Recovery from Chronic Musculoskeletal Pain with Psychodynamic Consultation and Brief Intervention: A Report of Three Illustrative Cases

Most physicians are unaware of the potential for complete remission from chronic musculoskeletal pain through a purely psychological approach. We report three cases in which various types of chronic musculoskeletal pain were successfully treated using a small-group psychological workshop combined with a single consultative session.Case report.Hospital-based clinic; retrospectively selected cases among patients with at least a 4-year history of chronic musculoskeletal pain prior to intervention.Structured interview.Each of three patients discussed reported pain-free status at last follow-up, which was at least 6 months following the intervention.Certain individuals with chronic musculoskeletal pain may greatly benefit from a primarily psychodynamic approach to treatment, even when standard approaches to pain treatment have failed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79392/1/j.1526-4637.2010.00853.x.pd

JAMA Study on Jefferson\u27s Rural Physician Shortage Area Program (PSAP)

No abstract available

Computer-assisted diagnosis in the noninvasive evaluation of patients with suspected coronary artery disease

A microcomputer program called CADENZA, which employs Bayes' theorem to analyze and report the results of various clinical descriptors and noninvasive tests relative to the diagnosis of coronary artery disease, was evaluated in 1,097 consecutive patients without previous myocardial infarction. With this program, each patient was characterized by a probability for coronary artery disease, based on Framingham risk factor analysis, symptom characterization, electrocardiographic stress testing, cardiokymography, cardiac fluoroscopy, thallium perfusion scintigraphy and technetium equilibrium-gated blood pool scintigraphy. A total of 11,808 probability estimates derived from various combinations of the available observations were analyzed: 2,180 in 170 patients undergoing coronary angiography and 9,628 in 969 patients who completed a 1 year follow-up for coronary events.The predicted probability of disease correlated linearly with observed angiographic prevalence in the 170 patients who subsequently had coronary angiography (prevalence = [0.001 ± 0.011] + [0.966 ± 0.019] x probability). The difference between probability and prevalence averaged 3.1%, and the magnitude of this correlation was not affected by the type or amount of data analyzed. The prevalence of multivessel disease in these patients increased as a monotonic function of disease probability. Below a probability of 25%, single vessel disease was slightly more common than multivessel disease. Above a probability of 75%, multivessel disease predominated. In the 969 patients followed up for 1 year from the date of testing, the incidence of cardiac death and nonfatal infarction increased as a cubic function of disease probability (from approximately 0 to 8% per year for each). Above a probability of 90%, however, the standard deviation for predicting these events was wide.These data indicate that Bayes' theorem in general— and CADENZA in particular—is an accurate, clinically applicable means for quantifying the prevalence of angiographic coronary artery disease, the risk of multivessel disease and the incidence of morbid coronary events in the year after testing

Trainee Teachers’ Reflections on Approaches to Enhance their Subject Knowledge in Physics and Mathematics

Subject knowledge enhancement (SKE) is considered an essential part of initial teacher training (ITT) for secondary school roles. The article gives an insight into trainee teachers’ different experiences and approaches they used to expand and acquire Physics and Mathematics subject knowledge, alongside other forms of knowledge. The unique feature of this article is that is written by four students in collaboration with their academic advisor. The trainee teachers joined the Physics with Maths Postgraduate Certificate in Education (PGCE) secondary course from varied backgrounds, with differing strengths. Therefore, they have enhanced their subject knowledge in different ways. Their reflections show how their subject knowledge has been synthesized from a range of previous experiences, subsequently developed in practice throughout the course, and how they develop their subject knowledge to the required level to begin their teaching careers in a confident manner

Enhancing preschoolers' executive functions through embedding cognitive activities in shared book reading

Given evidence that early executive functioning sets the stage for a broad range of subsequent outcomes, researchers have sought to identify ways to foster these cognitive capacities. An increasingly common approach involves computerized ‘brain training’ programs, yet there are questions about whether these are well suited for fostering the early development of executive functions (EFs). The current series of studies sought to design, develop, and provide evidence for the efficacy of embedding cognitive activities in a commonplace activity – shared reading of a children’s book. The book, Quincey Quokka’s Quest, required children to control their thinking and behaviour to help the story’s main character through a series of obstacles. The first study investigated effects of reading with embedded cognitive activities in individual and group contexts on young children’s executive functions (EFs). The second study compared reading with embedded cognitive activities against a more-active control condition (dialogic reading) that similarly engaged children in the reading process yet lacked clear engagement of EFs. The third study sought to investigate whether the effect of reading the story with embedded EF activities changed across differing doses of the intervention and whether effects persisted 2 months post-intervention. Findings provide converging evidence of intervention effects on working memory and shifting in as little as 3 weeks (compared to more traditional reading) and maintenance of these gains 2 months later. This suggests the efficacy of embedding cognitive activities in the context of everyday activities, thereby extending the range of users and contexts in which this approach can be used

On the dihedral main conjectures of Iwasawa theory for Hilbert modular eigenforms

We construct a bipartite Euler system in the sense of Howard for Hilbert modular eigenforms of parallel weight two over totally real fields, generalizing works of Bertolini-Darmon, Longo, Nekovar, Pollack-Weston and others. The construction has direct applications to Iwasawa main conjectures. For instance, it implies in many cases one divisibility of the associated dihedral or anticyclotomic main conjecture, at the same time reducing the other divisibility to a certain nonvanishing criterion for the associated p-adic L-functions. It also has applications to cyclotomic main conjectures for Hilbert modular forms over CM fields via the technique of Skinner and Urban.Comment: 58 pages, absolute final version with very minor edits, to appear in the Canadian Journal of Mathematic

Civil Liberties and Volunteering in Six Former Soviet Union Countries

To contribute to the debate as to whether volunteering is an outcome of democratization rather than a driver of it, we analyze how divergent democratization pathways in six countries of the former Soviet Union have led to varied levels of volunteering. Using data from the European Values Study, we find that Latvia, Lithuania, and Estonia—which followed a Europeanization path—have high and increasing levels of civil liberties and volunteering. In Russia and Belarus, following a pre-emption path, civil liberties have remained low and volunteering has declined. Surprisingly, despite the Orange Revolution and increased civil liberties, volunteering rates in Ukraine have also declined. The case of Ukraine indicates that the freedom to participate is not always taken up by citizens. Our findings suggest it is not volunteering that brings civil liberties, but rather that increased civil liberties lead to higher levels of volunteerin

The Benefits and Harms of Transmitting Into Space

Deliberate and unintentional radio transmissions from Earth propagate into space. These transmissions could be detected by extraterrestrial watchers over interstellar distances. Here, we analyze the harms and benefits of deliberate and unintentional transmissions relevant to Earth and humanity. Comparing the magnitude of deliberate radio broadcasts intended for messaging to extraterrestrial intelligence (METI) with the background radio spectrum of Earth, we find that METI attempts to date have much lower detectability than emissions from current radio communication technologies on Earth. METI broadcasts are usually transient and several orders of magnitude less powerful than other terrestrial sources such as astronomical and military radars, which provide the strongest detectable signals. The benefits of radio communication on Earth likely outweigh the potential harms of detection by extraterrestrial watchers; however, the uncertainty regarding the outcome of contact with extraterrestrial beings creates difficulty in assessing whether or not to engage in long-term and large-scale METI.Comment: Published in Space Polic