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 'function'. Sat, 03 Sep 2011 01:52:17 +0100 http://www.medworm.com/index.php?rid=5181679&cid=t_103259_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2011%2F09%2Fcardiac-output%2F The cardiac output is a commonly used parameter in the intensive care unit. It is considered an overall measure of cardiac function and is a calculated value as below: cardiac output = heart rate x stroke volume/1000 or CO = HR x SV/1000 Normal range is 4.0 – 8.0 L/min (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=5181679 Fri, 02 Sep 2011 06:00:21 +0100 5181679 http://www.medworm.com/index.php?rid=5182067&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2F83QTuZxBx3c%2F Obesity linked to Cognition (HealthCanal): - “Obese people tend to perform worse than healthy people at cognitive tasks like planning ahead, a literature review has found, concluding that psychological techniques used to treat anorexics could help obese people too.” - “According to a review of 38 studies on cognitive function and obesity by researchers from the University of NSW, obese people have a tendency toward “reduced executive function”, meaning planning, goal-oriented behaviour and decision-making.” - “Obesity may both cause and be caused by the reduced executive function, said review lead author Dr Evelyn Smith, from UNSW’s School of Psychiatry.” To read article: click Here. To access study: Click on A review of the association between obesity and cognitive fun... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=5182067 Fri, 26 Aug 2011 16:09:46 +0100 5182067 http://www.medworm.com/index.php?rid=5169611&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2F83QTuZxBx3c%2F Obesity linked to Cognition (HealthCanal): - “Obese people tend to perform worse than healthy people at cognitive tasks like planning ahead, a literature review has found, concluding that psychological techniques used to treat anorexics could help obese people too.” - “According to a review of 38 studies on cognitive function and obesity by researchers from the University of NSW, obese people have a tendency toward “reduced executive function”, meaning planning, goal-oriented behaviour and decision-making.” - “Obesity may both cause and be caused by the reduced executive function, said review lead author Dr Evelyn Smith, from UNSW’s School of Psychiatry.” To read article: click Here. To access study: Click on A review of the association between obesity and cognitive fun... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=5169611 Fri, 26 Aug 2011 16:09:46 +0100 5169611 http://www.medworm.com/index.php?rid=5140334&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F08%2F18%2Feducation-or-a-cognitive-behavioural-approach%2F In this study by Day, Thorn & Kapoor, the two approaches were used with a group of people from a rural area, with relatively low socio-economic status, and a reading grade level of about 8.  Both groups received a group-based programme of 10 sessions of 90 minutes.  They both received a workbook and additional reading material.  The CBT group had home-learning and also participated in behavioural activities such as relaxation in-session, while the education group did not. Interestingly, this study presents qualitative information on how participants experienced the sessions, rather than outcomes measures, so it’s difficult to establish whether pain, disability, mood or acceptance were influenced.  Instead it presents thematic analysis from in-depth interviews of the participa... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=5140334 Wed, 17 Aug 2011 19:35:42 +0100 5140334 http://www.medworm.com/index.php?rid=5103343&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fa-diet-enriched-with-olive-oil-is-associated-with-a-lower-stroke-risk-in-one-age-group%2F2011.08.05 More on the Mediterranean diet shows that olive oil is the key component associated with less stroke risk in seniors, a French study found. The Mediterranean diet has already been linked to better cardiovascular effects, so researchers poured it on to assess its link to stroke. A study of people 65 and older in the French cities of Bordeaux, Dijon and Montpellier divided 7,625 residents into three categories of olive oil consumption: no use, moderate use for cooking or dressing, or intensive use for both cooking and dressing. Researchers used plasma oleic acid as an indirect biological marker of oleic acid intake from olive oil. (They acknowledged that it could also stem from use of butter and goose or duck fat.) Results appeared in the Aug. 2 issue of Neurology. In the study, (more…... Better Health blogs http://www.medworm.com/rss/comments.php?id=5103343 Fri, 05 Aug 2011 18:00:00 +0100 5103343 http://www.medworm.com/index.php?rid=5051021&cid=t_103259_131_f&fid=35007&url=http%3A%2F%2Fbooks.mcgraw-hill.com%2Fmedical%2Fommbid%2Fblog%2F2011%2F07%2F21%2Ffaod-and-oxidative-stress%2F