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  • #46
    Psychological and behavioral differences between low back pain populations: a comparative analysis of chiropractic, primary and secondary care patients

    http://www.biomedcentral.com/1471-2474/16/306

    Abstract
    Background
    Psychological, behavioral and social factors have long been considered important in the development of persistent pain. Little is known about how chiropractic low back pain (LBP) patients compare to other LBP patients in terms of psychological/behavioral characteristics.

    Methods
    In this cross-sectional study, the aim was to investigate patients with LBP as regards to psychosocial/behavioral characteristics by describing a chiropractic primary care population and comparing this sample to three other populations using the MPI-S instrument. Thus, four different samples were compared. A: Four hundred eighty subjects from chiropractic primary care clinics. B: One hundred twenty-eight subjects from a gainfully employed population (sick listed with high risk of developing chronicity). C: Two hundred seventy-three subjects from a secondary care rehabilitation clinic. D: Two hundred thirty-five subjects from secondary care clinics. The Swedish version of the Multidimensional Pain Inventory (MPI-S) was used to collect data. Subjects were classified using a cluster analytic strategy into three pre-defined subgroups (named adaptive copers, dysfunctional and interpersonally distressed).

    Results
    The data show statistically significant overall differences across samples for the subgroups based on psychological and behavioral characteristics. The cluster classifications placed (in terms of the proportions of the adaptive copers and dysfunctional subgroups) sample A between B and the two secondary care samples C and D.

    Conclusions
    The chiropractic primary care sample was more affected by pain and worse off with regards to psychological and behavioral characteristics compared to the other primary care sample. Based on our findings from the MPI-S instrument the 4 samples may be considered statistically and clinically different.
    As an osteopath, I see chiropractic patients when for some reason they can't get in with their chiro. I find that they as a group, are more difficult to persuade that by and large their body will look after itself if given good food, rest and appropriate levels of activity. It does not require a team of technicians to keep it in good working order.
    Jo Bowyer
    Chartered Physiotherapist Registered Osteopath.
    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

    Comment


    • #47
      Depression-like episodes in mice harboring mtDNA deletions in paraventricular thalamus

      http://www.nature.com/mp/journal/vao...p2015156a.html

      Abstract
      Depression is a common debilitating human disease whose etiology has defied decades of research. A critical bottleneck is the difficulty in modeling depressive episodes in animals. Here, we show that a transgenic mouse with chronic forebrain expression of a dominant negative mutant of Polg1, a mitochondrial DNA (mtDNA) polymerase, exhibits lethargic behavioral changes, which are associated with emotional, vegetative and psychomotor disturbances, and response to antidepression drug treatment. The results suggested a symptomatic similarity between the lethargic behavioral change that was recurrently and spontaneously experienced by the mutant mice and major depressive episode as defined by DSM-5. A comprehensive screen of mutant brain revealed a hotspot for mtDNA deletions and mitochondrial dysfunction in the paraventricular thalamic nucleus (PVT) with similar defects observed in postmortem brains of patients with mitochondrial disease with mood symptoms. Remarkably, the genetic inhibition of PVT synaptic output by Cre-loxP-dependent expression of tetanus toxin triggered de novo depression-like episodes. These findings identify a novel preclinical mouse model and brain area for major depressive episodes with mitochondrial dysfunction as its cellular mechanism
      Jo Bowyer
      Chartered Physiotherapist Registered Osteopath.
      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

