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To evaluate the performance and test-retest reliability obtained when administering a computerized baseline neurocognitive exam to NCAA Division I student-athletes in a controlled laboratory setting versus an uncontrolled remote location.
A sample of 129 (female = 100) Division I student-athletes completed Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) pre-season assessments for two distinct and respective sports seasons in a controlled laboratory environment and an uncontrolled remote environment. Depending on the environment, participants were given verbal (controlled) or written (uncontrolled) guidelines for taking the test.
Multivariate repeated-measures ANOVA's determined that there were no within-subject differences between testing environments on ImPACT composite scores and cognitive efficiency index (CEI). The Chi-square test did not find any significant differences in impulse control or the number of invalid test scores, as determined by ImPACT, between environments. Intraclass correlations found the ImPACT subtest scores to range in test-retest reliability across testing environments, demonstrating moderate (verbal memory composite, r = 0.46; visual memory composite, r = 0.64; reaction time, r = 0.61; impulse control, r = 0.52; and CEI, r = 0.61) and good (visual motor composite, r = 0.77) test-retest reliability.
Results indicate that ImPACT is reliable between controlled and uncontrolled testing environments. This further suggests that ImPACT can be administered in a remote environment, pending specific adherence to testing instructions, or in the event of social distancing or isolation policies.
Results indicate that ImPACT is reliable between controlled and uncontrolled testing environments. This further suggests that ImPACT can be administered in a remote environment, pending specific adherence to testing instructions, or in the event of social distancing or isolation policies.
Care homes have been severely affected by the SARS-CoV-2 pandemic. Rapid antigen testing could identify most SARS-CoV-2 infected staff and visitors before they enter homes. We explored implementation of staff and visitor testing protocols using lateral flow devices (LFDs).
An evaluation of a SARS-CoV-2 LFD based testing protocol in 11 care homes in Liverpool, UK, including staff and visitor testing, plus a qualitative exploratory study in 9 of these homes. The proportion of pilot homes with outbreaks, and outbreak size, were compared to non-pilot homes in Liverpool. Adherence to testing protocols was evaluated. Fifteen staff were interviewed, and transcript data were thematically coded using an iterative analysis to identify and categorize factors influencing testing implementation.
1638 LFD rapid tests were performed on 407 staff. Protocol adherence was poor with 8.6% of staff achieving >75% protocol adherence, and 25.3% achieving $ge$50%. Six care homes had outbreaks during the study. Compared to non-pilot care homes, there was no evidence of significant difference in the proportion of homes with outbreaks, or the size of outbreaks. Qualitative data showed difficulty implementing testing strategies due to excessive work burden. Factors influencing adherence related to test integration and procedural factors, socio-economic factors, cognitive overload, and the emotional value of testing.
Implementation of staff and visitor care home LFD testing protocols was poorly adhered to and consequently did not reduce the number or scale of COVID-19 outbreaks. More focus is needed on the contextual and behavioural factors that influence protocol adherence.
Implementation of staff and visitor care home LFD testing protocols was poorly adhered to and consequently did not reduce the number or scale of COVID-19 outbreaks. More focus is needed on the contextual and behavioural factors that influence protocol adherence.
It remains unclear if migrants have different odds for adverse outcomes associated with GDM. We investigated if the associations between GDM and adverse pregnancy outcomes are modified by country of origin; and examined the odds of these outcomes according to GDM status and country of origin.
Nationwide register-based study of singleton deliveries in Denmark, 2004-2015. We used logistic regression models and tested for interaction.
Among the 710413 singleton deliveries, 2.6% had GDM and 14.4% were immigrants. Country of origin modified the association between GDM and pre-eclampsia, large for gestational age (LGA) and small for gestational age (SGA), but not between GDM and planned or emergency caesarean section and preterm delivery. GDM increased the risk of pre-eclampsia among women from Denmark (OR1.28, 95%CI 1.18-1.39), Lebanon (OR 3.34, 95%CI 1.35-8.26) and Morocco (OR 2.28, 95%CI 1.16-6.88). GDM was associated with increased odds of LGA among women from most countries, particularly women from Sri Lanka (OR 4.20 95%CI 2.67-6.61), and with reduced odds of SGA in some countries. Compared to Danish-born women with GDM, the odds of LGA were significantly lower and the odds of SGA higher among women with GDM from India, Lebanon, Pakistan, Iraq, and Somalia.
Our study documents that different immigrant groups have higher odds of different GDM associated adverse pregnancy outcomes - also among countries of origin often grouped together. YAP-TEAD Inhibitor 1 order This highlights the importance of increased awareness to both immigrant background and GDM status in the clinical assessment.
Our study documents that different immigrant groups have higher odds of different GDM associated adverse pregnancy outcomes - also among countries of origin often grouped together. This highlights the importance of increased awareness to both immigrant background and GDM status in the clinical assessment.Although malignant hyperthermia (MH) is a well-known complication of anesthesia, it presents unique considerations in the military health system. In this case report, the authors present a 26-year-old male active duty service member who experienced an MH crisis during a routine bilateral sagittal split osteotomy. The case presented here, which occurred at Brian D Allgood Army Community Hospital at Camp Humphreys, South Korea, highlights the challenges presented when caring for these patients in minimally staffed environments with frequent turnover of staff. The authors discuss the challenges to the military system such as the importance of adequate documentation of MH-susceptible service members, the benefits of rapidly dissolving dantrolene sodium nanosuspension, and the necessity for frequent training of military medical staff in the recognition and management of MH.
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