Self-reported Evaluation Research Articles

Same-Sex Couples in Advertisements: An Investigation of the Role of Implicit Attitudes on Cognitive Processing and Evaluation

This research examined how implicit attitudes are associated with cognitive processing and self-reported evaluation of advertisements featuring same-sex couples. Hypotheses were posited using the theoretical framework of social identity theory (Tajfel and Turner 1986) and perspectives on implicit attitudes. In Study 1, participants watched and evaluated 10 television advertisements while physiological measures of cognitive and affective processing were collected. Ads varied such that half used same-sex couples as protagonists while the other half used other-sex couples. Participants demonstrated less positive responses to ads featuring same-sex couples. Physiological and self-reported responses were associated with implicit attitudes toward homosexuality Negative implicit attitudes toward homosexuality were associated with more negative affect, less attention, less positivity, and less liking for ads featuring same-sex couples. Two subsequent studies replicated these findings in nonstudent samples, indicating that participants preferred ads with other-sex couples (Study 2) and that implicit attitudes were associated with this response (Study 3). This research suggests that implicit attitudes affect processing and evaluation of ads featuring same-sex couples in ways unaccounted for by explicitly measured attitudes. Results are discussed in terms of advancing theory, furthering understanding of the dynamic processing of ads featuring in-group and out-group members, and practical implications.

Effects of CPAP therapy on cognitive and psychomotor performances in patients with severe obstructive sleep apnea: a prospective 1-year study.

We prospectively investigated the effects of continuous positive airway pressure (CPAP) on long-term cognitive and psychomotor performances, and excessive daytime sleepiness in severe obstructive sleep apnea (OSA) patients. A total of 40 patients were recruited and 23 patients with severe OSA fully completed the study protocol to investigate the effects of CPAP therapy on psychomotor performance at 1, 3, and 6months and 1year following initiation of the therapy. Psychomotor CRD-series tests measuring reaction times of light stimulus perception, solving simple arithmetic operations, and complex psychomotor limb coordination, were used in this study. The data collected following CPAP therapy were compared to baseline values prior to the CPAP treatment for each patient. All of the measured variables improved following CPAP treatment. However, the most pronounced effect was observed in improvement of reaction times to complex psychomotor limb coordination test (p < 0.05). Self-reported evaluation of excessive daytime sleepiness measured by Epworth Sleepiness Scale (ESS) showed significant decrease from 10.0 ± 1.1 before to 3.5 ± 0.5 (p < 0.001), after 1year on CPAP therapy. The CPAP therapy improved cognitive and psychomotor performance on CRD-series tests with the most significant improvement observed in complex psychomotor limb coordination of severe OSA patients.

Associations and predictions of readmission or death in acutely admitted older medical patients using self-reported frailty and functional measures. A Danish cohort study

ObjectiveTo assess whether frailty in acutely admitted older medical patients, assessed by a self-report questionnaire and evaluation of functional level at discharge, was associated with readmission or death within 6 months after discharge. A second objective was to assess the predictive performance of models including frailty, functional level, and known risk factors. MethodsA cohort study including acutely admitted older patients 65+ from seven medical and two acute medical units. The Tilburg Frailty Indicator (TFI), Timed-Up-and-Go (TUG), and grip strength (GS) exposure variables were measured. Associations were assessed using Cox regression with first unplanned readmission or death (all-causes) as the outcome. Prediction models including the three exposure variables and known risk factors were modelled using logistic regression and C-statistics. ResultsOf 1328 included patients, 50% were readmitted or died within 6 months. When adjusted for gender and age, there was an 88% higher risk of readmission or death if the TFI scores were 8–13 points compared to 0–1 points (HR 1.88, CI 1.38;2.58). Likewise, higher TUG and lower GS scores were associated with higher risk of readmission or death. The area under the curve for the prediction models ranged from 0.64 (0.60;0.68) to 0.72 (0.68;0.76). ConclusionIn acutely admitted older medical patients, higher frailty assessed by TFI, TUG, and GS was associated with a higher risk of readmission or death within 6 months after discharge. The performance of the prediction models was mediocre, and the models cannot stand alone as risk stratification tools in clinical practice.

