-risk category.

The CalEnviroScreen created by the Office of Environmental Health Hazard Assessment, Sacramento, USA, is a place-based dataset developed to measure environmental and social indicators that are theorized to have cumulative health impacts on populations. The objective of this study was to examine the extent to which the composite scores of the CalEnviroScreen tool are associated with pediatric asthma hospitalization. This was a retrospective analysis of California hospital discharge data from 2010 to 2012. Children who were hospitalized for asthma-related conditions, were aged 0-14 years, and resided in California were included in analysis. Rates of hospitalization for asthma-related conditions among children residing in California were calculated. Poisson multilevel modeling was used to account for individual- and neighborhood-level risk factors. Every unit increase in the CalEnviroScreen Score was associated with an increase of 1.6% above the mean rate of pediatric asthma hospitalizations (rate ratio (RR) = 1.016, 95% confidence interval (CI) = 1.014-1.018). Every unit increase in racial/ethnic segregation and diesel particulate matter was associated with an increase of 1.1% and 0.2% above the mean rate of pediatric asthma, respectively (RR = 1.011, 95% CI = 1.010-1.013; RR = 1.002, 95% CI = 1.001-1.004). The CalEnviroScreen is a unique tool that combines socioecological factors and environmental indicators to identify vulnerable communities with major health disparities, including pediatric asthma hospital use. Future research should identify mediating factors that contribute to community-level health disparities.

Physically active adolescent females are at significantly greater risk for anterior cruciate ligament (ACL) injury than their male counterparts when participating in the same sports. While preventative neuromuscular (NM) exercise programs can reduce injury rates and improve function, they are not practical or safe for the ACL-injured individual. The effectiveness of a perturbation-based NM training program that is appropriate for the ACL-injured, physical active individual has been established for an adult population but has yet to be investigated in the adolescent female population. Scoring from two common clinical tools, the Star Excursion Balance Test (SEBT) and Y-Balance Test (YBT), are used to screen athletes at risk of injury, assess deficiencies after injury, and monitor progress in rehabilitation, are known to vary by age, sex and sport. Currently, there is little research examining performance and scoring on clinical dynamic balance tests in adolescent females who are healthy or ACL-injured and awaiting the standard of care, surgical reconstruction. This investigation used an evidence-based approach to investigate the utility of clinical dynamic balance testing and the effectiveness of a perturbation-based NM exercise program in healthy and ACL-injured adolescent females. Reach performance measures and injury classification of clinical dynamic balance tests should not be used interchangeably for physically active adolescent females as differences between the measured reach directions and injury classification were observed between the SEBT and YBT. Surprisingly, healthy and ACL-injured adolescent females demonstrate similar reach distances on the YBT. Although healthy adolescent females demonstrate a relationship between BMI, lower extremity strength, and the YBT, no such relationship exists for ACL-injured. Specific analysis of the YBT anterior reach direction indicates that both healthy and ACL-injured adolescent females demonstrate a variety of joint mov

This paper proposes a data-driven approach to develop a taxonomy in a data structure on list for triple bottom line (TBL) metrics. The approach is built from the authors reflection on the subject and review of the literature about TBL. The envisaged taxonomy framework grid to be developed through this approach will enable existing metrics to be classified, grouped, and standardized, as well as detect the need for further metrics development in uncovered domains and applications. The approach reported aims at developing a taxonomy structure that can be seen as a bi-dimensional table focusing on feature interrogations and characterizing answers, which will be the basis on which the taxonomy can then be developed. The interrogations column is designed as the stack of the TBL metrics features: What type of metric is it (qualitative, quantitative, or hybrid)? What is the level of complexity of the problems where it is used? What standards does it follow? How is the measurement made, and what are the techniques that it uses? In what kinds of problems, subjects, and domains is the metric used? How is the metric validated? What is the method used in its calculation? The column of characterizing answers results from a categorization of the range of types of answers to the feature interrogations. The approach reported in this paper is based on a screening tool that searches and analyzes information both within abstracts and full-text journal papers. The vision for this future taxonomy is that it will enable locating for any specific context, discern what TBL metrics are used in that context or similar contexts, or whether there is a lack of developed metrics. This meta knowledge will enable a conscious decision to be made between creating a new metric or using one of those that already exists. In this latter case, it would also make it possible to choose, among several metrics, the one that is most appropriate to the context at hand. In addition, this future framework will ea

