Includes bibliographical references / Background: Health care workers are at increased risk of acquiring latent tuberculosis infection (LTBI). The emergence of interferon - gamma release assays (IGRAs) for the diagnosis of LTBI, presents an opportunity for improved estimation of TB infection prevalence and incidence. Their utility in settings with high background prevalence TB and HIV infection is unknown. Major aims of the study were to: * Evaluate the prevalence and factors associated with TB infection using both tuberculin skin test (TST) and IGRA assays in a sample of health care workers. * Evaluate change in interval test response over one year to determine annual risk of infection and determinants associated with test conversion. Methods: Participants completed a questionnaire on occupational and environmental characteristics including a TB symptom screen and underwent chest radiograph and rapid HIV test. Three tests for latent TB infection were administered: TST, QuantiFERON - TB Gold In - Tube (QFT - GIT) and a T - SPOT.TB test. All tests were repeated one year later. Results: The prevalence of TB infection at baseline was 84%, 65% and 60% as measured by TST, QFT - GIT and T - SPOT.TB. There was only fair agreement between TST and IGRAs. HIV positive status was significantly associated with having a TST negative / T - SPOT.TB positive discordant test response (OR=4.72). TST had superior sensitivity than IGRAs for the diagnosis of LTBI. In primary level staff a positive TST outcome, was negatively associated with HIV positive status (OR=0.41). Long employment duration was positively associated with TST (OR=4.17) and QFT - GIT (OR= 2.42) positivity. Involvement in sputum collection (OR=3.25) and home - based care of TB patients (OR= 4.14) was associated with a positive IGRA test. The conversion rate for TST and IGRAs was 38% and 22%, respectively. Reversion rates ranged from 1 % - 16 % and was lowest for TST. Factors associated with conversion (for IGRAs) included employment sector, counselling of TB patients and a baseline positive TST. Conclusion: The annual rate of TB infection was very high pointing to occupational exposure as a contributory factor. TST had superior sensitivity than IGRAs for LTBI diagnosis but poor uptake on serial testing. IGRAs had excellent uptake but its clinical utility was negatively influenced by high rates of reversion.

As the incidence of major depressive disorders continues to rise, the need for depression screening in primary care is imperative. The objective of this quality improvement (QI) project is to increase depression screening and enhance the current referral process in an urban primary care setting in the southeast United States. To achieve a projected increase in identified depression within the current and future adult patient population, workflow processes have been restructured to incorporate consistent depression screening using the Patient Health Questionnaire-2 (PHQ-2) and -9 (PHQ-9). Revised clerical workflow processes include initiating PHQ-9 questionnaires for all new patients, while clinical workflow processes include conducting PHQ-2 questionnaires for all established patients. Scores on the PHQ-9 indicating moderate levels of depression will trigger primary care provider (PCP) notification. Providers offer three treatment options including Behavioral Health Care Navigator Services (BHCN), self-referral to a mental health care provider, or treatment by PCP. Data will be collected to determine the number of PHQ-9 questionnaires given to “New Patients” at check-in, PHQ-2 questionnaires conducted by clinical staff, PHQ-9 scores of 10 or greater, BHCN referrals placed, patients who elected self-referral, and completed initial mental health appointments with differentiation between BHCN scheduled appointments and self-referred appointments. This QI project is currently undergoing implementation with no outcomes to report, however, data collected during analysis is expected to reveal an increase in patients diagnosed with moderate to major depressive disorders and an increase in completed initial mental health appointments.

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Recently, researchers have attempted to increase the time efficiency of the smartphone DIN test by decreasing the number of presentations of the DIN. One suggestion was to use a variable step size based on the correctness of digits identified within the triplet. In contrast, another suggested using a fixed signal-to-noise ratio (SNR) presentation level for all presentations of the DIN test and producing a pass/fail result based on whether a 95% recognition level was reached. This study aimed to compare three novel DIN test procedures as a potential way to improve efficiency with acceptable reliability using smartphone technology. / Dissertation (MA (Audiology) )--University of Pretoria, 2021. / Speech-Language Pathology and Audiology / MA (Audiology) / Unrestricted

This study explored NCAA athletic departments' mental health screening practices, including the mental health concerns assessed for by the mental health screening, personnel responsible for administering and reviewing screeners, and resources available for athletes identified as "at risk." Participants were athletic department staff who had knowledge of their school's mental health screening processes. Frequencies and chi-square analyses were used to assess trends across divisional levels (DI vs. DII/DIII). Analyses show that significantly more DI than DII/DDIII institutions have a formal mental health screening program. Institutions' coverage of mental health topics in their screening did not vary significantly by Divisional level, with one exception: a larger percentage of DI institutions assessed whether student athletes had worked with a mental health practitioner than DII/DIII schools. DII/III were significantly more likely to have athletic trainers both administer and review mental health screeners and DI institutions were significantly more likely to have a sport psychologist employed within their athletic department than. DI schools were significantly more likely to have had a student athlete attempt suicide and participate in inpatient treatment than DII/III schools. Implications of the findings, limitations, and future directions are discussed.

