Pain intensity and attribution mediate the impact of patient weight and gender on activity recommendations for chronic pain

Background and purpose: Despite the notable benefits of physical activity for chronic pain, a large proportion of patients with chronic pain report that they do not receive activity-related recommendations from their providers. Research suggests that patient factors such as weight and gender influence activity-related recommendations for chronic pain. Research also suggests that appraisals of the intensity and cause of pain may explain these weight and gender effects. We investigated the influence of patient weight and gender on observers' likelihood of recommending activity-related treatments for pain. We also explored the mediating effects of observers' ratings of pain severity and the extent to which pain was due to medical and lifestyle factors (pain attribution). Patients and methods: Healthy young adults (N=616; 76% female) viewed videos (Ghent Pain Videos of Daily Activities) and vignettes of 4 patients with chronic back pain performing a standardized functional task. Patients varied by gender (female, male) and weight (normal, obese), but were otherwise equivalent on demographic characteristics and pain behaviors. Participants rated how much pain they perceived the patients to be experiencing, the extent to which they attributed the pain to medical and lifestyle factors, and their likelihood of recommending exercise, physical therapy (PT), and rest. Results: Patient weight and gender significantly interacted to influence exercise, PT, and rest recommendations. Both pain intensity and pain attribution mediated the relationships between patient weight and activity recommendations; however, these mediation effects differed across gender and recommendation type. Conclusion: Patient weight and gender influenced laypeople's activity recommendations for chronic pain. Moreover, the results suggest that observers' perceptions of pain intensity and pain attributions are mechanisms underlying these effects. If these findings are replicated in providers, interventions may need to be developed to reduce provider biases and increase their recognition of the benefits of physical activity for chronic pain

A flexible route to new spirodioxanes, oxathianes and morpholines

International audienceThis work describes a modular efficient route to 10-aza-4-thia-, 10-aza-4-oxa-, and 10-oxa-4-thia-1,7-dioxaspiro[5.5]undecanes. The synthetic pathway relies upon the iterative nucleophilic substitution of 1,3-dichloropropan-2-one O-benzyloxime by solketal derivatives. The oxime key-intermediates, submitted to an acidic deprotection–spiroacetalization process, afforded these original spiroketal compounds in three steps, few purifications, and very good yields

Older adults’ preferences for formal social support of autonomy and dependence in pain: development and validation of a scale

Chronic pain among older adults is common and often disabling. Pain-related formal social support (e.g., provided by staff at day-care centres, nursing homes), and the extent to which it promotes functional autonomy or dependence, plays a significant role in the promotion of older adults’ ability to engage in their daily activities. Assessing older adults’ preferences for pain-related social support for functional autonomy or dependence could contribute to increase formal social support responsiveness to individuals’ needs. Therefore, this study aimed at developing and validating the Preferences for Formal Social Support of Autonomy and Dependence in pain Inventory (PFSSADI). One hundred and sixty five older adults with chronic musculoskeletal pain (Mage=79.1, 67.3% women), attending day-care centers, completed the PFSSADI, the revised Formal Social Support for Autonomy and Dependence in Pain Inventory, and a measure of desire for (in)dependence; the PFSSADI was filled out again 6 weeks later. Confirmatory factor analyses showed a structure of two correlated factors (r= .56): (a) Preferences for Autonomy Support (?=.99); and (b) Preferences for Dependence Support (?=.98). The scale showed good test-retest reliability, sensitivity and discriminant and concurrent validity; the higher the preferences for dependence support the higher the desire for dependence (r=.33) and the lower the desire for independence (r=-.41). The PFSSADI is an innovative tool, which may contribute to explore the role of pain-related social support responsiveness on the promotion of older adults’ functional autonomy when in pain.info:eu-repo/semantics/acceptedVersio

The revised formal social support for autonomy and dependence in pain inventory (FSSADI_PAIN): confirmatory factor analysis and validity

ain among older adults is common and generally associated with high levels of functional disability. Despite its important role in elders' pain experiences, perceived (formal) social support (PSS) has shown inconsistent effects on their functional autonomy. This suggests a moderator role of 2 recently conceptualized functions of PSS: perceived promotion of dependence versus autonomy. The present study aimed at revising and further validating the Formal Social Support for Autonomy and Dependence in Pain Inventory (FSSADI_PAIN), which measures these 2 PSS functions among institutionalized elders in pain. Two hundred fifty older adults (mean age = 81.36 years, 75.2% women) completed the revised FSSADI_PAIN along with measures of physical functioning (ie, Medical Outcome Study Short Form-36) and informal PSS (ie, Social Support Scale of Medical Outcomes Study). Confirmatory factor analyses showed a good fit for a 2-factor structure: 1) perceived promotion of autonomy (n = 4 items; alpha = .89), and 2) perceived promotion of dependence (n = 4 items; alpha = .85). The revised FSSADI_PAIN showed good content, discriminant, and criterion-related validity; it discriminated the PSS of male and female older adults and also of elders with different levels of physical functioning. In conclusion, the revised FSSADI_PAIN is an innovative, valid, and reliable tool that allows us to assess 2 important functions of PSS, which may play a relevant role in the prevention and reduction of pain-related physical disability and functional dependence among institutionalized older adults. Perspective: This article presents a revised version of the FSSADI_PAIN that assesses elders' perceived promotion of functional autonomy/dependence as 2 independent functions of perceived social support. This measure may contribute to future research on the role of close interpersonal contexts on the promotion of active aging among elders with chronic pain.info:eu-repo/semantics/acceptedVersio

