Bakker, EWP, Koning, HJCMF, Verhagen, AP & Koes, BW 2003, 'Interobserver reliability of the 24-hour schedule in patients with low back pain: a questionnaire measuring the daily use and loading of the spine', Journal of Manipulative and Physiological Therapeutics, vol. 26, no. 4, pp. 226-232.
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Berle, D 2003, 'The Influence of Withdrawal Symptoms and Catastrophic Thinking on Smokers' Self-efficacy', Addictive Disorders & Their Treatment, vol. 2, no. 3, pp. 97-104.
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Objectives: This is a correlational study examining the relationships between reported withdrawal symptoms, catastrophic thinking about symptoms, general catastrophic thinking, self-efficacy concerning temptation, and self-efficacy concerning relapse. Methods: 83 university student smokers completed self-report questionnaires. Results: It was hypothesized that a greater expectation of withdrawal symptoms would be related to lower self-efficacy; it was found that the withdrawal symptom score was correlated with temptation self-efficacy, but not relapse self-efficacy. It was hypothesized that catastrophizing about withdrawal symptoms would be related to lower self-efficacy; when withdrawal symptoms were controlled for, only relapse self-efficacy was predicted by symptom catastrophizing. It was hypothesized that a general tendency to catastrophize life events would predict low self-efficacy; this was found not to be the case. Conclusions: The differing pattern of results for temptation and relapse self-efficacy emphasize the need to distinguish between the two when researching this area. Copyright © 2003 Lippincott Williams & Wilkins, Inc.
Brodaty, H, Berle, D, Hickie, I & Mason, C 2003, 'Perceptions of Outcome from Electroconvulsive Therapy by Depressed Patients and Psychiatrists', Australian & New Zealand Journal of Psychiatry, vol. 37, no. 2, pp. 196-199.
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Objective: To determine (i) patients' expectations before and attitudes after a course of electroconvulsive therapy (ECT); (ii) the concordance between the perceptions of patients and their psychiatrists; and (iii) whether patients and psychiatrists are accurate in predicting a positive outcome with ECT. Method: Eighty-one inpatients (mean 67.2 years, median 70 years) with major depression were assessed before and after receiving a course of ECT. On both occasions, patients were administered the Hamilton Rating Scale for Depression (HRSD) and the Global Assessment of Functioning Scale (GAF). Patients and two research psychiatrists rated their expectancy of treatment outcome before ECT and their impression of outcome after ECT was completed. Results: Both HRSD and GAF scores improved with treatment. Before treatment, 39.7% of patients believed ECT would improve their condition. Following treatment, 68.8% of patients thought their condition had improved as a result of ECT. There was only slight agreement between patients' and psychiatrists' expectations before and ratings of efficacy after treatment. The psychiatrists', but not the patients', pretreatment expectations of ECT efficacy were significantly associated with improvement in depression as measured by the effect size change in HRSD score from pre- to post-ECT. Conclusions: Patients were poor judges of ECT outcome and, in this sample, less positive than previous reports had suggested. Psychiatrists' expectations however, were generally accurate indicating good clinical selection.
Cream, A, Onslow, M, Packman, A & Llewellyn, G 2003, 'Protection from harm: the experience of adults after therapy with prolonged‐speech', International Journal of Language & Communication Disorders, vol. 38, no. 4, pp. 379-395.
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AbstractBackground: It is well documented that adults can control stuttering if they use certain novel speech patterns referred to generically as prolonged‐speech (PS). These speech patterns were refined in the 1960s and developed into behavioural treatment programmes. The bulk of available PS treatment research has focused on speech parameters thought to reflect favourable treatment outcome. Considering this, and that post‐treatment relapse is known to be common, clinicians and researchers could be usefully informed by knowledge about the experiences of those who receive these treatments. Subsequently, they could use such information in attempts to control stuttering in their clients. Yet, at present, systematic research on this topic is scant.Aims: The continued development of PS treatments could be usefully informed by research into the experiences of those who use PS to control stuttering. Hence, that is the topic of the present report.Methods & Procedures: The method used was phenomenology. Participants were a purposive sample of 10 people who had received PS treatment. During a 2‐year period, a collaborative approach to the study of the topic was developed between the participants and interviewer. Interviews were from 1.5 to 2 hours, and a total of 34 interviews and discussions were undertaken with participants. Transcripts of these were used to generate text from which themes were identified using line‐by‐line, holistic and selective approaches.Outcomes & Results: The main findings were that even after therapy with PS there is a continued risk of stuttering occurring, and although adults have the novel experience of controlling stuttering, they also continue to experience feeling different from those who do not stutter, which may be exacerbated after...
de Silva, P, Menzies, RG & Shafran, R 2003, 'Spontaneous decay of compulsive urges: the case of covert compulsions', Behaviour Research and Therapy, vol. 41, no. 2, pp. 129-137.