Mice models of VLCAD develop oxidative stress in the liver upon fasting, suggesting reactive oxygen species are important culprits in the hepatopathy of affected patients (Tucci et al, 2010, FEBS J 277:4699-708). Increased oxidative stress was also seen when over-expressing a mutant SCAD in cultured cells (Schmidt et al, 2010, Mol Genet Metab 100:155-62), while others noticed increased autophagy (Shirao et al, 2010, Hum Genet 127:619-28); the second possibly being a consequence of the first. Posted by Philippe Campeau, MD (Source: The OMMBID Blog) The OMMBID Blog blogs http://www.medworm.com/rss/comments.php?id=5051021 Thu, 21 Jul 2011 14:31:41 +0100 5051021 http://www.medworm.com/index.php?rid=5029273&cid=t_103259_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=4960202&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FKL0ko4TEcXU%2F A couple of very interesting recent announcements show (in a military context) how well-targeted brain training can complement and augment existing approaches, both to help “normal” and “clinical” populations, in ways that silo-based, rear-mirror thinking often misses: U.S. Department of Defense Awards $2 Million to Brain Plasticity Inc. to Study Impact of Brain Training for Traumatic Brain Injuries (press release): “Brain Plasticity Inc. (BPI), a technology incubator dedicated to the discovery and development of novel technologies that harness the basic principles of brain plasticity to improve the lives of people with neurological and psychiatric disorders, was recently awarded a $2 million grant from the United States Department of Defense.” “The grant will fund a two-year... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=4960202 Thu, 23 Jun 2011 11:21:27 +0100 4960202 http://www.medworm.com/index.php?rid=4945248&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F06%2F17%2Fwhat-to-do-about-catastrophising-even-when-youre-not-a-psychologist%2F In this study, 25.9% of those reporting acute pain, and 51.3% of those reporting chronic pain endorsed catastrophising beliefs.  And this group of people were not seeking treatment (as an aside, this is one of few studies to look at non-treatment-seeking people)!  The study also found that in those with high levels of catastrophising, mental health problems were more prevalent, and that catastrophising explained a good proportion of work disability.  In other words, even in this very healthy group of people, catastrophising was associated with greater vulnerability to having difficult managing pain and keeping mentally healthy.  If this finding is identified in other non-treatment-seeking people, I think we can confidently draw the conclusion that catastrophising may be one of the more... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4945248 Thu, 16 Jun 2011 23:24:01 +0100 4945248 http://www.medworm.com/index.php?rid=4893949&cid=t_103259_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=4841744&cid=t_103259_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2011%2F05%2Fjournal-of-cognitive-neuroscience.html I just spent some time browsing the articles lined up for forthcoming publication in the Journal of Cognitive Neuroscience. As a researcher who is looking for good research that links my primary are of interest (intelligence and measurement of intelligence) with underlying brain mechanisms, I think I have found the pot-o-gold at the end of the brain-behavior rainbow. Below is the list of articles the journal currently has "waiting in the wings." The depth and breadth is amazing. I have added this journal to my RSS feed so I can stay up-to-date when articles are published.What a way to start my day. Finding this will sipping my morning java. Now if I could only fine time to read just a 1/4 of these articles.Well MIT Press.Double click on images to enlarge- iPost using BlogPress from my Kevi... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=4841744 Tue, 17 May 2011 15:05:00 +0100 4841744 http://www.medworm.com/index.php?rid=4762891&cid=t_103259_131_f&fid=34989&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FGeneticsHealth%2F%7E3%2FM3gc8PuJPjw%2F A study published in Psychological Science earlier this year suggested that bladder control equals better mind control: When offered several choices (between receiving $16 tomorrow or $30 in 35 days, for example), subjects who had a full bladder made better overall decisions. The study begs jokes about gulping down coffee before heading to the mall, but there are more practical implications than just knowing that you’ll do better if you have to pee. Instead of assuming that the mind always controls the body, the research flips traditional thinking on its head: What we do with our body — everything from physical posture to what we eat — can also go to our head. Oliver Burkeman, author of This Column Will Change Your Life at The Guardian, recently mused about other such studies tha... Genetics and Health blogs http://www.medworm.com/rss/comments.php?id=4762891 Thu, 28 Apr 2011 17:56:13 +0100 4762891 http://www.medworm.com/index.php?rid=4753985&cid=t_103259_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=4747752&cid=t_103259_122_f&fid=38275&url=http%3A%2F%2Fwww.drjonathanreed.co.uk%2Fwordpress%2F2011%2F04%2Fthe-return-of-the-unconscious-mind%2F The founding father of psychology Sigmund Freud was fascinated by the unconscious mind and made this the centre of his study and practice.  