Hypnosis for pain management

Nurses are in a key position to learn and use hypnosis with patients to reduce pain and enhance self-esteem. However, most nurses lack knowledge about the clinical effectiveness of hypnosis and may seek continuing education to become skilled in its use. Painful procedures, treatments, or diseases remain a major nursing challenge, and nurses need complementary ways to relieve pain from surgery, tumors, injuries, and chemotherapy. This article examines the evidence base related to hypnosis for pain management, as well as how to assess and educate patients about hypnosis.     

Devolution and Patient Choice: Policy Rhetoric versus Experience in Practice

Background: market reforms in England have been identified as making a clear distinction between English health policy and health policy in the devolved systems in Northern Ireland, Scotland and Wales. Patient choice is a high profile policy in the English National Health Service that constitutes significant changes to the demand side of health care. It is not clear what national differences this has led to regarding implementation of policy. This article presents the findings from a large UK‐wide study on the development and implementation of policies related to patient choice of provider. The findings reported here relate specifically to the policy development and organizational implementation of choice in order to examine the impact of devolution on health care policy. Aim: this study examines patient choice of provider across all four countries of the UK to understand the effect of differences in national policies on the organization and service how choice of provider presented to patients. Methods: at the macro‐level, we interviewed policymakers and examined policy and guidance documents to analyze the provenance and determinants of national policy in each UK nation. At the Primary Care Trust or Health Board level, we interviewed a range of public and private health service providers to identify the range of referral pathways and where and when choices might be made. Finally, we interviewed ear, nose and throat, and orthopaedics patients to understand how such choices were experienced. Findings: while we found that distinct rhetorical differences were identifiable at a national policy level, these were less visible at the level of service organization and the way choices were provided to patients. Conclusion: historical similarities in both the structure and operation of health care, coupled with common operational objectives around efficient resource use and waiting times, mediate how strategic policy is implemented and experienced in the devolved nations of the UK.     

Windows to the Soul? Deliberate Eye Contact as a Cue to Deceit

Although people overwhelmingly believe that liars avoid eye contact, meta-analyses of deception literature have shown a non-significant relationship between gaze and deception. In the present experiment we measured eye movements in an innovative way. We coded the extent to which interviewees deliberately made eye contact with the interviewer. Liars take their credibility less for granted than truth tellers. They therefore may have a greater desire to be convincing and hence more inclined to monitor the interviewer to determine whether they seem to be being believed. We therefore hypothesized that liars would give more appearance of deliberately making eye contact than truth tellers (a relationship which opposes the stereotypical belief that liars look away). A total of 338 passengers at an international airport told the truth or lied about their forthcoming trip. As well as the deliberate eye contact variable, we coded the amount of time the interviewees looked away from the interviewer (e.g., gaze aversion), which is typically examined in deception research. Liars displayed more deliberate eye contact than truth tellers, whereas the amount of gaze aversion did not differ between truth tellers and liars.     

Reports of Conferences,Institutes, and Seminars

A busy time for librarians was late May through early July 2008 with the Ohio Valley Group of Technical Services Librarians meeting May 14–16, the North American Serials Interest Group meeting June 5–8, and an American Library Association preconference Electronic Serials 101: What I Wished I’d Known Before I Got in Over My Head, June 27.     

Experiences of Violence, Post-Traumatic Stress, Academic Achievement and Behavior Problems of Urban African-American Children

This study examined the frequency of family violence, community violence, and witnessing of violence for 110 African-American children. Levels of post-traumatic stress, academic achievement and behavior problems of the children were also examined. The students were sixth graders between the ages of 11 and 13 from four inner-city Chicago public schools. The level of exposure to family violence was significantly related to levels of behavior problems and negatively related to school achievement. The level of exposure to community violence was associated with levels of behavior problems and approached significance in a negative direction with school achievement. Academic achievement was not significantly related to behavior, but was significantly associated with post-traumatic stress disorder, family violence, witnessing violence and approached significance with community violence exposure.     

Integrated Analysis: Combining Risk and Economic Assessments While Preserving the Separation of Powers

This article presents a process for an integrated policy analysis that combines risk assessment and benefit-cost analysis. This concept, which explicitly combines the two types of related analyses, seems to contradict the long-accepted risk analysis paradigm of separating risk assessment and risk management since benefit-cost analysis is generally considered to be a part of risk management. Yet that separation has become a problem because benefit-cost analysis uses risk assessment results as a starting point and considerable debate over the last several years focused on the incompatibility of the use of upper bounds or "safe" point estimates in many risk assessments with benefit-cost analysis. The problem with these risk assessments is that they ignore probabilistic information. As advanced probabilistic techniques for risk assessment emerge and economic analysts receive distributions of risks instead of point estimates, the artificial separation between risk analysts and the economic/decision analysts complicates the overall analysis. In addition, recent developments in countervailing risk theory suggest that combining the risk and benefit-cost analyses is required to fully understand the complexity of choices and tradeoffs faced by the decisionmaker. This article also argues that the separation of analysis and management is important, but that benefit-cost analysis has been wrongly classified into the risk management category and that the analytical effort associated with understanding the economic impacts of risk reduction actions need to be part of a broader risk assessment process.     

The ethical aspects of gain sharing with physicians

Gain sharing arrangements involving physicians can be a model combination of ethical business practices and maximizing profits. Or, gain sharing can be as unethical as fee-splitting was at the turn of the century, and as corrupt as any conflict of interest. The devil is--or is not--in the details.