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It is well established that many patients with obsessive-compulsive disorder have covert, or internal, compulsions. Empirical studies of this phenomenon, however, are limited. The present study followed the paradigm developed by Rachman and his colleagues for the study of overt compulsions. Patients with urges to carry out covert compulsions underwent an experimental procedure in which their compulsive urges were provoked, followed by a period of response prevention. The strength of the compulsive urges and associated discomfort were monitored. There was marked, and relatively rapid, spontaneous decay of both the compulsive urges and the discomfort. Implications of these results are discussed. © 2002 Elsevier Science Ltd. All rights reserved.
Gilroy, LJ, Kirkby, KC, Daniels, BA, Menzies, RG & Montgomery, IM 2003, 'Long-term follow-up of computer-aided vicarious exposure versus live graded exposure in the treatment of spider phobia', Behavior Therapy, vol. 34, no. 1, pp. 65-76.
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A case of an adolescent boy with multiple phobias who was treated successfully for his dental phobia is described to illustrate the clinical utility of the Dental Cognitions Questionnaire (DCQ) in aiding effective cognitive-behavior therapy. The client showed drops in dental anxiety that coincided with the use of the DCQ in cognitive restructuring, and there was a close correlation between dental cognitions and degree of dental anxiety over the time-course of therapy and follow up.
Hemsley, B & Balandin, S 2003, 'Disability, dysphagia, and complex communication needs: Making room for communication in ethical decisions about dysphagia', Advances in Speech Language Pathology, vol. 5, no. 2, pp. 125-129.
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Effective functional communication is important for successful management of dysphagia with individuals who have lifelong disability and complex communication needs (CCN).1CCN is a broad term used to describe functional outcome in communication according to skills and needs: "Some people have complex communication needs associated with a wide rangeof physical, sensory and environmental causes which restrict/limit their ability to participate independently in society. They and their communication partners may benefit from using Alternative or Augmentative Communication (AAC) methods either temporarily or permanently" (Balandin, 2002, p. 2). Many people with dysphagia have associated communication difficulties that may affect their ability to participate in their dysphagia management plan. Speech pathologists are well placed to ensure, wherever possible, that individuals with dysphagia not only have an appropriate dysphagia management plan but also have a functional communication system that will support their involvement in the planning and ongoing management process. In this article, the importance of a functional communication system for individuals with dysphagia is highlighted in relation to ethical decision making in dysphagia management. © 2003 Informa UK Ltd All rights reserved.
Hodge, C & Friedrich, J 2003, 'Diabetes case study. Eye series 6.', Aust Fam Physician, vol. 32, no. 7, pp. 537-538.
Hodge, C & Friedrich, J 2003, 'Test your knowledge. Chronic red eye.', Aust Fam Physician, vol. 32, no. 5, pp. 353-354.
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A 62 year old woman has come to the practice complaining of an irritable, red eye (Figure 1). This has occurred intermittently over a number of years. The condition tends to resolve over a week or so with the help of a series of lid bathes and hot compresses. For mild to moderate episodes she has previously been prescribed Predsol steroid eye drops for which she has responded quickly. The patient feels that the episodes are increasing and the eye is remaining 'gritty' for longer. Vision in the right eye has become poorer than the left eye.
Hodge, C & Martin, F 2003, 'Sudden onset double vision. Eye series--11.', Aust Fam Physician, vol. 32, no. 12, pp. 1016-1017.
Hodge, C & Martin, P 2003, 'Thyroid eye disease. Eye series--10.', Aust Fam Physician, vol. 32, no. 11, pp. 939-940.
Hodge, C & Martin, PA 2003, 'Test your knowledge. Droopy eyelid. Eye series. 2.', Aust Fam Physician, vol. 32, no. 3, pp. 159-160.
Hodge, C & McKay, D 2003, 'Increasing visual disturbances. Eye series 5.', Aust Fam Physician, vol. 32, no. 6, pp. 459-460.
Hodge, C & Roberts, T 2003, 'Flashes and floaters. Eye series--9.', Aust Fam Physician, vol. 32, no. 10, pp. 851-852.
Hodge, C & Roberts, T 2003, 'Glaucoma. Eye series. 7.', Aust Fam Physician, vol. 32, no. 8, pp. 643-644.
Hodge, C & Sutton, G 2003, 'Dry eyes. Eye series. 3.', Aust Fam Physician, vol. 32, no. 4, pp. 265-266.
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During her regular check-up a 68 year old woman patient mentions, as an aside, that the recent hot weather has left her eyes with a 'dry, gritty feeling'. The feeling is more noticeable toward the end of the day and on further questioning has gradually become more prominent over the past few years.
Hodge, C, Molloy, A & Rogers, C 2003, 'Sterile corneal infiltrates. Contact lens case study--eye series 8.', Aust Fam Physician, vol. 32, no. 9, pp. 748-749.
Hodge, C, Roberts, TV & McKay, D 2003, 'Test your knowledge. Sudden right eye shadow. Eye series 1.', Aust Fam Physician, vol. 32, no. 1-2, pp. 53-54.
Kingston, M, Huber, A, Onslow, M, Jones, M & Packman, A 2003, 'Predicting treatment time with the Lidcombe Program: replication and meta‐analysis', International Journal of Language & Communication Disorders, vol. 38, no. 2, pp. 165-177.
