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Purpose To optimize the hepatic dysfunction alert tool at our institution to identify appropriate patients and minimize irrelevant alerts. Methods This single-center, retrospective review included adults hospitalized over a 1-month period for whom a hepatic dysfunction alert fired for a medication order placed in the electronic health record. The existing alert determines hepatic dysfunction based on laboratory tests. The primary objective was to determine the proportion of patients with an alert that was deemed to be clinically relevant. Alerts were considered relevant if the patient had a Child-Pugh score in class B or C and were ordered a medication with a hepatic warning from FDA or LiverTox. The performance of 14 alternative models was evaluated. Results A total of 1,541 alerts fired for 309 patients. Of these patients, 155 were randomly selected for the analysis, and the alert was deemed relevant in 86 patients (55%). Patients with relevant alerts were more likely to have documented liver disease and worsening measures on liver function tests. Of the alternative models evaluated, a model that excluded INR and albumin resulted in a 27% decrease in the number of alerts fired, of which 73% were relevant; however, it failed to identify 30% of patients with relevant hepatic dysfunction. None of the other models performed better. Conclusion The existing hepatic dysfunction clinical decision support tool correctly identifies patients with relevant hepatic dysfunction only 55% of the time. Alternative models were able to improve the rate of relevant results, but not without missing patients with relevant hepatic dysfunction. [ABSTRACT FROM AUTHOR]

Background: Polysomnography (PSG) is resource-intensive but remains the gold standard for diagnosing Obstructive Sleep Apnea (OSA). We aimed to develop a screening tool to better allocate resources by identifying individuals at higher risk for OSA, overcoming limitations of current tools that may under-diagnose based on self-reported symptoms. Methods: A total of 884 patients (490 diagnosed with OSA) were included, which was divided into the training, validation, and test sets. Using multivariate logistic regression analyses, we developed a scoring system incorporating male sex, age, sawtooth pattern, area under the inspiratory flow-volume curve (AreaFI), and neck circumference to objectively identify patients at higher risk of OSA. Sensitivity and specificity were evaluated using area under the curve (AUC) metrics. The M-APNE Score was compared to other non-symptom-based tools, the No-Apnea Score and the Symptomless Multivariable Apnea Prediction (sMVAP) model, using the Delong test. Results: The M-APNE Score showed sensitivity rates of 79.3% in the training set, 70.8% in the test, and 80% in the validation set. ROC analysis for M-APNE score yielded AUCs of 0.82 in the training, 0.76 in the test, 0.82 in the validation set. The discriminative accuracy of M-APNE Score were found to be better than the No-Apnea Score (AUC = 0.82 vs. 0.76, p < 0.001) and the sMVAP (AUC = 0.82 vs. 0.75, p = 0.001) in the training set. Hosmer Lemeshow test indicated good calibration for M-Apne Score (p = 0.46). Conclusions: The M-APNE Score is a robust and objective tool for OSA screening, potentially reducing classification errors and improving accuracy. [ABSTRACT FROM AUTHOR]

Objective: The "Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls" (SARC-F) is a simple, five-item tool used to identify individuals with suggestive signs of sarcopenia. This study assessed the validity of the Sinhala version of the SARC-F, evaluating its ability to detect sarcopenia in older women and its potential to predict health-related quality of life (HRQoL). Methods: The culturally adapted Sinhala version of the SARC-F, along with the Short Form-36 (SF-36) survey, was administered among 350 older women (aged ≥ 65) attending medical clinics at National Hospital Galle, Sri Lanka. Handgrip strength (HGS) was measured using a handheld dynamometer, and relative appendicular skeletal muscle mass index (RSMI) was estimated with a Sri Lankan-specific anthropometry-based equation. Gait speed (GS) was assessed using 4-m customary-paced walk test. Results: The mean (± SD) age of the participants was 72 (± 5) years, with 56.3% (n = 197) having sarcopenia based on a SARC-F score of ≥ 4. The Sinhala version of SARC-F demonstrated a good internal consistency (Cronbach's alpha = 0.72). A significant positive correlation between SARC-F and HGS indicated concurrent validity (r = 0.23, p < 0.001). Women with sarcopenia had significantly lower HRQoL scores, HGS and GS compared to those without, confirming discriminant validity (p < 0.01). The sensitivity, specificity, and accuracy of the Sinhala SARC-F were 54.8%, 67.3%, and 60.3%, respectively, with an Area Under the Curve (AUC) of 0.61 (95% CI: 0.55–0.67) in detecting probable sarcopenia. The HRQoL domains of SF-36 (excluding emotional well-being), HGS and GS were inversely correlated with SARC-F (Spearman's rho range: -0.19 to -0.56, p < 0.001). SARC-F significantly associated with the physical function and pain domains of SF-36 explained 42% of the variance in the model (r = 0.65, R2 = 0.42). Conclusions: The Sinhala version of SARC-F is a reliable and valid tool for screening sarcopenia in Sinhala-speaking older women in Sri Lanka. It can be integrated into clinical practice to identify those with suggestive signs of sarcopenia and to predict HRQoL enabling timely interventions. Future studies with larger, more diverse populations, including men, are needed to enhance the tool's generalizability and diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Background/Objectives: It would be helpful for primary healthcare professionals to have access to a brief, general screening tool allowing them to detect patients suffering from major mental illness. This also holds for organizations and institutions at which pregnant women ask for support during the perinatal period. An evaluation of the psychometric properties, validity, and reliability of the Fainareti mental health screening tool was carried out in Greek women in this study. Methods: The study participants consisted of 518 women retrospectively followed from pregnancy to their first year postpartum as part of a health intervention at the Day Center for Women's Mental Health Care (Perinatal Mental Health Disorders), operated by the non-profit organization Fainareti. Alongside the newly developed screening tool, this study utilized the Perinatal Anxiety Screening Scale (PASS), the Patient Health Questionnaire (PHQ-9), and the Edinburgh Postnatal Depression Scale (EPDS). Results: The assessment of the tool's internal reliability included computing two separate internal consistency indices, with both indicating its significant level of reliability. The correlation analysis between the tool and the scales included in this study demonstrated the tool's strong convergent validity, while factor analyses confirmed its satisfactory construct validity. Conclusions: Overall, these findings suggest that the one-factor Fainareti mental health screening tool is suitable for initial assessments of the mental health of Greek women. [ABSTRACT FROM AUTHOR]

Mistreatment of older adults is common and has serious health consequences but is underrecognized and underreported. Screening for mistreatment of older adults and initiation of intervention in primary care clinics may be helpful, but the value of existing tools is not supported by evidence. We argue that shifting the focus to individual subtypes of mistreatment of older adults can provide improved approaches to screening and ultimately to intervention. We focus on the example of caregiver neglect, the subtype associated with highest mortality. To develop caregiver neglect screening and intervention programs and to measure their effectiveness and impact, we assert that it is critical to: (1) define the phenomenon, (2) develop a conceptual model to explain why it occurs, (3) develop measurement strategies, and (4) systematically examine existing literature. We describe here the initial components of this development process. [ABSTRACT FROM AUTHOR]

