The Influence of the COVID-19 Pandemic on Baseline Concussion Symptom Assessments Among Adolescents.

Introduction The COVID-19 pandemic resulted in the cancellation of high school sports in spring 2020, a modified resumption of sports in the 2020-2021 academic year, and a return to pre-pandemic sports in 2021-2022. This cancellation had a major impact on the quality of life of adolescent athletes, but it is unknown exactly how these pandemic-driven sports disruptions on athlete baseline (preseason) symptoms affected quality of life. Therefore, the current study retrospectively evaluated symptom inventories from Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) assessments to determine whether the cancellation of sports during the COVID-19 pandemic affected baseline (preseason) self-reported symptoms among adolescent athletes. Methods Our study used a retrospective cohort design to evaluate high school athletes with complete ImPACT assessments in the academic years before (2018-2019 and 2019-2020), during (2020-2021), and after (2021-2022) the pandemic. Specifically, data from a 22-item symptom report called the Post-Concussion Symptom Scale (PCSS) assessed during ImPACT was collected and analyzed using generalized linear models with a Tweedie exponential dispersion model and post hoc Tukey's honestly significant difference tests. The main outcomes were the total symptom severity score and the affective cluster score. Secondary outcomes were the analysis of the vestibular-somatic, cognitive-sensory, and sleep-arousal symptom clusters. Results Of the 104,274 ImPACT assessments, the total symptom severity score on the PCSS was different across years (p<0.001). There were lower symptom scores in 2020-2021 (5.33, 95% CI = 5.13-5.54) than in 2018-2019 (6.82, 95% CI = 6.63-7.01), 2019-2020 (6.94, 95% CI = 6.75-7.14), and 2021-2022 (6.44, 95% CI = 6.25-6.64). The cluster scores on the PCSS for affective, cognitive-sensory, sleep-arousal, and vestibular-somatic were also lower (p<0.001) in 2020-2021 than in 2018-2019, 2019-2020, and 2021-2022. Conclusion Contrary to our expectations, total symptom severity and cluster scores on the PCSS during the pandemic (2020-2021) were significantly lower than during the years before and after the pandemic-driven sports disruptions, suggesting the pandemic did not negatively affect these athletes as expected. These results also suggested that self-reported symptoms utilized in the PCSS component of ImPACT may not be as sensitive to sports disruption among adolescent athletes as other quality-of-life measures, especially during the COVID-19 pandemic.

Observation of Seven Astrophysical Tau Neutrino Candidates with IceCube.

We report on a measurement of astrophysical tau neutrinos with 9.7 yr of IceCube data. Using convolutional neural networks trained on images derived from simulated events, seven candidate ν_{τ} events were found with visible energies ranging from roughly 20 TeV to 1 PeV and a median expected parent ν_{τ} energy of about 200 TeV. Considering backgrounds from astrophysical and atmospheric neutrinos, and muons from π^{±}/K^{±} decays in atmospheric air showers, we obtain a total estimated background of about 0.5 events, dominated by non-ν_{τ} astrophysical neutrinos. Thus, we rule out the absence of astrophysical ν_{τ} at the 5σ level. The measured astrophysical ν_{τ} flux is consistent with expectations based on previously published IceCube astrophysical neutrino flux measurements and neutrino oscillations.

Advancing Virtual at-Home Care for Community Health Center Patients Using Patient Self-Care Tools, Technology, and Education.