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AbstractBackground: The benefits of treating stuttering close to onset have become obvious in recent years, and the Lidcombe Program has emerged as an effective and safe treatment method for children in their preschool years. The benefits of implementing the programme with young children, however, need to be weighed against the knowledge that many children recover from stuttering without treatment. In light of this, speech‐language therapists need to know how long treatment is likely to take and whether treatment time can be predicted. In particular, they need to know if adopting a ‘watchful waiting’ approach—to see if natural recovery occurs—jeopardizes responsiveness to treatment. A recent Australian study of 250 preschool‐age children found that stuttering rate was the only significant predictor of treatment time with the Lidcombe Program. In other words, children whose stuttering was more severe took longer to pass through the programme. There were other trends in the data but they did not reach significance.Aims: The present study, conducted independently in the UK, was designed to replicate the Australian study. Direct replication enabled pooling of the data from the two studies in a meta‐analysis.Methods & Procedures: The study included 66 children who began treatment before 6 years of age. They were treated with the Lidcombe Program at a specialist stuttering clinic in Norwich. Logistic regression analyses were conducted on the data. The data from both the British and Australian cohorts were pooled in a meta‐analysis.Outcomes & Results: Results indicated that Stage 1 of the Lidcombe Program was completed in a median of 11 clinic visits, which is in line with the findings of the Australian study. Stuttering rate at first clinic visit was again found ...
Kneebone, II & Martin, PR 2003, 'Coping and caregivers of people with dementia', British Journal of Health Psychology, vol. 8, no. 1, pp. 1-17.
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Purpose: To critically review the research based on Lazarus and Folkman's (1984) stress and coping model, in respect to the coping of those caring for persons with dementia in the community, in an attempt to establish its implications for interventions aimed at improving caregiver adjustment.Method: Published material on the coping of caregivers of persons with dementia was identified through computerized literature searches (Med‐line, Psych‐Info) to December 1999, employing search terms including Alzheimer's disease, dementia, caregiving, caregiver burden, adaptation, psychological, coping, and stress. Studies were chosen to be considered in detail, based on the reviewer's opinion that they would contribute to an understanding of the current state of the research and its clinical implications. This material was then critically reviewed against the tenets of Lazarus and Folkman's (1984) model.Results: Sixteen studies were selected to be included in the review, 12 cross‐sectional and 4 longitudinal. Seven of the studies did not incorporate coping measures specific to caregiving and/or assess coping in respect of specific caregiver problems. Nine of the studies did do this. The research suggests that a general tendency towards problemsolving and acceptance styles of coping is likely to be advantageous to caregivers of people with dementia.Conclusions: Despite this finding, it is concluded that the ability of the research to inform the clinician is severely limited. It is proposed that while longitudinal studies considered specific caregiver problems which incorporate coping measures specific to the caregiving task may improve understanding, a substantial revision of methodology and perspective may be required to produce findings that are likely to influence practice.
Kneebone, II, Dunmore, EC & Evans, E 2003, 'Symptoms of depression in older adults with multiple sclerosis (MS): Comparison with a matched sample of younger adults', Aging & Mental Health, vol. 7, no. 3, pp. 182-185.
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Lawless, MA, Hodge, C, Rogers, CM & Sutton, GL 2003, 'Laser in situ Keratomileusis with Alcon CustomCornea', Journal of Refractive Surgery, vol. 19, no. 6.
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ABSTRACT PURPOSE: To report the 3-month results of our first cases of laser in situ keratomileusis (LASIK) with Alcon's CustomCornea. METHODS: Wavefront analysis was performed using the LADARWave aberrometer and ablation was performed with the LADARVision4000 system. Thirty-one eyes of 17 patients were analyzed prospectively, at 1 and 3 months after CustomCornea surgery. Psychophysical tests were performed, including high and low contrast acuity, and contrast sensitivity under scotopic and photopic conditions. In addition, psychometric testing was performed using a subjective vision questionnaire. RESULTS: Mean spherical equivalent refraction improved from a baseline -3.05 ±1.92 D to +0.02 ± 0.28 D at 3 months (28 eyes). At 3 months, 46.4% (13 eyes) had uncorrected visual acuity of 20/16, 92.7% (26 eyes) had 20/20, and 100% (28 eyes) had 20/25 uncorrected visual acuity. Three months after CustomCornea surgery, there was a statistically significant improvement in contrast sensitivity under both scotopic and photopic conditions, and a statistically significant increase in third and fourth order aberrations. There was a statistically significant improvement in visual quality as measured by the subjective vision index, increasing from a preoperative mean 66.62 to 87.63 at 3 months after surgery. CONCLUSIONS: CustomCornea was an improvement over conventional LASIK as measured by most psychophysical and psychometric parameters. The relationship between higher order aberrations and other psychophysical and psychometric measurements needs more analysis. [J Refract Surg 2003;19:S691-S696]
Lievense, AM, Bierma‐Zeinstra, SMA, Verhagen, AP, Bernsen, RMD, Verhaar, JAN & Koes, BW 2003, 'Influence of sporting activities on the development of osteoarthritis of the hip: A systematic review', Arthritis Care & Research, vol. 49, no. 2, pp. 228-236.
