Creating Experimental Analogs with Available Clinical Information

SUMMARY

Comparison of the implementation and findings of a “gold standard” evaluation of social work intervention and its experimental analog based on available clinical information illustrates the strengths and weaknesses of each. From a practice-research integration perspective, however, “clinical data-mining” may be a credible alternative to randomized controlled experiments.     

FROM THE EDITOR'S DESK

No abstract available for this article.     

Judgments About Elder Abuse and College Students' Relationship with Grandparents

Abstract

Using brief scenarios describing adult caregiver/elder parent interactions, college students made judgments about how justifiable aggressive behavior by caregivers were, the abusiveness of these behaviors, and the abusiveness of the behavior of the elderly parent. The extent of students' contact with their grandparents was obtained. Results indicate that judgments of abusiveness are context specific, and that senile or agitated elders were viewed as more abusive, and behaviors against them as more justified, than were more “helpless” elders. In addition, results indicate that students' involvement with grandparents has an effect on the judgments of abusiveness and the justifiability of caregiver behaviors toward elderly mothers. It is suggested that programs that promote interaction between younger and older persons should be encouraged in order to develop a heightened understanding between these age groups and to help relieve generational tensions that may exist.     

Critical reflections on school-based occupational therapy

This article describes the process of facilitating change to practice that is more client-centered and occupation-based in a diverse suburban public school district in the USA from 2001 to 2006. The author sets the context, describes the process that included the use of the School AMPS, and considers factors that facilitated and constrained change.     

Qualitative outcome assessment and research on chronic disease management in general practice. Highlights from a keynote lecture,EGPRN May 2011, Nice

At its 2011 conference in Nice, France, the European General Practice Research Network (EGPRN), considered the issue of Relevant Outcome Measures in General Practice Research into Chronic Diseases. This paper, which is adapted from a keynote lecture given during that conference, considers the role of qualitative outcome assessments in research. Such assessments have a great deal in common with the patient-centred approach of general practice as they can capture the overall state of a patient rather than capturing only certain aspects. Research suggests that patients can be categorized, based on qualitative outcome assessment, and over time might change category. This approach to assessment brings to our attention alternative ways of considering the future: future as currently being made or future as predictable, at least to some extent. Although general practice needs the evidence from research that predicts the future, it also needs to engage in research that seeks to understand patients as they make their future, and to understand the impact of clinical interventions on this process.     

Cancer prognosis by general practitioners

Background: General practitioners are probably asked regularly about the prognosis for patients with cancer. There is no readily available source of information on the accuracy of their estimates.

Objective: To discover studies that have reported general practitioners estimates of prognosis.

Methods: A search for studies of estimates of prognosis in terminal cancer by general practitioners.

Results: Three papers were discovered, reporting on 836 patients. In only a quarter of patients was prognosis accurately estimated by general practitioners, even within broad limits. Hospital doctors and nurses performed similarly. We suggest considerable scope for further studies in general practice, which should not require sophisticated procedures.

Conclusion: Evidence of GP's limited performance in cancer prognostication should push us to do better.     

An Interprofessional Psychiatric Advanced Pharmacy Practice Experience

Objective. To create an interprofessional psychiatry advanced pharmacy practice experience (APPE) and assess the initial outcomes.Design. An elective psychiatry APPE was developed in a setting of interdisciplinary practice. Preceptor responsibilities were shared between a psychiatric pharmacist and an attending psychiatrist or psychiatric nurse practitioner. Students were also given the opportunity to shadow and work with other health care professionals such as nurses, social workers, therapists, family nurse practitioners, and utilization review staff members.Assessment. Midpoint and final evaluations demonstrated student advancement throughout the experience as well as the development of communication skills with patients and an increased ability to work collaboratively with other health care providers. Students rated this practice experience highly and their comments reflected achievement of the established learning objectives.Conclusion. An interdisciplinary elective practice experience in psychiatry at a local teaching hospital was effective in teaching psychiatric care and interprofessional interaction. This teaching model can be adapted for use in other practice settings or specialty areas.