Purpose: Palliative care (PC) focuses on relief of suffering and improving quality of life for patients and families facing life-limiting illness. When a patient is told their life may be cut short, it is important to help them define their own focal points. Using PC in oncology care can help address goals, and make them obtainable by decreasing symptom burden, completing advanced care planning, and assisting to increase quality and quantity of life. Unfortunately, PC is highly underused within the inpatient oncology population. It is frequently introduced too late in the patient’s plan of care leading to distress. In line with the evidence around the need for increased PC services, the purpose of this quality improvement project is to assess if using a validated screening tool would increase the potential PC referrals by 10% over a two-month period. Rationale: Using PC in standardized oncology care can help patients and families not only identify goals, but also make them obtainable by decreasing symptom burden, completing advanced care planning, and assisting to increase their quality and quantity of life. Barriers to implementation exist that include lack of knowledge on when to implement PC services, what diagnosis would qualify, and that PC is only associated with end of life. Research has shown that early implementation of PC has positive patient outcomes compared to late implementation in the oncology population. Using a validated screening tool would allow oncology providers and nurses to understand and help identify when an oncology patient would benefit from a PC referral in the inpatient setting. Approach Methods: The project aims to assess if the implementation of a screening tool will adequately increase the number of potential PC referrals in our organization over a two-month period. The evidence-based screening tool chosen for this project was the Palliative Care Screening Tool adapted from the National Comprehensive Cancer Network guidelines. Oncolog

Purpose: The purpose of the study was to identify major symptom domain variables common to child trauma and create a prototype short trauma symptom screening tool (STST) intended for use in pediatric medical settings. Methods: This manuscript describes the first two phases of an on-going prospective mixed-method instrument development study. Phase 1 exploratory factor analysis was conducted with an archived LONGSCAN CBCL dataset to: (1) identify behavioral symptoms endorsed by children with known trauma exposure; and (2) generate a preliminary STST item pool. During Phase 2, researchers convened an expert panel (N = 10) and conducted Content Validity Index (CVI) procedures with the 20-item preliminary STST item pool, to further inform item retention, elimination and modification for an updated prototype STST. Findings: Expert quantitative scores yielded a CVI of 0.90 for the overall preliminary STST. The first two phases of this study assisted researchers with identifying 12 items that represent nine child trauma symptom domain variables, which include: (1) aggression/anger; (2) anxiety/fear; (3) sexual concerns; (4) elimination concerns; (5) somatic concerns; (6) depression; (7) dissociation; (8) physical acting out; and (9) dysregulation. Conclusions: The first two phases of STST development resulted in development of a brief, empirically-derived prototype screening tool that features 12 items operationalizing nine domains of child trauma symptoms. Developers can now advance to the next phase of STST development; feasibility assessment and psychometric testing.

Social media has become an integrated part of human communication, both as a means to establish and maintain social relationships, and as a means of sharing and co-creating information. Social media comes with an array of possibilities for individuals as well as organizations, corporations, and authorities. Within the field of crisis communication, social media possibilities such as online sharing and social networking have had an impact on the way crisis information is disseminated and updated. This paper addresses the issues related to using social media for communicating crisis information and broadcasting alert messages to the general population, discusses the role of social media in future pan-European crisis alerting, and presents a prototype system demonstrating the possibilities. An extensive systematic literature review was carried out to identify factors that affect the use of social media for alerting and warning. These factors were mirrored in experiences, collected through interviews, obtained by emergency management organizations in three European countries (Sweden, Czech Republic, and Spain). The factors finally form the basis for suggestions and recommendations regarding the design of technological tools for both communication and information collection to serve as an integral part of a future pan-European crisis alerting system., QC 20180307

Background: Neuropathic pain is defined as pain caused by a lesion or disease of the somatosensory nervous system and is a major therapeutic challenge. Several screening tools have been developed to help physicians detect patients with neuropathic pain. These have typically been validated in populations pre-stratified for neuropathic pain, leading to a so called "Catch-22 situation:" "a problematic situation for which the only solution is denied by a circumstance inherent in the problem or by a rule". The validity of screening tools needs to be proven in patients with pain who were not pre-stratified on basis of the target outcome: neuropathic pain or non-neuropathic pain. This study aims to assess the validity of the Dutch PainDETECT (PainDETECT -Dlv ) in a large population of patients with chronic pain. Methods: A cross-sectional multicentre design was used to assess PainDETECT -Dlv validity. Included where patients with low back pain radiating into the leg(s), patients with neck-shoulder-arm pain and patients with pain due to a suspected peripheral nerve damage. Patients' pain was classified as having a neuropathic pain component (yes/no) by two experienced physicians ("gold standard"). Physician opinion based on the Grading System was a secondary comparison. Results: In total, 291 patients were included. Primary analysis was done on patients where both physicians agreed upon the pain classification (n = 228). Compared to the physician's classification, PainDETECT -Dlv had a sensitivity of 80% and specificity of 55%, versus the Grading System it achieved 74 and 46%. Conclusion: Despite its internal consistency and test-retest reliability the PainDETECT -Dlv is not an effective screening tool for a neuropathic pain component in a population of patients with chronic pain because of its moderate sensitivity and low specificity. Moreover, the indiscriminate use of the PainDETECT -Dlv as a surrogate for clinical assessment should be avoided in daily clinical practice

