Good Samaritan Drug Overdose Act awareness among people who use drugs in British Columbia, Canada

Introduction: To address the increase in opioid-related overdoses and deaths in Canada the Good Samaritan Drug Overdose Act (GSDOA) was enacted in May 2017. The GSDOA aims to reduce concerns of police attending overdose events and encourage bystanders to call emergency services. This study explores GSDOA awareness and understanding and the factors associated with GSDOA awareness among people who use drugs (PWUD). Methods: A cross-sectional drug and harm reduction service use survey containing GSDOA-specific questions wasconducted from October to December 2019 at 22 harm reduction supply distribution sites across British Columbia.Descriptive analysis and multivariable logistic regression were conducted to assess correlates of GSDOA awareness. Results: Overall, 54.2% (n = 315) of the eligible study sample (n = 581) reported being aware of the GSDOA. Of respondents reporting awareness, 45.2% and 61.3%, respectively, had a full understanding of when and to whom the GSDOA provides legal protection. In the multivariable model, GSDOA awareness was significantly associated with respondents identifying as cis-men (adjusted odds ratio (AOR) = 2.03 [95% CI: 1.30–3.19]); and those who obtained harm reduction supplies frequently (at least a few times/week) compared with those who did not obtain supplies or obtained them less frequently (AOR = 1.78 [95% CI: 1.14–2.76]). Conclusion: More than 2 years after its introduction, approximately half of harm reduction site clients reported being aware of the GSDOA, and, of these, less than two-thirds had a complete understanding of who is legally protected by the GSDOA. Future GSDOA knowledge dissemination should target PWUD who are less engaged with harm reduction services to improve GSDOA awareness and understanding.

Post COVID-19 Organizing Pneumonia: A Systematic Review and Meta-analysis

Introduction: Several observational studies have found parallels between COVID-19 pneumonia and organizing pneumonia (OP). This study aims to investigate the published literature of OP related to COVID-19, estimates the prevalence of OP among COVID-19 patients, and assesses the risk or COVID-19 severity associated with OP. Methodology: This was a systematic review and meta-analysis. A systematic electronic search through PubMed, Web of Science, Science Direct, EBSCO, and Google Scholar was conducted to include relevant and eligible literature. The authors used Review Manager 5.4 to perform quantitative data synthesis for the condition of interest analyses. Results: A total of 9 eligible study articles and 12 case reports were included in this study. The estimated pooled organizing pneumonia prevalence among COVID-19 patients was 45.6% [23.1%-68.2%]. The association between OP and severe COVID-19 infection revealed a pooled OR [95% CI] of 5.22 [-0.96-11.41]. Conclusion: COVID-19 patients had a rather high OP prevalence (43%). Surprisingly, cancer patients with COVID-19 infection had the lowest OP prevalence. OP was identified as a possible risk factor for the severity of COVID-19 infection.

Music listening practices of college-going students and their impact on hearing

<p class="abstract"><strong>Background:</strong> A billion youngsters are at risk of recreational noise-induced hearing loss. Motivated by WHO’s campaign ‘Make listening safe’, the objective of this study was to estimate the prevalence of the habit of listening to music at high volumes using Personal Listening Devices (PLDs) among college students and to analyze their audiometric findings.</p><p class="abstract"><strong>Methods:</strong> This cross-sectional study was performed between December 2019 and May 2020 on college-going students with a habit of listening to music using PLDs. PTA was performed on the eligible study subjects. A modified LHQ was given to the selected candidates to answer. </p><p class="abstract"><strong>Results:</strong> The study population comprised 62 boys (24.5%) and 191 girls (75.5%) of the age of 17-24 years. 77.1% of the participants listened to music through PLD, at a scale of &gt;5 on 10 (median PLD volume-7). 26.1% of students listened to music for more than 14 hours a week using their headphones or earphones. Fifteen students (5.93%) had evidence of a 4 kHz dip on PTA out of which 9 patients (3.56%) had bilateral and 6 patients (2.37%) had unilateral involvement.</p><p class="abstract"><strong>Conclusions:</strong> Though many students had some awareness regarding safe volume levels while listening to music, not many were aware of daily sound allowance (DSA). Health education to the target population along with the addition of an in-built app in all PLDs for monitoring device volume and DSA may reduce the impact of music on hearing.</p>

Effectiveness of Double-hit Model (Post-weaning Social Isolation and NMDA Receptor Antagonist) in the Development of Schizophrenic Like Symptoms on Rodents: A Protocol for a Systematic Review.