Introduction: Health centers are community-based, patient directed primary care providers that offer accessible, high-quality primary care within medically underserved communities. Screening for cancer and managing complex chronic conditions such as diabetes, hypertension, obesity, and depression are vital services for the vulnerable populations seen by community health centers. Delivering care for complex chronic conditions and preventive services using virtual models that integrate self-care tools and technology is an important approach to increasing access for hard-to-reach patients served by health centers. Objective: This study aimed to explore the use of a virtual care model, applied using a systems approach and patient-driven tools and technology, on the performance of clinical and patient experience measures. Methods: A virtual care model, applied using a systems approach offered by the Value Transformation Framework (VTF), was combined with self-care tools and technology in twenty health centers across 17 states to drive improvement efforts. Changes in clinical measures and patient experience were compared. Results: A total of 385 patients were enrolled and 270 (70.1%) completed a baseline visit and at least four virtual visits during the six-month intervention period. Statistically significant improvements were seen in measures for HbA1c, systolic and diastolic blood pressure, and bodyweight. Among the 270 who completed the baseline and at least 4 virtual visits, the percentage up-to-date for colorectal cancer screening increased from 113/270 (41.9%) to 169/270 (62.6%) after six months, p<0.001, a 20.7% increase. Patients completing the baseline visit and at least 4 virtual visits reported a 10.7% decrease in depression and increased satisfaction with virtual care visits compared to in-person visits (p<0.001). Conclusion: Health centers applying the Value Transformation Framework's organizing framework to the use of virtual care models together with patient self-care tools, technology, and education, had improvements in measures for chronic and preventive conditions and patient experience.

3D Printing Bacteria to Study Motility and Growth in Complex 3D Porous Media.

Bacteria are ubiquitous in complex three-dimensional (3D) porous environments, such as biological tissues and gels, and subsurface soils and sediments. However, the majority of previous work has focused on studies of cells in bulk liquids or at flat surfaces, which do not fully recapitulate the complexity of many natural bacterial habitats. Here, this gap in knowledge is addressed by describing the development of a method to 3D-print dense colonies of bacteria into jammed granular hydrogel matrices. These matrices have tunable pore sizes and mechanical properties; they physically confine the cells, thus supporting them in 3D. They are optically transparent, allowing for direct visualization of bacterial spreading through their surroundings using imaging. As a proof of this principle, here, the capability of this protocol is demonstrated by 3D printing and imaging non-motile and motile Vibro cholerae, as well as non-motile Escherichia coli, in jammed granular hydrogel matrices with varying interstitial pore sizes.

Unit-Based Nurses' Development of a Couplet Care Acuity Scoring Tool.

OBJECTIVE: To evaluate content validity (CV) and interrater reliability (IRR) of an acuity scoring tool developed for the couplet care/postpartum/nursery patient population and to determine if there was agreement between supervisor or director scoring and staff scoring. DESIGN: A scoring tool to assess the acuity of the couplet care/postpartum/nursery patients was developed. SETTING: Two hospitals: one Level 2 hospital, one Level 3 hospital. Unit-based patient care councils participated in the development, and all couplet care nurses participated in scoring patients for testing. MEASUREMENTS: The final tool was evaluated for CV and IRR using expert review, universal agreement scores, and discriminant content validation. RESULTS: Regarding CV for the Couplet Care Acuity Scoring Tool, the average of the number of experts in agreement divided by the total number of experts across all items was 1.00. Regarding IRR, the intraclass correlation coefficient was 0.85, indicating that the tool is valid and reliable for the study sample. CONCLUSION: The tool was reliable and valid in this study. Future testing is needed with larger samples and different health care facilities.

Improving Athletic Trainers' Knowledge of Clinical Documentation through Novel Educational Interventions: A Randomized Controlled Trial.

