Chemsex Among Men Who Have Sex With Men: A Systematic Scoping Review of Research Methods

Chemsex refers to the use of psychoactive substances with sex. We carried out a systematic scoping review of methodological characteristics of chemsex research among men who have sex with men (MSM), published between 2010 and 2020. For inclusion, chemsex had to be the main focus, and studies had to specify GHB/GBL, stimulant (amphetamine, crystal meth, ecstasy/MDMA, cathinones, cocaine) and/or ketamine use with sex as a variable. From 7055 titles/abstracts, 108 studies were included, mostly cross-sectional, and from Western countries. About one-third of studies recruited exclusively from clinical settings. A majority of these recruited from sexually transmitted infection (STI) clinics. The included quantitative studies analyzed possible associations between chemsex and STI health (40%), mental health (15%), drug health (12%), sexological health (10%), and post-diagnostic HIV health (7%). Most studies included GHB/GBL and crystal meth in their operationalization of chemsex. Definitions and operationalizations of chemsex vary greatly in the literature, and researchers of chemsex among MSM should consider ways in which this variation impacts the validity of their results. More studies are needed among MSM in non-high income and non-Western countries, and examination of possible links between chemsex and post-diagnostic HIV health, sexological health, and mental health

A match made in EAHIL+ICAHIS+ICLC 2015 – experiences of a research-minded initiative at the Workshop in Edinburgh

A match made in EAHIL+ICAHIS+ICLC 2015 - a combination of handouts, a bulletin board and some post-it-notes, announcements in Facebook and Twitter, and a workshop session - was an initiative at the EAHIL+ICAHIS+ICLC 2015 Workshop in Edinburgh. As members of the International Programme Committee (IPC) the authors formed a sub-group that organized a possibility for the workshop delegates to find partners for their research projects

Röntgendiagnosticerad handartros i relation till exponering för handöverförda vibrationer. En systematisk kunskapsöversikt och meta-analys.

Source at https://hdl.handle.net/2077/73757.Det finns idag ingen uppdaterad evidensbaserad systematisk kunskapsöversikt för sambandet mellan hand-arm vibrationsexponering och röntgen diagnosticerad artros i finger- och handled respektive för benuppluckring (malaci) av handlovsben där vibrationsexponeringsnivåerna kan jämföras. Det saknas även riskbedömningsmodeller som medger risk-värdering utifrån exponerings-respons samband. Följande systematiska kunskapsöversikt syftar till att specifikt besvara frågan om röntgendiagnosticerade artrosförändringar i händerna är relaterat till exponering för hand över förda vibrationer. Syftet avgränsas sålunda till enbart studier på karaktä-ristiska röntgenfynd för artros och bortser från de studier som utgår från kliniska fynd och subjektiva besvär. Kunskapsöversikten syftar även till att bedöma eventuellt exponerings-svars sam band mellan vibrationsdos och röntgendiagnosticerade artrosförändringar samt värdera sambandet med hänsyn tagen till modifierande individfaktorer liksom annan sam varierande exponering

Dupuytrens sjukdom i relation till exponering för handöverförda vibrationer. En systematisk kunskapsöversikt och meta-analys.

Source at https://hdl.handle.net/2077/71843.Kunskapsöversikten syftar till att specifikt besvara frågan om risk för Dupuytrens sjukdom i relation till exponering för handöverförda vibrationer. Litteraturgenomgången följde PRISMAs systematiska metod omfattande databaserna Ovid MEDLINE® , Embase® Classic och Embase® för perioden 1947 till juli 2020 kompletterat med manuell uppdatering i databasen PubMed® fram till 2020-12-31 samt genomgång av referenslistor i översiktsartiklar och originalartiklar. Vid databassökning erhölls totalt 75 referenser till vilka adderades 13 referenser efter kompletterande manuell sökning. För detaljerad granskning kvarstod 61 artiklar. Selektionskraven innefattade att studien publicerats i granskad tidskrift, på engelskt språk samt avsåg Dupuytrens sjukdom/kontraktur och innefattade uppgifter om vibrationsexponering. Den slutliga selektionen omfattade 11 artiklar varav 8 av tvärsnittsdesign, 2 av fallkontrolldesign och 1 av kohortdesign. Granskning och analys innefattade detaljerad genomgång av studieupplägg, population, design, exponering och utfall med hänsyn tagen till modifierande faktorer. Selekterade studier bedömdes utifrån risk för bias enligt uppställda kriterier för diagnostisk tillförlitlighet, exponering och metodologisk kvalité. Meta-analys avsåg beräkningar av sammanfattande risk för Dupuytrens sjukdom i jämförelse mellan grupper exponerade för vibrationer kontra inte exponerade samt mellan grupper med hög respektive låg exponering av vibrationer inom samma studie. Resultaten visade att den sammanvägda prevalensen av Dupuytrens sjukdom bland exponerade män var cirka 8 % och 4 % bland inte vibrationsexponerade män. Riskbestämningen byggd på en kvalitativ, beskrivande analys (narrativ syntes) av de studier som skattades ha lägre risk för bias bedömdes motsvara, en drygt fördubblad risk för Dupuytrens sjukdom vid arbete med vibrerande maskiner. En kompletterande sammanfattande statistisk syntes (meta-analys) visade på en drygt fördubblad risk. För ett möjligt exponeringsrespons samband talar resultatet från en meta-analys, som visade på en dubblerad risk för högexponerade relativt lågexponerade. De sammanvägda resultaten stödjer slutsatsen att arbete med vibrerande maskiner kan utgöra en enskild riskfaktor för Dupuytrens sjukdom, beaktat att underlaget är litet och att det finns en interaktion mellan ålder och exponering samt att det kan finnas individuella skillnader i predisposition