Students with internalizing behavioral concerns are an overlooked and underserved segment within education. The trend unfortunately results in poor academic and societal outcomes. In response, early prevention and identification through universal screening practices has become an important method for combating internalizing problems in education. However, additional research in the field is needed, including better psychometric understanding of the instruments available and what types of informants provide the best evidence for proper identification. Therefore, the purpose of the following study was to investigate how student and teacher informants of internalizing behaviors influence outcomes in the context of universal screening. Comparison of these two informants were done by analyzing the relationship between a teacher completed screener, the Student Internalizing Behavioral Screener (SIBS) and a student completed behavior rating scale, the Behavioral Assessment System for Children – 2nd edition (BASC-2). In addition to exploration of informant agreement, discrepancies in test score outcomes for different student age groups were investigated along with criterion relatedness of the SIBS when using student self-report as a criterion measure. Results included low agreement between teacher and student informant, as well as poor discriminate ability of the SIBS when using student self-report as a criterion. Findings also revealed a small but significant age discrepancy in the total score for the SIBS when comparing a child vs. adolescent sample. Implications of the findings suggest teachers as a sole informant about internalizing behaviors of students may not be sufficient for desired outcomes of proper identification with internalizing behaviors. Moreover, age may be a factor in monitoring internalizing problems across development and current psychometric evaluation of screeners (e.g., type of validity) should also include other informants. Based on the findings, future directions of research are also proposed. This includes exploration of the impact teachers and teacher training as well as considerations for multi-informant screening procedures.

The GHQ-12 has been recommended as a reliable screening instrument for psychological distress in all clinical groups. The usefulness of the GHQ-12 was evaluated in individuals with significant facial disfigurement by examination of the impact of alternative scoring methods on case detection rates. The type of scoring method used had a significant impact on the relative prevalence of `cases'. However, examination of the receiver operating characteristics (ROC) of the alternative scoring methods revealed a good fit between methods. The use of the GHQ-12 as a screening instrument to determine psychological distress in individuals with facial disfigurement may be enhanced by inclusion of an appearance-specific measure in the screening schedule and by the adoption of one scoring method; the GHQ method.

Yes / Specialist services for dementia are seeing an increasing number of patients. We investigated whether interactional and linguistic features in the communication behaviour of patients with memory problems could help distinguish between those with problems secondary to neurological disorders (ND) and those with Functional Memory Disorder (FMD). In Part 1 of this study, a Diagnostic Scoring Aid (DSA) was developed encouraging linguists to provide quantitative ratings for 14 interactional features. An optimal cut-off differentiating ND and FMD was established by applying the DSA to 30 initial patient-doctor memory clinic encounters. In Part 2, the DSA was tested prospectively in ten additional cases analysed independently by two Conversation Analysts blinded to medical information. In part one, the median score of the DSA was +5 in ND and -5 in FMD (p<0.001). The optimal numeric DSA cut off (+1) identified patients with ND with a sensitivity of 86.7% and a specificity of 100%. In part two, DSA scores of rater one correctly predicted 10/10 and those of rater two 9/10 diagnoses. This study indicates that interactional and linguistic features can help distinguish between patients developing dementia and those with FMD and could aid the stratification of patients with memory problems. / NIHR Research for Patient Benefit (RfPB) Programme: PB-PG-0211-24079 – Using Conversation Analysis in the Differential Diagnosis of Memory Problems: a pilot study. 2013-2015

Virtual Sreening (VS) is an in silico technique for drug discovery. An overview of VS methods is given and is seen to be approachable from two sides: structure based and ligand based. Structure based virtual screening uses explicit knowledge of the target receptor to suggest candidate receptor-ligand complexes. Ligand based virtual screening can infer required characteristics of binders from known ligands. A consideration for all virtual screening techniques is the amount of computing time required to arrive at a solution. For this reason, techniques of high performance computing have been applied to both the structural and ligand based approaches. A proven structure based virtual screening code LIDAEUS (Ligand Discovery At Edinburgh University) has been ported and parallelised to a massively parallel computing platform, the University of Edinburgh’s IBM Bluegene/l, consisting of 2,048 processor cores. A challenge in achieving scaling to such a large number of processors required implementation of a minimal communication parallel sort algorithm. Parallel efficiencies achieved within this parallelisation exceeded 99%, confirming that a near optimum strategy has been followed and capacity for running the code on a greater number of processors exists. This implementation of the program has been successfully used with a number of protein targets. The development of a new ligand based virtual screening code has been completed. The program UFSRAT (Ultra Fast Shape Recognition with Atom Types) takes the features of known binders and suggests molecules which will be able to make similar interactions. This similarity method is both fast (1 million molecules per hour per processor) and independent of input orientation. Along with UFSRAT, some other methods (VolRAT and UFSRGraph) based on UFSRAT have been developed, addressing different approaches to ligand based virtual screening. UFSRAT as an approach to discovering novel protein-ligand complexes has been validated with the discovery of a number of inhibitors for 11β-Hydroxysteroid Dehydrogenase type 1 and FK binding protein 12.

Breast cancer is the second leading cause of cancer death among women in the United States. Nonadherence to recommended screening guidelines and lack of screening contribute to late stage diagnosis and increased morbidity and mortality among racial and ethnic women in the United States. The purpose of this study was to assess breast cancer screening practices, knowledge, and beliefs among Cameroonian immigrant women who were 40 years and older living in the metropolitan Washington, D.C. region. This quantitative cross-sectional study was guided by the health belief model and used the revised version of Champion's health belief model scale. A convenience sample (N=267) responded to a 60-item self-administered online survey that assessed knowledge of breast cancer screening, demographic variables, constructs of the health belief model and adherence (defined as obtaining a mammogram within two years). Data analyses performed included descriptive analysis, correlational and multiple linear regression. Results of this study revealed that increased level of education and self-efficacy were associated with greater knowledge of the benefits of mammography. Additionally, women who had more self-efficacy in obtaining a mammogram, perceived less cultural barriers, lived longer in the United States, and who had a regular healthcare provider were more likely to be adherent. Study findings suggest that positive social change can be achieved by empowering women to take control of their health. Efforts promoting awareness of breast cancer screening guidelines and facilitating access to a regular healthcare provider could significantly increase uptake of screening services and lead to better health outcomes and reduced mortality.