Introduction: Malnutrition risk (MR) in older adults with neurological disorders is high, but there is little evidence for validated screening tools in this group, as well as for the clinical and socioeconomic factors associated with a high MR. Objectives: To determine the association of MR using the Malnutrition Universal Screening Tool (MUST) with mortality and length of stay (LOS) in older adults with neurological diseases. Secondarily, the association of clinical, and socioeconomic factors with MR and clinical outcomes was sought. Methods: A retrospective cohort study was carried out at a third-level neurological disease referral center in Mexico. All patients older than 60 years admitted from January 2017 to December 2018 were considered. MUST, clinical and socioeconomic factors were assessed at hospital admission. Outcomes were followed up to hospital discharge or a maximum of 6 months. Results: A total of 765 patients were included, of whom 24.7% (n = 189) were at high risk. A high MR was independently associated with mortality (OR 3.09; 95% CI 1.60-5.98, p =.001) and LOS >14 days (OR 4.38; 95% CI 2.79-6.89, p = <.001). The only factors independently associated with high MR was economic dependence and unemployment. Patients with high MR and economic dependence (OR 4.0; 95% CI 1.34-11.99, p =.013) or unemployment (OR 3.43; 95% CI 1.17-10.06, p =.025) had the highest mortality. Conclusions: In hospitalized older adults with neurological diseases, high MR is independently associated with increased mortality and LOS. Economic dependence or unemployment are associated with worse clinical outcomes in patients with high MR. [ABSTRACT FROM AUTHOR]

Purpose: Diffuse large B-cell lymphoma (DLBCL) is one of the most common and aggressive forms of non-Hodgkin’s lymphoma. This study aimed to evaluate the performance of the abbreviated Comprehensive Geriatric Assessment (aCGA) in assessing frailty and predicting clinical outcomes in elderly patients with DLBCL. Methods: A total of 91 patients aged ≥ 65 years with newly diagnosed DLBCL and who received immunochemotherapy at a single medical center in Taiwan between August 2019 and December 2022 were prospectively enrolled. Frailty was assessed in all participating patients within seven days of the first cycle of immunochemotherapy. The primary objective was to compare aCGA’s accuracy in assessing frailty with that of the full CGA. Secondary objectives included assessing correlations between frailty and severe adverse events (sAEs), early mortality, and overall survival (OS). Results: In the cohort, 50 (55%) and 38 (42%) patients were categorized as frail based on CGA and aCGA, respectively. A high number of aCGA domains impairment were positively associated with a high number of CGA domains impairment. The receiver operating characteristic for aCGA for detecting frailty was 0.846 (95% confidence interval [CI], 0.756–0.926). A cut-off point of ≥ 2 aCGA domain impairments indicated frailty, with a sensitivity of 70.0% and specificity of 92.7%. Based on aCGA, the early mortality rate was 7.5% and 26.3% (p = 0.019) for fit and frail patients, respectively. The 1-year and 2-year OS rates were 77.7% and 67.4% for fit patients, and 57.1% and 45.4% for frail patients, respectively. The adjusted hazard ratio for OS was 2.42 (95% CI, 1.06–5.49, p = 0.035) for frail patients compared to fit patients. Conclusions: This finding suggested that aCGA could be used as an efficient alternative to the full CGA, potentially improving the clinical management and treatment decision-making for elderly patients with DLBCL. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Background: Screening for depression remains a priority for people living with HIV (PLWH) accessing care. The 9-item Patient Health Questionnaire (PHQ-9) is a widely used depression screening tool, but has limited accuracy when applied across various cultural contexts. We aimed to evaluate the performance of alternative PHQ-9 scoring algorithms in sub-Saharan African PLWH. Setting: Five HIV programs in Cameroon, Côte d'Ivoire, Kenya, Senegal, and the Republic of Congo. Methods: Adult PLWH were screened for depression during the 2018–2022 period. Diagnosis confirmation was done by psychiatrist blinded clinical evaluation (gold standard). Diagnostic performances, including sensitivity and area under the curve (AUC) of the traditional PHQ-9 scoring (positive screening − score ≥ 10), were compared to alternative scoring algorithms including (1) the presence of ≥1 mood symptom (PHQ-9 items 1 and 2) combined with ≥2 other symptoms listed in the PHQ-9, and (2) a simplified recoding of each 4-response item into 2 categories (absence/presence). Results: A total of 735 participants were included [54% women, median age 42 years (interquartile range 34–50)]. Depression was diagnosed by a psychiatrist in 95 (13%) participants. Alternative scoring sensitivities (0.59–0.74) were higher than that of the traditional score's (0.39). Compared to traditional scoring, AUC was significantly higher for PHQ-9 alternative scoring. Across settings, alternative scoring algorithms increased sensitivity and reduced variability. Conclusions: As a primary screening test, new scoring algorithms seemed to improve the PHQ-9 sensitivity in identifying depression and reducing heterogeneity across settings. This alternative might be considered to identify PLWH in need of referral for further diagnostic evaluations. [ABSTRACT FROM AUTHOR]

Introduction: Postpartum depression (PPD) is defined as a depressive episode occurring during pregnancy or until 4-weeks post-childbirth. Studies show that postpartum depression (PPD) affects at least 10 percent of women and that many depressed mothers do not get proper treatment. The Edinburgh Postnatal Depression Scale (EPDS) was developed to assist health professionals in detecting mothers suffering from Postpartum depression. Aim & Objective: To Identify the risk factors and screening of Post partum depression in postnatal mothers in a Tertiary care centre. Materials and Methods: A Prospective Study conducted on Postnatal women. Data collected regarding history, complaints, risk factors and Edinburgh postnatal depression scale. Results: In our study, according to Edinburgh Postnatal Depression Scale (EPDS),among postnatal mothers screened 1% of postnatal mothers have postpartum depression,19% mothers are at risk of postpartum depression, remaining 80% of population screened is devoid of symptoms. Conclusion: The EPDS was tailored to distinguish between the typical stress and fatigue postpartum women often experience and the more severe symptoms of depression This method of questioning aims to capture the frequency and severity of depressive symptoms, providing clinicians with a clear picture of a patient’s mental state. [ABSTRACT FROM AUTHOR]

Abstract Objective The "Strength, Assistance with walking, Rise from a chair, Climb stairs, and Falls" (SARC-F) is a simple, five-item tool used to identify individuals with suggestive signs of sarcopenia. This study assessed the validity of the Sinhala version of the SARC-F, evaluating its ability to detect sarcopenia in older women and its potential to predict health-related quality of life (HRQoL). Methods The culturally adapted Sinhala version of the SARC-F, along with the Short Form-36 (SF-36) survey, was administered among 350 older women (aged ≥ 65) attending medical clinics at National Hospital Galle, Sri Lanka. Handgrip strength (HGS) was measured using a handheld dynamometer, and relative appendicular skeletal muscle mass index (RSMI) was estimated with a Sri Lankan-specific anthropometry-based equation. Gait speed (GS) was assessed using 4-m customary-paced walk test. Results The mean (± SD) age of the participants was 72 (± 5) years, with 56.3% (n = 197) having sarcopenia based on a SARC-F score of ≥ 4. The Sinhala version of SARC-F demonstrated a good internal consistency (Cronbach’s alpha = 0.72). A significant positive correlation between SARC-F and HGS indicated concurrent validity (r = 0.23, p