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Mathie, A, Clarke, CE, Ranatunga, KM & Veale, EL 2003, 'What are the roles of the many different types of potassium channel expressed in cerebellar granule cells?', The Cerebellum, vol. 2, no. 1, pp. 11-25.
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Mathie, A, Veale, EL, Clarke, CE & Ranatunga, KM 2003, 'What are the roles of the many different types of potassium channel expressed in cerebellar granule cells?', The Cerebellum, vol. 2, no. 1, pp. 11-25.
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Nguyen, VA, Freeman, AW & Alais, D 2003, 'Increasing depth of binocular rivalry suppression along two visual pathways', Vision Research, vol. 43, no. 19, pp. 2003-2008.
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O'Brian, N, O'Brian, S, Packman, A & Onslow, M 2003, 'Generalizability Theory I', Journal of Speech, Language, and Hearing Research, vol. 46, no. 3, pp. 711-717.
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Perceptual rating scales can be valid, reliable, and convenient tools for evaluating speech outcomes in research and clinical practice. However, they depend on the perceptions of observers. Too few raters may compromise accuracy, whereas too many would be inefficient. There is therefore a need to determine the minimum number of raters required for a reliable result. In this context, the ideas of Generalizability Theory have become increasingly popular in the behavioral sciences; suggestions have been made for their application to the assessment of speech-language disorders. Here we review the concepts involved, which are applied in a companion article dealing with speech naturalness data obtained from clients who recently completed treatment for their stuttering. We pay particular attention to the statistical requirements of the theory, including some cautions about possible inappropriate use of these techniques. We also offer a new interpretation of the results of the analysis that aims to be more meaningful to most speech-language pathologists.
O'Brian, S, Onslow, M, Cream, A & Packman, A 2003, 'The Camperdown Program', Journal of Speech, Language, and Hearing Research, vol. 46, no. 4, pp. 933-946.
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Considerable research has been directed at the outcomes of prolonged-speech (PS) treatment for the control of chronic stuttering, but little research to date has focused on the PS treatment process. This report examines a Stage 2 clinical trial of a reconceptualized PS treatment model known as the Camperdown Program. This program requires fewer clinician hours than traditional programs and has no formal transfer phase. Additionally, it incorporates the following treatment process innovations, which replace treatment process components that are intuitively and empirically problematic: (a) PS is taught without incorporating target behaviors in clinician instruction, (b) participants learn to control stuttering without programmed instruction, and (c) the treatment process does not involve clinician identification of stuttering moments. Thirty participants were initially enrolled in the trial. Final outcome data are presented for the 16 participants who completed all trial requirements, including 12 months posttreatment data collection. These 16 participants showed minimal or no stuttering in everyday speaking situations for up to 12 months after entering the maintenance program, with speech rates in the normal range. Speech naturalness and social validation data were also favorable. Although self-report data generally confirmed the speech data, the results were not as positive. The present outcomes were achieved in a mean of 20 hours of clinic attendance per participant, which is much fewer than the hours required by treatment programs reported recently that run intensively over 2–3 weeks. The promise of this Stage 2 clinical trial has led the authors to initiate a Stage 3 randomized controlled trial of the Camperdown Program.
O'Brian, S, Packman, A, Onslow, M & O'Brian, N 2003, 'Generalizability Theory II', Journal of Speech, Language, and Hearing Research, vol. 46, no. 3, pp. 718-723.
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Generalizability theory has been recommended as the most comprehensive method for assessing the reliability of observational data. It provides a framework for calculating the various sources of measurement error and allows further design of measurements for a particular purpose. This paper gives a practical illustration of how this method may be used in the analysis of observational data. We use the ratings of 15 unsophisticated raters using the 9-point speech naturalness scale of R. R. Martin, S. K. Haroldson, and K. A. Triden (1984) to evaluate the speech of adults before and after treatment for stuttering. We calculate various sources of measurement error and use these to estimate the minimum number of raters and ratings per rater for a reliable result. For posttreatment data, the average of three independent raters, and for pretreatment data, the average of five independent raters should give a result within one scale point of the hypothetical true score for the speaker in at least 80% of samples. The example illustrates the advantages of using this method of analysis.
O'Brian, S, Packman, A, Onslow, M, Cream, A, O'Brian, N & Bastock, K 2003, 'Is Listener Comfort a Viable Construct in Stuttering Research?', Journal of Speech, Language, and Hearing Research, vol. 46, no. 2, pp. 503-509.
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This article reports the development of a tool for measuring how comfortable a person feels when communicating with someone who has undergone treatment for stuttering. The person rates the speaker on a 9-point Listener Comfort Scale (9 = extremely comfortable , 1 = extremely uncomfortable ). In a preliminary investigation of the reliability and validity of the scale, 15 unsophisticated listeners rated video recordings of 10 adults before and after a prolonged-speech treatment for stuttering and of 10 matched controls. The results were compared with those of another 15 listeners who rated the same recordings with the widely used 9-point Speech Naturalness Scale (R. R. Martin, S. K. Haroldson, & K. A. Triden, 1984). Results showed that reliability of the Speech Naturalness Scale was superior to the Listener Comfort Scale, although users of both scales were able to distinguish between pretreatment speech, posttreatment speech, and the speech of controls. The results suggest that the Listener Comfort Scale captures information that is somewhat different than the information captured by the Speech Naturalness Scale. The authors concluded that the concept of listener comfort is a potentially useful additional way of investigating the social validity of behavioral treatments for stuttering.