Korean Sauna (Jjimjilbang) Wellness Tourism as Perceived by Westerners Living in South Korea

Korean Sauna (Jjimjilbang) Wellness Tourism as Perceived by Westerners Living in South Korea Ph.D. Candidate D. Kessler, Professor K.J. Chung, Professor B.J. Jang Abstract In this paper, we examined attitudes of westerners living in South Korea regarding Korean saunas (jjimjilbangs). We surveyed (n=225) westerners living in South Korea who have visited a Korean sauna at least once during their stay. The purpose of our research was to measure subjective attitudes, frequency, and motivation towards sauna usage along with their self-reported health evaluations and basic demographic variables. We hypothesized there would be a positive correlation between the respondent's self-reported health evaluations and the frequency of usage of the spa. Additionally, we hypothesized that there would be a positive correlation between the length of time living in South Korea and the frequency of spa usage. Using the SF-36 to measure self-reported health characteristics, results of our statistical analysis indicate a Pearson Correlation of .428 between the frequency of spa usage and SF-36 respondents scores. Moreover, we found no correlation in the length of staying in Korea and frequency of spa usage. Findings from this research are consistent with the findings from our literature review of the general health benefits of saunas. Full Text: PDF DOI: 10.15640/jthm.v6n2a8

Intense Therapeutic Ultrasound for Chronic Lateral Epicondylitis Pain Reduction

Introduction: Intense therapeutic ultrasound (ITU) is a newly established ultrasound-based, non-invasive therapy in which sound waves are concentrated and focused on musculoskeletal tissue for the purpose of pain reduction. This technology produces selective thermal coagulative changes over a small controlled area while leaving the surrounding tissue unaffected and without impacting the integrity of the dermis.Methods: A clinical study evaluating 29 patients (Age: 39 – 60, Male: 59%, Female 41%) for the effectiveness, safety and patient tolerance of Intense Therapeutic Ultrasound (ITU) for treatment of chronic (average length of symptoms prior to treatment: 12.9 months), subcutaneous lateral Epicondylitis musculoskeletal tissue pain reduction was conducted. All patients enrolled in this IRB approved study had been previously diagnosed with Chronic Lateral Epicondylitis and had failed previous Standard-of-Care treatment regimen. Two ITU treatments were administered four weeks apart. Self-reported lateral elbow Universal Visual Analog pain scores and Patient-Rated Tennis Elbow Evaluation pain scores while performing normal daily tasks, were recorded pre-treatment (baseline measurement) and again at each follow-up time point - 4, 8, 12, and 26 weeks - after initial treatment. The goal for all subjects was to reduce overall pain and pain while performing everyday tasks by at least 25% on the average and more than 25% individually. While arbitrary, such criteria appear to be rigorous to reduce standard error and individual selfassessment variability.Results: Successful reduction of overall pain scores at 12 and 26 weeks following the first treatment are 88% and 82% of patients meeting the pain reduction criteria respectively. Also, at the same follow-up time points, patients reported an average VAS Pain Score reduction of 59% (Week 12) and 57% (Week 26) from a pre-treatment average of 5.08 down to an average of 2.2 at week 26. Additionally, patients reported an average pain reduction while performing everyday tasks of 58% and 61% respectively. Patient satisfaction remained over 80% for all follow-up dates.Conclusion: ITU is a promising non-invasive pain relief treatment for cases of chronic lateral epicondylitis.

Knowledge, Motivation Behavior and Level of Physical Activity for Medical Students

