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 'disability'. Sat, 03 Sep 2011 01:53:14 +0100 http://www.medworm.com/index.php?rid=5130967&cid=t_105241_133_f&fid=35095&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAutismsEdges%2F%7E3%2Fk8_DcA02pcw%2Fblogher-2011-unpacking-special-needs.html (Source: Autism's Edges) Autism's Edges blogs http://www.medworm.com/rss/comments.php?id=5130967 Mon, 15 Aug 2011 22:08:00 +0100 5130967 http://www.medworm.com/index.php?rid=5130968&cid=t_105241_133_f&fid=35095&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FAutismsEdges%2F%7E3%2FxgguL-RQVg8%2Foctopuss-garden-by-sea.html (Source: Autism's Edges) Autism's Edges blogs http://www.medworm.com/rss/comments.php?id=5130968 Mon, 15 Aug 2011 02:18:00 +0100 5130968 http://www.medworm.com/index.php?rid=5119029&cid=t_105241_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2011%2F08%2Fdisability-or-ability-tvs-alphas.html I watch a fair amount of TV. Now that I'm home 2 extra days, I keep it on for noise during the day. One of the shows i have started watching is Alphas from the SyFy channel. Alphas so far appears to be a fairly standard superheroes kind of show in the line of XMen, Heroes, etc mixed in with some espionage and spy work. I like those kind of shows, so I can tolerate some of the less-than-awesome dialogue and recycled plots. Of the 5 types of Alphas described, even mild comic book or superhero fans could list other characters that fit these types. What spiked my interest in the show was the character who is a "transducer" and able to act as an antenna to intercept and decode messages. "Gary" is able to read all wavelengths- TV, cell phones, computer traffic on the internet, etc. This is an ... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=5119029 Wed, 10 Aug 2011 23:27:00 +0100 5119029 http://www.medworm.com/index.php?rid=5051009&cid=t_105241_129_f&fid=38945&url=http%3A%2F%2Fwww.disabled-world.com%2Fdisability%2Fblogs%2Fenmeshment.php A word that frequently comes up in family therapy is "enmeshment." It's a therapeutic term that is sometimes misused and often misunderstood. (Source: Disabled World Blogs) Disabled World Blogs blogs http://www.medworm.com/rss/comments.php?id=5051009 Wed, 20 Jul 2011 20:22:39 +0100 5051009 http://www.medworm.com/index.php?rid=5036612&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F18%2Fwhat-matters-patient-determined-outcomes-and-clinicianresearcher-outcomes%2F It’s easy to forget, sometimes, that when we choose an outcome measure, we need to seriously consider who will use the measures in the end.  Of course, I am assuming that we’re all using outcome measures – we are, aren’t we?  If anyone isn’t, shame on you – how on earth will you establish whether what you’re doing is having an effect? And don’t come at me with “oh but I just ask them” because I don’t want to have to list all the response bias, demand characteristics, and lack of consistency problems again. kthx. Anyway, where was I? That’s right, the end-user in outcome measures.  Over the past few years, interest has risen in identifying the range of outcome measures that can be/should be used in research of treatm... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=5036612 Sun, 17 Jul 2011 19:30:31 +0100 5036612 http://www.medworm.com/index.php?rid=5107803&cid=t_105241_133_f&fid=35084&url=https%3A%2F%2Fballastexistenz.wordpress.com%2F2011%2F07%2F13%2Fwhat-a-total-non-apology%2F I’m not generally one to throw a blog post out there every time someone uses a disability slur. But the way this was handled is just pissing me off on multiple levels. So a politician named Rahm Emanuel decided to insult a bunch of political activists by calling them “f.ing retarded” when they didn’t agree with him on something. Then when he realized this was going to get out, he called Tim Shriver (CEO of the Special Olympics) to apologize. This apology was apparently accepted. Newspapers are calling this an apology to the disability community. Here’s where my brain’s starting to stall on me coming up with the language for it. He didn’t apologize to the people the insult was aimed at. Argh brain splitting up into pieces. He apologized to Tim Shriv... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=5107803 Wed, 13 Jul 2011 02:41:48 +0100 5107803 http://www.medworm.com/index.php?rid=5029273&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F12%2Fself-efficacy-and-fear-of-movement-mediate-pain-intensity-and-disability-in-acute-pain%2F Most clinicians working in chronic pain management are well aware that the time it takes for people to finally be referred for management of their pain is far too long and some of the readers of this blog who work with people who have acute pain may wonder whether anything I write about applies to them and the people they treat.  To both groups of readers – today’s post should apply! Arguably the most common reason for people seeing a doctor is because of a musculoskeletal pain.  Treatment is usually quite simple: diagnosis, pain relief, anti-inflammatories and gradual return to function.  It’s this last part of treatment that seems to cause the most trouble for people - what if the pain doesn’t settle, what if I’m damaging my body, how long should I &#8220... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=5029273 Mon, 11 Jul 2011 19:29:01 +0100 5029273 http://www.medworm.com/index.php?rid=5028752&cid=t_105241_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fmultiple-sclerosis-and-the-question-of-disability-insurance%2F I’m not sure if the advancement of a post-holidays head cold into a sinus infection (and the associated MS issues related to a fever) had any part of my sensitivity to comments that circulated here on the Life With MS Blog and our Facebook Page but I thought that it might be time we discuss disability insurance and SSDI again. In this day and age of starkly divided political views many see “leaving work” because of MS as yet another way in which too many people are grasping at a government entitlement and suckling from the public teat. Others see SSDI as an insurance plan into which they have paid and, like any other insurance policy, when they need it they expect it to be there for them. There are many, many problems with the entire “disability” system (for lack of better termin... Life with MS blogs http://www.medworm.com/rss/comments.php?id=5028752 Mon, 11 Jul 2011 19:26:57 +0100 5028752 http://www.medworm.com/index.php?rid=5008504&cid=t_105241_129_f&fid=38945&url=http%3A%2F%2Fwww.disabled-world.com%2Fdisability%2Fblogs%2Fblogging.php No matter what your area of business you cannot ignore the power of the blog in today's world of business. (Source: Disabled World Blogs) Disabled World Blogs blogs http://www.medworm.com/rss/comments.php?id=5008504 Fri, 08 Jul 2011 17:39:13 +0100 5008504 http://www.medworm.com/index.php?rid=4993017&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F07%2F01%2Fwhat-is-this-thing-called-pain%2F As I’m busy writing up research papers for publications to “count” towards my research productivity, I’m reminded of one reason I keep on blogging – and it’s this: blogs are open to anyone.  People can comment on what I write.  When someone comments, whether they agree, disagree, or simply pose a question, it’s an opportunity for dialogue and reflection. That’s not nearly as easy to do in a peer-reviewed journal! As a result of comments from my post yesterday, I’m musing on ways to explain the distinction between acute and chronic pain that will make sense to someone who experiences fluctuations in pain intensity. I think I’m clear in my own mind between the two, but perhaps things are not as distinct as I’ve made them &#8... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4993017 Thu, 30 Jun 2011 21:04:56 +0100 4993017 http://www.medworm.com/index.php?rid=4976238&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F06%2F29%2Fblack-and-white-thinking-must-be-abolished%2F Black and white thinking, for those readers unfamiliar with cognitive distortions, refers to the tendency to reduce complex ideas and situations into simple, dichotomous, and mutually exclusive categories. Think of good or bad, yes or no, all correct or all wrong, acute pain or chronic pain, neuromatrix or peripheral mechanisms, cure the pain or manage the pain. It’s a way of simplifying arguments or decisions that can work well when the situation requires very fast decision-making, or where the options are very limited. It doesn’t work at all in the messy and complicated worlds of clinical reasoning, theory development, or in discussions to broaden understanding. I’m pondering this because of the way various aspects of pain management and the science of pain are misrepre... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4976238 Tue, 28 Jun 2011 19:15:22 +0100 4976238 http://www.medworm.com/index.php?rid=4921783&cid=t_105241_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F06%2Fnews-is-so-sad-today-i-dont-even-know.html There are a couple important stories in the news today that everyone needs to watch.In this first story we see an absolute lack of understanding in how a governmental agency responded to an adult who was trying to board a plane with his family:Dr. David Mandy: Special Needs Son Harassed by TSA at Detroit Metropolitan Airport: MyFoxDETROIT.comIn the second story we see people completely disrespecting and interfering with a Special Olympics activity. It is certainly within their rights to express their displeasure about whatever they want, but sane people would choose a time and place that is appropriate for such a protest:Lastly, and most tragically, is the continued failure of NYS - all these years after Willowbrook we thought it would never happen again:It is very clear to me that as a so... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4921783 Thu, 09 Jun 2011 20:12:00 +0100 4921783 http://www.medworm.com/index.php?rid=4921427&cid=t_105241_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fnew-who-report-more-than-1-billion-people-are-disabled%2F2011.06.09 The World Health Organization (WHO) and the World Bank just revealed the first-ever global estimate of disability. The report suggests that at least 1 billion people are currently disabled, and about 1/5 of those are experiencing significant difficulties with their activities of daily living. Since  people with disabilities experience poorer health, lower educational achievements, fewer economic opportunities and higher rates of poverty than people without disabilities, this vulnerable segment of the population needs much closer attention. I’m a physical medicine and rehabilitation (PM&R) specialist by training, and there are only about 8000 of us in the United States. Some have called PM&R specialists: “primary care physicians for the disabled” and I think that&... Better Health blogs http://www.medworm.com/rss/comments.php?id=4921427 Thu, 09 Jun 2011 18:00:37 +0100 4921427 http://www.medworm.com/index.php?rid=4911548&cid=t_105241_107_f&fid=34860&url=http%3A%2F%2Fwww.corporeality.net%2Fmuseion%2F2011%2F06%2F08%2Fmalling-hansens-braille-writing-ball-on-display%2F A very special artefact from Medical Museion’s collections in on display in a new exhibition at the Copenhagen Post and Tele Museum, celebrating the centennial of the Danish Association for the Blind. The insect compund eye looking thing is actually a Braille version of the writing ball patented by Rasmus Malling-Hansen in 1870. Selling well in Europe (Remington was the favourite typewriting machine in the US), it received prizes at a number of international exhibitions, including the World Exhibitions in Vienna in 1873 and Paris in 1878. The most famous owner of a Malling-Hansen writing ball was in fact Friedrich Nietzsche, who got one in 1882, but apparently didn’t use it much. (More about the writing ball on the Malling-Hansen Society website.) Malling-Han... Biomedicine on Display blogs http://www.medworm.com/rss/comments.php?id=4911548 Wed, 08 Jun 2011 13:00:40 +0100 4911548 http://www.medworm.com/index.php?rid=4911487&cid=t_105241_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fscuba-diving-with-a-disability%2F2011.06.07 Outdoor recreation is intended for everyone, and can be enormously beneficial for persons with disabilities. I am in awe of disabled skiers, climbers, divers, and others who have learned to coordinate their bodies and take great enjoyment and a sense of accomplishment from their wilderness activities. It behooves everyone in the healthcare profession to be aware of certain special medical concerns for persons who are disabled physically or emotionally. Additionally, family members and friends are often well aware of what they can do to help in providing a joint effort to support the disabled. At the 2010 Wilderness Medical Society annual meeting in Snowmass, Colorado, JenFu Cheng, MD (a pediatric rehabilitation specialist from NJ), gave a wonderful presentation on the medical aspects of ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4911487 Tue, 07 Jun 2011 12:00:00 +0100 4911487 http://www.medworm.com/index.php?rid=4902423&cid=t_105241_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-myth-of-the-rich-doctor%2F2011.06.05 This is my column in June’s EM News. ‘But you’re a rich doctor, right?’ Have you had that conversation? There’s a certain expectation of physicians, that we’re all just filthy rich, overflowing with boxes of cash tucked neatly away beneath our gilded beds. When we were building our house, our builder talked with my wife: ‘Jan, I want you to meet me to look for counters and cabinets. Don’t bathe the kids. Put them in dirty play clothes and don’t wear anything nice. Don’t ever tell them your husband is a doctor.’ He’s a wise man. What he knew was that the word ‘doctor’ means ‘cash.’ Or at least, means ‘cash’ to the popular mind. I wonder if this perception is the reason patients come to the emergency department and say things like this: ‘I don’t have ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4902423 Sun, 05 Jun 2011 17:00:02 +0100 4902423 http://www.medworm.com/index.php?rid=4893948&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F06%2F02%2Fcatastrophising-and-pain-ii%2F What are some of the indications that someone tends to catastrophise about their pain? How do we know? Do we have to use a questionnaire? Is it really my job to know about this if I’m not a psychologist – and what do I do about it? These are the kinds of questions that have been posed to me as I’ve explored the topic of catastrophising, and I propose to answer the last question in my next post (sorry to keep stringing you along like this – I think many may know my take on that already!). I work in a wonderful interdisciplinary team setting, in a centre where everyone who attends the Centre gets to complete a set of psychometrically sound questionnaires that all of the team are encouraged to use and interpret, so any of the team can be confident about identifying and... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4893948 Thu, 02 Jun 2011 08:26:50 +0100 4893948 http://www.medworm.com/index.php?rid=4893949&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F06%2F01%2Fpain-behaviours-persist%2F In this study by Martel, Thibault and Sullivan (2010), people with back pain were recorded on two separate occasions (on averge 22 days apart) while carrying out two lifting tasks designed to elicit pain behaviours.  These recordings were reviewed by trained observers who recorded the number of pain behaviours in each segment of film using a standardised coding scheme (developed by Keefe and Block, 1982).  Participants in the lifting tasks also completed a range of questionnaires – the Tampa Scale for Kinesiophobia, the McGill Pain Questionnaire, and the Pain Catastrophising Scale. Before I describe the findings, in this study two different forms of pain behaviour were identified – communicative behaviours are things like grimacing, speaking, sighing, moaning and so on; while... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4893949 Wed, 01 Jun 2011 05:26:00 +0100 4893949 http://www.medworm.com/index.php?rid=4821180&cid=t_105241_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F05%2Forwellian-analysis-of-cse-meetings.html Sometimes when children progress from preschool to school it is determined that they still need to be classified and receive special education services. Sometimes it is determined that they should be declassified. There is a defined process that is supposed to be followed.Patrick is a preschooler who has disabilities and if he enrolled in kindergarten last year he would have either continued his classification and received services OR continued his occupational therapy services in the school under a declassification plan for one year. Given his severity of delay he would have also been a likely participant in a summer readiness program designed to help support children's performance when they are struggling with key developmental skills.The goalposts have been moved again this year. Now th... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4821180 Fri, 13 May 2011 18:52:00 +0100 4821180 http://www.medworm.com/index.php?rid=4813360&cid=t_105241_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F05%2F11%2Fva-mental-health-care-is-so-bad-its-unconstitutional%2F So says a three-judge panel of the 9th U.S. Circuit Court of Appeals in San Francisco, after reviewing the evidence about the ability of the U.S. Department of Veterans Affairs (VA) to offer an appropriately level of mental health care and treatment to returning soldiers. In this way, the costs of the ongoing wars in Iraq and Afghanistan have been grossly underestimated, because they don’t take into account the increased needs and costs of the vets’ ongoing and increasing mental health care. The longer we’re at war, the worse it’s going to get. According to the article on TIME.com about the recent ruling, not only do some vets have to wait weeks to get in to see a mental health professional at many VA medical centers, but there’s often no significant triaging ... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4813360 Wed, 11 May 2011 15:30:28 +0100 4813360 http://www.medworm.com/index.php?rid=4753985&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F04%2F26%2Fa-new-way-of-looking-at-coping-maybe%2F One half of knowing what you want is knowing what you must give up before you get it. ~Sidney Howard Many are stubborn in pursuit of the path they have chosen, few in pursuit of the goal. ~Friedrich Wilhelm Nietzsche There are few topics closer to my heart than goals.  This is partly because of my background in occupational therapy, where goals are seen as part of how we live purposeful, meaningful lives – but it’s also because they’re incredibly difficult to help others to do, yet goal setting is seen as integral to therapy. I’ve also been considering the whole topic of coping recently.  What is coping? Which coping strategies are helpful? Is it possible to view coping efforts without also looking at the context in which they’re being used? My current concl... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4753985 Mon, 25 Apr 2011 19:33:35 +0100 4753985 http://www.medworm.com/index.php?rid=4684664&cid=t_105241_134_f&fid=35213&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fblogspot%2FYNchP%2F%7E3%2FGLvXELWVa78%2Fback-to-work-way-too-soon.html And the signs are starting to show up. This is a guy who NEVER cries.....and he has been on the brink of tears twice this week because of things going on at work. He works from home, but it's just as stressful. He missed a call while getting back xrays last week and they moved 3 of his key employees into other units. Then yesterday, he got a phone call to join an emergency meeting and he had one hour to give the name of an employee they could cut. It's a huge corporation and he has excellent income and benefits and can do all this from home. But his stress is beyond anything I have ever seen with him. So, we decided that he has 3 options after a lengthy talk yesterday afternoon.....into the evening. 1. He can go back out on a 6 month short term leave with full pay and see what happens a... Wife of a Diabetic blogs http://www.medworm.com/rss/comments.php?id=4684664 Thu, 07 Apr 2011 15:15:00 +0100 4684664 http://www.medworm.com/index.php?rid=4636561&cid=t_105241_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fdisabled-in-the-uk-to-be-hurt-by-reforms%2F In the United Kingdom, the letters ESA and DLA stand for programs similar to those in the United States (SSD & SSI). Here, Supplemental Security Income (SSI) is a Federal income supplement program funded by general tax revenues, (not Social Security taxes) which is designed to help aged, blind, and disabled people with little or no income. It provides cash to meet basic needs for food, clothing and shelter. Social Security Disability Insurance pays benefits to you and certain members of your family if you are “insured,” meaning that you worked long enough and paid Social Security taxes. In the United Kingdom, the Employment and Support Allowance (ESA) and the Disability Living Allowance (DLA) are designed to help people who can’t work due to (among other things) disablin... Life with MS blogs http://www.medworm.com/rss/comments.php?id=4636561 Fri, 25 Mar 2011 20:25:35 +0100 4636561 http://www.medworm.com/index.php?rid=4631569&cid=t_105241_129_f&fid=36038&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Ftrevis-life-with-multiple-sclerosis-ms%2Fdisabled-parking-about-to-take-a-hit-in-seattle%2F In a move parking officials in Seattle see as a way to “free up hundreds of [parking] spaces,” our city council is looking to limit free parking for people with legitimate disabling issues… in the neighborhoods around hospitals! According to flyers posted around the proposed “test” area, the city wants to impose a 4-hour limit on people who need extra time to get around because, “[Disabled parking] placards represent golden tickets to free parking, especially in downtown Seattle where monthly parking is so expensive.” Mr Mayor, City Council of Seattle: I am offended! So my disability – the medical condition that slows everything from my thinking to my ability to move around my city – is a Golden Ticket in your eyes?!?!?! Are You Kidding Me? Don’t get me wrong. I... Life with MS blogs http://www.medworm.com/rss/comments.php?id=4631569 Thu, 24 Mar 2011 15:29:22 +0100 4631569 http://www.medworm.com/index.php?rid=4549735&cid=t_105241_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FXMbyjb3qMVo%2F By Tad DeHavenWhile Congress haggles over Republican ambitions to trim $61 billion in funding for domestic discretionary programs, it’s important to remember that mandatory (or “entitlement”) spending is the main driver of recent and future budget growth. The following chart compares fiscal 2007 spending to the president’s proposal for fiscal 2012 for the largest areas of overall federal spending: Note that the area of spending that has increased the most dramatically is “other mandatory.” Major programs in this category range from food stamps to retirement and disability benefits for federal workers. The following chart shows the increase in spending for the largest of these programs: This area of spending, and the programs that it consists of, are often forgotten in the deb... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4549735 Fri, 04 Mar 2011 20:54:18 +0100 4549735 http://www.medworm.com/index.php?rid=4522107&cid=t_105241_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-map-app-for-wheelchair-users%2F2011.02.25 Getting around a city can be hard when you’re in a wheelchair because some places simply aren’t designed for wheels. Wheelmap is an iPhone app for wheelchair users which tells you about the accessibility of nearby restaurants, cafes, clubs, museums, and other locations. Locations are color-coded on a map to show how accessible they are. The current location, but also any place around the world, can be viewed. Maps are based on OpenStreetMap data, and accessibility data about locations can be modified and sent back to the servers by users from within the app. There is also a corresponding website showing the same information online. As with any other crowd-sourced initiative, success depends on the number of contributors, but we have good hopes for this one to succeed. Because ... Better Health blogs http://www.medworm.com/rss/comments.php?id=4522107 Fri, 25 Feb 2011 16:00:31 +0100 4522107 http://www.medworm.com/index.php?rid=4455498&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F02%2F09%2Fmore-on-choosing-chronic-pain-questionnaires%2F Mood and anxiety - depression, anxiety and pain-specific anxiety were chosen because of their importance to outcomes, and the need to treat psychopathology Catastrophising – because this is thought to be one of the most important aspects of cognition that needs to be addressed Pain-related anxiety and avoidance – because this appears to be one of the strongest predictors of ongoing disability Acceptance – this domain has been emerging as an increasingly important treatment process variable, and may be a target for intervention Pain location and intensity - yes, we do ask, just in case you wondered! Pain self efficacy – again, this seems to be an important process variable, and a target for treatment.  It’s also associated with higher levels of disability. Pain-related disability... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4455498 Wed, 09 Feb 2011 08:56:40 +0100 4455498 http://www.medworm.com/index.php?rid=4455226&cid=t_105241_86_f&fid=38272&url=http%3A%2F%2Flaikaspoetnik.wordpress.com%2F2011%2F02%2F09%2Fmuch-ado-about-adhd-research-is-there-a-misrepresentation-of-adhd-in-scientific-journals%2F The reliability of science is increasingly under fire. We all know that media often gives a distorted picture of scientific findings (i.e. Hot news: Curry, Curcumin, Cancer & cure). But there is also an ever growing number of scientific misreports or even fraud (see bmj editorial announcing retraction of the Wakefield paper about causal relation beteen MMR vaccination [...] (Source: Laika's MedLibLog) Laika's MedLibLog blogs http://www.medworm.com/rss/comments.php?id=4455226 Wed, 09 Feb 2011 03:16:41 +0100 4455226 http://www.medworm.com/index.php?rid=4446048&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F02%2F07%2Fchoosing-chronic-pain-questionnaires%2F Choosing a set of questionnaires for an assessment battery can be a task fraught with all kinds of traps, because if there is one thing bound to get clinical tongues flapping, it’s the idea that their favourite questionnaire will be left out of the mix! And to complicate matters for us Southern Hemispherians, most of the research into normative data for questionnaires is North American, so it can be a long, quite tedious and epic job to arrive at a set that covers all the basic domains, doesn’t give the client questionnaire-fatigue, and uses psychometrically-sound  instruments. At the Centre where I work, the set of questionnaires has just been reviewed and, working with a number of clinicians from around the country, we have arrived at a set that seems to be a reasonably work... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4446048 Mon, 07 Feb 2011 05:53:13 +0100 4446048 http://www.medworm.com/index.php?rid=4441965&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2011%2F02%2F06%2Fsunday-news-round-up-everything-is-miscellaneous%2F Via Siobhan, a project intended to train volunteer interpreters to provide services to survivors of torture, trauma, and sexual abuse. Lyon-Martin Health Services in San Francisco, which serves a lot of people of color, gay and lesbian and transgender people, is raising money to try to stay open. Vivir Latino is going to be tweeting on Monday from a media breakfast hosted by the Planned Parenthood Federation of America and Latina Magazine, on issues and inequalities in reproductive health care affecting Latinas. I’m not terribly familiar with abortion laws in Mexico, but the Latin American and Caribbean Women’s Health network reports on the case of a woman apparently sentenced to a 23-year jail term for murder/abortion for what she states was a miscarriage. The Ovarian Canc... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=4441965 Sun, 06 Feb 2011 19:29:31 +0100 4441965 http://www.medworm.com/index.php?rid=4436783&cid=t_105241_107_f&fid=34860&url=http%3A%2F%2Fwww.corporeality.net%2Fmuseion%2F2011%2F02%2F04%2Fvision-and-touch-a-material-history-of-blindness%2F Our own Jan Eric Olsén has received 3.2 mill DKK (about 400.000 euro) from the Velux Foundation for a research project on the history of blindness, titled “Vision and touch: a material history of the world of blindness”. Drawing on archival sources from the Danish Institute for the Blind and Visually Impaired, as well as the big ophthalmological and blind-historical collections in Medical Museion, the project will explore the medical and cultural tension between vision and blindness: The material objects used by the blind and by emphasising the importance of the sense of touch, the project will provide an alternative viewpoint to earlier historical accounts of blindness and its complex relation to vision. By shifting focus from the iconography of blindness to the material ob... Biomedicine on Display blogs http://www.medworm.com/rss/comments.php?id=4436783 Fri, 04 Feb 2011 15:13:03 +0100 4436783 http://www.medworm.com/index.php?rid=4424281&cid=t_105241_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F02%2F01%2Fposting-about-health-concerns-on-facebook-twitter%2F If you’re thinking about posting your health or mental health concerns on Facebook or Twitter, you may want to think twice. According to an article published last week in The LA Times, health insurers will often turn to social networks to check out someone’s story — especially when that person is receiving medical leave or disability payments from an insurer. If you’re filing (or intending to file) a health insurance claim, be careful. This once-hypothetical scenario is now commonplace, as insurers look for ways to keep cutting costs and payments to what they perceive as people intending to commit fraud against them. In fact, insurance companies don’t just randomly check out a social networking website when a claim comes in — it is now standard practice,... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4424281 Tue, 01 Feb 2011 18:10:47 +0100 4424281 http://www.medworm.com/index.php?rid=4399841&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F26%2Fpulling-it-all-together-biopsychosocial-assessment%2F Over the past little while I’ve been writing about how a comprehensive pain assessment can be carried out.  Today it’s time to pull that information together to develop a formulation, or set of possible explanations for why this person presents in this way at this time – at least for one or two aspects of his presentation. For example, if the person’s pain is low back pain, where surgery has failed to improve the person’s pain, but he has maintained working in a teaching job where physical demands are reasonably light, but is having trouble with sleep, feels irritable, can’t manage things like mowing lawns, and is very careful not to bend because he was advised after surgery to avoid bending because it may affect healing.   Limited forward flexion, si... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4399841 Wed, 26 Jan 2011 01:00:45 +0100 4399841 http://www.medworm.com/index.php?rid=4389378&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F24%2Fpulling-the-biopsychosocial-assessment-together%2F Over the past couple of posts I’ve described one way to assess a person’s chronic pain presentation from a medical, psychosocial and functional perspective.  I don’t think there is much difficulty in seeing how these three perspectives can help us develop a biopsychosocial explanation, or formulation, for why this person is presenting in this way at this time – and that’s what assessment is about, when it comes to chronic pain. A quick note on why explanations or formulations are useful when working in chronic pain.  Acute pain is, as most people know, usually directly related to some sort of tissue damage, potential or actual.  The usual rule for helping someone with acute pain is to diagnose the underlying cause of the pain, remediate that causal factor,... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4389378 Mon, 24 Jan 2011 01:25:20 +0100 4389378 http://www.medworm.com/index.php?rid=4372260&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F20%2Fa-comprehensive-pain-assessment-continued%2F One of the hallmarks of chronic pain is the effect on functional performance.  It’s for this reason alone that an assessment of function needs to be a major part of any comprehensive pain assessment.  This, however, is probably where agreement begins – and ends. Function is all about doing, and in this kind of pain assessment, what I’m interested in is how the person with pain goes about engaging in activities that are important and necessary to him or her.  Like any measure, the sum weight a person can shift in a manual handling task means very little without some sort of context.  I’m more interested in how the person planned the movements; the quality of his or her movements; the pace the person moved; the thoughts or images that went through the person&#8217... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4372260 Wed, 19 Jan 2011 18:41:54 +0100 4372260 http://www.medworm.com/index.php?rid=4361318&cid=t_105241_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2011%2F01%2Froulette-wheel-of-qualifying-for.html I received a referral today for Trevon, who I initially evaluated eight months ago. His mother was concerned about his development and asked the school system for help when he turned three years old. The initial OT evaluation indicated that he had significant fine motor delays and a speech evaluation indicated that he had significant speech and language delays. The school approved speech therapy and a special education teacher but declined the occupational therapy.Eight months later, I received an authorization to provide services because the motor concerns were impacting his participation in preschool. In the interim months when there was no OT intervention a second OT evaluation was completed which had essentially identical findings to the first evaluation. Apparently, the lobbying effor... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=4361318 Tue, 18 Jan 2011 19:56:00 +0100 4361318 http://www.medworm.com/index.php?rid=4361321&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F19%2Fa-comprehensive-pain-assessment%2F What makes up a comprehensive pain assessment?  I could begin and never end this particular topic, I know, so I’ll try to confine myself to some of the major themes as I see it.  While this is my opinion, and readers should always remember this, there are some very good researchers and clinicians who hold this view as well – and I’ll cite one or two at least! The first aspect to determine in any assessment is its purpose.  I’ll explore this much further in future posts – the process I’ll describe is to guide initial case formulation and broad direction for pain management.  That is, it’s to identify any medical strategies required, to ascertain the basic coping ability (and thus the need for self management), and finally, to gauge the general f... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4361321 Tue, 18 Jan 2011 18:15:38 +0100 4361321 http://www.medworm.com/index.php?rid=4355702&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2011%2F01%2F16%2Fweekly-news-round-up-two-day-weekend-edition%2F A few stories that have caught my attention over the last week: Unlike many people, the larger workplace does not have MLK Day tomorrow as a holiday. I’m going to two lectures at work, though – the first is from Robert L. Satcher, Jr., physician and astronaut, on “Fulfilling the Dream: Minorities in Biosciences.” The second will be Julian Bond, civil rights activist, on “The Road to Freedom: From Alabama to Obama.” The Julian Bond talk is free and open to the public but tickets are required; on Friday the Sarratt box office still had tickets. The CDC released their first report on health disparities and inequalities. It provides data on a number of issues and disparities, including exposure to air pollution, health insurance coverage, infant deaths, inadequate... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=4355702 Sun, 16 Jan 2011 19:37:25 +0100 4355702 http://www.medworm.com/index.php?rid=4327074&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F01%2F10%2Fits-really-all-about-the-brain%2F Neuroscience is such a geeky area to study. And I have to say I didn’t really study the brain all that well in my undergraduate training all those years ago – but oh, how the worm has turned! It’s so exciting to see how basic science directly influences treatments that we can use for people who don’t have many pharmacologic options for their pain. While I don’t have really up-to-date papers today, I think the 2008 paper by Herta Flor presages some of the approaches we’re starting to use in clinical settings now, a scant three years later. Flor’s work has always been impressive – she has often looked at what happens when brains are deprived of their normal feedback because of trauma or amputation, and (really exciting!) she is coming to Austra... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4327074 Mon, 10 Jan 2011 03:02:46 +0100 4327074 http://www.medworm.com/index.php?rid=4305037&cid=t_105241_133_f&fid=37107&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Faspiewebnet%2F%7E3%2FwK9PcCWBzrU%2F Reports are coming forth that Apple Computers is being sued for discriminating against a disabled employee at one of their stores.  According to a law suit filed in federal court the employee needed to take a leave of absence due to a nervous disorder and when returning to the Apple store she was assigned to [...] (Source: AspieWeb.net) AspieWeb.net blogs http://www.medworm.com/rss/comments.php?id=4305037 Mon, 03 Jan 2011 03:57:20 +0100 4305037 http://www.medworm.com/index.php?rid=4285187&cid=t_105241_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fi4gWVYb6rWA%2F By Walter OlsonAssorted media clips worth catching up with over the holiday: You’ve probably seen the ongoing scandal about how local officials used the southern California city of Bell to enrich themselves at taxpayer expense. A Los Angeles Times investigation finds that the city was milking small tradespeople too: “Legal experts point to a lack of due process and judicial oversight in hundreds of ‘civil compromises,’ in which plumbers, carpet cleaners and bottle-gatherers paid up to $1,000 for alleged code violations.” “To get the check, you’ve got to medicate the child”: a horrifying Boston Globe series exposes how the incentives created by the federal SSI dependent disability program result in the overdiagnosis of disability among school-age kids. ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4285187 Thu, 23 Dec 2010 15:20:48 +0100 4285187 http://www.medworm.com/index.php?rid=4214078&cid=t_105241_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FUAcr2RvZA4w%2F By Tad DeHavenThe disability insurance component of Social Security was created in 1956 to provide income support to individuals aged 50 to 64 who were permanently disabled. As is typical with government programs, eligibility and benefits were greatly expanded over the subsequent decades. SSDI, which is funded through a 1.8 percent payroll tax on all workers, was recently described by the Congressional Budget Office as “not financially sustainable.” The following chart shows that SSDI benefit payments have soared 119 percent since 1995 in real or inflation-adjusted terms: What was supposed to be a narrowly tailored program to help individuals who could no longer work has blossomed into a gigantic budgetary burden that acts more like an unemployment program. Indeed, the number of indiv... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4214078 Tue, 30 Nov 2010 15:40:19 +0100 4214078 http://www.medworm.com/index.php?rid=4175986&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F11%2F18%2Fmedication-and-self-managing-chronic-pain-iii%2F When discussing medication and pain reduction for chronic pain, it’s not surprising there are some very strong opinions and emotions.  After all, having pain is universally known to be unpleasant, very few people really want to have pain (except those who like the rush of acute pain – vis a vis body suspension!), and the first person many people go to discuss their pain is a medical practitioner. The way the centre in which I work views medication is that it forms part of a toolkit for managing pain, alongside all the self management strategies that we also endorse.  So, by and large, most of the people we see are on a stable regime of medication targeting the underlying mechanisms thought to be influencing the nervous system’s sensitivity to stimuli. A reader suggested... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4175986 Wed, 17 Nov 2010 20:03:55 +0100 4175986 http://www.medworm.com/index.php?rid=4152303&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F11%2F10%2Frebuilding-work-identity%2F I love helping people return to work.  It’s got to be one of the most rewarding parts of pain management for me because not only is work important for health, it’s a major part of our day, and it’s a whole lot about individual identity.  So helping people reconstruct their sense of self to the point where they can go to an employer and say ‘I can do this for you’ with confidence is an enormous challenge. To feel confident enough to put yourself on the line to an employer despite chronic pain is a challenge.  It involves at least some of the following (and yes, this is mostly from my experience on this post!): Good self efficacy for managing pain - to the point where fluctuations in pain intensity can be taken with equanimity Strong knowledge of what you ca... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4152303 Wed, 10 Nov 2010 01:28:00 +0100 4152303 http://www.medworm.com/index.php?rid=4139278&cid=t_105241_107_f&fid=34860&url=http%3A%2F%2Fwww.corporeality.net%2Fmuseion%2F2010%2F11%2F05%2Fperforming-fetal-bodies%2F The challenge of how to display fetal bodies was attacked from very different angles at the September conference. Morten Skydsgaard introduced us to the exhibition The incomplete child, in which the idea was to show the deviant body in its own right. He emphasized the importance, especially in controversial displays, of giving the visitors time and space for reflection afterwards. Read Morten’s full abstract here. The next speaker, Sniff Andersen Nexø, talked about the meeting between research and exhibition making, as a desirable but not unproblematic way of curating an exhibition. She pointed out that it’s a great challenge to translate the theoretically informed academic research process into a display of physical objects and a minimum of words. Read Sniff’s full abstract here. S... Biomedicine on Display blogs http://www.medworm.com/rss/comments.php?id=4139278 Fri, 05 Nov 2010 12:55:29 +0100 4139278 http://www.medworm.com/index.php?rid=4119760&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F28%2Fwhats-missing-from-pain-assessment%2F I am stumped. Here is a common clinical quandary – one of the most important outcomes from pain management is to increase participation in daily activity (occupation), yet the measures we use just don’t quite cut it for me. Here’s a couple of examples: in the IMMPACT recommendations from 2008 (in the paper I’ve cited below and from the one I cited earlier this week) two ‘disability’ measures are suggested as a way to assess disability.  One is the ‘Interference’ subscale from the Multidimensional Pain Inventory, and the other is the Pain Disability Index.  Both of these have sound psychometric properties, have been used for a long time in pain management research and clinical use – but both of them have problems. The problems are abou... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4119760 Wed, 27 Oct 2010 18:39:19 +0100 4119760 http://www.medworm.com/index.php?rid=4106087&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F26%2Fwhat-matters-to-people-with-persistent-pain%2F I’ve read many written expectations of people coming for pain management – and without a doubt, the majority of people want to get on with life, go back to doing what they enjoy, and feel better in themselves. The only problem with that? Most of them preface their goals with ‘reduce my pain so I can…’, or words to that effect. And the reality is that for many of them, that particular goal is frustratingly difficult to achieve. I would think that most clinicians working in pain management want to practice patient-centred care – but what is it that patients really want when pain can’t be completely eliminated? Luckily for us (maybe), the team developing the IMMPACT (Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials) recommend... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4106087 Mon, 25 Oct 2010 18:29:08 +0100 4106087 http://www.medworm.com/index.php?rid=4082125&cid=t_105241_107_f&fid=34860&url=http%3A%2F%2Fwww.corporeality.net%2Fmuseion%2F2010%2F10%2F19%2Fart-and-communicating-medicine%2F At the conference “Contemporary medical science and technology as a challenge to museums” in Copenhagen last month, one of the very hot topics was art. What contributions can art make to exhibitions of contemporary medicine? The first speaker of this session, Yin Chung Au from Taipei, pointed out that we should move away from displaying the frozen end product of medical science, and show objects in use instead. Visitors don’t get their experiences from being awed by the wondrous possibilities of contemporary science, but from personal experiences with the objects. MedArt can help us display the processes of medical science and allow people to engage with it. At the same time it can blur the boundaries of traditional medical ways of thinking, and expose scientific discourse as normat... Biomedicine on Display blogs http://www.medworm.com/rss/comments.php?id=4082125 Tue, 19 Oct 2010 08:00:16 +0100 4082125 http://www.medworm.com/index.php?rid=4077625&cid=t_105241_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F10%2Fstruggling-as-ot-for-my-family.html Any medical professional can tell you the hardest patients are the ones you're related to. Once you express interest in a degree, the health questions start coming in from all sides. I remember using my special tests book to r/o fracture after my brother punched a wall, digging through an orthopedic text to find the painful ROM arc of my mom's shoulder over the phone, and trying to diagnose a no-longer-present-but-still-bothersome-that-it-had-ever-appeared nodule for my dad- incredulous that this didn't involve a trip to the doctor. But there are limits to what anyone can do, especially from far away.My dad had a heart attack after I finished my final OT fieldwork. I had several weeks that I was able to spend at home while he recovered. I don't recall doing much during that time except for... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=4077625 Sun, 17 Oct 2010 01:06:00 +0100 4077625 http://www.medworm.com/index.php?rid=4074323&cid=t_105241_133_f&fid=37107&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Faspiewebnet%2F%7E3%2FpQELRKLZz5M%2F While this is not an Autism Advocacy issue its a disability advocacy issue.  A local self advocate was traveling to a self advocate conference and was told by the air line he has to disembark from the plane as he was too disabled to fly according to reports. John Tuitel who markets himself as ‘America’s [...] (Source: AspieWeb.net) AspieWeb.net blogs http://www.medworm.com/rss/comments.php?id=4074323 Thu, 14 Oct 2010 21:37:56 +0100 4074323 http://www.medworm.com/index.php?rid=4053432&cid=t_105241_133_f&fid=37107&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Faspiewebnet%2F%7E3%2FRbNDYb-TJaA%2F The Social Security Administration is expected to announce this week that there will be no Cost of Living Adjustment increase for yet another year.  This is the second year since 1975 that there will be no increase in Social Security benefits.  The first year was 2010.  Cost of living increases are set based on the [...] (Source: AspieWeb.net) AspieWeb.net blogs http://www.medworm.com/rss/comments.php?id=4053432 Sun, 10 Oct 2010 14:56:07 +0100 4053432 http://www.medworm.com/index.php?rid=4013604&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F29%2Fgo-on-expose-yourself%2F …er, maybe not that way OK?! Graded exposure in vivo (with response prevention) is a specific treatment for pain-related anxiety/fear and avoidance.  More specifically, it’s for people who are avoiding activities that are not going to harm them, but may increase their pain.  Their beliefs as to why they ‘shouldn’t do’ these activities or movements differ widely – some people recognise that while they’re not going to harm themselves, they don’t want to or feel overwhelmed when they experience increases in pain, while others are definitely concerned that their pain means some damage is likely to occur, or more often, ‘might’ occur. Simple reassurance doesn’t help people in this situation.  Just telling someone that ’... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4013604 Wed, 29 Sep 2010 03:56:33 +0100 4013604 http://www.medworm.com/index.php?rid=4003454&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F28%2Ffearanxietyavoidance-%25e2%2580%2593-treatments-review%2F For years, clinicians working in pain management have mixed together a rich assortment of strategies to help people function better.  But to identify the ‘active ingredients’ of multidisciplinary pain management using a cognitive behavioural approach, it’s been important to tease each element apart.  One size does not fit all – and just as a physician chooses the most effective medication for a disorder, in time I hope we will be able to choose the most effective strategy for the problems each individual experiences rather than applying our current ‘scatter-gun’ approach. Yesterday I gave a brief overview of the three main treatments to helping people who are fearful/anxious of their pain (or harm) and avoid activities as a result. They are: Graded ex... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4003454 Mon, 27 Sep 2010 18:25:26 +0100 4003454 http://www.medworm.com/index.php?rid=4002874&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F09%2F26%2Fsunday-news-round-up-the-website-is-done-edition%2F A libraryland interlude: we finally launched the new website (the first overhaul in >8 years) for the library where I work, wrapping up months of work. With it, we launched our Twitter and Facebook accounts, chat ref via Meebo, remote access to UpToDate, online payment for document delivery for departments, a PolyMeta federated search tool, and a new WordPress-based news site. Whew. I’m glad that’s done. Now for some things that have flown through my reader and networks while I’ve been buried in work: I can’t believe I missed this: Planned Parenthood clinic in California damaged; California Planned Parenthood Medical Center Firebombed Madera police say someone threw a makeshift explosive through the clinic’s window early Thursday morning, breaking the gla... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=4002874 Sun, 26 Sep 2010 17:40:43 +0100 4002874 http://www.medworm.com/index.php?rid=3969154&cid=t_105241_136_f&fid=39213&url=http%3A%2F%2Fbeingcancer.net%2F2010%2F09%2F15%2Fdisability%2F The folks at Unum are really serious.  In the mail yesterday I got a heavy packet of material from them.  They say they will be requesting information from five additional physicians that I see – urologist, ENT, primary care physician, and dermatologist.  I am not sure that anyone but my eye doctor (and my transplant doctors) can offer an opinion regarding my disability (I have acquired monocular vision, i.e. I lost sight in one eye due to infection). The also need for me to fill out a “Work Experience & Education Questionnaire”.  It asks me to list job experience,  degree of education, and formal computer training.  This is pretty self-explanatory.  But I wasn’t sure about the intent of the question asking do I “have any experience in home or door-... Being Cancer Network blogs http://www.medworm.com/rss/comments.php?id=3969154 Wed, 15 Sep 2010 04:10:23 +0100 3969154 http://www.medworm.com/index.php?rid=3915309&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F30%2Fexposure-in-vivo-for-kinesiophobia%2F In this study, the authors firstly looked at outcomes of graded exposure and whether anxiety, depression and catastrophising moderated these.  While anxiety was found to influence outcome generally (leading to poorer outcomes for those who were more anxious), catastrophising was found to have a more complex relationship.  Graded exposure was effective for low and moderate catastrophising, but for those with high catastrophising the results were far less spectacular.  And depression? Made little difference to outcome at all. After finding that high levels of catastrophising influenced outcome, the next step in this study was to examine those people who made a good deal of changein disability  and compare them with those who made much less change in disability.   For this part of the s... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3915309 Sun, 29 Aug 2010 19:33:53 +0100 3915309 http://www.medworm.com/index.php?rid=3895891&cid=t_105241_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-global-cost-of-fighting-cancer%2F2010.08.23 Cancer is the world’s costliest disease, sapping the equivalent of 1.5 percent of the global gross domestic product through disability and loss of life, according to the American Cancer Society (ACS). Cancer cost $895 billion in 2008, and that’s before factoring in the cost of treating cancer. Cancer and other chronic diseases cost more than infectious diseases and even AIDS, according to a report the ACS [presented last] week. While chronic diseases are 60 percent of all deaths globally, they receive only 3 percent of private and public research funding. The organization is calling for a new look at priorities by the United Nations and the World Health Organization. (Associated Press) *This blog post was originally published at ACP Internist* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3895891 Mon, 23 Aug 2010 12:00:00 +0100 3895891 http://www.medworm.com/index.php?rid=3891670&cid=t_105241_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ftoo-old-to-be-practicing-medicine%2F2010.08.22 With apologies to the Beatles: “When I get older, losing my hair, many years from now, Will you see need me, will you still feed me, When I’m ninety four?” From the New York Post: Former NYPD chief cardiologist Dr. Irving Kroop retired in 1986 — when he was 70 — with a $64,364 disability pension awarded because of a bad heart, according to sources and city records. All the while, he’s maintained a private practice in Brooklyn and moonlighted at NYCERS, the New York City Employees Retirement System, which paid him $14,479 last year to help determine whether other city workers should get disability pensions. “Hats off to the man — he’s 94 years old but disabled? And still going strong?” said an incredulous Carol Kellerman, head of t... Better Health blogs http://www.medworm.com/rss/comments.php?id=3891670 Sun, 22 Aug 2010 12:00:00 +0100 3891670 http://www.medworm.com/index.php?rid=3868932&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F16%2Fhow-well-do-we-really-communicate%2F In this study, Habit 4 and the total score were used to measure the quality of the interactions, and scoring was rated by one clinician who had been recently trained in the system, while a second clinician re-rated a random sample of 16 videos independently. Inter-rater reliability was 0.835 (CI 0.600; 0.939). Patients also completed a set of questionnaires about their experience, and several biographical details such as age, duration of pain and so on. What did they find? Firstly, the providers included chiropractors, physiotherapists and doctors, and a total of 21 clinicians were included.  79 encounters were rated.  There were no real differences between the various professions, and patient variables such as gender, educational level and social class weren’t associated with any ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3868932 Mon, 16 Aug 2010 00:03:49 +0100 3868932 http://www.medworm.com/index.php?rid=3868710&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F08%2F15%2Fsunday-news-round-up-hot-tomato-edition%2F Yesterday I went to the Tomato Art Fest here in Nashville. It was almost 100 degrees out, and I was coated head to toe in sunscreen (good thing, because there was practically no shade). I really enjoyed much of the tomato art at the Art & Invention Gallery, especially the handful of pieces that made me laugh out loud. I got to see Whit Hill & the Postcards perform. I love them, and didn’t realize until their show that they have relocated from Detroit to Nashville. I also had the cantelope popsicle from Las Paletas. Yum. On to items of interest from the week: This past week was the first annual Latina Week of Action for Reproductive Justice, and Nuestra Vida, Nuestra Voz has a blog carnival rounding up posts from the week. Joan has had two abortions! They are just wrapping u... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3868710 Sun, 15 Aug 2010 20:29:03 +0100 3868710 http://www.medworm.com/index.php?rid=3849077&cid=t_105241_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F08%2Ferosion-of-special-education-services.html Money is tight and the new method for getting budgets passed in the NY State capital is to cram everything into emergency budget extensions that the public never gets to see or comment on.The other method for cost savings is to make rule and regulatory changes that have a public comment period - but it does not matter what the public says because the rules are going to be passed no matter what.Early intervention providers saw this earlier in the year when they experienced a 10% rate reduction for most home and community based visits. This effectively limits the reimbursement to therapy providers and is driving a large number of professionals out of the delivery system. A mandatory 10% pay cut is significant, and although there were public hearings about changes to the rates and other deliv... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3849077 Mon, 09 Aug 2010 19:15:00 +0100 3849077 http://www.medworm.com/index.php?rid=3808857&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F02%2Fmeasuring-the-total-impact-of-a-health-condition%2F When I think of the ‘cost’ of having a disability, I have to say I usually think about the effect of the disorder alone on the ability to do valued activities – I haven’t usually thought about the impact of the treatment itself on how people live their lives. I came across this paper by Gerald Devins while searching for ways to measure the effectiveness of interventions on the lives of people attending the Pain Management Centre in which I work.  (I had been looking for something that could measure ‘interference’ of pain on activity and found a couple of good measures such as the Interference subscale from the Westhaven Yale Multidimensional Pain Inventory and the Interference bank of statements from the PROMIS bank.) Anyway, Devins introduced me to the... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3808857 Mon, 02 Aug 2010 08:25:40 +0100 3808857 http://www.medworm.com/index.php?rid=3808644&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F08%2F01%2Fsunday-news-round-up-2%2F Some items of interest this week: Following up on the 20th anniversary of the Americans with Disabilities Act, just a note to check out @Disabilitygov on Twitter, which tweets disability-related news and resources and is tied to the U.S. government site, disability.gov. Also, a new document has been released by the government, Access To Medical Care For Individuals With Mobility Disabilities. It is intended to be an educational tool for health care providers, as it provides standards and answers to frequently asked questions about patient care, but could also be a good tool for individuals who need to raise accessibility concerns with providers. There is also a PDF version that could be downloaded and printed. At Academic Ob/Gyn, Dr. Nicholas Fogelson describes his dislike for the term ... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3808644 Sun, 01 Aug 2010 18:41:19 +0100 3808644 http://www.medworm.com/index.php?rid=3790849&cid=t_105241_133_f&fid=35098&url=http%3A%2F%2Fclub166.blogspot.com%2F2010%2F07%2Ftv-psychologist-gets-it-right.html There's been a story going around that I just heard about a couple of weeks ago. Abbie Dorn, a young mother of triplets who suffered severe brain damage due to complications during delivery, is in a legal battle to see her children. Her ex-husband, who divorced her just a year after the event, saying he needed to "move on", has prohibited their three (now four year old) children from visiting her, and even prohibits anyone mentioning her at all to them. Oh, and after she received a malpractice financial settlement, he's reportedly suing her for child support.Good Morning America covered this story on April 14th of this year, and played up the "tragedy" of the whole situation. It wasn't terrible coverage, but it wasn't too great, either. It didn't really scratch the surface, so was more exp... Club 166 blogs http://www.medworm.com/rss/comments.php?id=3790849 Tue, 27 Jul 2010 03:53:00 +0100 3790849 http://www.medworm.com/index.php?rid=3787113&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F07%2Fplanning-my-ritualistic-morning.html I just drove over after supper to pick up my diet Cokes for the morning.  Mom heard me pull up in the driveway and was waiting at the backdoor for me with questions – lots of questions. “How much do you make a month?” she asked obtrusively. “About $650 dollars,” I replied. She sighed with relief. “Well, at least you’re not over the limit.” “What’s got you so obsessive about this Social Security?” I asked. “Your father says you are going to lose it and you can’t work a full time job that will support you.  I just worry about you.  You haven’t worked in eight years.  That is a very long time.  I could never go back to work.” I then sighed. “Mom, I am 38 years old. I will be fine.  I can work full time given some job experience and... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3787113 Mon, 26 Jul 2010 00:10:00 +0100 3787113 http://www.medworm.com/index.php?rid=3767338&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F20%2Fwhat-do-people-really-do-about-their-back-pain-an-on-line-survey-reveals%2F There are many studies describing the way treatment providers fail to follow clinical guidelines for managing acute low back pain – and because there are inconsistencies between various guidelines for chronic low back pain, it’s not surprising that people with back pain (whether acute or chronic) get a little confused about what to do.  Of course, if you use a popular search engine or two you’ll be able to find loads of sites on the internet that put forward their ideas of how to manage, and the quality of these sites is pretty variable.  So when a group of Australians carried out an online survey asking what people did when they had back pain, you can guess there was a pretty wide range of strategies used. In February 2009, 1001 participants who met the inclusion crite... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3767338 Tue, 20 Jul 2010 05:53:25 +0100 3767338 http://www.medworm.com/index.php?rid=3758080&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F07%2Fearnings-limit-to-receive-social.html I am receiving Social Security disability benefits.  Will I lose my benefits if I work and earn money? Not right away.  We have special rules called work incentives that help you keep your disability and Medicare benefits while you test your ability to work. For example, there is a trial work period during.  During the trial work period you can receive full benefits regardless of how much you earn.  You just have to report your work activity and continue to have a disabling impairment.  The trial work period continues until you accumulate nine months (not necessarily consecutive) in which you perform what we call services within a rolling 60-month period. We consider your work to be services if you earn more than $720 a month in 2010.  For 2009, this amount wa... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3758080 Thu, 15 Jul 2010 22:00:00 +0100 3758080 http://www.medworm.com/index.php?rid=3750314&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F14%2Fways-to-ask-about-sensitive-topics%2F I teach postgraduate courses in pain and pain management.  Many of my students are experienced general practitioners who often ask me “how do I talk to people with pain about psychosocial issues without them thinking I’m telling them their pain is ‘all in the head’?” It can be a pretty sensitive topic for the person with unexplained pain that doesn’t go away because to somehow suggest (a) they’re not coping with their situation or (b) they have some psychological problem can seem uncaring or even that the person’s pain is ‘imaginary’. The psychosocial ‘yellow flags’ are widely known, but even after a decade or more of exposure to what the ‘yellow flags’ are, there is much confusion and misconception.  Tod... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3750314 Tue, 13 Jul 2010 19:32:03 +0100 3750314 http://www.medworm.com/index.php?rid=3746964&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F07%2Fregarding-sunset-brews-and-my.html This seems to be this biggest source of contention with my readers on the blog these days – my drinking of my nightly sunset brews.  I have received more well intentioned advice and concern on this subject than more than anything in years.  I am trying to emulate the homeless Albert Vanderburg's nightly routine on Waikiki beach of this same ritual.  If you’ve known me for long, then you know I love rituals and routines. I also tend to romanticize the homeless lifestyle, and this routine seems so masculine, worldly, and helplessly homelessly romantic to me.  George will love reading about it in the blog posts I am mailing him each day.  He will live vicariously through my words and I have him in mind many nights when I drink them.  We both lived a pseudo ho... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3746964 Mon, 12 Jul 2010 06:25:00 +0100 3746964 http://www.medworm.com/index.php?rid=3743709&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F07%2Fregarding-sunset-brews-and-my.html This seems to be this biggest source of contention with my readers on the blog these days – my drinking of my nightly sunset brews.  I have received more well intentioned advice and concern on this subject of more than anything in years.  I am trying to emulate the homeless Albert Vanderburg's nightly routine on Waikiki beach of this same ritual.  If you’ve known me for long, then you know I love rituals and routines. I also romanticize the homeless lifestyle, and this routine seems so masculine and helplessly homelessly romantic to me.  George will love reading about it in the blog posts I am mailing him each day.  He will live vicariously through my words and I have him in mind many nights when I drink them.  We both lived a pseudo homeless existence for... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3743709 Mon, 12 Jul 2010 06:25:00 +0100 3743709 http://www.medworm.com/index.php?rid=3743735&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F12%2Fself-report-or-really-doing-it-or-both%2F In this study, a group of women with widespread pain, some reaching threshold for fibromyalgia, who had been referred for a pain management programme had their activities of daily living performance assessed in two ways: one was the typical pen and paper questionnaire, this time the Fibromyalgia Impact Questionnaire (Burckhardt, Clark, and Bennett, 1991); and the other an occupational therapy specific measure AMPS, or Assessment of Motor and Process Skills (Fisher, 1993). All participants were assessed prior to participating in the outpatient interdisciplinary pain management programme, and once a completion of the programme and again at follow-up. AMPS requires that the person carry out two of 85 standardised personal ADL and domestic ADL tasks, calibrated to be at the level appropriate f... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3743735 Sun, 11 Jul 2010 19:36:56 +0100 3743735 http://www.medworm.com/index.php?rid=3742395&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F07%2Fthink-before-you-smoke-dummy.html   “I hate to get on to you. You’ve done so well, but you don’t need to be smoking as you bring the carts in from the parking lot,” my supervisor told me this morning.  “Smoke off to the side of the store near the oil change area. You’re doing an awesome job, though.  That’s my only complaint with what you are doing.” “Sorry!” I replied, feeling like crap. I am so sensitive – really a perfectionist at heart. I can’t take much criticism.  “I just wasn’t thinking. It won’t happen again.” “It just looks bad,” my supervisor said. “Remember you are representing the store and you are usually the first Wal-Mart employee customers see besides the greeter.” Work was routine other than that. I trained the new guy – a big bustling black guy... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3742395 Sat, 10 Jul 2010 19:07:00 +0100 3742395 http://www.medworm.com/index.php?rid=3733275&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F07%2Fpossible-parolee.html “George might be eligible for parole in October!” Florene told me over the phone very animatedly and excitedly tonight. “I talked to him on the phone late this afternoon.  He said he is going to have to wear an alcohol monitoring device for months, though.  Possibly a year.” “How did he feel about that?” I asked excited, but worried about my friends tendency to drink without thought.  The urge to drink can be all encompassing for an alcoholic at times.  “He said he was willing to do anything to get out of jail,” she told me. “He promised me.  He said he would gladly give up drinking for his freedom. Andrew, he sounds so miserable!” I can only hope my dear best friend gets home before Christmas.  October would be a boon. If George doesn’t ... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3733275 Wed, 07 Jul 2010 23:32:00 +0100 3733275 http://www.medworm.com/index.php?rid=3730120&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F07%2F10-things-you-really-oughta-know-about-chronic-pain%2F …with apologies to the therapists in the Special Interest Group who first raised this topic! Something I’m acutely aware of after working in pain management for a while is the number of assumptions that I hold about what people ‘should’ know about pain…sometimes I can be quite rightly accused of leaping waaaaaaay ahead of what people are ready for in terms of new information! So it’s time to summarise the ’10 things you really oughta know about chronic pain’ In My Humble Opinion. 1.  Pain is a biopsychosocial experience, that it’s “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” and what that means in real terms.  I think it’s imp... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3730120 Tue, 06 Jul 2010 19:37:30 +0100 3730120 http://www.medworm.com/index.php?rid=3726801&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F06%2Fwho-looks-for-treatment-when-they-have-back-pain%2F I’m not a primary care clinician. The people I see with pain have long-term, chronic, persistent pain that has been around for ages. I think the shortest time someone might have had pain before I see them is 4 months! The average is something like more than 4 years. But I AM interested in who is likely to ask for treatment for their pain because while the people I see may be ‘experienced’ in the ways of being a patient, not everyone who has a back pain looks for treatment.  And I wonder whether people who seek treatment at one point in time might carry on seeking treatment each time they have trouble with their pain. When I came across this paper by Ferreira, Machado, Latimer and colleagues, I was really interested in what they found out from their review of papers datin... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3726801 Mon, 05 Jul 2010 19:32:48 +0100 3726801 http://www.medworm.com/index.php?rid=3726757&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F07%2Fmy-trial-by-fire-first-day-is-under-my.html Well, I made it there and back again this morning. I survived one of my hardest mentally and physically taxing days in years.  