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PubMed1998

Relational and overt forms of peer victimization: a multiinformant approach.

This research addressed 2 limitations of past research on peer victimization: the tendency to study boys only and the tendency to focus on forms of peer maltreatment that are common in boys' peer groups (victimization through overt aggression) but occur much less frequently in girls' peer groups. Peer- and self-report instruments were used to assess a relational form of victimization in addition to the overt form that has been the focus of past research. Results showed that girls were more relationally victimized, whereas boys were more overtly victimized. Both forms of victimization were shown to predict concurrent sociopsychological adjustment problems significantly (e.g., peer rejection, loneliness) beyond aggression. Victims identified through a combination of self- and peer-reports were particularly maladjusted.

Aggression↗
PubMed2006

Forming and belonging to a peer consultation group for your own mental health and creating a psychotherapy practice that addresses specific topics.

One of the visions for this column when it was created was to provide a forum for those of you who are advanced practice psychiatric/mental health nurses when you are seeking ideas and recommendations about setting up and conducting your practices. As I write the column I use a variety of sources for ideas about the content. One source will be the list of questions I have been asked when I've spoken on the issues of private practice. Another source will be the e-mail questions that I receive from you (and I encourage you to write to me when you have a question!). Yet another source will be the types of issues I've dealt with in my own practice over the past 25 years. As I begin this column, one of the recommendations that I have found invaluable in my own practice is belonging to a peer group of P/MH APRNs.

Humans↗
PubMed2006

Are peer support groups for adolescents with Asperger's syndrome helpful?

There is very little documentation dealing with peer support groups for people with Asperger's syndrome, and especially about groups for adolescents. This article gives a description of three such groups that were run in parallel with support groups for parents. The great majority of the participants completed the course of the group. In a consumer satisfaction survey, the majority of the participants (76.5%) and nearly all of their parents (95%) rated satisfaction with the group meetings as good or very good. These responses indicate that adolescents with Asperger's syndrome and their parents perceive peer support groups as helpful.

Adolescent↗
PubMed1996

An exploration of the quality of peer review group activities within Australasia.

OBJECTIVE: To describe a two-phase study of the structure of Australasian psychiatrist peer review groups. METHOD (Phase one): Initially, information was sought from chairs/coordinators of psychiatrist peer review groups regarding the nature and organisation of their group. RESULTS (Phase one): One hundred and three questionnaires were returned describing a number of models of peer review. Three principal models were identified: a teaching hospital model, a private practice model, and a private institution model. METHOD (Phase two): The second-phase questionnaire sought information on the quality of the review, using six proposed standards developed by the Quality Assurance Committee of the Royal Australian and New Zealand College of Psychiatrists. RESULTS (Phase two): Many groups indicated that four of the proposed standards (those relating to documentation, having clear goals, reviewing actual clinical cases, and rigorous protection of confidentiality) were either already being followed or would be relatively easy to implement. The remaining two proposed standards (including structure, process and outcome dimensions of health care in the case discussion, and the use of explicit criteria) presented more difficulty. CONCLUSION: The application of such standards to peer review group meetings should assist groups to provide a forum for presentation and evaluation of clinical work where participants know they will be challenged in an environment which is both supportive and educational.

Attitude of Health Personnel↗
PubMed2002

Second national external quality assessment scheme in hematology: the Philippine experience.

The Philippine Council for Quality Assurance In Clinical Laboratories has conducted two National External Quality Assessment Schemes (NEQAS) in Hematology. The first survey was conducted in December 1999 and the second in August 2000, with 95 and 187 laboratories, using mostly automated analyzers, participating respectively. Control materials were distributed during a two-week period by human network, and analyzed over a six to eight week period. For the first survey, only 36 laboratories (38.0%) submitted results. Data was divided into 4 peer groups based on the manufacturer. Since most of the samples were hemolysed upon analysis, only WBC and HGB parameters were evaluated. No outliers were detected in each peer group after analysis by the 'Peer Group Mean and SDI' method. Using the clinical laboratory improvement act of 1988 proficiency testing criteria (CLIA'88), only 5 results (13.9%) were unsatisfactory for WBC, and all results were satisfactory for HGB. For the second survey, 87 laboratories (47%) responded. Data was divided into 5 peer groups. There were few incidents of sample deterioration. Although majority of the coefficient of variations were acceptable, about 23 (12.6%) participants showed abnormality in at least one parameter after analysis by the 'Peer Group Mean and SDI'. Using CLIA'88, 5 WBC (6.5%), 6 RBC (7.6%), 8 HGB (9.7%), 15 HCT (19.0%), and 7 PLT (8.0%) results were unsatisfactory. In summary, the first NEQAS study served as a pilot study. Valuable lessons were learned for the improvement of the second NEQAS. The second NEQAS study was marked by a much larger sample size and better results.