Background: Dance involves movements of complexity and physical intensity which result in stress on the body. As a consequence, dancers are at risk of injury which can impact on their well-being. Screening tools are used for injury prevention to identify those dancers at risk of injury. The aim of this study was to investigate which screening tools can predict injury in dancers, encompassing all dance genres, levels and ages. Methods: An electronic search of seven databases from their inception to December 2017 was conducted. The databases were the Allied and Complementary Medicine Database (AMED), CINAHL, eBOOK Collection (EBSCOhost), MEDLINE, Cochrane Database of Systematic Reviews, SPORTDiscus and PEDro: the Physiotherapy Evidence Base. The following search terms were used: (i) Dance AND injury AND Screening, (ii) Screening AND dance and (iii) Musculoskeletal AND Screening AND Dance. Studies were assessed using a 20-point scoring tool, and eligible studies were included in a meta-analysis. Results: The mean methodological quality score was 12.2 points. Injured dancers had a significantly higher compensated turnout range of motion than non-injured dancers: pooled mean difference of compensated turnout (23.29°; 95% CI 14.85–31.73; P < 0.00001; I 2 = 0%). Injured dancers had significantly greater functional turnout range of motion when compared to non-injured dancers: pooled mean difference of functional turnout (14.08°; 95% CI 7.09–21.07; P < 0.0001; I 2 = 0%). There also some evidence for use of hip range of motion as a predictor of dance injury. Conclusions: Some evidence exists for the potential use of dance-specific positions as a predictor of injury. A number of studies were limited by a lack of prospective injury design, injury definition and self-reporting of injury.

Due to the continuous growth of patients with mental disorders, it has been a strenuous job to look after each patient and tailor the appropriate treatments for them on time. The thesis proposes a design science framework in the form of an IT artefact to prioritize the patients with mental disorders, considering the severity of the situation. The IT arte-fact will be using expert’s knowledge to design a self-assessment screen-ing tool that will evaluate the criticality of a patient’s mental health. This tool will also incorporate the psychometric scale DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure, Adult electronically to de-termine what will be the next stage in the process of patients’ treat-ments. The process of prioritizing patients is prolonged and remains to be tedious at the hospital and also there is always a possibility of miss-ing some information while carrying out the job manually. The self-assessment system will serve two goals. It will shorten the initial screen-ing process and also the likelihood of any human error. The system is not meant to replace healthcare professionals but to build a bridge be-tween the patients and the doctors to make everyone’s life more orga-nized. The results indicate that it is possible to create a framework and the relevant prototype with the help of expert’s knowledge that can prioritize patients with mental disorders. It also demonstrates that the system can digitalize DSM-5 Self-Rated Level 1 Cross-Cutting Symp-tom Measure, Adult scale to determine possible problem domains for further diagnosis.

This study explores energy information literacy by applying an adapted version of an everyday health information literacy (EHIL) screening tool. For this study, the original EHIL tool was modified by adjusting its ten statements to an energy context. Data were collected with an online survey from students present for the academic year in 2016–2017 (n = 11,381) at the University of Oulu. Statistical analyses include an exploratory factor analysis and comparison of mean factor scores. Survey items on respondents’ background were also included in the analyses. The response rate was 12.2% (n = 1,390). The screening tool’s factorial structure was found to be multifaceted and to resemble that of the original EHIL tool with three factors: motivation (‘motivation’), confidence in finding energy information (‘confidence’), and perceived ability to evaluate it (‘evaluation’). Mean factor scores varied by gender and field of study. The study is among the first to examine energy information literacy.

