Comments on: “Transcranial Direct Current Stimulation for Obsessive-Compulsive Disorder: A Systematic Review”

Dear Editor, Brunelin et al. [1] recently conducted a systematic review that evaluated the effect of applied transcranial direct current stimulation (tDCS) on patients with obsessive compulsive disorder (OCD).[...

Psychometric Proprieties of the Arabic Version of the Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS)

Background: Preoperative competence is a crucial aspect of nursing student’s education for improving the quality of care and patient safety. The Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS) has been developed in the English language to assess the preoperative competence of nursing students. Hence, translation and evaluation of the psychometric proprieties of the PPreCC-NS scale in the Arabic context are urgently required. Aim: To examine the psychometric proprieties of the Arabic version of the Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS). Methods: A descriptive, cross-sectional, methodological study was carried out among 202 nursing students using online questionnaire. The student’s selection was based on probability simple random sampling technique. The international guidelines were followed in the translation of the PPreCC-NS. Exploratory factor analysis and reliability tests were used to evaluate the psychometric properties and internal consistency. Result: The exploratory factor analysis led to the extraction of five factors, with final 22 items. The obtained factor structure was explained by 62.71% of the variance. The Cronbach’s alpha values of the five domains ranged from 0.70 to 0.85, and the total scale of Cronbach’s alpha is > 0.7. Conclusion: The translated questionnaire demonstrated valid and reliable psychometric properties when administered to nursing students. Implication for nursing: The findings may be helpful for nursing educators, nursing managers and decision-makers to develop effective methods for enhancing preoperative nursing care. Further research’s essential to understand factors affecting nursing students’ knowledge regarding preoperative nursing care

The Relationship between Intensive Care Unit’s Nurses’ Informatics Competency and Quality of Patients’ Electronic Health Record’s Documentation

Background: Nursing Informatics (NI) and the development and growth of Health Information Technology (HIT) are becoming a necessary part of all aspects of the nursing practice, especially in critical care settings. In addition, researchers agree on using standardized and electronic documentation to support the nursing process and promote nursing documentation quality. Purpose: To examine the relationship between Intensive Care Unit Nurses' Informatics Competency and Quality of Patients' Electronic Health Record Documentation. Method: A descriptive, correlational, retrospective, cross-sectional design was used. Three hospitals that implemented the Electronic Health Records (EHRs) system were included in this study, using non-probability convenience sampling technique to recruit a total of 176 nurses. The nursing informatics competency was measured by the Self-Assessment of Nursing Informatics Competencies Scale (SANICS). The Quality of Electronic Health Record Documentation was assessed by the Audit instrument for nursing care plans in the patient record (Cat-ch-Ing). Descriptive and Inferential statistics were utilized to answer research questions. Results: The overall mean informatics competency score among nurses was 2.49 (SD = .73), with most of the nurses (81.79%) reporting a low competency score of less than three. The highest percentage of participants 29.4% (n = 52) have moderate quality of EHR documentation. Also, personal and clinical related characteristics accounts for 93.7% of the variance in quality of patients’ electronic health record documentation (R2 = .937, F = 8.707, p = .004). Once nursing informatics competency were entered into the model R2 still the same, making a total explained variance 93.7% (R2 = .937, F = 6.907, p = .013). Conclusion: The present study revealed low levels of nursing informatics competency among nurses, and the highest percentage of participants have moderate quality of EHR documentation. In addition, personal and clinical related characteristics accounts for 93.7% of the variance in quality of patients’ electronic health record documentation Implication to Nursing: This study provides evidence to guide nursing leaders, supervisors and policymakers in their planned actions and policies to support nursing capacity, nursing education, and nursing practice in the area of nursing informatics and electronic nursing documentation. &nbsp

Effects of Transcranial Direct Current Stimulation on Sleep in Athletes: A Protocol of a Randomized Controlled Trial

