Aims:
Sexualised drug taking is increasingly reported on national and international levels. We aim to review existing evidence of the relationship between recreational drug use (RDU) and sexual ...intercourse among men who have sex with men (MSM).
Methods:
We reviewed published abstracts and full articles identified from Cochrane, MEDLINE and Embase databases from November 2010 to 2017. We included any existing studies investigating RDU in MSM and at least one of the following: high-risk sexual practices, sexually transmitted infections (STIs) or barriers to accessing specialist support.
Results:
In total, 112 studies were included. Of them, 38 studies specifically reported the prevalence of chemsex-related drug use. Links with sexualised drug taking and high-risk sexual practices including condomless sex and group sex were reported by several studies. Recreational drug use in the sexual setting appears linked to the acquisition of STIs, including hepatitis C, syphilis and gonorrhoea. Reports of adverse mental health outcomes are increasingly described, with several studies documenting chemsex-related inpatient admission. A paucity of research addressing barriers to those accessing specialist drug support services was identified.
Conclusion:
This review demonstrates the complex interplay between recreational drug use, high-risk sexual practices and STIs. It identifies the description of adverse mental health outcomes in the chemsex setting, thus highlighting the need for a multidisciplinary approach across specialties in the management of those adversely affected. Finally, it illuminates the need for future research into perceived barriers of those who require access to support services to ensure timely and comprehensive support provision.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
It is commonly believed that visual short-term memory (VSTM) consists of a fixed number of "slots" in which items can be stored. An alternative theory in which memory resource is a continuous ...quantity distributed over all items seems to be refuted by the appearance of guessing in human responses. Here, we introduce a model in which resource is not only continuous but also variable across items and trials, causing random fluctuations in encoding precision. We tested this model against previous models using two VSTM paradigms and two feature dimensions. Our model accurately accounts for all aspects of the data, including apparent guessing, and outperforms slot models in formal model comparison. At the neural level, variability in precision might correspond to variability in neural population gain and doubly stochastic stimulus representation. Our results suggest that VSTM resource is continuous and variable rather than discrete and fixed and might explain why subjective experience of VSTM is not all or none.
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BFBNIB, NMLJ, NUK, PNG, SAZU, UL, UM, UPUK
Background Intimate partner violence (IPV) has been shown to have serious health consequences for both women and men, including poor general health, depressive symptoms, substance use, and elevated ...rates of chronic disease. Aside from crime surveys, there have been no large-scale IPV prevalence studies since the 1996 National Violence Against Women Survey. The lack of regular, ongoing surveillance, using uniform definitions and survey methods across states has hindered efforts to track IPV. In addition, the lack of state-specific data has hampered efforts at designing and evaluating localized IPV prevention programs. Methods In 2005, over 70,000 respondents were administered the first-ever IPV module within the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a Centers for Disease Control and Prevention–sponsored annual random-digit-dialed telephone survey, providing surveillance of health behaviors and health risks among the non-institutionalized adult population of the United States and several U.S. territories. Results Approximately 1 in 4 women and 1 in 7 men reported some form of lifetime IPV victimization. Women evidenced significantly higher lifetime and 12-month IPV prevalence, and were more likely to report IPV-related injury than men. IPV prevalence also varied by state of residence, race/ethnicity, age, income, and education. Conclusions State-level data can assist state health officials and policy planners to better understand how many people have experienced IPV in their state. Such information provides a foundation on which to build prevention efforts directed toward this pervasive public health problem.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Music industry touring professionals are generally assumed to be at elevated risk for mental health issues, highlighted by numerous high-profile suicides in recent years. Few studies have explored ...the prevalence of depression, suicidality and associated factors within this population. This study aims to gain an empirical understanding of the mental health issues among international touring professionals, with a particular focus on risk for depression and suicidality, and to identify potential protective factors. Data were collected between February–March 2020 as part of the Tour Health Research Initiative's Touring Health and Wellness Survey 2020. Using a multidimensional questionnaire with a sample of 1154 international touring professionals (artists and crew members), participants who completed all psychosocial measures (n = 508) demonstrated elevated levels of suicidality, risk for clinical depression, stress, anxiety and burnout. The median depression score for completers matched the recommended cutoff score of 20, which qualified 254 participants as high risk for clinical depression, while 200 (39.4%) demonstrated high scores for suicidality. In ROC curve analyses, all psychosocial measures were significant predictors of high suicidality, with a combined emotional and social measure yielding the highest classification accuracy (80%). Moderate strength linear relations were observed for all pairs of measures. Positive correlations were found among all risk factors (depression, anxiety, stress, and burnout) and these measures yielded negative correlations with the protective factors (mindfulness and the emotional/social measure). Findings suggest that interventions enhancing mindfulness and emotional/social well-being may serve as valuable treatment components for this population.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPUK, ZAGLJ, ZRSKP
Background: Neuromuscular and proprioceptive training programs can decrease noncontact anterior cruciate ligament injuries; however,
they may be difficult to implement within an entire team or the ...community at large.
