The Cambridge Cognitive Examination for Down's Syndrome (CAMCOG-DS) was developed to assess cognitive functioning and dementia-related cognitive decline in people with Down's Syndrome (DS). It has been translated into different languages and is often used in international studies. Although adapted for people with intellectual disabilities (ID), many tasks involve verbal responses and instructions are presented orally. Therefore, the administration for people with severe language deficits can be challenging. The aim of this retrospective data analysis is to examine the influence of language ability and reasoning on CAMCOG-DS performance. Study 1 examined the relationship between CAMCOG-DS, picture naming, single word comprehension and reasoning in adults with DS. Study 2 replicates and broadens the findings in a sample of children and adults with DS.

Study 1 included 40 adults with DS between 18 and 51 years (M = 28.6, SD = 8.4). 25 had a mild and 15 a moderate ID. CAMCOG-DS, the short form of the Boston Naming test (BNT), a test for single word comprehension from the Werdenfelser Testbatterie (WTB) and the Colored Progressive Matrices (CPM) were administered. Study 2 included 38 participants between 8 and 59 years (23 children, M = 11.4; 15 adults; M = 31.3). 3 had a borderline, 23 a mild, and 12 a moderate ID. The same tasks as in Study 1 were applied, but the CPM was replaced by its successor, the Raven's 2.

In Study 1, participants with mild ID performed better in all tasks than those with moderate ID (p < .05). Moderate relationships were found between CAMCOG-DS total score and the language tasks (r = .56 and r = .46), which remained significant when level of ID was controlled for. There was also a moderate relationship between CAMCOG-DS and reasoning (r = .46). Regression analysis showed that BNT performance predicted CAMCOG-DS performance (R2 = .31). In Study 2, those with mild ID, compared to those with moderate ID, performed better in all tasks (p < .05), however, regarding the CAMCOG-DS and language tasks, this effect was larger in adults than in children. Adults performed better than children in the CAMCOG-DS and BNT (p < .05), but not in single word comprehension or reasoning. As in Study 1, moderate to large correlations were revealed between CAMCOG-DS and language tasks and between CAMCOG-DS and reasoning (r > .52), remaining significant when age and ID level were controlled for. Regression analysis showed that both naming and reasoning but not single word comprehension or age predicted CAMCOG-DS performance (R2 = .69), however, performance was best predicted by naming (R2 = .65).

Our results suggest that language ability and reasoning relate to CAMCOG-DS performance, which is best predicted by BNT picture naming. This should be considered in CAMCOG-DS interpretation, as the capabilities of patients with lesser language ability might be underestimated. Future developments of dementia assessments for people with ID should include more nonverbal tasks.

Nurses perform several functions that are integral for antimicrobial stewardship (AMS). However, nurses are underrepresented in research and underutilized in implementation of AMS interventions. The objective of this pilot study was to assess the effect of asynchronous microlearning on inpatient nursing staff knowledge, attitudes, and practices (KAP) regarding AMS principles.

A team of pharmacists, physicians, and nurses developed 9 case-based, multiple-choice questions with accompanying educational explanations on associated AMS principles. One case was delivered to participants daily via an institutional web-based application (QuizTime). A KAP survey with 20 questions on a 5-point Likert scale was administered before and after the intervention. Survey results were compared using a Wilcoxon signed-rank test.

Participants’ mean survey score after the intervention demonstrated statistically significant improvement for 18 (90%) of 20 items compared to before the intervention. Participants’ confidence improved in key AMS activities: (1) differentiating between colonization and infection (mean difference, 0.63; P < .001), (2) identifying unnecessary urine cultures and inappropriate treatment of urinary tract infections (mean difference, 0.94; P < .001), (3) recognizing opportunities for intravenous to oral therapy conversion (mean difference, 1.07; P < .001), and (4) assessing for antibiotic-associated adverse effects (mean difference, 0.54; P < .001).

Nursing education provided through an asynchronous, microlearning format via a mobile platform resulted in statistically significant improvement in most KAP topics. Nurses are integral members of a multidisciplinary AMS team, and novel education methods can help equip them with the necessary AMS tools. This pilot study forms the basis for expanded AMS educational efforts in all healthcare professionals.