Background: Sleep disturbances are common among athletes. There is recently a growing interest in improving sleep quality by using noninvasive brain stimulation techniques such as transcranial direct current stimulation (tDCS). We hypothesized that bilateral dorsolateral prefrontal cortex anodal tDCS could improve sleep in different sports athletes. A randomized controlled trial is to be conducted to test this hypothesis. Methods: Eighty-four athletes are selected based on specific eligibility criteria and randomly allocated to the intervention or control group. Each participant will receive a 20-min session of bilateral anodal tDCS with an intensity of 1.5 mA (0.057 mA/cm2) in density 3 times a week for 2 weeks. The tDCS current will be delivered only for 30 seconds in the control group. This study’s outcome is a set of subjective and objective sleep parameters. Conclusion: This study assessed the effect of a novel tDCS protocol represented by bilateral anodal stimulation and may result in important advances in sleep management among athletes. Because of the high incidence and impact of athletes’ poor sleep quality, it is particularly important to explore effective interventions. Trial Registration: ClinicalTrials.gov: NCT05318352

Prevalence of attention-deficit hyperactivity disorder in children, adolescents and adults in the Middle East and North Africa region: a systematic review and meta-analysis

Objectives To systematically estimate the overall prevalence of attention-deficit hyperactivity disorder (ADHD) in children, adolescents and adults across the Middle East and North Africa (MENA) region.Design Systematic review and meta-analysis conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement.Data sources Medline and Scopus databases were comprehensively and systematically searched between 1990 and February 2023.Eligibility criteria for selecting studies We included all cross-sectional or cohort studies that diagnosed ADHD using validated diagnostic tools (eg, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria, ADHD rating scales and ADHD diagnostic interview) or non-validated tools (eg, brain imaging techniques, computerised cognitive tests and quantitative electroencephalography).Data extraction and synthesis Two reviewers performed the data extraction independently using standardised data collection sheet. Newcastle-Ottawa Scale was used to assess the quality of the included studies. Individualised and pooled event rate and upper and lower limit at 95% CI were calculated according to the ADHD cases and the total sample size using a random-effect model. The subgroup prevalence analyses according to ADHD subtypes, gender, MENA country and age were also performed.Results A total of 63 articles met the inclusion criteria involving 849 902 participants. The overall prevalence of ADHD was 10.3% (95% CI 0.081 to 0.129). The prevalence rate ranged from 1.3% (Yemen) to 22.2% (Iran). Subgroup analyses showed that the prevalence in adults was 13.5 and 10.1 in children and adolescents. Males exhibited significantly higher prevalence compared with females as these were 11.1% and 7%, respectively. Attention-deficit subtype was significantly the most prevalent (46.7%) compared with hyperactivity/impulsivity (33.7%) and combined types (20.6%).Conclusion The overall prevalence of ADHD was high in the MENA region. It is crucial to allocate more attention and resources towards the prevention and treatment of ADHD in children, adolescents and adults within the region

Relationship between Sleep Quality and Shoulder Disorders in People with Stroke

Background and objective: The primary aim of the study was to investigate the relationship between sleep quality (SQ) and shoulder disorders in people after a stroke. The secondary aim was to explore the relationship between SQ and stroke outcomes, including the impact of stroke, fatigue, and quality of life (QOL). Material and Methods: A sample of 94 stroke patients was included. The Pittsburgh Sleep Quality Index (PSQI) was used to assess SQ, whereas the Shoulder Pain and Disability Index (SPADI) was utilized to assess shoulder pain and disability. The Stroke Impact Scale 16, the Modified Fatigue Impact Scale, and the Medical Outcomes Study Short Form 12 were also used as secondary measures. Results: The prevalence of poor SQ, shoulder pain, and shoulder disability in our sample was 60%, 78%, and 85%, respectively. The global PSQI score had a significant association with the SPADI pain subscale. There were some significant correlations between the PSQI subscales and shoulder pain and disability. The PSQI significantly correlated with stroke recovery, fatigue, and QOL. The daytime dysfunction PSQI subscale was significantly correlated with all shoulder and stroke outcomes and their subscale. Conclusion: SQ was associated more with the non-motor outcomes of stroke, including pain, cognitive fatigue, and mental status, than the motor outcomes. Considering SQ during upper extremity rehabilitation and care processes is essential

Therapeutic interventions for Pisa syndrome in idiopathic Parkinson's disease. A Scoping Systematic Review

