Medical journals, impact and social media: an ecological study of the Twittersphere

BACKGROUND

Twitter is an increasingly popular means of research dissemination. I sought to examine the relation between scientific merit and mainstream popularity of general medical journals.

METHODS

I extracted impact factors and citations for 2014 for all general medical journals listed in the Thomson Reuters InCites Journal Citation Reports. I collected Twitter statistics (number of followers, number following, number of tweets) between July 25 and 27, 2015 from the Twitter profiles of journals that had Twitter accounts. I calculated the ratio of observed to expected Twitter followers according to citations via the Kardashian Index. I created the (Fifty Shades of) Grey Scale to calculate the analogous ratio according to impact factor.

RESULTS

Only 28% (43/153) of journals had Twitter profiles. The scientific and social media impact of journals were correlated: in adjusted models, Twitter followers increased by 0.78% (95% confidence interval [CI] 0.38%-1.18%) for every 1% increase in impact factor and by 0.62% (95% CI 0.34%-0.90%) for every 1% increase in citations. Kardashian Index scores above the 99% CI were obsverved in 16% (7/43) of journals, including 6 of the 7 highest ranked journals by impact factor, whereas 58% (25/43) had scores below this interval. For the Grey Scale, 12% (5/43) of journals had scores above and 35% (15/43) had scores below the 99% CI.

INTERPRETATION

The size of a general medical journal's Twitter following is strongly linked to its impact factor and citations, suggesting that higher quality research received more mainstream attention. Many journals have not capitalized on this dissemination method, although others have used it to their advantage.

Resilience measurement in later life: a systematic review and psychometric analysis

OBJECTIVES

To systematically review and examine the psychometric properties of established resilience scales in older adults, i.e. ≥60 years.

METHODS

A systematic review of Scopus and Web of Science databases was undertaken using the search strategy "resilience" AND (ageing OR aging)". Independent title/abstract and fulltext screening were undertaken, identifying original peer-reviewed English articles that conducted psychometric validation studies of resilience metrics in samples aged ≥60 years. Data on the reliability/validity of the included metrics were extracted from primary studies.

RESULTS

Five thousand five hundred nine studies were identified by the database search, 426 used resilience psychometrics, and six psychometric analysis studies were included in the final analysis. These studies conducted analyses of the Connor Davidson Resilience Scale (CD-RISC) and its shortened 10-item version (CD-RISC10), the Resilience Scale (RS) and its shortened 5- (RS-5) and 11- (RS-11) item versions, and the Brief Resilient Coping Scale (BRCS). All scales demonstrated acceptable levels of internal consistency, convergent/discriminant validity and theoretical construct validity. Factor structures for the RS, RS-11 and CD-RISC diverged from the structures in the original studies.

CONCLUSION

The RS, RS-5, RS-11, CD-RISC, CD-RISC10 and BRCS demonstrate psychometric robustness adequate for continued use in older populations. However, results from the current study and pre-existing theoretical construct validity studies most strongly support the use of the RS, with modest and preliminary support for the CD-RISC and BRCS, respectively. Future studies assessing the validity of these metrics in older populations, particularly with respect to factor structure, would further strengthen the case for the use of these scales.

Americans shooting themselves in the foot: the epidemiology of podiatric self-inflicted gunshot wounds in the United States

OBJECTIVE

To examine the epidemiology of Americans shooting themselves in the foot.

DESIGN

Data from the Firearm Injury Surveillance Study (1993-2010) collected using the National Electronic Injury Surveillance System were examined. Non-fatal firearm-related injuries were recorded during patients' initial emergency department visits.

SETTING

United States hospital emergency departments, 1993-2010.

PARTICIPANTS

69 111 individuals admitted to US emergency departments after non-fatal firearm-related incidents.

MAIN OUTCOME MEASURE

Demographic and incident characteristics of patients presenting with self-inflicted gunshot wounds to the foot.