Onslow, M 2003, 'Evidence-based treatment of stuttering: IV. empowerment through evidence-based treatment practices', Journal of Fluency Disorders, vol. 28, no. 3, pp. 237-245.
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Assertion-based treatments for stuttering have historically been more popular than evidence-based treatments. In this paper it is argued that the use of evidence-based treatments for stuttering is professionally empowering for clinicians, but that the use of assertion-based treatments is a circular process that inhibits professional development. The arguments in favor of evidence-based treatment are elaborated under headings of "professional investment," "professional development and diversity," and "optimizing treatment efficacy." Educational objectives: The reader will understand and be able (1) to describe the distinction between assertion-based and evidence-based treatment practices (2) to present a series of arguments that evidence-based treatment practices are professionally empowering. © 2003 Elsevier Inc. All rights reserved.
Onslow, M, Packman, A & Beer, T 2003, 'The motor learning hypothesis and stuttering adaptation', Asia Pacific Journal of Speech, Language and Hearing, vol. 8, no. 3, pp. 193-199.
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Otters, HBM, Roelofs, PDDM & Verhagen, AP 2003, 'Exercise and Weight Loss in Obese Postmenopausal Women', JAMA, vol. 289, no. 14, pp. 1778-1778.
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Pate, JW 2003, 'Glove punctures in cardiac surgery', The Annals of Thoracic Surgery, vol. 75, no. 5, pp. 1680-1681.
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Peterson, G, Aslani, P & Williams, K 2003, 'How do Consumers Search for and Appraise Information on Medicines on the Internet? A Qualitative Study Using Focus Groups', Journal Of Medical Internet Research, vol. 5, no. 4, pp. 1-15.
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Background Many consumers use the Internet to find information about their medicines. It is widely acknowledged that health information on the Internet is of variable quality and therefore the search and appraisal skills of consumers are important for selecting and assessing this information. The way consumers choose and evaluate information on medicines on the Internet is important because it has been shown that written information on medicines can influence consumer attitudes to and use of medicines. Objective To explore consumer experiences in searching for and appraising Internet-based information on medicines. Methods Six focus groups (N = 46 participants) were conducted in metropolitan Sydney, Australia from March to May 2003 with consumers who had used the Internet for information on medicines. Verbatim transcripts of the group discussions were analyzed using a grounded theory approach.
Peterson, G, Aslani, P & Williams, KA 2003, 'Consumers, medicine information and searching the internet: How does the Internet influence the way consumers use their medicines?', Australian Journal of Pharmacy, vol. 84, no. 996, pp. 186-189.
Peterson, G, Aslani, P & Williams, KA 2003, 'How do Consumers Search for and Appraise Information on Medicines on the Internet? A Qualitative Study Using Focus Groups', Journal of Medical Internet Research, vol. 5, no. 4, pp. e33-e33.
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Many consumers use the Internet to find information about their medicines. It is widely acknowledged that health information on the Internet is of variable quality and therefore the search and appraisal skills of consumers are important for selecting and assessing this information. The way consumers choose and evaluate information on medicines on the Internet is important because it has been shown that written information on medicines can influence consumer attitudes to and use of medicines.To explore consumer experiences in searching for and appraising Internet-based information on medicines.Six focus groups (N = 46 participants) were conducted in metropolitan Sydney, Australia from March to May 2003 with consumers who had used the Internet for information on medicines. Verbatim transcripts of the group discussions were analyzed using a grounded theory approach.All participants reported using a search engine to find information on medicines. Choice of search engine was determined by factors such as the workplace or educational environments, or suggestions by family or friends. Some participants found information solely by typing the medicine name (drug or brand name) into the search engine, while others searched using broader terms. Search skills ranged widely from more-advanced (using quotation marks and phrases) to less-than-optimal (such as typing in questions and full sentences). Many participants selected information from the first page of search results by looking for keywords and descriptions in the search results, and by looking for the source of the information as apparent in the URL. Opinions on credible sources of information on medicines varied with some participants regarding information by pharmaceutical companies as the "official" information on a medicine, and others preferring what they considered to be impartial sources such as governments, organizations, and educational institutions. It was clear that although most participants were skeptical ...
Pont, LG, Sturkenboom, MCJM, van Gilst, WH, Denig, P & Haaijer‐Ruskamp, FM 2003, 'Trends in prescribing for heart failure in Dutch primary care from 1996 to 2000', Pharmacoepidemiology and Drug Safety, vol. 12, no. 4, pp. 327-334.