Introduction: Students overestimate alcohol consumption of those around them and underestimate their own, so that quantitative approach may not be the most relevant to assess students’ drinking. The main objective was to provide an appropriate tool for screening students’ drinking. Methods: A multicentre cross-sectional survey was conducted by internet between February and June, 2013 in France. Thirteen questions explored alcohol consumption of which 8 concerned withdrawal effects (4 items of the AUDIT) and alcohol behaviour (CAGE test). A multiple correspondence analysis (MCA) was conducted to identify profiles of student’s alcohol consumption. Partitioning methods were used to group students according to their mode of alcohol use. The most relevant items included in the MCA were identified. Three questions were identified as most pertinent among the students with potential drinking problems and ranked by a decision tree with the Chi-square Automatic Interaction Detector method. Finally, the generalization of our model was assessed.Results: A total of 36,427 students participated in the survey: 25,679 females (70.5% of respondents), sex ratio 0.42 and mean aged 21.2 (sd 3.7 years). Among those who had experimented with alcohol (N=33,113), three consumption profiles were identified: “simple/non-use” (66.9%), “intermediate consumption” (25.9%) and “problem drinking” (7.2%) Instead, for the latter group, the three most relevant items were (Q20) "not able to stop drinking after starting”, (Q21) "failed to do what was normally expected”, and (Q23) "unable to remember what happened the night before”.Conclusions: Healthcare professionals have a screening tool of three items for students’ drinking.

Purpose: Acquired communication disorders (ACD), following stroke and traumatic brain injury, may not be correctly identified in Aboriginal Australians due to a lack of linguistically and culturally appropriate assessment tools. Within this paper we explore key issues that were considered in the development of the Aboriginal Communication Assessment After Brain Injury (ACAABI) – a screening tool designed to assess the presence of ACD in Aboriginal populations. Method: A literature review and consultation with key stakeholders were undertaken to explore directions needed to develop a new tool, based on existing tools and recommendations for future developments. Result: The literature searches revealed no existing screening tool for ACD in these populations, but identified tools in the areas of cognition and social-emotional wellbeing. Articles retrieved described details of the content and style of these tools, with recommendations for the development and administration of a new tool. The findings from the interview and focus group views were consistent with the approach recommended in the literature. Conclusions: There is a need for a screening tool for ACD to be developed but any tool must be informed by knowledge of Aboriginal language, culture and community input in order to be acceptable and valid.

Background The Lower Limb Assessment Score (LLAS) has only been validated in a paediatric population. The aim of this study was to validate the use of the LLAS in an adult population by: i) evaluating its ability to discriminate between different extents of lower limb hypermobility, ii) establishing a cut-off score to identify lower limb hypermobility, and iii) determining if the LLAS is able to identify Generalised Joint Hypermobility (GJH). Methods Participants were recruited across three groups representing varying degrees of hypermobility. They were assessed using the LLAS, Beighton score and clinical opinion. Pearson’s correlation coefficient and MANOVA were used to assess between-group differences in the LLAS. The cut-off score was determined using median and inter-quartile ranges and the Receiver Operator Characteristic Curve. The ability of the LLAS to identify GJH was assessed using percent agreement with clinical opinion. Results One hundred twelve participants aged 18–40 years were recruited. The LLAS distinguished the control from the likely hypermobile and known hypermobile cohorts (both p < 0.001), as well as the likely hypermobile from the known hypermobile cohort (p = 0.003). The LLAS cut-off score for identifying lower limb hypermobility was ≥7/12 with a specificity of 86% and sensitivity of 68%. The LLAS accurately identified those with GJH with high percentage agreement compared to clinical opinion across all cohorts (69–98%). Conclusions The LLAS is a valid tool for identifying lower limb specific hypermobility and GJH in adults at a cut-off score of ≥7/12. It demonstrates excellent specificity and moderate sensitivity, and discriminates well between extents of hypermobility.

