Non-significant Findings Research Articles

Understanding the Role of Patient Portals in Fostering Interprofessional Collaboration Within Mental Health Care Settings: Mixed Methods Study.

Patient portals are web-based systems through which patients can access their personal health information and communicate with their clinicians. The integration of patient portals into mental health care settings has been evolving over the past decade, as cumulated research to date has highlighted the potential role of portals in facilitating positive health outcomes. However, it is currently unknown whether portal use can foster interprofessional collaboration between clinicians and patients or whether the portal is a tool to support an already established collaborative relationship. This mixed methods study aimed to understand how the use of a patient portal within mental health settings can impact the level of interprofessional collaboration between clinicians and patients. This study was conducted in a large mental health care organization in Ontario, Canada. A convergent mixed methods design was used, where the primary data collection methods included questionnaires and semistructured interviews with patients who had experience using a portal for their mental health care. For the quantitative strand, participants completed the Health Care Communication Questionnaire and the Self-Empowerment subscale of the Mental Health Recovery Measure at 3 time points (baseline, 3 months of use, and 6 months of use) to measure changes in scores over time. For the qualitative strand, semistructured interviews were conducted at the 3-month time point to assess the elements of interprofessional collaboration associated with the portal. For the quantitative strand, 113 participants completed the questionnaire. For the Health Care Communication Questionnaire scores, the raw means of the total scores at the 3 time points were as follows: baseline, 43.01 (SD 7.28); three months, 43.19 (SD 6.65); and 6 months, 42.74 (SD 6.84). In the univariate model with time as the only independent variable, the scores did not differ significantly across the 3 time points (P=.70). For the Mental Health Recovery Measure scores, the raw mean total scores at the 3 time points were as follows: baseline, 10.77 (SD 3.63); three months, 11.09 (SD 3.81); and 6 months, 11.10 (SD 3.33). In the univariate model with time as the only independent variable, the scores did not differ significantly across the 3 time points (P=.34). For the qualitative strand, 10 participants were interviewed and identified various elements of how interprofessional collaboration can be supplemented through the use of a patient portal, including improved team functioning, communication, and conflict resolution. Although the quantitative data produced nonsignificant findings in interprofessional collaboration scores over time, the patients' narrative accounts described how the portal can support various interprofessional collaboration concepts, such as communication, leadership, and conflict resolution. This provides useful information for clinicians to support the interprofessional relationship when using a portal within a mental health setting. RR2-10.1136/bmjopen-2018-025508.

The effects of transcranial direct current stimulation on corticospinal excitability: A systematic review of nonsignificant findings.

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can modulate brain activity through the application of low-intensity electrical currents. Based on its reported effects on corticospinal excitability (CSE), tDCS has been used to study cognition in healthy individuals and reduce symptoms in a variety of clinical conditions. Despite its increasing popularity as a research and clinical tool, high interindividual variability has been reported in the response to protocols using transcranial magnetic stimulation (TMS) to assess tDCS-induced changes in CSE leading to several nonsignificant findings. In this systematic review, studies that reported no significant modulation of CSE following tDCS were identified from PubMed and Embase (Ovid) databases. Forty-three articles were identified where demographic, TMS and tDCS parameters were extracted. Overall, stimulation parameters, CSE measurements and participant characteristics were similar to those described in studies reporting positive results and were likewise heterogeneous between studies. Small sample sizes and inadequate blinding were notable features of the reviewed studies. This systematic review suggests that studies reporting nonsignificant findings do not markedly differ from those reporting significant modulation of CSE.

Combatting Social Isolation, Anxiety, and Loneliness in Hospitalized Patients: A Quasi-Experimental Study.

