Badia, Xavier Colombo,/ Jose Antonio/ Lara, Nuria/ Llorens, M Angels/ Olmos, Luis/ Sainz de los Terreros, Miguel/ Varela, Jose Antonio/ Vilata, Juan Jose. Combination of qualitative and quantitative methods for developing a new Health Related Quality of Life measure for patients with anogenital warts. Health and Quality of Life Outcomes 2005, 3, 24, 1-7.
Abstract
Background: Anogenital warts are the most easily recognized sign of genital Human Papilloma Virus infection. The objective was to develop a short, valid and reliable questionnaire to measure Health Related Quality of Life (HRQL) in patients with anogenital warts.
Methods: First a literature review was performed to identify relevant papers describing the impact of anogenital warts in HRQL; second the main domains were identified by some experts in a focus group, and third in-depth-semi-structured interviews were conducted in patients with anogenital warts to identify the initial set of items. A qualitative reduction of the initial set of items was performed based on the mean scoring of the experts for the three scales: clarity, frequency and importance. The initial questionnaire was pilot tested in 135 patients. Rasch analysis was performed with the results of the questionnaire in order to refine the instrument. Spearman's correlation was calculated between the initial questionnaire and the reduced version. Additionally the measurement properties (validity and reliability) of the resulting final questionnaire were tested and compared using standard procedures (Cronbach's Alpha and item-total
correlation).
Results: the main domains identified as affected in patient's life were: sexual, colleagues and partner relationships. After a proper qualitative reduction the initial set of 134 items was reduced to 22. The questionnaire was pilot tested in 135 patients and two dimensions were identified after the multifactorial analysis: emotional dimension and sexual activity dimension. As a result of the Rasch analysis the questionnaire was reduced to 10 items. High correlation was found between the initial and the reduced version for the two dimensions. Cronbach's alpha values were acceptable (0.86).
Conclusion: The initial 22 items questionnaire was reduced by Rasch analysis to a version of 10 items, with two dimensions: emotional and sexual. The results suggest the adequacy of the 10 items to evaluate HRQL of patients with anogenital warts in a valid and reliable way.

Berman, Jonathan D./ Straus, Stephen E. Implementing A Research Agenda For Complementary And Alternative Medicine. Annu. Rev. Med. 2004. 55, 239–54.
Abstract Complementary and alternative medicine (CAM) consists of diverse clinical interventions that are practiced because of their popularity rather than the prior demonstration of safety and efficacy required for conventional agents. CAM therapies can be grouped into five categories: biologically based therapies, manipulative and body-based interventions, mind-body interventions, “energy” therapies, and alternative medical systems. The present evidence that individual CAM interventions are efficacious is largely anecdotal, but hundreds of small trials have yielded positive results. For a few modalities, existing data are either very encouraging or else sufficient to conclude that they are ineffective. CAM interventions are presumed to be safe, yet they may not be, particularly in the case of botanical agents with inherent toxicities, significant drug interactions, or potent adulterants. The public health questions regarding CAM can only be addressed through a research agenda that defines which interventions have favorable therapeutic indices. Implementation of this agenda involves adequate characterization and standardization of the product or practice, with rigorous investigation to demonstrate its safety, mechanism of action, and efficacy.

Evans, C. Stephen. Is There A Basis For Loving All People? Journal of Psychology and Theology 2006, 34(1), 78-90.
Many ethical systems hold that there are obligations to love and value all human beings. This essay assumes the existence of such universal obligations, and argues that a divine command meta-ethical theory provides a better account of these obligations than secular meta-ethical theories, such as the evolutionary biology and contractual meta-ethical accounts that are favored by many psychologists. God’s command to humans to love their neighbors as themselves
not only explains the existence of such obligations, but also gives a plausible account of the psychological motivation for acting in accord with such a duty.