Diagnostic accuracy of heart auscultation for detecting valve disease: a systematic review

Objective The objective of this study was to determine the diagnostic accuracy in detecting valvular heart disease (VHD) by heart auscultation, performed by medical doctors. Design/methods A systematic literature search for diagnostic studies comparing heart auscultation to echocardiography or angiography, to evaluate VHD in adults, was performed in MEDLINE (1947–November 2021) and EMBASE (1947–November 2021). Two reviewers screened all references by title and abstract, to select studies to be included. Disagreements were resolved by consensus meetings. Reference lists of included studies were also screened. The results are presented as a narrative synthesis, and risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2. Main outcome measures Sensitivity, specificity and likelihood ratios (LRs). Results We found 23 articles meeting the inclusion criteria. Auscultation was compared with full echocardiography in 15 of the articles; pulsed Doppler was used as reference standard in 2 articles, while aortography and ventriculography was used in 5 articles. One article used point-of-care ultrasound. The articles were published from year 1967 to 2021. Sensitivity of auscultation ranged from 30% to 100%, and specificity ranged from 28% to 100%. LRs ranged from 1.35 to 26. Most of the included studies used cardiologists or internal medicine residents or specialists as auscultators, whereas two used general practitioners and two studied several different auscultators. Conclusion Sensitivity, specificity and LRs of auscultation varied considerably across the different studies. There is a sparsity of data from general practice, where auscultation of the heart is usually one of the main methods for detecting VHD. Based on this review, the diagnostic utility of auscultation is unclear and medical doctors should not rely too much on auscultation alone. More research is needed on how auscultation, together with other clinical findings and history, can be used to distinguish patients with VHD

When should acute exacerbations of COPD be treated with systemic corticosteroids and antibiotics in primary care: a systematic review of current COPD guidelines.

Not all patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) benefit from treatment with systemic corticosteroids and antibiotics. The aim of the study was to identify criteria recommended in current COPD guidelines for treating acute exacerbations with systemic corticosteroids and antibiotics and to assess the underlying evidence. Current COPD guidelines were identified by a systematic literature search. The most recent guidelines as per country/organisation containing recommendations about treating acute exacerbations of COPD were included. Guideline development and criteria for treating acute exacerbations with systemic corticosteroids and antibiotics were appraised. Randomised controlled trials directly referred to in context with the recommendations were evaluated in terms of study design, setting, and study population. A total of 19 COPD guidelines were included. Systemic corticosteroids were often universally recommended to all patients with acute exacerbations. Criteria for treatment with antibiotics were mainly an increase in respiratory symptoms. Objective diagnostic tests or clinical examination were only rarely recommended. Only few criteria were directly linked to underlying evidence, and the trial patients represented a highly specific group of COPD patients. Current COPD guidelines are of little help in primary care to identify patients with acute exacerbations probably benefitting from treatment with systemic corticosteroids and antibiotics in primary care, and might contribute to overuse or inappropriate use of either treatment