Ambulatory monitoring is gaining popularity in mental and somatic health care to capture an individual's wellbeing or treatment course in daily-life. Experience sampling method collects subjective time-series data of patients' experiences, behavior, and context. At the same time, digital devices allow for less intrusive collection of more objective time-series data with higher sampling frequencies and for prolonged sampling periods. We refer to these data as parallel data. Combining these two data types holds the promise to revolutionize health care. However, existing ambulatory monitoring guidelines are too specific to each data type, and lack overall directions on how to effectively combine them.

Literature and expert opinions were integrated to formulate relevant guiding principles.

Experience sampling and parallel data must be approached as one holistic time series right from the start, at the study design stage. The fluctuation pattern and volatility of the different variables of interest must be well understood to ensure that these data are compatible. Data have to be collected and operationalized in a manner that the minimal common denominator is able to answer the research question with regard to temporal and disease severity resolution. Furthermore, recommendations are provided for device selection, data management, and analysis. Open science practices are also highlighted throughout. Finally, we provide a practical checklist with the delineated considerations and an open-source example demonstrating how to apply it.

The provided considerations aim to structure and support researchers as they undertake the new challenges presented by this exciting multidisciplinary research field.

The most common treatment for major depressive disorder (MDD) is antidepressant medication (ADM). Results are reported on frequency of ADM use, reasons for use, and perceived effectiveness of use in general population surveys across 20 countries.

Face-to-face interviews with community samples totaling n = 49 919 respondents in the World Health Organization (WHO) World Mental Health (WMH) Surveys asked about ADM use anytime in the prior 12 months in conjunction with validated fully structured diagnostic interviews. Treatment questions were administered independently of diagnoses and asked of all respondents.

3.1% of respondents reported ADM use within the past 12 months. In high-income countries (HICs), depression (49.2%) and anxiety (36.4%) were the most common reasons for use. In low- and middle-income countries (LMICs), depression (38.4%) and sleep problems (31.9%) were the most common reasons for use. Prevalence of use was 2–4 times as high in HICs as LMICs across all examined diagnoses. Newer ADMs were proportionally used more often in HICs than LMICs. Across all conditions, ADMs were reported as very effective by 58.8% of users and somewhat effective by an additional 28.3% of users, with both proportions higher in LMICs than HICs. Neither ADM class nor reason for use was a significant predictor of perceived effectiveness.

ADMs are in widespread use and for a variety of conditions including but going beyond depression and anxiety. In a general population sample from multiple LMICs and HICs, ADMs were widely perceived to be either very or somewhat effective by the people who use them.

Performance characteristics of SARS-CoV-2 nucleic acid detection assays are understudied within contexts of low pre-test probability, including screening asymptomatic persons without epidemiological links to confirmed cases, or asymptomatic surveillance testing. SARS-CoV-2 detection without symptoms may represent presymptomatic or asymptomatic infection, resolved infection with persistent RNA shedding, or a false-positive test. This study assessed the positive predictive value of SARS-CoV-2 real-time reverse transcription polymerase chain reaction (rRT-PCR) assays by retesting positive specimens from 5 pre-test probability groups ranging from high to low with an alternate assay.

In total, 122 rRT-PCR positive specimens collected from unique patients between March and July 2020 were retested using a laboratory-developed nested RT-PCR assay targeting the RNA-dependent RNA polymerase (RdRp) gene followed by Sanger sequencing.

Significantly fewer (15.6%) positive results in the lowest pre-test probability group (facilities with institution-wide screening having ≤3 positive asymptomatic cases) were reproduced with the nested RdRp gene RT-PCR assay than in each of the 4 groups with higher pre-test probability (individual group range, 50.0%–85.0%).

Large-scale SARS-CoV-2 screening testing initiatives among low pre-test probability populations should be evaluated thoroughly prior to implementation given the risk of false-positive results and consequent potential for harm at the individual and population level.

Identify risk factors that could increase progression to severe disease and mortality in hospitalized SARS-CoV-2 patients in the Southeast region of the United States.

Multicenter, retrospective cohort including 502 adults hospitalized with laboratory-confirmed COVID-19 between March 1, 2020, and May 8, 2020 within 1 of 15 participating hospitals in 5 health systems across 5 states in the Southeast United States.