CONTEXT: Athletic trainers (ATs) have reported the need for more educational resources about clinical documentation. OBJECTIVE: To investigate the effectiveness of passive and active educational interventions to improve practicing ATs' clinical documentation knowledge. DESIGN: Randomized control trial, sequential explanatory mixed methods study. SETTING: Online module(s), knowledge assessment and interviews. PATIENTS OR OTHER PARTICIPANTS: We emailed 18,981 practicing ATs across employment settings, of which 524 ATs were enrolled into a group [personalized learning pathway (PLP=178), passive reading list (PAS=176), control (CON=170)] then took the knowledge assessment. There were 364 ATs who did not complete the intervention and/or post-knowledge assessment; therefore, complete responses from 160 ATs (PLP=39, PAS=44, CON=77; age=36.6±11.2y, years certified=13.9±10.7y) were analyzed. MAIN OUTCOME MEASURE(S): Knowledge assessment (34 items) and interview guides (12-13 items) were developed, validated, and piloted with ATs prior to study commencement. We summed correct responses (1 point each, 34 points maximum) and calculated percentages and pre- and post-knowledge mean change scores. Differences among groups (PLP, PAS, CON) and time (pre- intervention, post-intervention) were calculated using a 3X2 repeated-measures ANOVA (P≤.05) with post hoc Tukey HSD. Semi-structured interviews were conducted (PLP=15, PAS=14), recorded, transcribed, and analyzed following the consensual qualitative research tradition. RESULTS: No differences in the pre-knowledge assessment were observed between-groups. We observed a group x time interaction (F2,157 = 15.30, P<.001; partial eta-squared=0.16). The PLP exhibited greater mean change (M=3.0±2.7) than PAS (M=1.7±3.0, P=.049) and CON (M=0.4±2.2, P<.001). Descriptively, ATs scored lowest on legal (61.3%±2.1%), value of the AT (63.7%±4.3%), and health information technology (65.3%±3.7%) items. Whereas ATs described being confident in their documentation knowledge, they also identified key content (eg, legal considerations, strategies) they deemed valuable. CONCLUSIONS: The educational interventions improved ATs' knowledge of clinical documentation and provided valuable resources for their clinical practice; however, targeted continuing education is needed to address knowledge gaps.

The Ability of Vestibular and Oculomotor Screenings to Predict Recovery in Patients After Concussion: A Systematic Review of the Literature.

OBJECTIVE: The objective of this systematic review was to investigate if a positive vestibular or oculomotor screening is predictive of recovery in patients after concussion. DATA SOURCES: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search through PubMed, Ovid MEDLINE, SPORTDiscus, and the Cochrane Central Register of Controlled Trials (CENTRAL) and hand searches of included articles. STUDY SELECTION: Two authors evaluated all articles for inclusion and assessed their quality using the Mixed Methods Assessment Tool. DATA EXTRACTION: After quality assessment was completed, the authors extracted recovery time, vestibular or ocular assessment results, study population demographics, number of participants, inclusion and exclusion criteria, symptom scores, and any other outcomes of assessments reported in the included studies. DATA SYNTHESIS: Data were critically analyzed by 2 of the authors and categorized into tables regarding the ability of researchers of each article to answer the research question. Many patients who have vision, vestibular, or oculomotor dysfunction appear to have longer recovery times than patients who do not. CONCLUSIONS: Researchers routinely reported that vestibular and oculomotor screenings are prognostic of time to recovery. Specifically, a positive Vestibular Ocular Motor Screening test appears to consistently predict longer recovery.

Self-Measured Blood Pressure Monitoring During the COVID-19 Pandemic: Perspectives From Community Health Center Clinicians.

ABSTRACT: The early period of the COVID-19 pandemic necessitated a rapid increase in out-of-office care. To capture the impact from COVID-19 on care for patients with hypertension, a questionnaire was disseminated to community health center clinicians. The extent, types, and causes of care delays and disruptions were assessed along with adaptations and innovations used to address them. Clinician attitudinal changes and perspectives on future hypertension care were also assessed. Of the 65 respondents, most (90.8%) reported their patients with hypertension experienced care delays or disruptions, including lack of follow-up, lack of blood pressure assessment, and missed medication refills or orders. To address care delays and disruptions for patients with hypertension, respondents indicated that their health center increased the use of telehealth or other technology, made home blood pressure devices available to patients, expanded outreach and care coordination, provided medication refills for longer periods of time, and used new care delivery options. The use of self-measured blood pressure monitoring (58.5%) and telehealth (43.1%) was identified as the top adaptations that should be sustained to increase access to and patient engagement with hypertension care; however, barriers to both remain. Policy and system level changes are needed to support value-based care models that include self-measured blood pressure and telehealth.