The role of the unconscious in psychology quickly fell out of fashion.  This was because it could not be measured or easily understood.  Initially behaviourism became dominant, based on the objective analysis of observable behaviour.  Later the focus in psychology shifted to studying cognition – the study of thought processes.  Both areas resulted to different psychological therapies for example,  Cognitive Behavioural Therapy (CBT), and different ways of understanding learning.  Over the last decade or so neuropsychology has started to emerge.  Neuropsychology focuses on the relationship between the brain and behaviour (including cogniti... Child Neuropsychology blogs http://www.medworm.com/rss/comments.php?id=4747752 Sun, 24 Apr 2011 12:13:54 +0100 4747752 http://www.medworm.com/index.php?rid=4704983&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F04%2F12%2Ftalking-about-it-is-it-worth-encouraging-emotional-disclosure-for-people-with-pain%2F One of the more common coping strategies for people with chronic pain is talking about stressful experiences. It’s thought to be healthy to be open and express feelings, while the very idea of repressing or avoiding emotional content seems almost Victorian. And there are various talk therapies in which emotional disclosure is encouraged – in fact, one popular approach suggests that people risk developing chronic pain if they don’t discuss ‘trauma’ (Sarno). So, does it work? Some studies of emotional disclosure have found that it has ‘moderate’ effects – people can feel emotionally better, and their general health status can also improve.  Other studies are more equivocal, with less positive outcomes.  Even in meta-analyses, outcomes have be... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4704983 Mon, 11 Apr 2011 18:56:57 +0100 4704983 http://www.medworm.com/index.php?rid=4554805&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F03%2F07%2Fafter-quake-aftermath%2F Once again I’m lead to pondering the different ways my situation has affected me, and what might be helpful to mitigate some of the less frequently mentioned aspects of coping in a disaster. Like many people, I’m still managing with quite limited power, water that is a trickle (not enough pressure to fill a toilet cistern let alone the hot water cylinder!), and the hassles of finding a supermarket and shops that are open, a petrol station before I run out of gas, and ways to dispose of human waste matter safely. I posted before about the loss of cues that usually help me to maintain my normal routine.  With the loss of these cues, and changes to my usual routine, as well as the inevitable anxiety that comes with repeated aftershocks (Is that a truck going by or an aftershock? ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4554805 Mon, 07 Mar 2011 03:16:10 +0100 4554805 http://www.medworm.com/index.php?rid=4532586&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2011%2F03%2F01%2Fan-occupational-view-of-the-christchurch-earthquake%2F The picture – what greeted us as we walked through the front door – and that sparkly stuff on the ground? It’s all my crystal in tiny sharp shards…The wooden thing you can see is the bottom of our sideboard, and to the far right, the doorway. It’s not often I post with a specific focus on ‘occupation’ as the occupational therapy profession defines it.  This is not, I hasten to add, because I don’t think it’s important, it’s more a case of my posts being about the processes that underlie effective engagement in ‘occupation’ for people with chronic pain. But today, in the aftermath of the horrific earthquake in Christchurch one week ago, I’m taking time to reflect on some aspects of the earthquake that people have... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4532586 Tue, 01 Mar 2011 00:34:39 +0100 4532586 http://www.medworm.com/index.php?rid=4507291&cid=t_103259_88_f&fid=38129&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Flifeinthefastlane%2FWZHV%2F%7E3%2FV7SJ85Z99i0%2F A man, originally from Somalia, is jaundiced and has abnormal LFTs. Can you work out the cause? (Source: Life in the Fast Lane) Life in the Fast Lane blogs http://www.medworm.com/rss/comments.php?id=4507291 Tue, 22 Feb 2011 00:00:28 +0100 4507291 http://www.medworm.com/index.php?rid=4470466&cid=t_103259_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2011%2F02%2Fthecognitive-atlas-project-way-cool.html Very intriguing article and description of the Cognitive Atlas Project, a scientific social collaborative knowledge project.Poldrack, R. A. (2010). Mapping Mental Function to Brain Structure: How Can Cognitive Neuroimaging Succeed? Perspectives on Psychological Science, 5(6), 753-761AbstractThe goal of cognitive neuroscience is to identify the mapping between brain function and mental processing. In this article, I examine the strategies that have been used to identify such mappings and argue that they may be fundamentally unable to identify selective structure–function mappings. To understand the functional anatomy of mental processes, it will be necessary for researchers to move from the brain-mapping strategies that the field has employed toward a search for selective associations. Th... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=4470466 Sat, 12 Feb 2011 18:04:00 +0100 4470466 http://www.medworm.com/index.php?rid=4460054&cid=t_103259_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2011%2F02%2Fresearch-bytes-neuro-imaging-research.html Beck, D. M. (2010). The Appeal of the Brain in the Popular Press. Perspectives on Psychological Science, 5(6), 762-766.Since the advent of human neuroimaging, and of functional magnetic resonance imaging (fMRI) in particular, the popular press has shown an increasing interest in brain-related findings. In this article, I explore possible reasons behind this interest, including recent data suggesting that people find brain images and neuroscience language more convincing than results that make no reference to the brain (McCabe & Castel, 2008; Weisberg, Keil, Goodstein, Rawson, & Gray, 2008). I suggest that part of the allure of these data are the deceptively simply messages they afford, as well as general, but sometimes misguided, confidence in biological data. In addition to cataloging som... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=4460054 Fri, 11 Feb 2011 00:46:00 +0100 4460054 http://www.medworm.com/index.php?rid=4445745&cid=t_103259_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F02%2F07%2Fnursing-times-2010-vol-107-no-4%2F This article outlines the physical and psychosocial effects of constipation, the difficulties patients have talking about constipation and areas to consider before treating a patient with abdominal massage therapy. Contact the Library for a copy of this article. Filed under: Journals Tagged: Bowel Function, Constipation, Gastroenterology, Massage Therapy (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4445745 Mon, 07 Feb 2011 08:33:00 +0100 4445745 http://www.medworm.com/index.php?rid=4405823&cid=t_103259_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F01%2F27%2Fphrenology-examining-the-bumps-of-your-brain%2F The next time you say, “so and so should have her head examined,” remember that this was literally done in the 19th century. Phrenology, as it became known, is the study of brain function. Specifically, phrenologists believed that different parts of the brain were responsible for different emotional and intellectual functions. Furthermore, they felt that these functions could be ascertained by measuring the bumps and indentations in your skull. That is, the shape of your skull revealed your character and talents. Viennese doctor and anatomist Franz Josef Gall originated phrenology, though he called it cranioscopy. He was correct in saying that brain function was localized (this was a novel idea at the time), but unfortunately, he got everything else wrong. When Gall was young, he not... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4405823 Thu, 27 Jan 2011 12:01:01 +0100 4405823 http://www.medworm.com/index.php?rid=4399673&cid=t_103259_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2011%2F01%2Folfaction.html From The Independent:The smelling test: The genetics of olfactionWhy are some people more sensitive to odours than others? And why do no two people experience a scent in the same way? The answer lies in our genes, explains Laura Spinney24 January 2011read the article (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=4399673 Tue, 25 Jan 2011 21:57:00 +0100 4399673 http://www.medworm.com/index.php?rid=4389378&cid=t_103259_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=4382759&cid=t_103259_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fn4nr7ZdVKdM%2F Blogger Concetta Tomaino who participated in the December 1st Event is truly a disruptive woman as described in the post below.  