      Comment


      • #48
        Associations of Dispositional Mindfulness with Obesity and Central Adiposity: the New England Family Study

        http://www.sciencedaily.com/releases...1020140944.htm

        Abstract
        Purpose
        To evaluate whether dispositional mindfulness (defined as the ability to attend nonjudgmentally to one’s own physical and mental processes) is associated with obesity and central adiposity.
        Methods
        Study participants (n = 394) were from the New England Family Study, a prospective birth cohort, with median age 47 years. Dispositional mindfulness was assessed using the Mindful Attention Awareness Scale (MAAS). Central adiposity was assessed using dual-energy X-ray absorptiometry (DXA) scans with primary outcomes android fat mass and android/gynoid ratio. Obesity was defined as body mass index ≥30 kg/m2.
        Results
        Multivariable-adjusted regression analyses demonstrated that participants with low vs. high MAAS scores were more likely to be obese (prevalence ratio for obesity = 1.34 (95 % confidence limit (CL): 1.02, 1.77)), adjusted for age, gender, race/ethnicity, birth weight, childhood socioeconomic status, and childhood intelligence. Furthermore, participants with low vs. high MAAS level had a 448 (95 % CL 39, 857) g higher android fat mass and a 0.056 (95 % CL 0.003, 0.110) greater android/gynoid fat mass ratio. Prospective analyses demonstrated that participants who were not obese in childhood and became obese in adulthood (n = 154) had −0.21 (95 % CL −0.41, −0.01; p = 0.04) lower MAAS scores than participants who were not obese in childhood or adulthood (n = 203).
        Conclusions
        Dispositional mindfulness may be inversely associated with obesity and adiposity. Replication studies are needed to adequately establish whether low dispositional mindfulness is a risk factor for obesity and adiposity.
        Jo Bowyer
        Chartered Physiotherapist Registered Osteopath.
        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

        Comment


        • #49
          Musculoskeletal Symptoms and Risk of Burnout in Child Care Workers — A Cross-Sectional Study

          http://journals.plos.org/plosone/art...l.pone.0140980

          Abstract

          Objectives

          German child care workers' job satisfaction is influenced by the consequences of unfavourable underlying conditions. Child care workers tend to suffer from psychosocial stress, as they feel that their work is undervalued. The objective of the present study is to investigate how the psychosocial factors of the effort-reward imbalance (ERI) model influence musculoskeletal symptoms (MS) and the risk of burnout. To our knowledge this is the first study investigating the association between the factors of the ERI model and MS in child care workers.

          Methods and Findings

          Data from 199 child care workers were examined in a cross-sectional study. Psychosocial factors were recorded with the ERI questionnaire. MS was recorded with the Nordic Questionnaire and risk of burnout with the Personal Burnout scale of the Copenhagen Burnout Inventory. Multivariate analysis was performed using linear and logistic regression models. The response rate was 57%. In most of the sample (65%), an effort-reward imbalance was observed. 56% of the child care workers were at risk of burnout and 58% reported MS. Factors associated with risk of burnout were subjective noise exposure (OR: 4.4, 95%CI: 1.55–12.29) and overcommitment (OR: 3.4; 95%CI: 1.46–7.75). There were statistically significant associations between MS and overcommitment (low back pain—OR: 2.2, 95%CI: 1.04–4.51), low control (overall MS OR: 3.8; 95%CI: 1.68–3.37) and risk of burnout (overall MS OR: 2.3, 95%CI: 1.01–5.28). For ERI no statistically significant associations were found with reference to risk of burnout or MS.

          Conclusion

          Overcommitment in child care workers is related to MS and risk of burnout. There is also evidence that low control is associated with MS and subjective noise exposure with risk of burnout. Effort-reward imbalance is not related to either outcome. This occupational health risk assessment identifies changeable working factors in different types of facilities.
          Jo Bowyer
          Chartered Physiotherapist Registered Osteopath.
          "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