Introduction. Hereditary transthyretin amyloidosis with polyneuropathy (hATTR-PN) is a severe progressive hereditary disease. Even with the availability of genetic testing for transthyretin (TTR) gene variants, timely hATTR-PN diagnosis remains challenging due to a great variability in its clinical presentation. Patients with hATTR-PN are often misdiagnosed with chronic idiopathic axonal polyneuropathy (CIAP). The objective of our study is to describe the baseline electrophysiological, clinical, and demographic characteristics of hATTR-PN and CIAP patients and to establish patients' pre-selection criteria for genetic testing. Materials and methods. Retrospective analysis was performed in 42 hATTR-PN patients and 58 CIAP patients (according to diagnosis defined in medical records from 1 January 2017 to 1 March 2024). Demographic, clinical, and electrophysiological data were collected at diagnosis. To identify factors influencing the likelihood of the hATTR-PN presence, a logistic regression model including clinically relevant variables was developed. Results. The mean age of hATTR-PN and CIAP patients was 57.7 and 60.9 years, respectively. As compared with CIAP patients, those with hATTR-PN more frequently exhibited gait disturbances (64.3% vs 37.9%), autonomic (47.6% vs 12.1%), cardiac (35.7% vs 10.3%) and gastrointestinal symptoms (64.3% vs 12.1%), unintentional weight loss (45.2% vs 12.1%), and heart failure with preserved ejection fraction (26.2% vs 6.9%). Peripheral nerve conduction scores were also lower in the hATTR-PN group. In predicting hATTR-PN, the logistic regression model had a sensitivity of 91% and a specificity of 97%. Conclusion. Demographic, clinical, and electrophysiological characteristics of patients with hATTR-PN and CIAP were described. Based on the screening data, it is feasible to predict hATTR-PN in CIAP patients with relatively high accuracy, sensitivity, and specificity.

Abstract This study aimed to investigate whether lymphocyte-C-reactive protein ratio (LCR) upon admission can predict disease progression and intensive care unit (ICU) admission in adult patients with diabetic ketoacidosis (DKA). A single-center retrospective study was conducted, including adult DKA patients admitted to the First Affiliated Hospital of Harbin Medical University between March 2018 and March 2023. Multiple demographic and clinical data were collected from the medical records upon admission and during hospitalization. Subsequently, sequential organ failure assessment (SOFA) score and LCR were calculated based on relevant clinical parameters within 24 h of admission. These indicators were compared among different disease severity groups, and factors related to severe DKA, concurrent acute kidney injury (AKI), and ICU admission were further analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine the sensitivity, specificity, area under the ROC curve (AUC), and cut-off value of LCR. A total of 271 adult DKA patients were enrolled and categorized into three groups: mild group (n = 42), moderate group (n = 64), and severe group (n = 165). Significant differences in demographic and clinical data were observed among these groups. Glasgow coma scale (GCS) score, LCR, pH, and bicarbonate (HCO3 -) were identified as protective factors for severe DKA. Conversely, SOFA score, neutrophil count (NEUT), serum creatinine (SCr), and glucose (GLU) were risk factors for concurrent AKI. Concurrent AKI and SOFA score were risk factors for ICU admission, while pH was a protective factor. The areas under the ROC curve (AUC) of LCR to classify adult DKA patients into mild group, severe group, and ICU admission were 0.679, 0.718, and 0.621, respectively, with cut-off value of 212.80, 96.16, and 63.35, sensitivity of 54.8%, 76.4%, and 78.9%, and specificity of 76.0%, 62.4%, and 46.3%. LCR upon admission provides great potential to predict disease progression and ICU admission in adult patients with DKA.

Abstract Background The Stay Independent Brochure (SIB) is part of the CDC’s STEADI initiative and is a fall risk screening self-report tool. This study aimed to translate and cross-culturally adapt the Arabic version of the SIB (AR-SIB) and evaluate its psychometric properties among community-dwelling older adults. Methods The translation and cross-cultural adaptation process followed standard guidelines, including forward and backward translation, expert committee review, and pretesting to ensure semantic and conceptual equivalence, clarity, and cultural relevance of the Arabic version of the SIB. Internal consistency was assessed using the Kuder-Richardson formula (KR-20), and test–retest reliability was evaluated with the intraclass correlation coefficient (ICC2,1). Convergent validity of the AR-SIB was evaluated using Spearman’s rank correlation coefficients (rs) with the Timed Up and Go (TUG) test and the Berg Balance Scale (BBS) and point-biserial correlation coefficients (rpb) with the three key questions. Floor and ceiling effects and the operating characteristic (ROC) curve were also calculated. Results A total of 104 community-dwelling older adults participated in the study. The majority of participants were female (52.9%) and had a mean age of 63.77 ± 4.74 years. The AR-SIB demonstrated good internal consistency with an overall KR-20 of 0.73 and excellent test–retest reliability (ICC2,1 = 0.96). The AR-SIB showed moderate correlations with the TUG (rs = 0.51, 95% CI: 0.35 to 0.64) and the BBS (rs = -0.56, 95% CI: -0.69 to -0.41), and a high correlation with the three key questions (rpb = 0.75, 95% CI: 0.65 to 0.82). No floor or ceiling effects were observed. The cutoff point of the AR-SIB was determined to be 4.5. Conclusions The AR-SIB is a reliable and valid tool to discriminate falls and screen for fall risk among Arabic-speaking community-dwelling older adults. The AR-SIB can facilitate the implementation of evidence-based fall prevention initiatives tailored to Arabic-speaking older adults.

Abstract Patients with chronic diabetes may have a physical performance decline, which significantly increases the risk of falling. The study aimed to assess the validity of the Circular Tandem Walk Test (CTWT) in determining fall risk among older community-dwelling Thais with type 2 diabetes mellitus (T2DM). This is a cross-sectional diagnostic study of 71 older participants with T2DM from various communities. The participants were divided into “faller” (who had experienced one or more fall events) and “non-faller” groups based on 6-month fall history data. They were then interviewed about their fear of falling (FOF) using a single question and the Falls Efficacy Scale International (FES-I), followed by the CTWT. Thirty-five participants reported having fallen in the past six months. Significant differences were in the fallers and non-fallers CTWT, FOF, and FES-I scores (p

Abstract Objectives This rapid review is designed to identify existing tools in the Canadian literature that assess the impacts of climate change on the health of perinatal families, particularly those who are equity-denied. Addressing the needs of equity-denied perinatal populations in the face of climate change is crucial to promoting equitable and inclusive perinatal care in Canada. Methods Rapid review methodology was selected to provide evidence in a timely and cost-effective manner. PubMed/MEDLINE and gray literature (Google and Google Scholar) were searched for English and French papers published from 2013 onward. The original research question, focused on climate change and health, yielded very few relevant results. Therefore, the search was broadened to include environmental health. Garrity et al.’s (J Clin Epidemiol 130:13–22, 2021) nine-stage process was used to identify 11 relevant papers, extract the relevant data, and complete the narrative synthesis. Synthesis. This review revealed a significant lack of tools for comprehensively assessing climate-health impacts on perinatal families and equity-denied perinatal families. While Canadian perinatal health screenings focus on equity via indicators of several social determinants of health (e.g., income, social support), they largely omit climate considerations. Environmental health factors are more commonly included but remain minimal. Conclusion Climate-health screening tools are lacking yet needed in routine perinatal healthcare. Given the seriousness of climate change, urgent engagement of health systems and healthcare workers is essential to help mitigate and adapt to climate-health challenges, particularly for perinatal families experiencing health inequities.

