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.     

Contextual analysis of home environment factors influencing the acquisition of early reading skills in Zambian families

This study examined the effect of home environment factors in the acquisition of early reading skills (orthographic awareness and decoding competence). To assess these factors, a sample of seventy-two (72) first grade learners (females?=?55%; age range?=?7–8 years) and their maternal parents (age range 26–61 years old) from low SES in Zambia's capital city, Lusaka were recruited. Parents, in response to a home literacy questionnaire, reported on their attitudes towards reading, literacy teaching in the home, the home literacy environment, presence of reading materials for adults and children, parental education, occupation, family size and family possessions. Two measures of reading skill were administered at school. Correlations revealed that parental education, occupation and the size of the family were not significantly associated with the reading measures. Family possessions, parental reading attitudes, literacy activities, and reading materials significantly predicted orthographic awareness. In predicting decoding competence, only family possessions, parental reading attitudes and literacy activities were predictive. Regardless of the context, children experience literacy in varied forms and quantities.     

The effect of geographic indication in advertising background pictures on product evaluation: The moderating role of familiarity

This study investigates whether geographic indications in the backgrounds of advertising pictures might affect the viewer's evaluation of a product. The findings reveal that participants in the proximal geographic indication evaluated the product more favourably than those in the distal geographic indication when they were exposed to feasibility‐related information. By contrast, participants in the distal geographic indication evaluated the product more favourably than those in the proximal geographic indication when they were exposed to desirability‐related information. However, familiarity with geographic indications eliminated this effect.     

Chaos,danger, and maternal parenting in families: Links with adolescent adjustment in low‐ and middle‐income countries

The current longitudinal study is the first comparative investigation across low‐ and middle‐income countries (LMICs) to test the hypothesis that harsher and less affectionate maternal parenting (child age 14 years, on average) statistically mediates the prediction from prior household chaos and neighborhood danger (at 13 years) to subsequent adolescent maladjustment (externalizing, internalizing, and school performance problems at 15 years). The sample included 511 urban families in six LMICs: China, Colombia, Jordan, Kenya, the Philippines, and Thailand. Multigroup structural equation modeling showed consistent associations between chaos, danger, affectionate and harsh parenting, and adolescent adjustment problems. There was some support for the hypothesis, with nearly all countries showing a modest indirect effect of maternal hostility (but not affection) for adolescent externalizing, internalizing, and scholastic problems. Results provide further evidence that chaotic home and dangerous neighborhood environments increase risk for adolescent maladjustment in LMIC contexts, via harsher maternal parenting.     

Early executive functioning in a global context: Developmental continuity and family protective factors

This study extends the methodological and theoretical understanding of executive functions (EFs) in preschoolers from low‐ and middle‐income countries (LMIC). First, the authors describe a rigorous process of adapting and evaluating six EF tasks to produce a culturally and developmentally appropriate measure of emerging EFs in a large sample of at‐risk children in rural Pakistan. Next, the authors identify critical developmental and family factors that relate to preschoolers’ EFs over the first 4 years of life. Direct assessment of children's general cognitive skills at age two showed developmental continuity with EFs at age four, and these early cognitive skills mediated the effect of an antecedent parenting intervention on EFs as well as associations of targeted individual and family factors with EFs. Furthermore, directly assessed maternal cognitive capacities and observed maternal scaffolding uniquely predicted EFs in preschoolers. This study is also the first to demonstrate a significant overlap between direct assessments of IQ and EFs in young children from LMIC. Children's general intelligence mediated the associations of EFs with antecedent physical growth and cognitive skills as well as concurrent family factors (maternal verbal intelligence, maternal scaffolding, and home stimulation). After controlling for shared variance between preschoolers’ general intelligence and EFs, three factors emerged as unique predictors of EFs: exposure to an early parenting intervention, physical growth status at age two, and number of older siblings. The findings have important implications for the design of interventions that aim to improve EFs in young children in LMIC. A video abstract of this article can be viewed at https://vimeo.com/316329544/5abde94cd7     

Cyberbullying Involvement of Adolescents with Low Vision Compared to Typical Adolescents,as Related to Perceived Social Support

This study examined adolescents with low vision (LV) compared to students without disabilities regarding their cyberbullying experiences, as related to perceived social support. Sample consisted of 407 students (61 with LV) who completed self-reported questionnaires. Findings revealed that students with LV are using the computer and the Internet as much as the typical students, but students with LV had less frequent Internet interactions with friends. Students with LV reported being more involved in cyberbullying as cybervictims, cyberperpetrators, cyberwitnesses, knowing someone and telling their online experience to another, and having lower social support compared to students without disabilities. Students with LV are more willing to report and to share their online experiences with another person. The findings add to our knowledge about students’ experiences of cyberbullying and suggest implementing effective coping strategies programs to raise the awareness of cyberbullying risky behavior.     

“儿童认知发展水平诊断工具”动态测验的初步编制与应用

本研究旨在将“儿童认知发展水平诊断工具” (Inventory of Piaget’s Developmental Task, IPDT)中的守恒与关系领域分测验改编成动态测验, 并应用于不同程度学业成绩儿童当中以探查其认知发展的潜在水平。在实验研究基础上结合以往动态测验的编制技术, 把动态施测过程分为“前测—干预—迁移—后测”4个阶段, 分别确定各阶段的测题并构建了6等级提示系统。在中等学业成绩儿童(n = 33)和低学业成绩儿童(n = 35)中的应用发现, 动态测验测得的能力获得变量对儿童的学业成绩具有重要的预测作用, 证实了所改编测验的有效性; 动态测验情境下中、低学业成绩儿童的潜在认知水平基本相同, 所改编的动态测验有助于发掘儿童的潜在认知发展水平。     

IABP在心脏直视手术围术期低心排的应用

为了探讨主动脉内球囊反搏（IABP）治疗心脏手术围术期低心输出量综合征（LCOS）的临床疗效,对16例心脏手术围术期LCOS患者,经过股动脉放置IABP导管于降主动脉内进行左心辅助治疗,IABP治疗前、后监测患者连续有创动脉收缩压（SABP）、有创平均动脉压（MABP）、中心静脉压（CVP）、动脉血氧分压（PaO2）、心率（HR）、尿量和血管活性药物的使用。结果显示,IABP辅助治疗时间25h～116h,平均（78．5±40．5）h。行IABP治疗后,SABP、MABP、PaO2较术前明显提高（P〈0．05）,HR、CVP明显下降（P〈0．05）,尿量增加,血管活性药物使用量明显减少（P〈0．05）,12例患者心功能好转而脱离IABP,11例（69．3％）存活,4例死于心源性休克,1例死于多器官功能不全综合征（MODS）。提示正确及时地使用IABP能明显改善心脏手术围术期LCOS患者的血流动力学指标,减少血管活性药物的使用,建议对有适应证者应尽早应用,适时撤离。     

低出生体重与代谢综合征

低出生体重是发生成年期代谢综合征的高危因素。“代谢程序化”与“营养程序化”概念的提出对人们从多层面认识该现象的内在机制有重要指导作用。随着对发生机制研究的深入,人们终将找到预防低出生体重发生成年期代谢综合征的早期干预措施。     

下腰痛综合征的诊治与人文思想

下腰痛是一种常见的骨科病症,轻者可影响患者生活,重者可使患者丧失劳动力。它的发病原因有很多,治疗方法各有不同。在下腰痛的诊断中要按照适度医疗的原则选择合适的检查;在下腰痛的治疗中须按照最优化医疗的原则选择最佳的治疗方案。在治疗中要注意结合人文思想来提高下腰痛的治疗效果。