Standardized Screening Tools Research Articles

Using the VES-13 score for risk stratification in outpatient heart failure management to predict mortality

Abstract Background We have previously demonstrated the efficacy of the Vulnerable Elders Survey-13 (VES-13) as a valuable tool for identifying frailty and predicting outcomes, such as mortality and hospitalisations, in heart failure (HF) outpatients when frailty is detected using a cut-off value of ≥3. Purpose This study aims to assess whether scores obtained from the VES-13, beyond its initial use with a frailty diagnosis threshold, enable a more precise categorization of mortality risk among heart failure outpatients. Methods Nurses administered the VES-13 during patients' initial consultations. We examined a sample of 331 patients, analyzing their main characteristics and individual VES-13 scores. VES-13 scores were categorized into quintiles for risk assessment. Results A total of 331 outpatients were prospectively included in the study. Patient characteristics were as follows: mean age of 69.85±11.96 years, 68% males, 67.6% in NYHA class II, and 25.7% in class III; ischemic aetiology was the most common (42%), and the mean left ventricular ejection fraction (LVEF) was 38.79±13.58. The VES-13 mean’s score was 2.67±2.81. Quintile 1 corresponded to a VES-13 score of 0, quintile 2 to score of 1, quintile 3 to score of 2, quintile 4 to scores of 3 or 4, and quintile 5 to a VES-13 score of 5 points or higher. During a follow-up period of 17.6±6.6 months (up to 24 months), 41 patients died (12.4%). After adjusting for sex, LVEF and ischemic aetiology stratifying VES-13 scores into quintiles allowed us to observe an accurate stratification of the risk of death with a statistically significant relationship between higher VES-13 quintiles and higher mortality (p=0.001) (Figure 1). Indeed, quintiles 4 and 5 were showed a very high hazard of risk of death compared to quintile 1 group (HR 6.97 [1.53, 31.65], p=0.012 for quintile 4; and HR 12.17 [2.77, 53.54], p=0.001 for quintile 5). Conclusions The VES-13, a standard screening tool in our heart failure clinic for identifying frailty, demonstrated the ability, when divided in quintile groups, of accurately stratify the risk of death over a follow-up period of up to two years.

84 Methods to screen caregivers for previous and current substance use in the paediatric office: A scoping review

Abstract Background Paediatric healthcare providers have been shown to miss opportunities to screen caregivers for substance use. Individuals who use or have used substances face general healthcare barriers and may disengage with the system to avoid stigma or discrimination. Poorly worded or administered substance use screening practices by paediatricians could lead to retraumatization or judgment of caregivers that may affect the ability to continue providing healthcare to the child. There is limited information in the literature regarding best approaches for screening caregivers for substance use in paediatrics. Objectives The unique objective of this review was to identify current methods for, approaches to, and acceptability of caregiver substance use screening in paediatric offices. Design/Methods Searches were performed in CINAHL, PsycInfo, MEDLINE, and Social Sciences Abstracts databases with results limited from 2000 to 2023. Keywords included “perinatal”, “postnatal” “paediatric OR paediatric”, “substance use” OR “substance abuse” OR substances OR “alcohol use” OR “alcohol abuse” OR “addiction”, AND “screening”. Studies must have been conducted in Canada, the USA, Australia, or Scandinavia. Literature that was published in a language other than English, described screening caregivers for substance use using biological samples, or that focused solely on screening pregnant caregivers for substance use was excluded. Individual approaches to and provider and patient perspectives on screening were identified. Three authors completed title, abstract, and full text screening in Covidence screening software. Qualitative thematic coding identified geographical setting, the specific paediatric clinical setting, substances for which each study screened, characteristics of the participants, method of screening, and feedback related to acceptability, outcomes, or methods of screening. Results Practitioners used standardized and informal substance use screening tools. This review found that paediatric practitioners reported gaps in guidance on how best to screen caregivers for substance use and a desire for more improvement. Lack of guidance made it uncomfortable to screen caregivers. Increased comfort with screening was noted when a social needs survey was used as guidance. Caregivers were generally highly comfortable being screened for substance use and felt it was an acceptable action for paediatricians to undertake. However, the input of families in caregiver substance use screening methods was otherwise lacking. Substance use questions were often paired with questions asking caregivers to rate acceptability while other studies simply used the openness of being approached or absence of objections as acceptance of being screened. None of the studies identified in this review included the ability for families to participate more fully in screening acceptability or design. Conclusion Family engagement in research regarding the ideal acceptability and design of screening methods is lacking while paediatric healthcare providers continue to be uncomfortable screening caregivers for substance use and wish for improved methods that facilitate trust with families. Further research into the design of trauma-informed caregiver substance use screening in paediatric settings may be needed.