Hematologic Tests↗
PubMed1992

Peer support group for adolescents with chronic illness.

This study assessed the effects of a monthly peer support group for adolescents with cancer and other hematological diseases. These adolescents shared activities and experiences with nondisabled high school students. At the group's conclusion, the adolescents reported that the group helped them cope with their illness and improved the quality of their daily lives. Nondisabled students reported that the group favorably affected their attitudes about, and intended behavior toward, peers with chronic illnesses. These results suggest that such groups can provide important benefits for individuals with chronic illnesses as well as for their nondisabled peers.

Adaptation, Psychological↗
PubMed2003

Peer rejection, temperament, and cortisol activity in preschoolers.

In this study, we examined a model that describes both direct and indirect pathways between children's temperament and activity of the hypothalamic-pituitary-adrenal (HPA) axis when children are in peer-group settings. We hypothesize that in peer-group settings both shy, inhibited and exuberant, undercontrolled children would exhibit higher cortisol levels, but these associations would operate through different pathways. Sociometric measures of peer rejection, salivary cortisol, and teacher reports of temperament were collected on 82 preschoolers. Children who were rejected by classmates had higher cortisol levels than the other children. The combination of Surgency and Poor Effortful Control (Effortful Control, reverse scored) was associated with elevated cortisol through a pathway mediated by aggressive interactions with peers and peer rejection. With the indirect path explained, the combination of Surgency and Poor Effortful Control also was directly and negatively associated with classroom cortisol levels. These results help explain why temperament associations with HPA activity have been variable and difficult to discern when children are assessed in peer-group contexts. In these contexts, both direct and indirect pathways between temperament and cortisol need to be examined.

Aggression↗
PubMed1999

Education and peer discussion group interventions and adjustment to breast cancer.

BACKGROUND: We report a clinical trial comparing the effectiveness of education-based and peer discussion-based group interventions on adjustment to breast cancer. METHODS: Women with stage I, II, or III breast cancer (n = 312) were randomly assigned to 1 of 4 group conditions: control, education, peer discussion, or education plus peer discussion (combination). Seven groups (each comprising 8-12 women) were conducted in each of the 4 conditions (28 groups total). Adjustment was measured before the intervention, immediately after the intervention, and 6 months after the intervention. RESULTS: Consistently positive effects on adjustment were seen in the education groups both immediately following and 6 months after the intervention. There were no benefits of participation in peer discussion groups, and some indications of adverse effects on adjustment at both follow-up examinations. The effects could be explained by changes in self-esteem, body image, and intrusive thoughts about the illness. CONCLUSIONS: Education-based group interventions facilitated the initial adjustment of women diagnosed with early stage breast cancer. There was no evidence of benefits from peer discussion group interventions.

Adaptation, Psychological↗
PubMed2006

Clinicians' attitudes to prostate cancer peer-support groups.

OBJECTIVE: To assess clinicians' knowledge and attitudes to prostate cancer peer-support groups, essential in improving support services for men with prostate cancer, as patients' perceptions of their clinicians' attitudes to such groups predict patients' positive and negative perceptions of their experiences at such groups. SUBJECTS AND METHODS: In all, 36 clinicians (75% response) across Australia, of whom 27 were urologists and nine were radiation oncologists, were interviewed in-depth using a key-informant approach. Nine clinicians were from regional Australia, with the remaining 27 from major metropolitan settings. Subsequently, 30 clinicians (69% response) completed surveys to confirm identified themes. RESULTS: Peer support was rated positively by most clinicians and most report a fair to good knowledge of such groups. However, less than a quarter regularly refer their patients to these groups. While clinicians can describe positive aspects of peer support, many are concerned that biased viewpoints and misinformation within these groups might potentially contribute to patients' decisional uncertainty and regret. CONCLUSIONS: Further research is needed to establish for whom these support groups are most helpful. Concerns about misleading information that might be proffered in support groups is a barrier to clinician referral to these groups. Dialogue between prostate cancer interest groups and clinicians to resolve concerns presents as a key strategy to improve support for men with prostate cancer.

Attitude of Health Personnel↗
PubMed1983

Behavior of cancer patients: a randomized study of the effects of education and peer support groups.

Two prospective, controlled studies were conducted to determine if psychological and social functioning could be enhanced in patients with Hodgkin's disease by either education or participation in a peer support therapy group. Eighty-one patients were evaluated with the Cancer Patient Behavior Scale prior to and following intervention. Following education, patients experienced significant improvement in the frequency of Anxiety, Treatment Problems, Depression, and Life Disruption (p less than or equal to 0.1) compared to a control group. Following participation in peer support groups, patients showed no improvement in any of 10 areas of life functioning. Thus education represents an effective, efficient, and inexpensive means of improving psychological and social behavior in patients with Hodgkin's disease. Participation in this peer support therapy group did not result in significant behavior change.

