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In response to advancing clinical practice guidelines regarding concussion management, service members, like athletes, complete a baseline assessment prior to participating in high-risk activities. While several studies have established test stability in athletes, no investigation to date has examined the stability of baseline assessment scores in military cadets. The objective of this study was to assess the test–retest reliability of a baseline concussion test battery in cadets at U.S. Service Academies.
All cadets participating in the Concussion Assessment, Research, and Education (CARE) Consortium investigation completed a standard baseline battery that included memory, balance, symptom, and neurocognitive assessments. Annual baseline testing was completed during the first 3 years of the study. A two-way mixed-model analysis of variance (intraclass correlation coefficent (ICC)3,1) and Kappa statistics were used to assess the stability of the metrics at 1-year and 2-year time intervals.
ICC values for the 1-year test interval ranged from 0.28 to 0.67 and from 0.15 to 0.57 for the 2-year interval. Kappa values ranged from 0.16 to 0.21 for the 1-year interval and from 0.29 to 0.31 for the 2-year test interval. Across all measures, the observed effects were small, ranging from 0.01 to 0.44.
This investigation noted less than optimal reliability for the most common concussion baseline assessments. While none of the assessments met or exceeded the accepted clinical threshold, the effect sizes were relatively small suggesting an overlap in performance from year-to-year. As such, baseline assessments beyond the initial evaluation in cadets are not essential but could aid concussion diagnosis.
There are no large published studies of the prevalence of seasonal affective disorder (SAD) among UK populations.
To determine the prevalence of SAD among patients attending a general practitioner (GP).
Patients aged 16–64 consulting their GPs in Aberdeen during January were screened with the Seasonal Pattern Assessment Questionnaire (SPAQ). SPAQs were also mailed to 600 matched patients, who had not consulted their GP during January. Surgery attenders who fulfilled SPAQ criteria for SAD were invited for interview to determine whether they met criteria for SAD in DSM–IVand the Structured Interview Guide for the Hamilton Rating Scale for Depression– Seasonal Affective Disorder Version (SIGH–SAD).
Of 6161 surgery attenders, 4557 (74%) completed a SPAQ; 442 (9.7%) were SPAQ cases of SAD. Rate of caseness on the SPAQ did not differ between surgery attenders and non-attenders. Of 223 interviewed SPAQ cases of SAD, 91 (41%) also fulfilled DSM–IVand SIGH–SAD criteria.
There is a high prevalence of SAD among patients attending their GPs in January in Aberdeen; this is likely to reflect a similar rate in the community.
In the Children's Department of the Maudsley Hospital an “Item Sheet” is routinely completed in respect of each child who attends. The items on this sheet (or “check-list”) cover a wide range of possible features in a child's personality, history, background and environment, as well as in his psychological and physical condition, and symptomatology.
A number of samples of these Item Sheets have been submitted to statistical analysis, with a view to identifying any common factors that may be present in the case data they summarize. The various samples have been arrived at according to age and sex of the children concerned. An earlier paper (1) has described the results of this procedure in respect of two such samples, boys and girls between eight and ten years of age. A subsequent paper will give an account of the results in respect of thirteen to fifteen year olds. The present report gives the results that emerged for the younger ages of referral to the clinic, boys and girls between approximately five and seven years of age.
The Underwood Report (12) drew attention to the need for some system of classification in child psychiatry. This paper presents the results of a statistical study which was undertaken as relevant to that general enquiry.
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