Meta-analysis of psychological interventions for chronic low back pain.

The purpose of this meta-analysis of randomized controlled trials was to evaluate the efficacy of psychological interventions for adults with noncancerous chronic low back pain (CLBP). The authors updated and expanded upon prior meta-analyses by using broad definitions of CLBP and psychological intervention, a broad data search strategy, and state-of-the-art data analysis techniques. All relevant controlled clinical trials meeting the inclusion criteria were identified primarily through a computer-aided literature search. Two independent reviewers screened abstracts and articles for inclusion criteria and extracted relevant data. Cohen's d effect sizes were calculated by using a random effects model. Outcomes included pain intensity, emotional functioning, physical functioning (pain interference or pain-specific disability, health-related quality of life), participant ratings of global improvement, health care utilization, health care provider visits, pain medications, and employment/disability compensation status. A total of 205 effect sizes from 22 studies were pooled in 34 analyses. Positive effects of psychological interventions, contrasted with various control groups, were noted for pain intensity, pain-related interference, health-related quality of life, and depression. Cognitive-behavioral and self-regulatory treatments were specifically found to be efficacious. Multidisciplinary approaches that included a psychological component, when compared with active control conditions, were also noted to have positive short-term effects on pain interference and positive long-term effects on return to work. The results demonstrated positive effects of psychological interventions for CLBP. The rigor of the methods used, as well as the results that reflect mild to moderate heterogeneity and minimal publication bias, suggest confidence in the conclusions of this review.     

Religion and the Human Rights Idea

Three recent books focus, in different ways, on the idea of human rights and its relation to religion and religious ethics. All three books discussed here address criticisms of the human rights idea and seek to establish the relationship of religion and human rights with regard to the field of policy. The present discussion begins with an overview that places these three books in the larger context of the development of the human rights idea and its historical relationship with religion. It then turns to Little's book, next to the collection of essays edited by Twiss, Simion, and Petersen, which is described internally as a Festschrift for Little, and then to Hogan's book, and in the final section it explores comparisons among the books.     

Suicide and Homicide Rates in Canada and the United States

Suicide and homicide rates by age were analyzed for Canada and the United States, indicating that suicide is higher in Canada and that homicide is higher in the United States. Results indicated a positive association between homicide and suicide rates in the United States but these two rates of death were not significantly associated in Canada. Holinger (1987) had associated the relative size of the cohort to the rates of suicide and homicide in young people in the United States. The more current data in both countries did not support Holinger's results. Using the measure devised by Easterlin (1980) and Ahlburg and Schapiro (1984) –that is, the proportion of youths aged 15–24 relative to adults aged 25–64–the correlation between the size of the youth cohort and the suicide rate of youths aged 15–24 was negative. It is concluded that the two patterns in these two countries may be explained from a historical perspective.     

Epistemic constraints on practical normativity

What is the relation between what we ought to do, on the one hand, and our epistemic access to the ought-giving facts, on the other? In assessing this, it is common to distinguish ‘objective’ from ‘subjective’ oughts. Very roughly, on the objectivist conception what an agent ought to do is determined by ought-giving facts in such a way that does not depend on the agent’s beliefs about, or epistemic access to, those facts; whereas on the subjectivist conception, what an agent ought to do depends on his beliefs. This paper defends the need for, and explicates, a third category of ‘ought’: ‘warranted oughts’. Section 1 introduces the distinction between objective and subjective ‘oughts’. Sections 2–3 draw attention to some serious problems with each. Section 4 examines, though rejects, a recent attempt to replace subjective ‘oughts’ with objective ‘wide-scope oughts’ operating on belief-action combinations. Section 5 explicates the notion of a warranted ‘ought’ and defends the account against some possible objections. The resulting a picture is one in which an adequate analysis of practical normativity requires both objective and warranted ‘oughts’. Section 6 concludes by responding to a worry about countenancing both.