Identifying Child Abuse in Patients With Femur Fractures Through Pathway Compliance: A Pilot Study.

Background Child abuse is a significant cause of morbidity and mortality in children. A thorough history and physical exam is critical to identifying abuse. Standardized screening tools as well as clinical pathways can assist with identifying patients who may have an injury secondary to abuse. There are varied recommendations for the upper age in which to routinely evaluate pediatric patients for child abuse. Objectives The primary objective of this study was to describe the outcomes of the implementation of an evidence-based clinical pathway for suspected non-accidental trauma for all pediatric patients aged five years and under presenting with a femur fracture. This pathway includes orders for imaging, labs, and consults. In addition, the characteristics of this population and the findings were described. Methods A retrospective study of patients at a single institution who met the National Trauma Data Standard registry inclusion criteria and had a femur fracture was performed. Variables analyzed included age, demographics, mechanism and location of injury, admission status and service, injury severity, hospital characteristics, and discharge status. Patients with a metabolic bone disease were excluded. Results There were 200 patients who met the inclusion criteria. Thirty-two patients had a diagnosis of confirmed or suspected child abuse. While all 32 patients had a skeletal survey performed, only 23 (71.9%) had the complete workup per the clinical pathway, and 21 (65.6%) had a diagnosis of confirmed child abuse. Conclusion Clinical pathways are established to provide the standardization of clinical assessments and interventions; however, this process relies on a single individual to make a judgment determining whether or not to implement the pathway. Children presenting to an emergency department with confirmed or suspected child abuse are a vulnerable population. A child abuse diagnosis is a clinical judgment; however, clinical pathways aid in the diagnosis in hopes to stop any further abuse. For a pathway to be successful, each step needs to be addressed.

Partnering for Progress: Lessons Learned From Mental Health Assessment for Youth Living With HIV in India Through Community-Based Participatory Research

Youth living with HIV (YLHIV) face diverse mental health challenges necessitating interventions informed by their lived experiences. Failure to do so can perpetuate a self-reinforcing cycle of misaligned and ineffective support, further exacerbating existing vulnerabilities. This study directly addresses this gap by using a community-based participatory research (CBPR) approach to empower YLHIV in India to address their mental health challenges. YLHIV actively participated in adapting and implementing a culturally responsive mental health screening program. The study, incorporating CBPR principles at every step aimed to identify practical methods for integrating YLHIV voices in research, and showcase the value of YLHIV participation in co-creating and implementing impactful interventions. Six youth investigators aged 18-24, born with HIV and residing in southern Indian states underwent certification in human subjects’ protection and training in mental health screening and survey administration techniques. They actively shaped the research process by culturally adapting standardized mental health screening tools (PHQ-9, GAD-7) through iterative discussions with experts, drawing on their own perspectives. Following field assessments of the mental health screening tools among their peers, they documented their reflections in surveys and written essays. Youth investigators’ involvement improved the research process by optimizing tools, combating stigma, and facilitating reliable data collection. Beyond data collection, the youth investigators’ participation significantly boosted their own knowledge, self-confidence, and research skills. This study serves as an illustrative model of CBPR in mental health research among YLHIV, highlighting the importance of interactive training, continuous feedback mechanisms, and respectful youth engagement in fostering impactful research that can inform tailored sustainable interventions.

Baseline practice-level financial screening processes and resources among Children’s Oncology Group National Cancer Institute Community Oncology Research Programs (NCORP).

