MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'avoidance'. Sat, 03 Sep 2011 02:05:09 +0100 http://www.medworm.com/index.php?rid=5158998&cid=t_177432_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-outlines-injury-prevention-strategies-in-extreme-weather-conditions%2F2011.08.24 It may seem rather unusual to talk about injuries and weather in the same context, but extreme weather can pose significant risks for many kinds of injury.  Currently, many parts of the United States are experiencing a major heat wave, with record-setting heat and heat indices over the next few weeks.  As we have seen in the recent past, deaths are occurring from heat-related and possibly from participation in outside activities that increase the risk of heat-related illness. During the month of August, many athletes train for the fall sports season, sometimes participating in two practices a day over the course of a few weeks.  While training is necessary and important for athletes to build up their stamina and to improve their performance, health consequences can be deadly if (more&#8... Better Health blogs http://www.medworm.com/rss/comments.php?id=5158998 Wed, 24 Aug 2011 16:00:44 +0100 5158998 http://www.medworm.com/index.php?rid=5159200&cid=t_177432_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F08%2F24%2Ffrom-end-to-beginning-navigating-a-transition-well%2F I’ve had transitions on my mind recently. A lot of clients I work with feel stuck in the middle of a transition they didn’t quite anticipate, or that felt thrust upon them, or whose ramifications they just couldn’t calculate at the outset of the change. Marriage, divorce, childbirth, graduating college, losing a job, moving back home: whether positive or negative, transitions can be messy. And they can also give birth to previously unforeseen opportunities for growth. Therapy is, after all, about change, so I guess it is no surprise that as a therapist I should be witness to transitions galore. William Bridges, author of a book aptly titled Transitions, writes that moving from here to there involves three distinct stages: endings, the middle ground, and beginnings. He emphasizes that... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5159200 Wed, 24 Aug 2011 15:21:17 +0100 5159200 http://www.medworm.com/index.php?rid=5057723&cid=t_177432_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Favoiding-wild-animal-attacks%2F2011.07.23 By now, most everyone is familiar with the tragic circumstances in which a visitor on a trail in Yellowstone National Park on July 6, 2011 surprised a brown (grizzly) bear with cubs, provoking a fatal attack. Fortunately, events like this are rare. At the same time, they are also predictable by virtue of our understanding of bear behavior, particularly in the wildland-urban interface. It was not the victim’s fault, and our hearts go out to his family and friends. For the benefit of others who will backpack and explore in bear country here is an excerpt about avoidance of hazardous animals, in particular bears, adapted from the book Medicine for the Outdoors: Avoidance of Hazardous Animals Most wild animal encounters can be avoided with caution and a little common sense. Follow these rule... Better Health blogs http://www.medworm.com/rss/comments.php?id=5057723 Sat, 23 Jul 2011 14:00:00 +0100 5057723 http://www.medworm.com/index.php?rid=5029044&cid=t_177432_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2011%2F07%2Fthis-morning-i-am-in-avoidance-mode.html I am in avoidance mode this morning. I am scheduled to have an endoscopy this morning. An endoscopy is not a big test. They put you to sleep and stick a camera down your throat to look for bad things - mostly to tell you how bad your heart burn really is.I was very concerned about the idea of a camera down my throat because I googled it and read all the descriptions of what they do. Then I asked my husband how it was when he had one - and he said it was no big deal. I also asked the nurse who called to ask me all the questions and she said they put you to sleep and you wake up and its over. So that is now okay.But with my medical history, they have to be sure. Which always scares the crap out of me - because of my medical history and needing to being sure. How many bad things are found in ... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=5029044 Wed, 13 Jul 2011 10:24:00 +0100 5029044 http://www.medworm.com/index.php?rid=4992690&cid=t_177432_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffourth-of-july-top-tips-for-fireworks-safety%2F2011.07.01 As the 4th of July approaches, I’ve begun to hear fireworks exploding in my neighborhood.  It’s been dry here, so in addition to the risk of injuring a person, there is a risk of setting the fields on fire.  I sure hope my neighbors are being responsible. I hope you will all have a safe and happy July 4th.  Be safe and stay out of the ER. Please use the following tips: Never allow children to play with or ignite fireworks.  A responsible adult should be in charge. Read and follow all warnings and instructions. Be sure other people are out-of-range before lighting fireworks. Small children should be kept a safe distance from the fireworks; older children that use fireworks need to be carefully supervised. Do not smoke when handling any type of “live” firecracker, rocke... Better Health blogs http://www.medworm.com/rss/comments.php?id=4992690 Fri, 01 Jul 2011 16:00:00 +0100 4992690 http://www.medworm.com/index.php?rid=4828884&cid=t_177432_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcreative-semantics-used-by-health-insurance-companies-to-avoid-payments%2F2011.05.16 Insurance companies are supposed to pay for health care, although they do everything they can think of to avoid doing so. One company in particular (a small player here though a much bigger gorilla in other markets) does so by playing with words, even when another behemoth lost a lawsuit over the same issue. The topic involves paying for preventive services while a patient is in the office for care of an acute illness or management of a chronic condition. The way we communicate with insurance companies about what we do in the office is by way of codes; CPT codes, to be precise. There are separate codes to differentiate between preventive services and the so-called Evaluation and Management (E/M) services. The latter are your basic office visit codes covering all the “cognitive” service... Better Health blogs http://www.medworm.com/rss/comments.php?id=4828884 Mon, 16 May 2011 16:00:32 +0100 4828884 http://www.medworm.com/index.php?rid=4797800&cid=t_177432_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F08%2Fdo-you-need-a-mama-psychodrama%2F Grown don’t mean nothing to a mother.  