          Comment


          • #50
            Embodied cognition is not what you think it is

            http://journal.frontiersin.org/artic...013.00058/full

            The most exciting hypothesis in cognitive science right now is the theory that cognition is embodied. Like all good ideas in cognitive science, however, embodiment immediately came to mean six different things. The most common definitions involve the straight-forward claim that “states of the body modify states of the mind.” However, the implications of embodiment are actually much more radical than this. If cognition can span the brain, body, and the environment, then the “states of mind” of disembodied cognitive science won’t exist to be modified. Cognition will instead be an extended system assembled from a broad array of resources. Taking embodiment seriously therefore requires both new methods and theory. Here we outline four key steps that research programs should follow in order to fully engage with the implications of embodiment. The first step is to conduct a task analysis, which characterizes from a first person perspective the specific task that a perceiving-acting cognitive agent is faced with. The second step is to identify the task-relevant resources the agent has access to in order to solve the task. These resources can span brain, body, and environment. The third step is to identify how the agent can assemble these resources into a system capable of solving the problem at hand. The last step is to test the agent’s performance to confirm that agent is actually using the solution identified in step 3. We explore these steps in more detail with reference to two useful examples (the outfielder problem and the A-not-B error), and introduce how to apply this analysis to the thorny question of language use. Embodied cognition is more than we think it is, and we have the tools we need to realize its full potential.



            Enactive Approach and Dual-Tasks for the Treatment of Severe Behavioral and Cognitive Impairment in a Person with Acquired Brain Injury: A Case Study

            http://journal.frontiersin.org/artic...016.01712/full

            One of the most important sequela in persons who suffer from acquired brain injury is a behavioral disorder. To date, the primary approaches for the rehabilitation of this sequela are Applied Behavior Analysis, Cognitive-Behavior Therapy, and Comprehensive-Holistic Rehabilitation Programs. Despite this theoretical plurality, none of these approaches focuses on rehabilitating behavioral disorders considering the relation between affordance and environmental adaptation. To introduce this therapeutic view to neurorehabilitation, we apply the theoretical tenets of the enactive paradigm to the rehabilitation of a woman with severe behavioral and cognitive impairment. Over seventeen sessions, her behavioral and cognitive performance was assessed in relation to two seated affordances (seated on a chair and seated on a ball 65 cm in diameter) and the environmental adaptation while she was working on various cognitive tasks. These two seated affordances allowed to incorporate the theoretical assumptions of the enactive approach and to know how the behavior and the cognition were modified based on these two postural settings and the environmental adaptation. The findings indicate that the subject exhibited better behavioral (physical and verbal) and cognitive (matching success and complex task) performances when the woman worked on the therapeutic ball than when the woman was on the chair. The enactive paradigm applied in neurorehabilitation introduces a level of treatment that precedes behavior and cognition. This theoretical consideration allowed the discovery of a better relation between a seated affordance and the environmental adaptation for the improvement behavioral and cognitive performance in our case study.
            Update 12/07/2017
            Last edited by Jo Bowyer; 12-07-2017, 09:55 AM.
            Jo Bowyer
            Chartered Physiotherapist Registered Osteopath.
            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

            Comment


            • #51
              Who Mothers Mommy? Factors That Contribute to Mothers’ Well-Being.

              http://psycnet.apa.org/?&fa=main.doi...037/dev0000051

              Developmental science is replete with studies on the impact of mothers on their children, but little is known about what might best help caregivers to function well themselves. In an initial effort to address this gap, we conducted an Internet-based study of over 2,000 mostly well-educated mothers, seeking to illuminate salient risk and protective processes associated with their personal well-being. When women’s feelings in the parenting role were considered along with dimensions of personal support as predictors, the latter set explained at least as much variance—and often much more—across dimensions of mothers’ personal well-being. Within the latter set of personal support predictors, findings showed that 4 had particularly robust links with mothers’ personal adjustment: their feeling unconditionally loved, feeling comforted when in distress, authenticity in relationships, and satisfaction with friendships. Partner satisfaction had some associations with personal adjustment outcomes, but being married in itself had negligible effects. Findings are discussed in terms of implications for future research, and for interventions aimed at fostering resilience among mothers facing high level of stress in their role as parents. (PsycINFO Database Record (c) 2015 APA, all rights reserved)
              Jo Bowyer
              Chartered Physiotherapist Registered Osteopath.
              "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

              Comment


              • #52
                The enduring effects of depressive thoughts on working memory

                http://www.jad-journal.com/article/S...154-3/abstract

                Abstract
                Background
                Depressive thoughts are known to persist in persons with depressed mood leading to rumination and exacerbation of depressive symptoms. What has not yet been examined is whether this persistence of depressive thoughts can lead to impairment of working memory (WM).