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AbstractPurposeThe aim of this study is to explore trends in primary care prescribing for chronic heart failure (CHF) over a 5‐year period (1996–2000).MethodsThis study consisted of repeated cross‐sectional surveys in a dynamic cohort from the Integrated Primary Care Information (IPCI) primary care database. The cohort comprised all patients aged ≥55 years with a CHF diagnosis and prescribed a cardiovascular medication during the study period. The point prevalence per calendar year was determined for each of the main drug groups used to treat CHF.ResultsThe study population consisted of 3121 CHF patients. Small increases were seen in the percentage of CHF patients prescribed spironolactone (4.6%, 95% CI: 2.3–6.9%), β‐blockers (6.1%, 95% CI: 2.6–9.5%) and angiotensin II antagonists (6.8%, 95% CI: 5.1–8.6%) during the study period, while the prescribing of digoxin decreased (−4.4%, 95% CI: −8.2 to −0.7). Prescribing of diuretics (difference: −0.7% 95% CI: −2.7–4.2) and ACE inhibitors (difference: 4.0% 95% CI: −0.1–8.2%) remained unchanged.ConclusionsPrescription of some drug groups for CHF increased. However, given the new scientific evidence that has emerged in past 15 years regarding CHF pharmacotherapy, the changes observed were less than expected. Copyright © 2003 John Wiley & Sons, Ltd.
Pont, LG, van Gilst, WH, Lok, DJA, Kragten, HJA & Haaijer‐Ruskamp, FM 2003, 'The relevance of heart failure severity for treatment with evidence‐based pharmacotherapy in general practice', European Journal of Heart Failure, vol. 5, no. 2, pp. 187-193.
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AbstractAims:Internationally, research indicates that pharmacotherapy for chronic heart failure (CHF) is sub‐optimal. Traditionally, assessment of drug use in heart failure has focused on the use of individual agents irrespective of CHF severity. This study investigates drug use for CHF patients in general practice with respect to the available evidence, incorporating both disease severity and the use of combination drug regimes.Methods and results:A cross‐sectional survey of 769 Dutch CHF patients was performed as part of IMPROVEMENT of HF study. For each New York Heart Association severity classification the minimum treatment appropriate for the heart failure severity according to the scientific evidence available at the time of the study (1999) was defined. The proportion of patients treated with each drug increased with increasing severity, with the exception of the β‐blockers. Patients with less severe heart failure were approximately four to eight times more likely to receive evidence‐based treatment than those with more severe heart failure.Discussion:To assess pharmacological treatment of heart failure, in relation to the available evidence, it is important to take severity into account. While the number of drugs prescribed increased with increasing severity, the use of evidence‐based regimes was lower in patients with more severe heart failure.
Roberts, AS, Hopp, T, Sorensen, E, Benrimoj, SI, Chen, T, Herborg, H, Williams, K & Aslani, P 2003, 'Understanding practice change in community pharmacy: A qualitative research instrument based on organisational theory', Pharmacy World & Science, vol. 25, no. 5, pp. 227-234.
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Introduction: The past decade has seen a notable shift in the practice of pharmacy, with a strong focus on the provision of cognitive pharmaceutical services (CPS) by community pharmacists. The benefits of these services have been well documented, yet th
Roberts, AS, Hopp, T, Sorensen, EW, Benrimoj, SI, Chen, TF, Herborg, H, Williams, K & Aslani, P 2003, 'Understanding practice change in community pharmacy: a qualitative research instrument based on organisational theory', PHARMACY WORLD & SCIENCE, vol. 25, no. 5, pp. 227-234.
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Introduction: The past decade has seen a notable shift in the practice of pharmacy, with a strong focus on the provision of cognitive pharmaceutical services (CPS) by community pharmacists. The benefits of these services have been well documented, yet their uptake appears to be slow. Various strategies have been developed to overcome barriers to the implementation of CPS, with varying degrees of success, and little is known about the sustainability of the practice changes they produce. Furthermore, the strategies developed are often specific to individual programs or services, and their applicability to other CPS has not been explored. There seems to be a need for a flexible change management model for the implementation and dissemination of a range of CPS, but before it can be developed, a better understanding of the change process is required. Objectives: This paper describes the development of a qualitative research instrument that may be utilised to investigate practice change in community pharmacy. Specific objectives included gaining knowledge about the circumstances surrounding attempts to implement CPS, and understanding relationships that are important to the change process. Methods: Organisational theory provided the conceptual framework for development of the qualitative research instrument, within which two theories were used to give insight into the change process: Borum's theory of organisational change, which categorises change strategies as rational, natural, political or open; and Social Network Theory, which helps identify and explain the relationships between key people involved in the change process. Results: A semi-structured interview guide was produced, combining the factors affecting practice change found in the literature that warranted further investigation with the theoretical perspectives of organisational change and social networks. To address the research objectives, the instrument covered four broad themes: roles, experien...
Rose, T, Worrall, L & McKenna, K 2003, 'The effectiveness of aphasia‐friendly principles for printed health education materials for people with aphasia following stroke', Aphasiology, vol. 17, no. 10, pp. 947-963.
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Scholten-Peeters, GGM, Verhagen, AP, Bekkering, GE, van der Windt, DAWM, Barnsley, L, Oostendorp, RAB & Hendriks, EJM 2003, 'Prognostic factors of whiplash-associated disorders: a systematic review of prospective cohort studies', Pain, vol. 104, no. 1, pp. 303-322.
