Coping with pain in the hip or knee in relation to physical disability in community-living elderly people

__Objective__ To investigate the use of pain coping strategies by community-living older people with pain in the hip or knee and the mediating role of coping with pain in the relationship between the chronicity of pain and physical disability. __Methods__ A group of 157 people with pain 'in the last month' was identified. Coping with pain was assessed with the Pain Coping Inventory, physical disability with the Sickness Impact Profile, and household and sport activities with a validated structured interview method. __Results__ People with chronic pain used relatively more 'resting,' and 'reducing demands' as pain coping strategies. Pain chronicity made a significant contribution to physical disability; however, when corrected for other variables in a regression model, no significant partial correlation was found. __Conclusion__ We conclude that pain coping has a mediating role in the relationship between pain chronicity and physical disability. Less use of 'resting' and a physically active lifestyle are independently associated with less physical disability

Psychological factors predicting violent prison inmates' anger and aggression

Based on a functional analysis of aggressive behavior, the present study investigates the psychological determinants of state anger and aggression in violent prison inmates. Comparing psychiatric forensic inpatients with violent prison inmates revealed considerable overlap in these determinants between both samples. Next, the personality traits of neuroticism, agreeableness, conscientiousness, hostility, and anger were studied in explaining the violent prison inmates’ state anger and aggression. Data were obtained from 102 male inmates prisoned for four years or more because of a serious violent crime. Linear regression models were used to assess the relationship between the patients’ characteristics of anger and aggression. It was found that neuroticism, trait anger, and hostility contributed to state anger. Furthermore, the main factor contributing to aggression was state anger. Implications of the results for reducing anger and aggression in violent prison inmates are discussed

Psychological factors predicting self-reported and observed aggression in male forensic psychiatric inpatients

The present study examined the psychological determinants of self-reported and observed aggression in male violent forensic psychiatric inpatients. Baseline data came from 232 inpatients referred to a cognitive–behavioral treatment program. Linear regression models were used to assess the relationship between the patients’ psychological characteristics and aggressive behavior. Self-reported aggression was studied with cross-sectional data, while the inpatients’ observed aggression in the ward was investigated with prospective data. The main factors contributing to the prediction of self-reported aggression were state anger, antisocial lifestyle and agreeableness, while the main factors contributing to the prediction of observed aggression were trait anger and agreeableness. The findings support the focus of treatment programs for forensic psychiatric inpatients on anger management.</p

Psychological factors predicting self-reported and observed aggression in male forensic psychiatric inpatients

The present study examined the psychological determinants of self-reported and observed aggression in male violent forensic psychiatric inpatients. Baseline data came from 232 inpatients referred to a cognitive–behavioral treatment program. Linear regression models were used to assess the relationship between the patients’ psychological characteristics and aggressive behavior. Self-reported aggression was studied with cross-sectional data, while the inpatients’ observed aggression in the ward was investigated with prospective data. The main factors contributing to the prediction of self-reported aggression were state anger, antisocial lifestyle and agreeableness, while the main factors contributing to the prediction of observed aggression were trait anger and agreeableness. The findings support the focus of treatment programs for forensic psychiatric inpatients on anger management.</p

Occupational therapy for rheumatoid arthritis: A systematic review

Patients with rheumatoid arthritis (RA) show a reduction in physical capacities compared with healthy persons. Symptoms such as pain, fatique, stiffness, and decreased muscle strength cause difficulties with daily activities such as grooming and dressing, cooking a meal, cleaning, shopping, work, and leisure activities. The physical, personal, familial, social, and vocational consequences of RA are extensive. Occupational therapy (OT) is concerned with facililtating people in performing their activities of daily living overcoming barriers by maintaining or improving abilities, or compensating for decreased ability in the performance of occupation (1). The most important interventions in OT are training of skills, counseling, education about joint protection, prescription of assistive devices, and the provision of splints (2). Advice/ instruction in the use of assistive devices, training in self-care activities, and training in productivity activities are the 3 interventions for RA patients chosen most often by occuptional therapists (3). (aut. ref.