Introduction: Intense therapeutic ultrasound (ITU) is a newly established ultrasound-based, non-invasive therapy in which sound waves are concentrated and focused on musculoskeletal tissue for the purpose of pain reduction. This technology produces selective thermal coagulative changes over a small controlled area while leaving the surrounding tissue unaffected and without impacting the integrity of the dermis.Methods: A clinical study evaluating 29 patients (Age: 39 – 60, Male: 59%, Female 41%) for the effectiveness, safety and patient tolerance of Intense Therapeutic Ultrasound (ITU) for treatment of chronic (average length of symptoms prior to treatment: 12.9 Months), subcutaneous lateral Epicondylitis musculoskeletal tissue pain reduction was conducted. All patients enrolled in this IRB approved study had been previously diagnosed with Chronic Lateral Epicondylitis and had failed previous Standard-of-Care treatment regimen. Two ITU treatments were administered four weeks apart. Self-reported lateral elbow Universal Visual Analog pain scores and Patient-Rated Tennis Elbow Evaluation pain scores while performing normal daily tasks, were recorded pre-treatment (baseline measurement) and again at each follow-up time point - 4, 8, 12, and 26 weeks - after initial treatment. The goal for all subjects was to reduce overall pain and pain while performing everyday tasks by at least 25% on the average and more than 25% individually. While arbitrary, such criteria appear to be rigorous to reduce standard error and individual selfassessment variability.Results: Successful reduction of overall pain scores at 12 and 26 weeks following the first treatment are 88% and 82% of patients meeting the pain reduction criteria respectively. Also, at the same follow-up time points, patients reported an average VAS Pain Score reduction of 59% (Week 12) and 57% (Week 26) from a pre-treatment average of 5.08 down to an average of 2.2 at week 26. Additionally, patients reported an average pain reduction while performing everyday tasks of 58% and 61% respectively. Patient satisfaction remained over 80% for all follow-up dates.Conclusion: ITU is a promising non-invasive pain relief treatment for cases of chronic lateral epicondylitis.

The effect of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on the acoustic and prosodic features in patients with Parkinson's disease: A study protocol for the first trial on Iranian patients.

Background: The effect of subthalamic nucleus deep brain stimulation (STN-DBS) on the voice features in Parkinson’s disease (PD) is controversial. No study has evaluated the voice features of PD underwent STN-DBS by the acoustic, perceptual, and patientbased assessments comprehensively. Furthermore, there is no study to investigate prosodic features before and after DBS in PD. The current study aimed to assess the efficacy of STN-DBS on the voice and prosodic features by acoustic, perceptual and self-reported evaluations in PD. Methods and Analysis: An experimental prospective cohort pretest-posttest group has been designed to survey patients with PD candidates for STN-DBS surgery. All participants will be evaluated by a speech and language pathologist before and after surgery in four different conditions as follow: pre-surgery: Medication On/ Medication Off; post-surgery: Stimulation On/ Stimulation Off. To compare pre-surgery and post-surgery conditions paired- samples T Test or Wilcoxon signed-rank test will be used. A 95% confidence interval (p value of <0.05) will be considered to be statistically significant. This study protocol is approved by the Ethical Committee of Teheran University of Medical Sciences, and the results of the study will be published in a peer-reviewed journal and presented at national congresses.

The Portuguese version of “The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty”: validation and clinical application

IntroductionThe evaluation of surgical outcomes measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery. ObjectiveThe aim of this study was to perform the translation, cross-cultural adaptation and validation of “The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty” from English to Portuguese. MethodsRetrospective study involving 50 patients undergoing to rhinoplasty comparing the preoperative period with the current postoperative situation (minimum 6 months and maximum 24 months postoperatively). Statistical analysis was performed to assess internal consistency, test–retest reliability, validity and responsiveness. ResultsNo patients received a negative score on the visual analogue scale comparing preoperative and postoperative appearance. The postoperative improvement on the visual analogue scale revealed a Gaussian curve of normal distribution with a mean improvement of 4.44 points. The test–retest reliability showed a positive correlation between the postoperative response and the same questionnaire repeated ninety-six hours later. The internal consistency was high (Cronbach's alpha value: Preoperative=0.88; Postoperative=0.86). The authors observed a significant improvement in response for all individual questions in the postoperative phase as compared with preoperative situation (t-student test – p<0.05). ConclusionThe Portuguese version of “The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty” is a valid instrument to assess patients’ outcomes following rhinoplasty surgery.