RESULTS

Of the 69 111 reported firearm-related injuries, 667 (1.0%) were self-inflicted gunshot wounds to the foot. Of these, 597 of the patients (89.6%) were men and 51.7% (345) were aged between 15 and 34 years. Patients generally presented with puncture wounds (265 patients, 39.7%), foreign bodies (164 patients, 24.6%) and bruised egos. Those who shot themselves in the foot were significantly more likely than individuals with other firearm-related injuries to be male (odds ratio [OR], 1.28) and married (OR, 2.6). As the festive season approached, the number of incidents increased; November and December were peak months for shooting oneself in the foot.

CONCLUSIONS

The nature of and the circumstances surrounding self-inflicted gunshot wounds to the foot were unique when compared with other firearm-related injuries. Through the large-scale examination of the characteristics of these incidents, trends in the nature of Americans shooting themselves in the foot have been elucidated. Young married men are at particular risk of shooting themselves in the foot. Particular caution must be taken during the festive season to avoid being caught under the missing toe.

Successful aging and frailty: mutually exclusive paradigms or two ends of a shared continuum?

The conceptualization of positive and negative states of aging is contentious at the inter- and intraparadigm level; lack of consensus exists within and between states. Working within their respective paradigms, successful aging and frailty researchers may have lost sight of the larger picture. Are successful aging researchers describing nonfrail individuals? Are frailty researchers describing unsuccessful aging? It is imperative that researchers are cognizant of the ways in which their perspectives are contextualized within the literature and within related paradigms, so as to be able to clearly communicate their research and to ensure they are working within the appropriate paradigm to facilitate desired outcomes. Here we discuss the similarities and differences between successful aging and frailty in terms of the scope and emphasis of their constituent components and functioning: both SA and frailty include biomedical components; SA examines the high end, whilst frailty predominately examines the low end of the functioning spectrum. Frailty models emphasize the biomedical realm, whilst SA models emphasize both the biomedical and the psychosocial.

The association between depressive symptoms in the community, non-psychiatric hospital admission and hospital outcomes: a systematic review

OBJECTIVES

This paper aims to systematically review observational studies that have analysed whether depressive symptoms in the community are associated with higher general hospital admissions, longer hospital stays and increased risk of re-admission.

METHODS

We identified prospective studies that looked at depressive symptoms in the community as a risk factor for non-psychiatric general hospital admissions, length of stay or risk of re-admission. The search was carried out on MEDLINE, PsycINFO, Cochrane Library Database, and followed up with contact with authors and scanning of reference lists.

RESULTS

Eleven studies fulfilled our inclusion and exclusion criteria, and all were deemed to be of moderate to high quality. Meta-analysis of seven studies with relevant data suggested that depressive symptoms may be a predictor of subsequent admission to a general hospital in unadjusted analyses (RR=1.36, 95% CI: 1.28-1.44), but findings after adjustment for confounding variables were inconsistent. The narrative synthesis also reported depressive symptoms to be independently associated with longer length of stay, and higher re-admission risk.

CONCLUSIONS

Depressive symptoms are associated with a higher risk of hospitalisation, longer length of stay and a higher re-admission risk. Some of these associations may be mediated by other factors, and should be explored in more details.

Health-related quality of life in the Cambridge City over-75s Cohort (CC75C): development of a dementia-specific scale and descriptive analyses

BACKGROUND

The assessment of Health Related Quality of Life (HRQL) is important in people with dementia as it could influence their care and support plan. Many studies on dementia do not specifically set out to measure dementia-specific HRQL but do include related items. The aim of this study is to explore the distribution of HRQL by functional and socio-demographic variables in a population-based setting.

METHODS

Domains of DEMQOL's conceptual framework were mapped in the Cambridge City over 75's Cohort (CC75C) Study. HRQL was estimated in 110 participants aged 80+ years with a confirmed diagnosis of dementia with mild/moderate severity. Acceptability (missing values and normality of the total score), internal consistency (Cronbach's alpha), convergent, discriminant and known group differences validity (Spearman correlations, Wilcoxon Mann-Whitney and Kruskal-Wallis tests) were assessed. The distribution of HRQL by socio-demographic and functional descriptors was explored.

