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Using Multivariate Statistics

by J. Biggs and C. Tang, Maidenhead, England,
Open University Press, 2007, 360 pp., £29.99, ISBN-13: 978-0-335-22126-4

Teaching for quality learning at university

Background: Placebo and nocebo effects occur in clinical or laboratory medical contexts after administration of an inert treatment or as part of active treatments and are due to psychobiological mechanisms such as expectancies of the patient. Placebo and nocebo studies have evolved from predominantly methodological research into a far-reaching interdisciplinary field that is unravelling the neurobiological, behavioural and clinical underpinnings of these phenomena in a broad variety of medical conditions. As a consequence, there is an increasing demand from health professionals to develop expert recommendations about evidence-based and ethical use of placebo and nocebo effects for clinical practice. Methods: A survey and interdisciplinary expert meeting by invitation was organized as part of the 1st Society for Interdisciplinary Placebo Studies (SIPS) conference in 2017. Twenty-nine internationally recognized placebo researchers participated. Results: There was consensus that maximizing placebo effects and minimizing nocebo effects should lead to better treatment outcomes with fewer side effects. Experts particularly agreed on the importance of informing patients about placebo and nocebo effects and training health professionals in patient-clinician communication to maximize placebo and minimize nocebo effects. Conclusions: The current paper forms a first step towards developing evidence-based and ethical recommendations about the implications of placebo and nocebo research for medical practice, based on the current state of evidence and the consensus of experts. Future research might focus on how to implement these recommendations, including how to optimize conditions for educating patients about placebo and nocebo effects and providing training for the implementation in clinical practice.

/pdf/implications-of-placebo-and-nocebo-effects-for-clinical-12wmvxcgr0.pdf

Implications of Placebo and Nocebo Effects for Clinical Practice: Expert Consensus.

Meaning, Medicine, and the “Placebo Effect” Daniel Moerman Cambridge: Cambridge University Press, 2002. xiii. 172 pp.

Meaning, Medicine, and the “Placebo Effect”

https://www.onlinecjc.ca/article/S0828-282X(16)00007-6/pdf

Diagnosis, Prevention, and Management of Statin Adverse Effects and Intolerance: Canadian Consensus Working Group Update (2016)

Does feeling understood matter? : the effects of validating and invalidating interactions

While eating disorders (EDs) are more commonly diagnosed in females, there is growing awareness that men also experience EDs and may do so in a different way. Difficulties with emotion processing and emotion regulation are believed to be important in EDs, but as studies have involved predominantly female samples, it is unclear whether this is also true for males.In a sample of 1604 participants (n = 631 males), we assessed emotion processing and emotion regulation in males with EDs (n = 109) and compared results to both females with EDs (n = 220) and males from the general population (n = 522). We also looked at whether emotion processing and emotion regulation difficulties predicted various aspects of eating psychopathology and whether this was moderated by sex. We assessed emotion processing with the Toronto Alexithymia Scale, emotion regulation with the Difficulties in Emotion Regulation Scale and the Emotion Regulation Questionnaire, and eating psychopathology with the Eating Disorder Examination Questionnaire.We found that males with ED, like their female counterparts, suffered from emotion processing and emotion regulation deficits. We did find some sex differences, in that males with EDs tended to report more difficulties with their emotions as well as a more externally oriented thinking style compared to females with EDs. Difficulties with emotion processing and emotion regulation were strongly predictive of various aspects of eating psychopathology in both sexes. Importantly, we found that sex moderated the relationship between cognitive reappraisal and eating restraint. As such, low use of reappraisal was found to be associated with higher levels of restraint in females but not in males.Difficulties with emotion processing and emotion regulation are associated with eating psychopathology in both males and females. Reappraisal was not found to be associated with reduced eating psychopathology in males, suggesting a cautious approach to interventions targeting this strategy. Research around explanatory mechanisms and interventions must adopt a broader viewpoint including those that are traditionally overlooked in EDs.While eating disorders (EDs) are more common in females, males also suffer from these conditions and are generally neglected in research around EDs. Difficulty identifying and managing emotions is believed to be important in the development and maintenance of EDs, but as studies have been conducted mostly in females, it is unclear whether this is also true for males. We recruited 1604 participants (631 were males, and 329 were diagnosed with EDs comprising 109 males and 220 females) and compared how males and females processed and regulated their emotions. We found that males with EDs, like their female counterparts, suffered from difficulties identifying and regulating their emotions, though they showed a slightly different profile of difficulties. While difficulties with emotions were associated with ED behaviours in both sexes, difficulties using reappraisal, an emotion regulation strategy where one reinterprets an event from a different perspective, were associated with restraint in females but not in males. This suggests that while interventions to help with emotional functioning could be beneficial for both women and men with EDs, the different emotional profiles of men with EDs must be considered, as interventions targeting particular emotional processes (e.g. reappraisal) may be relevant for women but not men. 

https://jeatdisord.biomedcentral.com/counter/pdf/10.1186/s40337-022-00715-6

What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders

Improving informed choice about acupuncture and placebo interventions

Importance for patients of feeling accepted and understood by physicians before and after multimodal pain rehabilitation.

Introduction: The medical professional at a direct clinical interface with COVID 19 has been under enormous strain. But how has the pandemic impacted urologists whose skills may have been under-utilized? Materials and Methods: An online survey was emailed to BAUS trainee and consultant members between the first and second pandemic lockdowns. Data were sought regarding individuals' views on work/life balance (WLB) before and after the lockdown on a 10-point Visual Analogue Scale (VAS);0 was biased towards "work" and 10 towards "life". Mean scores were analyzed for trainees and then in quinquennials from consultant appointment, up to 20 years. Data were also sought regarding the impact of lockdown on consultants' views of retirement in the same groupings. Results: 59 trainees and 261 consultants responded to the pre- and post-lockdown WLB questions and 324 consultants to the question about retirement intentions. Work/Life balance was positively influenced across all groups during the first lockdown (table 1), whilst consultants in post for >11 years considered their lockdown experiences an influence to consider earlier retirement (table 2). Conclusions: Urologists' WLB improved during lockdown but more senior consultants questioned their desire to continue working. This data concurs with the GMC's. 'The state of medical education and practice in the UK 2020' report which demonstrates that specialist doctors were poorly re-deployed, possibly with underemployment, during lockdown. Deployment to a protected elective treatment environment would appear to be the best way of utilizing a specialist surgical workforce during emergency crises and, maybe, for the long-term.

Maddy Greville-Harris

Papers

Does feeling understood matter? : the effects of validating and invalidating interactions

What about males? Exploring sex differences in the relationship between emotion difficulties and eating disorders

Improving informed choice about acupuncture and placebo interventions

Importance for patients of feeling accepted and understood by physicians before and after multimodal pain rehabilitation.

The counterintuitive impact of COVID 19 on the urological workforce. Should urologists be deployed differently