BACKGROUND: In the Emergency Department (ED), early and rapid identification of older people at risk of adverse outcomes, who could best benefit from complex geriatric intervention, would avoid wasting time, especially in terms of prevention of adverse outcomes, and ensure optimal orientation of vulnerable patients. We wanted to test the predictive ability of a screening tool assessing risk of functional decline (FD), named SHERPA, 10 years after its conception, and to assess the added value of other clinical or biological factors associated with FD. METHODS: A prospective cohort study of older patients (n = 305, ≥ 75 years) admitted through the emergency department, for at least 48 h in non-geriatric wards (mean age 82.5 ± 4.9, 55% women). SHERPA variables (i.e. age, pre-admission instrumental Activity of Daily Living (ADL) status, falls within a year, self-rated health and 21-point MMSE) were collected within 48 h of admission, along with socio-demographic, medical and biological data. Functional status was followed at 3 months by phone. FD was defined as a decrease at 3 months of at least one point in the pre-admission basic ADL score. Predictive ability of SHERPA was assessed using c-statistic, predictive values and likelihood ratios. Measures of discrimination improvement were Net Reclassification Improvement and Integrated Discrimination Improvement. RESULTS: One hundred and five patients (34%) developed 3-month FD. Predictive ability of SHERPA decreased dramatically over 10 years (c = 0.73 vs. 0.64). Only two of its constitutive variables, i.e. falls and instrumental ADL, were significant in logistic regression analysis for functional decline, while 21-point MMSE was kept in the model for clinical relevance. Demographic, comorbidity or laboratory data available upon admission did not improve the SHERPA predictive yield. CONCLUSIONS: Prediction of FD with SHERPA is difficult, but predictive factors, i.e. falls, pre-existing functional limitation and cognitive

Background Female soccer has only recently become a professional sport within the UK. The need for accurate and reliable screening and profiling of professional female soccer players could assist in the design of injury prevention programmes. Objective To evaluate the clinical joint and limb measures during a preseason screening process in professional female soccer players. Design Cross-sectional, descriptive study. Setting Sports Therapy clinic. Participants 32 professional UK-based female soccer players (aged 23±3.60, mass 62.41±6.37 kg, height 167±6.65 cm) participated in the study. Assessment of Risk Factors Risk factors were assessed during the English Women's Super League preseason, January 2016. The independent variable was leg dominance. Main Outcome Measurements The outcome measures were leg length, knee to wall distance, knee flexion and extension, hip flexion and extension, hip internal and external rotation ranges of motion (ROM), straight leg raise hip flexion angle from both dominant and non-dominant legs. A qualified and experienced Sports Therapist subjectively assessed and recorded joint ligament laxity at the knee and ankle. Results Paired T-Tests revealed significantly reduced ROM in the dominant side compared to the non-dominant side for both hip flexion (p=0.005) and hip internal rotation (p=0.021). However, all other ROM measurements demonstrated limb symmetry. The most notable findings from the subjective laxity measures was that 35.9% of players had ankle talar inversion laxity. Conclusions Reduced hip ROM in the dominant side of players may increase the risk of lower limb injury. It may be important to include hip flexibility training into pre-season injury prevention programmes for female soccer players to ensure lower limb symmetry. Furthermore, ankle strengthening, proprioception and single leg change of direction exercises may be included in training pr

Huvuddelen av den svenska ambulanssjukvården har idag begränsat med verktyg för att effektivt kunna identifiera patienter med sepsis. Laktat ackumuleras i blodet vid syrebrist i kroppens vävnader vilket kan uppstå i samband med sepsis. Prehospital laktatbestämning kan vara en metod för att ge ambulanssjuksköterskan underlag för bedömning av patienter med sepsis. Ambulanssjuksköterskan är skyldig att arbeta patientsäkert och med evidensbaserade metoder. Prehospital laktatbestämning är en metod som bör bygga på en god vetenskaplig grund för att kunna anses vara evidensbaserad. Syftet var att beskriva det vetenskapliga underlaget för nyttan med prehospital laktatbestämning hos patienter med sepsis. Litteraturstudie valdes som metod och data samlades in via databaserna Cinahl, PubMed och SweMed+. Tolv artiklar kunde inkluderas, vilka alla var originalartiklar, skrivna på svenska eller engelska och publicerade mellan år 2007 och 2017. Sökorden kombinerades med hjälp av booleska sökoperatorer. Det insamlade materialet analyserades genom textanalys vilket mynnade ut i fyra teman där gemensamma mönster och regelbundenheter identifierades i de olika artiklarna. Resultatet efter genomförd textanalys bestod av fyra teman; laktat och allvarlig sjukdomsutveckling, laktatbestämning kopplat till mortalitet, laktatbestämning bidrog till tidigare identifiering och snabbare behandling av sepsis samt nyttan med laktatbestämning kunde inte styrkas. Slutsatsen var att resultatet tydde på att prehospital laktatbestämning kunde bidra till tidigare identifiering av patienter med sepsis och att det fanns en koppling till mortalitet. Dock ansågs det vetenskapliga underlaget vara alltför begränsat för att metoden med säkerhet skulle kunna anses vara evidensbaserad och därmed patientsäker., Most of the Swedish ambulance service has limited access to screeningtools for efficiently identifying patients with sepsis. Lactate does accumulate in the blood as a result of hypoxia of the bodily tissues, which may occur during sepsis. Prehospital lactate reading might be a method for assisting ambulance personnel in assessing patients with sepsis. The ambulance nurse must work according to patient safety and use evidence based methods. Prehospital lactate reading is a method which should rely on a solid scientific basis to be considered as evidence based. The aim of this study was to describe the scientific basis for the benefit of prehospital lactate reading in patients with sepsis. The method chosen was a systematic literature review and data were collected via three databases; Cinahl, PubMed and SweMed+. A total of twelve scientific articles were included, all original articles written in swedish or English and published between year 2007 and 2017. The keywords were combined using boolean search operators. The material was analyzed using content analysis which resulted in forming of four themes where patterns and regularities were identified from the included studies. The result consisted of four themes; lactate and poor outcome, lactate reading associated to mortality, lactate reading contributed to early identification and reduced time to treatment of sepsis and finally; the benefit of lactate reading could not be proven. As conclusion, the result indicated that prehospital lactate reading could improve identification of septic patients and there was an association to mortality. There was not enough research available to strongly consider the method of prehospital lactate reading to be evidence based.