The objective of this study was to determine the effectiveness of an intervention related to social isolation and loneliness among hospitalized patients by improving: 1) social connectedness; 2) anxiety; and 3) loneliness and to evaluate experiences of the connection intervention. Social isolation and loneliness can lead to detrimental effects on morbidity/mortality and health indices. A connection intervention was developed by investigators using key strategies to promote connectedness, providing in-person contact for hospitalized patients to meet individual and self-care needs. This quasi-experimental study was conducted in a Midwest adult academic health center. Social connectedness, anxiety, and loneliness were evaluated at baseline and postintervention using a paired-sample t test. Experience responses were analyzed using content analysis. There were no significant differences in social connectedness, anxiety, or loneliness when comparing baseline with postintervention. Experience themes included sharing personal stories back and forth, treating me as a person, mitigating loneliness, and finding benefit. Despite nonsignificant findings, participants found benefit in filling the social void of being an inpatient. Clinicians should ensure that holistic care is delivered to hospitalized inpatients. Inclusive patient-centered strategies targeted to decrease social isolation and loneliness among acute care inpatients should continue to be developed and tested.

PERBEZAAN KOMPETENSI GURU-GURU SAINS SOSIAL: MATA PELAJARAN SEJARAH ANTARA JANTINA DI SEKOLAH-SEKOLAH ZON UTARA

Educators, as individuals, hold a crucial position in fostering the development of outstanding and high-caliber students. A teacher's comprehensive grasp and perception, coupled with their determination towards diversifying abilities and enhancing knowledge, are indispensable attributes. The teacher's proficiency in teaching high-level history subjects facilitates systematic instructional activities, commencing from the initial stages and progressing towards the conceptual development through the utilization of knowledge and skills, ultimately culminating with reinforcement and reinforcement activities. Of the 98 history teachers surveyed, the sample included 59 male teachers and 39 female teachers, and an independent T-test was conducted using SPSS Version 26 to examine the gender-based competency differences between the teachers. The teacher's teaching and learning proficiency across genders exhibited a significant difference, with a value of p < 0.05, whereas the teacher's professionalism and teaching effectiveness showed non-significant findings (p > 0.05). This study involved teachers who specialize in the subject of History. The effort to implement a wide range of teaching techniques by history teachers constitutes a shift in the subject of history that aligns with the National Education transformation process, as outlined by the Primary School Standard Curriculum (KSSR) and the Secondary School Standard Curriculum (KSSM). These standards necessitate the time and commitment of teachers to master the subject content and teaching strategies.

Identifying spin bias of nonsignificant findings in biomedical studies

ObjectiveThe purpose of this research note is to share a technique for the identification of spin bias that we developed as part of a living systematic review on the cardiovascular testing of e-cigarette substitution for cigarette smoking. While some researchers have remarked on the subjective nature of ascertaining spin bias, our technique objectively documents forms of spin bias arising from the misrepresentation of nonsignificant findings and from the omission of data.ResultsWe offer a two-step process for the identification of spin bias consisting of tracking data and findings and recording of data discrepancies by describing how the spin bias was produced in the text. In this research note, we give an example of the documentation of spin bias from our systematic review. Our experience was that nonsignificant results were presented as causal or even as significant in the Discussion of studies. Spin bias distorts scientific research and misleads readers; therefore it behooves peer reviewers and journal editors to make the effort to detect and correct it.

Child DNA methylation in a randomised controlled trial of a video-feedback intervention to promote positive parenting and sensitive discipline (VIPP-SD)