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Scholten-Peeters, GGM, Verhagen, AP, Neeleman-van der Steen, CWM, Hurkmans, JCAM, Wams, RWA & Oostendorp, RAB 2003, 'Randomized clinical trial of conservative treatment for patients with whiplash-associated disorders: considerations for the design and dynamic treatment protocol', Journal of Manipulative and Physiological Therapeutics, vol. 26, no. 7, pp. 412-420.
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Schulz, M & Schmoldt, A 2003, 'Therapeutic and toxic blood concentrations of more than 800 drugs and other xenobiotics.', Pharmazie, vol. 58, no. 7, pp. 447-474.
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In order to assess the significance of drug levels measured in clinical and forensic toxicology as well as for Therapeutic Drug Monitoring (TDM) it is essential that good collections of data are readily available. For more than 800 substances, therapeutic ('normal') and, if data was available, toxic, and fatal plasma concentrations as well as elimination half-lives were compiled in a table. The compilation includes data for hypnotics, benzodiazepines, neuroleptics, antidepressants, sedatives, analgesics, anti-inflammatory agents (e.g., NSAIDs), antihistamines, antiepileptics, betaadrenergic antagonists, antibiotics (penicillins, cephalosporins, aminoglycosides, gyrase inhibitors), diuretics, calcium-channel blockers, cardiac glycosides, antiarrhythmics, antiasthmatics, ACE-inhibitors, opiate agonists, and local anesthetics, among others. In addition, toxicologically relevant xenobiotics were listed. Data have been abstracted from published information, both compilations and primary sources and have been completed with data collected in our own forensic and clinical toxicology laboratories. Wherever possible, ranges for therapeutic plasma concentrations are expressed as trough concentration at steady state. The half-life values given for each drug are chosen to represent the terminal log-linear phase at most. It is the purpose to rapidly assess the significance of drug levels for the therapeutic monitoring of patients, and to facilitate the diagnostic and clinical assessment in case of intoxications.
Sitharthan, T, Job, RFS, Kavanagh, DJ, Sitharthan, G & Hough, M 2003, 'Development of a Controlled Drinking Self‐Efficacy Scale and appraising its relation to alcohol dependence', Journal of Clinical Psychology, vol. 59, no. 3, pp. 351-362.
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AbstractThere is no specific self‐efficacy measure that has been developed primarily for problem drinkers seeking a moderation drinking goal. In this article, we report the factor structure of a 20‐item Controlled Drinking Self‐Efficacy Scale (CDSES; Sitharthan et al., 1996; Sitharthan et al., 1997). The results indicate that the CDSES is highly reliable, and the factor analysis using the full sample identified four factors: negative affect, positive mood/social context, frequency of drinking, and consumption quantity. A similar factor structure was obtained for the subsample of men. In contrast, only three factors emerged in the analysis of data on female participants. Compared to women, men had low self‐efficacy to control their drinking in situations relating to positive mood/social context, and subjects with high alcohol dependence had low self‐efficacy for situations relating to negative affect, social situations, and drinking less frequently. The CDSES can be a useful measure in treatment programs providing a moderation drinking goal. © 2003 Wiley Periodicals, Inc. J Clin Psychol 59: 351–362, 2003.
Stuart, M, Turman, AB, Shaw, J, Walsh, N & Nguyen, V 2003, 'Effects of aging on vibration detection thresholds at various body regions', BMC Geriatrics, vol. 3, no. 1, pp. 1-10.
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Background: The ability to detect sinusoidal vibrations on the skin surface is dependent on the activation of two classes of receptors. The density of such receptors varies across the skin surface and is a factor in determining the sensory acuity of each skin area. However, the acuity of many sensory systems is known to deteriorate with advancing age. The aim of this study was to determine if vibrotactile sensibility of several skin surfaces deteriorated equally with advancing age. Methods: Vibration detection thresholds for two frequencies of vibration (30 Hz and 200 Hz) were determined using a method of limits protocol, in two groups of healthy adults, one group aged 17 to 27 years and the other aged 55 to 90 years. Sinusoidal vibrations were generated by a computer and delivered to the skin surface via the probe (diameter = 2 mm) of a mechanical vibrator. Four skin sites (palmar surface of the tip of the middle finger, volar surface of the forearm, lateral aspect of the shoulder, cheek just caudal to the zygoma) were tested. Results: The fingertip was the most sensitive site for vibrotactile detection at both frequencies in a substantial majority of subjects. The older group of subjects showed significantly higher detection thresholds for both frequencies at all sites, except the fingertip, when compared to young subjects. Conclusion: The study confirms the deterioration of vibrotactile acuity at several skin sites previously reported in the literature. However, there appears to be no significant reduction in vibrotactile detection at the fingertips in older subjects. This may reflect the high receptor density of this area, or the functional importance of vibrotactile sensibility of the fingertips or some combination of both of these factors.
Teesson, K, Packman, A & Onslow, M 2003, 'The Lidcombe Behavioral Data Language of Stuttering', Journal of Speech, Language, and Hearing Research, vol. 46, no. 4, pp. 1009-1015.