34 Background: Financial toxicity is an increasingly recognized and prevalent adverse effect during cancer treatment. Systematic financial screening is recommended for families of children with cancer, and emerging data support the importance of system-level support and interventions to mitigate financial toxicity. Financial distress is a key, measurable domain of financial toxicity. Methods: To inform interventions for pediatric oncology settings, we are conducting ACCL20N1CD, a Children’s Oncology Group (COG) prospective, multilevel observational study among NCORP practices in the US, to determine the risk and trajectory for financial distress in guardians of children with newly diagnosed acute lymphoblastic leukemia. We analyzed baseline survey data from COG NCORP practices that enrolled at least one parent. Data were collected via REDCap following the practice’s first parent enrollment. We describe practice participation patterns, current approaches to financial screening, and available resources to address identified needs including navigation. Results: Of 50 eligible COG NCORP practices, 40 (80%) activated the study, and 28 (56%) enrolled at least 1 participant and thus, completed the survey. Most (61%) of these practices treated 50-99 new pediatric oncology patients annually; 10 (36%) enrolled at least 5 participants in ACCL20N1CD. Twenty (71%) reported that their practice routinely conducted financial screening in addition to insurance assessment; 15 (75%) of these 20 practices conducted financial screening at more than one timepoint. Social workers were primarily responsible for screening (16/20; 80%). Only three practices (3/28; 11%) used a standardized financial screening tool. Most practices had access to a private foundation/organization (25/28, 89%), institutional support (23/28, 82%), or local referrals to organizations (22/28, 78%) that provided financial support for patients/families. Fewer practices had patient navigators (9/28, 32%), financial navigators (8/28, 28%), or legal advocates (3/28, 11%) available to assist families. Conclusions: Though most COG practices treating children of parents enrolled in 20N1CD conduct financial screening, processes are not standardized, and resources available to address identified needs and potentially mitigate financial toxicity vary. Further, these data represent enrolling sites which may overestimate screening practices within COG NCORP practices. Variations in financial screening procedures and lack of individual-level resources to facilitate screening may impact delivery of equitable high-quality cancer care across NCORP COG practices. Clinical trial information: NCT04928599 .

Food Insecurity Screening and Referral Practices of Pediatric Clinicians in Metropolitan Washington, DC.

In 2022, 17.3% of US households with children experienced food insecurity (FI). The objective of this study was to examine pediatric clinicians' FI screening and management immediately following the release of the American Academy of Pediatrics (AAP) 2015 FI Policy Statement. Data were collected in 2016 from 85 primary care pediatric clinicians via an online survey of clinicians in the Washington, DC metropolitan area. Descriptive statistics were calculated using univariate/bivariate analyses. Fisher's exact test and Chi-square tests were used to explore the association between FI screening, health insurance, and clinician demographics. Sixty-six percent of clinicians indicated that they infrequently screened for FI. Only 13% of clinicians used a standardized FI screening tool. Forty-five percent of clinicians screened for FI only when they perceived an acute concern. About 70% of them screened for FI when a patient presented with poor weight gain or was underweight. Immediately after the release of the AAP Policy Statement, it was found that few pediatric clinicians appropriately and frequently screened for FI in our regional sample. Our data emphasize the common misconceptions held by clinicians around FI and the necessity to incorporate training that underscores the invisibility of FI along with effective techniques to screen and intervene.

Story Recall in Peer Conflict Resolution Discourse Task to Identify Older Adults Testing Within Range of Cognitive Impairment.

The current study used behavioral measures of discourse complexity and story recall accuracy in an expository discourse task to distinguish older adults testing within range of cognitive impairment according to a standardized cognitive screening tool in a sample of self-reported healthy older adults. Seventy-three older adults who self-identified as healthy completed an expository discourse task and neuropsychological screener. Discourse data were used to classify participants testing within range of cognitive impairment using multiple machine learning algorithms and stability analysis for identifying reliably predictive features in an effort to maximize prediction accuracy. We hypothesized that a higher rate of pronoun use and lower scores on story recall would best classify older adults testing within range of cognitive impairment. The highest classification accuracy exploited a single variable in a remarkably intuitive way: using 66% story recall as a cutoff for cognitive impairment. Forcing this decision tree model to use more features or increasing its complexity did not improve accuracy. Permutation testing confirmed that the 77% accuracy and 0.18 Brier skill score achieved by the model were statistically significant (p < .00001). These results suggest that expository discourse tasks that place demands on executive functions, such as working memory, can be used to identify aging adults who test within range of cognitive impairment. Accurate representation of story elements in working memory is critical for coherent discourse. Our simple yet highly accurate predictive model of expository discourse provides a promising assessment for easy identification of cognitive impairment in older adults. https://doi.org/10.23641/asha.26543824.