A comparative study of the perception of music emotion between adults with and without visual impairment

In music listening, limitations on visual experience affect a listener’s abstract information processing and conceptualization of the music. The aim of this study is to examine the differences in emotional responses to music between adults with visual impairment (VI) and adults with normal vision (NV). By using specific, emotion-inducing music reflecting happiness, sadness, anger, and fear, this study considers factors such as music emotion identification, emotional valence, arousal, intensity, and musical preference. A total of 120 participants (60 VI and 60 NV) listened to sixteen 15-second music excerpts and reported which emotion and to what extent they perceived it, using a self-reported music emotion evaluation scale. The results indicated that both of the groups showed high congruence in music emotion identification. However, the VI group showed significantly higher arousal, intensity and preference for sadness, while showing the lowest score for the intensity of fear. The main factor affecting emotion identification was preference for the VI group, and valence for the NV group.

Assessing sleep quality using self-report and actigraphy in PTSD.

Sleep disturbance is commonly reported by participants with post-traumatic stress disorder, but objective evidence of poor sleep is often absent. Here we compared self-report and actigraphic evaluations of sleep between veterans with post-traumatic stress disorder and controls. Participants reported their sleep retrospectively for the month before the recording night and on the recording night. On the recording night, they wore an Actiwatch-64 and were instructed to press the marker button upon getting into bed, each time they awoke, and at their final awakening. The post-traumatic stress disorder group reported much worse sleep than controls on the Pittsburgh Sleep Quality Index for the previous month and somewhat poorer sleep on the recording night. However, on the recording night, neither diary nor actigraphic measures of number of awakenings, total time in bed, nor time lying awake after sleep onset differed between participants with and without post-traumatic stress disorder. Diary-reported number of awakenings was fewer than actigraphically captured awakenings. These results suggest a memory bias towards remembering worse sleep on the nights before the recording night.

Malaria control in rural Malawi: implementing peer health education for behaviour change

BackgroundInterventions to reduce malaria burden are effective if communities use them appropriately and consistently. Several tools have been suggested to promote uptake and use of malaria control interventions. Community workshops on malaria, using the ‘Health Animator’ approach, are a potential behaviour change strategy for malaria control. The strategy aims to influence a change in mind-set of vulnerable populations to encourage self-reliance, using community volunteers known as Health Animators. The aim of the paper is to describe the process of implementing community workshops on malaria by Health Animators to improve uptake and use of malaria control interventions in rural Malawi.MethodsThis is a descriptive study reporting feasibility, acceptability, appropriateness and fidelity of using Health Animator-led community workshops for malaria control. Quantitative data were collected from self-reporting and researcher evaluation forms. Qualitative assessments were done with Health Animators, using three focus groups (October–December 2015) and seven in-depth interviews (October 2016–February 2017).ResultsSeventy seven health Animators were trained from 62 villages. A total of 2704 workshops were conducted, with consistent attendance from January 2015 to June 2017, representing 10–17% of the population. Attendance was affected by social responsibilities and activities, relationship of the village leaders and their community and involvement of Community Health Workers. Active discussion and participation were reported as main strengths of the workshops. Health Animators personally benefited from the mind-set change and were proactive peer influencers in the community. Although the information was comprehended and accepted, availability of adequate health services was a challenge for maintenance of behaviour change.ConclusionCommunity workshops on malaria are a potential tool for influencing a positive change in behaviour towards malaria, and applicable for other health problems in rural African communities. Social structures of influence and power dynamics affect community response. There is need for systematic monitoring of community workshops to ensure implementation fidelity and strengthening health systems to ensure sustainability of health behaviour change.

Reconceptualizing Cultivation: Implications for Testing Relationships Between Fiction Exposure and Self-Reported Alcohol Use Evaluations

ABSTRACTThis article responds to calls for conceptual clarification in the media effects domain by providing a definition for attitudinal cultivation effects. Our definition contains 5 core characteristics: the (a) linear effects of (b) repeated media exposure on (c) the evaluation as given by memory associations (d) strengthened by and (e) valenced in line with those media messages. We reason that, when accepting this definition, the cultivation hypothesis predicts effects of repeated media use on evaluations to primarily occur at the level of gut evaluations given by automatically activated memory associations. Corroborating this logic for the effects of alcohol use portrayals in television fiction, we find the relationship between fiction exposure and self-reported alcohol use evaluations to be (a) moderated by speed of expressing those evaluations and (b) mediated by responses to self-reports tapping into gut feelings. The implications of these findings for future media effects studies are discussed.

