Use of the psychomotor vigilance test to aid in the selection of risk controls in an air medical transport operation.

Study Objectives: This study evaluated the utility and ecological validity of the 3-minute psychomotor vigilance test (PVT) completed by safety-critical personnel in an air medical transport operation as part of a fatigue risk management program. Methods: Crewmembers in an air medical transport operation self-administered an alertness assessment incorporating a 3-minute PVT at different time points during their duty schedule. The prevalence of alertness deficits was evaluated based on a failure threshold of 12 errors considering both lapses and false starts. To evaluate the ecological validity of the PVT, the relative frequency of failed assessments was evaluated relative to crewmember position, timing of the assessment within the duty schedule, time of day, and sleep quantity in the last 24 h. Results: 2.1% of assessments were associated with a failing PVT score. Crewmember position, timing of assessment within the duty shift, time of day, and sleep quantity in the last 24 h were found to affect the relative frequency of failed assessments. Obtaining less than 7-9 h of sleep was associated with systematic increases in the failure rate (F[1, 54 612] = 168.1, p < .001). Obtaining less than 4 h of sleep was associated with a frequency of a failed assessment 2.99 times higher than the frequency of a failed assessment when obtaining 7-9 h of sleep. Conclusions: Results provide evidence for the utility and ecological validity of the PVT as well as the suitability of the PVT failure threshold to support fatigue risk management in safety-critical operations.

PrEP navigation continuum among men who have sex with men, trans women, and people with alternative gender identities in three California counties.

Strategies to reduce new HIV infections include pre-exposure prophylaxis (PrEP). Of the estimated over 221,000 Californians with an indication for PrEP, only 31,280 (14 %) were currently taking the medication as of 2019. Centers for Disease Control and Prevention Project PrIDE funds were used to support and develop California PrEP navigation programs designed to increase PrEP uptake among trans persons and men who have sex with men (MSM). An analysis of PrIDE-funded PrEP navigation service outcomes was conducted to highlight where continuum drop-off occurred and how it varied among priority populations. Quantitative service delivery data for PrEP navigation program activities conducted from October 1, 2015 to September 30, 2018 were collected across three county-level local health jurisdictions (LHJs) via standardized, agency-completed service delivery data collection tools. Analyses included frequencies and crosstabs. These variations were not tested statistically but highlight group-specific needs to be addressed before implementing PrEP navigation within California. Continued systematic collection and analyses of PrEP continuum outcomes will allow programs to dynamically identify and address barriers to PrEP uptake in priority populations.