Impact of improper sample handling on Cobas CT/NG testing platform with dual swab sample collection kit for detecting Chlamydia trachomatis and Neisseria gonorrhoeae

IMPORTANCE

The importance of this observation lies in its potential to directly impact testing outcomes and patient care. By identifying improper sample handling as a contributing factor to a substantial number of invalid results, we emphasize the need for meticulous adherence to recommended protocols during sample collection. Laboratories that overlook or are unaware of such deviations may inadvertently compromise the reliability and efficacy of their diagnostic processes, leading to misdiagnoses, delayed treatment, and patient dissatisfaction.

Prevalence of invalid ImPACT baseline test results among high school athletes with invalidity and sandbagging indices

Objective: The comparison of baseline neuropsychological test results with post-concussion neuropsychological test results is a common practice to assess the aftermath of a sport-related concussion. The effectiveness of this approach is compromised when invalid baseline test performances occur. The present study was designed to assess the prevalence of invalid baseline test results of high school athletes, using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). Method: A large sample of 8938 high school athletes' baseline test data were examined, including the four ImPACT Composite scores and three sets of embedded invalid indices: five ImPACT Invalidity Indicators, four ImPACT sandbagging red flags, and two ImPACT sandbagging subtest flags. Results: There were 8394 (93.91%) Valid scorers, who failed no Invalidity Indicators; 544 (6.09%) Invalid scorers, who failed at least one Invalidity Indicator, 2718 (30.41%) Red Flag scorers, who had at least one Red Flag score; and 4154 (46.47%) Subtest Flag scorers, who had at least one Subtest Flag score. Of the entire sample, 4485 (54.65%) failed at least one of the invalid indices. Conclusions: As in prior studies of high school athletes, the Invalidity Indicators identified a low portion (6.09%) of the athletes with invalid baseline test results, while other invalidity measures found 30.41% to 46.48% of the athletes producing questionable test results. The high rate of invalid test findings suggested in this research calls for greater efforts to improve the accuracy of baseline test results.

Normal cognitive test scores cannot be interpreted as accurate measures of ability in the context of failed performance validity testing: A symptom- and detection-coached simulation study

Introduction: While use of performance validity tests (PVTs) has become a standard of practice in neuropsychology, there are differing opinions regarding whether to interpret cognitive test data when standard scores fall within normal limits despite PVTs being failed. This study is the first to empirically determine whether normal cognitive test scores underrepresent functioning when PVTs are failed.Method: Participants, randomly assigned to either a simulated malingering group (n = 50) instructed to mildly suppress test performances or a best-effort/control group (n = 50), completed neuropsychological tests which included the North American Adult Reading Test (NAART), California Verbal Learning Test - 2^nd Edition (CVLT-II), and Test of Memory Malingering (TOMM).Results: Groups were not significantly different in age, sex, education, or NAART predicted intellectual ability, but simulators performed significantly worse than controls on the TOMM, CVLT-II Forced Choice Recognition, and CVLT-II Short Delay Free Recall. The groups did not significantly differ on other examined CVLT-II measures. Of simulators who failed validity testing, 36% scored no worse than average and 73% scored no worse than low average on any of the examined CVLT-II indices.Conclusions: Of simulated malingerers who failed validity testing, nearly three-fourths were able to produce cognitive test scores that were within normal limits, which indicates that normal cognitive performances cannot be interpreted as accurately reflecting an individual's capabilities when obtained in the presence of validity test failure. At the same time, only 2 of 50 simulators were successful in passing validity testing while scoring within an impaired range on cognitive testing. This latter finding indicates that successfully feigning cognitive deficits is difficult when PVTs are utilized within the examination.

Feedback with patients who produce invalid testing: Professional values and reported practices

OBJECTIVE

Providing feedback to clinical patients who produce invalid neuropsychological test data presents with several potential challenges. Given the limited guidance available on the topic, neuropsychologists most likely utilize approaches that idiosyncratically incorporate professional values related to both assessment and patient care to address overarching feedback goals. The current article discusses professional values believed to inform feedback decisions and presents survey results regarding how neuropsychologists would approach feedback across various clinical scenarios where testing is invalid.

METHOD

Participants were 209 adult-focused clinical neuropsychologists recruited via professional listservs, the majority of whom reported being board certified. Respondents were provided three case vignettes of clinical patients who produced invalid test data and were asked how they would provide feedback to each patient. Open-ended responses were coded to determine the relative frequency of feedback approaches, explicit statements, and implied goals.

RESULTS

Nearly all respondents (98%) indicated that feedback would include some description of the invalid findings, and most respondents indicated that they would provide explanations for the reasons of invalidity (67%) and statements regarding the impact of invalidity on test interpretation (75%). There was little agreement across respondents, however, regarding specific feedback approach. Feedback goals included to Inform, Investigate, Treat, Educate, and Correct, with the presence of these implied goals also varying across respondents.

CONCLUSIONS

The findings indicate that there is minimal consensus regarding feedback approaches provided to patients who produce invalid test data and underscore a need for further development and validation of specific feedback methods. The results are discussed within the context of the potentially competing professional values of evidence-based assessment, patient-doctor collaboration, and aspirational principles of beneficence and fidelity.

[Some aspects of rehabilitation of disabled persons of the elderly and senior age at the present stage.]

The article presents the results of the analysis of the needs of elderly and elderly disabled in various types of rehabilitation, including providing them with technical means of rehabilitation, reflects the problems that this group of people have when it comes to resolving issues of medical and social rehabilitation. The importance of an integrated approach in carrying out rehabilitation measures in the study contingent was stressed. Attention is focused on some imperfection of the current regulatory and legal framework in the part concerning the examination in the service of medical and social expertise of the disabled elderly and senile. It is proposed to make appropriate changes that provide for a simplified, in-absent examination of this contingent of persons in the service of medical and social expertise, if it is necessary to make or introduce changes to the current individual rehabilitation program, to habilitate.

Advice and recipes for invalid and convalescent cookery in Australian cookbooks 1860-1950

AIMS

The aims of the present study were to assess the prevalence of recipes about invalid cookery in Australian cookbooks published from 1860 to 1950; describe the dishes regarded as suitable for invalids and summarise the advice about how best to feed invalids or convalescents in the home.

METHODS

Using published bibliographies, the Trove database, and the author's private collection, all available cookbooks published in Australia up to 1950 were reviewed and all recipes and advice about feeding invalids were recorded.

RESULTS

Eight hundred and eighty-nine book titles were examined and 25% contained some recipes specifically designed for people who were sick or convalescing. One thousand, four hundred and seventy-one different recipes were recorded with more than half for beverages, desserts and soups. The most common recipes were for beef tea, barley water, gruel and meat broths. Advice about feeding focused on the food requirements of invalids, safe and appealing meal service, cooking methods and suitable food choices. The recipes and advice did not appear to change substantially over the nine decades and most did not appear to be based on any clear scientific evidence.

CONCLUSIONS

Many of the general principles of invalid cookery in these books are similar to the requirements of the light diet, commonly used in Australian hospitals up until the 1980s. Further research into the source and rationale for the advice in these books would be worthwhile.