A systematic review of postpartum psychosis resulting in infanticide: missed opportunities in screening, diagnosis, and treatment.

Impacting 1 in 1000 women, untreated postpartum psychosis is associated with a 4% infanticide rate. This systematic review aims to identify factors that are associated with infanticide resulting from psychosis in the puerperal period and pinpoint areas of missed opportunity for intervention. A systematic literature review was conducted in accordance with PRISMA guidelines to identify and synthesize cases of maternal infanticide among perinatal females with evidence of postpartum psychosis. Four independent reviewers screened 231 articles identified in searches of three databases (PsycInfo, PubMed, and Web of Science) for studies conducted from 2013 to 2023. Twelve studies were included in the final review. Findings indicate that those experiencing puerperal psychosis have increased incidence of infanticide suggesting missed opportunities for intervention and treatment. Common factors in mothers who committed infanticide as a result of delusions and/or hallucinations associated with PMADs were identified, including lack of standardized screening tools, preference for traditional and/or cultural healing practices, and access to care. The current body of evidence supports developing and evaluating clinical interventions aimed at improving maternal mental health outcomes and infant outcomes in perinatal women experiencing puerperal psychosis.

Interventions promoting resilience through climate smart agricultural practices for women farmers: A systematic review.

Climate change poses a significant threat to agricultural production worldwide, with developing countries being particularly vulnerable to its negative impacts. Agriculture, which is a crucial factor in ensuring food security and livelihoods, is particularly vulnerable to changes in climate patterns, such as increased temperatures, drought, and extreme weather events. One approach to addressing these challenges is by promoting the adoption of climate-smart agriculture (CSA) practices among farmers. CSA combines traditional agricultural practices with innovative techniques and technologies to adapt to and mitigate the impacts of climate change. infrastructure. By adopting CSA practices, farmers can enhance their resilience to climate variability and improve their productivity. This review examines the effectiveness of interventions promoting CSA to enhance farmers' knowledge of the benefits of CSA approaches, subsequent adoption of CSA, and disadoption of harmful agricultural practices in low- and middle-income countries (LMICs). We searched 39 academic and online databases, websites, and repositories and screened over 19,000 experimental and quasi-experimental publications to identify studies promoting CSA practices to women farmers. We conducted a citation tracking process on included studies and contacted experts to ensure a thorough search. The review focused on studies that included interventions promoting climate-smart agricultural approaches. Using EPPI Reviewer 4, two review authors independently screened the impact evaluation using a standardized screening tool. Information about participant characteristics, intervention characteristics, control conditions, research design, sample size, bias risk, outcomes, and results were gathered. Data collection and quantitative analysis were conducted using standard Campbell Collaboration methods. Eight impact evaluations were found (two randomized controlled trials) evaluating the effects of CSA practices on farmer's knowledge gains of the benefits of CSA practices and subsequent adoption. Knowledge dissemination approaches such as Farmer Field Schools and weather and climate information services were found to positively impact farmers' knowledge and adoption of specific CSA practices. However, the evidence supporting this claim is uncertain as a high risk of bias was assessed for five of the eight included studies. However, we found no effects on the disadoption of harmful practices such as pesticide overuse. The evidence base for studies promoting climate-smart agricultural approaches (CSA) to farmers in LMICs is small, and there is a lack of studies reporting sex-disaggregated data and studies explicitly targeting women farmers. The review suggests that knowledge dissemination techniques are significantly effective in improving CSA knowledge and adoption, including integrated pest management techniques and their benefits, adoption of climate-resilient rice seed varieties (STRVs), and use of botanical pesticides by farmers. More and better confidence studies are needed to inform policy and programming, including those that look at a wider range of interventions, including changing norms, values, and institutional arrangements.