Training Dental Hygiene Students to Care for Patients with Disabilities.

Purpose The purpose of this study was to evaluate the impact of a novel training program on dental hygiene students' knowledge, attitudes and beliefs about caring for individuals with disabilities.Methods A mixed methods approach was used. Students from five dental hygiene programs based at community colleges completed a two-hour didactic training session to supplement their existing special care dentistry coursework. Students completed an original 14-item pretest and posttest before and after the training that assessed attitudes and beliefs, and two validated posttests that assessed knowledge. Afterwards, students completed a clinical rotation in an advanced care dental clinic at a local academic institution gaining hands-on experience with equipment and patient treatment. Descriptive statistics were used to report training scores, types of services rendered and modifications to treatment. Student comments about their experiences were assessed using thematic analysis.Results Two hundred and ninety-four students completed didactic training and 261 completed clinical rotations. Posttest scores indicated positive improvements in knowledge, attitudes and beliefs. All students provided direct patient care. Sixty-nine percent treated patients with intellectual and developmental disabilities; 75% placed silver diamine fluoride or fluoride varnish. Altered patient positioning was used by 70.5%. Most students (95.4%) reported that their experience positively changed their attitudes towards caring for patients with disabilities in the future. Eight themes emerged, notably increased comfort and confidence, a willingness and desire to treat patients, the acquisition of new skills, and clinician behaviors of empathy and compassion towards others.Conclusion Training can help prepare dental hygiene students with the confidence and skills to address the oral health needs of individuals with disabilities.

Training dental hygiene students to care for patients with disabilities.

OBJECTIVE: The purpose of this study was to evaluate the impact of a novel training programme on dental hygiene students' knowledge, attitudes, and beliefs about caring for individuals with disabilities. METHODS: A mixed methods approach was used. Students from five dental hygiene programmes based at community colleges completed a two-hour didactic training session to supplement their existing special care dentistry coursework. Students completed an original 14-item pretest and posttest before and after the training that assessed attitudes and beliefs, and two validated posttests that assessed knowledge. Afterwards, students completed a clinical rotation in an advanced care dental clinic at a local academic institution, gaining hands-on experience with equipment and patient treatment. Descriptive statistics were used to report training scores, types of services rendered, and modifications to treatment. Student comments about their experiences were assessed using thematic analysis. RESULTS: Two hundred and ninety-four students completed didactic training, and 261 completed clinical rotations. Posttest scores indicated positive improvements in knowledge, attitudes, and beliefs. All students provided direct patient care. Sixty-nine percent treated patients with intellectual and developmental disabilities; 75% placed silver diamine fluoride or fluoride varnish. Altered patient positioning was used by 70.5%. Most students (95.4%) reported that their experience positively changed their attitudes towards caring for patients with disabilities in the future. Eight themes emerged, notably increased comfort and confidence, a willingness and desire to treat patients, the acquisition of new skills, and clinician behaviours of empathy and compassion towards others. CONCLUSION: Training can help prepare dental hygiene students with the confidence and skills to address the oral health needs of individuals with disabilities.

Influence of Gender in Preceptor-Student Dyads on Student Performance in Clinical Education: A Report from the AATE Research Network.

CONTEXT: Health professions education programs incorporate clinical education to prepare students for autonomous clinical practice. Although preceptor-student gender dyads impact student evaluations, specific influences of gender dyad pairings on student autonomy and behavior implementation have not been identified. OBJECTIVE: To examine the influence of preceptor-student gender dyads on athletic training student opportunities to engage in clinical practice during clinical experiences and to determine whether constitution of preceptor-student gender dyads influenced student ability to enact professional behaviors during patient encounters (PEs). METHODS: Multisite panel design involving 12 professional athletic training programs (ATPs, 5 undergraduate, 7 graduate). Participants included 338 athletic training students enrolled in ATPs that used E*Value to document PEs during clinical experiences. Student gender, student role in the PE (observe, assist, or perform), preceptor gender, and student implementation of behaviors associated with core competencies during the PE were measured outcomes. RESULTS: The 30,446 PEs were categorized into 4 preceptor-student dyad categories. Female students with male preceptors were less likely to perform PEs than they were to observe them (OR 0.76; 95%CI 0.69, 0.83; p<0.001). Female students with female preceptors reported fewer opportunities for behaviors associated with interprofessional education and collaborative practice (IPECP) (X2(3)=16.6, p=0.001). CONCLUSIONS: Female athletic training students under male preceptorship had fewer opportunities to perform during PEs, and female students under female preceptorship had limited opportunities to participate in IPECP. Health professions education program administrators should encourage students to advocate for opportunities in autonomous practice and implementation of professional behaviors.