                Methods
                We assessed whether receiving a WM task featuring depressive cues could bias performance on a subsequent, non-depressive WM task for dysphoric individuals (DIs) compared to non-DIs.

                Results
                DIs showed significantly attenuated performance on the WM task with depressive cues compared to non-DIs. Further, when DIs were given the WM task with depressive cues first, they showed deficits on a second WM task without depressive cues, compared to DIs given the non-depressive WM task first and non-DIs in either condition.

                Limitations
                Unselected recruitment procedures did not permit balanced sample sizes in each group. Future research is needed to assess whether these results extend to a clinically depressed sample and whether WM deficits are the consequence of depressed mood, or a risk factor for the development and maintenance of depressed mood.

                Conclusions
                Results suggest that, for DIs, the influence of depressive cues on performance transfers to subsequent tasks in which these cues are no longer present. These results support the hypothesis that when depressive thoughts are part of depressed persons’ conscious experience, cognitive deficits arise. Further, these results suggest an ecologically-relevant mechanism by which day-to-day cognitive deficits in depression can develop.
                Depression, anxiety, rumination and perseverating thoughts can all present in complex pain patients. Active listening during consultation and dialogue during and after,via email, may help to unclog the stream. What I can see of the minds of some of my chronically ill and injured patients sometimes reminds me of a watercourse obstructed by vegetation and discarded supermarket trollies. Writing emails may help to marshall their thoughts and boost working memory.
                Last edited by Jo Bowyer; 04-11-2015, 12:20 PM.
                Jo Bowyer
                Chartered Physiotherapist Registered Osteopath.
                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                Comment


                • #53
                  Outcomes One and Two Winters Following Cognitive-Behavioral Therapy or Light Therapy for Seasonal Affective Disorder

                  http://ajp.psychiatryonline.org/doi/....2015.15060773

                  Abstract
                  Objective:
                  The central public health challenge for winter seasonal affective disorder (SAD) is recurrence prevention. Preliminary studies suggest better long-term outcomes following cognitive-behavioral therapy tailored for SAD (CBT-SAD) than light therapy. The present study is a large, randomized head-to-head comparison of these treatments on outcomes one and two winters after acute treatment.

                  Method:
                  Community adults with major depression, recurrent with seasonal pattern (N=177) were followed one and two winters after a randomized trial of 6 weeks of CBT-SAD (N=88) or light therapy (N=89). Prospective follow-up visits occurred in January or February of each year, and major depression status was assessed by telephone in October and December of the first year. The primary outcome was winter depression recurrence status on the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version (SIGH-SAD). Other outcomes were depression severity on the SIGH-SAD and the Beck Depression Inventory-Second Edition (BDI-II), remission status based on severity cutoff scores, and major depression status from tracking calls.

                  Results:
                  The treatments did not differ on any outcome during the first year of follow-up. At the second winter, CBT-SAD was associated with a smaller proportion of SIGH-SAD recurrences (27.3% compared with 45.6%), less severe symptoms on both measures, and a larger proportion of remissions defined as a BDI-II score ≤8 (68.3% compared with 44.5%) compared with light therapy. Nonrecurrence at the next winter was more highly associated with nonrecurrence at the second winter among CBT-SAD participants (relative risk=5.12) compared with light therapy participants (relative risk=1.92).

