Sex differences in HIV effects on visual memory among substance-dependent individuals

HIV’s effects on episodic memory have not been compared systematically between male and female substance-dependent individuals. We administered the Brief Visuospatial Memory Test–Revised (BVMT–R) to 280 substance-dependent HIV+ and HIV– men and women. Groups were comparable on demographic, substance use, and comorbid characteristics. There were no significant main effects of sex or HIV serostatus on BVMT–R performance, but HIV+ women performed significantly more poorly on delayed recall. This effect was most prominent among cocaine-dependent HIV+ women. Our findings are consistent with recent speculation that memory impairment may be more common among HIV+ women, particularly those with a history of cocaine dependence

Inter-Rater Reliability of Historical Data Collected by Non-Medical Research Assistants and Physicians in Patients with Acute Abdominal Pain

OBJECTIVES: In many academic emergency departments (ED), physicians are asked to record clinical data for research that may be time consuming and distracting from patient care. We hypothesized that non-medical research assistants (RAs) could obtain historical information from patients with acute abdominal pain as accurately as physicians.METHODS: Prospective comparative study conducted in an academic ED of 29 RAs to 32 resident physicians (RPs) to assess inter-rater reliability in obtaining historical information in abdominal pain patients. Historical features were independently recorded on standardized data forms by a RA and RP blinded to each others' answers. Discrepancies were resolved by a third person (RA) who asked the patient to state the correct answer on a third questionnaire, constituting the "criterion standard." Inter-rater reliability was assessed using kappa statistics (kappa) and percent crude agreement (CrA).RESULTS: Sixty-five patients were enrolled (mean age 43). Of 43 historical variables assessed, the median agreement was moderate (kappa 0.59 [Interquartile range 0.37-0.69]; CrA 85.9%) and varied across data categories: initial pain location (kappa 0.61 [0.59-0.73]; CrA 87.7%), current pain location (kappa 0.60 [0.47-0.67]; CrA 82.8%), past medical history (kappa 0.60 [0.48-0.74]; CrA 93.8%), associated symptoms (kappa 0.38 [0.37-0.74]; CrA 87.7%), and aggravating/alleviating factors (kappa 0.09 [-0.01-0.21]; CrA 61.5%). When there was disagreement between the RP and the RA, the RA more often agreed with the criterion standard (64% [55-71%]) than the RP (36% [29-45%]).CONCLUSION: Non-medical research assistants who focus on clinical research are often more accurate than physicians, who may be distracted by patient care responsibilities, at obtaining historical information from ED patients with abdominal pain

Emotional Self-Report, Socioemotional Memory, and Anhedonia in Schizophrenia

A secondary analysis of recognition memory and clinical data from people with schizophrenia (N = 112) and healthy control participants (N = 118) was carried out to assess the relationship between the capacity to remember stimuli of varied social and emotional content and anhedonia. Across all participants, no significant zero-order correlations were observed between memory ability and anhedonia. Analysis of memory performance revealed a content (social vs. non-social stimuli) by emotional valence (positive vs. neutral vs. negative) interaction, such that among social images, negative ones were remembered most frequently, whereas among non-social images, negative images were remembered least frequently. This pattern did not differ by diagnosis. In a hierarchical multiple regression, after controlling for diagnosis and disease severity, memory for social images explained a significant proportion of variance in anhedonia. Implications for the Strauss and Gold model of anhedonia and the Accessibility Model of Emotional Self-Report are discussed

Inter-Rater Reliability of Historical Data Collected by Non-Medical Research Assistants and Physicians in Patients with Acute Abdominal Pain

Objectives: In many academic emergency departments (ED), physicians are asked to record clinical data for research that may be time consuming and distracting from patient care. We hypothesized that non-medical research assistants (RAs) could obtain historical information from patients with acute abdominal pain as accurately as physicians.Methods: Prospective comparative study conducted in an academic ED of 29 RAs to 32 resident physicians (RPs) to assess inter-rater reliability in obtaining historical information in abdominal pain patients. Historical features were independently recorded on standardized data forms by a RA and RP blinded to each others’ answers. Discrepancies were resolved by a third person (RA) who asked the patient to state the correct answer on a third questionnaire, constituting the “criterion standard.” Inter-rater reliability was assessed using kappa statistics (κ) and percent crude agreement (CrA).Results: Sixty-five patients were enrolled (mean age 43). Of 43 historical variables assessed, the median agreement was moderate (κ 0.59 [Interquartile range 0.37-0.69]; CrA 85.9%) and varied across data categories: initial pain location (κ 0.61 [0.59-0.73]; CrA 87.7%), current pain location (κ 0.60 [0.47-0.67]; CrA 82.8%), past medical history (κ 0.60 [0.48-0.74]; CrA 93.8%), associated symptoms (κ 0.38 [0.37-0.74]; CrA 87.7%), and aggravating/alleviating factors (κ 0.09 [-0.01-0.21]; CrA 61.5%). When there was disagreement between the RP and the RA, the RA more often agreed with the criterion standard (64% [55-71%]) than the RP (36% [29-45%]).Conclusion: Non-medical research assistants who focus on clinical research are often more accurate than physicians, who may be distracted by patient care responsibilities, at obtaining historical information from ED patients with abdominal pain.[WestJEM. 2009;10:30-36.