RESULTS

The HRQL score ranged from 0 to 16 and showed an internal consistency Alpha of 0.74. Validity of the instrument was found to be acceptable. Men had higher HRQL than women. Marital status had a greater effect on HRQL for men than it did for women. The HRQL of those with good self-reported health was higher than those with fair/poor self-reported health. HRQL was not associated with dementia severity.

CONCLUSIONS

To our knowledge this is the first study to examine the distribution of dementia-specific HRQL in a population sample of the very old. We have mapped an existing conceptual framework of dementia specific HRQL onto an existing study and demonstrated the feasibility of this approach. Findings in this study suggest that whereas there is big emphasis in dementia severity, characteristics such as gender should be taken into account when assessing and implementing programmes to improve HRQL.

Lay perspectives of successful ageing: a systematic review and meta-ethnography

OBJECTIVES

The aim of the current study was to conduct a systematic review of lay perspectives of successful ageing (SA), synthesise these data using a metaethnographic framework and to provide a snapshot of extant lay perspectives of SA.

DESIGN

A systematic review of layperson perspectives of SA was conducted across MEDLINE, PsycInfo, CINAHL, EMBASE and ISI Web of Knowledge.

PARTICIPANTS

Peer-reviewed studies conducting qualitative investigations of lay perspectives of SA were included. Included studies were coded and analysed using NVivo V.9 to examine underlying themes of SA.

RESULTS

The search strategy identified 7285 articles; 26 articles met the inclusion criteria. Laypersons identified psychosocial components, notably engagement (eg, social engagement), and personal resources (eg, attitude) as integral components of SA more often than 'physiological' components, such as longevity or physical functioning. These results also highlight the profound under-representation of non-Western countries and the cultural homogeneity of research participants.

CONCLUSIONS

The current study reveals the importance laypersons place on incorporating psychosocial components into multidimensional models of SA, as well as highlighting the need for increased research with under-represented populations.

Latent structure of the Hospital Anxiety And Depression Scale: a 10-year systematic review

OBJECTIVE

To systematically review the latent structure of the Hospital Anxiety and Depression Scale (HADS).

METHODS

A systematic review of the literature was conducted across Medline, ISI Web of Knowledge, CINAHL, PsycInfo and EmBase databases spanning articles published between May 2000 and May 2010. Studies conducting latent variable analysis of the HADS were included.

RESULTS

Twenty-five of the 50 reviewed studies revealed a two-factor structure, the most commonly found HADS structure. Additionally, five studies revealed unidimensional, 17 studies revealed three-factor, and two studies revealed four-factor structures. One study provided equal support for two- and three-factor structures. Different latent variable analysis methods revealed correspondingly different structures: exploratory factor analysis studies revealed primarily two-factor structures, confirmatory factor analysis studies revealed primarily three-factor structures, and item response theory studies revealed primarily unidimensional structures.

CONCLUSION

The heterogeneous results of the current review suggest that the latent structure of the HADS is unclear, and dependent on statistical methods invoked. While the HADS has been shown to be an effective measure of emotional distress, its inability to consistently differentiate between the constructs of anxiety and depression means that its use needs to be targeted to more general measurement of distress.

Mokken scaling analysis of the Hospital Anxiety and Depression Scale in individuals with cardiovascular disease

OBJECTIVE

The Hospital Anxiety and Depression Scale (HADS) is a prolifically used scale of anxiety and depression. The original bidimensional anxiety-depression latent structure of the HADS has come under significant scrutiny, with previous studies revealing one-, two-, three- and four-dimensional structures. The current study examines the latent structure of the HADS using a non-parametric item response theory method.

METHOD

Using data conglomerated from four independent studies of cardiovascular disease employing the HADS (n=893), Mokken scaling procedure was conducted to assess the latent structure of the HADS.

RESULTS

A single scale consisting of 12 of 14 HADS items was revealed, indicating a unidimensional latent HADS structure.

DISCUSSION

The HADS was initially intended to measure mutually exclusive levels of anxiety and depression; however, the current study indicates that a single dimension of general psychological distress is captured.