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Concept: Complaint

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The purpose of this study was to evaluate the impact on sleep quality of a nursing-driven sleep hygiene protocol (SHP) instituted in a single burn-trauma intensive care unit. Criteria for eligibility were adult patients admitted to the Burn Service who were not delirious, able to respond verbally, and had not received general anesthesia in the prior 24 hours. Patients were surveyed using the validated Richards-Campbell Sleep Questionnaire prior to implementation (“PRE”; May to December 2010) and following implementation (“POST”; January to August 2011) of a SHP that sought to minimize environmental stimuli and limit disruptions during the night. This analysis includes only initial survey responses from each patient. A total of 130 patients were surveyed, 81 PRE and 49 POST; 60% were burn admissions. There was no significant difference in responses to the questionnaire between burn and nonburn patients. All patients in the POST group were significantly older and more frequently endorsed taking sleep medication at home. Although not significant, POST patients reported falling asleep somewhat more quickly, but no other differences were identified between the two groups. Among patients who reported having sleep difficulties prior to admission, POST patients not only reported a significantly higher pain score than PRE patients, but also reported significant improvement in falling asleep and being able to go back to sleep. Frequency of complaints of sleep disruption was unchanged between PRE and POST patients. POST patients did complain significantly less than PRE patients about sleep disruptions by clinicians. Implementation of the SHP permitted acutely injured or ill patients in our intensive care unit to fall asleep more quickly and to experience fewer sleep disruptions. A sleep protocol may be helpful in improving sleep and overall well-being of burn center patients.

Concepts: Sleep, Sleep disorder, Illness, Anesthesia, Complaint, Sleep hygiene

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INTRODUCTION: Benign paroxysmal positional vertigo (BPPV) is the most common vestibular disorder. However, BPPV in children has been studied less extensively than in the adult population. This is because the observation of benign paroxysmal positional nystagmus (BPPN) in children is technically very difficult and BPPV is rare in children. In this study, we present the only two cases of BPPV in children in which we successfully recorded and analyzed the BPPN. METHODS: One case was an 11-year-old boy and the other was a 3-year-old girl. We analyzed their BPPN three-dimensionally. RESULTS: Apogeotropic positional nystagmus was observed in the first case. We analyzed it to verify the presence of cupulolithiasis in the horizontal semicircular canal (HSCC). Geotropic positional nystagmus was observed in the second case, and the analyzed data indicated the presence of canalolithiasis in HSCC. Over the last decade, we have examined 3341 patients complaining of vertigo or dizziness. Among them, there were 63 children with the same complaint, so that the proportion of cases of BPPV in children was only 3% (2/63). DISCUSSION: Among patients complaining of vertigo or dizziness, children with BPPV are rare (3%). However, we have recorded their BPPN to confirm that BPPV does occur in children and that their characteristics of positional nystagmus are generally identical to those in adults. We emphasize that this is the first report of a child as young as 3 years old being diagnosed with BPPV.

Concepts: Scientific method, Observation, Semicircular canal, Ear, Case, Pathologic nystagmus, Complaint, Benign paroxysmal positional vertigo

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Insomnia identity refers to the conviction that one has insomnia, and this sleep complaint can be measured independently of sleep. Conventional wisdom predicts that sleep complaints are synchronous with poor sleep, but crossing the presence or absence of poor sleep with the presence or absence of insomnia identity reveals incongruity with expected patterns. This review of existing research on insomnia identity processes and influence finds that about one-fourth of the population are uncoupled sleepers, meaning there is an uncoupling of sleep and sleep appraisal, and daytime impairment accrues more strongly to those who endorse an insomnia identity. Research supports the conclusion that there is a cost to pathologizing sleep. Individuals claiming an insomnia identity, regardless of sleep status, are at greater risk for a range of sequelae including self-stigma, depression, suicidal ideation, anxiety, hypertension, and fatigue. A broad research agenda is proposed with hypotheses about the sources, clinical mechanisms, and clinical management of insomnia identity.

Concepts: Sleep deprivation, Bipolar disorder, Somnolence, Depression, Suicide, Complaint, The Conclusion, Legal terms

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Self-presentation is a fundamental aspect of social life, with myriad critical outcomes dependent on others' impressions. We identify and offer the first empirical investigation of a prevalent, yet understudied, self-presentation strategy: humblebragging. Across 9 studies, including a week-long diary study and a field experiment, we identify humblebragging-bragging masked by a complaint or humility-as a common, conceptually distinct, and ineffective form of self-presentation. We first document the ubiquity of humblebragging across several domains, from everyday life to social media. We then show that both forms of humblebragging-complaint-based or humility-based-are less effective than straightforward bragging, as they reduce liking, perceived competence, compliance with requests, and financial generosity. Despite being more common, complaint-based humblebrags are less effective than humility-based humblebrags, and are even less effective than simply complaining. We show that people choose to deploy humblebrags particularly when motivated to both elicit sympathy and impress others. Despite the belief that combining bragging with complaining or humility confers the benefits of each strategy, we find that humblebragging confers the benefits of neither, instead backfiring because it is seen as insincere. (PsycINFO Database Record

Concepts: Sociology, Empiricism, Experiment, Virtue, Abstraction, Complaint

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Letters of complaint written by patients and their advocates reporting poor healthcare experiences represent an under-used data source. The lack of a method for extracting reliable data from these heterogeneous letters hinders their use for monitoring and learning. To address this gap, we report on the development and reliability testing of the Healthcare Complaints Analysis Tool (HCAT).