Feinstein, David. An Overview of Research In Energy Psychology. www.EnergyPsychEd.com

Fonnebo, Vinjar/ Grimsgaard, Sameline/ Walach, Harald/ Ritenbaugh, Cheryl/ Norheim, Arne Johan/ MacPherson, Hugh/ Lewith, George/ Launso, Laila/ Koithan, Mary/ Falkenberg, Torkel/ Boon, Heather/ Aickin, Mikel. Researching complementary and alternative treatments - the gatekeepers are not at home. BMC Medical Research Methodology 2007, 7(7), 2-18.
Abstract
Background To explore the strengths and weaknesses of conventional biomedical research strategies and methods as applied to complementary and alternative medicine (CAM), and to suggest a new research framework for assessing these treatment modalities.
Discussion There appears to be a gap between published studies showing little of no efficacy of CAM, and reports of substantial clinical benefit from patients and CAM practitioners. This “gap” might be partially due to the current focus on placebo-controlled randomized trials, which are appropriately designed to answer questions about the efficacy and safety of pharmaceutical agents. In an attempt to fit this assessment strategy, complex CAM treatment approaches have been dissected into standardized and often simplified treatment methods, and outcomes have been limited. Unlike conventional medicine, CAM has no regulatory or financial gatekeeper controlling their therapeutic “agents” before they are marketed. Treatments may thus be in widespread use before researchers know of their existence. In addition, the treatments are often provided as an integrated ‘whole system’ of care, without careful consideration of the safety issue.
We propose a five-phase strategy for assessing CAM built on the acknowledgement of the inherent, unique aspects of CAM treatments and their regulatory status in most Western countries. These phases comprise:
1. Context, paradigms, philosophical understanding and utilization
2. Safety status
3. Comparative effectiveness.
4. Component efficacy
5. Biological mechanisms

Summary Using the proposed strategy will generate evidence relevant to clinical practice, while acknowledging the absence of regulatory financial gatekeepers for CAM. It will also emphasize the important but subtle differences between CAM and conventional medical practices.

Gilgun, Jane F. The Four Cornerstones of Qualitative Research. Qualitative Health Research Mar 2006, 16(3), 436-443.
Evidence-based practice (EBP) is more than the application of best research evidence to practice. Advocates for evidence-based medicine (EBM), the parent discipline of EBP, state that EBP has three, and possibly four, components: best research evidence, clinical expertise, and patient preferences and wants.  Person-centered physicians also advocate for the person of the practitioner as a fourth component. In this article, the author shows the centrality of qualitative
research to this fuller version of EBP. She also shows how qualitative research has four cornerstones that parallel the four components of EBP.

Halberstein, Robert/ DeSantis, Lydia/ Sirkin, Alicia/ Padron-Fajardo, Vivian/ Ojeda-Vaz, Maria. Healing With Bach® Flower Essences: Testing a Complementary Therapy. Complementary Health Practice Review Jan 2007, 12(1), 3-14.
Bach® Original Flower Essence (BFE) Rescue® Remedy, a modality used since 1930 but not yet thoroughly investigated scientifically, was evaluated for the reduction of acute situational stress. A double-blind clinical trial comparing a standard dosage of BFE Rescue remedy against a placebo of identical appearance was conducted in a sample of 111 individuals aged 18 to 49, randomized into treatment (n = 53) and control (n = 58) groups. The Spielberger State-Trait Anxiety inventory (STAI) was administered before and after the use of Rescue Remedy or placebo. Downward trends in anxiety level measurements were discovered in both the treatment (Rescue Remedy) and control (placebo) groups. Statistically significant difference between pretest and posttest scores. The results suggest that BFE Rescue Remedy may be effective in reducing high levels of situational anxiety.

Hall Gueldner, Sarah/ Michel, Yvonne/ Hains Bramlett, Martha/ Liu, Chin-Fang/ Johnston, Linda W./ Endo, Emiko/ Minegishi, Hideko/ Searcy Carlyle, Mable. The Well-Being Picture Scale: A Revision of the Index of Field Energy. Nursing Science Quarterly Jan 2005, 18(1), 42-50.
This paper reports the development and psychometric properties of the Well-Being Picture Scale, a 10-item non language based pictorial scale that measures general well-being, based on Martha Rogers’ view of human beings as energy fields in continual mutual process with their environment. The Well-Being Picture Scale was designed for use with the broadest possible range of adult populations, including persons who are unable to respond to English based text or lengthy, complex measurement instruments. Psychometric properties were established in a sample of more than 2,000 individuals from the United States, Taiwan, Japan, and Africa. The overall Cronbach’s alpha is .8795.