Observation of high-energy neutrinos from the Galactic plane.

The origin of high-energy cosmic rays, atomic nuclei that continuously impact Earth's atmosphere, is unknown. Because of deflection by interstellar magnetic fields, cosmic rays produced within the Milky Way arrive at Earth from random directions. However, cosmic rays interact with matter near their sources and during propagation, which produces high-energy neutrinos. We searched for neutrino emission using machine learning techniques applied to 10 years of data from the IceCube Neutrino Observatory. By comparing diffuse emission models to a background-only hypothesis, we identified neutrino emission from the Galactic plane at the 4.5σ level of significance. The signal is consistent with diffuse emission of neutrinos from the Milky Way but could also arise from a population of unresolved point sources.

Implementation of Patient-Centered Care by Athletic Training Students during Clinical Experiences: A Report from the Association of Athletic Training Education Research Network.

Patient-centered care (PCC) is a core competency that should be required by all healthcare education programs, but little is known about its implementation in athletic training clinical experiences. Therefore, we examined characteristics of patient encounters documented by athletic training students implementing PCC behaviors. A multisite panel design was used to recruit 363 students from twelve professional athletic training programs (five undergraduate, seven graduate). Over 1.5 years, clinical experience patient encounter data were logged in E*Value Case Logs, including student role during the encounter, length of encounter, and clinical site. Generalized estimating equations models characterized the likelihood students included PCC behaviors in 30,522 encounters. Discussing patient goals was associated with student role (χ2(2) = 40.6, p < 0.001) and length of encounter (χ2(4) = 67.6, p < 0.001). Using patient-reported outcome measures was associated with student role (χ2(2) = 21.6, p < 0.001), length of encounter (χ2(4) = 34.5, p < 0.001), and clinical site (χ2(3) = 17.3, p = 0.001). Implementing clinician-rated outcome measures was affected by length of encounter (χ2(4) = 27.9, p < 0.001) and clinical site (χ2(3) = 8.6, p = 0.04). PCC behaviors were largely associated with student role and length of encounters; clinical site had less impact. Athletic training educators should emphasize progressive autonomous supervision with preceptors and encourage students to facilitate slightly longer patient visits, when possible, to incorporate more PCC behaviors.

Athletic Trainers' Perceptions of and Experience with Social Determinants of Health.

The role that social determinants of health (SDHs) play in athletic healthcare is gaining attention, yet little is known about athletic trainers' (ATs) perceptions of and encounters with the impact of SDHs. The purpose of this study was to evaluate ATs' perceptions of various SDHs and their experience treating patients whose health and well-being were influenced by SDHs. This was a cross-sectional, web-based survey completed by 1694 ATs (completion rate = 92.6%; 61.1% female; age = 36.6 ± 10.8 years). The survey consisted of several multipart questions focusing on specific SDHs. Descriptive statistics were used to report frequencies and percentages. Results indicated widespread agreement that SDHs matter to patient health and are of concern in athletic healthcare. The SDHs that ATs most commonly reported encountering included lifestyle choices (n = 1306/1406; 93.0%), social support (n = 1185/1427; 83.0%), income (n = 1167/1502; 77.7%), and access to quality and timely healthcare (n = 1093/1420, 77.0%). The SDHs that ATs least commonly reported having experience with was governmental policy (n = 684/1411; 48%). The perceived importance of SDHs among ATs and their commonly reported experiences managing patient cases in which SDHs negatively influence patients' health and healthcare suggest that efforts to assess these factors are needed so that strategies to address their influence on athletic healthcare can be identified.