IntroductionA major modifiable risk factor for behavioural difficulties is harsh and insensitive parenting, and it has been hypothesised that the biological mechanism by which parenting influences child behaviour is via changes in the child's DNA methylation. We attempted to, in part, address the hypothesis that parenting is associated with child DNA methylation and, in turn, behaviour.MethodsPrimary caregivers of young children with behavioural difficulties (children aged 12–36 months) were randomised to receive a video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) (n = 151), or usual care (n = 149). Child buccal samples were collected at a 2-year post-randomisation follow up (children aged 3–5 years, VIPP-SD group n = 106, usual care group n = 117) and were assessed for DNA methylation at the NR3C1, FKBP5 and OXYR genes. Child behaviour was assessed at baseline, post-intervention and 2-years post-randomisation using the Preschool Parental Account of Children's Symptoms (PPACS). We examined group differences in DNA methylation, associations of DNA methylation with behaviour, and sex differences.ResultsFor the NR3C1 and OXYR genes, there were no group differences, sex differences, or associations of DNA methylation with child behaviour, though all non-significant findings were in the hypothesised direction. For FKBP5 DNA methylation, there was a significant interaction between group and sex, such that males in the usual care group had higher DNA methylation than females, but in the intervention group females had higher DNA methylation than males. However, FKBP5 DNA methylation was not associated with behaviour in males or females.DiscussionWe provide the first evidence from a randomised controlled trial focused on improving parenting for sex-specific changes in child DNA methylation at a key gene involved in stress reactivity and psychopathology. This study adds to our understanding of causal mechanisms linking parenting with child behaviour, which is important for developing targeted interventions. A key limitation is that child DNA methylation was only assessed at one time point, so we were unable to assess change in DNA methylation over time. However, we demonstrate that is possible to collect and analyse DNA samples from families with young children receiving parenting interventions in the community, providing impetus for further research on this topic.

Relationship between parity and breast cancer risk: A critical review of evidence (with focus on sub-Saharan Africa)

ABSTRACT The association between parity and breast cancer has been widely investigated in high-income countries. However, in sub-Saharan African (SSA) region, only a few studies have investigated this association. The aim of this study was to critically review the available evidence, highlighting their strength and weakness, thereby providing a basis for more studies in SSA on the topic. A literature search in MEDLINE, Scopus, PubMed, Google Scholar, and reference list of published studies was conducted. Key case control and cohort studies published between 2000 and 2018 were selected for detailed review based on sample size, geographical distributions, and relevance of the findings. Nonanalytical studies were excluded. The findings were summarized using the tables and forest plots based on R Statistical Software version 3.4.0 (2017). This was primarily to provide visual overview of the reviewed studies and not necessarily to provide a pooled estimate. The conclusion was drawn by comparing the number of observed significant findings (assessed based on confidence intervals) with the number of nonsignificant findings across countries and SSA taking into considerations their strengths and weaknesses. Twenty-six case − control studies and 12 cohort studies across the four regions of the world North America, Europe, Asia, and Africa were reviewed. A reduced risk of breast cancer (especially estrogen receptor [ER] positive breast cancer) was observed in most studies, especially studies from high-income countries. While several studies that reported a nonsignificant observation in SSA were limited in sample size, the few that observed a reduced risk of breast with parity among all women were subject to confounding. Nevertheless, recent studies suggest that the role of parity may be modified by ER status and menopausal status. Further investigation of these suggestions will be needed for a clearer understanding of the relationship between parity and breast cancer in SSA.

A Meta-Analysis of eHealth Interventions on Ischaemic Heart Disease Health Outcomes.

Electronic Health (eHealth) interventions as a secondary prevention tool to empower patients' health in decision-making and behaviour. With the growing body of evidence supporting the use of eHealth interventions, the intention is to conduct a meta-analysis on various health outcomes of eHealth interventions among ischaemic heart disease (IHD) patients. Based on PRISMA guidelines, eligible studies were searched through databases of Web of Science, Scopus, PubMed, EBSCOHost, and SAGE (PROSPERO registration CRD42021290091). Inclusion criteria were English language and randomised controlled trials published between 2011 to 2021 exploring health outcomes that empower IHD patients with eHealth interventions. RevMan 5.4 was utilised for meta-analysis, sensitivity analysis, and risk of bias (RoB) assessment while GRADE software for generating findings of physical health outcomes. Non-physical health outcomes were analysed using SWiM (synthesis without meta-analysis) method. This review included 10 studies, whereby, six studies with 895 participants' data were pooled for physical health outcomes. Overall, the RoB varied significantly across domains, with the majority was low risks, a substantial proportion of high risks and a sizeable proportion of unclear. With GRADE evidence of moderate to high quality, eHealth interventions improved low density lipoprotien (LDL) levels in IHD patients when compared to usual care after 12 months of interventions (SMD -0.26, 95% CI [-0.45, -0.06], I2 = 0%, p = 0.01). Significance appraisal in each domain of the non-physical health outcomes found significant findings for medication adherence, physical activity and dietary behaviour, while half of the non-significant findings were found for other behavioural outcomes, psychological and quality of life. Electronic Health interventions are found effective at lowering LDL cholesterol in long-term but benefits remain inconclusive for other physical and non-physical health outcomes for IHD patients. Integrating sustainable patient empowerment strategies with the advancement of eHealth interventions by utilising appropriate frameworks is recommended for future research.