Measuring Social Frailty: A Scoping Review of Available Scales and Tools.

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. 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. 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. 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.

Genetic Counselors' attitudes & perceptions regarding suicide risk assessment and identification in practice.

While the heritability of suicidal tendencies is debated, receipt of various genetic diagnoses has shown an increased risk of suicidal ideation and behavior while simultaneously conferring risk to mental health concerns that may further increase this risk. However, the role of genetic counselors (GCs) in assessing and addressing suicide risk remains underutilized. A 15-item recruitment survey was distributed via the National Society of Genetic Counselors Student Research Survey Listserv, and interested individuals could opt to be contacted for an interview after completion. The data analysis included 107 survey responses and 15 semi-structured interviews, which were conducted to explore whether GCs feel that formal suicide risk assessment (SRA) falls within their scope of practice and the frequency with which it is employed during counseling sessions. Additionally, the study examined GCs' experiences, comfort levels, and training in assessing for suicide risk. All interviews were transcribed verbatim and independently coded by two researchers. The coding scheme was systematically constructed, integrating both deductive and inductive coding methods to inform the authors' interpretive description of SRA in the clinic, with four major themes identified by content analysis. Most respondents reported that they had worried about a patient harming themselves or having suicidal thoughts. Most respondents agreed or strongly agreed that SRA is within a GC's scope of practice. Lack of training emerged as the primary barrier to assessing suicide risk and conducting risk assessments. Other barriers included low self-efficacy, societal stigma, and personal discomfort, while access to social workers, natural inclination, and standardized screening tools served as facilitators. Despite encountering patients at risk of self-harm and suicide, most GCs do not utilize SRA tools. Furthermore, GCs expressed a strong desire for additional training to enhance their skills in identifying and managing at-risk patients. A multifocal approach to suicide risk reduction and education is required.

Diagnostic accuracy, reliability, and construct validity of the German quick mild cognitive impairment screen

BackgroundEarly detection of cognitive impairment is among the top research priorities aimed at reducing the global burden of dementia. Currently used screening tools have high sensitivity but lack specificity at their original cut-off, while decreasing the cut-off was repeatedly shown to improve specificity, but at the cost of lower sensitivity. In 2012, a new screening tool was introduced that aims to overcome these limitations – the Quick mild cognitive impairment screen (Qmci). The original English Qmci has been rigorously validated and demonstrated high diagnostic accuracy with both good sensitivity and specificity. We aimed to determine the optimal cut-off value for the German Qmci, and evaluate its diagnostic accuracy, reliability (internal consistency) and construct validity.MethodsWe retrospectively analyzed data from healthy older adults (HOA; n = 43) and individuals who have a clinical diagnosis of ‘mild neurocognitive disorder’ (mNCD; n = 37) with a biomarker supported characterization of the etiology of mNCD of three studies of the ‘Brain-IT’ project. Using Youden’s Index, we calculated the optimal cut-off score to distinguish between HOA and mNCD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic accuracy based on the area under the curve (AUC). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Reliability (internal consistency) was analyzed by calculating Cronbach’s α. Construct validity was assessed by analyzing convergent validity between Qmci-G subdomain scores and reference assessments measuring the same neurocognitive domain.ResultsThe optimal cut-off score for the Qmci-G was ≤ 67 (AUC = 0.96). This provided a sensitivity of 91.9% and a specificity of 90.7%. The PPV and NPV were 89.5% and 92.9%, respectively. Cronbach’s α of the Qmci-G was 0.71 (CI95% [0.65 to 0.78]). The Qmci-G demonstrated good construct validity for subtests measuring learning and memory. Subtests that measure executive functioning and/or visuo-spatial skills showed mixed findings and/or did not correlate as strongly as expected with reference assessments.ConclusionOur findings corroborate the existing evidence of the Qmci’s good diagnostic accuracy, reliability, and construct validity. Additionally, the Qmci shows potential in resolving the limitations of commonly used screening tools, such as the Montreal Cognitive Assessment. To verify these findings for the Qmci-G, testing in clinical environments and/or primary health care and direct comparisons with standard screening tools utilized in these settings are warranted.