Quick-Release Antifouling Hydrogels for Solar-Driven Water Purification.

Hydrogels are promising soft materials for energy and environmental applications, including sustainable and off-grid water purification and harvesting. A current impediment to technology translation is the low water production rate well below daily human demand. To overcome this challenge, we designed a rapid-response, antifouling, loofah-inspired solar absorber gel (LSAG) capable of producing potable water from various contaminated sources at a rate of ∼26 kg m-2 h-1, which is sufficient to meet daily water demand. The LSAG-produced at room temperature via aqueous processing using an ethylene glycol (EG)-water mixture-uniquely integrates the attributes of poly(N-isopropylacrylamide) (PNIPAm), polydopamine (PDA), and poly(sulfobetaine methacrylate) (PSBMA) to enable off-grid water purification with enhanced photothermal response and the capacity to prevent oil fouling and biofouling. The use of the EG-water mixture was critical to forming the loofah-like structure with enhanced water transport. Remarkably, under sunlight irradiations of 1 and 0.5 sun, the LSAG required only 10 and 20 min to release ∼70% of its stored liquid water, respectively. Equally important, we demonstrate the ability of LSAG to purify water from various harmful sources, including those containing small molecules, oils, metals, and microplastics.

Patient-Reported Outcomes at Return to Sport After Lateral Ankle Sprain Injuries: A Report From the Athletic Training Practice-Based Research Network.

CONTEXT: Limited evidence exists regarding the assessment of single-item patient-reported outcomes when patients are medically cleared to return to sport after a lateral ankle sprain (LAS) injury. OBJECTIVE: To evaluate self-reports of improvement in health status, pain, function, and disability at return to sport after an LAS. DESIGN: Descriptive study. SETTING: Sixty-nine athletic training facilities across 24 states. PATIENTS OR OTHER PARTICIPANTS: A total of 637 patients (males = 53.2%) who were diagnosed with an LAS, restricted from sport after injury, and subsequently medically cleared to return to sport within 60 days were included. MAIN OUTCOME MEASURE(S): Descriptive statistics were used to summarize scores for health status (Global Rating of Change), pain (Numeric Pain Rating Scale), function (Global Rating of Function), and disability (Global Rating of Disability). Mann-Whitney U tests were used to compare score differences between sexes. A Kaplan-Meier analysis was performed to provide a visual depiction of sex differences in the time to return to sport. RESULTS: Most patients sustained an LAS injury while participating in basketball, football, or soccer and were cleared to return to sport 8 days after injury. More than two-thirds of patients reported a meaningful improvement in health status between the time of injury and return to sport. However, many noted deficits related to pain (65.1%), function (86.2%), or disability (35.8%) at return to sport. No differences were seen between males and females for pain (P = .90), function (P = .68), change in health status (P = .45), or disability (P = .21) at return to sport, although males returned to sport slightly sooner than females (P = .025). CONCLUSIONS: Despite self-perceived improvements in health status since the time of injury, patients typically returned to sport with deficits in pain, function, and disability after an LAS. Patients may be returning to unrestricted sport participation before they feel their bodies have fully recovered from the injury.

Using the Practical Robust Implementation and Sustainability Model (PRISM) to Identify and Address Provider-Perceived Barriers to Optimal Statin Prescribing and Use in Community Health Centers.