Hypothesis: A simple on-field alternative warm-up program can reduce noncontact ACL injuries.
Study Design: Randomized controlled trial (clustered); Level of evidence, 1.
Methods: Participating National Collegiate Athletic Association Division I womenâs soccer teams were assigned randomly to intervention
or control groups. Intervention teams were asked to perform the program 3 times per week during the fall 2002 season. All
teams reported athletesâ participation in games and practices and any knee injuries. Injury rates were calculated based on
athlete exposures, expressed as rate per 1000 athlete exposures. A z statistic was used for rate ratio comparisons.
Results: Sixty-one teams with 1435 athletes completed the study (852 control athletes; 583 intervention). The overall anterior cruciate
ligament injury rate among intervention athletes was 1.7 times less than in control athletes (0.199 vs 0.340; P = .198; 41% decrease). Noncontact anterior cruciate ligament injury rate among intervention athletes was 3.3 times less than
in control athletes (0.057 vs 0.189; P = .066; 70% decrease). No anterior cruciate ligament injuries occurred among intervention athletes during practice versus
6 among control athletes ( P = .014). Game-related noncontact anterior cruciate ligament injury rates in intervention athletes were reduced by more than
half (0.233 vs 0.564; P = .218). Intervention athletes with a history of anterior cruciate ligament injury were significantly less likely to suffer
another anterior cruciate ligament injury compared with control athletes with a similar history ( P = .046 for noncontact injuries).
Conclusion: This program, which focuses on neuromuscular control, appears to reduce the risk of anterior cruciate ligament injuries in
collegiate female soccer players, especially those with a history of anterior cruciate ligament injury.
Keywords:
RCT
ACL
soccer
injuries
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
To determine whether the variability in rate of sale of prescription opioid analgesics is related to the variability in rates of drug poisoning mortality among states in the United States in 2002.
...Drug poisoning deaths were defined as unintentional deaths or those of undetermined intent whose underlying cause was coded to “narcotics” (X42) or “other and unspecified” drugs (X44) in the National Vital Statistics System. Per capita sales of ten opioid analgesics from the Drug Enforcement Administration and combined sales in morphine equivalents were correlated with drug poisoning mortality rates by state using multivariate linear regression. Regression coefficients between mortality rates and sales rates were adjusted for race (percent white, percent black) and age (percent aged 24 years or younger, and percent aged 65 years and older).
There was over a ten-fold variability in sales of some opioid analgesics. Combined sales ranged 3.7-fold, from 218 mg per person in South Dakota to 798 mg per person in Maine. Drug poisoning mortality varied 7.9-fold, from 1.6/100,000 in Iowa to 12.4/100,000 in New Mexico. Drug poisoning mortality correlated most strongly with non-OxyContin® oxycodone (
r=0.73,
p<0.0001), total oxycodone (
r=0.68,
p<0.0001), and total methadone (
r=0.66,
p<0.0001) in the multivariate analysis. A scatterplot demonstrated a linear relationship between total opioid analgesic sales and drug poisoning mortality.
