Participant diversity in ACER: 2010-2022

BACKGROUND

Increasing diversity has become a priority for all fields working with human subjects due to historic exclusions and misrepresentations of participants with minoritized identities. To create a more representative and generalizable science of alcohol use, the Research Society on Alcohol (RSA) and its official journal, Alcohol: Clinical and Experimental Research (ACER), have increasingly incorporated diversity and inclusion into their posted values and programming.

METHODS

We analyzed the content of articles published in ACER from 2010 through 2022 (6 years before and after the formation of RSA's Diversity Committee) to assess the reporting of participants' demographic information and whether there has been increased inclusion of diverse samples in alcohol research over time. Our team screened 3292 abstracts for data extraction; studies were included if they were primary analyses of data collected from human subjects (n = 1043).

RESULTS

Reporting of all demographic variables increased over time, with significant increases in reporting for race/ethnicity, sexual orientation, gender identity, socioeconomic status (SES), income, and educational attainment. Demographic variables were also increasingly used in analyses. However, representation of research outside the United States diminished significantly over time.

CONCLUSIONS

We provide recommended journal article reporting standards for ACER to continue the positive progress in reporting demographics in alcohol research and facilitate meta-analyses examining demographic modulation and the impact of social determinants of health.

Facilitators and barriers to patient-centred goal-setting in rehabilitation: A scoping review

Objective

Identify, map, and synthesize existing reviews, to extract and analyse the most prominent barriers and facilitators to applying patient-centred goal-setting practice in rehabilitation using the Capability, Opportunity Motivation Behaviour (COM-B) model.

Design

Scoping review.

Data source

A primary search was conducted in MEDLINE, CINAHL, EMBASE, PsychInfo, and Cochrane. Citation chaining was employed.

Review methods

All types of review (systematic, scoping, and narrative) studies published up to June 14, 2022 that included physical and neurological rehabilitation, patient-centeredness, and goal-setting were reviewed. Studies were scrutinized for relevance, quality was not assessed. The most prominent barriers and facilitators were synthesized using thematic content analysis and mapped onto the COM-B model.

Results

Twenty-six review studies covering a range of conditions and settings, acute to community were included. Barrier and facilitators were identified at patient, provider, and organizational level. Barrier themes include provider's existing beliefs about goal-setting, lack of skills, and integration into clinical routines. Patient barriers related to capacity and opportunity to participate. Organizational barriers include lack of clinical guidelines, patient preparation, insufficient provider time, and high productivity expectations. Facilitators included goal-setting guidelines, training and education of providers and patients, revised clinical routines, performance monitoring, adequate time, and resources.

Conclusion

Healthcare providers should be the primary target of intervention. A provider's motivation to change current practice is the most prominent barrier, followed closely by capacity and opportunity. Patients require information, training, and structured engagement opportunities. Organizations play a key role in creating the optimal environmental conditions to enable patient-centred goal-setting.

Health-Related Quality of Life in Non-Concussed Children: A Normative Study to Inform Concussion Management

Purpose: There has been a shift to consider pediatric concussion recovery beyond symptom management by considering how health-related quality of life (HRQoL) affects recovery. This study investigated normative ranges of HRQoL in children and explored its relationship with common pediatric concussion variables. Methods: A cross-sectional study of 1,722 non-concussed children 8-12 years old (M = 10.52 ± 1.23 years; 1,335 males, 387 females) was conducted by secondary analysis of clinical baseline concussion data. Demographic information, concussion-like symptoms (PCSI-C), and HRQoL (KIDSCREEN-10 Index) were self-reported. Results: The most reported concussion-like symptoms were common stress symptoms and were significantly negatively correlated with HRQoL. Premorbid histories of attention deficit hyperactivity disorder, mental health challenges, headaches/migraines, and concussion significantly lowered HRQoL. The number of diagnosed concussions and PCSI-C scores were significantly negatively correlated with HRQoL. Conclusions: The normative ranges and model can indicate HRQoL levels to inform clinicians how children may respond to concussion and streamline care beyond traditional assessment models.