Influence of Zinc and Boron on Physico-chemical Properties of Soil under Maize Crop in an Inceptisol of Prayagraj, Uttar Pradesh, India

The research was conducted during the Rabi 2020-2021 and 2021-2022. The experiment was laid out in Randomized Block Design with sixteen treatments and three replications with four levels of Zinc and Boron along with NPK as RDF. The non-significant findings were B.D, P.D, % pore space, water holding capacity, and pH were as, the present macro- micro nutrients in soil and also the morphological parameters have significant findings which comprises color is yellowish brown sandy loam textured neutral to alkaline soil that is non- saline in nature among all the treatment combination applied. The OC, NK observed significantly medium to high in treatment T16 RDF (120:60:40 NPK kg ha-1) + Zinc@20 kg ha-1+ Boron @5 kg ha-1), micro-nutrients such as Zinc, Boron were knowingly medium to high in T16 RDF (120:60:40 NPK kg ha-1) + Zinc@20 kg ha-1+ Boron @5 kg ha-1). The maximum mean value for bulk density (1.33 Mg m-3), particle density (2.589 Mg m-3) percent pore space (47.98%), and percent maximum water holding capacity (45.87%) were found. The chemical soil parameters with a cumulative mean of slightly saline soil pH (7.93), average Electrical conductivity (0.41 dS m-1), maximum percent OC (0.42), high Available N (288.52 kg ha-1), high Available P in T2 (16.85 kg ha-1) due to the antagonistic effect of zinc on Phosphorous, high Available K (207.98 kg ha-1), high Available Zn (1.144 mg kg-1), and high Available B (1.243 mg kg-1) were categorized in evaluation to other NPK and micronutrients levels treatments.

Impact of Zinc and Boron on Physico-chemical Properties of Soil under Green Gram Crop in an Inceptisol of Prayagraj, Uttar Pradesh, India

The research entitled “Impact of Zinc and Boron on Soil Health Parameters and Yield Attributes of Green gram in an inceptisol of Prayagraj U.P., India” conducted at the department of Soil Science and Agricultural Chemistry Research Farm, Sam Higginbottom University of Agriculture, Technology and Sciences, Prayagraj, U.P during the Zaid 2021-2022. The experiment was laid out in Randomized Block Design with sixteen treatments and three replications with four levels of Zinc and Boron along with NPK as RDF. The non-significant findings that is B.D, P.D, % pore space, water holding capacity, and pH were as, macro- micro nutrients, in soil and also the morphological parameters have significant findings which comprises yellowish brown sandy-loam textured neutral to alkaline soil that is non- saline in nature between all the treatment combination applied. The OC, NPK were founded significantly medium to high in treatment T16 RDF (20:40:20 NPK kg ha-1) + Zinc@6 kg ha-1+ Boron @3 kg ha-1, micro-nutrients such as Zinc, Boron were knowingly medium to high in treatment T16 RDF (20:40:20 NPK kg ha-1) + Zinc@6 kg ha-1+ Boron @3 kg ha-1. the maximum mean value for Bulk density (1.34 Mg m-3), Particle density (2.588 Mg m-3) percent pore space (47.63%), and percent supreme water holding capacity (46.25%) were found. The chemical soil parameters with a cumulative mean of slightly saline soil pH (8.35), average electrical conductivity (0.419 dSm-1), maximum percent O.C. (0.427), high Available N (284.62 kg ha-1), high Available P in T2 (16.60 kg ha-1) due to the antagonistic effect of zinc on Phosphorous, high Available K (206.93 kg ha-1), high Available Zn (1.132 mg kg-1), and high Available B (1.233 mg kg-1) were considered in evaluation to other NPK and micronutrients levels treatments.