University counseling service for improving students' mental health.

The main aims of this study were to provide an initial sociodemographic and clinical characterization of university students' academic and psychological functioning and to investigate and compare the feasibility and clinical utility of psychotherapies (cognitive behavior vs. psychodynamic) delivered at a large University in Northern Italy for improving university students' mental health, using self and observer-report measures. One hundred forty-9 students (102 women; MAge = 24.55, SD = 3.35) were consecutively interviewed and extensively assessed by independent clinicians of the Service before and after the intervention, using the Clinical Outcomes in Routine Evaluation and the Global Assessment Scale. Patients were enrolled in an individual psychotherapy and allocated to cognitive behavior or psychodynamic approach according to specific criteria. Psychotherapists who were not involved in the assessment phase administered the treatment. The majority of students was female and the most severe conditions emerged among students enrolled in philosophy, arts, and communication and medical schools. At posttreatment, all students improved both in terms of well-being and distress, regardless of the type of psychotherapy received. This improvement emerged both by students' self-report and clinicians' evaluations. These findings point to the feasibility and clinical utility of psychotherapy in promoting well-being and reducing young adults' distress. The importance of university counseling services for promoting students' mental health, and a positive transition to adulthood is discussed. (PsycINFO Database Record

Cross cultural adaptation and refinement of an English version of a Dutch patient-reported questionnaire for hand sensitivity: The Radboud Evaluation of Sensitivity

Study DesignLongitudinal clinical measurement. IntroductionSensory alterations in the hand can present as both decreased sensation or numbness, and hyperesthesia, including mechanical allodynia and cold intolerance. However, few patient-reported outcomes have been developed and validated for evaluation, particularly for increased sensitivity. The Radboud Evaluation of Sensitivity was developed in the Netherlands for patient-reported evaluation of hand sensitivity in complex regional pain syndrome. Purpose of the StudyThe purpose of this study was to translate into English and culturally validate the Radboud Evaluation of Sensitivity for the North American context. MethodsForward and backward translation, followed by a psychometric evaluation of the synthesized version of the translated tool, was undertaken in a heterogeneous group of persons after hand injury, including nerve injuries, hand trauma, and complex regional pain syndrome. ResultsThirty-six persons completed test-retest reliability testing, yielding an intraclass correlation coefficient of 0.92 (95% CI 0.85 to 0.96) for single measures. Internal consistency was also high at α = 0.96 in a larger sample (n = 56). Although some support for construct validity was generated, several validity hypotheses were not confirmed. Of interest, there appeared to be significant differences in the scores between persons with hypoesthesia as compared with those with hyperesthesia. ConclusionsThe Radboud Evaluation of Sensitivity, English version appears to be a reliable tool for the self-reported evaluation of sensory alterations in the hand, including both hypoesthesia and hyperesthesia. More research is needed to add to the extent of and confidence in the validity and responsiveness of this assessment. Level of EvidenceLevel II.

The Combined Roles of Nonsomatic Depressive Symptomatology, Neurocognitive Function, and Current Substance Use in Medication Adherence in Adults Living With HIV Infection

Depression, global neurocognitive (GNC) function, and substance use disorders (SUDs) are each associated with medication adherence in persons living with HIV (PLWH). Because somatic symptoms can inflate depression scores in PLWH, the role of nonsomatic depressive symptomatology (NSDS) should be considered in adherence. However, the combined roles of NSDS, GNC function, and current SUDs in predicting combined antiretroviral therapy (cART) adherence remain poorly understood. Forty PLWH (70% Latina/o; 30% non-Hispanic White) completed psychiatric/SUD, neurocognitive, and self-report cART adherence evaluations. Higher NSDS was associated with suboptimal adherence (p<.01), but optimal and suboptimal adherers did not differ in GNC function or current SUDs. Only NSDS was associated with suboptimal adherence, after accounting for GNC function and SUDs (p=.01). NSDS uniquely predicted self-reported adherence, beyond GNC function and current SUDs among ethnically diverse PLWH. Methodological issues between present and prior studies should also be considered.

