Gender disparities in neuropsychological assessment research in drug abuse populations: A systematic review

Objective: To systematically review the literature on the neurocognitive effects of drug use to determine if there are significant gender differences. Methods: In April 2023, we conducted a broad search in MEDLINE (via PubMed), PsycINFO, and Embase for original research studies that used objective neuropsychological assessment to evaluate neurocognition in persons with drug use. Data extraction was performed in a masked, duplicate fashion. Results: Our initial search returned 22,430 records, of which 273 articles were included in our analysis. We found significant underrepresentation of women as participants in the studies. Twenty-one percent of studies had exclusively male participants; when women were included, they averaged only 23% of the sample. Only 49 studies sufficiently documented an analysis of their results by gender; due to the heterogeneity in study characteristics, no conclusions about cognitive differences between women and men could be made. Conclusions: Women are significantly underrepresented in the research on cognition in drug use. Increased efforts to include more women participants and consistent analysis and reporting of data for potential gender differences will be required to close this gap in knowledge, which may lead to improved substance abuse treatment approaches for women.

Evaluating the underreporting of patient-reported outcomes in carpal tunnel syndrome randomized controlled trials

CONTEXT

In recent years, patient-centered healthcare has become a primary concern for researchers and healthcare professionals. When included in randomized controlled trials (RCTs), patient-reported outcome (PRO) measures serve a critical role in supplementing efficacy outcomes with a patient perspective.

OBJECTIVES

The goals of this study are to evaluate the reporting completeness of PROs within literature concerning carpal tunnel syndrome (CTS) utilizing the Consolidated Standards of Reporting Trials Patient-Reported Outcomes (CONSORT-PRO) extension.

METHODS

We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL) for published RCTs relating to CTS with at least one PRO measure from 2006 to 2020. Two investigators screened all RCTs for inclusion utilizing Rayyan (https://rayyan.qcri.org/), a systematic review screening platform. In an independent, masked fashion, investigators then evaluated all RCTs utilizing the CONSORT-PRO adaptation and Cochrane Collaboration Risk of Bias (RoB) 2.0 tool. Bivariate regression analyses were utilized to assess relationships between trial characteristics and completeness of reporting.

RESULTS

Our search returned 374 publications, yet only 31 unique RCTs met the inclusion criteria. The mean overall percent of adherence for CONSORT-PRO was 41%. Our secondary outcome-assessing study characteristics-indicated significantly higher completeness of reporting in the absence of a conflict of interest statement (p<0.05), 'some concerns' for bias (p<0.005), and when journals required the use of the CONSORT statement (p<0.005). The RoB assessment determined overall suspicion for bias among included RCTs, with 35% (n=11/31) being labeled as 'high,' 58% (n=18/31) as 'some concerns,' and 7% (n=2/31) as 'low.'

CONCLUSIONS

Our study indicated that the completeness of CONSORT-PRO reporting was deficient within CTS trials. Because of the importance placed on PROs in clinical practice, we recommend adherence to CONSORT-PRO prior to publication of RCTs to increase the understanding of various interventions on patients' quality of life (QoL).

An Evaluation of Primary Studies Published in Predatory Journals Included in Systematic Reviews From High-Impact Dermatology Journals: Cross-sectional Study

BACKGROUND

Predatory publishing is a deceptive form of publishing that uses unethical business practices, minimal to no peer review processes, or limited editorial oversight to publish articles. It may be problematic to our highest standard of scientific evidence-systematic reviews-through the inclusion of poor-quality and unusable data, which could mislead results, challenge outcomes, and undermine confidence. Thus, there is a growing concern surrounding the effects predatory publishing may have on scientific research and clinical decision-making.

OBJECTIVE

The objective of this study was to evaluate whether systematic reviews published in top dermatology journals contain primary studies published in suspected predatory journals (SPJs).

METHODS

We searched PubMed for systematic reviews published in the top five dermatology journals (determined by 5-year h-indices) between January 1, 2019, and May 24, 2021. Primary studies were extracted from each systematic review, and the publishing journal of these primary studies was cross-referenced using Beall's List and the Directory of Open Access Journals. Screening and data extraction were performed in a masked, duplicate fashion. We performed chi-square tests to determine possible associations between a systematic review's inclusion of a primary study published in a SPJ and particular study characteristics.

RESULTS

Our randomized sample included 100 systematic reviews, of which 31 (31%) were found to contain a primary study published in a SPJ. Of the top five dermatology journals, the Journal of the American Academy of Dermatology had the most systematic reviews containing a primary study published in an SPJ. Systematic reviews containing a meta-analysis or registered protocol were significantly less likely to contain a primary study published in a SPJ. No statistically significant associations were found between other study characteristics.

