Inter-rater agreement and reliability of the COSMIN (COnsensus-based Standards for the selection of health status Measurement Instruments) Checklist

Background  

The COSMIN checklist is a tool for evaluating the methodological quality of studies on measurement properties of health-related patient-reported outcomes. The aim of this study is to determine the inter-rater agreement and reliability of each item score of the COSMIN checklist (n = 114).     

Prevalence of complementary and alternative medicine (CAM) use by menopausal women: A systematic review of surveys

Large proportions of women have turned to complementary and alternative medicine (CAM) for relief from their menopausal symptoms. This highlights the need for more rigorous research into CAM. This article is aimed at critically reviewing surveys that examine the prevalence of CAM use by menopausal women worldwide. Eleven databases were searched for peer-reviewed surveys published in any language between 01 January 2000 and 27 October 2012. The bibliographies of the retrieved articles and relevant book chapters were also hand searched. Twenty-six surveys were identified, and they included a total of 32,465 menopausal women. The majority of these surveys were of poor methodological quality. Based on 6 surveys, 32.9% of women stated they were current/regular CAM users. Based on 9 surveys, 50.5% of women reported that they used CAM specifically for their menopausal symptoms. The average 12-month prevalence of CAM use was 47.7% (range: 33.1–56.2). Fifty-five percent of women did not disclose their use of CAM to their healthcare professional. The majority of women sought information about CAM from the media. The most popular CAM modality was herbal medicine, followed by soy/phytoestrogens, evening primrose oil, relaxation and yoga. There are a large number of predominantly low-quality surveys monitoring the prevalence of CAM use among menopausal women worldwide. The available evidence suggests that the prevalence of CAM use is high.     

Evaluation of Seldinger Technique Emergency Cricothyroidotomy versus Standard Surgical Cricothyroidotomy in 200 Cadavers

Background: Percutaneous cricothyroidotomy is a lifesaving procedure for airway obstruction in trauma victims who need airway establishment and cannot be intubated or in whom intubation has failed.

Methods: The purpose of this study was to examine whether there is a training effect using Seldinger technique emergency cricothyroidotomy (group 1; Arndt Emergency Cricothyroidotomy Catheter Set; Cook Critical Care, Bloomington, IN) versus standard surgical cricothyroidotomy (group 2). Twenty emergency physicians performed five cricothyroidotomies with each method in a total of 200 human cadavers, comparing efficacy and safety (speed, success rate, and injuries).

Results: Seven attempts in group 1 and six in group 2 had to be aborted. Time intervals from the start of the procedure to location of the cricothyroid membrane were not significantly different between the groups. However, time to tracheal puncture (P < 0.01) and time to first ventilation (P < 0.001) were significantly longer in group 2. No time effect could be observed in both groups. The airway was accurately placed into the trachea through the cricothyroid membrane in 88.2% (82 of 93) of the cadavers in group 1 and in 84.0% (79 of 94) in group 2 (not significant). No injuries were observed in group 1, whereas there were six punctures of the thyroid vessels in group 2 (P < 0.05).     

The development and initial validation of the narrative foreclosure scale

Objectives: As people grow older, identity development in later life becomes a more and more relevant topic. Studying processes that hinder or promote identity development in later life is of importance. Within this broader field, there has been a growing interest in narrative foreclosure. Our goal was to develop a short, reliable and easy–to-use instrument measuring narrative foreclosure and to validate this instrument in two samples.Methods: The narrative foreclosure scale (NFS) was validated in two studies with a sample of middle-aged adults (n = 319) and a sample with older adults (n = 174). Several analyses were conducted to assess the psychometric properties, the factor-structure and incremental validity of the scale.Results: Confirmatory factor analyses generally showed an acceptable fit of the two-factor (NF-Future and NF-Past) model to the data in both samples. Both factors of the NFS demonstrated adequate to good internal consistency, with alpha coefficients ranging from .79 for NF-Past in study 2 to .88 for NF-Future in study 1. Construct validity was good as shown by moderate to large correlations to related constructs. The scale adds a unique portion of explained variance to positive mental health, thereby showing the incremental validity of the NFS.Conclusion: A reliable scale is now available that allows to study the premature hindering of identity development in older populations. The use of the NFS as a process measure in studies on the effectiveness of interventions aiming at meaning making and identity development, such as life-review therapy and narrative therapy, is also recommended.     

Segmentation of Progressive Multifocal Leukoencephalopathy Lesions in Fluid-Attenuated Inversion Recovery Magnetic Resonance Imaging

BACKGROUND AND PURPOSE: The authors compared the reproducibility of a manual and a semiautomated technique for the quantitation of white-matter lesions in magnetic resonance imaging (MRI). METHODS: Volumes of white-matter lesions were determined using fluid-attenuated inversion recovery MRI in 23 AIDS patients with progressive multifocal leukoencephalopathy. Manual outlining was compared to an automated method based on region growing and adaptive thresholding. RESULTS: Lesion volumes from the 2 methods correlated well (61 lesions, r = 0.99, P < 10(-4)), although the volumes differed substantially (12.8% +/- 13.7%). Interscan, intrasubject reproducibility was better for the automated than the manual method (2.9% +/- 3.2% vs 12.4% +/- 16.2% volume difference, P = .02). CONCLUSION: The automated algorithm appeared more reproducible, which renders it superior to the manual method for longitudinal studies.     

Anticipatory Pleasure Skills Training: A New Intervention to Reduce Anhedonia in Schizophrenia

PURPOSE. Anhedonia is a challenging symptom of schizophrenia and remains largely recalcitrant to current pharmacological treatments. The goal of this exploratory pilot study was to assess if a cognitive–sensory intervention could improve anticipatory pleasure. DESIGN AND METHODS. Five participants meeting the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) criteria for schizophrenia, presenting severe anhedonia and stabilized on atypical antipsychotic medication, received between 10 hours and 25 hours of training. FINDINGS. Results show that the patients improved on the anticipatory scale of the Temporal Experience of Pleasure Scale. Daily activities of the patients were also increased. PRACTICE IMPLICATIONS. These preliminary data need to be interpreted with caution given the small sample of the study, but they offer promising paths to develop new interventions to alleviate anhedonia in schizophrenia.