Background Some studies have suggested antipsychotic-naive patients with nonaffective psychosis (NAP) have glucose intolerance. Aims To conduct a systematic review and meta-analysis of fasting glucose (FG), two hour values in the oral glucose tolerance test (2HG), fasting insulin concentration (INS), and insulin resistance (IR). Method We identified possibly relevant studies, then selected studies, following usual guidelines, with two authors reviewing the manuscripts. We required studies to include subjects with nonaffective psychosis and control subjects. Results There were 911 patients and 870 control subjects in the analysis of FG; their average ages were respectively 28.7 and 29.5 years. Significant differences were found for all four variables, with effect size estimates ranging from 0.21 to 0.58. Conclusions As a group, at the time of first clinical contact for psychosis, people with NAP have a slight increase in FG, which most of them maintain in the normal range despite a small increase in IR by secreting additional INS. When faced with a physiological challenge such as a glucose tolerance test or antipsychotics, they are no longer able to maintain a normal glucose concentration.

This article seeks to analyze the current state of scientific knowledge concerning critical thinking in nursing.The methodology used consisted of a scoping review of the main scientific databases using an applied search strategy. A total of 1518 studies published from January, 1999, to June, 2013, were identified, of which 90 met the inclusion criteria.The main conclusion drawn is that critical thinking in nursing is experiencing a growing interest both in the study of its concepts and its dimensions, as well as in the development of training strategies to further its development among both students and professionals.Furthermore, the analysis reveals that critical thinking has been investigated principally in the university setting independent of conceptual models, with a variety of instruments used for its measurement.We recommend the (i) investigation of critical thinking among working professionals,(ii) the designing of evaluative instruments linked to conceptual models, and (iii) the identification of strategies to promote critical thinking in the context of providing nursing care.

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