Introduction: Family members caring for a person living with dementia (PWD) can experience caregiver burden, leading to psychological distress if unmanaged. It's essential for healthcare professionals, especially nurses to identify caregivers at risk of stress and depression, triggering prompt management during their contact with caregivers of PWD. The study team developed an evidence-based caregiver burden-mastery hybrid assessment and intervention decision matrix (CHAT-MI) for caregivers of PWD and examined its feasibility of use. Objective: To determine the feasibility and usability of implementing the CHAT-MI assessment-decision matrix tool in an outpatient setting in Singapore. Methods: CHAT-MI was developed through earlier research, research evidence, clinical guidelines, and expert opinion. A multimethod study was conducted in a Singapore outpatient memory clinic from November 2020 to January 2021. Caregivers of PWD who attended the clinic self-administered the assessment tool to determine their burden and personal mastery levels. Clinicians used a decision matrix to guide interventions based on the assessments. Feedback was gathered from both caregivers and clinicians through surveys and semistructured interviews. Results: Thirty-four caregivers and six clinicians participated in the study. Caregivers found the burden-mastery assessment tool relatively easy to use and understand and helpful. Clinicians found the assessment-decision matrix tool acceptable, feasible, and useful, enhancing standard care by providing insights into caregivers' current coping capabilities. Clinicians shared that junior clinicians could benefit from CHAT-MI to better detect caregiving stress and deliver interventions. Nevertheless, more can be done to train clinicians in the understanding of the concept of mastery (i.e., perceived control over life events) to help clinicians better engage and support caregivers. Conclusion: CHAT-MI was found to be relatively brief and can aid the outpatient clinic setting. This suggests that such an evidence-based assessment cum intervention can be considered for use in a real-world clinical setting to aid both caregivers and clinicians. [ABSTRACT FROM AUTHOR]

Background: The Stay Independent Brochure (SIB) is part of the CDC's STEADI initiative and is a fall risk screening self-report tool. This study aimed to translate and cross-culturally adapt the Arabic version of the SIB (AR-SIB) and evaluate its psychometric properties among community-dwelling older adults. Methods: The translation and cross-cultural adaptation process followed standard guidelines, including forward and backward translation, expert committee review, and pretesting to ensure semantic and conceptual equivalence, clarity, and cultural relevance of the Arabic version of the SIB. Internal consistency was assessed using the Kuder-Richardson formula (KR-20), and test–retest reliability was evaluated with the intraclass correlation coefficient (ICC2,1). Convergent validity of the AR-SIB was evaluated using Spearman's rank correlation coefficients (rs) with the Timed Up and Go (TUG) test and the Berg Balance Scale (BBS) and point-biserial correlation coefficients (rpb) with the three key questions. Floor and ceiling effects and the operating characteristic (ROC) curve were also calculated. Results: A total of 104 community-dwelling older adults participated in the study. The majority of participants were female (52.9%) and had a mean age of 63.77 ± 4.74 years. The AR-SIB demonstrated good internal consistency with an overall KR-20 of 0.73 and excellent test–retest reliability (ICC2,1 = 0.96). The AR-SIB showed moderate correlations with the TUG (rs = 0.51, 95% CI: 0.35 to 0.64) and the BBS (rs = -0.56, 95% CI: -0.69 to -0.41), and a high correlation with the three key questions (rpb = 0.75, 95% CI: 0.65 to 0.82). No floor or ceiling effects were observed. The cutoff point of the AR-SIB was determined to be 4.5. Conclusions: The AR-SIB is a reliable and valid tool to discriminate falls and screen for fall risk among Arabic-speaking community-dwelling older adults. The AR-SIB can facilitate the implementation of evidence-based fall prevention initiatives tailored to Arabic-speaking older adults. [ABSTRACT FROM AUTHOR]

Unresolved family conflicts regarding caring for older adults can devastate their overall health, well-being, and the quality of care from their support networks. To better understand conflict in the context of caring for older populations, this study developed and piloted a new screening tool, the Eldercaring Conflict Checklist (ECC). The ECC was developed to help professionals provide targeted responses and interventions. The ECC is based on a literature review focusing on the factors associated with the typologies of family conflict in caring for older populations. A diverse sample of 157 professionals serving older populations in conflict answered an online survey using a case study vignette and the ECC. The ECC's validity, reliability, and factor structure were analyzed and explored quantitatively and by coding emerging themes in open-ended qualitative questions in the survey. The respondents reported that the ECC is comprehensive and useful, indicating its value as an intake screening tool and helpful for reliably and thoroughly assessing and measuring conflict within older adult family relations. Results show that the ECC demonstrates very high internal validity and model fit indices for the entire ECC, and each of the eight factors showed promising results. Implications are discussed regarding working with families within eldercaring coordination and elder mediation. [ABSTRACT FROM AUTHOR]

Aims: Frailty in older adults is influenced by various factors, such as poor nutritional status. Mid‐upper arm circumference (MUAC) is a validated, simple, and non‐invasive tool for assessing nutritional status. Despite its potential, no study has explored the association between MUAC and physical frailty in older adults. This study aims to investigate this association and assess whether MUAC can be used as a screening tool in community and primary clinical practice. Methods: A cross‐sectional study was conducted with 1178 participants aged 71.8 to 86.7 years from the 2019 Korean Frailty and Aging Cohort Study (KFACS). Physical frailty was defined using the Fried frailty phenotype criteria. MUAC was measured as the average circumference of both upper arms without compressing the subcutaneous tissue. Odds ratios (ORs) and 95% confidence intervals (CIs) for physical frailty, stratified by sex, were estimated using multiple logistic regression analysis after adjustments. Results: MUAC was lower in physically frail men compared with non‐frail men (28.0 ± 2.9 vs. 29.4 ± 2.6 cm, P < 0.001). MUAC was negatively correlated with the Frailty Index (r = −0.155, P < 0.001). Multiple logistic regression analysis revealed that MUAC was an independent factor for physical frailty in men (OR 0.986, 95% CI 0.973–1.000, P = 0.049). The optimal MUAC cutoff for identifying physical frailty in men was 28.2 cm (sensitivity 60.7%, specificity 71.4%, AUC 0.672, 95% CI 0.595–0.749, P < 0.001). No significant results were found for women. Conclusion: Low MUAC is significantly associated with physical frailty in older men, suggesting the potential for MUAC to be utilized as a screening tool for physical frailty in community and primary clinical settings. Geriatr Gerontol Int 2024; 24: 1292–1299. [ABSTRACT FROM AUTHOR]

