Proxy ratings of psychological well-being in patients with primary brain tumors: A systematic review.

OBJECTIVE: This systematic review examined the agreement of proxy ratings of depression and anxiety in neuro-oncology patients. METHODS: Searches were conducted across 4 databases (MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science) to identify studies that compared proxy ratings (non-health care providers) of anxiety and depression in patients with brain cancer. Methodological quality and potential risk of bias were evaluated using the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS: Out of the 936 studies that were screened for inclusion, 6 were included for review. The findings were mixed in terms of whether patient and proxy ratings were accurate (e.g., deemed equivalent), with many of the selected studies suggesting moderate level of agreement for several of the selected studies and, when both depression and anxiety were included, depression ratings from proxy raters were more accurate than for anxiety. We identified important limitations across the selected articles, such as low sample size, clarity on defining proxy raters and the different instructions that proxy raters are given when asked to assess patients' mood symptoms. CONCLUSIONS: Our findings suggest that proxy ratings of depression and anxiety should be interpreted with caution. While there is some agreement in proxy and patients with brain cancer ratings of depression and anxiety (greater agreement for depression), future work should recruit larger samples, while also remaining mindful of defining proxy raters and the instructions given in collecting these ratings.

An examination of the sensory structures in the oral cavity of the American alligator (Alligator mississippiensis).

The location and distribution of mucosal sensory structures of the crocodilian oral cavity are poorly understood. Although there are several descriptions of these structures in adults, nothing is known about their development. The purpose of this study was to document location, morphology, and relative abundance of these mucosal sensory structures in both hatchling and subadult alligators. Numerous mucosal sensory structures and pale staining dome-shaped papillae were observed only in the upper palate and tongue. In hatchlings, these papillae, which house either mechanoreceptive or chemosensory (taste buds) structures, were larger and more prevalent on the tongue than the upper palate. In the subadult, however, these papillae housed primarily mechanoreceptive structures and possibly degenerate taste buds. Although the presence of the mechanoreceptive structures in the palates of the suabadult alligator are to be expected, the loss of most taste buds is hitherto undocumented. Thus, there is morphological support for an ontogenetic shift in the role of the sensory palate, from a prey detection gustatory sensory system in hatchlings to a prey-manipulative mechanoreceptive system in subadults.