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Maroc Med. 1949 Jan;28(284):22-31

Authors: BINOIS R

PMID: 18115354 [PubMed - indexed for MEDLINE]

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Methodological issues in undertaking independent cost-effectiveness analysis for NICE: the case of therapies for ADHD.

Eur J Health Econ. 2008 May;9(2):137-45

Authors: Griffin SC, Weatherly HL, Richardson GA, Drummond MF

This paper outlines methodological challenges encountered in producing an independent economic evaluation for the National Institute for Health and Clinical Excellence (NICE) to inform its technology appraisal process. The analysis used to highlight these challenges is a recent evaluation of pharmacological treatments for attention deficit hyperactivity disorder (ADHD). The NICE reference case for economic evaluation is compared with the methods necessary to complete an evaluation given the evidence base for ADHD. The primary analysis deviated from NICE methods guidelines most noticeably in the time horizon. Identifying appropriate utility data was challenging, and the results were sensitive to the values used. Issues found in this evaluation are common to many technology appraisals. Although challenging to undertake, economic evaluation in disease areas such as ADHD has great potential to add value, making the limitations of the data explicit, combining available evidence in a systematic and transparent framework and identifying future research needs.

PMID: 17476538 [PubMed - indexed for MEDLINE]

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[A meta-analysis of effects of job stress management interventions (SMIs)]

Taehan Kanho Hakhoe Chi. 2007 Jun;37(4):529-39

Authors: Kim JH

PURPOSE: This quantitative meta analysis sought to determine the effectiveness of SMIs. METHOD: Forty-six experimental studies with a randomized or nonequivalent control group pre-post test design were included in the analysis. The selected studies were classified according to the sample characteristics, the types and methods of the interventions, and the types of outcome variables. Six intervention types were distinguished: cognitive-behavioral intervention(CBT), relaxation techniques(RT), exercise(EX), multimodal programs 1 and 2(MT1, 2), and organization focused interventions(OTs). Effect sizes were calculated for the 4 outcome categories across intervention types: psycho-social outcome, behavioral-personal resources, physiologic, and organizational outcome. RESULTS: Individual worker-focused interventions(ITs) were more effective than OTs. A small but significant overall effect was found. A moderate effect was found for RT, and small effects were found for other ITs. The effect size for OTs was the smallest. The interventions involving CBT and RT appeared to be the preferred means of reducing worker’s psycho-social and organizational outcomes. With regard to physiologic outcomes, RT appeared to be most effective. CBT appeared to be most effective in reducing psycho-social outcomes. The effects of OT were non-significant, except for the psycho-social outcomes. CONCLUSIONS: SMIs are effective. Interventions involving RT and CBT are more effective than other types.

PMID: 17615474 [PubMed - indexed for MEDLINE]

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[Effect of aromatherapy massage on abdominal fat and body image in post-menopausal women]

Taehan Kanho Hakhoe Chi. 2007 Jun;37(4):603-12

Authors: Kim HJ

PURPOSE: The purpose of this study was to verify the effect of aromatherapy massage on abdominal fat and body image in post-menopausal women. METHOD: A Non-equivalent control group pre-post test Quasi-experimental design of random assignment was applied. All subjects received one hour of whole body massage as treatment by the same researcher every week for 6 weeks. Participants also massaged their own abdomen two times everyday for 5 days each week for 6 weeks. The two groups used different kinds of oil. The experimental group used 3% grapefruit oil, cypress and three other kinds of oil. The control group used grapeseed oil. Data was collected before and after the treatment using Siemens Somatom Sensation 4, a tape measure and MBSRQ. Data was analyzed by ANCOVA using the SPSS/PC+Win 12 Version. RESULT: Abdominal subcutaneous fat and waist circumference in the experimental group significantly decreased after aromatherapy massage compared to the control group. Body image in the experimental group was significantly better after aromatherapy massage than in the control group. CONCLUSION: These results suggest that Aromatherapy massage could be utilized as an effective intervention to reduce abdominal subcutaneous fat, waist circumference, and to improve body image in post-menopausal women.

PMID: 17615482 [PubMed - indexed for MEDLINE]

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Nursing students’ learning of managing cross-infections–scenario-based simulation training versus study groups.