I really haven’t worked in eight years as I’ve said many times and I am home again after four hours of my first day of work.  I worked from eight till noon this first day to break me in gently for which I was much relieved.  I don’t think I could’ve worked much longer than that for the first day.  I will probably be working longer hours as the weeks progress my supervisor said and that will be my true trial by fire. They only have two people doing my job and it is a 24 hour store.  A teenager comes in the afternoons and works the second shift.  Can I work an eight hour day of standing on my feet all day?  My mental illness... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3726757 Mon, 05 Jul 2010 16:59:00 +0100 3726757 http://www.medworm.com/index.php?rid=3724505&cid=t_105241_122_f&fid=38275&url=http%3A%2F%2Fwww.drjonathanreed.co.uk%2Fwordpress%2F2010%2F07%2Fbrain-injury-and-creativity%2F I work a lot with children and young people who have suffered a brain injury.  It is one of the most devastating conditions.  Brain injury often results in changes to personality, to memory, to social ability and sometime to physical disability.  It often occurs to normally developing individuals.  Because brain cells do not repair themselves there is no cure and it is a case of living with and adapting to the condition.  I have noticed however that there is one area of functioning that seems to be preserved and often actually enhanced following a brain injury and that is creativity.  Although the brain can not repair itself new neural pathways can develop which I believe can allow new talents to emerge or create a different way of seeing the world.  I have worked with several young... Child Neuropsychology blogs http://www.medworm.com/rss/comments.php?id=3724505 Sun, 04 Jul 2010 08:21:05 +0100 3724505 http://www.medworm.com/index.php?rid=3721915&cid=t_105241_133_f&fid=35098&url=http%3A%2F%2Fclub166.blogspot.com%2F2010%2F07%2Fhonesty-justice-and-trust.html photo credit-navetscreative commons licenseI'm not the kind of person that immediately shouts for someone to lose their job when they do something wrong. We all make mistakes, and jobs are hard to come by nowadays.But I'm also the kind of person that gets their dander up when organizations try to sweep problems under the rug, and whitewash a situation to cover their own backside.I recently wrote about how two police officers in Tybee Island, Georgia tased a young autistic man who was sitting outside a restaurant waiting for his brother, who was inside. They not only tased him, but wrestled him to the ground, bruising him and breaking his tooth in the process. Originally, the police chief did what might be expected. He defended the actions of his men, and even went so far as to "blame the v... Club 166 blogs http://www.medworm.com/rss/comments.php?id=3721915 Fri, 02 Jul 2010 14:43:00 +0100 3721915 http://www.medworm.com/index.php?rid=3706894&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F06%2Felation.html I can remember back in the early nineties when I was first diagnosed as schizophrenic.  I was strangely elated.  Most people would cry in horror at being diagnosed with such a devastating disease of the brain.   We now knew what was wrong with me – the strangeness with what I had struggled with since I was a child.  The paranoia.  The delusions.  There was the hope for help with a solid diagnosis.  I had answers and not some nebulous accusation of lack of character or laziness for the cause of my problems.  Medication after medication was tried with little absolution to my problems, though.  It was a time before the atypical antipsychotics were discovered or were still in clinical trials.  I grew depressed and drank heavier and heavi... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3706894 Tue, 29 Jun 2010 07:40:00 +0100 3706894 http://www.medworm.com/index.php?rid=3707025&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F29%2Fphysical-and-organisational-ergonomic-interventions-so-far-not-effective%2F A million years ago (truly, ask my daughter if I’m that old!) I completed several papers in postgraduate ergonomics, primarily physical and organisational ergonomics rather than cognitive, and for a while there I could recall the NIOSH lifting equation and even discuss biomechanics with some confidence. Sad to say, over the years, my familiarity with those mathematical concepts has rather fallen away, but with an ongoing interest in work and workplaces, I’m still trying to keep up-to-date with the literature on the effectiveness of these interventions. My frustration with ergonomics grew as I started to realise how limited biomechanical modelling that I used was by comparison with the real work of real people in a real workplace.  All of those ‘reals’ add up to mes... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3707025 Mon, 28 Jun 2010 19:43:58 +0100 3707025 http://www.medworm.com/index.php?rid=3703114&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F28%2Fhi-ho-hi-ho-its-off-to-work-we-go%2F I know, it’s Monday and such cheer about work should be reserved for people with no life – but helping people return to work has been and still is one of my favourite parts of pain management. A pity that work rehabilitation has become somewhat far removed from pain management as it is practiced in New Zealand. This paper by a group of Canadian researchers takes the basic steps to returning to work, and maps them onto relevant theory associated with both managing low back pain and changing behaviour. It is one of a very few papers I’ve read that demonstrate the reasoning behind how an effective work rehabilitation programme is established. The focus of this paper is on describing how a work rehabilitation programme can work by “having trained personnel coordinate th... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3703114 Sun, 27 Jun 2010 19:37:17 +0100 3703114 http://www.medworm.com/index.php?rid=3691027&cid=t_105241_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D638 (For those who don’t know, he’s a guy who was arrested for sitting outside a library while autistic and black.) Before I even heard much more of the story than those details in the last sentence, I wrote the following: And the guy’s both autistic and black. In America that’s two counts against you and cops have been known to make up stories in either case and outright kill both disabled and black people who have not assaulted anyone and then make up some “well he was violent/he LOOKED violent” thing to cover their own asses. And as an autistic person who has been in similar situations (had the cops called on me multiple times for sitting and waiting outside for people, walking down the street, and other major crimes) the cops don’t even always appr... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=3691027 Thu, 24 Jun 2010 06:52:57 +0100 3691027 http://www.medworm.com/index.php?rid=3687374&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F23%2Fwhat-goes-in-to-the-social-part-of-biopsychosocial%2F The biopsychosocial model gets bandied about a lot in pain management – but often it’s recognised as ‘bio’ and ‘psychosocial’, as if the social part doesn’t really exist outside of the psychological.  I have to say at the outset I’m not a sociologist but it does seem to me that to conflate psychological and social could very well miss some important aspects of the model, and that this might not be the best for the people we work with.  Over the past couple of weeks I have been reading more about the social aspects and while I’m not yet entirely certain of all the elements that could be encompassed by it, I’m starting to get a feel for at least some of them. The first observation I have is that often the biopsychosocial model get... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3687374 Tue, 22 Jun 2010 20:43:06 +0100 3687374 http://www.medworm.com/index.php?rid=3659177&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F14%2Fhow-social-is-your-biopsychosocial-model%2F It’s called the biopsychosocial model, but how much attention do we really pay to the social part of this model? While we know the medical model has its limitations (especially when we’re looking at how people respond to having health problems), in pain management I wonder whether we now have a ‘psychological’ model of pain rather than a biopsychosocial model? The first time I started pondering this was when a large purchasing body in New Zealand removed the word ‘social’ from what is called a ‘Comprehensive Pain Assessment’. This is an assessment that has medical, functional and psychosocial components – but without the social part it seems to omit some of those really important aspects of the experience of both pain and disability&#82... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3659177 Sun, 13 Jun 2010 19:42:06 +0100 3659177 http://www.medworm.com/index.php?rid=3645072&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F09%2Fgroup-based-cbt-for-pain-in-primary-care%2F I briefly discussed yesterday the content of this six-session group-based cognitive behavioural approach for chronic pain, delivered in the community. Today I want to look a little more closely at the way the programme was delivered and how the findings might differ from what happens in New Zealand. To refresh your memory, this is a study of around 700 people with sub-acute or chronic ‘troublesome’ low back pain, recruited via their GP, who were randomised into two groups – while both groups received ‘advice’ in the form of ‘The Back Book’, the CBT group also received the CBT programme, while the other group were able to seek their ‘usual care’. The programme was delivered to groups of roughly 8 participants by a single therapist, and t... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3645072 Wed, 09 Jun 2010 00:03:57 +0100 3645072 http://www.medworm.com/index.php?rid=3644934&cid=t_105241_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D633 I haven’t yet got to my third post about feline ethics, which is going to be about power. But I just found out today that an article I thought was only in a print copy of Mouth Magazine is also published online by Disability Studies Quarterly. I had gotten the article because someone claimed in response to a feline ethics post, that everyone who loved animals would agree that euthanasia is a good thing. And AnneC pointed out that this is not in fact the case, and that she (as I do) has serious problems with the overuse of euthanasia on cats. And I remembered this article. Unique in breaking the massive taboo against questioning pet euthanasia: Disability Culture Meets Euthanasia Culture: Lessons From My Cat The biggest power we have over cats is the power of life and death. Whether ... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=3644934 Tue, 08 Jun 2010 21:50:39 +0100 3644934 http://www.medworm.com/index.php?rid=3641350&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F08%2Fgroup-based-cbt-for-troublesome-low-back-pain%2F These two papers have created a bit of a storm in the health news recently – a six-session CBT group programme for chronic low back pain that not only provides good outcomes, but is also cost-effective?  Unbelievable!  And it’s not delivered exclusively by any specific health professionals.  AND it’s delivered in primary care! My take on this study is, much like others, very positive.  I think it’s wonderful that an intervention that has been used for years in secondary and tertiary health care has been successfully translated into primary care.  It seems to have used a pragmatic study methodology, and pretty fairly represents the kind of person that, at least in New Zealand anyway, misses out on pain management of this kind unless they’re funded by ACC (... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3641350 Mon, 07 Jun 2010 19:35:11 +0100 3641350 http://www.medworm.com/index.php?rid=3629896&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F04%2Fdivergent-pathways-in-pain-management%2F I’ve been watching and listening to discussions about what is important in pain management over many years – the debate between reducing pain or improving function as the priority continues.  Often it’s a divergence of opinion between the ‘interventionist’ medical team and the ‘self management’ therapy team – and it can lead to some mighty divisions that don’t seem to resolve.  Of course, it’s not a simple one or the other… but over time the focus can and should change – when the emphasis should shift away from pain reduction is the multi-million-dollar question! In this particular debate, the waters are very murky indeed because, as most of us know, given the possibility of removing or eliminating pain, patients (an... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3629896 Thu, 03 Jun 2010 21:14:55 +0100 3629896 http://www.medworm.com/index.php?rid=3603890&cid=t_105241_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F05%2Fevil-exists-in-world-knowledge-can-help.html June 1st is coming - and it reminded me of a particularly sad CSE meeting that I attended a few years ago. There are rules and regulations governing special education in NYS and to some degree there is room for interpretation of those rules and regulations. Parents and districts sometimes disagree on what those rules and regulations mean, and sometimes districts can 'bend' the regulations to accommodate student needs.In the sad meeting I referenced I sat in amazement as the CSE chairperson approved every single service for a child - and I was surprised because this particular chairperson had a reputation among the parents for being somewhat recalcitrant to parent requests and unfriendly in general. I really didn't expect the meeting to go so smoothly because it was the parent's intent to e... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3603890 Thu, 27 May 2010 14:30:00 +0100 3603890 http://www.medworm.com/index.php?rid=3595823&cid=t_105241_133_f&fid=35098&url=http%3A%2F%2Fclub166.blogspot.com%2F2010%2F05%2Fgeogia-zero-tolerance-for-differences.html photo credit-centralasiancreative commons licenseEvidently it's not safe to walk around (or sit) any place in Georgia while being autistic. At least not by yourself. Because if you do, you're fair game for being tased by the police. At least, that's what the police chief of Tybee Island, Georgia seems to think.A little over a week ago, it was a 14 year old boy being arrested on felony terrorism charges for drawing threatening one inch stick figure drawings on his homework. Now it's an 18 year old autistic young man tasered after being confronted by police while he was sitting on the curb waiting for his brother and a friend to come out of a restaurant.WMBF news reported yesterday on how 18 year old Clifford Grevemberg was waiting on the curb outside the Rock House Bar and Grill for his bro... Club 166 blogs http://www.medworm.com/rss/comments.php?id=3595823 Mon, 24 May 2010 22:04:00 +0100 3595823 http://www.medworm.com/index.php?rid=3570085&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F05%2F17%2Fa-dilemma-act-ing-well-living-well%2F In this study, an intervention in which individuals considered their personal values (in other words, what is important to them, what influences the direction in which they take actions) was carried out, and its influence on tolerance to a cold pressor test was evaluated. Two previous studies have shown that low levels of experiential avoidance and high acceptance are reportedly related to higher pain tolerance, conversely one would expect that high levels of experiential avoidance and low levels of acceptance would be related to lower tolerance to pain.  A couple of definitions here: pain tolerance is about how long a person is prepared to ‘put up with’ pain before attempting to move away from it, as opposed to pain threshold which is the point at which the person identifies ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3570085 Sun, 16 May 2010 19:21:00 +0100 3570085 http://www.medworm.com/index.php?rid=3566769&cid=t_105241_133_f&fid=35098&url=http%3A%2F%2Fclub166.blogspot.com%2F2010%2F05%2Fterrorism-really-or-get-out-of-our.html If this wasn't so over the top ridiculous, it might be funny.A 14 year old Georgia boy has been charged with a felony (making terrorist threats) for a small (about 1 inch high) set of stick figures he drew on a paper in class. The stick figures depict one figure (labeled "me") shooting another stick figure (labeled with his teacher's name). There is no question that his drawing the picture was both inappropriate and wrong. There is also no question in my mind that the school's response is so wildly disproportionate as to make me question why they would do such a thing. There has been no allegation of the boy attacking his teacher, bringing a weapon to class, or even of having formed a definite plan as to how he would accomplish the task in his drawing. There has been no mention of the scho... Club 166 blogs http://www.medworm.com/rss/comments.php?id=3566769 Sat, 15 May 2010 04:30:00 +0100 3566769 http://www.medworm.com/index.php?rid=3542604&cid=t_105241_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-tool-to-help-the-visually-impaired-see-facial-expressions%2F2010.05.06 Shafiq ur Réhman, a doctoral student at Umeå University in Sweden has unveiled his thesis project — a technology that converts facial emotions into special tactile sensations for the visually impaired. The system uses a webcam to capture faces, and then subsequently converts the captured emotion into a series of vibrations that correspond with the expressed emotion. The users are expected to train themselves by making their own faces into the webcam and getting a feel for how the vibrations change with the faces they’re making. (more…) *This blog post was originally published at Medgadget* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3542604 Thu, 06 May 2010 20:00:02 +0100 3542604 http://www.medworm.com/index.php?rid=3529959&cid=t_105241_133_f&fid=37107&url=http%3A%2F%2Fwww.aspieweb.net%2Fdisability-and-relationships%2F There is a great movie coming out about Monica and David, two people with developmental disabilities that get married.  