To peritonealize or not to peritonealize? A randomized trial at abdominal hysterectomy

OBJECTIVES: Our purpose was to determine whether nonclosure of the visceral and parietal peritoneum alters the intraoperative or postoperative course at abdominal hysterectomy. STUDY DESIGN: The setting was a gynecology unit in a university teaching hospital. A parallel-group, single-blind randomized controlled trial was performed on 144 women who underwent abdominal hysterectomy with or without salpingo-oophorectomy. Seventy-six women were allocated to the control "closed" group and 68 women to the study "open" group. The main outcome measures were operative time, estimated blood loss, postoperative pain assessed by visual analog scale, and amount of postoperative analgesia. RESULTS: The mean operative time was shorter by 10 minutes (p < 0.001) and there was a 45 ml reduction of estimated blood loss in the nonclosure group (p=0.03). There were no differences in postoperative pain in the two groups. CONCLUSIONS: Peritoneal closure at abdominal hysterectomy provides no immediate postoperative benefits while unnecessarily lengthening surgical time and anesthesia exposure. We suggest that the traditional practice of visceral and parietal peritoneal closure be abolished at abdominal hysterectomy.     

What makes group MET work? A randomized controlled trial of college student drinkers in mandated alcohol diversion.

Nationally, college drinkers exhibit the highest rates of alcohol consumption and represent the largest percentage of problem drinkers. Group motivational enhancement therapy (GMET) has been found to catalyze problem drinking reductions among college student samples. Although research supporting the use of single-session GMET in college samples (general and mandated) is emergent, no studies have evaluated a comprehensive model of the potential active ingredients of this group intervention. College students (N = 206; 88% White; 63% men; M age = 18.6) mandated to a university alcohol diversion program were randomly assigned to 1 of 3 conditions: the standard-of-care 2-session “Focus on Alcohol Concerns” education group (FAC), a single GMET, or a single alcohol information-only control group (AI) to evaluate the role of 5 putative mediators: readiness to change, self-efficacy, perceived risk, norm estimates, and positive drinking expectancies. At 3- and 6-month follow-ups, GMET students demonstrated greater reductions in problem drinking outcomes (drinks per drinking day, hazardous drinking symptoms, and alcohol-related problems). Of the 5 mediators proposed, only self-efficacy emerged as a significant mediator. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive–behavioral therapy, behavioral weight loss, and sequential treatment for obese patients with binge-eating disorder: A randomized controlled trial.

Objective: Cognitive–behavioral therapy (CBT) is the best established treatment for binge-eating disorder (BED) but does not produce weight loss. The efficacy of behavioral weight loss (BWL) in obese patients with BED is uncertain. This study compared CBT, BWL, and a sequential approach in which CBT is delivered first, followed by BWL (CBT + BWL). Method: 125 obese patients with BED were randomly assigned to 1 of the 3 manualized treatments delivered in groups. Independent assessments were performed posttreatment and at 6- and 12-month follow-ups. Results: At 12-month follow-up, intent-to-treat binge-eating remission rates were 51% (CBT), 36% (BWL), and 40% (CBT + BWL), and mean percent BMI losses were ?0.9, ?2.1, and 1.5, respectively. Mixed-models analyses revealed that CBT produced significantly greater reductions in binge eating than BWL through 12-month follow-up and that BWL produced significantly greater percent BMI loss during treatment. The overall significant percent BMI loss in CBT + BWL was attributable to the significant effects during the BWL component. Binge-eating remission at major assessment points was associated significantly with greater percent BMI loss cross-sectionally and prospectively (i.e., at subsequent follow-ups). Conclusions: CBT was superior to BWL for producing reductions in binge eating through 12-month follow-up, while BWL produced statistically greater, albeit modest, weight losses during treatment. Results do not support the utility of the sequential approach of providing BWL following CBT. Remission from binge eating was associated with significantly greater percent BMI loss. Findings support BWL as an alternative treatment option to CBT for BED. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Does self-threat promote social connection? The role of self-esteem and contingencies of self-worth.

Six studies examined the social motivations of people with high self-esteem (HSE) and low self-esteem (LSE) following a threat to a domain of contingent self-worth. Whether people desired social contact following self-threat depended on an interaction between an individual's trait self-esteem and contingencies of self-worth. HSE participants who strongly based self-worth on appearance sought to connect with close others following a threat to their physical attractiveness. LSE participants who staked self-worth on appearance wanted to avoid social contact and, instead, preferred a less interpersonally risky way of coping with self-threat (wanting to enhance their physical attractiveness). Implications for theories of self-esteem, motivation, and interpersonal processes are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Why are some texts good and others not? Relationship between text quality and management of the writing processes.