A child is a child.  They get bigger, older, but grown?  What’s that suppose to mean?  In my heart it don’t mean a thing.  ~Toni Morrison, Beloved, 1987 The first relationship with another human being is with our mother.  We forge our sense of who we are, who we are going to love, and our needs based on the interactions and understandings derived from through thousands of encounters with mom.  For better or worse we are molded by an emotional dance with mom. Then we move on.  We deal with dad and siblings, develop friendships, find lovers, and then a spouse.  Throughout this journey mom serves as a role model and becomes a source of  encouragement, love, anxiety, frustration, avoidance, support and conflict. “It’s comp... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4797800 Sun, 08 May 2011 10:35:06 +0100 4797800 http://www.medworm.com/index.php?rid=4615189&cid=t_177432_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F03%2F19%2Fcompulsive-hoarding-and-6-tips-to-help%2F It’s been awhile since I covered the topic of compulsive hoarding, because the last time I did I posted photos of my nut collection and book pile, and the next thing I know I was contacted by Discovery Disney to be fixed on some hoarding special show. Seems like that’s kind of a pattern, now that I think about it. I go public with my stuff … I get invited onto shows! Well, anyway, I was reading an article in the Fall 2007 issue of The Johns Hopkins Depression & Anxiety Bulletin — an interview with Gerald Nestadt, M.D., M.P.H, Director of the Johns Hopkins Obsessive-Compulsive Disorder Clinic and Jack Samuels, Ph.D., an assistant professor with a joint appointment in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Me... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4615189 Sat, 19 Mar 2011 18:30:05 +0100 4615189 http://www.medworm.com/index.php?rid=4536051&cid=t_177432_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FPzWOR-NmY5s%2F By Daniel J. MitchellHere's a new mini-documentary from the Center for Freedom and Prosperity, narrated by Natasha Montague of Americans for Tax Reform, that explains why the process of tax competition is a critical constraint on the propensity of governments to over-tax and over-spend. The issue is very simple. When labor and capital have the ability to escape bad policy by moving across borders, politicians are more likely to realize that it is foolish to impose high tax rates. And they oftentimes compete for jobs and investment by lowering tax rates. This virtuous form of rivalry helps explain why so many nations in recent years have lowered tax rates and adopted simple and fair flat tax systems. Another great feature of the video is the series of quotes from winners of the Nobel Prize... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4536051 Tue, 01 Mar 2011 20:41:13 +0100 4536051 http://www.medworm.com/index.php?rid=4482826&cid=t_177432_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F02%2F15%2Fpunishment-a-cultural-phenomenon%2F We are a culture that believes in punishment. Not just for the criminal or the misbehaving child, but in almost every interaction we have, from our intimate partners to our global enemies and friends. We don’t just see punishment as a deterrent. We think punishment works to change another’s behavior. Just look around. Take a closer look at how you approach a difficult conversation. We all do it. We use punishment all of the time. We don’t even think about it. Punishment is a completely ineffective way to change anyone’s behavior. Punishment simply breeds punishment-avoidance — and what we resist persists. In spite of ongoing and frequent evidence to the contrary, Americans rely on punishment to effect positive change in all areas of our lives. From our child-rearing prac... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4482826 Tue, 15 Feb 2011 18:31:57 +0100 4482826 http://www.medworm.com/index.php?rid=4389176&cid=t_177432_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FxPMowgGLFf4%2F By Daniel J. MitchellThere’s a supposed expose’ in the U.K.-based Daily Mail about how major British companies have subsidiaries in low-tax jurisdictions. It even includes this table with the ostensibly shocking numbers. This is quite akin to the propaganda issued by American statists. Here’s a table from a report issued by a left-wing group that calls itself “Business and Investors Against Tax Haven Abuse.” At the risk of being impolite, I’ll ask the appropriate rhetorical question: What do these tables mean? Are the leftists upset that multinational companies exist? If so, there’s really no point in having a discussion. Are they angry that these firms are legally trying to minimize tax? If so, they must not understand that management has a fidu... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4389176 Mon, 24 Jan 2011 00:32:12 +0100 4389176 http://www.medworm.com/index.php?rid=4172153&cid=t_177432_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2F4SgCwXMISB0%2F by Randy Williams, MD FACC, CEO of Pharos Innovations The results from the National Institutes of Health (NIH)-sponsored Tele-HF trial are in, and the findings are worth considering . The results are counter to most of the findings of other studies examining telemonitoring for heart failure and at face value are disappointing to us, and the industry. Upon closer examination, however, this study offers us an excellent opportunity for further innovation, refinement of solutions and continuous improvement. It also provides a snapshot of how significant the challenges remain in transforming U.S. healthcare – from a system that is episodic, reactive, acute care based to a system of care that incorporates proactive, interactive, continuum-based chronic care management.  The genesis for this ... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4172153 Tue, 16 Nov 2010 22:59:18 +0100 4172153 http://www.medworm.com/index.php?rid=4036758&cid=t_177432_113_f&fid=35744&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fe-CareManagement%2F%7E3%2FdrvBwJYXAbs%2F Last week I attended and participated in an excellent conference — the National Reducing Hospital Readmissions Forum sponsored by World Research Group. One of my main take aways is to observe a simple — yet huge — difference in mindset between hospital executives and vendors. Over the past few months I’ve heard many vendors with diverse health care offerings talking about building readmission avoidance “programs” that they want to sell to hospitals.  Their idea here is to put together a soup-to-nuts offering of technologies and services — a “program” that hospitals would mostly outsource to a 3rd  party vendor. This concept has never quite sat right with me. Having spent the first 15 years of my career in and around the hospital world, I’ve often observe... e-CareManagement blogs http://www.medworm.com/rss/comments.php?id=4036758 Wed, 06 Oct 2010 00:35:58 +0100 4036758 http://www.medworm.com/index.php?rid=3954224&cid=t_177432_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FAnycXvlRsU8%2F By Daniel J. MitchellI sympathize with almost all taxpayers, but it’s difficult to feel sorry for government workers who get in trouble with the IRS. Compensation packages for federal bureaucrats are twice as lucrative as those for workers in the productive sector of the economy and their pensions are similarly extravagant. Yet they often can’t be bothered to fully pay their taxes, owing billions of dollars to the IRS according to a Washington Post report. Among the biggest scofflaws are the folks at the Postal Service, who have accumulated more than $283 million of unpaid taxes. Retired bureaucrats, meanwhile, have amassed nearly $455 million of back taxes. Even tax collectors sometimes fall behind. Treasury Department bureaucrats owe $7.7 million. How hard can it be for them ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3954224 Thu, 09 Sep 2010 19:08:47 +0100 3954224 http://www.medworm.com/index.php?rid=3929218&cid=t_177432_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FcIecKUx-rM0%2F By Daniel J. MitchellHere’s a Reuters story about the Australian Tax Office harassing Paul Hogan, better known to Americans as Crocodile Dundee, because of a tax dispute. The grinches at the tax office took advantage of Hogan’s return for his mother’s funeral to hold him hostage, refusing to let him leave the country until he coughs up some cash. It appears that the tax police in Australia are just as politicized and above the law as the IRS. Hogan has never been charged with tax evasion and there are plenty of signs that the bureaucrats want to make him a high-profile victim to justify the amount of money that has been squandered in a probe of supposed offshore evasion. Actor Paul Hogan, star of the “Crocodile Dundee” movies, has vowed to continue fighting ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3929218 Thu, 02 Sep 2010 17:02:34 +0100 3929218 http://www.medworm.com/index.php?rid=3915308&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F31%2Fgraded-exposure-in-the-real-world%2F Well, not exactly the real world – yet – just the clinic. A man I’m working with is very worried about his back.  Some years ago he had a discectomy and his surgeon told him he needed to be ‘very careful’ with his back – and so he has.  No bending, twisting, lifting for this man!  He’s given up some of his favourite things like fishing and whitebaiting and even golf because of this worry, although when I talk things through with him he’s not exactly sure what might happen if he ‘disobeyed’. Let’s call him Matt for wont of a better name (and yes, as usual, details have been changed to ensure confidentiality), and he’s a fairly ‘blokey’ man who loved his fishing, diving, and taking off for days in his conv... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3915308 Mon, 30 Aug 2010 21:02:47 +0100 3915308 http://www.medworm.com/index.php?rid=3784239&cid=t_177432_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FeyOkz-Lp6CU%2F By Daniel J. MitchellIn the future, dictionary publishers should get rid of their existing definitions for “hypocrisy” and replace them with a photo of Massachusetts Sen.ator John Kerry. He’s just been caught committing the horrible sin of saving his family more than $500,000 by domiciling his new yacht in Rhode Island (which is a tax haven for such luxuries) rather than his home state. Or at least Senator Kerry says that tax planning is a horrible sin when conducted by “Benedict Arnold” companies and facilitated by those wicked tax havens. But I guess that it’s not such a bad thing when Senator Kerry is protecting his wealth. For the rest of us peasants, it’s our job to meekly get in line and submit to whatever taxes Senator Kerry graciously dec... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3784239 Fri, 23 Jul 2010 19:16:36 +0100 3784239 http://www.medworm.com/index.php?rid=3767287&cid=t_177432_136_f&fid=39026&url=http%3A%2F%2Fcarolinemfr.blogspot.com%2F2010%2F07%2Fim-in-avoidance-mode.html This week is not going to be a fun one. I have a doctor appointment today, tomorrow my meds therapist, a test, and another doctor appointment and Thursday a radiofrequency denervation on my right SI joint. I can't wait. I don't want to talk about my medical stuff until I know more about it so today I am in avoidance mode. It is the most mature way I can deal with this - letting my inner three year old out who can close her eyes and make it go away. Okay, its not mature, but it lets me cope better. I also have pills. And a busy schedule. Yesterday we went sailing. The weather was awesome and I was up on deck and saw this big black thing in front of us... and then a fin appeared and it turned out it was a Minke whale. No I am not coordinated enough to get my camera out in time and get its pi... Caroline's Breast Cancer Blog blogs http://www.medworm.com/rss/comments.php?id=3767287 Mon, 19 Jul 2010 11:00:00 +0100 3767287 http://www.medworm.com/index.php?rid=3581857&cid=t_177432_151_f&fid=35818&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FRecoveryIsSexycom%2F%7E3%2FM-DHjXM6q9I%2F The term “co-dependency” was coined more than 20 years ago by authors who studied the negative impact of drug and alcohol use on families. Since then, use of the term has been expanded to include a pattern of psychologically unhealthy behaviors that are learned by individuals as a way of coping with a family environment marked by ignored or denied emotional turmoil. Most people are able to enjoy a sense of healthy, mutual interdependence in their lives. However, people with co-dependency seem to habitually form relationships that are one-sided and emotionally destructive. The central feature of co-dependency is an unhealthy dependence on relationships, usually in an attempt to avoid the feeling of abandonment. Signs and symptoms of co-dependency include: Controlling behavior M... Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3581857 Wed, 19 May 2010 18:39:01 +0100 3581857 http://www.medworm.com/index.php?rid=3564199&cid=t_177432_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FPSiRUKFcokE%2F Besides simply selling pills at a profit, Forest Labs appears to engage in what’s known as transfer pricing - a highly complicated way of avoiding taxes by creating overseas subsidiaries that, in Forest’s case, are used to hold patents and facilitate transactions out of reach of the US Treasury. To illustrate the complexities, Bloomberg News attempted to follow the mysterious trail of dollars generated by Lexapro, Forest’s wildly popular antidepressant, an effort that involved visiting not only a manufacturing plant in Ireland, where tax rates are lower, but also revealed subsidiaries in Bermuda and The Netherlands that appear to function merely as convenient shells. By playing the avoidance game, Forest cut its US tax bill by more than one-third last year and various in... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3564199 Fri, 14 May 2010 13:11:26 +0100 3564199 http://www.medworm.com/index.php?rid=3526729&cid=t_177432_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FGl-Vi6sm0QU%2F This study also emphasizes that where people perceive the tax rate as too high, an increase in the (marginal) tax rate will lead to a decrease in tax revenue. It is worth noting the Schneider’s research also shows why Obama’s tax policy is very misguided. The President wants to boost the top tax rate by nearly five percentage points, and that’s on top of the big increase in the tax rate on saving and investment included in Obamacare. Based on Schneider’s research, we can expect America’s underground economy to expand. Shifting back to Greece, Schneider does not claim that tax rates are the only factor determining compliance. But his research indicates that more onerous enforcement regimes are unlikely to put much of a dent in tax evasion unless accompanied by ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3526729 Mon, 03 May 2010 12:41:10 +0100 3526729 http://www.medworm.com/index.php?rid=3420776&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F30%2Fyoure-just-being-a-hypochondriac-health-anxiety-chronic-pain%2F I think that label has to be one of the most feared amongst the people I see with chronic pain.  To be judged as being obsessed about nonexistant illnesses when actually having pain every day must be incredibly difficult to cope with.  At the same time, being anxious about health and having mistaken beliefs about the meaning of symptoms can be part of both having chronic pain and having health anxiety (the condition previously known as hypochondriasis).  And the temptation some health providers have to say “Oh just go and pull yourself together and stop worrying”  is both unhelpful and part of the problem! I’ve been reading about health anxiety as I look at ways to identify and work with people who are fearful of experiencing pain while at the same time have been told... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3420776 Mon, 29 Mar 2010 18:35:56 +0100 3420776 http://www.medworm.com/index.php?rid=3408676&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F26%2Ffear-of-pain-not-always-fear-of-harm%2F I know it’s actually Friday Funnies day, but before I go there I want to explore something I’ve been observing for a while.  Over the past four or five years, the TSK (Tampa Scale for Kinesiophobia) has been a really popular instrument for identifying and monitoring pain-related anxiety and avoidance.  It has been found to have a two-factor structure, ‘harm’ and ‘activity avoidance’, and has been used as both a predictive measure and an outcome measure that is strongly associated with disability. What I’ve seen though, is that many patients have a fairly low score overall on the TSK, particularly characterised by a low score on the ‘harm’ scale.  At the same time, these patients have been among the most fearful of the patients I see ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3408676 Thu, 25 Mar 2010 19:40:32 +0100 3408676 http://www.medworm.com/index.php?rid=3119066&cid=t_177432_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Fpatterns-of-denial-behaviour%2F Denial has many faces Denial by alcoholics and addicts often follow distinct patterns and they can move from one to another when one is perceived to be losing its effectiveness. The following forms of denial are evident in most alcoholics and addicts at some time. Refusing to face facts, to acknowledge negative consequences of using or drinking. Rejecting clear evidence of tolerance to alcohol Minimizing the facts: Minimizing negative consequences, tolerance, and so forth. Avoiding: Sleeping a lot, becoming socially isolated or becoming compulsive (addictive) in some other way, such as a hobby, work or eating. Exaggeration of others drinking in an effort to normalize one’s own use. Blaming someone/something else for alcohol use (a bad marriage, family conflicts, feeling depre... Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3119066 Thu, 24 Dec 2009 13:37:08 +0100 3119066 http://www.medworm.com/index.php?rid=3082611&cid=t_177432_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Fwhat-is-codependency%2F The term “co-dependency” was coined more than 20 years ago by authors who studied the negative impact of drug and alcohol use on families. Since then, use of the term has been expanded to include a pattern of psychologically unhealthy behaviors that are learned by individuals as a way of coping with a family environment [...] (Source: Recovery Is Sexy.com) Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3082611 Sat, 12 Dec 2009 04:08:00 +0100 3082611 http://www.medworm.com/index.php?rid=3075782&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F12%2F10%2Frecovering-from-a-wrist-or-ankle-fracture-pain-related-fear-catastrophising-and-pain-influences-outcome%2F I have no idea how many wrist and ankle fractures occur every year, but I can bet it’s not a small number by any imagination. For most of us, I’m guessing we’d expect to have a fracture, wield a wonderfully-autographed cast, get it removed and go on our merry way – but after reading this article, and having seen some very sad people over the years, perhaps my expectations of speedy return to normal might be over-inflated! This paper by Linton and colleagues from Orebro, Sweden, is a novel one in that most of our knowledge about chronic pain comes from observing people recovering from low back pain. After all, low back pain is one of the most common pains, it’s the one that produces the most long-term work disability, and treatments for it eat up health budgets... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3075782 Thu, 10 Dec 2009 05:50:57 +0100 3075782 http://www.medworm.com/index.php?rid=3030098&cid=t_177432_151_f&fid=35822&url=http%3A%2F%2Fwww.whatwinnersdo.com%2Favoidance-behavior-awareness%2F In active addiction, part of my avoidance tactics included taking something like a small nagging headache and turning it into a reason to miss work, lay in bed all day and pretty much take a vacation from life. Since those minor aches and pains show up more and more in active addiction...I spent a lot of time "sick". The tendency to either fake or exaggerate illness as an avoidance tactic did not go away just because I stopped taking drugs. It seemed that anytime I had an extremely full day or I wasn't in that great of a mood, my brain would want me to pretend that I was sick as a way of getting out of life. It took a lot of hard work but I can say that since entering into addiction recovery I have not given into these impulses and have not once been "sick" for the sake of laying low. I fe... What Winners Do blogs http://www.medworm.com/rss/comments.php?id=3030098 Sun, 22 Nov 2009 07:00:10 +0100 3030098 http://www.medworm.com/index.php?rid=2947144&cid=t_177432_151_f&fid=35822&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FWhatWinnersDo%2F%7E3%2FE5fFIDEuiNo%2F The post I recently did about learning to accept the things I cannot change got me thinking about a negative behavior that I was riddled with in active addiction...not facing problems head on. The behavior of avoiding problematic situations is something that is very common with addicts. See, the key to successfully living in denial about all of your problems is to numb yourself into oblivion until you don't think about them anymore. Simple right? So what happens when you are no longer numbing away your problems with drugs or alcohol? Well, unless you want to continue living a miserable life that is completely based on denial and a disconnection from your soul you need to master the art of facing problems head on in recovery. Now when I tell you that I never faced problems head on I really ... What Winners Do blogs http://www.medworm.com/rss/comments.php?id=2947144 Sat, 31 Oct 2009 00:49:07 +0100 2947144 http://www.medworm.com/index.php?rid=2820618&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F09%2F22%2Fmore-on-anxiety-and-pain-pain-related-anxiety%2F It seems obvious that something unpleasant is something to be avoided – and if we’re meant to avoid it, we’re likely to be just a little bit afraid of it. Yesterday I talked about health anxiety in general, and today I want to touch on a specific sub-group of health anxiety – pain-related anxiety. Many people will be familiar with pain-related anxiety and avoidance, the model of so-called ‘fear avoidance’ that is a compelling explanation for how so many people become deactivated and disabled when they have persistent pain. It might be a surprise to some that the term ‘fear avoidance’ is actually not technically correct! There are two parts to the phenomenon: fear (or really, pain anxiety) and avoidance. It’s possible to be fearful or an... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2820618 Mon, 21 Sep 2009 19:37:13 +0100 2820618 http://www.medworm.com/index.php?rid=2772731&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F09%2F07%2Fpacing-and-avoidance-in-fibromyalgia%2F The recent emergence of study into ‘pacing’ or activity regulation in pain management is a welcome addition to our knowledge of this coping strategy. Although pacing has been described and included in many self-help books as well as clinical texts as an effective strategy for people with chronic pain to use, the research base for its use is pretty skinny (see Gill and Brown, 2009). McCracken and Samuels (2007) found that increased use of pacing was associated with higher disability and less acceptance, while Nielson and Jensen (2004) found that it was associated with lower disability in people with fibromyalgia. The study I’m looking at today, by Karsdorp and Vlaeyen, looked in whether pacing specifically was different from ‘other behavioural strategies assessed wit... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2772731 Sun, 06 Sep 2009 19:32:30 +0100 2772731 http://www.medworm.com/index.php?rid=2730384&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F08%2F25%2Fsafety-behaviours-do-they-maintain-kinesiophobia%2F Let me start by saying this post is conjecture, but based both on observing patients, and after reading an interesting paper on ’subtle avoidance and safety behaviours relevant to social anxiety’. First some definitions: I hope you’re all familiar with the term ‘kinesiophobia’, or ‘fear of movement’ – it’s the fear and avoidance of movements that an individual believes will hurt or harm them. Safety behaviours: are strategies that may be used to reduce the anxiety of carrying out a behaviour – and are usually ‘logically’ linked to the underlying belief about the movement.  For example, using ’safe lifting techniques’ can be a safety behaviour in someone who is fearful of bending; taking a deep breath in an... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2730384 Mon, 24 Aug 2009 19:29:17 +0100 2730384 http://www.medworm.com/index.php?rid=2667402&cid=t_177432_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FY7hHnHE4ohw%2F My friend Pierre Bessard of Switzlerand’s Liberales Institut has a columnin today’s New York Times defending financial privacy from the predations of both international bureaucracies and American tax collectors. Pierre sagely notes that the Swiss system respects the privacy of citizens, unlike the “Orwellian” systems in places like America. This approach results in a very high level of tax compliance in Switzerland, and also provides a refuge for oppressed people around the world: …for us here in Switzerland, our financial privacy laws are a foundation for individual dignity and basic property rights. Unfortunately, the confidentiality that is the hallmark of Swiss banking is coming under increasing pressure. … We think government exists to serve us, no... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2667402 Mon, 03 Aug 2009 16:13:54 +0100 2667402 http://www.medworm.com/index.php?rid=2523127&cid=t_177432_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2009%2F06%2F26%2Fboredom-can-be-a-door-to-new-growth%2F A few days ago a friend forwarded me a post on DailyOM.com called “Boredom: Fanning the Creative Flames.” It says: The human mind thrives on novelty. What was once a source of pleasure can become tedious after a time. Though our lives are full, boredom lurks around every corner because we innately long for new experiences. Yet boredom by its very nature is passive. In this idle state of mind, we may feel frustrated at our inability to channel our mental energy into productive or engaging tasks. We may even attempt to lose ourselves in purposeless or self-destructive pursuits. While this can be a sign of depression, it can also be an invitation issued from your mind, asking you to challenge yourself. Boredom can become the motivation that drives you to learn, explore the exotic... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=2523127 Fri, 26 Jun 2009 15:32:10 +0100 2523127 http://www.medworm.com/index.php?rid=2329678&cid=t_177432_146_f&fid=38266&url=http%3A%2F%2Fsleepeducation.blogspot.com%2F2009%2F04%2Fus-navy-paying-attention-to-sleep.html The dramatic rescue of Capt. Richard Phillips from Somali pirates has focused the world’s attention on the U.S. Navy and the Navy SEALs. The mission exemplified the Navy ethos of being “disciplined and well-prepared.”Does sleep play a role in this preparation of Navy sailors and pilots?An article in the Virginian-Pilot takes a look. It finds that within the Naval ranks awareness of the importance of sleep is growing.One major issue of concern is the effect that rotating work shifts and missions can have on performance and alertness. The article reports that a squadron in Iraq is experimenting to find the best way to rotate its pilots' flight schedules.But it’s not just the pilots who need sleep. Crew members often get by on short naps during carrier operations.There also is concern... Sleep Education blogs http://www.medworm.com/rss/comments.php?id=2329678 Tue, 14 Apr 2009 17:37:00 +0100 2329678 http://www.medworm.com/index.php?rid=1970821&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F11%2F18%2Fadding-graded-exposure-or-graded-activity-makes-no-difference%2F This study by George, Zeppieri, Cere et al. (2008) looks at a clinical trial comparing the effectiveness of treatment-based classification (TBC) physical therapy alone to TBC augmented with graded activity (GA) or graded exposure (GX) for patients with acute and sub-acute LBP. ‘Graded exercise and graded exposure are specific behavioral interventions that dose exercise and activity parameters on factors other than pain intensity. Briefly, graded exercise uses a quota system to progress subjects’ therapeutic exercise and activity. In contrast, graded exposure hierarchically exposes subjects to specific situations of which they are fearful by starting with exercise or activity that elicits minimal amounts of fear, and then gradually increasing to situations that elicit larger amounts... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1970821 Tue, 18 Nov 2008 00:34:45 +0100 1970821 http://www.medworm.com/index.php?rid=1956521&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F11%2F13%2Fpain-related-anxiety-and-avoidance-a-practical-application-of-theory-and-research-to-clinical-practice%2F In 1995 I started work at the Burwood Pain Management Centre.  It wasn’t my first foray into pain management, but it was the first time I had worked in a fully integrated interdiscipinary team environment.  It was also significant because of the use of the words ‘fear-avoidance’, ‘guarding’ and ‘anticipatory anxiety’. What the team had observed was that there were a specific group of patients who were not just worried about experiencing pain, but were also showing the signs of increased physiological arousal, avoidance of specific activities, and firm beliefs about harm, reinjury, or doing further damage. At the time we used an operant conditioning model (based on Fordyce, 1971 & 1976), along with graded reactivation using a physical conditio... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1956521 Thu, 13 Nov 2008 08:55:51 +0100 1956521 http://www.medworm.com/index.php?rid=1953267&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F11%2F13%2Ftheory-and-really-practical-clinical-reasoning%2F I’ve been mulling over my delight and joy in theory, and wondering whether this turns people off reading my blog.  So today I thought I’d draw a link between theory and everyday work in pain management. Theory and models really matter!  They form the organisational framework for the data we collect (ie the things we look for when we assess people), from the models we use, we develop hypotheses, or potential explanations for the way the person presents. It’s these hypotheses we test when we actually carry out therapy: to confirm our predictions.  If our predictions don’t hold, we’ve probably got the wrong explanation and need to look for another one, if they do hold, we can probably work with the underlying theory or model to develop other hypotheses or inte... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1953267 Wed, 12 Nov 2008 18:31:02 +0100 1953267 http://www.medworm.com/index.php?rid=1856011&cid=t_177432_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F10%2F06%2Fphobias-not-just-fear%2F I was browsing some of my regular news sites and came across an article in CNN.com’s Living section about phobias. (It was actually a syndicated article from a New York Times company, go figure.) In the piece, which actually gets to some good suggestions at the end, it promulgates a common misrepresentation of what a phobia is: A “specific” phobia, or an “excessive and unreasonable fear of a specific object, place or situation,” afflicts about 19 million people in the U.S., according to the Anxiety Disorders Association of America. Okay, that’s fine. That’s the shorthand version of what a phobia is. But the real diagnosis includes meeting all 6 criteria, including this very important one (often overlooked in the mainstream media): The diagno... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1856011 Tue, 07 Oct 2008 01:41:45 +0100 1856011 http://www.medworm.com/index.php?rid=1838589&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F09%2F30%2Fcase-formulation-the-next-few-steps%2F Over the past few days I’ve been writing about case formulation because in pain management, it’s rare to find only one single causal factor that is influencing either the pain or the disability. Most times we are looking at many factors coming from all three areas of the biopsychosocial model. In each person, the relationships between and combinations of these factors will be unique. And that’s the value of a case formulation as opposed to a diagnosis, which is more like ’shorthand’ for a group of symptoms that go together and are supposedly linked by a causal mechanism (in the case of non-mental health problems). After identifying stable phenomena (symptoms that are present over time and in different places), the next step is to identify the underlying biopsy... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1838589 Tue, 30 Sep 2008 08:54:55 +0100 1838589 http://www.medworm.com/index.php?rid=1827168&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F09%2F25%2Fan-introduction-to-case-formulation%2F One definition of case formulation is ‘Case formulation aims to describe a person’s presenting problems and use theory to make explanatory inferences about causes and maintaining factors that can inform interventions’. What this means is that it is essentially a story not just to describe, but explain, how a person’s problem has developed, and how it is maintained so that treatments can be based on influencing those factors. There are many different frameworks for case formulation, but several key elements are usually present: a description of the presenting issues; the factors that act to create vulnerability or precipitate the problems developing; factors that may not have been involved in the initial problem developing, but are helping to maintain the problems; and ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1827168 Thu, 25 Sep 2008 09:34:04 +0100 1827168 http://www.medworm.com/index.php?rid=1803855&cid=t_177432_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2008%2F09%2F18%2Fsuccess-why-measuring-outcome-is-so-rewarding%2F Not a research post today, but a great experience that I hope will encourage anyone who is not already a fan of regular outcome measurement to get on with it! I saw a person yesterday who has had pain for about 3 years.  Superficially she’d been managing quite well - still working, having a social life, managing all her household activities and in general, looking good.  BUT - and you knew there would be a ‘but’ - once I started to look a little deeper, it was absolutely amazing to see how much she had adapted her life to avoid specific movements. I used the PHODA (photographs of daily activities) to assess the specific movements and activities she didn’t like to do.  I’ve blogged about PHODA (Kugler et al, 1999) before - a set of photographs of everyday ac... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=1803855 Thu, 18 Sep 2008 06:10:08 +0100 1803855 http://www.medworm.com/index.php?rid=1646123&cid=t_177432_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Flonger-aa-attendance-predicts-change%2F This study examined the predictors of self-efficacy in the year after treatment and 15 years later. A sample of 420 individuals with alcohol use disorders was assessed five times over the course of 16 years. Predictors of self-efficacy at 1 year included improvement from baseline to 1 year in heavy drinking, alcohol-related problems, depression, impulsivity, avoidance coping, social support from friends, and longer duration of participation in mutual-help Alcoholics Anonymous (AA). Female gender, more education, less change in substance use problems, and impulsivity during the first year predicted improvement in self-efficacy over 16 years. Clinicians should focus on keeping patients engaged in self-help of AA, addressing depressive symptoms, improving patient’s coping,... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=1646123 Tue, 22 Jul 2008 12:15:11 +0100 1646123 http://www.medworm.com/index.php?rid=1360806&cid=t_177432_151_f&fid=35822&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FWhatWinnersDo%2F%7E3%2F267218113%2F The post I recently did about learning to accept the things I cannot change got me thinking about a negative behavior that I was riddled with in active addiction…not facing problems head on. The behavior of avoiding problematic situations is something that is very common with addicts. See, the key to successfully living in denial about all of your problems is to numb yourself into oblivion until you don’t think about them anymore. Simple right? So what happens when you are no longer numbing away your problems with drugs or alcohol? Well, unless you want to continue living a miserable life that is completely based on denial and a disconnection from your soul you need to master the art of facing problems head on in recovery. (more…) Related Posts:February 19, 2008 -- Lifest... What Winners Do blogs http://www.medworm.com/rss/comments.php?id=1360806 Wed, 09 Apr 2008 19:49:37 +0100 1360806 http://www.medworm.com/index.php?rid=1269660&cid=t_177432_151_f&fid=35822&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FWhatWinnersDo%2F%7E3%2F243599492%2F