The study objectives were to identify risk factors that could increase progression to hospital mortality and severe disease (defined as a composite of intensive care unit admission or requirement of mechanical ventilation) in hospitalized SARS-CoV-2 patients in the Southeast United States.

In total, 502 patients were included, and 476 of 502 (95%) had clinically evaluable outcomes. The hospital mortality rate was 16% (76 of 476); 35% (177 of 502) required ICU admission and 18% (91 of 502) required mechanical ventilation. By both univariate and adjusted multivariate analyses, hospital mortality was independently associated with age (adjusted odds ratio [aOR], 2.03 for each decade increase; 95% confidence interval [CI], 1.56-–2.69), male sex (aOR, 2.44; 95% CI, 1.34–4.59), and cardiovascular disease (aOR, 2.16; 95% CI, 1.15–4.09). As with mortality, risk of severe disease was independently associated with age (aOR, 1.17 for each decade increase; 95% CI, 1.00–1.37), male sex (aOR, 2.34; 95% CI, 1.54–3.60), and cardiovascular disease (aOR, 1.77; 95% CI, 1.09–2.85).

In an adjusted multivariate analysis, advanced age, male sex, and cardiovascular disease increased risk of severe disease and mortality in patients with COVID-19 in the Southeast United States. In-hospital mortality risk doubled with each subsequent decade of life.

To investigate knowledge and practice of Brazilian public primary and secondary health care dentists during the coronavirus disease (COVID-19) pandemic.

An online questionnaire with sociodemographic and COVID-19 knowledge questions was used.

A total of 4048 dentists working in the Brazilian public primary and secondary health care system were investigated; 4024 (99.41%) believe that COVID-19 can be transmitted through dental procedures. A fair level of COVID-19 symptoms knowledge by these dentists was observed (3.76±1.27 of 6.00), as well as the skepticism in personal protective equipment (3382; 83.55%) and biosafety procedures (3278; 80.98%) used as an efficient form of COVID-19 transmission prevention. Country region, performance of social distancing, dental specialty, the use of personal protective equipment, and biosafety preventive measures influenced the likelihood of dentists to perform dental treatment, either elective or urgent, during the COVID-19 pandemic.

The need of extra preventive barriers for dental treatment may bring an extra financial stress in the Brazilian public primary and secondary health care system, as well as in the patient-dentist relationship, which may have to be reframed. Internationally accepted public guideline policies regarding dental treatment safety, as well as the technological development of preventive tools, are needed to deal with the challenges brought by COVID-19.

Robust personal protective equipment is essential in preventing the transmission of coronavirus disease 2019 to head and neck surgeons who are routinely involved in aerosol generating procedures.

This paper describes the collective experience, across 3 institutes, of using a reusable half-face respirator in 72 head and neck surgery cases.

Cost analysis was performed to demonstrate the financial implications of using a reusable respirator compared to single-use filtering facepiece code 3 masks.

The reusable respirator is a cost-effective alternative to disposable filtering facepiece code 3 respirators. Supplying reusable respirators to individual staff members may increase the likelihood of them having appropriate personal protective equipment during their clinical duties.

To investigate the central electrode artefact effect of different ion chambers in the verification phantom using the dose calculation algorithms Analytical Anisotropic Algorithm (AAA) and Acuros XB.

The dosimetric study was conducted using an in-house fabricated polymethyl methacrylate head phantom. The treatment planning system (TPS)-calculated doses in the phantom with detectors were compared against the dummy detector fillets using AAA and Acuros XB algorithm. The planned and measured doses were compared for the study.

The mean percentage variation in volumetric-modulated arc therapy plans using Acuros XB and the measurement in the head phantom are statistically significant (p-value = 0.001) for FC65 and CC13 chambers. In small volume chambers (A14SL and CC01), the measured and TPS-calculated dose shows a good agreement.

The study confirmed the CT set of the phantom with detectors (FC65 and CC13) give more artefacts/heterogeneity caused a significant variation in dose calculation using Acuros XB. Therefore, the study suggests a method of using phantom CT set with the dummy detector for mean dose calculation for the Acuros XB algorithm.