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that occurs during the developmental period and affects overall cognitive, emotional, social, and physical health. Comprehensive screening for ASD can assist in diagnosis and intervention planning. The primary aim of this study was to develop and validate a screening tool for ASD based on the diagnostic guidelines of the International Classification of Diseases (ICD-11). The Social-Emotional Rating Scale for Autism Spectrum Disorder (SERA) was validated with 504 participants, including healthcare professionals who have worked with individuals with ASD and parents/primary caregivers of children with ASD. A confirmatory factor analysis on 78 participants with ASD and 27 participants without ASD indicated a good fit for the data. As an intervention planning tool, the developed SERA appears promising for identifying a person's social-emotional functioning level in line with autistic characteristics. [ABSTRACT FROM AUTHOR]

Despite initiatives to increase palliative care awareness, referrals in primary care settings are still primarily based on provider judgment, causing a lack of appropriate referrals and disparities in access to palliative care resources. The purpose of this quality improvement project was to develop and implement an evidence-based, standardized palliative care referral protocol to increase the palliative care referral rate for eligible patients at a primary care clinic. The project used a preimplementation and postimplementation design with the use of the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to successfully implement and evaluate the standardized referral process. Over the 10-month project period, the palliative care referral rate increased from 2% (4/193) preimplementation to 11% (16/147) postimplementation of the standardized referral process, which is an increase of 9%. Taking into consideration the potential impact of multiple extraneous variables, there was an overall decrease of 69% in emergency room visits and 73% in hospitalizations for patients who received a palliative care referral. These outcomes support expansion of the standardized referral process throughout other primary care clinics to increase palliative care referrals and sustain a high level of quality patient care. [ABSTRACT FROM AUTHOR]

Objectives: This rapid review is designed to identify existing tools in the Canadian literature that assess the impacts of climate change on the health of perinatal families, particularly those who are equity-denied. Addressing the needs of equity-denied perinatal populations in the face of climate change is crucial to promoting equitable and inclusive perinatal care in Canada. Methods: Rapid review methodology was selected to provide evidence in a timely and cost-effective manner. PubMed/MEDLINE and gray literature (Google and Google Scholar) were searched for English and French papers published from 2013 onward. The original research question, focused on climate change and health, yielded very few relevant results. Therefore, the search was broadened to include environmental health. Garrity et al.'s (J Clin Epidemiol 130:13–22, 2021) nine-stage process was used to identify 11 relevant papers, extract the relevant data, and complete the narrative synthesis. Synthesis. This review revealed a significant lack of tools for comprehensively assessing climate-health impacts on perinatal families and equity-denied perinatal families. While Canadian perinatal health screenings focus on equity via indicators of several social determinants of health (e.g., income, social support), they largely omit climate considerations. Environmental health factors are more commonly included but remain minimal. Conclusion: Climate-health screening tools are lacking yet needed in routine perinatal healthcare. Given the seriousness of climate change, urgent engagement of health systems and healthcare workers is essential to help mitigate and adapt to climate-health challenges, particularly for perinatal families experiencing health inequities. [ABSTRACT FROM AUTHOR]

Patients with chronic diabetes may have a physical performance decline, which significantly increases the risk of falling. The study aimed to assess the validity of the Circular Tandem Walk Test (CTWT) in determining fall risk among older community-dwelling Thais with type 2 diabetes mellitus (T2DM). This is a cross-sectional diagnostic study of 71 older participants with T2DM from various communities. The participants were divided into "faller" (who had experienced one or more fall events) and "non-faller" groups based on 6-month fall history data. They were then interviewed about their fear of falling (FOF) using a single question and the Falls Efficacy Scale International (FES-I), followed by the CTWT. Thirty-five participants reported having fallen in the past six months. Significant differences were in the fallers and non-fallers CTWT, FOF, and FES-I scores (p < 0.001). CTWT results were significantly correlated with FOF (rpb = 0.605, p < 0.001), FES-I (rho = 0.837, p < 0.001), and number of falls (rho = 0.736, p < 0.001). The study suggested that the cutoff score for CTWT is 15.2 s, with a sensitivity = 80.00, specificity = 86.11, and AUC = 0.915. This study demonstrated the validity of the CTWT for determining the risk of falls in older community-dwelling individuals with T2DM. Implementing this tool in a community setting would be helpful in the initial screening and referral of data by concerned healthcare professionals. However, further studies may be needed to explore the reliability of CTWT and ensure the appropriate clinical use of CTWT by healthcare professionals. [ABSTRACT FROM AUTHOR]

Purpose: Patients with osteoporosis are at risk of fractures, which can lead to immobility and reduced quality of life. Early diagnosis and treatment are crucial for preventing fractures, but many patients are not diagnosed until after a fracture has occurred. This study aimed to evaluate the performance of 10 osteoporosis screening tools (OSTs) in rural communities of Taiwan. In this prospective study, a total of 567 senior citizens from rural communities underwent bone mineral density (BMD) measurement using dual-energy X-ray absorptiometry (DXA) and ten OSTs were administered. Discrimination analysis was performed using the area under the receiver operating characteristic curve (AUROC). Primary outcomes included area under curve (AUC) value, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The DXA examination revealed that 63.0% of females and 22.4% of males had osteoporosis. Among females, Osteoporosis Index of Risk (OSIRIS) and Osteoporosis Self-Assessment Tool for Asians (OSTA) presented the best AUC value with 0.71 (0.66–0.76) and 0.70 (0.66–0.75), respectively. Among males, BWC had the best AUC value of 0.77 (0.67–0.86), followed by OSTA, Simple Calculated Osteoporosis Risk Estimation (SCORE), and OSIRIS. OSTA and OSIRIS showed acceptable performance in both genders. The specificity of Fracture Risk Assessment Tool (FRAX-H), SCORE, National Osteoporosis Foundation Score, OSIRIS, Osteoporosis Risk Assessment Instrument, Age, Bulk, One or Never Estrogen (ABONE), and Body weight criteria increased in both genders after applying the optimum cut-off. Considering it high AUC and simplicity of use, OSTA appeared to be the recommended tool for seniors of both genders among the ten OSTs. This study provides a viable reference for future development of OSTs in Taiwan. Further adjustment according to epidemiological data and risk factors is recommended while applying OSTs to different cohorts. [ABSTRACT FROM AUTHOR]

