Development and Validation of the Behavioral Tendencies Questionnaire

At a fundamental level, taxonomy of behavior and behavioral tendencies can be described in terms of approach, avoid, or equivocate (i.e., neither approach nor avoid). While there are numerous theories of personality, temperament, and character, few seem to take advantage of parsimonious taxonomy. The present study sought to implement this taxonomy by creating a questionnaire based on a categorization of behavioral temperaments/tendencies first identified in Buddhist accounts over fifteen hundred years ago. Items were developed using historical and contemporary texts of the behavioral temperaments, described as “Greedy/Faithful”, “Aversive/Discerning”, and “Deluded/Speculative”. To both maintain this categorical typology and benefit from the advantageous properties of forced-choice response format (e.g., reduction of response biases), binary pairwise preferences for items were modeled using Latent Class Analysis (LCA). One sample (n1 = 394) was used to estimate the item parameters, and the second sample (n2 = 504) was used to classify the participants using the established parameters and cross-validate the classification against multiple other measures. The cross-validated measure exhibited good nomothetic span (construct-consistent relationships with related measures) that seemed to corroborate the ideas present in the original Buddhist source documents. The final 13-block questionnaire created from the best performing items (the Behavioral Tendencies Questionnaire or BTQ) is a psychometrically valid questionnaire that is historically consistent, based in behavioral tendencies, and promises practical and clinical utility particularly in settings that teach and study meditation practices such as Mindfulness Based Stress Reduction (MBSR)

Review of epidemiologic data on the debate over smokeless tobacco's role in harm reduction

Some tobacco researchers have argued that the European Union should remove its ban on a form of low-nitrosamine smokeless tobacco referred to as Swedish 'snus'. This argument has developed in to an international debate over the use of smokeless tobacco as a measure of harm reduction for smokers. Leading authorities in the USA have firmly stated that there is no safe tobacco - a message which does not allow for any discussion of comparative tobacco risks. This commentary is intended to review the origin of the controversy over Swedish 'snus', to examine briefly the meta-analysis on cancer risks by Peter Lee and Jan Hamling (published in July in BMC Medicine) and to discuss the anticipated direction of the debate on tobacco-harm reduction in the USA. We anticipate that much of the debate will shift from the discussion of epidemiologic data to the discussion of the marketing, health communication and economics of smokeless tobacco. While the Food and Drug Administration's newly approved authority over tobacco will undoubtedly affect the smokeless products, it may not be the sole determinant of harm reduction's fate in the USA

Are women birthing in New South Wales hospitals satisfied with their care?

Abstract Background Surveys of satisfaction with maternity care among Australian women have been conducted using overnight inpatient surveys and dedicated maternity surveys in a number of Australian states and territories, however to date no information on satisfaction with maternity care has been published for women birthing in New South Wales. The aim of this study was to investigate the effects of pregnancy and birth characteristics, hospital location and type of care provision on patient satisfaction with hospital care at the time of birth. Results Analysis of responses from 5,367 obstetric patients completing overnight patient surveys between 2007 and 2011 revealed three quarters of women were satisfied with care provided in hospital. Compared with women who had previously given birth, first-time mothers were more likely to recommend their birth hospital to friends and family (60.5% versus 56.4%; P<0.05), less likely to have experienced differing messages from staff (44.8% vs 59.4%; P<0.001), and less likely to feel they had received sufficient information about feeding (58.8% vs 65.0%; P<0.001) and caring for their babies (52.4% vs 65.2%; P<0.001). Women having a caesarean birth were more likely to have a negative experience of differing messages from doctors and nurses than women giving birth vaginally (52.7% vs 44.3%; P<0.001). While metropolitan women were more likely to rate their birth hospital positively (76.0% vs. 71.3%; P<0.05) than their rural counterparts, rural women tended to rate the care they received (68.1% vs. 63.4%; P<0.05), and doctors (70.7% vs 61.1%; P<0.05) and nurses (73.5% vs. 66.9%; P<0.001) more highly than metropolitan women. Conclusions The overall picture of maternity care satisfaction in New South Wales is a positive one, with three quarters of women satisfied with care. The differences in care ratings among some subgroups of women (for instance, by parity and rurality) may assist in targeting allocation of resources to improve maternity satisfaction. Further resources could be dedicated to ensuring consistency and amount of information provided, particularly to first-time mothers.Australian Research Council Future Fellowship (#FT120100069)