Nurse Educ Today. 2008 Aug;28(6):664-71

Authors: Mikkelsen J, Reime MH, Harris AK

Up to 33% of all health care-associated infections are preventable [Alexander, M., 2006. Nursing Practice. Hospital and Home. Elsevier, Churchill Livingstone]. Nurses must consider how they can address infection prevention, control and management within health care settings. An outbreak of any infectious disease can occasionally occur, even when protocols have been followed. A well-coordinated, multidiscipline response will minimize the impact of the outbreak by controlling and managing the impact and ongoing risks. In this study nursing students were challenged to manage cross-infections based on two hypothetical cases, MRSA and Norovirus. The purpose of the study was to determine the most efficient teaching strategies for managing cross-infections and determining the teachers’ role by comparing three different teaching methods; scenario-based study groups with and without teacher and simulation training. A class of 141 2nd year nursing students participated as part of their learning programme on infection control. Out of these 21 students were randomly selected to take part in three focus groups assigned to evaluate the program. Overall, the findings indicated that scenario-based simulation training made the students more aware of how complex each scenario was. Events occurred that they had not expected, and this lead to a better recollection of details. By asking appropriate questions, giving feedback and hypothetical examples, the teacher’s role was crucial in both teaching strategies.

PMID: 18164104 [PubMed - indexed for MEDLINE]

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The impact of assessment methods on the learning of nursing students.

Nurse Educ Today. 2008 Aug;28(6):711-9

Authors: Leung SF, Mok E, Wong D

Assessment methods can influence the learning approaches of nursing students. Assessments designed to assess understanding rather than rote learning can contribute to a deep learning approach. Multiple-choice questions can be formulated at high cognitive levels for nursing assessments. This study aimed to examine the effect of high quality multiple-choice tests on the learning approaches of students enrolled in a mental health nursing course as measured by the revised two-factor study process questionnaire (R-SPQ-2F). Data were collected from 136 students in a higher diploma (HD) in nursing programme and 142 baccalaureate (BSN) nursing students. Two-step cluster analysis yielded three clusters represented by students who were predominantly deep, predominantly surface or intermediate in their orientation to learning. There was a general decrease in the deep learning score and an increase in the surface learning score of the students on the course, possibly related to the excessive workload in nursing studies. However, there was no direct association with multiple-choice assessment. The academic achievement of students correlated negatively with their surface learning approach. Students (n=31) in four focus group interviews believed that assessments constructed using scenario-based questions, simulated role-play situations and case studies could direct desired learning in order to facilitate their understanding of knowledge, their use of critical thinking, and their application of knowledge.

PMID: 18164105 [PubMed - indexed for MEDLINE]

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Impact of duration of untreated psychosis on pre-treatment, baseline, and outcome characteristics in an epidemiological first-episode psychosis cohort.

J Psychiatr Res. 2008 Oct;42(12):982-90

Authors: Schimmelmann BG, Huber CG, Lambert M, Cotton S, McGorry PD, Conus P

INTRODUCTION: To assess the impact of duration of untreated psychosis (DUP) on baseline and 18-month follow-up characteristics controlling for relevant confounders in an epidemiological first-episode psychosis (FEP) cohort. METHOD: The Early Psychosis Prevention and Intervention Centre (EPPIC) in Australia admitted 786 FEP patients from January 1998 to December 2000. Data were collected from medical files using a standardized questionnaire. Data from 636 patients were analyzed. RESULTS: Median DUP was 8.7 weeks. Longer DUP was associated with worse premorbid functioning (p<0.001), higher rate of schizophrenia-spectrum disorders (p<0.001), and younger age at onset of psychosis (p=0.004). Longer DUP was not associated with baseline variables but with a lower rate of remission of positive symptoms (p<0.001) and employment/occupation (p<0.001), a higher rate of persistent substance use (p=0.015), worse illness severity (p<0.001) and global functioning (p<0.001) at follow-up after controlling for relevant confounders, explaining approximately 5% of variance of remission of positive symptoms (p<0.001) in the total sample and 3% in schizophrenia-spectrum disorders excluding bipolar I disorder (p=0.002). Outcome was significantly worse when DUP exceeded 1-3 months. CONCLUSION: Avoiding pitfalls of non-epidemiological studies, DUP appears to be a modest independent predictor of prognosis in the medium-term. Results support the need for assertive early detection strategies.

