Completeness of reporting of randomised controlled trials including people with transient ischaemic attack or stroke: A systematic review.

PURPOSE: To assess the adherence of stroke randomised controlled trials to Consolidated Standards Of Reporting Trials reporting guidelines and investigate the factors that are associated with completeness of reporting. METHOD: We took a random sample from the Cochrane Stroke Group's Trial Register of transient ischaemic attack or stroke randomised controlled trials, published in English in 1997-2016 inclusive. Two reviewers assessed the published report of the final primary results of stroke randomised controlled trials with a 10-point truncated Consolidated Standards Of Reporting Trials reporting checklist to investigate adherence over time, univariable associations and independent associations with total Consolidated Standards Of Reporting Trials reporting score in a multiple linear regression model. FINDINGS: In this random sample of 177 stroke randomised controlled trials, the mean score on the truncated Consolidated Standards Of Reporting Trials checklist was 5.8 (SD 2.2); reporting improved from 1997-2000 (4.9 SD 2.0) to 2001-2009 (5.8 SD 2.1) and to 2010-2016 (6.8 SD 2.1). A higher Consolidated Standards Of Reporting Trials score was independently associated with publication during epochs following a revision of Consolidated Standards Of Reporting Trials reporting guidelines (p < 0.001), journal endorsement of the Consolidated Standards Of Reporting Trials reporting guideline at the time of randomised controlled trial publication (p < 0.001) and modified journal impact factor using median citation distribution (p = 0.012). DISCUSSION: Stroke randomised controlled trial reporting to Consolidated Standards Of Reporting Trials standards has improved over time, but could be better. CONCLUSION: Journal endorsement and enforcement of Consolidated Standards Of Reporting Trials reporting guidelines could further improve the reporting of stroke randomised controlled trials.Systematic review registration: Registered with PROSPERO (CRD42017072193).

Spontaneous fracture of the genial tubercles: a case report.

UNLABELLED: Spontaneous fracture of the genial tubercles is rare and, of the 13 reported cases in the literature, all involve the older edentulous patient. A case of genial tubercle fracture in a 62-year-old edentulous female is presented. The symptoms are pain and swelling of the floor of the mouth and restricted tongue movement. Surgical intervention was not required and a complete recovery without loss of function was made. CLINICAL RELEVANCE: This case aims to make practitioners aware of genial tubercle fracture as a possible diagnosis when the older edentulous patient presents with pain and swelling in the floor of the mouth.

Very low-dose risperidone in first-episode psychosis: a safe and effective way to initiate treatment.

Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms (EPSs) when treated with the doses of neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less toxic in this population. Here, we report the results of a biphasic open label trial designed to assess the efficacy, safety, and tolerability of low-dose (2-4 mg/day) risperidone treatment in a group of 96 first-episode nonaffective psychosis patients. At the end of the trial, 62% of patients met the response criteria although approximately 80% had achieved a response at some time during the study. Reports of EPS remained low, and there were no dystonic reactions. We conclude that even at a dose of 2 mg/day, risperidone was highly effective in reducing acute symptomatology in a real world sample of young first-episode psychosis patients.

Pilot study evaluating the effect of massage therapy on stress, anxiety and aggression in a young adult psychiatric inpatient unit.

OBJECTIVE: The aim of the present pilot study was to examine the effectiveness of a relaxation massage therapy programme in reducing stress, anxiety and aggression on a young adult psychiatric inpatient unit. METHOD: This was a prospective, non-randomized intervention study comparing treatment as usual (TAU) with TAU plus massage therapy intervention (MT) over consecutive 7 week blocks (May-August 2006). MT consisted of a 20 min massage therapy session offered daily to patients during their period of hospitalization. The Kennedy Nurses' Observational Scale for Inpatient Evaluation (NOSIE), the Symptom Checklist-90-Revised (SCL-90-R), the State-Trait Anxiety Inventory (STAI) and stress hormone (saliva cortisol) levels were used to measure patient outcomes at admission and discharge from the unit. The Staff Observation Aggression Scale-Revised (SOAS-R) was used to monitor the frequency and severity of aggressive incidents on the unit. RESULTS: There was a significant reduction in self-reported anxiety (p < 0.001), resting heart rate (p < 0.05) and cortisol levels (p < 0.05) immediately following the initial and final massage therapy sessions. Significant improvements in hostility (p = 0.007) and depression scores (p < 0.001) on the SCL-90-R were observed in both treatment groups. There was no group x time interaction on any of the measures. Poor reliability of staff-reported incidents on the SOAS-R limited the validity of results in this domain. CONCLUSIONS: Massage therapy had immediate beneficial effects on anxiety-related measures and may be a useful de-escalating tool for reducing stress and anxiety in acutely hospitalized psychiatric patients. Study limitations preclude any definite conclusions on the effect of massage therapy on aggressive incidents in an acute psychiatric setting. Randomized controlled trials are warranted.

An outline of the planned work of the Royal Australian and New Zealand College of Psychiatrists' Board of Education.

OBJECTIVE: The aim of this paper is to inform College Fellows, trainees and other stakeholders about the structure, principles and functioning of the new Board of Education. CONCLUSION: The educational activities of the College are likely to evolve and to be developed over the next 5 years by a process taking account of the views of key stakeholders. In the short term, there will be no changes to training or examination processes which would disadvantage trainees.

Expressed emotion, attributions, utility beliefs, and distress in parents of young people with first episode psychosis.

This study examined the relationship between expressed emotion (EE), attributions of control, beliefs about the utility of EE behaviors, and distress in parents of young people with first episode psychosis. Fifty-three parents completed self-report measures of EE, attributions of patient and parent control over the psychotic illness, and beliefs about the utility of EE behaviors in controlling the patient's symptomatology. Measures of parental distress and parental assessment of patient symptomatology were also completed. Parents high on criticism EE were more likely to make attributions that the psychotic illness was controllable by the young person, and to endorse the potential utility of person-focused criticism (i.e., telling the patient about the parents' dissatisfaction and frustration with them as a person) in controlling the patient's symptoms. Beliefs in the utility of person-focused criticism and self-sacrifice were significantly associated with distress, but attributions that the illness was controllable by the patient or the parent were not. Beliefs about the utility of criticism may play an important role in EE among parents of young people with first episode psychosis, and may provide further direction for interventions designed for this group.