                  Conclusions:
                  CBT-SAD was superior to light therapy two winters following acute treatment, suggesting greater durability for CBT-SAD.
                  Jo Bowyer
                  Chartered Physiotherapist Registered Osteopath.
                  "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                  Comment


                  • #54
                    Neuroanatomical Correlates of Theory of Mind Deficit in Parkinson’s Disease: A Multimodal Imaging Study

                    http://journals.plos.org/plosone/art...l.pone.0142234

                    Abstract

                    Background

                    Parkinson’s disease (PD) patients show theory of mind (ToM) deficit since the early stages of the disease, and this deficit has been associated with working memory, executive functions and quality of life impairment. To date, neuroanatomical correlates of ToM have not been assessed with magnetic resonance imaging in PD. The main objective of this study was to assess cerebral correlates of ToM deficit in PD. The second objective was to explore the relationships between ToM, working memory and executive functions, and to analyse the neural correlates of ToM, controlling for both working memory and executive functions.

                    Methods

                    Thirty-seven PD patients (Hoehn and Yahr median = 2.0) and 15 healthy controls underwent a neuropsychological assessment and magnetic resonance images in a 3T-scanner were acquired. T1-weighted images were analysed with voxel-based morphometry, and white matter integrity and diffusivity measures were obtained from diffusion weighted images and analysed using tract-based spatial statistics.

                    Results

                    PD patients showed impairments in ToM, working memory and executive functions; grey matter loss and white matter reduction compared to healthy controls. Grey matter volume decrease in the precentral and postcentral gyrus, middle and inferior frontal gyrus correlated with ToM deficit in PD. White matter in the superior longitudinal fasciculus (adjacent to the parietal lobe) and white matter adjacent to the frontal lobe correlated with ToM impairment in PD. After controlling for executive functions, the relationship between ToM deficit and white matter remained significant for white matter areas adjacent to the precuneus and the parietal lobe.

                    Conclusions

                    Findings reinforce the existence of ToM impairment from the early Hoehn and Yahr stages in PD, and the findings suggest associations with white matter and grey matter volume decrease. This study contributes to better understand ToM deficit and its neural correlates in PD, which is a basic skill for development of healthy social relationships.
                    Jo Bowyer
                    Chartered Physiotherapist Registered Osteopath.
                    "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                    Comment


                    • #55
                      Is cognitive-behavioural therapy useful for neck pain?

                      http://www.bodyinmind.org/cbt-and-neck-pain/

                      Neck pain is common and has become an important cause of work absenteeism and disability. One suggested intervention when symptoms persist and cause disruption to daily life is cognitive-behavioural therapy.

                      Cognitive-behavioural therapy is a psychological technique that includes cognitive and behavioural modifications of specific activities to reduce the impact of pain as well as physical and psychosocial disability and to overcome perceived barriers to physical and psychosocial recovery. It is increasingly used in subjects with low back pain, but there remains uncertainty about its efficacy when neck complaints are addressed.
                      We concluded that more high quality randomised trials are still needed to address short and long term benefits of cognitive-behavioural therapy in subacute and chronic neck pain, and its effectiveness compared with other treatments, as well as to better understand which patients (for example, those suffering from whiplash injuries) may benefit most from this type of intervention. Also, it would be of interest to identify which psychological factors (e.g. fear of movement, catastrophising, anxiety, depression, …) might have the strongest influence on a patients’ experience of neck pain and which of these factors can be utilised as appropriate outcome measures. More specifically targeted interventions which might have the potential to achieve stronger treatment effects and the involvement of clinical psychologists and health professionals specifically trained in cognitive-behavioural therapy should be also promoted.
                      I am flagging this up because I used to have my practice in a centre which specialised in the talking therapies.

                      Where there were psychosocial comorbidities, I found that highly stressed complex pain patients did better when they were having CBT or other forms of talking therapy. Several of these individuals were having problems with work and home life and some thought that the fact that they were having intrusive thoughts had made them more accident/injury prone in the first place.

