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Background/aims: The value of using qualitative methods within clinical trials is widely recognised. How qualitative research is integrated within trials units to achieve this is less clear. This paper describes the process through which qualitative research has been integrated within Cardiff University's Centre for Trials Research (CTR) in Wales, UK. We highlight facilitators of, and challenges to, integration. Methods: We held group discussions on the work of the Qualitative Research Group (QRG) within CTR. The content of these discussions, materials for a presentation in CTR, and documents relating to the development of the QRG were interpreted at a workshop attended by group members. Normalisation Process Theory (NPT) was used to structure analysis. A writing group prepared a document for input from members of CTR, forming the basis of this paper. Results: Actions to integrate qualitative research comprised: its inclusion in Centre strategies; formation of a QRG with dedicated funding/roles; embedding of qualitative research within operating systems; capacity building/training; monitoring opportunities to include qualitative methods in studies; maximising the quality of qualitative research and developing methodological innovation. Facilitators of these actions included: the influence of the broader methodological landscape within trial/study design and its promotion of the value of qualitative research; and close physical proximity of CTR qualitative staff/students allowing sharing of methodological approaches. Introduction of innovative qualitative methods generated interest among other staff groups. Challenges included: pressure to under-resource qualitative components of research, preference for a statistical stance historically in some research areas and funding structures, and difficulties faced by qualitative researchers carving out individual academic profiles when working across trials/studies. Conclusions: Given that CTUs are pivotal to the design and conduct of RCTs and related study types across multiple disciplines, integrating qualitative research into trials units is crucial if its contribution is to be fully realised. We have made explicit one trials unit's experience of embedding qualitative research and present this to open dialogue on ways to operationalise and optimise qualitative research in trials. NPT provides a valuable framework with which to theorise these processes, including the importance of sense-making and legitimisation when introducing new practices within organisations. [ABSTRACT FROM AUTHOR]

Simon Noble, Hayley Prout, Annmarie Nelson Marie Curie Palliative Care Research Centre, Cardiff University, Cardiff, Wales, UK Introduction: Thrombosis remains the most common preventable cause of mortality in cancer patients receiving chemotherapy. Whilst the prophylaxis and treatment of this condition is well understood, the patient experience and subsequent behavioral factors are not. Methods: Patients receiving treatment for cancer-associated thrombosis (CAT) were interviewed about their experiences of CAT within the context of their cancer journey. Twenty interviews were transcribed and analyzed using framework analysis. Results: Chemotherapy patients were well informed about the risks of febrile neutropenia, how to recognize it, and when to seek medical attention. However, they had limited knowledge about CAT and received no information about the condition. Red flag symptoms suggestive of CAT were attributed to chemotherapy or the underlying cancer, resulting in delayed presentation to hospital, and diagnosis. The CAT journey was considered a distressing one, with limited support or information, in complete juxtaposition with the treatment they received for their cancer. Patients felt there was little ownership for the management of CAT, which further added to their distress. Conclusion: CAT is a common occurrence and patients view their experiences of it within the context of their overall cancer journey. However, patients receive little information to help recognize CAT and access timely treatment on the development of symptoms. Whilst other cancer complications have clear treatment pathways, thrombosis does not appear to have been afforded the same priority. A proactive approach to increase patient awareness, coupled with established CAT pathways is likely to reduce mortality, morbidity, and long-term psychological distress. Keywords: venous thromboembolism, qualitative, patient journey, low-molecular-weight heparin, patient experience

A meta-analysis was conducted with 65 school-based psychotherapy and counseling dissertations over the last 10 years (1998-2008) to assess if a file-drawer problem (i.e., studies conducted but not published that, as a whole, have different results than studies in the same area published) exists in the school-based outcome literature. An overall mean effect size of 0.44 was found for 73 treatment interventions. This effect size is comparable to Prout and DeMartino's 1986 meta-analysis conducted with published school-based studies and approximately half a standard deviation smaller than Prout and Prout's 1998 meta-analysis of school-based intervention studies. A bias does appear to exist but seems to be smaller than the bias found in the general child and adolescent psychotherapy outcome literature. Most of the dissertation studies evaluated group interventions and used a cognitive-behavioral or skills training intervention. Skills training and interventions with elementary-school students yielded the largest effect sizes. Comparisons of the current study with previous school-based intervention meta-analyses are discussed as are suggestions for future research. (Contains 1 figure and 3 tables.)

Issues with adolescents with intellectual disabilities have received little attention in the research literature. This study compared adolescents with and without intellectual disabilities on several indices of psychosocial adjustment. The participants were selected from a large longitudinal database and comparisons were made at three points in time. Analyses indicated that adolescents with intellectual disabilities report mild to moderate depression over time when compared with their typically developing peers, they express more family connectedness, but differ little on measures of self-concept. In later adolescence, typically developing adolescents appear to have a significant increase in optimism that is not experienced by the adolescents with intellectual disabilities. Implications of the findings are discussed as well directions for further investigation. (Contains 8 tables and 3 footnotes.)

The quality of life construct has gained prominent attention in human services over the last 20 years. We investigated whether quality of life differences exist between adults with developmental disabilities and the general population. Differences were found in scales measuring well-being and decision-making as well as other more specific variables. The two groups also differed in overall quality of life; those with developmental disabilities had lower quality of life. A logistic regression model comprised of the life dimensions differentiated between the groups with over 90% accuracy. Overall results of this static group comparison indicate that adults with developmental disabilities are at a significant disadvantage with regard to quality of life in comparison with the general population.

