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.     

Genetic and environmental factors in orientation anisotropy: a field study in the British Isles

Visual acuity for the detection of gratings at four orientations was measured for groups of ten boys and ten girls aged five to seven years, from the following four populations: Scots in Glasgow, Pakistanis in Glasgow, Gaels in Stornoway (Outer Hebrides) and East Anglians in Littleport (Cambridgeshire fenlands). The Glaswegians, both Scottish and Pakistani, showed the normal pattern of anisotropy, with poorest acuity for oblique orientations; the East Anglians showed no significant anisotropy; while the Gaels were unusual in showing poorest horizontal acuity. A group of fourteen Pakistani children in Stornoway differed slightly from a matched group of Gaels. The group differences bore little relation to the visual environments, and were probably due to genetic or cultural factors. The relatively poor horizontal acuity of the Gaels was not correlated with astigmatism. Sex differences were also found, with the boys showing higher mean acuity and a higher ratio between vertical and oblique acuity.