Publication bias, time-lag bias, and place-of-publication bias in social intervention research: An exploratory study of 527 Swedish articles published between 1990-2019.

Publication and related biases constitute serious threats to the validity of research synthesis. If research syntheses are based on a biased selection of the available research, there is an increased risk of producing misleading results. The purpose fo this study is to explore the extent of positive outcome bias, time-lag bias, and place-of-publication bias in published research on the effects of psychological, social, and behavioral interventions. The results are based on 527 Swedish outcome trials published in peer-reviewed journals between 1990 and 2019. We found no difference in the number of studies reporting significant compared to non-significant findings or in the number of studies reporting strong effect sizes in the published literature. We found no evidence of time-lag bias or place-of-publication bias in our results. The average reported effect size remained constant over time as did the proportion of studies reporting significant effects.

Managerial ties and learning ambidexterity: the moderating effects of manager service support and employee service rewards

PurposeManagerial ties (i.e. business ties and political ties) could help manufacturers conduct learning ambidexterity by providing external resources. However, the resource management perspective claims that merely accessing external resources does not guarantee learning ambidexterity. As manufacturers utilize their resources by implementing services, this study aims to investigate how the impact of managerial ties on learning ambidexterity depends on human resource service practices (i.e. manager service support and employee service rewards).Design/methodology/approachThis study collected data from 150 high-tech manufacturing firms through a survey-based questionnaire, which was completed by two managers in one firm. The ordinary least squares regression was employed to test the research model and hypotheses.FindingsBusiness ties hurt learning ambidexterity when manager service support is high, whereas business ties benefit learning ambidexterity when employee service rewards are high. Similar findings are not applied to political ties.Research limitations/implicationsThe authors did not examine the mechanism underlying the effect of managerial ties on learning ambidexterity. The non-significant findings on political ties suggest potential mediators for future research. Another limitation is that the study’s data are only from China. Manager ties are also important in other developing countries like Turkey. More data from other countries are needed to test the generalization of the authors’ findings.Practical implicationsFirst, managers should focus on business ties more than political ties when learning ambidexterity is important to their firms. Second, managers should reward service-oriented employees.Originality/valueThe study enriches the literature on investigating the impact of managerial ties on learning ambidexterity. The authors also contribute to the literature by examining servitization as a service context. Prior studies mainly examine servitization as a driver of firm performance. The findings suggest that servitization as a business context can affect other business activities.

Promoting perceived creativity and innovative behavior: Benefits of future problem-solving programs for higher education students

While it is widely acknowledged that Future Problem Solving (FPS) programs may have the potential for engendering creativity and innovation skills in pupils, a somewhat opaque landscape emerges in terms of identifying the benefits of such programs for higher education students. In this quasi-experimental study, an FPS program was employed in two study tracks: peace education and teacher training. Its main objective was to assess students’ perceived awareness of future problem-solving, creativity, and innovative behavior before and after the program implementation. Another aim was to evaluate the potential links between the three variables. Data were collected from 432 students by using three measurements: Awareness of future problems scale; Short Scale of Creative Self - SSCS; and Innovative Behavior scale. Findings showed that the participants’ awareness of future problems, their belief in their ability to produce creative ideas, and their perceived innovative behavior have increased by the end of the FPS program implementation, relative to its onset. Non-significant findings were detected in the control group. The empirical model indicated the mediating role of perceived creativity in linking awareness of future problems to students’ perceived innovative behavior.

