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5) Articles of Interest
1. Rosner A. 2011. Evidence-based medicine: Revisiting the pyramid of priorities.
Journal of Bodywork and Movement Therapies
Evidence-based medicine: article in press to review click here
Summary: Evidence-based medicine (EBM) is beset with numerous problems. In addition to the fact that varied audiences have each customarily sought differing types of evidence, EBM traditionally incorporated a hierarchy of clinical research designs, placing systematic reviews and meta-analyses at the pinnacle. Yet the canonical pyramid of EBM excludes numerous sources of research information, such as basic research, epidemiology, and health services research. Models of EBM commonly used by third party payers have ignored clinical judgment and patient values and expectations, which together form a tripartite and more realistic guideline to effective clinical care. Added to this is the problem in which enhanced placebo treatments in experimentation may obscure verum effects seen commonly in practice. Compounding the issue is that poor systematic reviews which comprise a significant portion of EBM are prone to subjective bias in their inclusion criteria and methodological scoring, shown to skew outcomes. Finally, the blinding concept of randomized controlled trials is particularly problematic in applications of physical medicine. Examples from the research literature in physical medicine highlight conclusions which are open to debate. More progressive components of EBM are recommended, together with greater recognition of the varying audiences employing EBM.
2. Beggs, C., Shields, D., & Goodin, H. (June, 2011). Using guided reflection to reduce test anxiety in nursing students.
Journal of Holistic Nursing. 29(2): 140-147. doi:10.1177/0898010110393352
This article discusses the use of Johns's Model for Structured Reflection to reduce test anxiety in student nurse
Abstract Test anxiety is a phenomenon that can affect as many as 40% of students. Many nursing students are under great stress from long hours of study, a rigorous curriculum, and balancing work and family life. These stressors can lead to anxiety in many areas of the student's life, most notably in situations where he or she is being evaluated. This article will aim to discuss how the use of guided reflection can help the student actualize his or her feelings about test anxiety by using Johns's Model for Structured Reflection. By using cues from the model and structure provided by a guide, the student will partake in a journey to gain insight about oneself and discover ways to decrease test anxiety that can be incorporated into the student's holistic self-care plan
3. Avino, K. (Nov 2011). Knowledge, attitudes, and practices of nursing faculty and students related to complementary and alternative medicine: A statewide look. Holistic Nursing Practice, 25(6): 280-288.
Abstract A comprehensive assessment of the knowledge, attitudes, and practices of nursing faculty and students related to complementary and alternative medicine (CAM) of one state in the Mid-Atlantic region of the United States was conducted and information was obtained from faculty about CAM content in their individual courses. Using a descriptive study design, a 32- and a 23-question online surveys were sent through e-mail to faculty and students, respectively. The response rate was: faculty 76% (N = 117) versus students 41% (N = 578). Positive support was found with regard to the addition of CAM into the nursing curriculum (81% students vs 92% faculty). Faculty provided some CAM didactic content to students on an inconsistent basis. It is unknown what CAM competencies students are expected to achieve. Integrating in the curriculum, experiential learning, a broad view of CAM therapies and holistic concepts, and evidence regarding CAM therapies is necessary. The results informed a plan for a professional development program for faculty.
4. Hölzela, B., Carmodyc, J., Vangela, M., Congletona, C., Yerramsettia, S., Gard, T.,Lazar, S. Mindfulness practice leads to increases in regional brain gray matter density. Psychiatry Research: Neuroimaging, 30 January 2011, 36-43.
Abstract Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular, but to date little is known about neural mechanisms associated with these interventions. Mindfulness-Based Stress Reduction (MBSR), one of the most widely used mindfulness training programs, has been reported to produce positive effects on psychological well-being and to ameliorate symptoms of a number of disorders. Here, we report a controlled longitudinal study to investigate pre-post changes in brain gray matter concentration attributable to participation in an MBSR program. Anatomical magnetic resonance (MR) images from 16 healthy, meditation-naïve participants were obtained before and after they underwent the 8-week program. Changes in gray matter concentration were investigated using voxel-based morphometry, and compared with a waiting list control group of 17 individuals. Analyses in a priori regions of interest confirmed increases in gray matter concentration within the left hippocampus. Whole brain analyses identified increases in the posterior cingulate cortex, the temporo-parietal junction, and the cerebellum in the MBSR group compared with the controls. The results suggest that participation in MBSR is associated with changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.
5. Airosa, F., Andersson,S., Falkenberg, T.,Forsberg, C., Nordby-Hörnell, E., Öhlén, G., Sundberg, T. Tactile massage and hypnosis as a health promotion for nurses in emergency care-a qualitative study. BMC Complementary and Alternative Medicine 2011, 11:83doi:10.1186/1472-6882-11-83 Published: 1 October 2011
Abstract
Background This study explores nursing personnel's experiences and perceptions of receiving tactile massage and hypnosis during a personnel health promotion project. Nursing in a short term emergency ward environment can be emotionally and physically exhausting due to the stressful work environment and the high dependency patient care. A health promotion project integrating tactile massage and hypnosis with conventional physical activities was therefore introduced for nursing personnel working in this setting at a large university hospital in Sweden. Methods Four semi-structured focus group discussions were conducted with volunteer nursing personnel participants after the health promotion project had been completed. There were 16 participants in the focus groups and there were 57 in the health promotion intervention. The discussions were transcribed verbatim and analysed with qualitative content analysis. Results The findings indicated that tactile massage and hypnosis may contribute to reduced levels of stress and pain and increase work ability for some nursing personnel. The sense of well-being obtained in relation to health promotion intervention with tactile massage and hypnosis seemed to have positive implications for both work and leisure. Self-awareness, contentment and self-control may be contributing factors related to engaging in tactile massage and hypnosis that might help nursing personnel understand their patients and colleagues and helped them deal with difficult situations that occurred during their working hours. Conclusion The findings indicate that the integration of tactile massage and hypnosis in personnel health promotion may be valuable stress management options in addition to conventional physical activities. |
