Before/after study to determine the effectiveness of the align-right cylindrical cervical pillow in reducing chronic neck pain severity.

OBJECTIVE: To determine the effectiveness (at the 0.1 level of statistical significance) of the Align-Right (roll-shaped) cervical pillow (ARCP) on neck pain severity and headache/neck pain medication use in chronic neck pain subjects. DESIGN: The design was a "before/after" (i.e., a "pre/post" trial). SUBJECTS: Twenty-eight subjects, 25-45 yr of age with cervical spine pain of biomechanical origin of > 2 on an 11-point ordinal pain scale. OUTCOME MEASURES: The primary outcome measure was severity of morning and evening neck pain. The secondary outcome measure was daily quantity of analgesics ingested. The data were analyzed descriptively and inferentially for clinically and statistically significant pre/post intervention differences. METHODS: Eligible subjects who successfully finished a 2-wk baseline data-gathering period by mailing in two properly completed diaries each received a pillow and four more diaries (to be filled in over the subsequent 4 wk). Three repeated-measures analyses of variance were performed using the Bonferroni-corrected level of statistical significance of 0.03. Ninety-five percent confidence intervals (for paired-samples mean differences) were also calculated for those pre/post differences that seemed descriptively clinically important. RESULTS: The clinically and statistically significant reductions in neck/shoulder pain severity in this sample of chronic neck pain subjects suggest that the ARCP is an effective therapy for target populations with the same profile as this sample. Patient characteristics predicting suitability were not studied in this project. CONCLUSION: The results suggest that the ARCP has clinically important beneficial effects on the neck pain severity of most chronic neck-pain sufferers. Further randomized clinical trial research comparing the ARCP with other commonly used cervical pillows is recommended.

The everyday experience of psychiatric hospitalization: the users' viewpoint.

Using 38 focussed accounts the author reports on the hospitalization experiences of patients 18 to 38 years old in the psychiatric ward. The sample comes from the psychiatric wards of two general hospitals in the Montréal area (Canada). The data were analyzed using a qualitative method. Empirical categories were inferred from the respondents' discourse based on the broad themes which make up the psychiatric experience: admission; hospital environment and rules; daily life; medication; relations with the staff and leaving the hospital. The results shed light on the suffering, dissatisfaction and ambivalent feelings surrounding the patients' hospital experience. Based on the experience of psychiatric patients, the author identified five processes at work during psychiatric hospitalization.

[" Is it possible to offer innovative services in psychiatry ? The case Jean-Talon "]. / «Est-ce possible d'offrir des services innovateurs en psychiatrie? Le cas Jean-Talon¼

The authors describe their experience at the Jean-Talon Hospital. In 1975 a department of psychiatry was created according to a new model. After describing the vicissitudes of the project, the achievements and failures, the authors analyse the reasons for the failure. There are several reasons : the medical and administrative powers who refuse change, and the members of the team who do not feel prepared to assume the power.

[Solidarity-Psychiatry inc.]. / Solidarité-Psychiatrie Inc.

The authors, after explaining what it is to suffer a depression and the consequences involved, then follow with a criticism of the psychiatric institution. They describe their project : <> inspired by D. W. Winnicott's experience and M. Mannoni's concept of institution. The aim of this project is to provide a meeting place for people concerned with the reality of mental illness where they would reflect on different aspects of mental illness and learn how to read to its manifestations in everyday life. The project became operational in April 1979, since then more than 110 persons have benefited from it. They have weekly meetings, ongoing activities such as a theatrical play, regular discussions on various themes; three committees have been formed 1) a committee for a theatrical workshop; 2) a committee of reflexion; 3) a committee to deal with emergencies. They are also working on the procedures necessary for the request of a chart.