The von Economo neurons in frontoinsular and anterior cingulate cortex in great apes and humans

The von Economo neurons (VENs) are large bipolar neurons located in frontoinsular (FI) and anterior cingulate cortex in great apes and humans, but not other primates. We performed stereological counts of the VENs in FI and LA (limbic anterior, a component of anterior cingulate cortex) in great apes and in humans. The VENs are more numerous in humans than in apes, although one gorilla approached the lower end of the human range. We also examined the ontological development of the VENs in FI and LA in humans. The VENs first appear in small numbers in the 36th week post-conception, are rare at birth, and increase in number during the first 8 months after birth. There are significantly more VENs in the right hemisphere than in the left in FI and LA in postnatal brains of apes and humans. This asymmetry in VEN numbers may be related to asymmetries in the autonomic nervous system. The activity of the inferior anterior insula, which contains FI, is related to physiological changes in the body, decision-making, error recognition, and awareness. The VENs appear to be projection neurons, although their targets are unknown. We made a preliminary study of the connections of FI cortex based on diffusion tensor imaging in the brain of a gorilla. The VEN-containing regions connect to the frontal pole as well as to other parts of frontal and insular cortex, the septum, and the amygdala. It is likely that the VENs in FI are projecting to some or all of these structures and relaying information related to autonomic control, decision-making, or awareness. The VENs selectively express the bombesin peptides neuromedin B (NMB) and gastrin releasing peptide (GRP) which are also expressed in another population of closely related neurons, the fork cells. NMB and GRP signal satiety. The genes for NMB and GRP are expressed selectively in small populations of neurons in the insular cortex in mice. These populations may be related to the VEN and fork cells and may be involved in the regulation of appetite. The loss of these cells may be related to the loss of satiety signaling in patients with frontotemporal dementia who have damage to FI. The VENs and fork cells may be morphological specializations of an ancient population of neurons involved in the control of appetite present in the insular cortex in all mammals. We found that the protein encoded by the gene DISC1 (disrupted in schizophrenia) is preferentially expressed by the VENs. DISC1 has undergone rapid evolutionary change in the line leading to humans, and since it suppresses dendritic branching it may be involved in the distinctive VEN morphology

Encoding edge type information in graphlets.

Graph embedding approaches have been attracting increasing attention in recent years mainly due to their universal applicability. They convert network data into a vector space in which the graph structural information and properties are maximumly preserved. Most existing approaches, however, ignore the rich information about interactions between nodes, i.e., edge attribute or edge type. Moreover, the learned embeddings suffer from a lack of explainability, and cannot be used to study the effects of typed structures in edge-attributed networks. In this paper, we introduce a framework to embed edge type information in graphlets and generate a Typed-Edge Graphlets Degree Vector (TyE-GDV). Additionally, we extend two combinatorial approaches, i.e., the colored graphlets and heterogeneous graphlets approaches to edge-attributed networks. Through applying the proposed method to a case study of chronic pain patients, we find that not only the network structure of a patient could indicate his/her perceived pain grade, but also certain social ties, such as those with friends, colleagues, and healthcare professionals, are more crucial in understanding the impact of chronic pain. Further, we demonstrate that in a node classification task, the edge-type encoded graphlets approaches outperform the traditional graphlet degree vector approach by a significant margin, and that TyE-GDV could achieve a competitive performance of the combinatorial approaches while being far more efficient in space requirements

Helping your partner with chronic pain: the importance of helping motivation, received social support, and its timeliness

Objective Like all intentional acts, social support provision varies with respect to its underlying motives. Greater autonomous or volitional motives (e.g., enjoyment, full commitment) to help individuals with chronic pain (ICPs) are associated with greater well-being benefits for the latter, as indexed by improved satisfaction of their psychological needs for autonomy, competence, and relatedness. The present study investigates the processes explaining why partners’ autonomous or volitional helping motivation yields these benefits. Methods A total of 134 couples, where at least one partner had chronic pain, completed a 14-day diary. Partners reported on their daily helping motives, whereas ICPs reported on their daily received support, timing of help, need-based experiences, and pain. Results On days when partners provided help for volitional motives, ICPs indicated receiving more help, which partially accounted for the effect of autonomous helping motivation on ICP need-based experiences. Timing of help moderated the effects of daily received support on ICP need-based experiences. Conclusions Findings highlight the importance of ICPs of receiving support in general and the role of timing in particular, which especially matters when there is little support being received.info:eu-repo/semantics/acceptedVersio