Background: Primary dysmenorrhea is often overlooked, underdiagnosed, and under-treated. This study attempts to develop a standardized tool for assessing primary dysmenorrhea among women in their reproductive years. Methodology: This study utilized a mixed-method approach to sample young Nigerian women. Specifically, the development of the Redeemer's University Primary Dysmenorrhea Screening Tool (RUN-PDST) involved a standardized methodology comprising two broad phases: (a) development and refinement of screening tool items and (b) establishment of psychometric properties. Results: The observed Kaiser-Meyer-Olkin (KMO) measure was .86, and Bartlett's Test of Sphericity (BTS) was (X2=3518.512, df=703, P = .000). The test of the principal components indicated nine extracted components, and the analysis of the components revealed all items that loaded based on the presence of nine components exceeding an eigenvalue of 1. Of the 38 items loaded, 24 were found to be significant and were subjected to principal component analysis using Varimax. The results from the component analysis further reduced the screening tool to 19 items. The item-total statistics of the tool indicate that all items have very good discrimination ability and should be retained. The internal consistency of the RUN-PDST among Nigerian samples revealed that the screening tool is reliable. Furthermore, paired with The Menstrual Symptom Questionnaire (MSQ), RUN-PDST has good concurrent validity. Conclusion: RUN-PDST is a reliable and valid screening tool for assessing and managing primary dysmenorrhea symptoms. [ABSTRACT FROM AUTHOR]

Background: Periodontal diseases are chronic inflammatory conditions that require early screening for effective long‐term management. Oral neutrophil counts (ONCs) correlate with periodontal inflammation. This study investigates a point‐of‐care test using a neutrophil enzyme activity (NEA) colorimetric strip for measuring periodontal inflammation. Methods: This prospective study had two phases. Phase 1 validated the relationship between ONCs and periodontal inflammation with 90 participants. Phase 2 examined the test's applicability in a real‐world setting through a multicentre clinical trial with 375 participants at four sites. ONCs were quantified in oral rinses using laboratory‐based methods, and the NEA strip was used for ONC stratification. Clinical measures included bleeding on probing (BoP), probing depth (PD) and clinical attachment loss (CAL). Results: ONCs were significantly elevated in patients with Grade B periodontitis and deep periodontal pockets (PD ≥ 5 mm, CAL ≥ 5 mm). The NEA strip accurately classified patients into high or low ONC categories, showing 80% sensitivity, 82.5% specificity and an AUC of 0.89. It also assessed the effectiveness of periodontal therapy in reducing ONC and inflammation. The test was user‐friendly, with no reported discomfort among patients. Conclusion: The NEA strip is a user‐friendly and rapid screening tool for detecting high ONCs associated with periodontal inflammation and for evaluating the effectiveness of periodontal therapy. [ABSTRACT FROM AUTHOR]

Mild cognitive impairment is associated with many neurodegenerative diseases. It is essential to detect mild cognitive impairment on time to reduce the prevalence of such disorders. Nevertheless, present clinically employed test scales and biomarkers are time-consuming, user-unfriendly, and expensive. Hence, we developed a neuropsychological test system based on virtual reality in this study, the Virtual Reality Neuropsychological Mild Cognitive Impairment Test (VRNPT). The diagnosis and classification of MCI were achieved by effectively combining digital cognitive parameters and EEG signal features obtained during the VRNPT cognitive task. The VRNPT contains three head-mounted display-based cognitive tasks that assess participants' attention, memory, spatial perception, working memory, and visuospatial executive ability across multiple cognitive domains of functioning. We investigated how to design and optimize these tasks. We conducted a field study by recruiting 80 participants (40 MCI patients and 40 normal older adults). The results showed that the classification accuracy of combining digitized cognitive parameters and EEG signals during VRNPT was 91.3%, higher than using only digitized parameters from VRNPT and applying EEG signals alone, demonstrating the validity and feasibility of this method for diagnosing MCI. The user satisfaction survey showed that the subjects were satisfied with VRNPT. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Design Methods Results Conclusion Implications for Patient Care Impact Reporting Method Patient or Public Contribution To refine and validate an electronic version of the Aggressive Behaviour Risk Assessment Tool (ABRAT) and determine the sensitivity and specificity for identifying potentially violent patients in non‐psychiatric inpatient units.A prospective cohort study design was used.All patients admitted or transferred to three inpatient units of an acute care hospital in Nebraska, USA, from 7 February to 9 April 2023, were included. The 10‐item ABRAT assessments were performed daily for the first 3 days of admission. The violent events were collected until discharge in three categories: Physical aggression towards others, physical aggression towards property and verbal intimidation/threat towards others. Kendall's tau tests and a multivariate logistic regression procedure were performed to select a parsimonious set of items that best predict violent events.Of 1179 patients, 69 had ≥1 violent event (5.9%). The revised six‐item tool with item weighting was named ABRAT for Hospitalised Patients (ABRAT‐H). The area under the curve from the Receiver Operating Characteristics analysis was 0.82. The sensitivity and specificity at a cutoff score of two were 68.1% and 85.2%, respectively. As ABRAT‐H scores increased, the percentage of violent patients also increased and for patients with scores ≥5, 55.2% became violent.ABRAT‐H appears to be useful for identifying potentially violent patients in non‐psychiatric inpatient units with satisfactory sensitivity and specificity.The availability of ABRAT‐H may help provide focused preventive measures that target patients at high risk for violence and reduce violent events.A majority of the nursing workforce is employed in acute care hospital setting, and the availability of ABRAT‐H can further enhance the culture of a safe work environment and have positive impacts not only on the nurses' physical and mental health but also on the quality of patient care.We have adhered to relevant STROBE guidelines for reporting observational studies.No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Background and Objectives Social frailty is an emerging concept characterized by state of vulnerability due to the lack or absence of social resources that enable health and well-being, particularly among older people. However, there is no consensus on how to accurately measure and assess social frailty, given the broad coverage of social dimensions affecting older individuals. This scoping review aimed to identify the existing tools and scales used to measure social frailty in older people. Research Design and Methods A scoping review methodology was employed. Articles published between January 2014 and April 2024 were searched in 6 electronic databases: PubMed, PsycINFO, ProQuest, Scopus, SocIndex, and CINAHL. The scoping review followed a 5-stage process by Arksey and O'Malley and adhered to the guidelines provided by Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Results Nine social frailty tools were identified across the 58 papers included in this review. The individual question item commonly used in the scales were classified into main categories based on their conceptual characteristics and intentions. The most common individual questionnaire constructs used to measure social frailty included financial status, social resources, social behaviors and activities, and sense of purpose. The reviewed tools varied in terms of their robustness and the process of scale development. Discussion and Implications Our review suggested the development of a standardized, psychometrically tested, and accurate screening tool to screen social frailty status. An accurate social frailty assessment can inform the development of useful interventions, which also has implications in preventing the development of physical frailty. [ABSTRACT FROM AUTHOR]

Introduction: Cervical cancer is one of the leading causes of cancer death among females worldwide and its behaviour epidemiologically likes a venereal disease of low infectiousness caused by HPV. Early age at first intercourse and multiple sexual partners have been shown to exert strong effects on risk. Aim & Objective: To study the role of pap smear as a screening tool for cervical cancer among healthcare workers. Materials and Methods: A Prospective Study conducted on sexually active women. Data collected regarding history, complaints and pap smear reports. Results: In our present study 46.2%women screened for cervical cancer belong to 31-40 age group and 37% women belong to 41-50 age group and remaining age group constitute less. Cytology report 55.5% Negative for Inflammatory smear and 20% had inflammatory smear with reactive atypia. Among cytology reports LSIL constituted 5.5% of which belong to age group 41 and above and 1.8% HSIL belong to age group 31-40. In our study second parity constituted 52.3% followed by first parity 13.2%.Majority were asymptomatic 46.2% and symptoms like irregular menstrual cycles constituting 18.5% and white discharge and amenorrhea constituting 9.25% in our study group. Conclusion: Pap smear testing is an effective, simple, affordable, and safe method for detecting precancerous lesions of cervix. It is available at free of cost in government hospitals. It should be implemented as a routine screening procedure to lessen the burden of treatment, as well as reduce morbidity and mortality related to cervical cancer. [ABSTRACT FROM AUTHOR]