The extent of opioid analgesics use varies widely in the United States. Variation in the availability of opioid analgesics is related to the spatial distribution of drug poisoning mortality by state.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Purpose Few studies have examined the association between intimate partner violence (IPV) and health outcomes for both women and men. The current study examined this relationship for women and men as ...part of a large cross-sectional public-health survey that collected information on a range of health behaviors and health risks. Methods In 2005, over 70,000 respondents in 16 states and 2 territories were administered the first-ever IPV module within the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS, sponsored by the Centers for Disease Control and Prevention, is an annual random-digit-dialed telephone survey. Lifetime IPV was assessed by four questions that asked about threatened, attempted, or completed physical violence, as well as unwanted sex. Results Women and men who reported IPV victimization during their lifetime were more likely to report joint disease, current asthma, activity limitations, HIV risk factors, current smoking, heavy/binge drinking, and not having had a checkup with a doctor in the past year. Conclusions Experiencing IPV is associated with a number of adverse health outcomes and behaviors. There remains a need for the development of assessment opportunities and secondary intervention strategies to reduce the risk of negative health behaviors and long-term health problems associated with IPV victimization.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
This study aimed to elucidate factors related to suicidality in a high-stress population—music industry touring professionals. It also examined whether trait mindfulness plays a moderating role in ...relations among these factors and suicidality. Touring professionals (N = 1,154) responded to an online questionnaire that included the Center for Epidemiological Studies Depression Scale–Revised (CES-D), Perceived Stress Scale (PSS), Suicide Behavior Questionnaire–Revised (SBQ-R), and the Mindful Attention Awareness Scale (MAAS). Mediation and moderated-mediation analyses were conducted on data from completed instruments (n = 550) with PSS as the antecedent, CES-D as the mediator, MAAS as the moderator, and SBQ-R as the outcome. The indirect effect of stress through depressive symptoms on suicidality was significant. The moderation of this indirect effect by mindfulness also reached significance, with greater mindfulness scores associated with an attenuation of the impact of stress on suicidality through depressive symptoms. Mindfulness was a moderator of stress on depressive symptoms and suicidality. Mindfulness-based interventions for populations under high stress, such as touring professionals, may be an important topic for future research.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Background
Surgical site infection (SSI) rates vary from 1% to 5% in the month following surgery. Due to the large number of surgical procedures conducted annually, the costs of these SSIs can be ...considerable in financial and social terms. Many interventions are used with the aim of reducing the risk of SSI in people undergoing surgery. These interventions can be broadly delivered at three stages: preoperatively, intraoperatively and postoperatively. The intraoperative interventions are largely focused on decontamination of skin using soap and antiseptics; the use of barriers to prevent movement of micro‐organisms into incisions; and optimising the patient's own bodily functions to promote best recovery. Both decontamination and barrier methods can be aimed at people undergoing surgery and operating staff. Other interventions focused on SSI prevention may be aimed at the surgical environment and include methods of theatre cleansing and approaches to managing theatre traffic.
Objectives
To present an overview of Cochrane Reviews of the effectiveness and safety of interventions, delivered during the intraoperative period, aimed at preventing SSIs in all populations undergoing surgery in an operating theatre.
Methods
Published Cochrane systematic reviews reporting the effectiveness of interventions delivered during the intraoperative period in terms of SSI prevention were eligible for inclusion in this overview. We also identified Cochrane protocols and title registrations for future inclusion into the overview. We searched the Cochrane Library on 01 July 2017. Two review authors independently screened search results and undertook data extraction and 'Risk of bias' and certainty assessment. We used the ROBIS (risk of bias in systematic reviews) tool to assess the quality of included reviews, and we used GRADE methods to assess the certainty of the evidence for each outcome. We summarised the characteristics of included reviews in the text and in additional tables.
Main results
We included 32 Cochrane Reviews in this overview: we judged 30 reviews as being at low risk of bias and two at unclear risk of bias. Thirteen reviews had not been updated in the past three years. Two reviews had no relevant data to extract. We extracted data from 30 reviews with 349 included trials, totaling 73,053 participants. Interventions assessed included gloving, use of disposable face masks, patient oxygenation protocols, use of skin antiseptics for hand washing and patient skin preparation, vaginal preparation, microbial sealants, methods of surgical incision, antibiotic prophylaxis and methods of skin closure. Overall, the GRADE certainty of evidence for outcomes was low or very low. Of the 77 comparisons providing evidence for the outcome of SSI, seven provided high‐ or moderate‐certainty evidence, 39 provided low‐certainty evidence and 31 very low‐certainty evidence. Of the nine comparisons that provided evidence for the outcome of mortality, five provided low‐certainty evidence and four very low‐certainty evidence.
