Book Received

There exist numerous difficulties in the recruitment of patients to drug trials for Alzheimer's disease. This article describes a successful community-based case-finding strategy. The success is largely attributed to effective liaison between the co-ordinating psychiatrist, GPs, community psychiatric nurses and practice nurses.     

Early Psychological Preventive Intervention For Workplace Violence: A Randomized Controlled Explorative and Comparative Study Between EMDR-Recent Event and Critical Incident Stress Debriefing

This randomized controlled trial study aims to investigate the efficacy of an early psychological intervention called EMDR-RE compared to Critical Incident Stress Debriefing on 60 victims of workplace violence, which were divided into three groups: ‘EMDR-RE’ (n = 19), ‘CISD’ (n = 23), and ‘delayed EMDR-RE’ (n = 18). EMDR-RE and CISD took place 48 hours after the event, whilst third intervention was delayed by an additional 48 hours. Results showed that after 3 months PCLS and SUDS scores were significantly lower with EMDR-RE and delayed EMDR-RE compared to CISD. After 48 hours and 3 months, none of the EMDR-RE-treated victims showed PTSD symptoms.     

The effect of massage on agitated behaviours in older people with dementia: a literature review

Aims and objectives. To review the literature on massage used to manage agitated behaviours in older people with dementia, assess its efficacy as a non‐pharmacological approach and provide recommendations for future research. Background. Agitation has traditionally been managed with chemical or physical restraint. There has been a growing interest in complementary therapies such as massage. Design. A literature review. Methods. Cooper’s five‐stage model of synthesising research guided the review process. The search terms ‘massage’, ‘agitation’ and ‘dementia’ were defined, and 10 databases were searched in October 2011. No date limitations were applied, although searches were limited to articles written in English. For relevant records, full‐text copies were obtained and assessed in terms of inclusion criteria and methodological quality using the Validity Rating Tool (VRT). Data were extracted using a form constructed with reference to the checklist of items to consider in data extraction, produced by the Cochrane Handbook for Systematic Reviews of Interventions. Results. Thirteen studies met the inclusion criteria and were assessed on the VRT. One study was considered of adequate methodological quality to be included in the review. This prospective study found that massage significantly reduced levels of agitation in 52 cognitively impaired residents in two long‐term care facilities. Conclusions. There is a severe paucity of research that considers the effects of massage on managing agitated behaviours in older people with dementia. Whilst conclusions cannot be drawn from the one study included in this review, it did provide evidence to support the use of massage as a non‐pharmacological approach to managing agitation in older people with dementia. More research, of better methodological quality, is needed. Relevance to clinical practice. There is a need for health practitioners to be aware of the limited evidence for massage as an intervention for agitation and to provide opportunities to validate massage practice.     

Learning in hospital settings

The study that this article is based on was designed to portray and assess the appropriateness of the learning environment in hospital settings for Resident Medical Officers (RMOs) in New South Wales (NSW), Australia. It included visits to selected hospitals and a mailed statewide survey of RMOs. This article focuses on the latter component of the study, the survey of 209 RMOs practicing during the last quarter of 1992 in various clinical rotations in NSW hospitals.

The study lends support to the perceived importance of organizational and sociopsychological variables as determinants of learning. These attributes include appropriate levels of autonomy, variety and workload, quality of supervision and social support, and, most important, the overall orientation toward teaching and learning, reflecting the culture prevailing in the clinical unit. The study provided an inventory of learning opportunities and their usefulness for the training of RMOs. It also explored the opportunity to practice particular procedures and skills in the respective clinical rotations.     

Laboratory study of the effectiveness of filters used by heroin injectors

Aims: (a) To compare in the laboratory the effectiveness of various filters at removing particles from heroin injections; (b) To measure the amount of heroin retained by the filters; and (c) To describe the relevance of these preliminary findings to future research.

Design: A laboratory‐based investigation. Injections were prepared with street heroin obtained from the police, copying the methods of injectors. Pieces of cigarette filter, hand‐rolling cigarette filter, cotton wool from buds and commercially produced syringe filters were tested. The Coulter Multisizer (IIe) was used to count and size particles; Capillary Zone Electrophoresis was used to measure the amount of heroin retained in the filters.

Findings: All methods of filtration reduced the amount of particles, with the commercially produced syringe filter producing the largest reduction. The syringe filter retained the most heroin after use; however, less drug material was evident on the spoon, suggesting further work is needed with a range of quantities. The cigarette, hand‐rolling and cotton bud filters all retained some drug with no significant difference detected between the different filters.

Conclusions: This preliminary study suggests all the filters tested may convey health benefits. Further work is needed with varying quantities of drug, acid and water and to establish safety in use. Then future studies can establish the health consequences for injecting drug users from the use of such filters.