Differences in Myoelectric Activity of the Lumbar Muscles between Recurrent and Chronic Low Back Pain : a cross-sectional study

Background: Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP). This study compared lumbar muscle activity during trunk extension in patients with continuous chronic LBP (CLBP), non-continuous CLBP, recurrent LBP (RLBP) and healthy subjects. Methods: In 75 subjects (16 continuous CLBP, 15 non-continuous CLBP, 23 RLBP, 21 healthy controls), surface electromyographic (EMG) activity of the lumbar erector spinae (ES), multifidus (MF), latissimus dorsi (LD) and gluteus maximus (GM) was recorded during the concentric, holding and eccentric phase of a modified Biering Sorenson exercise. Results: Continuous CLBP patients showed higher EMG activity in the ES and MF muscles compared to healthy controls in the concentric (p = 0.011; p = 0.009 respectively) and the holding phase (p = 0.015; p = 0.013). Higher EMG activity was observed in continuous CLBP compared to RLBP in the ES and MF muscles in the holding phase (p = 0.035; p = 0.037), and in the MF in the concentric phase (p = 0.046), but not in the ES (p = 0.062). No differences in muscle activity were established in either the concentric, holding, and eccentric phase for the LD and GM muscles. No differences were found between non-continuous CLBP and the other groups. Conclusions: An enhanced muscle activity of the lumbar muscles during the concentric and holding phase was observed during trunk extension in patients with continuous CLBP compared to patients with RLBP and healthy subjects. No differences between groups are present in the GM and LD muscles during concentric and holding phases and for and muscle in the eccentric phase

The role of environment and AGN feedback in quenching local galaxies: Comparing cosmological hydrodynamical simulations to the SDSS

We present an analysis of the quenching of local observed and simulated galaxies, including an investigation of the dependence of quiescence on both intrinsic and environmental parameters. We apply an advanced machine learning technique utilizing random forest classification to predict when galaxies are star forming or quenched. We perform separate classification analyses for three groups of galaxies: (a) central galaxies; (b) high-mass satellites ($M_{*} > 10^{10.5}{\rm M_{\odot}}$); and (c) low-mass satellites ($M_{*} < 10^{10}{\rm M_{\odot}}$) for three cosmological hydrodynamical simulations (EAGLE, Illustris, and IllustrisTNG), and observational data from the SDSS. The simulation results are unanimous and unambiguous: quiescence in centrals and high-mass satellites is best predicted by intrinsic parameters (specifically central black hole mass), whilst it is best predicted by environmental parameters (specifically halo mass) for low-mass satellites. In observations, we find black hole mass to best predict quiescence for centrals and high mass satellites, exactly as predicted by the simulations. However, local galaxy over-density is found to be most predictive parameter for low-mass satellites. Nonetheless, both simulations and observations do agree that it is environment which quenches low mass satellites. We provide evidence which suggests that the dominance of local over-density in classifying low mass systems may be due to the high uncertainty in halo mass estimation from abundance matching, rather than it being fundamentally a more predictive parameter. Finally, we establish that the qualitative trends with environment predicted in simulations are recoverable in the observation space. This has important implications for future wide-field galaxy surveys.Comment: Accepted to MNRAS; 32 pages; 22 figure

Differential effect of patient weight on pain-related judgements about male and female chronic low back pain patients

Compared with men, women report more pain and are at increased risk for having pain discounted or misattributed to psychological causes. Overweight individuals experience high rates of pain and may receive suboptimal care because of provider bias. Research suggests the social consequences of being overweight are worse for women than men, and that gender and weight uniquely and interactively affect pain experience and care. Healthy participants (n = 616) viewed 6 videos of back pain patients (1 female and 1 male of normal weight, overweight, and obese categories) performing a functional task. Participants provided judgements/ratings regarding patient pain (intensity, interference, exaggeration), potential sources of patient pain (medical, psychological), and treatment recommendations (opioids, psychological therapy, seek workplace accommodations). Results suggest that the pain of normal and overweight women and obese men was discounted (judged as less intense, less interfering, more exaggerated, and less attributable to medical factors) and judged as less in need of treatment (treated with less opioids and workplace accommodations). Across all weight categories, women's pain was attributed more to psychological factors and was more likely to receive recommendations for psychological therapy than men's pain. These findings highlight the differential effect of patient weight on pain-related judgements about women and men. Perspective This article examines the relationships among patient weight, patient gender, and observers' pain appraisals and treatment recommendations. These findings highlight the differential effect of patient weight on pain-related judgements about women and men and indicate the need for research to determine how these judgements affect treatment decisions in clinical settings