Are fear-avoidance beliefs related to the inception of an episode of back pain? A prospective study

Abstract

Fear-avoidance beliefs and catastrophizing have been implicated in chronic pain and theoretical models have been developed that feature these factor in the transition from acute to chronic pain. However, little has been done to determine whether these factors occur in the general population or whether they arc associated with the inception of an episode of neck or back pain. The aim of this study was to evaluate prospectively the effects of fear-avoidance beliefs and catastrophizing on the development of an episode of self-reported pain and associated physical functioning. To achieve this, we selected a sample of 415 people from the general population who reported no spinal pain during the past year. At the pretest a battery of questionnaires was administered to assess beliefs about pain and activity and it featured the Pain Catastrophizing Scale and a modified version of the Fear-Avoidance Beliefs Questionnaire. One year later outcome was evaluated by self-reports of the occurrence of a pain episode as well as a self-administered physical function test. The results showed that scores on both fear-avoidme and cabstrophizing were quite low. During the one year follow-up, 19% of the sample suffered an episode of back pain. Those with scores above the median on fear-avoidance beliefs at the pretest had twice the risk of suffering an episode of back pain and a 1.7 times higher risk of lowered physical function at the follow-up. Catastrophizing was somewhat less salient, increasing the risk of pain or lowered function by 1.5. but with confidence intervals falling below unity. These data indicate that fear-avoidance beliefs may be involved at a very early pint in the development of pain and associated activity problems in people with back pain. Theoretically. our results support the idea that fear-avoidance beliefs may develop in an interaction with the experience of pain. Clinically, the results suggest that catastrophizing and particularly fear-avoidance beliefs are important in the development of a pain problem and might be of use in screening procedures.     

Maternal attitudes towards pre-natal substance abuse,medical care,and treatment in a historically disadvantaged South African community

This study explored maternal substance abuse and the access to pre-natal medical care and treatment for substance abuse during pregnancy. Respondent mothers (n?=?102; mean age?=?27.8 years, SD?=?10.9 years) were from Mitchell’s Plain, a historically disadvantaged South African community. The mothers completed a mixed methods interview on the context and influences of their substance abuse during their pregnancy. Findings suggest that these mothers adopt the drug taking behaviour in their social environment. Women with prior histories of substance abuse were active consumers and dependent on drugs while childbearing. These findings may be important for possible intervention strategies among this particular group of vulnerable women.     

Web-based training improves on-field offside decision-making performance

ObjectiveThe present study examined to what extent off-field offside decision-making training transfers to real-life offside situations.Design/methodsEighteen Belgian assistant referees were included in the experiment. Ten assistant referees (i.e., training group) were exposed to a pre- and posttest and, in between, four off-field offside training sessions via a web-based training protocol. The remaining eight assistant referees participated in the control group and only completed the pre- and posttest. During both test sessions, which were conducted separately for each group, both an on- and off-field offside decision-making test was completed.ResultsFirst, an increase in response accuracy and a decrease in flag errors were observed for the training group from pre- to posttest in both the on- and off-field offside test. Second, only the training group improved in the recall and recognition accuracy of the position of the receiving attacker at the moment of the pass.ConclusionsThis study demonstrates that perceptual-cognitive skill training results in a positive and direct transfer to on-field offside decisions. Therefore, the structure and the content of the current training intervention mimics the perceptual difficulties of real-match situations and can help the assistant referees to mediate and enhance their offside decision-making skills, both on- and off-field.     

Assessment of dental anxiety: A facet approach

Dental anxiety is a complicated phenomenon, and its multicomponent nature is often not acknowledged in existing measurement instruments. Using a facet design, a new Dental Anxiety Inventory (DAI) was constructed. Facets chosen were: time (made up of four elements: at home, on your way to the denstist, in the denstist's waiting room, in the dental chair), situation (three elements: introductory aspects, dentist-patient interaction, actual dental treatment), and reaction (three elements: subjective feelings, physical reactions, cognitive reactions). Psychometric qualities of the DAI are good. The internal structure of the DAI was studied by linear and nonlinear techniques, and was partially recovered from the data. The construct and criterion validity of the DAI was supported in several studies.     