Pisa syndrome (PS) is a postural deformity characterized by marked and reversible lateral trunk flexion. PS can be seen in Parkinson's disease (PD) and several neurodegenerative diseases. A scoping systematic review was conducted to view the therapeutic interventions for PS in PD, their effectiveness, outcome measurements, and related cofactors. Databases and manual searches were performed. Studies that evaluate the effect of interventions on PS were included. Data were extracted and categorized by the main applied therapeutic intervention. A total of 19 published and 2 unpublished studies met the inclusion criteria. Wall and traditional goniometer, kinematic analysis, and clinical observations were used to detect PS. The included studies applied the following therapeutic protocols: Deep brain stimulation (DBS), Botulinum toxin injection, posture exercises, lidocaine injection, oculomotor correction, and spinal cord stimulation. The outcomes measurements of the included studies were linked to International Classification of Functioning, Disability and Health (ICF) model. The therapeutic interventions variously improve PS outcomes at short and long-term follow-up. The interventions did not report side effects or adverse events except DBS. PS severity was related to the DBS voltage amount in one study, and one participant in another study relapsed due to DBS. There are missing reported data in terms of participants' characteristics, medication status, and side effects. The current evidence shows the available interventions for PS, outcomes measurements, and related cofactors. The interventions may be safe and beneficial for PS. Further powerful studies are required

Ataxia Rating Scales: Content Analysis by Linking to the International Classification of Functioning, Disability and Health

Ataxia management is mainly based on rehabilitation, symptomatic management, and functional improvement. Therefore, it is important to comprehensively assess ataxic symptoms and their impact on function. Recently, the movement disorders society recommended four generic ataxia rating scales: scale for assessment and rating of ataxia (SARA), international cooperative ataxia rating scales, Friedreich’s ataxia rating scale (FARS), and unified multiple system atrophy rating scale (UMSARS). The aim of the study was to analyze and compare the content of the recommended ataxia rating scales by linking them to the international classification of functioning, disability and health (ICF). A total of 125 meaningful concepts from 93 items of the four included scales were linked to 57 different ICF categories. The ICF categories were distributed in body structure (n = 8), body function (n = 26), activity and participation (n = 20), and environmental factors (n = 3) components. UMSARS and FARS were the only ones that have addressed the body structure or environmental factors component. The content analysis of ataxia rating scales would help clinicians and researchers select the most appropriate scale and understand ataxic symptoms and their impact on function. It seems that SARA is the optimal scale for rapid assessment of ataxia or in busy clinical settings. UMSARS or FARS are more appropriate for the investigating the impact of ataxia on overall health, and monitoring ataxia progression and disability

Axial postural abnormalities and pain in Parkinson's disease

Axial postural abnormalities and pain are two main determinants of poor quality of life in patients with Parkinson's disease (PD). Indeed, a detailed characterization of pain and other non-motor symptoms in patients with PAs has not been provided yet. The aim of this study is to assess the phenomenology of pain and other non-motor symptoms in PD patients with Pisa syndrome and camptocormia compared to PD patients without axial postural abnormality. Forty-five PD participants were equally distributed in three groups: patients with Pisa syndrome (PS), patients with Camptocormia (CC), and patients without postural abnormalities (PD). Pain characteristics were assessed by Kings Parkinson's Pain Scale (KPPS), brief pain inventory (BPI), and numeric pain rating scale (NRS). All participants completed clinical assessments by non-motor symptom scale (NMSS), and movement disorder society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) parts II-III. Patients with and without axial postural abnormalities showed one or more types of pain, being fluctuation, nocturnal, chronic, and musculoskeletal the most frequently reported in Pisa Syndrome and camptocormia. PD group compared with PS and CC groups showed differences in the KPPS, NMSS, BPI pain severity and interference, and NRS total scores. No significant differences were found between PS group compared with CC group with exception of the NMSS total scores. PD patients with Pisa syndrome or camptocormia have a higher burden of musculoskeletal, chronic and fluctuation pain than PD patients without axial postural abnormalities, suggesting different etiologies of pain and possible different treatments