Adult↗
PubMed1992

A peer support group for adolescent dialysis patients.

Adolescents with chronic renal failure face unique problems often best understood by peers with the same condition. An adolescent peer support group can be a valuable tool to foster peer relationships and enhance self-esteem. Moreover, nurses can learn to be effective group leaders.

Adolescent↗
PubMed2005

Creatinine measurement: state of the art in accuracy and interlaboratory harmonization.

CONTEXT: The National Kidney Disease Education Program recommends calculating glomerular filtration rate from serum creatinine concentration. Accurate creatinine measurements are necessary for this calculation. OBJECTIVE: To evaluate the state of the art in measuring serum creatinine, as well as the ability of a proficiency testing program to measure bias for individual laboratories and method peer groups. DESIGN: A fresh-frozen, off-the-clot pooled serum specimen plus 4 conventional specimens were sent to participants in the College of American Pathologists Chemistry Survey for assay of creatinine. Creatinine concentrations were assigned by isotope dilution mass spectrometry reference measurement procedures. PARTICIPANTS: Clinical laboratories with an acceptable result for all 5 survey specimens (n = 5624). RESULTS: The fresh frozen serum (FFS) specimen had a creatinine concentration of 0.902 mg/dL (79.7 micromol/L). Mean bias for 50 instrument-method peer groups varied from -0.06 to 0.31 mg/dL (-5.3 to 27.4 micromol/L), with 30 (60%) of 50 peer groups having significant bias (P < .001). The bias variability was related to instrument manufacturer (P < or = .001) rather than method type (P = .02) with 24 (63%) of 38 alkaline picric acid methods and with 6 (50%) of 12 enzymatic methods having significant biases. Two conventional specimens had creatinine concentrations of 0.795 and 2.205 mg/dL (70.3 and 194.9 micromol/L) and had apparent survey biases significantly different (P < .001) from that of the FFS specimen for 34 (68%) and 35 (70%) of 50 peer groups, respectively. CONCLUSIONS: Thirty of 50 peer groups had significant bias for creatinine. Bias was primarily associated with instrument manufacturer, not with type of method used. Proficiency testing using a commutable specimen measured participant bias versus a reference measurement procedure and provided trueness surveillance of instrument-method peer groups.

Bacteriological Techniques↗
PubMedDate not supplied

Quality assessment and patient participation in care by means of a touch-screen computer.

Hospital characteristics vary greatly across a geographic area such as a state. Hospital peer groups internally exhibit similar characteristics and can be used as a basis for the analysis of data, the dissemination of information, and the adoption of continuous quality improvement project results. This paper reflects the efforts made toward the identification of hospital peer groups within the state of Michigan. Hospital characteristics data for fiscal year 1992 were obtained from the American Hospital Association's Annual Survey of Hospitals and the Health Care Financing Administration's MEDPRO database. Thirteen peer group clusters have been identified, reviewed, and commented on by the state's hospital association and have met general approval by hospital administrators across the state. The established peer groups are being used to identify the differences in patterns of care among hospitals in the state. The peer groups also are being used for the feedback of comparable data and the identification of hospitals for participation in continuous quality improvement projects. The next research objective is to experiment with other clustering techniques and other inpatient populations. The consistency of the peer groupings across all clustering techniques and across both Medicare and total inpatient populations will be studied.

Feasibility Studies↗
PubMed1993

Matrix effects and accuracy assessment. Identifying matrix-sensitive methods from real-time proficiency testing data.

Retrospective proficiency testing data may be used to screen for matrix effect, which is suspected when significant methodologic bias is detected. Prioritization is centered on those situations where relatively high unacceptability rates are associated with high bias. Before attributing high unacceptability rates to methodologic bias, factors such as peer grouping strategies, number of participants in peer groups, analyte concentration, evaluation limits, and interparticipant precision, all of which affect scoring, need to be considered. When bias-associated high unacceptability rates are detected, methods are candidates for further evaluations to identify the causes of bias, to determine if matrix effect is present. Using outputs from the College of American Pathologists Survey Management Enhancement Program, we have presented data from the 1991 Comprehensive Chemistry Survey to demonstrate methodology to study this problem, and have selected examples of method performance in which tabular and graphic information contribute to its study. For the analytes studied, unacceptability rates tend to be greatest in association with high methodologic bias and/or between-participant imprecision relative to external evaluation limits, samples at the upper extreme of analyte concentration, low numbers of participants in peer groups, grading by comparative method, and concentration-independent fixed evaluation limits. Specific examples of significant bias that is possibly matrix induced are presented for uric acid, glucose, creatinine, and total protein.