Trauma research in the Nordic countries,1995–2018–a systematic review

Abstract Background: Trauma is a major cause of mortality and reduced quality of life. Most trauma-related research originates from trauma centres, and there are limited available data regarding the treatment of trauma patients throughout the Nordic countries. These countries differ from economically similar countries due to their cold climate, mix of rural and urban areas, and the long distances separating many residents from a trauma centre. Research funders and the general public expect trauma research to focus on all links in the treatment chain. Here we conducted a systematic review to assess the amount of trauma-related research from the Nordic countries between January 1995 and April 2018, and the distribution of this research among different countries and different parts of the trauma treatment chain. Methods: A systematic literature search was conducted in Medline, Embase, the Cochrane Library, Web of Science, and Scopus. We included studies concerning the trauma population from Nordic countries, and published between January 1995 and April 2018. Two independent reviewers screened titles and abstracts, and performed data extraction from full-text articles. Results: The literature search yielded 5117 titles and abstracts, of which 844 full-text articles were included in our analysis. During this period, the annual number of publications increased. Publications were equally distributed among Norway, Sweden, and Denmark in terms of numbers; however, Norway had more publications relative to inhabitants. There were fewer overall publications from Finland and Iceland. We identified mostly cohort studies and very few randomized controlled trials. Studies focused on the level of care were predominantly epidemiological studies. Research at the pre-hospital level was three-fold more frequent than research on other elements of the trauma treatment chain. Conclusion: The rate of publications in the field of trauma care in the Nordic countries has increased over recent years. However, several parts of the trauma treatment chain are still unexplored and most of the available studies are observational studies with low research evidence. Keywords: Nordic countries, Trauma research, Trauma system, Systematic reviewpublishedVersio

Peer reviewing: a private affair between the individual researcher and the publishing houses, or a responsibility of the university?

Peer reviewing is mandatory for scientific journals as quality control of submitted manuscripts, for universities to rank applicants for scientific positions, and for funding agencies to rank grant applications. In spite of this deep dependency of peer reviewing throughout the entire academic realm, universities exhibit a peculiar lack of interest in this activity. The aim of this article is to show that by taking an active interest in peer reviewing the universities will take control over the management and policy shaping of scientific publishing, a regime that is presently largely controlled by the big publishing houses. The benefits of gaining control of scientific publishing policy include the possibility to implement open access publishing and to reduce the unjustifiably high subscription rates currently charged by some of the major publishing houses. A common international clean-up action is needed to move this pivotal element of scientific publishing from the dark hiding places of the scientific journals to where it should be managed: namely, at the universities. In addition to the economic benefits, we postulate that placing peer reviewing at the universities will improve the quality of published research

Biological rhythms in Arctic vertebrates.

Many biological processes show regular cyclical fluctuations that persist throughout an organism's life; these range from the transcription of DNA to patterns of behaviour. Persistent, cyclical phenomena of this kind are a fundamental feature of all organisms. They are governed primarily by endogenous rhythms generated by a 'biological clock' situated in the brain. Normally, however, the expression of the clock is modulated to a greater or lesser extent by environmental cues. This paper reviews the physiological control of the temporal organisation of cycles in vertebrates and, in particular, explores their regulation in arctic species like reindeer (Rangifer tarandus L.). We emphasise how exposure to the photoperiodic conditions that characterise polar regions places special demands on timing mechanisms and how arctic species, therefore, are of particular interest for the study of biological rhythms. Thus far, behavioural and physiological studies of these species show that arctic reindeer (and ptarmigan) appear to be truly opportunistic in summer and wintet, seemingly without any active biological clock and that they are, instead, driven directly by photoperiod. This situation, if confirmed, would be unique among vertebrates

Assessment of otoscopy: how does observation compare to a review of clinical evidence?

Background and Purpose: To investigate how much the method of observation agrees with a standardised review of evidence of clinical examination, for the assessment of clinical otoscopic competence. Methods: 65 medical students took part in an Objective Structured Clinical Examination (OSCE) station using patients with real pathology. Examiners assessed otoscopic competency in tympanic membrane examination solely by distant observation. An external examiner later reviewed candidates’ documented findings on a schematic drawing of the tympanic membranes. Observed agreement of the two methods and Cohen’s kappa coefficient were calculated. Results: Mean otoscopy scores for examiner 1 and examiner 2 were 67.7% and 29.4% respectively. There was a significant difference using the Mann-Whitney U-test. OSCE observation declared 47.7% of candidates (31/65) to be clinically competent. Drawing-based analysis however deemed only 4.6% (3/65) to have achieved this competency. This represented more than a ten-fold overestimation of clinical competency by OSCE assessment. Observed agreement between assessment methods was 59.6%. Cohen’s kappa coefficient was 0.1. Conclusions: OSCE observational assessment of otoscopic clinical competency correlates poorly with review of evidence from clinical examination. If evidence review is acceptable as a better marker for competency, observation should not to be used alone in OSCE assessment. Evidence review itself is vulnerable to candidate guesswork. OSCE could possibly explore candidate demonstration with explanation of findings, by use of digital otoscopy offering a shared view of the tympanic membranes, as an improved standard of clinical competency assessment