Self-efficacy in non-concussed youth: a normative study

OBJECTIVE

In pediatric concussion, there has been a shift to consider how pre-injury profiles, such as self-efficacy, affect the recovery trajectory. The aim of this study was to investigate normal ranges of self-efficacy (overall, academic, social, emotional) in youth and to explore its relationship with the effects of daily stressors, operationalized as concussion-like symptoms, demographic factors, pre-injury/learning related factors, and concussion history.

METHODS

A cross-sectional study of 1300 uninjured youth 13-18 years old (1111 males, 189 females) was conducted by secondary analysis of clinical pre-injury/baseline concussion data. Demographic information, concussion-like symptoms (Post-concussion Symptom Inventory), and self-efficacy (Self-efficacy Questionnaire for Children) were self-reported.

RESULTS

The most reported concussion-like symptoms were common stress symptoms and there was a strong negative relationship with self-efficacy. Males reported higher self-efficacy than females, but no age effects were observed. Pre-injury factors including learning disability, ADHD, special education, IEP, mental health challenges, history of headaches/migraines, and concussion history were associated with significantly lower overall self-efficacy.

CONCLUSIONS

These normative ranges and predictive model can be used to provide a benchmark of self-efficacy to indicate how youth may respond to a concussion, and to inform clinical care during recovery.

[Campylobacteriosis outbreaks in the state of Hesse, Germany, 2005-2011: raw milk yet again]

BACKGROUND

Campylobacter is the most frequently reported cause of acute infectious diarrhea in Germany. Campylobacter outbreaks are rare events. However, their investigation provides useful information on risks of infection and unused prevention potentials.

METHODS

We analyzed the Hessian database for notifiable diseases for cases of campylobacteriosis reported from 2005 through 2011. For campylobacter outbreaks including five or more cases we prospectively obtained additional information from local public health authorities.

RESULTS

From 2005 through 2011, 29,473 cases of campylobacteriosis were reported in Hesse, Germany (approx. 6 million inhabitants), yielding an annual incidence ranging from 53.4 to 81.4 cases per 100,000 inhabitants. Only 236 cases were part of 16 outbreaks with five or more cases. Among these, six outbreaks occurred among groups traveling outside Germany, four were associated with the consumption of raw milk. For eight outbreaks consumption of poultry was considered a probable or - based on the frequent consumption of poultry during group travel - possible vehicle of infection. Two of the raw-milk associated outbreaks were reported among two groups who visited the same farm within 18 days. Five of 14 members of several families and 77 of 117 students fell sick. The local public health authority was only informed when both groups had visited the farm.

CONCLUSION

The reported outbreaks can be attributed to known risk factors for campylobacteriosis - consumption of raw milk and poultry and international travel. This underlines that prevention possibilities are insufficiently used. These include avoiding the consumption of unpasteurized milk and milk products, the hygienically correct handling of raw poultry and timely identification and notification of outbreaks to public health authorities.

Serological survey for foot-and-mouth disease virus in wildlife in eastern Africa and estimation of test parameters of a nonstructural protein enzyme-linked immunosorbent assay for buffalo

In this study we estimate the seroprevalence of foot-and-mouth disease virus (FMDV) in wildlife from eastern and central Africa. Sera were sourced from between 1994 and 2002 from a rinderpest surveillance program. Our study compared a nonstructural protein enzyme-linked immunosorbent assay (Cedi test) with a virus neutralization test. The study shows that there is only a low seroprevalence of FMDV in sampled nonbuffalo species. The seroprevalence in the Cape buffalo was high for SAT2, lower for SAT1, and lowest for SAT3. As the SAT2 serotype was most prevalent, the Cedi test largely reflected the occurrence of SAT2-positive animals. The results also suggest that SAT2 became dominant around 1998, with a large increase in seroprevalence. The sensitivity and specificity of the Cedi test were estimated by comparison to the combined virus neutralization test results from all three SAT tests. A Bayesian implementation of the Hui-Walter latent class model was used to estimate the test parameters. The model permits estimation in the absence of a gold standard test. The final model, using noninformative priors and assuming conditional independence of test performance, estimated Cedi test sensitivity at 87.7% and specificity at 87.3%. These estimates are similar to those for domestic bovines; they suggest that the Cedi test is a useful tool for screening buffalo for infection with the various serotypes of FMDV.