Two experiments examined whether text quality is related to online management of the writing processes. Experiment 1 focused on the relationship between online management and text quality in narrative and argumentative texts. Experiment 2 investigated how this relationship might be affected by a goal emphasizing text quality. In both experiments, psychology students were instructed to think aloud while composing their texts. Reaction times to auditory probes were also collected to reflect writers' cognitive effort. Two sets of variables were measured: general temporal indicators (fluency, prewriting pause) and online management of writing processes (number, mean length of episodes). Finally, text quality was assessed. As expected, results confirmed that narrative and argumentative texts are composed using different strategies. Students also composed better texts when a quality-based goal had been set. The main reliable indicator of text quality was an increase of the prewriting pause and of planning processes. These findings indicate that writers tailor their writing behavior to match the type and quality of the text they are asked to produce. These results are discussed in the light of interventions and recommendations in the classroom. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Can I retake it? Exploring subgroup differences and criterion-related validity in promotion retesting.

Despite recent interest in the practice of allowing job applicants to retest, surprisingly little is known about how retesting affects 2 of the most critical factors on which staffing procedures are evaluated: subgroup differences and criterion-related validity. We examined these important issues in a sample of internal candidates who completed a job-knowledge test for a within-job promotion. This was a useful context for these questions because we had job-performance data on all candidates (N = 403), regardless of whether they passed or failed the promotion test (i.e., there was no direct range restriction). We found that retest effects varied by subgroup, such that females and younger candidates improved more upon retesting than did males and older candidates. There also was some evidence that Black candidates did not improve as much as did candidates from other racial groups. In addition, among candidates who retested, their retest scores were somewhat better predictors of subsequent job performance than were their initial test scores (rs = .38 vs. .27). The overall results suggest that retesting does not negatively affect criterion-related validity and may even enhance it. Furthermore, retesting may reduce the likelihood of adverse impact against some subgroups (e.g., female candidates) but increase the likelihood of adverse impact against other subgroups (e.g., older candidates). (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Chronic low-back pain: What does cognitive coping skills training add to operant behavioral treatment? Results of a randomized clinical trial.

This study examined the supplemental value of a cognitive coping skills training when added to an operant-behavioral treatment for chronic low-back pain patients. The complete treatment package (OPCO) was compared with an operant program?+?group discussion (OPDI) and a waiting-list control (WLC). After the WL period, the WLC patients received a less protocolized operant program usually provided in Dutch rehabilitation centers (OPUS). Regression analyses showed that, compared with WLC, both OPCO and OPDI led to less negative affect, higher activity tolerance, less pain behavior, and higher pain coping and pain control. At posttreatment, OPCO led to better pain coping and pain control than OPDI. Calculation of improvement rates revealed that OPCO and OPDI had significantly more improved patients than OPUS on all the dependent variables. The discussion includes findings regarding treatment credibility, compliance, and contamination bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy in two-plus-one sessions: Outcomes of a randomized controlled trial of cognitive–behavioral and psychodynamic–interpersonal therapy for subsyndromal depression.

A total of 116 clients with a range of subsyndromal depression received 3 therapy sessions: 2 sessions 1 week apart followed by a 3rd session 3 months later (the 2?+?1 model). Clients were stratified for severity on the Beck Depression Inventory (BDI) as stressed, subclinical, or low-level clinically depressed. In a 2?×?2 design, they received either cognitive–behavioral (CB) or psychodynamic–interpersonal (PI) therapy, either immediately or after a 4-week delay. An initial advantage for the immediate condition disappeared once the delayed-condition clients received treatment. Improvement rates at the end of treatment were 67% (stressed), 72% (subclinical), and 65% (low-level clinically depressed). There were no significant differences between CB and PI treatment methods, with the exception at 1-year follow-up, when the BDI showed a significant advantage for CB. Implications for designing very brief planned interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the effects of classroom discussion on students’ comprehension of text: A meta-analysis.

The role of classroom discussions in comprehension and learning has been the focus of investigations since the early 1960s. Despite this long history, no syntheses have quantitatively reviewed the vast body of literature on classroom discussions for their effects on students’ comprehension and learning. This comprehensive meta-analysis of empirical studies was conducted to examine evidence of the effects of classroom discussion on measures of teacher and student talk and on individual student comprehension and critical-thinking and reasoning outcomes. Results revealed that several discussion approaches produced strong increases in the amount of student talk and concomitant reductions in teacher talk, as well as substantial improvements in text comprehension. Few approaches to discussion were effective at increasing students’ literal or inferential comprehension and critical thinking and reasoning. Effects were moderated by study design, the nature of the outcome measure, and student academic ability. While the range of ages of participants in the reviewed studies was large, a majority of studies were conducted with students in 4th through 6th grades. Implications for research and practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can people remember how they coped? Factors associated with discordance between same-day and retrospective reports.