The story is a true story and talks about how people with Disabilities should be treated normally and be allowed to live as independently as possible.  The trailer below looks great. The mother of the bride has [...] (Source: AspieWeb.net) AspieWeb.net blogs http://www.medworm.com/rss/comments.php?id=3529959 Mon, 03 May 2010 19:30:56 +0100 3529959 http://www.medworm.com/index.php?rid=3526798&cid=t_105241_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F03%2Fmalingering-ptsd%2F You can “malinger” — fake — virtually any mental disorder, because mental illness is defined by symptom lists that are self-reported. That is, you tell the doctor or therapist the symptoms you’re experiencing, and they simply go down the list and figure out which disorder the symptoms best fit into. Since the symptoms are self-reported, you can easily make up the symptoms to qualify for whatever diagnosis you want. In medicine, things are a bit different. Although doctors might use your self-reported symptoms as a starting point on how to diagnose the medical problem you present with, they can usually followup by ordering a series of laboratory tests to confirm their diagnosis. There is no equivalent for mental health concerns (although there are many paper-an... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3526798 Mon, 03 May 2010 11:32:35 +0100 3526798 http://www.medworm.com/index.php?rid=3524087&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F05%2F02%2Fsunday-news-round-up-early-morning-tornado-siren-edition%2F Yikes – here in Nashville we’ve had some intense weather this weekend. I mean, it’s not every day that a portable classroom floats down the interstate. First, check out all of the great posts that were part of Blogging Against Disablism Day. Or maybe do that last, because you will be there for a while. I haven’t read them all, but one post I particularly liked was on the scrutiny of people who need painkilling medications. Info on the Children’s/Infants’ Tylenol, C/I Motrin, and children’s Zyrtec and Benadryl is online at http://www.mcneilproductrecall.com SB 529, the “OB/GYN Criminalization and Racial Discrimination Act” in Georgia (on race and abortion), was killed in committee. SisterSong has a press release [PDF] and Jodi Jacobson... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3524087 Sun, 02 May 2010 12:56:19 +0100 3524087 http://www.medworm.com/index.php?rid=3524088&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F05%2F01%2Fblogging-against-disablism-day-2010%2F Blogging Against Disablism Day is an online effort that has been going on for the past few years, in which “disabled and non-disabled people will blog about their experiences, observations and thoughts about disability discrimination. In this way, we hope to raise awareness of inequality, promote equality and celebrate the progress we’ve made.” It’s also an event for which many, many people other than me are much more qualified to speak on the subject. I’ve been reading more about disability-related topics in the past year or so, and have really appreciated those who take the time and effort to put out really informative content on language, media, ableism, accessibility, discrimination, and other issues. I’ve been inspired to consider my words, and also... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3524088 Sat, 01 May 2010 19:52:58 +0100 3524088 http://www.medworm.com/index.php?rid=3522773&cid=t_105241_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D625 [This is for Blogging Against Disablism Day.] I knew Adam. I didn’t know Adam’s mother. That’s important. I knew Adam in terms of who he was after he’d already been created. I knew this funny, smart kid who liked to grab my hand and walk in circles with me, who fearfully tried to hide in my room every night when staff came around to tie him to his bed, who looked and sounded very non-standard, and all of these things were just part of Adam. The non-standardness no more and no less than any other part of him. The only time I heard about Adam’s mother was through those sorts of overheard staff conversations that let you know exactly what you are to them. Through them I heard that no mother should be blamed for “giving up” a child like him, that the u... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=3522773 Sat, 01 May 2010 15:01:28 +0100 3522773 http://www.medworm.com/index.php?rid=3502782&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F04%2F25%2Fweekly-news-round-up-weather-radio-edition%2F I spent most of yesterday* listening to the weather radio repeatedly sound its alarm (we had tornado watches and severe thunderstorm warnings most of the day), watching the driveway fill up with water, and wondering what the lightning just hit to make that sound. It seems only right to start the round-up, then, with tornado safety tips: from NOAA; for kids; from the CDC; in Spanish; from the Red Cross. Nominations for the Our Bodies Ourselves 2010 Women’s Health Heroes awards are open through this Friday! Science & Sensibility has an interview with Judith Rooks about the use of nitrous oxide for labor pain relief and her advocacy for expanding the availability of this method in the United States. RH Reality Check has a couple of pieces responding to the meme that younger women ... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3502782 Sun, 25 Apr 2010 16:30:21 +0100 3502782 http://www.medworm.com/index.php?rid=3494564&cid=t_105241_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F04%2Fblogging-against-disablism-day.html May 1, 2010 is this year's Blogging Against Disablism Day. Though I will be at the AOTA Conference (and I hope you will be too) I will try to set up an entry in advance.Blogging Against Disablism day will be on Saturday, 1st May. This is the day where all around the world, disabled and non-disabled people will blog about their experiences, observations and thoughts about disability discrimination. In this way, we hope to raise awareness of inequality, promote equality and celebrate the progress we've made. ... At the same time, do not feel you have to use the same language that I do, even to talk about "disablism". If you prefer to blog against disability discrimination, ableism or blog for disability equality, then feel free to do so.For more info: Diary of a Goldfish (Source: Occupation... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3494564 Thu, 22 Apr 2010 11:12:00 +0100 3494564 http://www.medworm.com/index.php?rid=3483154&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F04%2F19%2Fwho-will-do-well-who-will-not%2F If I had a crystal ball, and could decide who would do well in self managing their pain, and who would not, what would I do? A holy grail for insurance companies and health economists and yes, clinicians, is to find some precise way to decide who needs the most help with their pain, and who will manage well without as much assistance – with the ultimate aim to reduce disabilty and therefore costs (both human and fiscal). The problem is that so far, the experience of pain can’t be objectively measured, and ultimately, it’s the person experiencing the pain who will do or not do, and we have no way of deciding whether the person ’should’ or ’should not’ be expected to function well. This poses an enormous problem in health and insurance. How on earth ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3483154 Sun, 18 Apr 2010 20:45:48 +0100 3483154 http://www.medworm.com/index.php?rid=3463878&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F04%2F13%2Fjust-doing-it-behavioural-activation%2F This post is sparked by a pre-print paper I read yesterday, but follows a long time cogitating about the use and value of “just doing it”. Behavioural reactivation is a set of techniques often used for mood management.  It usually incorporates activity monitoring, assessment of life goals and values, activity scheduling, skills training and problem solving, effective communication training, relaxation training, contingency management, and managing things like avoidance. Fellow occupational therapists will probably feel a tad superior here because these are core aspects of the ways in which occupational therapists work with people, but beware troops! The research from psychology is vast, and it’s rapidly gaining recognition as a psychological approach to reactivation. Beh... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3463878 Mon, 12 Apr 2010 19:31:38 +0100 3463878 http://www.medworm.com/index.php?rid=3460326&cid=t_105241_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D619 In discussions with other autistic people about how other people have reacted to us our whole lives, I recently realized another thing that makes me different from some other autistic people (I honestly have no clue whether it’s most or only some). Which is in my reactions to my surroundings. A lot of autistic people who, like me, were assumed (rightly or wrongly) to be anywhere from somewhat to highly capable by many people during our childhoods, seem to have something in common that I don’t have: They were most of the time a combination of several of… stiff, unusually formal, considered “dweeby”, reserved as far as interaction with their physical surroundings yet obviously “engaged” to a certain degree, and in general… lots of similar thin... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=3460326 Mon, 12 Apr 2010 13:15:14 +0100 3460326 http://www.medworm.com/index.php?rid=3460118&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F04%2F11%2Fsunday-news-round-up-back-online-edition%2F I’m finally back online at home! While I’ve been away, I’ve learned adult/child CPR/AED use and infant CPR, registered to be an organ donor, listened to a lot of classical music on the radio courtesy of the local public radio station, played a lot of Rummy and lost at Lord of the Rings Trivial Pursuit (as usual), had my first lunch at Swett’s, and read B is for Beer, Warbreaker, War Dances, The Lassa Ward and half of Middlemarch. Here are some things that transpired or were written with style in the interim. First, Our Bodies Ourselves is accepting nominations for the 2010 Women’s Health Heroes awards. Nominations are due by the end of this month, so make yours today! OBOS has also launched the Word by Word campaign, in which a donation to support the organi... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3460118 Sun, 11 Apr 2010 17:02:34 +0100 3460118 http://www.medworm.com/index.php?rid=3457906&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F04%2Freearch-briefs-4-10-10-working-memory.html The cognitive neuroscience constructs of working memory and executive function (EF) are hot topics in all areas of cognition.  Although working memory measures are now showing up on most contemporary IQ tests, the measurement of executive functioning (EF) is not...and is typically measured by special purpose tests, tests that all suffer from a solid empirical foundation of research that clearly specifies the elements of, relations between, operational definitions of, etc. the components of EF.I was thus excited to see the table of contents for the recent issue of the Journal of Intellectual Disability Research (see below), as it focuses primarily on working memory and EF research for people with ID/MR.  My excitement was short-lived as I found that, at least at my Universities li... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3457906 Sat, 10 Apr 2010 17:10:00 +0100 3457906 http://www.medworm.com/index.php?rid=3443848&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F04%2Fpsychometric-ps-to-johnston-v-florida.html This is a follow-up to my brief comments yesterday regarding the Johstone v Fl (2010) denied MR/ID appeal of two days ago.As mentioned in the decision and my blog comment, the WAIS-III/WAIS-IV tests correlated .94 in a study reported in the WAIS-IV technical manual.  This is a very high correlation...but does NOT mean that the two tests should be expected to provide identical IQ scores.  I discuss these issues in a prior IAP AP101 report.The tests have different norm dates and thus, the later version (WAIS-IV) would be expected to provide a lower score based on the Flynn effect.  More importantly, as reported in the IAP AP101 report, when one calculates the standard deviation of the difference score (see page 6 of that report) for a correlation of .94, the resulting value is 5.2 (round ... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3443848 Wed, 07 Apr 2010 14:29:00 +0100 3443848 http://www.medworm.com/index.php?rid=3443683&cid=t_105241_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fd1P7Gpd4uCk%2F Beth Sufian is one of the oldest survivors of Cystic Fibrosis. As an attorney, the Houstonian has fought for the medical rights of thousands of patients — even from her own hospital bed — and travels the country teaching parents how to advocate for their children. She took a few minutes to talk with Disruptive Women’s Wendy Grossman. Q: You’ve dedicated your career to fighting for people living with CF. A: Yes. Q: Can you tell me a little bit about your work? A: Working with CF is about half of what I do — the other half is serious medical conditions. Q: Like what? A: I run a hotline for people with CF from all over the country to call and get information about health insurance and benefits and rights and employment. We’ve been in existence since 1998, and w... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3443683 Wed, 07 Apr 2010 12:17:26 +0100 3443683 http://www.medworm.com/index.php?rid=3433140&cid=t_105241_140_f&fid=34849&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPWBlogs-Trouble%2F%7E3%2F7G840pfuORU%2F An incredibly eloquent submission by Joe Gutstein. Let’s imagine for a moment that you are long into the public mental health system. You have been in the hospital multiple times, in a couple of partial hospitalization programs, and have spent years in sheltered workshops and day programs. You’ve received the Prophecy of Doom, “Too sick for too long to get any better.” You’ve heard plenty of statements beginning with “You can’t, You won’t, and You will never.” You’ve been told endlessly that something is intrinsically (genetically) wrong with you and the only thing that will truly save you is a medication yet to be discovered. You’ve also been told that the most important thing you can do is get on SSI or SSDI in light of th... The Trouble With Spikol blogs http://www.medworm.com/rss/comments.php?id=3433140 Fri, 02 Apr 2010 15:42:05 +0100 3433140 http://www.medworm.com/index.php?rid=3429471&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F04%2F01%2Fhealth-anxiety-chronic-pain-ways-to-work-with-worried-people%2F There are many strategies to use when working with someone who is really anxious and worried that their pain is something nasty, and becomes hypervigilant to symptoms that are actually physiological arousal, or symptoms of anxiety. The first practical thing to do is take the time to listen and understand what the person thinks his or her symptoms indicate. Sounds easy, right?  But as people with persistent pain say time and again, very few clinicians go beyond asking for a description of symptoms, and few ask about the conclusions the person has drawn from both symptoms and bits of information they’ve heard (or misheard) from the various health providers they’ve seen (or even the internet sites they’ve been on, or books they’ve read). How could you do this? One way... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3429471 Thu, 01 Apr 2010 06:36:17 +0100 3429471 http://www.medworm.com/index.php?rid=3425148&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F31%2Fhealth-anxiety-chronic-pain%2F Yesterday’s post about ‘hypochondria’ and chronic pain created a bit of a storm.  Emotions run high when you have chronic pain and someone somewhere suggests (a) that it’s ‘all in your head’   or (b) you’re just being a ‘hypochondriac’.  There are loads of reasons why both of those comments are inaccurate and unhelpful, but as I said yesterday, there is also a lot of research suggesting that health anxiety might play quite a big part in increasing the distress and disability associated with having persistent pain, and maintaining both. How would you know if you, or a patient you were seeing, was anxious about his or her health? You know I’m going to say there is no black and white answer to this one, don’t you?! Anxiety ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3425148 Tue, 30 Mar 2010 20:12:49 +0100 3425148 http://www.medworm.com/index.php?rid=3420702&cid=t_105241_133_f&fid=37107&url=http%3A%2F%2Fwww.aspieweb.net%2Fautistic-appointment-placed-on-hold-council-on-disability-ari-neeman%2F Autistic Ari Ne’man’s appointment to the National Council on Disability has been placed on hold anonymously in the Senate according to news resources.  Ari Ne’man is the founding president of ASAN or the Autism Self Advocacy Network and has done large amounts of advocating on the Federal level.  Recently President Obama announced he would be [...] (Source: AspieWeb.net) AspieWeb.net blogs http://www.medworm.com/rss/comments.php?id=3420702 Tue, 30 Mar 2010 02:04:20 +0100 3420702 http://www.medworm.com/index.php?rid=3420776&cid=t_105241_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=3420621&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F03%2Faaidd-manual-on-intellectual-disability.html The AAIDD web site now has three video interviews available for viewing that deal with three broad topics related to the new green manual.  The titles, presenters, and links are provided below.  Click here for prior blomgaster (Dr. Kevin McGrew) critiques of the manual's chapter on intellectual functioning.On Legal Aspects of the New Intellectual Disability Definition Manual.  Co-author Ruth Luckasson, JD Distinguished Professor, University of New MexicoOn the New Intellectual Disability Definition Manual.  Co-author Bob Shalock, PhD Professor Emeritus and Former Psychology Chair, Hastings CollegeOn Education Aspects of the New Intellectual Disability Definition Manual.  Co-author Martha E. Snell, PhD Professor of Special Education, University of Virginia (Source: ... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3420621 Mon, 29 Mar 2010 17:02:00 +0100 3420621 http://www.medworm.com/index.php?rid=3412552&cid=t_105241_133_f&fid=35130&url=http%3A%2F%2Fautisticbfh.blogspot.com%2F2010%2F03%2Fsenate-needs-to-confirm-neeman.html In the wake of the long difficult struggle over health care reform, a large number of President Obama's nominees for administration positions remain in limbo because of holds placed on their confirmation by various senators. The rules of procedure in the Senate allow one lone senator to place such a hold on a presidential nominee, anonymously and for any reason or, sometimes, no reason at all. As reported by Reuters, the White House recently stated that President Obama has a total of 217 nominees pending before the Senate, and 34 of them have been pending for more than six months. Expressing his frustration with this situation, the president announced yesterday that he intends to place some of his nominees in their positions by means of recess appointments, which allow him to avoid the con... Whose Planet Is It Anyway? blogs http://www.medworm.com/rss/comments.php?id=3412552 Sun, 28 Mar 2010 14:08:00 +0100 3412552 http://www.medworm.com/index.php?rid=3411237&cid=t_105241_133_f&fid=35127&url=http%3A%2F%2Fthefamilyvoyage.blogspot.com%2F2010%2F03%2Fi-cant-wait.html Duncan had another appointment with the dentist this morning. Lady and Thomas have both started school now (more on that later- but it's going well) so it was just the two of us. The 1st time we were at that dentist it was a huge struggle to get him in the building. He stood outside crying for ages while I tried to reason with him. We made it into the waiting room where The Tweenies was playing on a tv, henceforth that room was known as "The Tweenies Room." Duncan utterly refused to leave the room so the dentist came to him and after Thomas modelled the procedure, Duncan consented to allow the dentist a brief glimpse inside his mouth right there. On the next visit he made it to the examination room but not onto the chair, though he did enjoy moving the stuffed dinosaur with the big teeth u... The Voyage blogs http://www.medworm.com/rss/comments.php?id=3411237 Fri, 26 Mar 2010 20:18:00 +0100 3411237 http://www.medworm.com/index.php?rid=3408676&cid=t_105241_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=3404074&cid=t_105241_133_f&fid=35130&url=http%3A%2F%2Fautisticbfh.blogspot.com%2F2010%2F03%2Fcampaign-for-disability-employment.html I'm reposting a message sent out by the Campaign for Disability Employment, an initiative funded by the Office of Disability Employment Policy at the U.S. Department of Labor, which provides resources to assist employers in recruiting, retaining, and advancing qualified employees with disabilities. The site also has information for workers and young people with disabilities, as well as family and educators. It is a collaborative effort among business and disability advocacy organizations.Work is fundamental to identity; it offers purpose and the opportunity to lead an independent, self-directed life for all people, including people with disabilities. That’s why we’d like to ask for your support of the Campaign for Disability Employment – a new collaborative effort among several leadi... Whose Planet Is It Anyway? blogs http://www.medworm.com/rss/comments.php?id=3404074 Thu, 25 Mar 2010 13:17:00 +0100 3404074 http://www.medworm.com/index.php?rid=3404070&cid=t_105241_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D615 This post is for the disability blog carnival. If I could eliminate any single disability stereotype, I would sit there and try to figure out which one underlies the most others, and pick that one. If you are going to be given a tool that selective and narrow, it’s good to choose carefully by picking the one whose destruction would destroy the most others. And after observing for a time, I have concluded that the stereotype that I would most want to eliminate is the one that says disabled people are not real or whole people. If we were real people, killing us would be bad, and killing ourselves would be unfortunate rather than something people build special laws to enable. If we were real people, the world would be designed in a way that allowed us to move through it without extra... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=3404070 Thu, 25 Mar 2010 00:44:10 +0100 3404070 http://www.medworm.com/index.php?rid=3404168&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F25%2Fwondering-does-targeting-specific-outcomes-have-an-effect%2F I’ve recently read a couple of studies of group-based CBT for chronic pain showing that outcomes are both durable and cost effective – and I started to ponder a little, as I do. So far, it seems that no-one can identify the vital ingredients in a CBT approach that ‘do the work’ or create the greatest change.  Despite the various studies that have been done, most of them treat the contents of a programme as some sort of ‘black box’ into which people are  taken, emerging some weeks later having made changes that then last.  But some studies have found that 12 months later the specific ’skills’ that individuals were shown during a programme (and carried on using 1 – 6 months later) have been dropped, but the positive changes in terms of... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3404168 Wed, 24 Mar 2010 18:30:49 +0100 3404168 http://www.medworm.com/index.php?rid=3399200&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F24%2Fefficiency-pain-management%2F I can’t remember a time when people working in health were told ‘Go and spend as much as you like to help people get well’ – in fact, in over 20 years I can only recall being told ‘there is less money in the kitty, we need to look for efficiencies, tighten your belts’! So it’s no surprise to me that once again, no matter where you look in the world, health professionals are being told to look at ways to be more efficient.   I don’t have a problem with this – if I’m a patient I want to know I can be treated quickly and effectively so I can get back to being a person and not a patient.  What I do have a problem with is when, in the urgency to save money, problems in health care are given a quick fix solution without taking a look... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3399200 Tue, 23 Mar 2010 18:32:54 +0100 3399200 http://www.medworm.com/index.php?rid=3391016&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F22%2Faccepting-chronic-pain%2F How willing are you to have persistent pain? Can you accept pain without fighting against it? If you were told your pain was going to be there forever, would you avoid important activities or would you start to get back into life again? Recently I reviewed about 200 questionnaires completed by people attending the Pain Management Centre where I work. I was looking especially at what they’d written down as goals for coming to the Centre, and unsurprisingly, most of them were to ‘reduce my pain’ – to tolerable levels, to manageable levels, or so the person could begin ‘living a normal life’. I hate to break it to you – even the most effective medication seems to only reduce pain by about 30%, and most people wanting pain reduction are after at least ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3391016 Sun, 21 Mar 2010 18:21:45 +0100 3391016 http://www.medworm.com/index.php?rid=3370473&cid=t_105241_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F03%2F16%2F7-ways-to-beat-depression-for-seniors%2F Roughly a quarter of people age 65 or older suffer from depression. More than half of doctor’s visits by the elderly involve complaints of emotional distress. Twenty percent of suicides in this country are committed by seniors, with the highest success rate belonging to older, white men. According to a recent report in the Journal of the American Geriatrics Society, depression is one of the major causes of decline in the health-related quality of life for senior citizens. Why all the depression? Rafi Kevorkian, M.D. calls them the five D’s: disability, decline, diminished quality of life, demand on caregivers, and dementia. To combat senior depression, then, requires coming up with creative methods to counter the five D’s. Here are 7 strategies to do just that, to help pe... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3370473 Tue, 16 Mar 2010 10:09:10 +0100 3370473 http://www.medworm.com/index.php?rid=3342929&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F09%2Ftragedies-in-pain-management%2F I thought about putting a warning at the start of this post, because if you’re enthusiastic, passionate, committed to good pain management, what I’m about to write may make you weep!  It’s about systems and missed opportunities and the effect this has on patients.  NB: this post is my personal opinion, does not reflect the opinions of my employers, children, partner, dog or cat.  I am not referring to any specific centre or service, and nothing in this post should be construed as anything other than opinion (although I’ll happily provide facts on request). Did you know that in New Zealand, one in six people has an arthritic or painful health condition?  And that the financial costs are thought to be around NZ$2.5 billion, financial costs comprise health sector c... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3342929 Mon, 08 Mar 2010 18:40:03 +0100 3342929 http://www.medworm.com/index.php?rid=3342612&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F03%2F07%2Fsunday-news-round-up-sunny-day-edition%2F It’s 57 degrees in Nashville, and somehow I managed to sleep until noon. Hmph. I’m playing around with Formspring, so, uh, ask me anything? This freely available perspective piece from the New England Journal of Medicine ties in nicely to what Dr. Abraham Verghese said last week about engaging at the patient bedside – Ministry of Touch — Reflections on Disaster Work after the Haitian Earthquake. It includes this line about the approach to women in labor: “We develop a system whereby one of us sits behind the woman and holds her, another rubs her back, and I sit or kneel near her, touching her belly and legs, whispering words of encouragement. I pray, and I watch the woman’s face for clues as the labor progresses.” There is some discussion here in TN a... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3342612 Sun, 07 Mar 2010 19:25:59 +0100 3342612 http://www.medworm.com/index.php?rid=3335548&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F03%2Fmy-thoughts-at-end-of-day_04.html The Defeated Man… Mom ate at Rodger’s tonight and then brought Maggie and I a barbeque plate – a welcomed surprise for a Thursday night.  We were sitting in my den when mom asked, “What’s wrong with you?  You’ve seemed off for the past few days.” “Oh, I’ve just had a tough few days that have made me question everything and anything.  I am really struggling with my obsessive compulsiveness.  The Luvox has quit working I fear,” I replied.  “I called dad today and told him I was willing to move into that home for the mentally disabled where Jeffrey lives. I don’t want to always be a burden on ya’ll.” “It’s your father’s fault you are a burden on us and not yours,” mom told me, her honesty and lucidity surprising me. “If he would j... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3335548 Thu, 04 Mar 2010 23:58:00 +0100 3335548 http://www.medworm.com/index.php?rid=3331545&cid=t_105241_136_f&fid=39016&url=http%3A%2F%2Fturquoisegates.blogspot.com%2F2010%2F03%2Fhe-goes-before.html An opthamologist from the U of M requested photos of Amelia before and after her illness where her conjugation (tracking) could be seen. I found it interesting that I had a hard time finding any photos of her eyes not tracking in my blog folder, where I keep my favorite photos. I found many more in the snapshot folder. Here are a few I sent him:Amelia in September, prior to encephalitis.Amelia 2 days before hospitalization for encephalitis - already sick.Amelia on day 8 of hospital stay #1.Amelia after discharge from hospital stay #2.Amelia during hospital stay #3.I did a lot of research two days ago, and found much that was useful. A lot of it is scary, too. I found some helpful information about the effects of encephalitis on behavior at a UK site. The "tips" way down at the bottom are e... Turquoise Gates blogs http://www.medworm.com/rss/comments.php?id=3331545 Thu, 04 Mar 2010 18:27:00 +0100 3331545 http://www.medworm.com/index.php?rid=3331631&cid=t_105241_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F03%2Fpediatric-occupational-therapists.html I received a lot of email regarding this recent article in the NY Times about occupational therapy. The email I received and online conversations I have scanned included comments like "I can't believe they would say that OT is only for rich people!" or "We need to let people know that this article does not represent what we do!" Although the article got a lot of occupational therapists upset I would like to suggest that we need to perform a reality check on this outrage.The article comments about how occupational therapy is being used by some more affluent people to promote children's development and how this can be contrasted to a more traditional application of the profession to children who have more severe disabilities. The article offers some incisive opinion that perhaps this kind of... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3331631 Thu, 04 Mar 2010 12:52:00 +0100 3331631 http://www.medworm.com/index.php?rid=3316208&cid=t_105241_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D605 Ten years ago, I went to the doctor. One of the things I mentioned, figuring it was just a really annoying manifestation of the movement disorder that’d recently been identified, was “I keep forgetting how to urinate.” The doctor snapped back at me, in a tone that took me and my mother aback, “Don’t be silly. Urination isn’t voluntary.” Unsurprisingly, I kept getting urinary tract infections. At one point my doctor actually yelled at me for not being able to give a big enough sample, even though it was bad enough at that point for there to be blood in my urine, among other signs of a nasty infection. I get things like that a lot. Both developmentally disabled people and people who’ve been in the psych system get things like that a lot. It&#8... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=3316208 Sun, 28 Feb 2010 06:12:49 +0100 3316208 http://www.medworm.com/index.php?rid=3302451&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F02%2Faaidd-position-paper-on-dsm-v-proposed.html Yesterday AAIDD presented its formal reaction to the DSM-V ASD and Developmental Disorders Subgroup, ID Subcommittee regarding the proposed DSM-V definition for intellectual disability (ID). The AAIDD 11th Edition Implementation Committee position paper (and recommendations) can be found by clicking here.Technorati Tags: psychology, forensic psychology, forensic psychiatry, neuropsychology, intelligence, IQ, IQ tests, IQ scores, adaptive behavior, intellectual disability, mental retardation, MR, ID, criminal psychology, criminal defense, ABA, American Bar Association, Atkins cases, death penalty, capital punishment, AAIDD, DSM-IV (Source: Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner)) Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3302451 Tue, 23 Feb 2010 18:05:00 +0100 3302451 http://www.medworm.com/index.php?rid=3294627&cid=t_105241_107_f&fid=34860&url=http%3A%2F%2Fwww.corporeality.net%2Fmuseion%2F2010%2F02%2F22%2Fmemoirs-about-disability%2F Just saw that Thomas Couser’s new book Signifying Bodies: Disability in Contemporary Living has been published by Minnesota University Press. According to the blurbs Couser explores “the extensive number of personal narratives by or about persons with disabilities” and “brilliantly demonstrates through synoptic readings, [how] these works challenge the ‘preferred rhetorics’ by which such narratives are usually written”. Looks like an excellent backdrop to our current plans for making the recently acquired collection of disability images from the Hans Knudsen Hospital available on the web. Read more here. (By the way, Couser is just now writing a book titled ‘How Memoir Works: A Reader’s and Writer’s Guide’ — could be a... Biomedicine on Display blogs http://www.medworm.com/rss/comments.php?id=3294627 Mon, 22 Feb 2010 08:00:08 +0100 3294627 http://www.medworm.com/index.php?rid=3280210&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F02%2F17%2Fgoals-and-satisfaction-with-pain-management%2F This study does all of this, and the language used and methods described mean it’s easy to see how they arrived at their conclusions. The findings from this study of 86 people who completed all measures showed that goal attainment scaling was a more sensitive measure of satisfaction than outcomes from any other questionnaires (using multiple regression analysis).   Satisfaction with progress was more stronly related to personal functional goal achievement than to more traditional outcome measures including pain, disability, fear-avoidance, lifting, trunk flexibility and treadmill endurance. Why would we worry about patient satisfaction? Good question if you are only worried about getting someone to go through a process and not as interested in what matters to the person you’r... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3280210 Tue, 16 Feb 2010 18:34:18 +0100 3280210 http://www.medworm.com/index.php?rid=3273107&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F02%2F15%2Fhow-to-judge-a-treatment%2F Last week I discussed an interview with F Sommer Anderson and also discussed aspects of central sensitisation syndromes, and Will Baum from where the client is kindly forwarded me a response by Dr Anderson.  I am going to muse on one or two aspects of her response because they raise issues that I think are relevant to anyone working in health – and more importantly, anyone working in pain management. For Dr Anderson’s website, go here, and for a copy of Dr Anderson’s response to my post, click here (when I learn how to link word docs!) Pain, like many other conditions, is complicated by the fact that it’s invisible – we don’t have any objective measures of pain itself, and we have to rely on behaviours (including verbal self report and movements) to det... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3273107 Sun, 14 Feb 2010 21:45:22 +0100 3273107 http://www.medworm.com/index.php?rid=3271153&cid=t_105241_133_f&fid=35084&url=http%3A%2F%2Fballastexistenz.autistics.org%2F%3Fp%3D601 I have seen a lot of “aspies” whining lately about the proposed changes in the DSM. Not productive critique of the new criteria, the medicalization of autistic lives, or the fact that the things most autistic people have truly in common have been left out of the criteria while peripheral things nonautistic people want to fix are spotlighted. No, nothing that useful. Just out and out whining. “I don’t want to be associated with that other kind of autistic people,” goes the standard whine line. “You know… Those Ones.” The crazy drooling retarded low functioning diaper wearing nonverbal ones who can’t take care of themselves and need to be on welfare. Which one of those or many other pejorative categories depends on the individual variati... Ballastexistenz blogs http://www.medworm.com/rss/comments.php?id=3271153 Sun, 14 Feb 2010 04:13:42 +0100 3271153 http://www.medworm.com/index.php?rid=3267054&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F02%2Fcritque-of-proposed-dsm5-intellectual.html Without question, the DSM-5 Proposed Draft Revision document has been generating considerable chatter among psychologists.  With regard to Atkins cases, the proposed definition of intellectual disability (ID) is no exception....emails and listservs have been busy debating and critiquing the ID proposed criteria.  Dr. Dale Watson has set out a well-written set of concerns and issues in the guest blog post below---which is reproduced "as is" from Dr. Watson.  Kudos to Dale for providing ICDP with his perspective.Dr. Dale Watson's critique of the proposed DSM-V ID criteria follows:The DSM-5 Proposed Draft Revisions to the Criterion sets for Mental Disorders have recently become available.  The proposed criteria for the diagnosis of Intellectual Disability retain the three-... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3267054 Fri, 12 Feb 2010 16:24:00 +0100 3267054 http://www.medworm.com/index.php?rid=3267225&cid=t_105241_165_f&fid=36767&url=http%3A%2F%2Fabctherapeutics.blogspot.com%2F2010%2F02%2Fare-we-focusing-on-best-things-so-we.html The value of anecdote is not in capturing a comprehensive analysis of a system's problems - but rather in making an example of a small issue that reflects a broader pattern. I understand that use of anecdote as a tool can also be fundamentally incorrect or even dangerous but I hope that I have documented enough other information about the early intervention program (in places like here and here) so that this presentation will be honest and fair.I also understand that any 'for the children' rhetoric causes large swaths of people to immediately tune out of a conversation but it is difficult to frame this discussion about early intervention services outside the context of how it actually impacts children and families. The truth is that the future is a little uncertain about early intervention... ABC Therapeutics Occupational Therapy Weblog blogs http://www.medworm.com/rss/comments.php?id=3267225 Thu, 11 Feb 2010 16:49:00 +0100 3267225 http://www.medworm.com/index.php?rid=3262824&cid=t_105241_133_f&fid=37107&url=http%3A%2F%2Fwww.aspieweb.net%2Fbeacon-specialized-living-services-bangor%2F I was placed at Beacon Specialized Living Services Lantern Bay Facility.  On numerous occasions I was threatened, assaulted, and harassed by Beacon’s staff members.  The following is a review of my experience. On one occasion when I was trying to open a gate, a staff member assaulted me throwing me face first into a snowbank and [...] (Source: AspieWeb.net) AspieWeb.net blogs http://www.medworm.com/rss/comments.php?id=3262824 Wed, 10 Feb 2010 23:17:51 +0100 3262824 http://www.medworm.com/index.php?rid=3259112&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F02%2Fdsm-5-proposed-draft-revisions.html The Proposed Draft Revisions to DSM-5 are now available on line.  MR/ID is described as the following:Intellectual DisabilityA. Current intellectual deficits of two or more standard deviations below the population mean, which generally translates into performance in the lowest 3% of a person's age and cultural group, or an IQ of 70 or below. This should be measured with an individualized, standardized, culturally appropriate, psychometrically sound measure.B. And concurrent deficits in at least two domains of adaptive functioning of at least two or more standard deviations, which generally translates into performance in the lowest 3 % of a person's age and cultural group, or standard scores of 70 or below. This should be measured with individualized, standardized, culturally appropriate, ... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3259112 Wed, 10 Feb 2010 16:42:00 +0100 3259112 http://www.medworm.com/index.php?rid=3259300&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F02%2F10%2Fbalance-control-passion%2F Yesterday a couple of colleagues were talking about balance in life, and making it plain that they think people who spend a lot of time and energy on their work are sad.  Their opinion? Work is the means to pay for your ‘real’ life, to spend more on working means less on what is really important to them. And musing on this, as I do, I thought about values and what we bring in to pain management and how this influences our practice.  It also started me thinking about the goals and values of the people we see with chronic pain and disability. One way of looking at the distress and disability associated with chronic pain might be to think of it as a result of conflict between what can be done (resources) and both values (what is important) and goals (how I want to express my val... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3259300 Tue, 09 Feb 2010 18:46:08 +0100 3259300 http://www.medworm.com/index.php?rid=3254577&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F02%2Fstephen-greenspan-on-minutes-to-discuss.html Stephen Greenspan (ANNALS OF GULLIBILITY, Praeger, 2009) is scheduled to appear on a  60 Minute segment scheduled to air on Sun, 2/14 @ 7 pm ET/PT; 6PM Central/ Mtn.  Greenspan has written extensively re: the critical importance of the concept of gullibility as it relates to the definition and identification of individuals with intellectual disabilities/mental retardation (ID/MR).According to Greenspan, the segment will focus mainly on Ponzi scheme implications, and will not get much or all into other implications, such as criminal justice, cognitive disabilities, Atkins MR death penalty cases, etc.Technorati Tags: Psychology, forensic psychology, forensic psychiatry, intellectual disabilities, mental retardation, social skills, social intelligence, social cognition, 60 minutes, ... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3254577 Tue, 09 Feb 2010 16:16:00 +0100 3254577 http://www.medworm.com/index.php?rid=3254753&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F02%2F09%2Fhow-do-you-establish-who-will-do-well-with-pain-management%2F Some people just won’t do well with pain management.  In just the same way as a surgeon selects good candidates for surgery, so people need to be selected for self management.  Although there is some truth that getting even a little pain management is good for everyone, the cost of doing so in staff energy and the effect on other participants can make it a very unrewarding task. How do you work out who is in and who is out? I’ve used a ‘readiness for change’ model, following Prochaska and diClemente’s ’stages of change’ approach for some time now.  This uses the idea that if we work with people at their level of readiness, we’ll reduce resistance to our efforts, and we can target our approach to suit. The problem with this lies in trying t... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3254753 Mon, 08 Feb 2010 18:32:11 +0100 3254753 http://www.medworm.com/index.php?rid=3251428&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F02%2F08%2Fhow-long-does-it-take-to-get-there%2F With so many people experiencing long term pain and disability, you’d think health care providers (and funders) would be doing all they could to make sure referrals to specialist centres were made as early as possible – and yet it’s still just not happening.  I took a brief look through the referrals to our tertiary pain management centre recently, and apart from finding that over half of the referrals were for people who had already been seen by us, the majority of the rest were for people with ongoing pain for more than 12 months.  In fact, although I didn’t calculate it, the ‘average’ pain duration varied between 8-9 months and over 10 years, roughly 3 or 4 years being the modal time. That’s a long, long time for someone to be seeing doctors f... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3251428 Sun, 07 Feb 2010 18:41:43 +0100 3251428 http://www.medworm.com/index.php?rid=3227986&cid=t_105241_140_f&fid=35433&url=http%3A%2F%2F4thavenueblues.blogspot.com%2F2010%2F02%2Fchoices-and-ramifications.html I had been homeless for about six months when I called my mother from my deceased grandmother’s house.  I had a key from when I lived with her.  Mom, her usually fretting self, immediately went into action.  She turned on the heat and made me a bed. “You’re not going to be homeless,” she told me. My father wasn’t too pleased, but what could he do?  Cast his son aside despite all his faults and drunkenness? I had planned on going to Nashville to live.  From reading “The Homeless Guy” I knew I could get a place to sleep, three meals a day, and social worker help.  I would also have my full disability allotment to drink with.  I wouldn’t have any expenses other than cigarettes and beer.   It was sad, though, that my life had come t... The 4th Avenue Blues blogs http://www.medworm.com/rss/comments.php?id=3227986 Mon, 01 Feb 2010 15:25:00 +0100 3227986 http://www.medworm.com/index.php?rid=3227900&cid=t_105241_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F01%2Fintellectual-heterogeneity-of-mrid-as.html This study clearly suggests that even a population of individuals with a shared genetic causal mechanism display significant individual differences in patterns of cognitive abilities.  If this is found in ID/MR populations with a strong shared genetic causal mechanism, one would be hard-pressed to argue that such variability does not exist for more milder forms of ID/MR and the general population.My point (again)---I'm very concerned that the AAIDD 11th Edition ID manual's "stuck on g" position is out of synch with contemporary intelligence theory and measurement and has the potential to cause serious harm when potentially life-altering decisions are made on the basis of a single g-based composite IQ scores that ignores the heterogeneity of human cognitive abilities across the ability... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3227900 Sun, 31 Jan 2010 21:29:00 +0100 3227900 http://www.medworm.com/index.php?rid=3228035&cid=t_105241_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F02%2F01%2Fif-you-were-designing-a-pain-management-programme-from-scratch%2F … what would you include? I’m a fan of using a group approach for pain management. Lots of reasons, but several that really spring to mind right now. Groups offer participants a chance to learn from each other – this can be both good and not so good!  Provided the group is managed well, and both CBT techniques and the group process are attended to, participants become their own (and other’s) therapists. Participants often challenge each other far more strongly than clinicians, because they already have ‘face validity’ – in other words, they’re all on an equal ‘I’m in it with you’ level. Groups enable each participant to be exposed to a broader range of issues and situations than individual therapy – as each participa... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3228035 Sun, 31 Jan 2010 21:00:59 +0100 3228035 http://www.medworm.com/index.php?rid=3227690&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F01%2F31%2Fweekly-news-round-up-snowed-in-edition%2F Nashville got a few inches of snow on Friday, and I’m still not sure about getting down the hill for work tomorrow. Snow day! Local and law student Goldni has two good posts this week, one on Roeder’s trial, and one on the parents who tried to get the dictionary removed from school because it contains *gasp* adult words. She writes: …the fact that it took a whole committee to decide that it would do more good than harm to let the kids use the dictionary, and the fact that there are still some parents who may think that the dictionary may be just too scandalous for their kids, is profoundly disturbing. As a librarian, I couldn’t agree more. Christine also posted on the Roeder verdict at Our Bodies Our Blog. I actually got a copy of the partner abuse/birth control... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3227690 Sun, 31 Jan 2010 17:05:16 +0100 3227690 http://www.medworm.com/index.php?rid=3223449&cid=t_105241_133_f&fid=35127&url=http%3A%2F%2Fthefamilyvoyage.blogspot.com%2F2010%2F01%2Fwere-not-supporting-andrew-wakefield.html I started a group on Facebook for everyone who wishes to record their opinion on the Andrew Wakefield GMC rulings. Anyone who is/is closely connected to an autistic person is especiallywelcome. Join here:Parents and autistic people supporting GMC rulings against Andrew Wakefield I want to show that we do not all support Andrew Wakefield who despite the damning verdict against him, is unrepentant and said in his recent statement "It remains for me to thank the parents whose commitment and loyalty has been extraordinary."The newspapers writing about the guilty man also refer to his support base and in some ways imply that parents of autistic children are more inclined to stand behind the disgraced doctor.Please join the group and spread the word to show how we really feel about a man who has... The Voyage blogs http://www.medworm.com/rss/comments.php?id=3223449 Sat, 30 Jan 2010 13:17:00 +0100 3223449 http://www.medworm.com/index.php?rid=3212264&cid=t_105241_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2010%2F01%2F26%2Fbig-surprise-tennessee%2F The Tennessee legislature is back in session. So, no surprise that somebody filed an abortion-related bill. SB 2687 / HB 2680 – from Diane Black and Matthew Hill, both Republican SECTION 1. Tennessee Code Annotated, Title 56, is amended by adding the following language as a new, appropriately designated section: No qualified health plan established in this state through an American Health Benefit Exchange or Small Business Health Options Program (known as a SHOP Exchange) pursuant to the federal Patient Protection and Affordable Care Act shall offer coverage for abortion services. For purposes of this section, “abortion” has the same meaning as defined in § 39-15-201. So, on the off chance that federal health reform legislation doesn’t include a bunch of on-top-... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=3212264 Wed, 27 Jan 2010 00:42:53 +0100 3212264 http://www.medworm.com/index.php?rid=3208597&cid=t_105241_133_f&fid=35127&url=http%3A%2F%2Fthefamilyvoyage.blogspot.com%2F2010%2F01%2Fdear-passengers-on-ei121.html So you've all booked a flight from Dublin to Orlando and luckily, you've chosen to go at the same time as me and my family. Some of you will, like us, be heading off for a bit of a holiday and hoping for sun, heat, roller coasters and perhaps some time at the home of the world's most famous rodent. It's likely that some of you will be travelling for work and others may be visiting family or returning home. Whatever the reason, I hope it's all good for you.I'm sure you understand that this route attracts many families with young children who are incredibly excited to be going on holiday to Disney World, and for whom the long flight can be quite a trial. I suggest that if you don't wish to be disturbed by their chatter and the hopefully infrequent but inevitable tears and tantrums, that you ... The Voyage blogs http://www.medworm.com/rss/comments.php?id=3208597 Tue, 26 Jan 2010 10:38:00 +0100 3208597 http://www.medworm.com/index.php?rid=3201927&cid=t_105241_165_f&fid=37962&url=http%3A%2F%2Fotnotes.blogspot.com%2F2010%2F01%2Faimless-thoughts.html Took a bit of an OT break with a vacay to Las Vegas and reading some novels instead of OT stuff pretty much since Thanksgiving. Now I'm back and ready to play! Been working on a few entries off and on, but this is mostly unstructured. My NBCOT was due to be renewed this year, which caused a minor panic attack the other day. Not that I've been slacking on licensure or anything, I've been going to conferences, but there was a wrinkle I didn't anticipate. I graduated in May '07, but didn't test until Aug '07. My original state license did not require first year graduates to submit continuing ed to be recertified. And unlike the first 2 years of my OT schooling, I didn't pick up any CEUs in my final year due to silly things like fieldwork, graduation, getting married, etc. Somewhere in the ba... Occupational Therapy Notes blogs http://www.medworm.com/rss/comments.php?id=3201927 Sun, 24 Jan 2010 03:05:00 +0100 3201927 http://www.medworm.com/index.php?rid=3200616&cid=t_105241_133_f&fid=35127&url=http%3A%2F%2Fthefamilyvoyage.blogspot.com%2F2010%2F01%2Fplanning-for-disney-world-with-autism.html We've done this before so I have a better idea of what I need to improve to make this flight across the Atlantic as painless as it can be for everyone. Last time we flew via London and Duncan was fine on the first short flight from Belfast but very distressed on the second leg of the journey. He had it in mind that once we arrived in London, Disney World would be just a taxi drive away. (This was a reasonable assumption since it's what had happened when we'd gone to Disneyland Paris.) The flight was delayed at London and we had paid to wait in a lounge (Virgin V Room) with good facilities for families. I'd hoped that as Duncan played about loads in the soft play room, he'd be tired and fall asleep on the plane. But he didn't even want to board the cavernous and to him, scary Virgin plane. ... The Voyage blogs http://www.medworm.com/rss/comments.php?id=3200616 Fri, 22 Jan 2010 18:39:00 +0100 3200616