Hendrickson, Darren/ Zollinger, Brett/ McCleary, Roseanna. Determinants of the Use of Four Categories of Complementary and Alternative Medicine. Complementary Health Practice Review Jan 2006, 11(1), 3-26.
The purpose of this research is to assess the social and health determinants of the use of four separate and distinct categories of complementary and alternative medical therapies: biologically based, mind-body, manipulative, and whole CAM medical systems. The behavioral model of health services use, which holds that health service use is a function of predisposing, enabling, and need  characteristics, is used as the theoretical framework for linking specific determinants with the four categories of CAM use. Data are taken from a statewide interview survey of Kansas adults (N = 2,166) conducted in 2001.
Results from multivariate analyses demonstrate that there is variation in the determinants of the use of different categories of CAM therapies. Overall, the results indicate that future research on the determinants of CAM must delineate between various CAM therapies to gain an accurate portrayal of the factors contributing to CAM use.

Humpel, Nancy/ Jones, Sandra C. Development of a Comprehensive Questionnaire of Complementary and Alternative Medicine Use Among Cancer Patients and Survivors. Complementary Health Practice Review Oct 2005, 10(3), 163-174.
The purpose of this study was to develop and pilot test a comprehensive measurement tool to quantify all aspects of complementary and alternative medicine (CAM) use among cancer survivors. Data are from 81 cancer patients and survivors with a mean age of 62 years and 77.2% women. CAM was used by 63% of the sample. The most common CAM was regular exercise (50%), meditation (48.5%), and fresh fruit and vegetable juices (38.8%). The main motivations for using CAM were to boost the immune system and enhance quality of life. More than 65% had told a doctor they were using CAM. Reported benefits included feeling better, having more energy, and providing a distraction. The main sources of information were support groups (61.5%), books (50%), and friends (45.3%). Few participants used CAM to cure the cancer, and they had realistic expectations about benefits they may receive from using CAM. Further studies are needed with larger sample sizes to confirm whether findings can be generalized to the broader population of cancer patients and survivors.

Im, Eun-Ok/ Chee, Wonshik. An Online Forum as a Qualitative Research Method Practical Issues. Nursing Research July/Aug 2006, 55(4), 267-273.
Background: Despite the positive aspects of online forums as a qualitative research method, very little is known on the practical issues involved in using online forums for data collection, especially for a qualitative research project.
Objectives: The aim of this study was to describe the practical issues encountered in implementing an online forum as a qualitative component of a larger study on cancer pain experience.
Methods: Throughout the study process, the research staff recorded issues ranging from minor technical problems to serious ethical dilemmas as they arose and wrote memos about them. The memos and written records of the discussions were reviewed and analyzed using content analysis.
Results: Two practical issues related to credibility were identified: (a) a high response and retention rate and (b) automatic transcripts. An issue related to dependability was the participants’ forgetfulness. The issues related to
confirmability were difficulties in theoretical saturation and unstandardized computer and Internet jargon. A security issue related to hacking attempts was noted as well.
Discussion: The analysis of these issues suggests several implications for future researchers who want to use online forums as a qualitative data collection method.

Mol, Annemarie. Proving or Improving: On Health Care Research as a Form of Self-Reflection. Qualitative Health Research Mar 2006, 16(3), 405-414.
As it is, clinical trials are the gold standard of health care research, employed to prove that the care practices they study are good. Here, the author suggests that we would do better to develop research methods that work toward another goal: to improve care practices. This requires that we no longer foreground the effectiveness but, instead, investigate the various effects of interventions. If undesirable, they might then be tinkered with. As a part of this, the effects on bodily parameters and on the intricacies of daily lives should not be separated out but studied in connection. With examples drawn from studies into care practices for patients with diabetes or atherosclerosis, the author argues that instead of trying to turn the clinic into a laboratory, we should strive to support and strengthen clinical ways of working.

Morse, Janice M.  Reconceptualizing Qualitative Evidence. Qualitative Health Research Mar 2006, 16(3), 415-422.
As qualitative researchers, we have not explored our own work from the qualitative evidence perspective. The author suggests that qualitative researchers need to explore the conflicting agendas of evidence-based medicine and qualitative inquiry, compare the anatomy of qualitative data and evidenced-based data, and explore the autonomy of qualitative inquiry within the context of evidenced-based medicine. By attending to and communicating the differences
in qualitative and quantitative evidence, and by accepting the differences in our
research agendas, qualitative researchers will achieve the legitimacy that they deserve and which they require.

Wadman, Meredith. Alternative medicine loses its champion. Nature Medicine Jan 2007, 13(1), 4.

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