Using alternate forms derived from 6 scales from the Revised Ways of Coping Checklist (P. P. Vitaliano, 1993), the authors obtained daily coping scores from students as they prepared for a demanding test, then obtained a 7-day retrospective measure of their coping. On average, only 25% shared variance was found between the daily and retrospective accounts. A consistent pattern of retrospective overestimation of daily coping occurred, and large individual differences in degree of correspondence were observed. Among students who reported the highest level of exam-related stress, less than 10% of the retrospective coping score variance was predicted by the daily measures. The results indicate that retrospective coping reports cannot be considered equivalent to measures obtained in closer proximity to the event. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are you interested? A meta-analysis of relations between vocational interests and employee performance and turnover.

A common belief among researchers is that vocational interests have limited value for personnel selection. However, no comprehensive quantitative summaries of interests validity research have been conducted to substantiate claims for or against the use of interests. To help address this gap, we conducted a meta-analysis of relations between interests and employee performance and turnover using data from 74 studies and 141 independent samples. Overall validity estimates (corrected for measurement error in the criterion but not for range restriction) for single interest scales were .14 for job performance, .26 for training performance, –.19 for turnover intentions, and –.15 for actual turnover. Several factors appeared to moderate interest–criterion relations. For example, validity estimates were larger when interests were theoretically relevant to the work performed in the target job. The type of interest scale also moderated validity, such that corrected validities were larger for scales designed to assess interests relevant to a particular job or vocation (e.g., .23 for job performance) than for scales designed to assess a single, job-relevant realistic, investigative, artistic, social, enterprising, or conventional (i.e., RIASEC) interest (.10) or a basic interest (.11). Finally, validity estimates were largest when studies used multiple interests for prediction, either by using a single job or vocation focused scale (which tend to tap multiple interests) or by using a regression-weighted composite of several RIASEC or basic interest scales. Overall, the results suggest that vocational interests may hold more promise for predicting employee performance and turnover than researchers may have thought. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Are psychotic psychopathology and neurocognition orthogonal? A systematic review of their associations.

A systematic review (58 studies, 5,009 individuals) is presented of associations between psychopathological dimensions of psychosis and measures of neurocognitive impairment in subjects with a lifetime history of nonaffective psychosis. Results showed that negative and disorganized dimensions were significantly but modestly associated with cognitive deficits (correlations from -.29 to -.12). In contrast, positive and depressive dimensions of psychopathology were not associated with neurocognitive measures. The patterns of association for the 4 psychosis dimensions were stable across neurocognitive domains and were independent of age, gender, and chronicity of illness. In addition, significantly higher correlations were found for the negative dimension in relation to verbal fluency (p = .005) and for the disorganized dimension in relation to reasoning and problem solving (p = .004) and to attention/vigilance (p = .03). Psychotic psychopathology and neurocognition are not entirely orthogonal, as heterogeneity in nonaffective psychosis is weakly but meaningfully associated with measures of neurocognition. This association suggests that differential latent cerebral mechanisms underlie the cluster of disorganized and negative symptoms versus that of positive and affective symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A school-randomized clinical trial of an integrated social–emotional learning and literacy intervention: Impacts after 1 school year.

Objective: To report experimental impacts of a universal, integrated school-based intervention in social–emotional learning and literacy development on change over 1 school year in 3rd-grade children's social–emotional, behavioral, and academic outcomes. Method: This study employed a school-randomized, experimental design and included 942 3rd-grade children (49% boys; 45.6% Hispanic/Latino, 41.1% Black/African American, 4.7% non-Hispanic White, and 8.6% other racial/ethnic groups, including Asian, Pacific Islander, Native American) in 18 New York City public elementary schools. Data on children's social–cognitive processes (e.g., hostile attribution biases), behavioral symptomatology (e.g., conduct problems), and literacy skills and academic achievement (e.g., reading achievement) were collected in the fall and spring of 1 school year. Results: There were main effects of the 4Rs Program after 1 year on only 2 of the 13 outcomes examined. These include children's self-reports of hostile attributional biases (Cohen's d = 0.20) and depression (d = 0.24). As expected based on program and developmental theory, there were impacts of the intervention for those children identified by teachers at baseline with the highest levels of aggression (d = 0.32–0.59) on 4 other outcomes: children's self-reports of aggressive fantasies, teacher reports of academic skills, reading achievement scaled scores, and children's attendance. Conclusions: This report of effects of the 4Rs intervention on individual children across domains of functioning after 1 school year represents an important first step in establishing a better understanding of what is achievable by a schoolwide intervention such as the 4Rs in its earliest stages of unfolding. The first-year impacts, combined with our knowledge of sustained and expanded effects after a second year, provide evidence that this intervention may be initiating positive developmental cascades both in the general population of students and among those at highest behavioral risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life manifestations and nursing. A discussion of K.E. L?gstrup''s ethics with starting point of Kari Martensen''s and Patricia Benner''s dialogs