Statins are an important but underutilized therapy to prevent cardiovascular events, particularly in high-risk patients. To increase use of statin therapy in high-risk patients, the Centers for Disease Control and Prevention funded a project led by the National Association of Community Health Centers to discover reasons for statin underuse in health centers and identify possible leverage points, particularly among vulnerable and underserved patients. The project further sought to develop training and educational materials to improve statin prescribing for and acceptance in eligible high-risk patients. As a first step, investigators implemented a questionnaire to clinical providers (n = 45) at health centers participating in the project to obtain their perspective on barriers to optimal statin use. We used the practical robust implementation and sustainability model (PRISM) domains to frame the overall project and guide the development of our questionnaire. This paper summarizes top perceived barriers to patient and health system/provider statin initiation and sustainment, as well as facilitators to prescribing, using PRISM as an organizing framework. Our questionnaire yielded important suggestions related to public awareness, education materials, health information technology (HIT)/data solutions, and clinical guidelines as key factors in optimizing statin use. It also informed the design of patient education resources and provider training tools. Future directions include using the full application of the PRISM implementation science model to assess how well our educational and training resources help overcome barriers to statin use in high-risk patients, including evaluating how key contextual factors influence successful implementation.

Patients Experience Significant and Meaningful Changes in Self-Report of Function During the First 2 Weeks After an Ankle Sprain Injury: A Report From the Athletic Training Practice-Based Research Network.

CONTEXT: Ankle sprains are common during sport participation and associated with long-term deficits in self-report of function. However, little is known of short-term changes in self-report of function following injury. The authors aimed to assess statistical and clinically meaningful changes in self-report of function, as measured by the Foot and Ankle Ability Measure (FAAM), during the first 2 weeks after an ankle sprain injury. DESIGN: A retrospective analysis of electronic medical records. METHODS: Eighty-eight patients, who were diagnosed with an ankle sprain injury by an athletic trainer, received usual care from an athletic trainer, and completed the FAAM during treatment at weeks 1 and 2 postinjury. The authors calculated the percentage of patients who reported clinically meaningful changes and used Wilcoxon signed-rank tests to compare differences in FAAM scores between time points. RESULTS: Between weeks 1 and 2, significant differences were noted for the FAAM Activities of Daily Living (FAAM-ADL) (P < .001) and FAAM Sport (FAAM-Sport) (P < .001). At the patient level, 86.5% (64/74) and 85.2% (69/81) of patients reported changes that exceeded the minimal clinically important difference value for the FAAM-ADL and FAAM-Sport, respectively, between weeks 1 and 2. At week 2, 31.8% (28/88) and 47.7% (42/88) of patients reported a score below 90% on the FAAM-ADL and below 80% on the FAAM-Sport subscale, respectively. Also, 36.4% (32/88) and 25.0% (22/88) of patients reported a score of 100% on the FAAM-ADL and FAAM-Sport subscales, respectively, at week 2. CONCLUSIONS: Patients report statistically significant and meaningful improvements in self-report of function during the first 2 weeks following ankle sprain injury. However, almost half of patients still report deficits in sport function at 2 weeks postinjury. Patient-reported outcome measures such as the FAAM, can help capture the patient's perception of function and inform patient care decisions. Research efforts should explore individual response patterns to treatment.

Acuity Tools for the Antepartum and Neonatal Intensive Care Units.

PURPOSE: To evaluate content validity and interrater reliability for acuity tools developed for the antepartum and neonatal intensive care unit (NICU) patient population. STUDY DESIGN AND METHODS: Antepartum and NICU acuity tools were developed to better evaluate nurse staffing assignment equity and patient needs. Following several iterations with staff nurses and nurse leaders, content validity of the acuity tools was established via a panel of experts in each substantive area using the Content Validity Index. The final tools were then evaluated for interrater reliability using Intraclass Correlation. RESULTS: Content validity for the Antepartum Acuity Tool was S-CVI/Ave = 0.87 and for the NICU Acuity Tool was S-CVI/Ave = 0.98. Interrater Reliability for the Antepartum Acuity tool was ICC = 0.88, and the NICU Acuity Tool was ICC = 0.95. CLINICAL IMPLICATIONS: These tools have established content validity and interrater reliability and are appropriate for use in the antepartum and NICU settings to determine patient acuity and promote appropriate nurse-to-patient assignments.