Background: Both diabetes and osteoporosis have developed into major global public health problems due to the increasing aging population. It is crucial to screen populations at higher risk of developing osteoporosis for disease prevention and management in postmenopausal women with type 2 diabetes (T2D). This study aims to quantitatively investigate the association between risk factors and bone mineral density (BMD) and develop a self-assessment tool for early osteoporosis screening in postmenopausal women with T2D. Methods: We retrospectively enrolled 1,309 postmenopausal women with T2D. Linear regression methods were used to assess the association between risk factors and BMD. Additionally, a multivariate logistic regression analysis was performed to identify independent risk factors associated with osteoporosis. Utilizing the logistic regression machine learning algorithm, we developed an osteoporosis screening tool that categorizes the population into three risk regions based on age and body mass index (BMI), indicating low, moderate, and high prevalence of osteoporosis in the age-BMI plane. Results: Older age and lower BMI were independently associated with decreased BMD. The BMD at the total hip, femur neck, and lumbar spine differed by 12.9, 10.9, and 15.5 mg/cm2 for each 1 unit increase in BMI, respectively. Both age and BMI were identified as independent predictors of osteoporosis. The osteoporosis screening tool was developed by using two straight lines with equations of BMI = 0.56 * age−4.12 and BMI = 0.56 * age−10.88; there were no significant differences in the prevalence of osteoporosis among the training, internal test, and external test datasets in the low-, moderate-, and high-risk regions. Conclusion: We have successfully developed and validated a self-assessment tool for early osteoporosis screening in postmenopausal women with T2D for the first time. BMI was identified as a significant modifiable risk factor. Our study may improve awareness of osteoporosis and is valuable for disease prevention and management for postmenopausal women with T2D. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to develop and validate items for the Screen of Cancer. Survivorship – Occupational Therapy Services (SOCS-OTS), a patient-driven screening tool to be used by frontline workers and filled out by cancer survivors that can indicate a need for appropriate occupational therapy (OT) referral. Methods: Five rounds of a classical Delphi study were conducted to determine item inclusion. Expert panelists in rounds 1 and 2 consisted of adults LWBC who verified proposed items relevant to issues in activities of daily living (ADLs). Expert panelists in rounds 3–5 consisted of expert OTs who determined item relevance through consensus and item modification. Results: Forty-five adults living with and beyond cancer (LWBC) and 14 expert oncology occupational therapists and researchers participated in five rounds of surveys. A total of 20 items reached consensus at 80% with a "check all that apply" format. Items included address ADLs meaningful to adults LWBC. Conclusions: The SOCS-OTS is an innovative content-valid screening tool designed to identify problems with ADLs relevant to OT referral. Implications for cancer survivors: The SOCS-OTS can empower cancer survivors and cancer care teams by indicating when daily activities are impacted enough to refer to OT services. This could ensure that cancer survivors receive the rehabilitation services they need. [ABSTRACT FROM AUTHOR]

Objectives: To develop a tool to assess pre-writing skills of 2-5 y old children in India. Methods: The tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10th, 25th, 50th, 75th, 90th). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10th-90th age-percentile bars. Results: The final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings. Conclusions: A 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established. [ABSTRACT FROM AUTHOR]

Background: This study aimed to determine the initial content validity and clinical utility of Mealtime Screening for School (MEALSS), a new screening tool that measures mealtime participation in students with intellectual and developmental disabilities 5 to 10 years of age. Methods: To determine the content validity of MEALSS, the researchers recruited five participants identified as pediatric occupational therapists and/or feeding experts to review the MEALSS. Item level content validity index (I-CVI) and scale level validity (S-CVI) were calculated, as well as modified kappa indices to reduce the probability of chance agreement. MEALSS was then revised based on feedback from the content experts. To determine the clinical utility of MEALSS, 20 school-based occupational therapists were recruited to assess the clinical usage of the revised version of the tool. The responses were thematized and analyzed. Results: Content experts rated 17 out of the 18 MEALSS items essential in assessing mealtime participation in the school setting. The majority of the clinician participants indicated a favorable response to the clinical utility of the tool, ease of use, and accuracy in identifying and measuring mealtime challenges in the school setting. Conclusion: The study provided useful perspectives on how the tool can be further improved to measure mealtime participation in school-aged children. [ABSTRACT FROM AUTHOR]

IntroductionSleep-disordered breathing (SDB) is considered the second most common chronic health condition in children. Untreated SDB is associated with long-term health consequences. Our objective was to translate the Pediatric Sleep Questionnaire (PSQ) into Lithuanian and culturally adapt and validate the translated version in order to improve the diagnosis of SDB in Lithuanian children.MethodsTranslations and cultural adaptations were performed to generate a Lithuanian version of the PSQ. Psychometric analysis was conducted on 112 Lithuanian children aged 2–17 years. All patients underwent overnight polysomnography.ResultsThe Lithuanian PSQ showed good internal consistency (Cronbach's alpha = 0.816). Lithuanian PSQ responses administered 14–30 days apart were strongly correlated (r = 0.924, p

Background Normal saline is commonly used for resuscitation in sepsis patients but has a high chloride content, potentially increasing the risk of acute kidney injury (AKI). This study evaluated risk factors and developed a predictive risk score for AKI in sepsis patients treated with normal saline. Methods This retrospective cohort study utilized the medical and electronic health records of sepsis patients who received normal saline between January 2018 and May 2020. Predictors of AKI used to construct the predictive risk score were identified through multivariate logistic regression models, with discrimination and calibration assessed using the area under the receiver operating characteristic curve (AUROC) and the expected-to-observed (E/O) ratio. Internal validation was conducted using bootstrapping techniques. Results AKI was reported in 211 of 735 patients (28.7%). Eight potential risk factors, including norepinephrine, the Acute Physiology and Chronic Health Evaluation II score, serum chloride, respiratory failure with invasive mechanical ventilation, nephrotoxic antimicrobial drug use, history of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers use, history of liver disease, and serum creatinine were used to create the NACl RENAL-Cr score. The model demonstrated good discrimination and calibration (AUROC, 0.79; E/O, 1). The optimal cutoff was 2.5 points, with corresponding sensitivity, specificity, positive predictive value, and negative predictive value scores of 71.6%, 72.5%, 51.2%, and 86.4%, respectively. Conclusions The NACl RENAL-Cr score, consisting of eight critical variables, was used to predict AKI in sepsis patients who received normal saline. This tool can assist healthcare professionals when deciding on sepsis treatment and AKI monitoring.

