Performance of Older Depressed Patients on Two Cognitive Malingering Tests: False Positive Rates for the Rey 15-item Memorization and Dot Counting Tests

To our knowledge, no investigations have been undertaken to determine whether depression impacts performance on two commonly used tests to detect malingering of cognitive symptoms, the Rey 15-item Memorization Test and the Rey Dot Counting Test. This is a critical issue because of the high rate of depressive symptoms in patients with neurological conditions. It was hypothesized that depressed individuals, especially those with more severe depression, might be at risk for failing the tests, because these patients exhibit mild deficits in mental speed, visual perceptual/spatial skills, and visual memory, abilities required for successful completion of the malingering tests. However, examination of test performance in 64 older participants with major depression generally revealed very low false positive rates for most test scores, and severity of depression was unrelated to test scores. These results add to accumulating data supporting the validity of these cognitive malingering tests by documenting few false positive identifications.     

Pulmonary Atresia with Ventricular Septal Defect and Multifocal Pulmonary Blood Supply: Does an Intensive Interventional Approach Improve the Outcome?

Introduction. Pulmonary atresia with ventricular septal defect (VSD) continues to be associated with significant morbidity and mortality, with significant institutional variation in therapeutic strategies. This study reports a single center experience utilizing an intensive transcatheter approach to promote pulmonary vascular growth. Methods. A retrospective analysis of 20 patients undergoing surgical and transcatheter treatment for pulmonary atresia with VSD between 2002 and 2010. Results. The median age at initial surgical palliation was 6.3 months (8 days to 2.5 years). Eleven patients (group 1) underwent initial surgical palliation without VSD closure and nine patients (group 2) underwent an initial complete repair with fenestrated or complete VSD closure. Group 1 had a smaller Nakata index (54 mm²/m² vs. 134 mm²/m², P= .04) and a smaller absolute native pulmonary artery diameter (2.7 mm vs. 4.5 mm, P= .01) than group 2. Intraoperative angiography was performed in 10 cases to evaluate if early transcatheter intervention was warranted. The median follow‐up during the study period was 2.3 years (1.6 months to 8.3 years). Of the 16 patients who survived the initial early postoperative period, 15 patients (94%) went on to receive surgical (n = 11) and/or interventional (n = 25) catheterization procedures. There was improvement in the mean Nakata index from the initial presurgical evaluation to the most recent catheterization data (38.4 mm²/m² vs. 169.7 mm²/m², P≤ .05). To date, two of 11 (18%) patients in group 1 ultimately underwent surgical VSD closure. Overall mortality was six of 20 (30%) with four deaths in group 1 and two deaths in group 2. There were no procedural deaths. Conclusions. Combining surgical unifocalization procedures with subsequent early and intensive catheter‐based pulmonary artery rehabilitation may improve vascular growth, ultimately rendering many patients suitable for fenestrated VSD closure. Risk stratification, including intraoperative exit angiography, is essential to determine the need for early transcatheter interventions.     

Nutritional Knowledge of UK Coaches

Athletes obtain nutritional information from their coaches, yet their competency in this area is lacking. Currently, no research exists in the UK which has a different coach education system to many other countries. Therefore, the aim of this study was to evaluate the sports nutrition knowledge of UK coaching certificate (UKCC) level 2 and 3, hockey and netball qualified coaches. All coaches (n = 163) completed a sports nutrition questionnaire to identify: (a) if they provided nutritional advice; (b) their level of sport nutrition knowledge; and (c) factors that may have contributed to their level of knowledge. Over half the coaches provided advice to their athletes (n = 93, 57.1%), even though they were not competent to do so. Coaches responded correctly to 60.3 ± 10.5% of all knowledge questions with no differences between those providing advice and those who did not (p > 0.05). Those coaches who had undertaken formal nutrition training achieved higher scores than those who had not (p < 0.05). In conclusion, UK sports coaches would benefit from continued professional development in sports nutrition to enhance their coaching practice.     

Gaining and maintaining recognition as a paediatric postgraduate trainer

Consultants who act as Educational or Clinical Supervisors to postgraduate doctors must now be recognised as trainers by the GMC. This is a formal process conducted at employer level using supporting information against domains formulated by the Academy of Medical Educators. Recognition is recommended to Health Education England and reported to the GMC. This article addresses how paediatricians in the UK can gain recognition as a trainer of foundation doctors and specialty trainees in paediatrics and how to maintain that recognition over the 5-year cycle.     

The prevalence of use,dependency and harms of legal ‘party pills’ containing benzylpiperazine (BZP) and trifluorophenylmethylpiperazine (TFMPP) in New Zealand

Piperazine‐based ‘party pills’ containing 1‐benzylpiperazine (BZP) and 1‐(m‐trifluorophenylmethylphenyl)piperazine (TFMPP) have become increasingly popular in New Zealand and many other countries. The aim of this study was to collect data on the population prevalence and related harm from legal party pill use in New Zealand. A national household sample of 2010 people aged 13–45 years old was collected using a computer‐assisted telephone interviewing (CATI) facility. Twenty per cent of the sample had tried legal party pills and 15% had used them in the previous year. Approximately 40% of males aged 18–24 years old had used legal party pills in the past year. While most users reported fairly minor problems from use, such as insomnia (50% of last year users), some users reported potentially more serious physical problems, such as ‘vomiting’ (12%), ‘inability to urinate’ (10%), ‘chest pains’ (4%) and ‘seizures’ (0.8%). Users also reported a range of psychological problems from use such as visual hallucinations (9%), paranoia (8%) and depression (8%). Two per cent of last year users were classified as dependent on legal party pills using a short dependency scale. The extent of harms and incidences of more serious problems, suggest that stricter regulation of the sale and use of legal party pills in New Zealand may be appropriate.