A randomized controlled study of trauma focused cognitive behavioural therapy compared to enhanced treatment as usual with patients in child mental health care traumatized from family violence

PurposeThis study compared the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) and enhanced treatment as usual (eTAU) in children and adolescents exposed to family violence and receiving mental health services. MethodsA total of 89 children, aged 5 to 17 years, with severe trauma symptoms participated with their non-offending caregiver in a randomized controlled trial (RCT) comparing TF-CBT and eTAU. Children were assigned a DSM-IV diagnosis at treatment start and after 6 months. Self-reported trauma symptoms and parental reports of children’s psychological well-being and their own psychological symptoms were obtained at treatment start and after 6 and 12 months. Intention-to-treat analyses were performed, and the reliable change index was calculated. ResultsReports from children, parents, and clinicians showed a statistically significant reduction in trauma and other mental health symptoms among children in both the TF-CBT and eTAU groups, with no statistically significant between-group differences. Trauma symptoms and other mental health symptoms decreased, with small to medium effects after both 6 and 12 months. Clinically significant change in core symptoms was however documented in less than half of the sample. Parents’ self-reported psychiatric and trauma symptoms showed small reductions in both groups, with no between-group differences. ConclusionsContrary to findings in prior RCTs, TF-CBT did not significantly outperform the control treatment (eTAU). The non-significant between-group findings and modest positive changes for individuals in both groups may be explained by the multi-traumatized study population, the treatment delivery, and/or the study design.

The association between dietary acid load and odds and severity of irritable bowel syndrome in adults

No study has been conducted to investigate the association between dietary acid load and irritable bowel syndrome (IBS). So, this cross-sectional study was performed to investigate the association between dietary acid load and odds of IBS, its severity, and IBS subtypes. A sample of 3362 Iranian subjects was selected from health centers in Isfahan province. A validated semi-quantitative food frequency questionnaire (DS-FFQ) was applied to estimate dietary intakes. The dietary acid load was measured using net endogenous acid production (NEAP), dietary acid load (DAL), and potential renal acid load (PRAL) scores. In crude models, the highest compared with the lowest category of the PRAL score was significantly associated with increased odds of IBS severity in participants with BMI ≥ 25 (kg/m2) (OR = 1.54; 95% CI = (1.03–2.32). Also, the results indicated a significant positive association between the PARL and odds of mixed subtype of IBS (OR = 1.74; 95% CI = (1.11–2.74); P trend = 0.02). In propensity score-adjusted model with potential confounders, only a positive association was found between PRAL and odds of mixed subtype of IBS (OR = 1.78; 95% CI = (1.05–3.00); P trend = 0.03). The DAL and NEAP scores tended to show non-significant similar findings. This study indicates that dietary acid load might be associated with odds of mixed type of IBS. However, further research is warranted to infer these findings.

Risk of Repeat Laparoscopy Following Surgical Diagnosis of Endometriosis: Effects of Hysterectomy, Oophorectomy, & Psychiatric Disease

<h3>Study Objective</h3> To quantify rates of repeat laparoscopy following initial surgical diagnosis of endometriosis and investigate risk factors associated with repeat surgery. <h3>Design</h3> Retrospective chart review of patients with surgical pathology confirming endometriosis. This study met exemption criteria (45CFR 46.101b) following IRB review. <h3>Setting</h3> Academic tertiary hospital system. <h3>Patients or Participants</h3> Women ages 12-50 receiving a primary surgical diagnosis of endometriosis, Jan 2017 - June 2018. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> Demographic variables, type of initial procedure (hysterectomy, oophorectomy, other laparoscopy), presence of psychiatric disease (defined by pre-determined clinical criteria) and repeat laparoscopy within 3 years of initial diagnosis. 136 patients met inclusion criteria. Initial surgeries included unilateral oophorectomy (8.1%), bilateral oophorectomy (3.7%), hysterectomy without oophorectomy (22.1%), hysterectomy with unilateral oophorectomy (5.9%), and hysterectomy with bilateral oophorectomy (6.6%). 53.7% underwent other laparoscopy not involving hysterectomy/oophorectomy. 66 patients (49%) met criteria for psychiatric disease. 15 patients (11%) underwent repeat laparoscopy. Comparing patients who underwent repeat laparoscopy with those who did not, there was no difference in age (35.7±5.9 vs. 37.9±11.1 years, respectively, p=0.46), BMI (26.2±7.0 kg/m² vs. 28.5±6.7 kg/m², p=0.22), or race/ethnicity (32% vs. 67% White, Chi-square p=0.55). There was no association between re-operation and psychiatric disease (RR=1.2, 95%CI: 0.48-3.06, p=0.79). Preservation of ≥1 ovary was not associated with re-operation (RR=0.87, 95%CI: 0.26-3.34, p=0.69). Uterine preservation may be associated with a greater risk of repeat laparoscopy, with a trend towards significance (RR=2.5, 95%CI: 0.98-6.40, p=0.09). <h3>Conclusion</h3> The 3-year repeat laparoscopy rate was 11%, consistent with prior literature. Psychiatric disease was not associated with re-operation. Uterine preservation at time of initial laparoscopy may be associated with re-operation, but ovarian preservation was not. While non-significant findings may be limited by underpowering due to a small sample size, these results may help inform counseling and surgical planning in the long-term management of endometriosis.