Self-Guided Psychological Treatment for Depressive Symptoms: A Meta-Analysis

Background: A number of trials have examined the effects of self-guided psychological intervention, without any contact between the participants and a therapist or coach. The results and sizes of these trials have been mixed. This is the first quantitative meta-analysis, aimed at organizing and evaluating the literature, and estimating effect size. Method: We conducted systematic literature searches in PubMed, PsycINFO and Embase up to January 2010, and identified additional studies through earlier meta-analyses, and the references of included studies. We identified seven randomized controlled trials that met our inclusion criteria, with a total of 1,362 respondents. The overall quality of the studies was high. A post-hoc power calculation showed that the studies had sufficient statistical power to detect an effect size of d = 0.19. Results: The overall mean effect size indicating the difference between self-guided psychological treatment and control groups at post-test was d = 0.28 (pless than0.001), which corresponds to a NNT of 6.41. At 4 to 12 months follow-up the effect size was d = 0.23. There was no indication for significant publication bias. Conclusions: We found evidence that self-guided psychological treatment has a small but significant effect on participants with increased levels of depressive symptomatology.Original Publication:Pim Cuijpers, Tara Donker, Robert Johansson, David C. Mohr, Annemieke van Straten and Gerhard Andersson, Self-Guided Psychological Treatment for Depressive Symptoms: A Meta-Analysis, 2011, PLoS ONE, (6), 6.http://dx.doi.org/10.1371/journal.pone.0021274Copyright: Public Library of Science (PLoS)http://www.plos.org

Team players against headache: multidisciplinary treatment of primary headaches and medication overuse headache

Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform for more intense collaboration between these professions and between headache centers is needed. Our aims were to establish closer collaboration and an interchange of knowledge between headache care providers and different disciplines. A scientific session focusing on multidisciplinary headache management was organised at The European Headache and Migraine Trust International Congress (EHMTIC) 2010 in Nice. A summary of the contributions and the discussion is presented. It was concluded that effective multidisciplinary headache treatment can reduce headache frequency and burden of disease, as well as the risk for medication overuse headache. The significant value of physiotherapy, education in headache schools, and implementation of strategies of cognitive behavioural therapy was highlighted and the way paved for future studies and international collaboration

Improving physical health and reducing substance use in psychosis - randomised control trial (IMPACT RCT): study protocol for a cluster randomised controlled trial

The National Institute for Health Research funds the IMPACT programme at King’s College London and South London and Maudsley NHS Foundation Trust (ref: RP-PG-0606-1049)

Meta-analysis of the relation between European and American smokeless tobacco and oral cancer

<p>Abstract</p> <p>Background</p> <p>Smokeless tobacco is often referred to as a major contributor to oral cancer. In some regions, especially Southeast Asia, the risk is difficult to quantify due to the variety of products, compositions (including non-tobacco ingredients) and usage practices involved. In Western populations, the evidence of an increased risk in smokeless tobacco users seems unclear, previous reviews having reached somewhat differing conclusions. We report a detailed quantitative review of the evidence in American and European smokeless tobacco users, and compare our findings with previous reviews and meta-analyses.</p> <p>Methods</p> <p>Following literature review a meta-analysis was conducted of 32 epidemiological studies published between 1920 and 2005 including tests for homogeneity and publication bias.</p> <p>Results</p> <p>Based on 38 heterogeneous study-specific estimates of the odds ratio or relative risk for smokeless tobacco use, the random-effects estimate was 1.87 (95% confidence interval 1.40–2.48). The increase was mainly evident in studies conducted before 1980. No increase was seen in studies in Scandinavia. Restricting attention to the seven estimates adjusted for smoking and alcohol eliminated both heterogeneity and excess risk (1.02; 0.82–1.28). Estimates also varied by sex (higher in females) and by study design (higher in case-control studies with hospital controls) but more clearly in studies where estimates were unadjusted, even for age. The pattern of estimates suggests some publication bias. Based on limited data specific to never smokers, the random-effects estimate was 1.94 (0.88–4.28), the eight individual estimates being heterogeneous and based on few exposed cases.</p> <p>Conclusion</p> <p>Smokeless tobacco, as used in America or Europe, carries at most a minor increased risk of oral cancer. However, elevated risks in specific populations or from specific products cannot definitely be excluded.</p