There is high‐ or moderate‐certainty evidence for the following outcomes for these intraoperative interventions. (1) Prophylactic intravenous antibiotics administered before caesarean incision reduce SSI risk compared with administration after cord clamping (10 trials, 5041 participants; risk ratio (RR) 0.59, 95% confidence interval (CI) 0.44 to 0.81; high‐certainty evidence ‐ assessed by review authors). (2) Preoperative antibiotics reduce SSI risk compared with placebo after breast cancer surgery (6 trials, 1708 participants; RR 0.74, 95% CI 0.56 to 0.98; high‐certainty evidence ‐ assessed by overview authors). (3) Antibiotic prophylaxis probably reduce SSI risk in caesarean sections compared with no antibiotics (82 relevant trials, 14,407 participants; RR 0.40, 95% CI 0.35 to 0.46; moderate‐certainty evidence; downgraded once for risk of bias ‐ assessed by review authors). (4) Antibiotic prophylaxis probably reduces SSI risk for hernia repair compared with placebo or no treatment (17 trials, 7843 participants; RR 0.67, 95% CI 0.54 to 0.84; moderate‐certainty evidence; downgraded once for risk of bias ‐ assessed by overview authors); (5) There is currently no clear difference in the risk of SSI between iodine‐impregnated adhesive drapes compared with no adhesive drapes (2 trials, 1113 participants; RR 1.03, 95% CI 0.66 to 1.60; moderate‐certainty evidence; downgraded once for imprecision ‐ assessed by review authors); (6) There is currently no clear difference in SSI risk between short‐term compared with long‐term duration antibiotics in colorectal surgery (7 trials; 1484 participants; RR 1.05 95% CI 0.78 to 1.40; moderate‐certainty evidence; downgraded once for imprecision ‐ assessed by overview authors). There was only one comparison showing negative effects associated with the intervention: adhesive drapes increase the risk of SSI compared with no drapes (5 trials; 3082 participants; RR 1.23, 95% CI 1.02 to 1.48; high‐certainty evidence ‐ rated by review authors).
Authors' conclusions
This overview provides the most up‐to‐date evidence on use of intraoperative treatments for the prevention of SSIs from all currently published Cochrane Reviews. There is evidence that some interventions are useful in reducing SSI risk for people undergoing surgery, such as antibiotic prophylaxis for caesarean section and hernia repair, and also the timing of prophylactic intravenous antibiotics administered before caesarean incision. Also, there is evidence that adhesive drapes increase SSI risk. Evidence for the many other treatment choices is largely of low or very low certainty and no quality‐of‐life or cost‐effectiveness data were reported. Future trials should elucidate the relative effects of some treatments. These studies should focus on increasing participant numbers, using robust methodology and being of sufficient duration to adequately assess SSI. Assessment of other outcomes such as mortality might also be investigated as part of non‐experimental prospective follow‐up of people with SSI of different severity, so the risk of death for different subgroups can be better understood.
Background
Improving access to neuroradiology investigations has led to an increased rate of diagnosis of incidental meningiomas.
Method
A cohort of 136 incidental meningioma patients collected by a ...single neurosurgeon in a single neurosurgical centre is retrospectively analysed between 2002 and 2016. Demographic data, imaging and clinical features are presented. The radiological factors associated with meningiomas progression are also presented.
Results
The mean age at diagnosis was 65 (range, 33–94) years. Univariate analysis showed oedema was most strongly correlated with progression (
p
= 0.010) followed by hyperintensity in T2-weighted (T2W) MRI (
p
= 0.029) and in Flair-T2W MRI (
p
= 0.017). Isointensity in Flair-T2W MRI (0.004) was most strongly correlated with non-progression of the meningioma followed by calcification (
p
= 0.007), older age (
p
= 0.087), hypointensity in Flair-T2W MRI (
p
= 0.014) sequences and in T2W MRI (
p
= 0.096). In multivariate analysis, the strongest radiological factor predictive of progression was peritumoural oedema (
p
= 0.016) and that of non-progression was calcification (
p
= 0.002). At the end of the median follow-up (FU) of 43 (range, 4–150) months, 109 (80%) patients remained clinically stable, 13 (10%) became symptomatic and 14 (10%) showed clinical and radiological progression.
Conclusions
One hundred and nine (80%) patients remained stable at the end of FU. Peritumoural oedema was predictive of meningiomas progression. Further prospective study is needed to identify the combination of factors which can predict the meningioma progression for an early surgery or early discharge.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
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