The effect of medical cannabis on cognitive functions: a systematic review

BackgroundCannabis-based medicines are widely used in the treatment of a number of medical conditions. Unfortunately, cognitive disturbances are often reported as adverse events, although conversely, cognitive improvements have been reported. Hence, the objective of the present study was to identify, critically appraise and synthesise research findings on the potential impact of cannabis-based medicines on cognitive functioning.MethodsFour databases (EMBASE, PsycINFO, PubMed and Scopus) were systematically searched. Studies were included if they provided findings on the impact of cannabis-based medicines in controlled settings on cognitive functioning measured by recognised cognitive tests in human adults. Study participants were required to be their own case-control, and neither studies on abuse, abstinences, patients with severe neurodegenerative diseases nor cancer-related pain conditions were included. Screening, risk of bias assessment and data extraction were conducted independently by two researchers. Findings were tabulated and synthesised by outcome.FindingsTwenty-three studies were included, comprising a total of N = 917. Eight studies used Sativex as the cannabis-based medicine two used Epidiolex, two other studies used sprays, three studies used gelatine capsules, five smoked cannabis, two other and finally one studied cannabis withdrawal. Fifteen studies reported non-significant findings; six reported cognitive impairments; one study found cognitive improvement and a single study found improvement following withdrawal. Thirteen studies had cognitive or neuropsychological functioning as the primary outcome.ConclusionsDue to a large heterogeneity and methodological limitations across studies, it is not possible to make any definite conclusions about the impact of cannabis-based medicines on cognitive functioning. However, the majority of high-quality evidence points in the direction that the negative impact of cannabis-based medicines on cognitive functioning is minor, provided that the doses of THC are low to moderate. On the other hand, long-term use of cannabis based medicines may still adversely affect cognitive functioning. In the studies that found impaired cognitive functioning to be significant, all of the test scores were either within the normal range or below what would be characterised as a neuropsychologically cognitive impairment.

Patterns of MRI Findings in Patients with Chronic Headache: A Retrospective Study from a Private Diagnostic Center in Addis Ababa, Ethiopia.

Headache is one of the most common complaints that lead the patient to seek medical advice however only a few patients with recurrent headaches have a secondary cause like intracranial mass. The appropriate utilization of neuroimaging is important to rule-out secondary cause of headache in resource-limited regions. The objective of this study is to describe the patterns of MRI findings in the evaluation of patients with chronic headache and to determine the clinical variables helpful in identifying patients with intracranial lesions. This cross sectional study was conducted among 590 selected patients who underwent an MRI scan of the head from September 2016 to January 2018 at Wudassie Diagnostic center in Addis Ababa, Ethiopia. Siemens Magnetom 0.35T MRI was used. Out of 590 patients, 372 (63.1%) were females and 218 (36.9%) were males; 300 (50.8%) patients with the mean age of 38.6 ± 0.5 years and a median of 37 ± 16.7years have normal brain MRI and 290(49.2%) have abnormal brain MRI reports. The abnormal findings further divided into non-significant findings were 166(28%) that did not alter patient management and clinically significant findings were 124 (21%) which included by decreasing order of frequency tumors, infection, hydrocephalus, hemorrhage, and vascular abnormalities. It was 1.3 times higher rate of positive brain MR findings in patients who had headaches plus abnormal neurologic findings as compared to patients without neurologic abnormality (P-value = 0.01). There is a high rate of significant abnormal MRI findings in this study as compared to studies from developed nations.