PMID: 18199456 [PubMed - indexed for MEDLINE]

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Emotional learning within the framework of nursing education.

Nurse Educ Pract. 2008 Sep;8(5):328-34

Authors: Christiansen B, Jensen K

Nursing requires a certain degree of emotional investment as well as the capacity to align one’s emotions to the norms and values of the profession. The article is based on a qualitative study among nursing students in Norway. It discusses how peer learning in connection with sessions involving role-play may contribute to developing these qualities in future professionals. As researchers, we acquired access to a particular communication course for the third year nursing students at Oslo University College. The study combines two methodological approaches: observation and focus group interviews. The findings illustrate how students, by commenting on each others’ experiences and performance, may be able to help each other to develop a richer repertoire in how to express themselves and to adapt their behavior to the needs of those being cared for.

PMID: 18289941 [PubMed - indexed for MEDLINE]

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Massage or music for pain relief in labour: a pilot randomised placebo controlled trial.

Eur J Pain. 2008 Nov;12(8):961-9

Authors: Kimber L, McNabb M, Mc Court C, Haines A, Brocklehurst P

Research on massage therapy for maternal pain and anxiety in labour is currently limited to four small trials. Each used different massage techniques, at different frequencies and durations, and relaxation techniques were included in three trials. Given the need to investigate massage interventions that complement maternal neurophysiological adaptations to labour and birth pain(s), we designed a pilot randomised controlled trial (RCT) to test the effects of a massage programme practised during physiological changes in pain threshold, from late pregnancy to birth, on women’s reported pain, measured by a visual analogue scale (VAS) at 90 min following birth. To control for the potential bias of the possible effects of support offered within preparation for the intervention group, the study included 3 arms–intervention (massage programme with relaxation techniques), placebo (music with relaxation techniques) and control (usual care). The placebo offered a non-pharmacological coping strategy, to ensure that use of massage was the only difference between intervention and placebo groups. There was a trend towards slightly lower mean pain scores in the intervention group but these differences were not statistically significant. No differences were found in use of pharmacological analgesia, need for augmentation or mode of delivery. There was a trend towards more positive views of labour preparedness and sense of control in the intervention and placebo groups, compared with the control group. These findings suggest that regular massage with relaxation techniques from late pregnancy to birth is an acceptable coping strategy that merits a large trial with sufficient power to detect differences in reported pain as a primary outcome measure.

PMID: 18304848 [PubMed - indexed for MEDLINE]

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Construing stigmatized identities: a golden section study.

Psychol Psychother. 2008 Sep;81(Pt 3):285-96

Authors: Raskin JD, Harasym MT, Mercuri MA, Widrick RM

OBJECTIVES: In order to examine whether persons belonging to stigmatized groups are evaluated more negatively than others, this study employed the golden section hypothesis, which predicts that people organize their evaluations in a ratio of roughly 62% positive to 38% negative. METHOD: Surveys were administered to 154 participants, with 143 surveys analysed. Participants rated nine different identities (business person, politician, lawyer, police officer, college professor, criminal, mental patient, homeless person, and self) along 12 different bipolar dimensions (generous-stingy, pleasant-unpleasant, true-false, fair-unfair, active-passive, energetic-lethargic, sharp-dull, excitable-calm, strong-weak, bold-timid, hard-soft, and rugged-delicate). These dimensions had well-established positive and negative poles. RESULTS: Non-stigmatized identities were evaluated slightly more positively than the golden section hypothesis predicts, while stigmatized identities were rated in a ‘reverse’ golden section pattern. A criminal identity was rated more negatively than the golden section hypothesis predicts and the self more positively. Follow-up analyses suggested that the percentages of positive adjectives assigned to the self and non-stigmatized others were consistent with a model that expands upon the golden section hypothesis. CONCLUSION: Stigmatized identities are rated using a reverse golden section ratio. This has implications for understanding how people construe stigmatized people. While the golden section hypothesis did not hold for non-stigmatized identities, this may be because the data are better explained by a more refined model that is slightly different from the golden section.

PMID: 18334083 [PubMed - indexed for MEDLINE]

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