Cramer H, Haller H, Lauche R, Dobos G. Mindfulness-based stress reduction
for low back pain. A systematic review. BMC Complementary and Alternative
Medicine 2012, 12:162 doi:10.1186/1472-6882-12-162
Background:
Mindfulness-based
stress reduction (MBSR) is frequently used for pain conditions. While
systematic reviews on MBSR for chronic pain have been conducted, there are no
reviews for specific pain conditions. Therefore a systematic review of the
effectiveness of MBSR in low back pain was performed.
Methods: MEDLINE, the
Cochrane Library, EMBASE, CAMBASE, and PsycInfo were screened through November
2011. The search strategy combined keywords for MBSR with keywords for low back
pain. Randomized controlled trials (RCTs) comparing MBSR to control conditions
in patients with low back pain were included. Two authors independently
assessed risk of bias using the Cochrane risk of bias tool. Clinical importance
of group differences was assessed for the main outcome measures pain intensity
and back-specific disability.
Results: Three RCTs
with a total of 117 chronic low back pain patients were included. One RCT on
failed back surgery syndrome reported significant and clinically important
short-term improvements in pain intensity and disability for MBSR compared to
no treatment. Two RCTs on older adults (age >= 65 years) with chronic
specific or non-specific low back pain reported no short-term or long-term
improvements in pain or disability for MBSR compared to no treatment or health
education. Two RCTs reported larger short-term improvements of pain acceptance
for MBSR compared to no treatment.
Conclusion:
This review
found inconclusive evidence of effectiveness of MBSR in improving pain
intensity or disability in chronic low back pain patients. However, there is
limited evidence that MBSR can improve pain acceptance. Further RCTs with
larger sample sizes, adequate control interventions, and longer follow-ups are
needed before firm conclusions can be drawn.
Callahan M, Green S, Houry D. Does mentoring new peer reviewers improve
review quality? A randomized trial. BMC Medical Education 2012, 12:83
doi:10.1186/1472-6920-12-83
ABSTRACT
Background:
Prior
efforts to train medical journal peer reviewers have not improved subsequent
review quality, although such interventions were general and brief. We
hypothesized that a manuscript-specific and more extended intervention pairing
new reviewers with high-quality senior reviewers as mentors would improve
subsequent review quality.
Methods: Over a
four-year period we randomly assigned all new reviewers for Annals of Emergency
Medicine to receive our standard written informational materials alone, or
these materials plus a new mentoring intervention. For this program we paired
new reviewers with a high-quality senior reviewer for each of their first three
manuscript reviews, and asked mentees to discuss their review with their mentor
by email or phone. We then compared the quality of subsequent reviews between
the control and intervention groups, using linear mixed effects models of the
slopes of review quality scores over time.
Results: We studied
490 manuscript reviews, with similar baseline characteristics between the 24
mentees who completed the trial and the 22 control reviewers. Mean quality
scores for the first 3 reviews on our 1 to 5 point scale were similar between
control and mentee groups (3.4 versus 3.5), as were slopes of change of review
scores (-0.229 versus -0.549) and all other secondary measures of reviewer
performance.
Conclusions:
A structured
training intervention of pairing newly recruited medical journal peer reviewers
with senior reviewer mentors did not improve the quality of their subsequent
reviews.
Bayrampour H, Heaman M, Duncan K, Tough S. Advanced maternal age and risk
perception: A qualitative study. BMC Pregnancy and Childbirth 2012, 12:100
doi:10.1186/1471-2393-12-100
ABSTRACT
Background:
Advanced
maternal age (AMA) is associated with several adverse pregnancy outcomes, hence
these pregnancies are considered to be "high risk." A review of the
empirical literature suggests that it is not clear how women of AMA evaluate
their pregnancy risk. This study aimed to address this gap by exploring the
risk perception of pregnant women of AMA.
Methods: A
qualitative descriptive study was undertaken to obtain a rich and detailed
source of explanatory data regarding perceived pregnancy risk of 15 women of
AMA. The sample was recruited from a variety of settings in Winnipeg, Canada.
In-depth interviews were conducted with nulliparous women aged 35 years or
older, in their third trimester, and with singleton pregnancies. Interviews
were recorded and transcribed verbatim, and content analysis was used to
identify themes and categories.
Results: Four main
themes emerged: definition of pregnancy risk, factors influencing risk
perception, risk alleviation strategies, and risk communication with health
professionals.
Conclusions:
Several
factors may influence women's perception of pregnancy risk including medical
risk, psychological elements, characteristics of the risk, stage of pregnancy,
and health care provider's opinion. Understanding these influential factors may
help health professionals who care for pregnant women of AMA to gain insight
into their perspectives on pregnancy risk and improve the effectiveness of risk
communication strategies with this group.
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