Assessment of spin in abstracts of Endodontic Systematic Reviews with meta-analyses published between 2010 and 2022. Are we in need of more transparent interpretation of findings?

Spin refers to reporting, interpretation and extrapolation related distortion or manipulation of the findings of a study. The aim of this report was to identify the prevalence and extent of spin in the abstracts of systematic reviews (SRs) including meta-analyses in the scientific field of Endodontics. A sensitive and inclusive search strategy in PubMed was developed to identify eligible SRs with meta-analyses in Endodontics, supplemented by an electronic search within 3 major specialty journals, from January 1, 2010 to April 16, 2022. Inclusion and extent of spin was recorded, per domain and following issues related to misleading reporting, interpretation and inappropriate extrapolation of meta-analyses' findings. Association of spin with publication characteristics such as year, journal type, number of authors, continent of authorship, funding, primary study design and significance of the outcome was explored. A hundred and eighty-six SRs with meta-analyses were retrieved, and inclusion of spin was detected in 125 abstracts (67.2%), for one or more domains. The majority of abstracts were affected by more than one types of spin (91/125; 72.8%). There was evidence that abstracts of meta-analyses of non-significant findings had 60% lower odds for inclusion of spin (Odds ratio, OR: 0.40; 95%CI: 0.19, 0.83; p= 0.04), after adjusting for year, journal type and number of authors. Misleading reporting and misinterpretation of findings in abstracts of meta-analyses is evident in endodontic research. Efforts should be reinforced to increase awareness within the scientific and academic community to improve adherence to transparent reporting and interpretation.

Sensory and Motor Visual Functions in Parkinson’s Disease with Respect to Freezing of Gait Symptoms

Purpose: Investigating intraobserver and interobservers repeatability, reproducibility and limits of agreement of anterior corneal indices using three different topographers. Methods: Forty five participants were recruited, involved two examiners and two sessions. They were assessed in random order with EyeSys Vista, Medmont E-300 and manual keratometer. The corneal indices were horizontal keratometer, vertical keratometer, eccentricity and inferior superior index. Repeatability and reproducibility of corneal power measurements were assessed based on the intersession, intrasession, Intraclass Correlation Coefficient (ICC), Spearman’s correlations and agreement was evaluated by Bland Altman test (95% Limits Of Agreement, LoA). Result: All devices showed high repeatability (p &lt; 0.01) and reproducibility (ICC&gt;0.75) of the corneal indices. Multivariate analysis of variance showed nonsignificant findings between visits and examiners (p &gt; 0.05), while there was a significant difference between the devices among keratometric readings (p &lt; 0.0001). The differences between the EyeSys, Medmont and manual keratometer were significant (p &lt; 0.01). Moderate relationship was found between the keratometric readings with the three devices (r = 0.60, p &lt; 0.0001). The 95% LoA for EyeSys and Medmont of the keratometric readings were larger than those for the Medmont and manual keratometer (±0.3 mm). The eccentricity and inferior superior index measurements were not significantly different between the EyeSys and Medmont (p &gt; 0.01). Conclusion: All devices exhibited excellent repeatability and reproducibility. The EyeSys is portable, repeatable, and reliable and have stable interobservers variability. Although EyeSys would not be used interchangeably with the other two devices due to lower agreement, corrected linear calculation was suggested to manage the differences between the EyeSys and the two devices.