Predicting the Significance of Necessity

With Necessary Condition Analysis (NCA), a necessity effect is estimated by calculating the amount of empty space in the upper-left corner in a plot with a predictor X and an outcome Y, and recently a method for testing the statistical significance of the necessity effect through permutation has been proposed. In the present simulation study, this method was found to give significant results already with a very weak true population necessity effect, i.e., exhibit high power, unless the sample size is very small. However, in some situations the significance of the necessity effect tends to increase with increased degree of sufficiency, which is paradoxical for a method whose objective is to find necessary but not sufficient conditions

Internet-delivered cognitive behavior therapy for adolescents with irritable bowel syndrome : a randomized controlled trial

OBJECTIVES: Few treatments have been able to effectively manage pediatric irritable bowel syndrome (IBS). Internet-delivered cognitive behavior therapy (Internet-CBT) based on exposure for abdominal symptoms is effective for adult IBS. The objective of this study was to evaluate the efficacy of Internet-CBT based on behavioral exposure for adolescents with IBS. METHODS: Adolescents with IBS fulfilling the Rome III criteria were randomized to either Internet-CBT or a wait-list control. The Internet-CBT was a 10-week intervention where the main component was exposure to IBS symptoms by reduction of avoidance of abdominal symptoms and instead stepwise provocation of symptoms. The primary outcome was total score on Gastrointestinal Symptoms Rating Scale for IBS (GSRS-IBS). Secondary outcomes included adolescent- and parent-rated quality of life and parent-rated gastrointestinal symptoms. Difference between groups was assessed from pretreatment to posttreatment and the Internet-CBT group was also evaluated at 6 months after treatment completion. RESULTS: A total of 101 adolescents with IBS (13-17 years of age) were included in this study. Dropout rates were low (6%) and all randomized patients were included in intent-to-treat analyses based on mixed effects models. Analyses showed a significant larger pretreatment to posttreatment change on the primary outcome GSRS-IBS (B=-6.42, P=0.006, effect size Cohen's d=0.45, 95% confidence interval (0.12, 0.77)) and on almost all secondary outcomes for the Internet-CBT group compared with the control group. After 6 months, the results were stable or significantly improved. CONCLUSIONS: Internet-CBT based on exposure exercises for adolescents with IBS can effectively improve gastrointestinal symptoms and quality of life.Jane and Dan Olsson foundation, 4-1559/2013Kempe-Carlgrenska foundationRuth and Richard Julin foundation, 2012Juli0048Ishizu Matsumurais DonationMajblomman foundationBengt Ihre research fellowshipBengt Ihre foundation, SLS-331861The Samariten foundationThe Swedish society of medicine, SLS-331681, SLS-410501VärkstadststiftelsenGadelius foundationSwedish Research Council, 521-2013-2846Regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, 20130129Accepte

HRV Biofeedback in Neck Pain Effects of Heart Rate Variability Biofeedback in Subjects with Stress-related Chronic Neck Pain: a Pilot study

Abstract Recent studies focusing on autonomic nervous system (ANS) dysfunctions, together with theoretical pathophysiological models of musculoskeletal disorders, indicate the involvement of ANS regulation in development and maintenance of chronic muscle pain. Research has demonstrated the effectiveness of heart rate variability (HRV) biofeedback (BF) in increasing HRV and reducing the symptoms of different disorders characterized by ANS aberration. The study investigated the effects of resonance frequency HRV BF on autonomic regulation and perceived health, pain, stress and disability in 24 subjects with stress-related chronic neckshoulder pain. Twelve subjects participated in 10 weekly sessions of resonant HRV BF and were compared to a control group. Subjective reports and HRV measures during relaxation and in response to a standardized stress protocol were assessed for both groups pre-and postintervention. Group X time interactions revealed a significantly stronger increase over time in perceived health (SF-36) for the treatment group, including vitality, bodily pain and social functioning. Interactions were also seen for HRV during relaxation and reactivity to stress. The present pilot study indicates improvement in perceived health over a 10 week intervention with HRV-biofeedback in subjects with chronic neck-pain. Increased resting HRV as well as enhanced reactivity to hand grip and cold pressor tests might reflect beneficial effects on ANS regulation, and suggest that this intervention protocol is suitable for a larger controlled trial

Psychosocial functioning and intelligence both partly explain socioeconomic inequalities in premature death. A population-based male cohort study

The possible contributions of psychosocial functioning and intelligence differences to socioeconomic status (SES)-related inequalities in premature death were investigated. None of the previous studies focusing on inequalities in mortality has included measures of both psychosocial functioning and intelligence.The study was based on a cohort of 49 321 men born 1949-1951 from the general community in Sweden. Data on psychosocial functioning and intelligence from military conscription at ∼18 years of age were linked with register data on education, occupational class, and income at 35-39 years of age. Psychosocial functioning was rated by psychologists as a summary measure of differences in level of activity, power of initiative, independence, and emotional stability. Intelligence was measured through a multidimensional test. Causes of death between 40 and 57 years of age were followed in registers.The estimated inequalities in all-cause mortality by education and occupational class were attenuated with 32% (95% confidence interval: 20-45%) and 41% (29-52%) after adjustments for individual psychological differences; both psychosocial functioning and intelligence contributed to account for the inequalities. The inequalities in cardiovascular and injury mortality were attenuated by as much as 51% (24-76%) and 52% (35-68%) after the same adjustments, and the inequalities in alcohol-related mortality were attenuated by up to 33% (8-59%). Less of the inequalities were accounted for when those were measured by level of income, with which intelligence had a weaker correlation. The small SES-related inequalities in cancer mortality were not attenuated by adjustment for intelligence.Differences in psychosocial functioning and intelligence might both contribute to the explanation of observed SES-related inequalities in premature death, but the magnitude of their contributions likely varies with measure of socioeconomic status and cause of death. Both psychosocial functioning and intelligence should be considered in future studies