BackgroundSchizophrenia is a heterogeneous neuropsychiatric disorder, categorized by positive, negative, and cognitive symptoms. In trying to improve diagnosis and treatment of schizophrenia researchers have turn to “dual hit” models of schizophrenia that are able to reproduce all symptoms of the disorder. The main objective of this protocol is to present a transparent process on how we plan to review the existing international literature on effectiveness of “dual hit” models used to induce schizophrenia on rodents. MethodsLiterature search strategies will be developed using medical search headings (MeSH). The MEDLINE (PubMed), EMBASE, and Google Scholar databases will be used to search for published studies electronically. We will search for studies involving inducing schizophrenic symptoms using “dual hit” rodent model (post-weaning social isolation and NMDA receptor antagonist). Studies will be screened by titles, abstracts, keywords, and synonyms followed by identifying the full-text articles. All studies that will pass the quality assessment will be included. Data will be extracted by two authors independently and in duplicate, from each eligible study in ensuring that there is consistency between reviews. If the design and comparator are sufficiently homogenous for all studies, meta-analysis will be conducted using a random-effect model.DiscussionThe results of this review will contribute in the development of new “dual hit” models that will be able to characterize schizophrenia symptoms better. It will also shed light to researchers on new developments that need to be made in improving animal models of schizophrenia.Systematic reviews registrationPROSPERO CRD42021247585

Are benzodiazepines effective in treating catatonia?

SUMMARYEstablishing an evidence base for the clinical management of catatonia is made difficult by the heterogeneous nature of the condition and the limited understanding of its pathophysiology. Benzodiazepines are a mainstay of treatment. The Cochrane review discussed identified only one eligible study (17 participants with catatonia who received either lorazepam or oxazepam), which found no difference on the single outcome measure (a 50% improvement on a visual analogue scale). This commentary discusses the findings in more detail, and considers what constitutes high-quality evidence for the acute treatment of catatonia, why there is such a paucity of randomised controlled trials (RCTs) on the topic and whether RCTs are both feasible and appropriate for the condition.

Geographic distributions of age-related macular degeneration incidence: a systematic review and meta-analysis

PurposeWe performed a systematic review and meta-analysis to summarise the geographic distribution of age-related macular degeneration (AMD) incidence.MethodsDatabases including PubMed, Embase and Web of Science were searched for publications of early and late AMD before September 2019. Studies were included if they applied a standardised photographic assessment and classification system. The proportion of participants with AMD in each eligible study was combined to obtain a pooled incidence from all studies using a random effects model. We also assessed sources of potential heterogeneity in the incidence of AMD using meta-regression analyses for both late and early AMD.ResultsTwenty-four population-based studies (70 123 individuals aged 55 years or older) were included in the meta-analysis. The pooled global annual incidences of early and late AMD were 1.59% (95% CI 1.12% to 2.10%) and 0.19% (95% CI: 0.13% to 0.28%), respectively. Individuals of European descent had the highest annual incidence of both early (2.73%, 95% CI 1.63% to 4.57%) and late (0.36%, 95% CI 0.17% to 0.75%) AMD than other ethnic groups. Average age (p=0.001) at baseline, ethnicity (p=0.001), region (p=0.043) and gender (p=0.011) were predictors for incident late AMD, while only average age (p=0.01) at baseline and ethnicity (p=0.025) was associated with incidence of early AMD.ConclusionsThis meta-analysis offers an up-to-date overview of AMD globally, which may provide scientific guidance for the design and implementation of public health strategies such as screening programmes for AMD in both specific geographic locations and ethnic groups, as well as worldwide.

Chloroquine and hydroxychloroquine effectiveness in human subjects during coronavirus: a systematic review

In a search to find effective treatments for COVID-19, chloroquine and hydroxychloroquine have gained attention. We aim to provide evidence to support clinical decision-making regarding medication for the treatment of COVID-19 by carrying out a systematic review of the literature. The electronic databases MEDLINE, EMBASE, Global Health, and HMIC were searched up to April 2020. Eligible study outcomes included: extubation or patient recovery. Relevant data were extracted and analysed by narrative synthesis. Our results included six studies in the review of which four studies were of good or fair quality. All eligible studies included were for coronavirus involving the use of either chloroquine or hydroxychloroquine to treat common symptoms such as fever, cough, shortness of breath and fatigue. Outcomes most commonly reported were improved lung function, viral clearance, and hospital discharge. Strong evidence to support the use of chloroquine and hydroxychloroquine in the treatment of COVID-19 is lacking. Fast track trials are riddled with bias and may not conform to rigorous guidelines which may lead to inadequate data being reported. The use of these drugs in combination with other medications may be useful but without knowing which groups they are suited for and when they may cause more harm than good.

A Call for Evaluation of Restorative Justice Programs

Restorative justice as a response to sexual violence continues to be subject to significant criticism. To assess the evidence, we sought to appraise and synthesize evaluations of restorative justice programs for sexual and family violence offences by conducting a systematic review of peer-reviewed literature. However, our rigorous search identified only one eligible study. This dearth of evidence leaves us unable to identify how best to achieve the aims for which programs were established and poses difficulties for policy makers determining whether it is justified to introduce restorative justice programs for sexual and family violence. We recommend that evaluations of restorative justice programs that accept sexual and family violence cases be conducted as a matter of urgency.