304 - Educational Effectiveness, Participant Demographics, and Practice Patterns Compared to Planned Program Goals of Three Heart Failure Society of America Activities

Background: Continuing medical education (CME) is required for professional competency and maintenance of professional licensure. A variety of educational formats are available, however, assessment of actual participant's responses and demographics compared to the developed target audience and program goals are rarely conducted. Objectives: To assess participant's knowledge, demographics, practice patterns, and the educational effectiveness compared to the program goals of 3 activities presented by the Heart Failure Society of America (HFSA). DESIGN: Educational outcomes and practice patterns from participants at a 90-minute Scientific Session on Hyperkalemia scheduled as part of the regular HFSA annual program for Sunday, September 18, 2016, a 60-minute industry supported case-based Breakfast Satellite symposium held September 19, and an online enduring activity, are being assessed. Analysis of demographics, practice patterns, and educational effectiveness, compared to the program goals was conducted utilizing pre-& post-activity surveys that included knowledge-based questions and self-reported practice related evaluations. Measurements: Changes in knowledge are calculated as a standardized difference and effect size. Practice pattern and change in performance data are self-reported via evaluations. Results: Data are presented for Activities 1 and 2, post activity follow-up surveys and Activity 3 are ongoing. The target audience was: cardiologists, cardiac surgeons, internists, geriatricians, scientists, cardiac rehabilitation specialists, nurses, and allied health personnel. The participation to date are cardiologists: 17.79%, physicians (other): 10.17%, physician assistants: 0.85%, nurse practitioners: 45.76%, nurses: 14.41%, pharmacists: 5.93%, and other: 4.23% (N = 118). Reported practice locations: inner city: 37.60%, urban: 37.60%, suburban: 16.24%, and rural 8.55%. Attendees reported that 29.91% had spent less than 5 years in practice, 11.11% spent 6–10 years, 18.8% spent 11–20 years, and 34.19% had spent greater than 20 years in practice. The most significant challenges to providing optimal care were the cost (15.79%), patient compliance with prescribed therapy (14.91%), lack of practitioner confidence in selecting appropriate therapy (5.26%), and lack of knowledge of evidence-based care (3.51%). Periodic monitoring of patient potassium levels was reported by 71.92% of participants. Conclusions: Data collection and analyses of these activities are ongoing. Preliminary data show that the majority of participants are physicians and nurse practitioners. Improvement in knowledge immediately following these educational activities is demonstrated. Assessment of the impact of this improvement and its application to clinical practice are ongoing.

A small group learning for evidence-based medicine in pre-clinical medical students

This article was migrated. The article was not marked as recommended. Background Evidence-based medicine (EBM) is the application of current, best-available clinical evidence to health care decisions for individual patients. Many medical schools put EBM courses in their curriculum as they considering it is important. However, to teach the EBM course in pre-clinical year medical students is challenging owning to their clinical inexperience. Methods A prospective study of the third-year medical students of Walailak University located in the southern part of Thailand. They participated in a two-week course of evidence-based medicine. The effectiveness of the course organization was assessed by percentage of students whose scores reached the minimal passing level and using pre-study and post-study self-reported evaluation. Results The percentage of students whose scores reached the minimum pass level (70%) was 100%. The scores are normally distributed with a mean of 88.59 (SD 3.33). Self-reported evaluation of knowledge and skills increased 4.28 scores (SD 2.06, p-value &lt;0.001) and 4.24 scores (SD 2.08, p-value&lt;0.001), respectively. Conclusion Using small group learning for evidence-based medicine in pre-clinical medical students achieved remarkable learning outcome regardless of clinical experiences. However, the role of the facilitator was of crucial importance as student learning depended on the facilitator's proper guidance and evaluation in the small group sessions.

What Sways People's Judgment of Sleep Quality? A Quantitative Choice-Making Study With Good and Poor Sleepers.