Variable selection under multiple imputation using the bootstrap in a prognostic study

Background: Missing data is a challenging problem in many prognostic studies. Multiple imputation (MI) accounts for imputation uncertainty that allows for adequate statistical testing. We developed and tested a methodology combining MI with bootstrapping techniques for studying prognostic variable selection. Method: In our prospective cohort study we merged data from three different randomized controlled trials (RCTs) to assess prognostic variables for chronicity of low back pain. Among the outcome and prognostic variables data were missing in the range of 0 and 48.1%. We used four methods to investigate the influence of respectively sampling and imputation variation: MI only, bootstrap only, and two methods that combine MI and bootstrapping. Variables were selected based on the inclusion frequency of each prognostic variable, i.e. the proportion of times that the variable appeared in the model. The discriminative and calibrative abilities of prognostic models developed by the four methods were assessed at different inclusion levels. Results: We found that the effect of imputation variation on the inclusion frequency was larger than the effect of sampling variation. When MI and bootstrapping were combined at the range of 0% (full model) to 90% of variable selection, bootstrap corrected c-index values of 0.70 to 0.71 and slope values of 0.64 to 0.86 were found. Conclusion: We recommend to account for both imputation and sampling variation in sets of missing data. The new procedure of combining MI with bootstrapping for variable selection, results in multivariable prognostic models with good performance and is therefore attractive to apply on data sets with missing values

Cost-effectiveness of minimal interventional procedures for chronic mechanical low back pain: design of four randomised controlled trials with an economic evaluation

Background: Minimal interventional procedures are frequently applied in patients with mechanical low back pain which is defined as pain presumably resulting from single sources: facet, disc, sacroiliac joint or a combination of these. Usually, these minimal interventional procedures are an integral part of a multidisciplinary pain programme. A recent systematic review issued by the Dutch Health Insurance Council showed that the effectiveness of these procedures for the total group of patients with chronic low back pain is yet unclear and cost-effectiveness unknown. The aim of the study is to evaluate whether a multidisciplinary pain programme with minimal interventional procedures is cost-effective compared to the multidisciplinary pain programme alone for patients with chronic mechanical low back pain who did not respond to conservative primary care and were referred to a pain clinic. Methods. All patients with chronic low back pain who are referred to one of the 13 participating pain clinics will be asked to participate in an observational study. Patients with a suspected diagnosis of facet, disc or sacroiliac joint problems will receive a diagnostic block to confirm this diagnosis. If confirmed, they will be asked to participate in a Randomized Controlled Trial (RCT). For each single source a separate RCT will be conducted. Patients with a combination of facet, disc or sacroiliac joint problems will be invited for participation in a RCT as well. An economic evaluation from a societal perspective will be performed alongside these four RCTs. Patients will complete questionnaires at baseline, 3 and 6 weeks, 3, 6, 9 and 12 months after start of the treatment

Experimental stress in inflammatory rheumatic diseases: a review of psychophysiological stress responses

Contains fulltext : 88668.pdf (publisher's version ) (Open Access)INTRODUCTION: Stressful events are thought to contribute to the aetiology, maintenance and exacerbation of rheumatic diseases. Given the growing interest in acute stress responses and disease, this review investigates the impact of real-life experimental psychosocial, cognitive, exercise and sensory stressors on autonomic, neuroendocrine and immune function in patients with inflammatory rheumatic diseases. METHODS: Databases Medline, PsychINFO, Embase, Cinahl and Pubmed were screened for studies (1985 to 2009) investigating physiological stress responses in inflammatory rheumatic diseases. Eighteen articles met the inclusion criteria. RESULTS: Results suggest that immune function may be altered in response to a stressor; such alterations could contribute to the maintenance or exacerbation of inflammatory rheumatic diseases during stressful events in daily life. CONCLUSIONS: This review emphasizes the need for more experimental research in rheumatic populations with controlled stress paradigms that include a follow-up with multiple evaluation points, simultaneous assessment of different physiological stress systems, and studying factors contributing to specific physiological responses, such as stress appraisal

On Monoids Related to Braid Groups and Transformation Semigroups

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