Abstract Objective To evaluate the Refractory Epilepsy Screening Tool for Lennox–Gastaut Syndrome (REST‐LGS) for real‐world identification of LGS in adults and to develop a scoring system for the tool. Methods A retrospective chart review of adults with drug resistant epilepsy (DRE) and intellectual development disorder (IDD) was conducted by 2 primary care providers blinded to diagnosis. The REST‐LGS was designed via the Modified Delphi Consensus and was previously validated. This tool consists of 8 criteria (4 major, 4 minor) considered indicative of LGS. To account for missing data in the earlier validation study and to evaluate applicability in a real‐world setting, the REST‐LGS was refined to include a scoring system in which major criteria were more heavily weighted than minor criteria, producing categories of “likely” (>11 points), “possible” (8–11 points), and “unlikely” (

Introduction: Hypermobility spectrum disorders (HSD) and hypermobile Ehlers-Danlos syndrome (hEDS) are often accompanied by varied and complex multisystemic comorbid symptoms/conditions. The Spider questionnaire was developed to evaluate the presence and impact of eight common multisystemic comorbidities. Thirty-one questions across eight symptom domains assess neuromusculoskeletal, pain, fatigue, cardiac dysautonomia, urogenital, gastrointestinal, anxiety, and depression symptoms. This study aimed to evaluate the Spider's construct validity in adults. Method: A cross-sectional observational study was conducted over four stages. Three international patient charities aided recruitment of participants through social media and website advertisements. Adults aged 18 to 65 years, with and without HSD/hEDS, were invited to participate. Validated, frequently used comparator questionnaires were used to establish convergent validity of Spider symptom domains. A control group was recruited for known-group validity analysis. Participants answered each Spider domain and the corresponding comparator questionnaire via surveys hosted by REDCap. Anonymous data were analysed using SPSS. Convergent validity was assessed through Spearman's correlational analysis and known-group validity through Mann–Whitney U analysis. Results: A total of 11,151 participants were recruited across the four stages. Statistically significant, moderate-to-strong correlations were found between all Spider domains and their comparators (p < 0.001, r = 0.63 to 0.80). Known-group validity analysis showed statistically significant differences (p < 0.001) between the hypermobile and control groups in all eight domains. Conclusions: Convergent and known-group validity of the Spider was established with adults. These results suggest the Spider can measure the presence and impact of multisystemic comorbid symptoms/conditions in adults with HSD/hEDS, providing a tool which guides multidisciplinary management. Key Points • The Spider questionnaire is a novel tool assessing the presence and impact of the multisystemic comorbid symptoms/conditions associated with HSD/hEDS. • Convergent and known-group validity of the Spider questionnaire was established in adults aged 18 to 65. • This tool provides a quick and easy method to visualise the symptom profile of those with HSD/hEDS to guide symptom management. [ABSTRACT FROM AUTHOR]

Communimetric screening tools help clinicians identify and communicate their patient's areas of need and the corresponding level of action. However, few tools exist to identify mental health (MH) and developmental needs in young children. We aimed to implement and evaluate a new communimetric MH and developmental screening tool for children under 6 (HEADS‐ED Under 6) in a community MH agency in Ontario, Canada. Using a prospective cohort design, we explored how intake workers used the HEADS‐ED Under 6 screening tool from November 2019 to March 2021. 94.5% of children (n = 535/566) were screened with the HEADS‐ED at intake. Total HEADS‐ED scores and domains were used to inform the intensity of recommended services. Three clinical domains (Eating & sleeping, Development, speech/language/motor, and Emotions & behaviors) also independently predicted a priority recommendation. The tool showed good concordance with the InterRAI Early Years for children under 4 years old. The HEADS‐ED Under 6 was a brief, easy, and valid screening tool, and can be used to identify important MH and developmental domains early, rate level of action/impairment, communicate severity of needs, and help determine intensity of service required. [ABSTRACT FROM AUTHOR]

Gaming Disorder was included as an addictive disorder in the latest version of the International Classification of Diseases (ICD-11), published in 2022. The present study aimed to develop a screening tool for Gaming Disorder, the Gaming Disorder Identification Test (GADIT), based on the four ICD-11 diagnostic criteria: impaired control, increasing priority, continued gaming despite harm, and functional impairment. We reviewed 297 questionnaire items from 48 existing gaming addiction scales and selected 68 items based on content validity. Two datasets were collected: 1) an online panel (N = 803) from Australia, United States, United Kingdom and Canada, split into a development set (N = 589) and a validation dataset (N = 214); and 2) a university sample (N = 408) from Australia. Item response theory and confirmatory factor analyses were conducted to select eight items to form the GADIT. Validity was established by regressing the GADIT against known correlates of Gaming Disorder. Confirmatory factor analyses of the GADIT showed good model fit (RMSEA=<0.001–0.108; CFI = 0.98–1.00), and internal consistency was excellent (Cronbach's alphas = 0.77–0.92). GADIT scores were strongly associated with the Internet Gaming Disorder Test (IGDT-10), and significantly associated with gaming intensity, eye fatigue, hand pain, wrist pain, back or neck pain, and excessive in-game purchases, in both the validation and the university sample datasets. The GADIT has strong psychometric properties in two independent samples from four English-speaking countries collected through different channels, and shown validity against existing scales and variables that are associated with Gaming Disorder. A cut-off of 5 is tentatively recommended for screening for Gaming Disorder. [ABSTRACT FROM AUTHOR]

This study aimed to examine the reliability and validity of a newly developed questionnaire for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). The aim was to contribute to future standardisation of screening methods for symptoms and comorbidity, as well as the measurement of symptom severity, daily life impairment, and treatment effectiveness in individuals diagnosed with PANDAS/PANS. 27 items from the PANDAS/PANS questionnaire concerning symptoms and comorbidities associated with PANDAS/PANS were divided into ten domains. To assess the external validity, 119 PANDAS/PANS questionnaires from a cohort of 65 children with PANDAS/PANS were correlated with three well-known validated questionnaires: the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Attention Deficit Hyperactivity Disorder Rating Scale (ADHD-RS), and the Strengths and Difficulties Questionnaire (SDQ). The internal validity of the PANDAS/PANS questionnaire was assessed by correlating the PANDAS/PANS items with the domains. Internal consistency of the PANDAS/PANS questionnaire was high, measuring moderate to very strong correlations. The external correlations for the PANDAS/PANS questionnaire showed a higher correlation with the ADHD-RS and CY-BOCS (r s ≥ 0.60) than with the SDQ (r s < 0.40). The validity and clinical feasibility of the PANDAS/PANS questionnaire were confirmed as an effective tool for screening symptoms, assessing symptom severity, and evaluating comorbidity and daily life impairment in individuals with PANDAS/PANS. These findings can potentially enhance the management of PANDAS/PANS patients in both clinical and research settings. • A new PANDAS/PANS questionnaire is an effective tool for screening symptoms. • Correlated with validated questionnaires with strong external correlations. • High internal consistency across ten PANDAS/PANS domains. • Potentially enhances the management of PANDAS/PANS patients. [ABSTRACT FROM AUTHOR]