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The Lidcombe Behavioral Data Language (LBDL; K. Bryant & A. Packman, 1999; A. Packman & M. Onslow, 1998; A. Packman, M. Onslow, & K. Bryant, 2000) is a recently developed taxonomy of stuttering. It fills a void in stuttering research because most current descriptive systems are taxonomies of disfluencies, not stuttering alone, and are not behaviorally based. This study is an investigation of intrajudge and interjudge agreement for the LBDL. Ten experienced speech-language pathologists and 10 undergraduate students received brief instruction in the LBDL and then applied it to 15 intervals of stuttered speech on 2 occasions. The speakers were children and adults. Intrajudge agreement was high for both groups but only experienced judges achieved satisfactory interjudge agreement. Results suggest that some stuttering behaviors may be easier to categorize than others. Possible applications of the LBDL to research and clinical practice in stuttering are discussed.
Torres, AM, Bansal, PS, Sunde, M, Clarke, CE, Bursill, JA, Smith, DJ, Bauskin, A, Breit, SN, Campbell, TJ, Alewood, PF, Kuchel, PW & Vandenberg, JI 2003, 'Structure of the HERG K+ Channel S5P Extracellular Linker', Journal of Biological Chemistry, vol. 278, no. 43, pp. 42136-42148.
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van Dijk, KN, Pont, LG, de Vries, CS, Franken, M, Brouwers, JRBJ & de Jong-van den Berg, LTW 2003, 'Prescribing Indicators for Evaluating Drug Use in Nursing Homes', Annals of Pharmacotherapy, vol. 37, no. 7-8, pp. 1136-1141.
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OBJECTIVE: To evaluate drug use in 2 Dutch nursing homes (254 residents) by developing and evaluating prescribing indicators based on pharmacy prescription data. METHODS: We evaluated the prescribing of benzodiazepines, nonsteroidal antiinflammatory drugs (NSAIDs), ulcer-healing drugs, and diuretics. Prescribing indicators were used to identify prescribing that was potentially not in line with recommendations in national and regional prescribing guidelines. We used both descriptive indicators, such as the number and percentage of users, and indicators reflecting potentially suboptimal prescribing, such as use of drugs outside the regional drug formulary, use of >1 drug from the same drug class, and prescription of drug dosages above recommended values. When potentially suboptimal prescribing was found, we verified the findings by means of an interview with 1 of the prescribers. RESULTS: The prescribing indicators we assessed were generally in agreement with national and regional guidelines. However, prescribing of NSAIDs without concomitant prescribing of gastroprotective drugs was found in a relatively high number of patients. After prescriber interview and patient chart review, it was found that some prescribing indicators, such as dosages above recommended values, were not always indicative for suboptimal prescribing. CONCLUSIONS: This pilot study showed that prescribing indicators based solely on pharmacy prescription data can be a useful tool to evaluate drug prescribing. With some of these prescribing indicators, we identified cases of potentially suboptimal prescribing. However, with other indicators such as those based on drug dosages, we could not identify suboptimal prescribing, and clinical information from the ...
Verhagen, AP, Bierma-Zeinstra, SMA, Boers, M, Cardoso, JR, Lambeck, J, de Bie, R & de Vet, HCW 2003, 'Balneotherapy for rheumatoid arthritis', The Cochrane database of systematic reviews, no. 4, p. CD000518.
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Background
Balneotherapy (spa therapy) for patients with arthritis is one of the oldest forms of therapy. One of the aims of balneotherapy is to soothe the pain, improve joint motion and as a consequence to relieve people' suffering and make them feel well.
Objectives
To perform a systematic review on the effectiveness of balneotherapy for rheumatoid arthritis.
Search strategy
Using the Cochrane search strategy, studies were found by screening: 1) The MEDLINE CD-ROM database from 1966 to June 2002 and 2) the database from the Cochrane 'Rehabilitation and Related Therapies' Field, the Pedro database up to June 2002. Also, 3) reference checking and 4) personal communications with authors was carried out to retrieve eligible studies. Date of the most recent literature search: June, 2002
Selection criteria
Studies were eligible if they were randomised controlled trials (RCTs) comparing balneotherapy with any other intervention or with no intervention. Included participants all suffered from definite or classical rheumatoid arthritis (RA) as defined by the American Rheumatism Association Criteria (ARA) or by the criteria of Steinbrocker. At least one of the WHO/ILAR core set of endpoints for RA clinical trials had to be among the main outcome measures.
Data collection and analysis
The Delphi list was the criteria list used to assess the components of methodological quality. Two reviewers carried out quality assessment and data extraction of the studies. Disagreements were solved by consensus.
Main results
Six trials, representing 355 people, were included in this review. Most trials reported positive findings (the absolute improvement in measured outcomes ranged from 0 to 44%), but were methodologically flawed to some extent. A 'quality of life' outcome was reported by two trials. None of the trials performed an intention-to-treat analysis and only two performed a comparison of effects between groups. Pooling of the data was ...
Williams, K & Wong, I 2003, 'Searching for health information on the internet: a pilot evaluation of pharmacists' skills.', Australian Pharmacist, vol. 22, no. 9, pp. 716-719.