Dietary Education Provision Within a Cardiac Rehabilitation Programme in the UK: A Pilot Study Evaluating Nutritional Intakes Alongside Physical Activity Levels

Background/aims: The primary aim of this study was to evaluate the effectiveness of two 30-minute dietary education sessions, within cardiac rehabilitation (CR), as a means to optimise nutrient and energy intakes (EI). A secondary aim was to evaluate patients’ habitual physical activity (PA) levels. Methods: Thirty patients (males: n = 24, 61.8 ± 11.2 years; females: n = 6, 66.7 ± 8.5 years) attended a six-week early outpatient CR programme in the UK and received two 30-minute dietary education sessions emphasising Mediterranean diet principles. EI and nutrient intakes were measured through completion of three-day food diaries in weeks one and six (before and after the dietary education sessions) to assess the impact of these sessions on nutrient intakes. At the same time-points, a sub-group (n = 13) of patients had their PA levels assessed via accelerometery to assess the impact of the CR programme on PA. Findings: Estimated energy requirements (EER) at week one (1988 ± 366 kcal . d -1 ) were not matched by actual EI (1785 ± 561 kcal . d -1 ) ( P = 0.047, d = -0.36). EI reduced to 1655 ± 470 kcal . d -1 at week six ( P = 0.66, d = -0.33) whereas EER increased as a function of increased activity (CR sessions). Nutrient intakes remained suboptimal, while no significant increases were observed in healthy fats and fibre, which consist core elements of a Mediterranean diet. Statistically significant increases were not observed in PA however patients decreased sedentary time by 11 ± 12% in week six compared to week one ( P = 0.009; d = -0.54). Conclusion : The present study findings suggest that two 30-minute dietary education sessions did not positively influence EI and nutrient intakes, while habitual PA levels were not significantly increased as a result of the CR programme. Future research should explore means of optimising nutrition and habitual PA within UK CR

Experimentell och epidemiologisk - relationen psykosocial exponering, stress, psykisk

In this literature overview is analyzed experimental studies, field studies, cross-sections' - and longitudinella studies of epidemiologic nature concerning the relationship psychosocial exposure, psychic load and muscle activity and pain in neck and shoulder with special focus on the Trapeziusmuscle. It is established within experimental oriented research that induced psychic load can lead to increased muscle activity obtained with use of either surface - intramuscular electromyografic technology (yEMG respective iEMG) in Trapezius. If the muscle activity already is high as a result of physically generated load so does not the psychic load contribute with further measurable muscle activity. Trapezius seems to last a part in, at least sometimes and in certain situations, our stressing mobilisation. We seem to therefore to use this muscle without that it at all is physically motivated. Compared with the spine's other muscles, is established that it is evolution pea reasonable, but that only limited research support the finding of the relative unique reaction pattern in the Trapezius muscle in regard to psychic load. Concurrent that it stands clear that stress can result in increased muscle activity it is unclear in the literature if induced muscle activity can trigger or maintain pain in Trapezius. Some mechanism oriented models are presented generally. It is in the future important to study what consequences an increased but still low and long lasting muscle activity can have in the development of pain. The need of continued discussion concerning epidemiologic research within the area is emphasized and a starched focus on experimental research in order to understand mechanisms is to be considered

Spurious prospective effects between work experiences and self-esteem: A reanalysis of a meta-analysis of longitudinal studies

A recent meta-analysis found reciprocal prospective effects between self-esteem and some aspects of work experience, e.g. job satisfaction, and the authors concluded that their findings were consistent with a causal model, where self-esteem affects, and is affected by, work experiences. However, the prospective effects were estimated while adjusting for a prior measure of the outcome variable, and it is known that such adjusted cross-lagged effects may be spurious due to correlations with residuals and regression to the mean. The present reanalyses of the same meta-analytic data found all prospective effects between self-esteem and work experiences to be spurious. It is important for researchers to be aware of the limitations of adjusted cross-lagged effects in order not to overinterpret findings

Inconclusive evidence for within-individual increasing effects of income on self-esteem: A reanalysis and comment on Bleidorn et al. (2023)

In a recent study, researchers analyzed data from the Dutch Longitudinal Internet Studies for the Social Sciences (LISS, N > 4,000) with a random-intercept cross-lagged panel model (RI-CLPM) and concluded that increases in self-esteem are a function of previous increases in income. However, our analyses of person-mean centered scores in the same sample revealed no within-individual increasing effects. Consequently, it appears premature to assume a within-individual increasing effect of income on self-esteem. It is important for researchers to be cognizant of potential bias in RI-CLPM and we advocate validation of identified effects through analyses of person-mean centered scores