Improving Quality of Care for Status Epilepticus: Putting Protocols into Practice.

Timely treatment of status epilepticus (SE) improves outcomes, however gaps between recommended and implemented care are common. This review analyzes obstacles and explores interventions to optimize effective, evidence-based treatment of SE. Seizure action plans, rescue medications, and noninvasive wearables with seizure detection capabilities can facilitate early intervention for prolonged seizures in the home and school. In the field, standardized EMS protocols, EMS education, and screening tools can address variability in SE definitions and treatment, particularly benzodiazepine dosing. In the emergency room and hospital, provider education, SE order sets and alerts, and rapid EEG technologies, can shorten time to first-line therapy, second-line therapy, and EEG initiation. Widespread, sustained improvement in SE care remains challenging. A multipronged approach including emphasis on pre-hospital intervention, treatment protocols adapted to local contexts, and SE databases to systematically collect process and outcome metrics have the potential to transform SE treatment and outcomes.

The role of maternal and child healthcare providers in identifying and supporting perinatal mental health disorders.

Perinatal depression (PND) is underdiagnosed in the clinical setting. This study explores the role of obstetricians, and other primary care providers of maternal and child healthcare in detecting, screening, and referring women during the perinatal period identified as depressed, anxious, or exhibiting other symptoms of mental health disorders. Information was gathered from obstetricians (n = 16), and other primary care providers (pediatricians, nurse practitioners, physician assistants) (n = 85), on identifying and supporting childbearing women with symptoms of perinatal depression using an online survey. Statistical comparisons across participant groups were adjusted for years of practice in the profession. Statistically significant differences were noted. Obstetricians inquired more about the mother's social support network (p = .011) and addressed mothers that appeared sad, upset, or unhappy (p = .044) compared to other primary care providers. Other primary care providers were more likely to refer patients to mental health support services (p = .005), provide PND-related information in their waiting rooms (p = .008), and use the Edinburgh Postnatal Depression Scale (EPDS) (p = .027). There was also a significant difference in positively identifying eight symptoms of PND between provider groups. Obstetricians had higher rates of identifying the following symptoms: excessive crying (p < .001), feeling little or no attachment to the infant (p < .001), little feeling of enjoyment (p = .021), feelings of failure (p < .001), hopelessness (p < .001), agitation with self and infant (p < .001), fear of being alone with the infant (p = .011), and fear that these symptoms would last (p < .001). Although certain screening practices were performed well, especially by the obstetrician group, screening deficits were noted within each group, and screening practices differed between groups. Training offered to maternal child health primary care providers on addressing perinatal mental health disorders may help improve provider screening practices and detection of PND symptoms in perinatal women. PND screening that combines face-to-face open-ended interviews with standardized screening tools can enhance patient-provider communication, potentially improving PND detection rates and follow-up care in perinatal women.

Practice Trends in (C)APD Assessment and Management: A Survey of Audiologists in Kerala.

Aims Present study investigates the current trends in (Central) Auditory Processing Disorder [(C)APD] assessment and management practices among Audiologists practicing in Kerala, India. Materials and Methods The questionnaire for the survey was developed based on the Knowledge, Attitude, and Practices(KAP) model and underwent validation by experts in Audiology. Online survey was conducted to collect data from Audiologists practicing in Kerala, with a valid RCI-CRR number. Descriptive statistics were used to analyze the responses. Results The majority of participants held bachelor's degrees and completed training modules on the assessment of (C)APD during their undergraduate studies. However, clinical exposure was very low. Even though 59.2% of participants reported that they were performing screening for (C)APD, the use of standardized screening tools was limited. Only 35% of participants reported that they were performing diagnostic evaluation. However, the rest of the participants used only speech-in-noise tests for (C)APD evaluation. The participants who performed management of (C)APD were even fewer, at only 13.4%. Lack of facilities, inadequate patient load, and lack of practical exposure were major obstacles to (C)APD assessment and management. The majority of participants strongly agreed that Audiologists are the most qualified persons to deal with (C)APD; however, the practice trends obtained from the study suggest that Audiologists have a really poor practice in this area. Conclusion The study highlights the need for standardized assessment tools, improved training opportunities, and increased awareness among Audiologists regarding (C)APD. Multidisciplinary collaboration and further research are essential for enhancing (C)APD assessment and management practices in Kerala.