The purpose of this study was to investigate school psychologists' attitudes toward lesbians and gay males. Aspects of school psychologists' knowledge, beliefs, current practices, and levels of preparedness related to issues of sexual orientation were also explored. A sample of 288 school psychologists (215 females and 73 males, mean age = 44 years) who were members of NASP participated in this study. Participants completed research packets containing a hypothetical case analogue vignette and three questionnaires querying their attitudes, beliefs, and knowledge about issues of sexual orientation. The results indicated school psychologists endorse relatively positive attitudes toward lesbians and gay males, report low-to-moderate levels of knowledge about lesbian and gay male issues, are willing to address lesbian and gay male issues on the job, are generally aware of how such issues impact schools, and are inadequately prepared to deal with lesbian and gay male issues. These findings are discussed in relation to their impact on the field and the implications for graduate training. (Contains 1 table.)

This study investigated the relationship between the Child Behavior Checklist/4-18 (CBCL/4-18) and two modified measures of social desirability, the Marlowe-Crowne Social Desirability Scale and the Edwards Social Desirability Scale with a sample of 65 parents of normal children from grades K-7. Results from correlational and multiple regression analyses showed that the Aggressive Behaviors and Attention Problems cross-informant syndromes were modestly associated with social desirability scale scores. The relevance of findings are discussed in terms of the susceptibility of behavior rating scales to the self-deception and other-deception factors of social desirability [Paulhus, D. L. (1984). In: J. P. Robinson et al., (eds.) "Measures of social psychological attitudes." (pp. 17-59). San Diego: Academic Press.] and fake-good response sets. (Contains 2 tables.)

Study evaluated referrals of students (N=1,222) for special education from grades K-5 to determine if youngest children were experiencing a higher rate of referral. Data confirmed the hypothesis that children referred for evaluations within the 5- to 7-year-old-group had summer birthdates. Article discusses ways of providing educational services for at-risk primary-age students. (Author/JDM)

Applies meta-analysis to school-based outcome studies of counseling and psychotherapy within a 10-year period. Results support the effectiveness of school-based therapeutic interventions, although this conclusion is offered with some caution. Findings apply almost exclusively to group interventions. Discusses implication for practice and directions for future research. (MKA)

Results of a national survey on mental health services for adults with mild mental retardation, completed by 156 directors of psychological services at community health centers, indicated that adults with mild mental retardation were not frequent consumers of community mental health services and received differential treatment when provided with services. (Author/DB)

Used analogue case study format to examine sex bias in clinical judgment among school psychologists. Varied sex of adolescent and problem type in 2 X 2 design. School psychologists read case study and rated perceived disturbance and importance of intervention. Psychologists rated it more important to intervene when subject was male; no differences on disturbance rating. (Author/NB)

This article reports a secondary analysis of past therapy outcome meta-analysis. Fifteen meta-analysts provided effect sizes from 56 studies in previous reviews that met 1 of 3 increasingly stringent levels of criteria for clinical representativeness. The effect sizes were synthesized and compared with results from the original meta-analyses. Effect sizes from more clinically representative studies are the same size at all 3 criteria levels as in past meta-analyses. Almost no studies exist that meet the most stringent level of criteria. Results are interpreted cautiously because of controversy about what criteria best capture the notion of clinical representativeness, because so few experiments have tested therapy in clinical conditions, and because other models for exploring the generalizability of therapy outcome research to clinical conditions might yield different results.

Investigated practices in diagnosing mental retardation within vocational rehabilitation. Reviewed files of 113 rehabilitation clients to determine which intelligence scales were used to diagnose clients. The results suggested that many considered retarded according to vocational rehabilitation might not be considered retarded according to other diagnostic systems. (BH)

Presents the Kinetic Drawing System as a logical integration of the Kinetic Family Drawing and Kinetic School Drawing techniques. Reviews the literature of these two projective techniques and provides a rationale and process toward their combination into a single approach. (LLL)

Applied the meta-analysis technique to school-based studies of psychotherapy. The results indicate that psychotherapy in the schools is moderately effective. Evidence was also found of the greater efficacy of group and behavioral theory interventions that target observed behaviors and problem-solving abilities. (Author/KS)

A five-question survey of state vocational rehabilitation agency policies regarding the diagnosing of mental retardation for eligibility for service reports results such as that most states do not use diagnostic criteria that are in line with the guidelines recommended by the American Assocation on Mental Deficiency. (Author/MC)

Thirty-seven institutionalized profoundly mentally retarded adults were studied to determine whether thyroid medication is an essential component of a recently introduced nutritional supplementation treatment. Biochemical assessments confirmed that compliance with the treatments was adequate; however, no significant IQ improvements were observed. (CL)

Obtained readability levels for several self-report measures designed for use with child/adolescent populations, using a recently developed readability formula based on an updated evaluation of reading materials. Also reports grade levels of words in individual items and in directions. Evaluation demonstrated lower reading levels than those produced by older formulas. (Author/KS)

The rationale for using a behavioral assessment approach in the evaluation of hyperactivity is explained, and the various procedures for behaviorally assessing hyperactivity are reviewed. Guidelines and resources are also suggested for the practitioner to use in behavioral assessment of hyperactivity. (SW)