Acceptance of Genetic Counseling and Testing in a Hospital-Based Series of Patients with Gynecological Cancer

Referral of patients with endometrial (EC) and/or ovarian cancer (OC) for genetic counseling is based on age at diagnosis and family history. Many patients with hereditary cancers are missed by following this strategy. We determined acceptance and mutation detection rate of offering genetic counseling and testing to unselected EC and OC patients. Therefore, in 2007, EC and OC patients were invited for genetic counseling and testing. Patients were asked for their reasons to accept or decline. Nineteen out of fifty-two EC patients (36 %) and twenty-two out of thirty-five OC patients (63 %) accepted genetic counseling, mainly to receive risk assessment for themselves and relatives. Counseling was declined mainly because patients did not want more tests or had no relatives for whom it was relevant. Eighteen out of nineteen EC patients (95 %) and twenty out of twenty-two OC patients (91 %) underwent genetic testing. One EC patient carried an MSH6 mutation (mutation detection rate: 6 %). BRCA1/2 mutations were found in two out of twenty OC patients (10 %). Eleven patients (29 %) received surveillance recommendations for themselves and their relatives. Finally, family history recorded by the gynecologist was compared to that taken by the clinical geneticist. Gynecologists reported family history in ten out of forty-one participants (24 %). In conclusion, genetic counseling and testing are acceptable to patients with OC and/or EC. The 10 % BRCA1/2 mutation detection rate and underreporting of family history by gynecologists warrant referral for genetic counseling for all OC patients, followed by BRCA1/2 testing if indicated. We recommend that microsatellite instability and immunohistochemical analysis be performed in all EC patients, followed by genetic counseling if appropriate. These strategies will lead to better cancer prevention in gynecological cancer patients and their relatives.     

Processing convexity and concavity along a 2-D contour: figure–ground, structural shape, and attention

Interest in convexity has a long history in vision science. For smooth contours in an image, it is possible to code regions of positive (convex) and negative (concave) curvature, and this provides useful information about solid shape. We review a large body of evidence on the role of this information in perception of shape and in attention. This includes evidence from behavioral, neurophysiological, imaging, and developmental studies. A review is necessary to analyze the evidence on how convexity affects (1) separation between figure and ground, (2) part structure, and (3) attention allocation. Despite some broad agreement on the importance of convexity in these areas, there is a lack of consensus on the interpretation of specific claims—for example, on the contribution of convexity to metric depth and on the automatic directing of attention to convexities or to concavities. The focus is on convexity and concavity along a 2-D contour, not convexity and concavity in 3-D, but the important link between the two is discussed. We conclude that there is good evidence for the role of convexity information in figure–ground organization and in parsing, but other, more specific claims are not (yet) well supported.     

Role stressors and exposure to workplace bullying: Causes or consequences of what and why?

Stressful working environments are commonly assumed to create conditions that can lead to bullying. Although environmental factors may relate to both exposure to and perpetration of workplace bullying, empirical knowledge is still limited regarding how environmental factors and bullying is causally linked. In line with interpretations of previous cross-sectional findings, the present study investigated an individual-level target-oriented model of role stressors as antecedents of exposure to workplace bullying, applying a two-wave longitudinal sample of the Norwegian working population. Results from structural regression analyses failed to identify any significant relationships between the role stressors and subsequent exposure to workplace bullying. However, prior exposure to workplace bullying accounted for subsequent variation in role ambiguity, role conflict, and role overload alike. The findings of the present study question conclusions regarding causality made in previous cross-sectional research on work-related factors as antecedents of exposure to workplace bullying. We argue that future research may benefit from adopting multilevel and actor-oriented perspectives in order to more fully understand how causal relationships between environmental factors and workplace bullying unfold.     

Actuarial Criminology: Meeting Current Challenges in Southern Africa

South African prisons were overcrowded by more than sixty-three percent in 2005. Overcrowding and poor prison conditions have enormous implications for rehabilitation efforts made by the South African Department of Correctional Services. The South African White Paper on Corrections (2005) commits the Department of Correctional Services to provide needs-based rehabilitation processes and a framework of continuous evaluation to measure the impact and success of such processes. It also acknowledges that monitoring the rates of recidivism is a critical indicator of the success, the effectiveness of needs-based rehabilitation, and improved service. A reliable system for monitoring recidivism will have to be developed and put in place. In this respect, actuarial criminology can make a vital contribution. This article poses a strategic alternative to the correctional industry in Southern Africa that can be used for the realization of correctional ideals, especially where retribution and overcrowding are still the main features of correctional institutions.     

Logic Games are Complete for Game Logics

Game logics describe general games through powers of players for forcing outcomes. In particular, they encode an algebra of sequential game operations such as choice, dual and composition. Logic games are special games for specific purposes such as proof or semantical evaluation for first-order or modal languages. We show that the general algebra of game operations coincides with that over just logical evaluation games, whence the latter are quite general after all. The main tool in proving this is a representation of arbitrary games as modal or first-order evaluation games. We probe how far our analysis extends to product operations on games. We also discuss some more general consequences of this new perspective for standard logic.