ObjectiveAdolescent suicidal behavior is a public health concern in South Africa. The purpose of this article is to report on the development of a screening tool for teachers to identify South African students who are most at risk for suicidal behavior. This need is addressed within the context of the limited number of mental health professionals available to provide screening and care services in South Africa.MethodGrade 8 students participated by completing sociodemographic questionnaires and self-report psychometric instruments. A screening tool for suicidal behavior was developed using a 4-phase approach.ResultsTwelve factors for high-risk suicidal behavior were identified and included in the screening tool. While further research is needed to validate the screening tool, the findings provide a useful preliminary starting point for teachers to refer students at high risk for suicidal behavior to mental health services for treatment.ConclusionThis screening tool is based on factors that were identified as being associated with suicidal behavior from local research on South African adolescents. The tool contributes to research on adolescent mental health, particularly suicidal behavior, in developing low and middle income countries like South Africa, with the aim of creating African prevention and intervention programs. (PsycINFO Database Record

Background : Many people with chronic conditions have complex health needs often due to multiple chronic conditions, psychiatric comorbidities, psychosocial issues, or a combination of these factors. They are at high risk of frequent use of healthcare services. To offer these patients interventions adapted to their needs, it is crucial to be able to identify them early. Objective : The aim of this study was to find all existing screening tools that identify patients with complex health needs at risk of frequent use of healthcare services, and to highlight their principal characteristics. Our purpose was to find a short, valid screening tool to identify adult patients of all ages. Methods : A scoping review was performed on articles published between 1985 and July 2016, retrieved through a comprehensive search of the Scopus and CINAHL databases, following the methodological framework developed by Arksey and O’Malley (2005), and completed by Levac et al. (2010). Results : Of the 3,818 articles identified, 30 were included, presenting 14 different screening tools. Seven tools were self-reported. Five targeted adult patients, and nine geriatric patients. Two tools were designed for specific populations. Four can be completed in 15 minutes or less. Most screening tools target elderly persons. The INTERMED self-assessment (IM-SA) targets adults of all ages and can be completed in less than 15 minutes. Conclusion : Future research could evaluate its usefulness as a screening tool for identifying patients with complex needs at risk of becoming high users of healthcare services.

研究報告

The development of a simple and low cost technique for determination of arsenic (As) in drinking water wells is an urgent need to accelerate As mitigation policy. The aim of this study was to evaluate the potentiality of tubewell platform color as low-cost, quick and convenient screening tool for As. The result shows strong correlation between the development of red color stain on tubewells platform and As enrichment in the corresponding tubewells water compared to WHO (10 μg/L) and BDWS (50 μg/L), with 99% certainty. The red color stain in the platform indicates 98% sensitivity with WHO (10 μg/L) and BDWS (50 μg/L). With regard to WHO and BDWS, the corresponding efficiency of the platform color as screening tool for As are 97.3% and 97%. This study suggests that platform color can be potentially used for screening tubewells, help users switch to tube wells with low As and facilitate sustainable As mitigation efforts in developing countries., Conference code: 175559; Export Date: 22 May 2017; Conference Paper; Funding details: Sida, Styrelsen för Internationellt Utvecklingssamarbete; Funding text: This study was supported by the Swedish International Development Cooperation Agency (SIDA) and Linnaeus Palme (LP) Academic Exchange programme. Partial support to MA was provided by a grant from Wagner College, New York, USA. QC 20170531