Bias↗
PubMed2006

Factors associated with alcohol consumption, problem drinking, and related consequences among high school students in Taiwan.

This research evaluated the risk factors associated with alcohol consumption, problem drinking, and related consequences among high school students in Taiwan. A total of 779 10th grade students from four randomly selected high schools in eastern Taiwan were included in the survey. Survey data were self-reported by students and analyzed using logistic regression methods. The results showed that alcohol consumption and problem drinking was 2.22-2.71-fold greater in male than in female adolescents. Parents and peer groups were the determinants influencing alcohol consumption, and these influences could be enhanced particularly by the drinking behaviors of fathers and peer groups, and the relationship of students with their peer groups. The probability of developing adolescent problem drinking was fourfold greater in students whose fathers had habits of drinking. Ethnicity had a notable impact on the risk of problem drinking. The occurrence of problem drinking among indigenous adolescents was 2.98-fold higher than among Hans, indicating a diversity of biological factors, social norms, and expectation for alcohol drinking between these two ethnic groups. This study suggests that a policy for preventing alcohol abuse among high school students should start by addressing the two major associated problems: a need to earn peer group recognition, and the lack of family support among at-risk students.

Adolescent↗
PubMed1996

Vigabatrin as initial therapy for infantile spasms: a European retrospective survey. Sabril IS Investigator and Peer Review Groups.

PURPOSE: The efficacy and tolerability of vigabatrin (VGB) as an add-on therapy in the treatment of infantile spasm (IS) prompted physicians to explore its use as the first drug in this seizure type. METHODS: Our retrospective study included 250 infants diagnosed with IS; the data obtained were subjected to peer-group review. Of this infant population, 192 infants were considered to have classic IS and had received VGB as their first treatment for the spasms. There was a slight preponderance of boys (57%) in this population. Mean age of IS onset was 5.8 months; 60% had typical hypsarrhythmia. RESULTS: Initial suppression of spasms was obtained in 68% of infants with a median time to response of 4 days at an average VGB dose of 99 mg/kg/day. The best response was seen in those infants with tuberous sclerosis (96% response) and in those younger than 3 months at onset of spasms (90% response). Of these infants, 43 (22%) of 192 subsequently had other types of seizures, and a recurrence of infantile spasms occurred in 28 (21%) of 131 responders. At the end of this study, 96 of 192 infants who could be evaluated were seizure free with VGB monotherapy. Treatment appeared to be well tolerated, with only 33 (13%) infants with adverse events, of which the most common were somnolence (15 patients) and hyperkinesia (eight patients). In only two cases did adverse events require VGB withdrawal. CONCLUSION: This study supports the opinion that VGB may be considered an initial treatment for IS regardless of cause.

Age of Onset↗
PubMed1998

The accuracy of laboratory measurements in clinical chemistry: a study of 11 routine chemistry analytes in the College of American Pathologists Chemistry Survey with fresh frozen serum, definitive methods, and reference methods.

CONTEXT: Better procedures are needed whereby national proficiency testing survey providers can assess and improve the accuracy of laboratory measurements in clinical chemistry. SETTING: The 1994 College of American Pathologists Comprehensive Chemistry Survey. DESIGN: This study of matrix effects and the accuracy of laboratory measurements for 11 analytes linked the logistics of the Survey to definitive methods at the National Institutes of Standards and Technology, reference methods at the Centers for Disease Control and Prevention, proficiency testing materials, and a fresh frozen serum sample. The data were analyzed with a statistical model of laboratory measurements. RESULTS: (1) Matrix biases affected the results reported from 69% of the 644 peer group/survey specimen pairs evaluated. (2) Because of matrix biases, the reference value was the correct target value only 32% of the time; thus, the traceability established by definitive method and reference method value assignments on Chemistry Survey specimens did not assure accuracy on patient samples. (3) In contrast to matrix biases, the error caused by random matrix effects with proficiency testing samples was about the same as that caused by random specimen effects with fresh frozen serum, and both were less than within-run random analytic error. (4) Calibration biases occurred in 73% of the 180 peer groups evaluated, and, after matrix biases were removed, the total variance of interlaboratory measurements was due to peer group calibration bias (48%), within-peer-group random calibration error (31 %), within-run random error (14%), and random specimen effects (7%). CONCLUSIONS: An opportunity exists to improve method calibration accuracy in clinical chemistry. With improved design, national proficiency testing surveys can monitor and help reduce method calibration error by converting reported survey results to a true accuracy base that predicts accuracy on patient samples. For medical purposes, the correct target values on artificial (matrix-modified) chemistry materials are reference values adjusted for the matrix bias of each peer group. Matrix biases estimated by the use of fresh frozen serum can be used as factors to transfer the accuracy of definitive methods from artificial reference materials to patient samples.

Bias↗