Analysing randomised controlled trials with missing data : Choice of approach affects conclusions

Copyright © 2012 Elsevier Inc. All rights reserved. PMID: 22265924 [PubMed - indexed for MEDLINE]Peer reviewedPostprin

Discrepancies between patient and nurse perceptions of post-operative pain: shortcomings in pain control

In this study of 60 patients and 30 nurses the objectives were to identify the degree of concordance between patient and nurse ratings of post-operative pain, and to assess the use of pain control methods used by nursing staff In the control of post-operative pain. Discrepancies existed between nurse and patient perceptions of post-operative pain experienced by patients 7.2 hours post-operatively with nurses significantly under-rating pain levels compared to patients. Unless patients complained of pain, nurses made no formal assessment of the patient's need for analgesia. There were often significant delays between requests for pro re nata (prn) analgesia and drug administration. Nurses tended to set higher priorities for institutional tasks, relying on analgesics for pain control rather than utilizing preparatory or non-pharmacological methods of pain control. This failure to use effective preparation plus non-pharmacological means of pain control in the management of post-operative pain has significant cost implications in terms of greater drug utilization and longer in-patient stays. This is in addition to the discomfort for patients from inadequate control of post-operative pain. These results indicate strong grounds for improving post operative pain control.published_or_final_versio

Reporting and dealing with missing quality of life data in RCTs : has the picture changed in the last decade?

Peer reviewedPublisher PD

Physical and psychosocial adjustment of Chinese women and their significant others to the impact of breast cancer and treatments

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Surgical treatment decision making in breast cancer among Chinese women: predicting psychological morbidity

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The perversion of scientific evidence for policy advocacy: A perspective on Avery 2010

The claims of scientific misconduct surrounding the pandemic influenza event in 2009 and the furor surrounding purported scientific manipulation at the University of East Anglia's Climate Research Unit were used as grounds in Avery's 2010 paper to ostensibly criticize how science is corrupted by the need to support particular political or ethical perspectives and, implicitly, that such perspectives are either lacking in evidence, or that such evidence is distorted or suppressed to maintain the politically correct interpretation. However, this rejoinder to Avery's paper demonstrates unambiguously that both unbalanced interpretation and one-sided presentation of opinion as evidence in support of these claims is in fact a thinly disguised attack on two issues that are contentious to certain vested interests. Having written the original paper on which Avery 2010 is based for a think tank well known for its opposition on ideological grounds to both environmental legislation and anthropogenic global warming, and for which some funding was received, Avery undermines his own arguments by appearing to embody the very problem he seeks to reveal. This rejoinder details why that seems to be the case. © 2011 Policy Studies Organization.published_or_final_versio

Uncertain news: Trust and preventive practices in respiratory infectious diseases

Trust influences a range of human behaviors including health decision making. Over the past 60 years a significant industry has sprung up to influence public opinion and mobilize grassroots challenges against evidence-based threats to vested interests. Simultaneously, media reports of scientific fraud, misrepresentation, constantly changing “evidence” for health, and “hyped” predictions of disasters that were ultimately less significant amplify doubts about the reliability of scientific evidence and technology when hazards arise. This has contributed to the appearance of decay of trust in the veracity of scientific claims. Population responses during communicable disease epidemics illustrate these interacting processes that simultaneously create uncertainty and significant discomfort within communities. Research on the relative influences of formal versus informal information sources in driving protective behavior during recent influenza epidemics shows how both the uptake of everyday preventive practices such as hand hygiene, and specific health interventions, such as vaccination are affected by these processes. We review recent work on influenza-related personal preventive practices, with a particular focus on the shifting roles and utility of formal and informal sources in decision making among the public, and consider the implications within the context of prevailing levels of trust, uncertainty, and doubt surrounding health care recommendations.postprin

The impact of a false-positive result from breast cancer mammography: a qualitative pilot study

Population mammographic screening to detect asymptomatic breast cancer for women over 40 years of age is common in developed countries, but remains controversial. Risks include anxiety and unnecessary investigations. Up to 1 000 000 false positives occur annually among 40- to 50-year-old American women. False positive test results increase anxiety, refusal to take future screening, and difficulty with accepting that the ‘all clear’ result really is correct. Most studies assessing the impact of false positive results in screening have been on Caucasian, African-American, Latina, and, rarely, Chinese women. We found no reports in the literature on the effects of false positive mammography results among Hong Kong Chinese women. Using qualitative methods, we studied the impact of false positive test results on these women.published_or_final_versio

The knowledge and perceptions of nurses and interns regarding acute pain and postoperative pain control

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Application of computer-aided dispatch in law enforcement: An introductory planning guide

A set of planning guidelines for the application of computer-aided dispatching (CAD) to law enforcement is presented. Some essential characteristics and applications of CAD are outlined; the results of a survey of systems in the operational or planning phases are summarized. Requirements analysis, system concept design, implementation planning, and performance and cost modeling are described and demonstrated with numerous examples. Detailed descriptions of typical law enforcement CAD systems, and a list of vendor sources, are given in appendixes