Integrating Speech-Language Pathologists Into Primary Care to Improve Early Identification of Developmental Concerns: A Brief Report

Purpose: Many young children in need of early intervention are not identified in a timely manner. This preliminary study explored the emerging role of speech-language pathologists (SLPs), providing training to improve the use of developmental screening in pediatric primary care. Method: A quantitative, descriptive methodology with a one-group pretest, posttest interventional design was utilized to assess the impact of an SLP-led educational intervention on the knowledge of 17 paraprofessional medical support personnel to administer a standardized developmental screening tool. Results: Data analysis revealed a significant increase on knowledge posttest scores from pretest scores. Conclusion: SLPs providing educational training in pediatric primary care is an important first step in identifying solutions to improving the early identification of children with developmental concerns.

(123) FEMALE SEXUAL DYSFUNCTION IN PREGNANT PATIENTS: A PILOT SURVEY OF OBGYN RESIDENTS’ SCREENING HABITS, METHODS, AND EDUCATION

Abstract Introduction Female sexual dysfunction (FSD) in pregnancy is highly prevalent, but largely underdiagnosed, as both patients and healthcare providers do not readily broach the topic. Recent studies have found that obstetrics and gynecology (OBGYN) residents in various programs feel comfortable inquiring about a patient’s sexual history and recognize sexual health training as a priority in residency. Other studies, however, have shown that residents report a lack of knowledge surrounding screening for and providing counseling on FSD. Currently, there is no literature evaluating the extent of OBGYN residency training on FSD in pregnancy. Objective This study aims to identify screening habits, methods, and education surrounding screening for FSD in pregnant patients by OBGYN residents at an academic residency program in Chicago, IL. Methods This study was an IRB-approved, cross-sectional study that included both a direct online survey and an in-person discussion session designed to collect data on residents’ knowledge, opinions, and perceived barriers to screening. The survey and discussion were administered immediately prior to their biennial lecture on FSD. Results 17 OBGYN residents at a single institution completed the study. Respondents included 4 (23.5%) PGY1s and 4 (23.5%) PGY2s, who are classified as junior residents, as well as 4 (23.5%) PGY3s and 5 (29.4%) PGY4s, who are classified as senior residents. 3 (17.6%) of the residents were men. Junior residents and senior residents reported that screening for FSD should be done 3.7 times and 2.8 times during pregnancy, respectively. On a scale of 0 to 10 with 0 being uncomfortable and 10 being comfortable, junior residents' and senior residents’ median scores were 3 and 2, respectively for both screening for and providing counseling on FSD in pregnancy. 10 (58.8%) of residents recalled receiving training on FSD during the course of their residency. Only 3 (17.6%) residents reported that they regularly screen for FSD in pregnant patients. Residents identified the most important time to screen for FSD in pregnancy as either the new obstetric visit 7 (41.1%) or the postpartum period 7 (41.1%). For barriers to screening and counseling on FSD in pregnancy, residents reported a lack of training (n=16, 94.1%) and interventions taking too much time (n=9, 52.9%). Qualitative discussion elucidated other barriers, such as having no standard screening tool, feeling unsure about treatment options, and limited curricular education. Conclusions Our study shows that although the majority (58%) of residents recall receiving some training in FSD, they do not feel comfortable screening for or counseling on it. Senior residents are only slightly more comfortable than junior residents (3 vs 2 on a 0-10 comfortability scale). The residents report a lack of training in FSD and time-consuming interventions as reasons. Other barriers include lack of a standard screening tool, unfamiliarity with treatment options, and limited curricular education. The knowledge gained from these results indicates a need for curriculum modification and enhancement of the education of OBGYN residents, specifically to address their indicated barriers. Disclosure No.

Long COVID in Brain Health Research: A Call to Action.