Intravesical CDDP therapy compared with combined CDDP and external radiation in noninvasive bladder cancer. Monitored with quantitative fluorescence cytology

Results of intravesical CDDP or CDDP combined with external beam radiation are compared in a group of 13 patients with low-stage bladder cancer. Six patients with low-stage bladder cancer received 4 or 12 treatments of CDDP intravesically with an initial complete response in 3 patients. Within six months, recurrent disease developed in 2 of 3 patients. Seven patients received the combination therapy of 400 rad (weekly for six weeks) followed two hours later with 50 mg of intravesical CDDP. A positive response was observed initially in all 7 patients as determined by pathology, PAP cytology, fluorescence cytology, and quantitative nuclear fluorescence determinations. Therapy was discontinued in 1 patient in each group because of irritative symptoms. The results indicate combination therapy is of tolerable toxicity, and quantitative fluorescence cytology is a useful adjuvant for guiding future treatments in patients with low- and high-grade bladder tumors.

Continuous ambulatory peritoneal dialysis. Treatment of dialysis-related ascites

Continuous ambulatory peritoneal dialysis is a new dialysis technique. It is unknown at this time which patient would be served best by this therapy. Two cases of dialysis-related ascites were successfully treated by this technique. We suggest that the continuous control of salt and water balance possible with this technique, as well as frequent drainage of the peritoneal cavity to prevent fluid reaccumulations, contributed to successful treatment. Continuous ambulatory peritoneal dialysis may be used to treat dialysis-related ascites.

Peritoneal dialysis during peritonitis

Peritonitis during peritoneal dialysis is the most frequent complication associated with this dialysis technique. We studied patients undergoing peritoneal dialysis when they were without peritonitis and during episodes of clinical infection. Peritonitis was associated with a significantly decreased dialysate effluent volume, increased absorption of glucose, clearance of urea and creatinine, and protein loss in the dialysate effluent. We suggest that the changes occurring to the peritoneal dialyzing surface with peritonitis might be explained by alterations in peritoneal blood flow, effective membrane surface area, or permeability.

Mammary neoplasia in a closed beagle colony

The incidence rate of mammary neoplasia in a large colony of beagles and the relationship to internal skeletal and/or liver radiation, age, relatively late ovariectomy (4 years and older), endometritis, parity status, and adrenal weight were examined. Of these various factors, age was the only condition that was clearly correlated with changes in the mammary tumor incidence. The rate became significant at approximately eight years of age and increased progressively throughout the older age classes. Among the female dogs, the incidence of mammary cancer was higher than that of any other form of spontaneous malignancy.

Oxygen cycles and metabolic autoregulation

Rhythmical three to eight per minute cycles in oxygen availability are characteristic of recordings from chronically implanted open tip polarographic electrodes. These were demonstrated to be progressively decreased in amplitude as mean arterial blood pressure was raised from 75 mm Hg to 160 mm Hg, at which level they were abolished. Amplitude of these :ycles also decreased as BP was reduced below 75 mm Hg and they again disappeared at an iverage of 60 mm Hg. Oscillation frequency appeared to be a function of rate of metabolism, oeing reduced by anesthesia, hypothermia, and ischemia. An hypothesis is proposed which relates these oscillations to the feedback delay between metabolic generation of CO 2 and the appropriate adjustment in tension of the pH sensitive muscle of the precapillary arteriole which in turn determines rate of local CO 2 clearance. The changes in amplitude of the oxygen cycles may indicate alteration in pH reactivity of precapillary smooth muscle as a function of BP.