                      I didn't suggest it if I was the first contact, but several asked having seen practitioner leaflets available in reception. Some chose therapies other than CBT.
                      Jo Bowyer
                      Chartered Physiotherapist Registered Osteopath.
                      "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                      Comment


                      • #56
                        Now it is loneliness who comes at night

                        http://noijam.com/2015/11/12/now-it-...omes-at-night/

                        If loneliness is a DIM (of course it is), then Vonnegut’s “most daring thing” suggests a powerful role for Society* in the ‘treatment’ of both loneliness and pain. But there are strategies that can be developed in the clinic too – just identifying loneliness as a DIM could be a start, and clinicians can help patients find greater quality in relationships, or recognise the need to do so and refer on, depending on their particular expertise.

                        One final thought – how many patients have found a ‘solution’ to their loneliness in a clinician? What moral and ethical issues might this raise?
                        My italics
                        Jo Bowyer
                        Chartered Physiotherapist Registered Osteopath.
                        "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                        Comment


                        • #57
                          And how many therapists find a solution to their loneliness in their job?

                          My mother was a social worker most of her life. Her life story is worse than any clichéburdened paperback could ever be (she used to say so herself, referring to a Swedish bestselling author that you probably never heard of, Sigge Stark)

                          Any way, her example, as well as watching my aunt (my fathers sister) and my younger sister - who are physiotherapists just like me - (and a whole other bunch of people I know, all working in some helping profession) have made me wary of those tendencies in myself.

                          So here I am, NOT working as a therapist, wondering what to do next.
                          Maybe I am sharpening my ability to put my thoughts into words and evoke response in the reader, by reading and writing in this forum. What is this, other than avoidance of loneliness?


                          Sent from my iPad using Tapatalk. Welcome to www.sekito.se :-)

                          Comment


                          • #58
                            A Psychological Exploration of Engagement in Geek Culture

                            http://journals.plos.org/plosone/art...l.pone.0142200

                            Abstract

                            Geek culture is a subculture of enthusiasts that is traditionally associated with obscure media (Japanese animation, science fiction, video games, etc.). However, geek culture is becoming increasingly mainstream; for example, in the past year alone, Dragon*Con, a major Geek convention in Atlanta, Georgia, attracted an attendance of over 57,000 members. The present article uses an individual differences approach to examine three theoretical accounts of geek culture. Seven studies (N = 2354) develop the Geek Culture Engagement Scale (GCES) to quantify geek engagement and assess its relationships to theoretically relevant personality and individual differences variables. These studies present evidence that individuals may engage in geek culture in order to maintain narcissistic self-views (the great fantasy migration hypothesis), to fulfill belongingness needs (the belongingness hypothesis), and to satisfy needs for creative expression (the need for engagement hypothesis). Geek engagement is found to be associated with elevated grandiose narcissism, extraversion, openness to experience, depression, and subjective well-being across multiple samples. These data lay the groundwork for further exploration of geek culture as well as provide a foundation for examining other forms of subculture participation.
                            I have found this group particularly difficult to engage with anything pertaining to movement and rehab in the real world post puberty, unless the presenting condition interferes with their ability to interface with the world they inhabit.
                            Jo Bowyer
                            Chartered Physiotherapist Registered Osteopath.
                            "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                            Comment


                            • #59
                              Isn't that always the problem, though - how to engage / provide meaning and context to different individuals?
                              Dan
                              Tactile Raconteur

                              Comment


                              • #60
                                Originally posted by Dan84 View Post
                                Isn't that always the problem, though - how to engage / provide meaning and context to different individuals?
                                I'm hoping that watching Studio Ghibli might get me a foot in the door. Apprentice geeks at lower and middle school will sometimes give me a run down of whatever floats their boat, but once testosterone kicks in, all I'm getting is the occasional grunt.
                                Jo Bowyer
                                Chartered Physiotherapist Registered Osteopath.
                                "Out beyond ideas of wrongdoing and rightdoing,there is a field. I'll meet you there." Rumi

                                Comment

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