Attention control groups strengthen randomized controlled trials of behavioral interventions, but researchers need to give careful consideration to the attention control activities. A comparative effectiveness research framework provides an ideal opportunity for an attention control group as a supplement to standard care, so participants potentially receive benefit regardless of group assignment. The anticipated benefit of the control condition must be independent of the study outcome. Resources needed for attention control activities need to be carefully considered and ethical considerations carefully weighed. In this paper we address nine considerations for the design and implementation of attention control groups: (1) ensure attention control activities are not associated with the outcome; (2) avoid contamination of the intervention or control group; (3) design comparable control and intervention activities; (4) ensure researcher training to adequately administer both treatment arms; (5) design control activities to be interesting and acceptable to participants; (6) evaluate attention control activities; (7) consider additional resources needed to implement attention control activities; (8) quantifying the effects of attention control and intervention groups; and (9) ethical considerations with attention control groups. Examples from the literature and ongoing research are presented. Careful planning for the attention control group is as important as for the intervention group. Researchers can use the considerations presented here to assist in planning for the best attention control group for their study.

Mutations in the voltage-gated sodium channel gene SCN1A are responsible for a number of epilepsy disorders, including genetic epilepsy with febrile seizures plus (GEFS+) and Dravet syndrome. In addition, dysfunction in SCN1A is increasingly being linked to neuropsychiatric abnormalities, social deficits and cognitive disabilities. We have previously reported that mice heterozygous for the SCN1A R1648H mutation identified in a GEFS+ family have infrequent spontaneous seizures, increased susceptibility to chemically and hyperthermia-induced generalized seizures and sleep abnormalities. In this study, we characterized the behavior of heterozygous mice expressing the SCN1A R1648H mutation (Scn1a(RH/+)) and the effect of stress on spontaneous and induced seizures. We also examined the effect of the R1648H mutation on the hypothalamic-pituitary-adrenal (HPA) axis response. We confirmed our previous finding that Scn1a(RH/+) mutants are hyperactive, and also identified deficits in social behavior, spatial memory, cued fear conditioning, pre-pulse inhibition and risk assessment. Furthermore, while exposure to a stressor did increase seizure susceptibility, the effect seen in the Scn1a(RH/+) mutants was similar to that seen in wild-type littermates. In addition, Scn1a dysfunction does not appear to alter HPA axis function in adult animals. Our results suggest that the behavioral abnormalities associated with Scn1a dysfunction encompass a wider range of phenotypes than previously reported and factors such as stress exposure may alter disease severity in patients with SCN1A mutations.

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Rest is a concept that is used frequently in the discipline of nursing but also in various other disciplines. Rest is a basic necessity for restorative sleep to enhance well-being through the restoration of the body, mind and spirit. Defining the concept of rest in the practice of patient care is necessary for consistent use of the term in the development of holistic, patient-centred therapies.

This article synthesises the current literature regarding the effects of omega 3 polyunsaturated fatty acids (omega 3 PUFAs) in various neurological disorders and suggests implications for nursing practice. Omega 3 PUFAs are essential fatty acids and are crucial in cell functioning. Docosahexaenoic acid is a particularly important omega 3 PUFA that modulates the lipid bilayer of neuronal cell membranes, reduces inflammation and synthesises neuroprotectin D1, which has anti-apoptotic properties (preventing cell death). Omega 3 PUFAs are reported to have neuroprotective properties in Alzheimer's disease, ischaemia, epilepsy and attention-deficit hyperactivity disorder. Because humans are not able to synthesise omega 3 PUFAs, the body's supply comes from consumption. Nursing practice should include assessment for risks of neurological disorders as well as education regarding omega 3 PUFA intake. Knowledge of omega 3 PUFAs allows the nurse to educate patients thoroughly and accurately regarding the importance of these supplements.