Concepts: Scientific method, Educational psychology, Reliability, Learning, Service of process, Knowledge, Complaint, Federal Rules of Civil Procedure

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This study examined the impact of eating during simulated night shift on performance and subjective complaints. Subjects were randomized to eating at night (n=5; 23.2±5.5y) or not eating at night (n=5; 26.2±6.4y). All participants were given one sleep opportunity of 8h (22:00h-06:00h) before transitioning to the night shift protocol. During the four days of simulated night shift participants were awake from 16:00h-10:00h with a daytime sleep of 6h (10:00h-16:00h). In the simulated night shift protocol, meals were provided at ≈0700h, 1900h and 0130h (eating at night); or ≈0700h, 0930h, 1410h and 1900h (not eating at night). Subjects completed sleepiness, hunger and gastric complaint scales, a Digit Symbol Substitution Task and a 10-minute Psychomotor Vigilance Task. Increased sleepiness and performance impairment was evident in both conditions at 0400h (p<0.05). Performance impairment at 0400h was exacerbated when eating at night. Not eating at night was associated with elevated hunger and a small but significant elevation in stomach upset across the night (p<0.026). Eating at night was associated with elevated bloating on night one, which decreased across the protocol. Restricting food intake may limit performance impairments at night. Dietary recommendations to improve night-shift performance must also consider worker comfort.

Concepts: Nutrition, Eating, Food, Stomach, Stomach cancer, Meal, Complaint, Psychomotor vigilance task

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Young people in Australia are frequently exposed to alcohol marketing. Leading health organisations recommend legislative controls on alcohol advertising as part of a comprehensive approach to reduce alcohol-related harm. However, Australia relies largely on industry self-regulation. This paper describes the development and implementation of the Alcohol Advertising Review Board (AARB), a world-first public health advocacy initiative that encourages independent regulation of alcohol advertising. The AARB reviews complaints about alcohol advertising, and uses strategies such as media advocacy, community engagement and communicating with policy makers to highlight the need for effective regulation. In 4 years of operation, the AARB has received more complaints than the self-regulatory system across a similar period. There has been encouraging movement towards stronger regulation of alcohol advertising. Key lessons include the importance of a strong code, credible review processes, gathering support from reputable organisations, and consideration of legal risks and sustainability. The AARB provides a unique model that could be replicated elsewhere.

Concepts: Alcohol, Policy, Complaint, Advocacy, Pleading

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Exposure to alcohol marketing is considered to be potentially harmful to adolescents. In addition to statutory regulation, industry self-regulation is a common way to protect adolescents from alcohol marketing exposures. This article critically reviews research designed to evaluate the effectiveness of the alcohol industry’s compliance procedures to manage complaints when alcohol marketing is considered to have violated a self-regulatory code.

Concepts: Alcohol abuse, Review, Source code, Complaint

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Primary care faces unprecedented challenges. A move towards a more comprehensive, multi-disciplinary service delivery model has been proposed as a means with which to secure more sustainable services for the future. One seemingly promising response has been the implementation of physiotherapy self-referral schemes, however there is a significant gap in the literature regarding implementation. Aim This evaluation aimed to explore how the professionals and practice staff involved in the delivery of an in-practice physiotherapy self-referral scheme understood the service, with a focus on perceptions of value, barriers and impact. Design and setting A qualitative evaluation was conducted across two UK city centre practices that had elected to participate in a pilot self-referral scheme offering ‘physiotherapy-as-a-first-point-of-contact’ for patients presenting with a musculoskeletal complaint.

Concepts: Understanding, Future, Perception, Service of process, Complaint, The Delivery, Jim Halpert, Federal Rules of Civil Procedure

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In recent years, several websites have been developed allowing drivers to post their complaints about other motorists online. These websites allow drivers to describe the nature of the offensive behaviour and to identify the offending motorist by vehicle type, colour, and license plate number. Some websites also ask drivers to list the location where the event took place and the exact date and time of the offence. The current study was a content analysis of complaints posted to RoadRagers.com between 1999 and 2007 (N=5624). The purpose of the study was to: (1) assess the research value of this novel data source; (2) demonstrate the value of content analysis to the study of driver behaviour; (3) further validate an existing coding scheme; (4) determine whether this new data source would replicate previous research findings regarding the most frequent types of driver complaints and temporal distribution of these reports; (5) provide recommendations for improved driver training and public safety initiatives based on these data. A coding scheme that was originally developed for an assessment of complaints submitted to the Ontario Provincial Police (OPP) (Wickens et al., 2005) was revised to accommodate the new dataset. The inter-rater reliability of the revised coding scheme as applied to the website complaints was very good (kappa=.85). The most frequently reported improper driver behaviours were cutting/weaving, speeding, perceived displays of hostility, and tailgating. Reports were most frequent on weekdays and during the morning and afternoon rush hour. The current study replicated several findings from the analysis of reports to the OPP, but possible differences in the sample and data collection method also produced some differences in findings. The value of content analysis to driver behaviour research and of driver complaint websites as a data source was demonstrated. Implications for driver safety initiatives and future research will be discussed.

Concepts: Psychology, Evaluation, Research, Behavior, Driving, Driver's license, Driver's education, Complaint