Study objectives:We conceptualized sleep quality judgment as a decision-making process and examined the relative importance of 17 parameters of sleep quality using a choice-based conjoint analysis.Methods:One hundred participants (50 good sleepers; 50 poor sleepers) were asked to choose between 2 written scenarios to answer 1 of 2 questions: “Which describes a better (or worse) night of sleep?”. Each scenario described a self-reported experience of sleep, stringing together 17 possible determinants of sleep quality that occur at different times of the day (day before, pre-sleep, during sleep, upon waking, day after). Each participant answered 48 questions. Logistic regression models were fit to their choice data.Results:Eleven of the 17 sleep quality parameters had a significant impact on the participants’ choices. The top 3 determinants of sleep quality were: Total sleep time, feeling refreshed (upon waking), and mood (day after). Sleep quality judgments were most influenced by factors that occur during sleep, followed by feelings and activities upon waking and the day after. There was a significant interaction between wake after sleep onset and feeling refreshed (upon waking) and between feeling refreshed (upon waking) and question type (better or worse night of sleep). Type of sleeper (good vs poor sleepers) did not significantly influence the judgments.Conclusions:Sleep quality judgments appear to be determined by not only what happened during sleep, but also what happened after the sleep period. Interventions that improve mood and functioning during the day may inadvertently also improve people’s self-reported evaluation of sleep quality.

Observed Relationship Behaviors and Sleep in Military Veterans and Their Partners.

Emerging research has begun to examine associations between relationship functioning and sleep. However, these studies have largely relied on self-reported evaluations of relationships and/or of sleep, which may be vulnerable to bias. The purpose of the study was to examine associations between relationship functioning and sleep in military couples. This is the first research to examine associations between observed relationship behaviors and subjective and polysomnographically measured sleep in a sample at-risk for both sleep and relationship problems. The sample included 35 military veterans and their spouses/partners. Marital functioning was coded from a videotaped conflict interaction. Analyses focused on behavioral codes of hostility and relationship-enhancing attributions. Sleep was assessed via self-report and in-home polysomnography. Greater hostility was associated with poorer sleep efficiency for oneself (b=-0.195, p=.013). In contrast, greater relationship-enhancing attributions were associated with higher percentages of stage N3 sleep (b=0.239, p=.028). Partners' hostility was also positively associated with higher percentages of stage N3 sleep (b=0.272, p=.010). Neither hostility nor relationship-enhancing attributions was associated with self-reported sleep quality, percentage of REM sleep, or total sleep time. Both partners' positive and negative behaviors during conflict interactions were related to sleep quality. These findings highlight the role that effective communication and conflict resolution skills may play in shaping not only the marital health of veterans and their spouses but also the physical health of both partners as well. Understanding the links between relationship functioning and sleep may be important targets of intervention in the aftermath of war.

Communication skills in the training of psychiatrists: A systematic review of current approaches.

A range of communication skills training programmes have been developed targeting trainees in various medical specialties, predominantly in oncology but to a lesser extent in psychiatry. Effective communication is fundamental to the assessment and treatment of psychiatric conditions, but there has been less attention to this in clinical practice for psychiatrists in training. This review examines the outcomes of communication skills training interventions in psychiatric specialty training. The published English-language literature was examined using multiple online databases, grey literature and hand searches. The review was conducted and reported using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies examining the efficacy of communication skills training were included. Randomised controlled trials, pseudo-randomised studies and quasi-experimental studies, as well as observational analytical studies and qualitative studies that met criteria, were selected and critically appraised. No limits were applied for date of publication up until 16 July 2016. Total search results yielded 2574 records. Of these, 12 studies were identified and reviewed. Two were randomised controlled trials and the remaining 10 were one-group pretest/posttest designs or posttest-only designs, including self-report evaluations of communication skills training and objective evaluations of trainee skills. There were no studies with outcomes related to behaviour change or patient outcomes. Two randomised controlled trials reported an improvement in clinician empathy and psychotherapeutic interviewing skills due to specific training protocols focused on those areas. Non-randomised studies showed varying levels of skills gains and self-reported trainee satisfaction ratings with programmes, with the intervention being some form of communication skills training. The heterogeneity of communication skills training is a barrier to evaluating the efficacy of different communication skills training programmes. Further validation studies examining specific models and frameworks would support a stronger evidence base for communication skills training in psychiatry. It remains a challenge to develop research to investigate behaviour change over time in clinical practice or to measure patient outcomes due to the effects of communication skills training.