This article discusses philosophical questions of ethics dealing with nursing as well as other human activities. The purpose is: 1) To communicate the content, status and function of the phenomenon "manifestation of life", as described by the Danish philosopher and theologian K.E. L?gstrup. 2) To discuss what L?gstrup has to teach us about ethics of care and from this point of view to discuss ethics in relation to the development of nursing. Inspired by the ongoing dialogue between the two nurses and professors Patricia Benner and Kari Martinsen about ethics in nursing the article deals in depth about with the central phenomenon "manifestation of life" as seen in relation to the positions of Benner and Martinsen. The relevance of this theme in relation to nursing is considered, and the article argues, that nurses have an obligation to matter-of-factness, and to develop nursing not only from practical experiences and reflections on concrete actions, but also by scientifically based activities. Both approaches are necessary. They are mutual conditions for development of good nursing practice.     

Persons or science? A philosophical question.

"As I have acquired experience as a therapist… and as I have worked as a scientific investigator… I have become increasingly conscious of the gap between these two roles." The roles and objectives of psychotherapist and psychological scientist are discussed and several issues are raised. An integration is developed "… in which the conflict between 'experientialist' and 'scientific' tends to disappear." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Was Lars sexually assaulted? A study in the reliability of witnesses and of experts.

A 5-year-old boy reported that he had been sexually assaulted by a neighborhood window cleaner. 2 court-appointed "experts" using divergent methods of approach came up with divergent findings. Detailed interviews and the case history are presented in this article and lead to a resolution of the disagreement and a reconstruction of the incident with the conclusion that Lars was not sexually assaulted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antipsychotic drugs: is more worse? A meta-analysis of the published randomized control trials

OBJECTIVES: The purpose of this study was to evaluate the usefulness of transesophageal echocardiography before electrical cardioversion in patients with atrial fibrillation and to determine the mechanism of thromboembolism after cardioversion. BACKGROUND: Thromboembolic complications after electrical cardioversion of atrial fibrillation have been attributed to the dislodgment of preexistent left atrial thrombus during the resumption of atrial contraction. Transesophageal echocardiography has been proposed as a method of screening patients for left atrial thrombus before cardioversion. METHODS: Seventy transesophageal echocardiographic studies were performed in 66 patients, predominantly with nonvalvular atrial fibrillation, before direct current cardioversion. In addition, transesophageal echocardiography was performed during the cardioversion procedure in 15 patients and immediately after in 1 patient. RESULTS: Left atrial thrombus was detected in one patient (1.4%), and cardioversion was cancelled. Thromboembolic complications occurred in 4 patients, none of whom had evidence of left atrial thrombus before cardioversion. Within 10 s of successful cardioversion, left atrial spontaneous echo contrast appeared in five patients, increased in one patient and was unchanged in nine patients. Patients with new or increased spontaneous echo contrast had more impaired atrial contraction and slower initial heart rates after cardioversion than those without. Left ventricular contraction was also impaired transiently by cardioversion. CONCLUSIONS: Transesophageal echocardiographic detection of left atrial thrombus before direct current cardioversion is important but infrequent in patients with predominantly nonvalvular atrial fibrillation. The occurrence of thromboembolic complications in the absence of demonstrable left atrial thrombus and the new development of spontaneous echo contrast in association with the transient atrial dysfunction ("stunning") caused by cardioversion suggest that cardioversion may promote new thrombus formation, in which case all patients should receive full anticoagulant therapy at the time of cardioversion.     

Opportunity for interaction? A naturalistic observation study of dual-earner families after work and school.

Everyday patterns of interaction can strengthen or undermine bonds between family members. This naturalistic observation study focused on an understudied facet of family life: opportunities for interaction among dual-earner family members after work and family members’ responses to these opportunities. Thirty dual-earner couples and their children were observed and video-recorded in their homes throughout two weekday afternoons and evenings. Two interaction opportunities were analyzed: (1) the behavior of family members toward a parent returning home from work and (2) the physical proximity of family members throughout the evening. Three main findings emerged. Women, who tended to return home before men, were greeted with positive behavior and reports of the day’s information from family members. Men, in contrast, returned home later in the day and received positive behavior or no acknowledgment from family members distracted by other activities. Throughout the evening, mothers spent more time with children whereas fathers spent more time alone. Couples were seldom together without their children. The implications of observed interaction patterns and the contribution of naturalistic observation methods to the study of family relationships are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How strong is the case against contemporary social and personality psychology? A response to Carlson.

Discusses a content analysis of the research published in the 1982 volumes of the Journal of Personality and Social Psychology, in which R. Carlson (see record 1985-11991-001) found that Carlson is incorrect in (a) an overly restrictive definition of what constitutes valid social and personality psychology, (b) her negative evaluations of the worth of the current approaches, and (c) an unjustified set of methodological prejudices. (58 ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)