The COVID-19 pandemic has brought attention to the long-term consequences of the virus, particularly the persistent symptoms that characterize long COVID. This syndrome, which can last for months after the initial infection, includes a range of neurological and neuropsychiatric manifestations that have significant implications for brain health and dementia research. This review explores the current understanding of long COVID's cognitive, neurological, and psychiatric symptoms and their potential impact on brain stimulation and neuroimaging studies. It argues that researchers must adapt their study designs and screening processes to account for the confounding effects of long COVID and ensure the accuracy and reliability of their findings. To advance the understanding of this condition and its long-term effects on brain health, the review proposes a series of strategies, including the development of standardized screening tools, the investigation of underlying mechanisms, and the identification of risk factors and protective factors. It also emphasizes the importance of collaborative research efforts and international data sharing platforms in accelerating the pace of discovery and developing targeted interventions for individuals with long COVID. As the prevalence of this condition continues to grow, it is imperative that the neuroscience community comes together to address this challenge and support those affected by long COVID.

Prevalence of musculoskeletal pain and associated factors among professional orchestra musicians in Norway.

Orchestra musicians have a high risk of experiencing musculoskeletal problems. These problems may lead to sleep and psychological disturbance. This study investigated the occurrence of musculoskeletal pain (MSP) among orchestra musicians and the coherence between pain and predictors such as gender, age and instrument. Further, the impact of pain on sleep and mental health was analysed to assess pain as a predictor threatening musicians' wellbeing. Some 358 musicians in eight different professional orchestras in Norway completed a questionnaire. Questions about pain experienced within the last 30 days were based on a national survey. Standardised screening tools like the Hopkins Symptom Checklist-25 (HSCL-25) and Bergen Insomnia Scale (BIS) were used to assess psychological distress and sleeping problems. Kruskal-Wallis tests were used to analyse the differences in the pain-related variables: experienced pain severity (EPS), number of pain areas, and work being perceived as the source of pain based on age. Mann-Whitney U tests were conducted to evaluate the statistical significance between gender and the pain-related variables. Spearman's rank correlations were used to examine the relationship between EPS and BIS, HSCL-25 and pain area. Additionally, simple linear regression models were employed to determine whether EPS can predict higher scores on the HSCL-25 and BIS scales. The prevalence of MSP experienced in the last 30 days among orchestra musicians in Norway was 85%. Musicians experienced frequent pain regardless of their gender, age or instrument group. Neck, shoulders and upper back represented the most reported pain areas. Further, it was observed that increased EPS was correlated with an increase in the number of pain areas and in work being perceived as the source of pain. EPS significantly predicted sleep- and psychological distress. Orchestra musicians have a high risk of encountering MSP. Furthermore, their psychological distress and sleeping problems seem to be related to experienced MSP. To deliver optimal health, these problems should be handled simultaneously.

Emergency Department-Based Medication for Opioid Use Disorder Program: Addressing Gaps in Linkages to Care.

Background Emergency department (ED)-based medication for opioid use disorder (MOUD) has been shown to be effective in providing ease of access and successful treatment rates for patients with opioid use disorder (OUD). This study examined the social determinants of health (SDOH) of patients entering an ED-based MOUD program through individual and focus group surveys. SDOHmay impact treatment retention for current and future patients. Methods A survey of all patients entering our MOUD program at two hospital-based EDs and two free-standing EDs was conducted from January to March 2022.Addiction care coordinators (ACCs) used standardized screening tools to enroll patients into the MOUD program, and trained research coordinators used a standardized form, using previously validated survey questions,to examine the role of SDOH.Focused group surveys were also collected. The survey measured patients' perspectives of the program and solicited feedback on SDOH and program barriers. Results Of the 60 OUD patients inducted into the ED-based MOUD program during our survey period, 19 (32%) participated in an individual or focus group interview. Of these, 16 patients (27%) completed all survey questions. The mean age was 42 years old, 94% identified as Caucasian, and 65% were males. Over 94% of subjects found the ACCs helpful in providing follow-up care.Nearly 40% experienced transportation and financial issues.The vast majority found the MOUD program beneficial in coping with withdrawal symptoms, dealing with their addiction, and supporting recovery. Conclusion OUD patients found the ACCs and the MOUD program helpful for their transition to the treatment stage. The MOUD program can improve some patients' reluctance to engage with a healthcare system by addressing barriers related to transportation to appointments and financial issues.