CONCLUSIONS

Studies published in SPJs are commonly included as primary studies in systematic reviews published in high-impact dermatology journals. Future research is needed to investigate the effects of including suspected predatory publications in scientific research.

ACE domains and depression: Investigating which specific domains are associated with depression in adulthood

BACKGROUND

The study of adverse childhood experiences (ACEs) has shown deleterious effects throughout adulthood. Little attention, however, is given to specific ACE domains as they relate to mental health outcomes, as most studies use cumulative ACE score models.

OBJECTIVE

The current study disaggregates ACEs domains to investigate their independent effect (while controlling for each other and other demographic covariates) on receiving a depression diagnosis as an adult.

PARTICIPANTS AND SETTING

Data were obtained from the Behavioral Risk Factor Surveillance Survey (BRFSS; N = 52,971).

METHODS

To control and account for the numerical number of ACEs, separate models were run among each ACE score (e.g., those with an ACE score of exactly two, three, etc.). An aggregate model with all participants is also included.

RESULTS

Across all ACE scores, those with a history of family mental illness had the highest likelihood of receiving a depression diagnosis. The second strongest association were those with sexual abuse. No other trends were found among the six other domains. Further, those with a combination of family mental illness and sexual abuse had the highest odds of depression.

CONCLUSIONS

Mental health providers should consider the numerical number of ACEs as well as the specific ACE domains (specifically, family mental illness and sexual abuse). Additionally, this provides evidence for a possible weighting schema for the ACEs scale.

Adherence to national recommendations on antibiotic policies and impact on prescribing in an NHS region

Focal points

Cerebral blood flow velocity during tilt table test for pediatric syncope

BACKGROUND

Brain hypoperfusion during neurocardiogenic syncope develops as a consequence of hypotension and bradycardia. Transcranial Doppler indicates that an increase in cerebral vascular resistance occurs before or during the loss of consciousness.

OBJECTIVE

Cerebral blood flow velocity was studied during tilt table testing in pediatric patients with neurocardiogenic syncope. We assessed whether a critical reduction in flow velocity (>40%) was predictive of the presyncopal manifestations during the test.

METHODS

A 2-MHz transcranial Doppler measured blood flow velocity in the right middle cerebral artery in 27 pediatric patients (ages, 8 to 18 years) during a three-stage 80 degrees tilt table test protocol. A positive test required development of syncope or presyncope with at least 30% decrease in systolic blood pressure and/or heart rate relative to preceding values. Patients were divided into: group I (isoproterenol-induced positive tests), group II (positive without isoproterenol), and group III (negative tests).

RESULTS

Within the first 3 minutes of the upright position mean cerebral blood flow velocity in groups I, II, and III decreased by 18%, 29%, and 17%, respectively, as the systolic and diastolic blood pressures showed only minimal changes. A decreased mean blood flow velocity of 48% and 45% and an increase in resistance index of 42% and 26% from supine values in the absence of hypotension, were detected in groups I and II at 46 seconds (range, 30-120 seconds) and 50 seconds (range, 0-300 seconds) before any clinical symptom (presyncope latency). Mean blood flow velocity during presyncope decreased by 58% and 59%, whereas resistance index was double. A significant correlation (rho = -0.62) was found between presyncope latency and the decreased mean cerebral blood flow velocity. Similar blood flow velocity changes were not detected in group III.

CONCLUSION

A sustained reduction >40% in mean cerebral blood flow velocity in the absence of hypotension always resulted in presyncopal or syncopal manifestations. It seems that once this critical threshold is identified during the tilt table testing, supine position may be resumed several seconds before the clinical manifestations of syncope.

When They Drink Too Much Nursing Interventions for Patients with DISORDERED WATER BALANCE

Disordered water balance affects as many as 60% of severely psychiatrically disabled persons. Most patients do not progress to the point of a medical emergency, but are in a state of mild chronic intoxication, making them unavailable for treatment and requiring nursing care to treat the effects of the chronic intoxicated state. Interventions depend on the severity of the disordered water balance and vary from teaching fluid intake control to controlling all patient access to fluids. Nursing management of water intoxication is a trial and error approach. Through a thorough assessment and close observation of the patient, the nurse can determine which interventions would be most appropriate for the patient.

Issues in the nursing management of patients with water intoxication

The syndrome of water intoxication, experienced by a small percentage of hospitalized chronically mentally ill patients, is a two-stage process, usually beginning with polydipsia. In some patients the physiological ability to excrete excess free water is lost, and polydipsia progresses to hypervolemia and hyponatremia. The hyponatremia responds to fluid restriction. Nevertheless, nursing intervention associated with limiting a patient's fluids is complex, including psychodynamic, social, and behavioral factors. Because of the complexity of nursing care, and because of the unanswered questions about etiology and treatment of water intoxication, the area is fertile for nursing research.