In active addiction, part of my avoidance tactics included taking something like a small nagging headache and turning it into a reason to miss work, lay in bed all day and pretty much take a vacation from life. Since those minor aches and pains show up more and more in active addiction…I spent a lot of time “sick”. The tendency to either fake or exaggerate illness as an avoidance tactic did not go away just because I stopped taking drugs. It seemed that anytime I had an extremely full day or I wasn’t in that great of a mood, my brain would want me to pretend that I was sick as a way of getting out of life. It took a lot of hard work but I can say that since entering into addiction recovery I have not given into these impulses and have not once been “sick&#8221... What Winners Do blogs http://www.medworm.com/rss/comments.php?id=1269660 Fri, 29 Feb 2008 23:48:09 +0100 1269660 http://www.medworm.com/index.php?rid=602003&cid=t_177432_87_f&fid=34882&url=http%3A%2F%2Fbreathspakids.blogspot.com%2F2007%2F05%2Fgreater-and-earlier-incidence-of.html There have been lots of advance warnings in the UK about the likelihood of widespread hayfever earlier this year; we have been advised that there will be an earlier onset to the pollen season than usual. It seems that these warnings were appropriate as there are reports of a doubling in sales of hayfever remedies and higher than usual numbers of people, between the ages of 5-44, who are experiencing eye problems.In the week ending 24 April, figures show that NHS Direct was receiving on average 150 calls a day from people with these hay symptoms, which is a rise of all calls to NHS Direct from 0.7% to 1.5%. The most likely cause of this is increased pollen from trees like the Silver Birch, Oak and Plane trees brought on by the recent warm sunny weather. Commenting on this Helen Young, Execu... Breath Spa for Kids blogs http://www.medworm.com/rss/comments.php?id=602003 Wed, 09 May 2007 15:34:00 +0100 602003 http://www.medworm.com/index.php?rid=478818&cid=t_177432_87_f&fid=34882&url=http%3A%2F%2Fbreathspakids.blogspot.com%2F2007%2F03%2Ftruthiness-and-referenciness-make-case.html And please let Shinga read some decent research papers before she explodes*.Prof. Ernst has frequently and elegantly rebutted the claim that CAM treatments and therapies are not amenable to standard forms of scientific investigation. However, hand in hand with the claims that CAM is not suited to scrutiny, it seems that there is a certain truthiness and referenciness that predominates in the claims of scientific support for some of these treatments.Dr Ben Goldacre, used this word to suggest a supposed scholarly reference that wasn't a real one: "The scholarliness of her work is a thing to behold: she produces lengthy documents that have an air of 'referenciness' ... but when you follow the numbers, and check the references, it's shocking how often they aren't what she claimed them to be." ... Breath Spa for Kids blogs http://www.medworm.com/rss/comments.php?id=478818 Sat, 03 Mar 2007 12:22:00 +0100 478818 http://www.medworm.com/index.php?rid=478813&cid=t_177432_87_f&fid=34882&url=http%3A%2F%2Fbreathspakids.blogspot.com%2F2007%2F02%2Fquote-mining-and-misrepresentation-poor.html This study is very poor; the claims being made for it are over-blown and disproportionate. Readers can not possibly assess these claims of NHS mis-treatment or mis-guided treatment if we have no way of discovering which treatment modalities were attempted.YorkTest also has the chutzpah to promote an obscure petition to provide free food intolerance tests on the NHS. Their pious hope is that the petition:re-enforces the view that the NHS should put peoples health at the forefront of its health service strategy. If the petition takes off, then it could make the health minister sit up and take action in saving the health service thousands of pounds whilst freeing up doctors valuable time. At best this petition might make the stakeholders of the health service to look at what is best for the p... Breath Spa for Kids blogs http://www.medworm.com/rss/comments.php?id=478813 Tue, 27 Feb 2007 15:15:00 +0100 478813 http://www.medworm.com/index.php?rid=478814&cid=t_177432_87_f&fid=34882&url=http%3A%2F%2Fbreathspakids.blogspot.com%2F2007%2F02%2Fwhat-is-significance-of-igg-antibodies.html I recently highlighted my misgivings about the claims of sound science or clinical validation for IgG testing for food intolerance. Dr. de Asis gives a very helpful and clear overview of food allergy, intolerance and testing. Similarly, Dr. Minocha offers an fine overview of food allergy and tolerance.I thought that it might be helpful to quote the position of some professional organisations on the topic of IgG significance and testing.The American Academy of Allergy, Asthma and Immunology commented on the significance of IgG anti-allergen antibodies in September 2006. They observed that a number of commercial labs claim to be able to measure IgG antibodies against common substances: they questioned the clinical significance of the findings. Although this piece probably refers to labs in t... Breath Spa for Kids blogs http://www.medworm.com/rss/comments.php?id=478814 Mon, 19 Feb 2007 15:41:00 +0100 478814 http://www.medworm.com/index.php?rid=478823&cid=t_177432_87_f&fid=34882&url=http%3A%2F%2Fbreathspakids.blogspot.com%2F2007%2F02%2Fwhy-igg-testing-for-food-intolerance-is.html What I know about the scientific validity of IgG testing to diagnose food intolerance could be written on a postcard leaving plenty of room for the address and stamp. I'm just mentioning this because it may be time for authors' competing interest declarations to be supplemented with a statement of scope of knowledge/ignorance/belief. I've been prompted to consider the need for this statement by Patrick Holford's theatrical outrage about BBC Watchdog's Dirty Allergy Trick* (NB, the original article has been removed, I shall do my best to keep up with other links to it). A healthy volunteer participated in three food allergy/intolerance tests – two VEGA tests (conducted at different times and with different operators), a hair test, and two YorkTest IgG Food Intolerance tests (he submitted ... Breath Spa for Kids blogs http://www.medworm.com/rss/comments.php?id=478823 Fri, 16 Feb 2007 12:18:00 +0100 478823