By Hope Ditto. We’re used to our Disruptive Women bloggers being on the cutting edge in their fields and doing amazing things every day. We’re used to them saving lives, fighting for those without a voice and revolutionizing the world around us. Still, it’s not every day that a major motion picture being featured at the world-famous Sundance Film Festival is directly connected to their work. Not that we’re bragging, but we feel pretty fortunate to call Dr. Concetta Tomaino, D.A., MT-BC, LCAT, one of our own these days. Besides having her work featured in The Music Never Stopped (and having Julia Ormond, the actress playing the music therapist in the m... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4382759 Fri, 21 Jan 2011 19:01:15 +0100 4382759 http://www.medworm.com/index.php?rid=4372260&cid=t_103259_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=4361321&cid=t_103259_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=4331116&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FtVPk1z9NXRg%2F Every Monday during the next 10 weeks we’ll discuss here what leading industry, science and policy experts –all of whom will speak at the upcoming 2011 SharpBrains Summit (March 30th — April 1st, 2011)– have to say about emerging opportunities and challenges to address, over the next 10 years, the growing brain-related societal demands. Without further ado, here you have what four Summit Speakers say… — Alvaro Pascual-Leone is the Direc­tor of the Berenson-Allen Cen­ter for Non-Invasive Brain Stim­u­la­tion at Har­vard Med­ical School. 1. How would you define “brain fitness” vs. “physical fitness”? Physical fitness can refer to an overall or general state of health and well-being. However, it is also often used more specifically to refer to the ability to perfor... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=4331116 Mon, 10 Jan 2011 20:57:18 +0100 4331116 http://www.medworm.com/index.php?rid=4304990&cid=t_103259_122_f&fid=38275&url=http%3A%2F%2Fwww.drjonathanreed.co.uk%2Fwordpress%2F2011%2F01%2Fa-new-way-of-looking-at-how-the-brain-works%2F I want to discuss an important new book for understanding how the brain works, which I have just read and is called Subcortical Structures and Cognition: Implications for Neuropsychological Assessment by Leonard Koziol and Deborah Budding.  Our current understanding of how the brain works using Neuropsychology has traditionally focused on the cortex part of the brain – frontal, temporal, parietal and occipital lobes and has looked at what happens psychologically when there is damage to these particular areas.  From this we understand perception, memory, language etc pretty well.  However we have tended to ignore subcortical brain areas such as the basal ganglia and cerebellum and have considered these areas as being responsible mainly for motor co-ordination.   This new book b... Child Neuropsychology blogs http://www.medworm.com/rss/comments.php?id=4304990 Mon, 03 Jan 2011 15:21:48 +0100 4304990 http://www.medworm.com/index.php?rid=4253468&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F12%2F14%2Fknowing-how-is-not-equal-to-doing%2F There have been several attempts to develop a standardised approach to self management – one of the most popular in New Zealand is the Flinders Program (TM). This is a programme developed in Australia from the 1990 Australian Coordinated Care Trials. It’s based on cognitive behavioural therapy, includes problem solving and motivational interviewing techniques, and provides a set of tools and processes that clinicians can use to help people assess and then develop self management plans. The aim, as for any self management programme, is to shift the ‘balance of power’ so to speak from clinician-centred to patient or client-centred partnership, so that shared decision-making about health occurs. It has been used in New Zealand for some years: the Arthritis New Zealand ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4253468 Mon, 13 Dec 2010 18:31:21 +0100 4253468 http://www.medworm.com/index.php?rid=4241831&cid=t_103259_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2010%2F12%2Folfactory-assessment-traditional.html CONCLUSION: In accord with the modifications, the scores on the prototype UPSIT-TC were significantly higher than those on the American UPSIT when administered to a Taiwanese sample. Both versions of the UPSIT were stable across repeated test sessions.PMID: 20109324 [PubMed - indexed for MEDLINE] (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=4241831 Wed, 08 Dec 2010 05:16:00 +0100 4241831 http://www.medworm.com/index.php?rid=4200564&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fimproving-health-for-older-adults%2F2010.11.24 New clinical trials and published research are giving us information on how to improve health in elderly patients. Here are some brief points from the Cleveland Journal of Medicine that were surprising to me: – Each year 30 percent of people age 65 or older fall and sustain serious injuries so preventing falls and fractures is important. Vitamin D prevents both falls and fractures, but mega doses of Vitamin D (50,000 mg) might cause more falls. A better dose is 1,000mg a day in people who consume a low-calcium diet.  – Exercise boosts the effect of influenza vaccine. – The benefits of dialysis in older patients is uncertain, as it does not improve  function in people over age 80. We don’t even know if it improves survival. Older patients who receive dialysis... Better Health blogs http://www.medworm.com/rss/comments.php?id=4200564 Wed, 24 Nov 2010 21:00:00 +0100 4200564 http://www.medworm.com/index.php?rid=4190157&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fsudden-cardiac-arrest-how-fast-does-it-cause-unconsciousness%2F2010.11.21 How fast does sudden cardiac arrest cause unconsciousness? In just seconds. Here’s a video of Salamanca soccer player Miguel Garcia’s episode. At the start of the video, Mr. Garcia can be seen in the background of the image kneeling behind the players in the foreground. Watch carefully as he stands after tying his shoes. Although it is difficult to see, it appears an automatic external defibrillator arrives in about two minutes, though given the fact his shirt is still on as he’s taken from the field, we note the device is on his gurney as he’s hurried to a nearby ambulance. Reportedly, he survived this sudden cardiac arrest event: This was NOT a heart attack, but rather a loss of cardiac function caused by a rapid, often disorganized heart rhythm disorder. Compar... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190157 Sun, 21 Nov 2010 19:00:00 +0100 4190157 http://www.medworm.com/index.php?rid=4183341&cid=t_103259_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F11%2F19%2Fyour-brain-on-exercise%2F It is quite common to read about, or hear exercise enthusiasts explain the benefits that exercise has on the heart, muscles, lungs, connective tissue, and so on. But, I have rarely heard mention of how exercise improves brain health.  Although, there is plenty of evidence showing that exercise is beneficial to the brain. Exercise improves memory and learning in humans and animals.  Exercising individuals might be less susceptible to loss of cognitive functioning associated with aging or neurodegenarative disease.  One of the key mechanisms underlying these effects on the brain is neuronal growth in the hippocampus — an area of the brain important for cognition (Kobilo, et al., 2010). In an article published in Trends in Neurosciences (2009), H. Van Pragg made the following commen... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=4183341 Fri, 19 Nov 2010 18:08:35 +0100 4183341 http://www.medworm.com/index.php?rid=4175986&cid=t_103259_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=4172341&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F11%2F17%2Fmedication-and-self-managing-chronic-pain-ii%2F If medication is to be part of a toolkit for self managing chronic pain, then it seems to me that it’s important to know as much about the medication and how it should be used as possible.  Once again, today I’m not directly referring to the literature because I haven’t found an awful lot discussing this integration approach, so please bear this in mind when you read what I’ve written.  I’m also not a medical doctor, I don’t prescribe, I don’t want to have prescribing rights, and I must advise any reader NOT to change, reduce or increase medications without having a good discussion with your own medical practitioner first. There are two main paths in pain management – one focuses on pain reduction, and this is where I think medication (and surgery and... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4172341 Tue, 16 Nov 2010 18:37:08 +0100 4172341 http://www.medworm.com/index.php?rid=4152302&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F11%2F11%2Fchronic-pain-in-the-interweb%2F It’s not very often that I’m moved to respond to other blogposts about chronic pain.  When I go onto Google and search for chronic pain SO many awful, quacky, misleading sites come up, promising this and that with so little evidence to support their claims, I’ve tended to avoid looking.  Today, however, thanks to the Neuroscience and Pain Science for Manual Physical Therapists group on Facebook (go Diane!) I was lead to the ever-challenging Science-Based Medicine blog in which a review of the book The Pain Chronicles by Melanie Thernstrom is posted. Now I have not read The Pain Chronicles (by all accounts it looks like a fascinating read), but one of the statements cited in SBM’s review is one of the more profound comments about the management of chronic pain that... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4152302 Wed, 10 Nov 2010 18:43:40 +0100 4152302 http://www.medworm.com/index.php?rid=4133712&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmental-illness-and-the-right-to-vote%2F2010.11.03 Back in the 1970s, Kansas passed a law that could prevent people with mental illness from voting. The law was never used, but advocates were successful in getting an amendment passed that revoked that law. This law was passed at a time when stigma against mental illness was much higher than now. I’m guessing it was presumed that folks with a mental illness could not reason enough to exercise an informed vote, which is not true, of course. If 1outta5 have a psychiatric illness, including anxiety, depression, and substance abuse, then there could have been a huge swath of disenfranchised voters. And there already exists, to a degree, a basic cognitive test for voting: Navigating the whole ballot process. In Maryland, ours was electronic and no harder to use than an iPad, but I could st... Better Health blogs http://www.medworm.com/rss/comments.php?id=4133712 Wed, 03 Nov 2010 22:00:00 +0100 4133712 http://www.medworm.com/index.php?rid=4134291&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F11%2F02%2Fresilience-catastrophising-and-positive-emotions%2F Catastrophising, or thinking the worst, is one of those psychological factors that we know influences distress and disability in people with chronic pain. It’s quite a common phenomenon, and sometimes can stand us in good stead – after all, if we can think of the worst things that can happen, then plan to avert those possible disasters, then life will be sweet, yes? ermmmm – no, as a matter of fact.  Catastrophising can actually function to narrow our thinking down, reducing the range of options we can come up with to manage situations, and it can also function to focus us on things that haven’t worked out while at the same time minimising our appreciation of things that are working well. In chronic pain, catastrophising is often an outcome to measure – the t... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4134291 Tue, 02 Nov 2010 08:49:36 +0100 4134291 http://www.medworm.com/index.php?rid=4119760&cid=t_103259_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=4119761&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F27%2Fpsychological-therapy-works-for-fibromyalgia%2F An ‘enigmatic’ disorder – this is what Perry Nicassio calls fibromyalgia. I hadn’t thought of it that way, because so many chronic pain problems seem to be equally ‘enigmatic’! It’s a common disorder, affects many more women than men, has a multiplicity of effects on people ranging from fatigue, poor sleep, widespread aching, other pain sensations such as stabbing or needle-like pains that can appear anywhere in the body, often with low mood and loss of function.  There are few medications that seem to help, and many people never seek treatment for their pain.  If people do look for treatment, they can be faced with skepticism from some health providers, despair from others, and offered a multiplicity of treatments that don’t seem to do an ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4119761 Tue, 26 Oct 2010 18:37:56 +0100 4119761 http://www.medworm.com/index.php?rid=4106087&cid=t_103259_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=4106088&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F25%2Fessential-skills-for-pain-clinicians%2F Strangely enough I don’t have a specific reading or paper for my post today – only my experience over a long time working in pain management. Now I know anecdotes are not strong evidence, yet at the same time there are some things that have yet to be well researched, so this is an attempt maybe to put something out there that someone will pick up and run with! What are some of the essential skills for pain clinicians? Whether they’re working in acute pain or chronic pain, I think the first and sot essential skill is the ability to listen and be empathic towards the peson with pain. To me, listening with the whole mind and heart is a clinical imperative. It means really hearing what the person is saying with words and body. Why would I put this skill at the top of the list... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4106088 Sun, 24 Oct 2010 21:01:05 +0100 4106088 http://www.medworm.com/index.php?rid=4082344&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F10%2F19%2Fworking-and-chronic-pain%2F If there is one aspect of chronic pain management that has received more attention than returning to work, I don’t know it! In 1995 when I started working at my current workplace, work was almost a dirty word. I was accused at one time of being a ‘Siberian workcamp’ Commandante because some people thought it was cruel to ‘force’ people with chronic pain into the workplace. Thankfully this attitude has changed over the years, and most people recognise that working when you have chronic pain, while difficult, is achievable and good for health. At the same time, returning to work with pain has never been especially easy and there are numerous issues to work through. Today is the first day I will discuss the practical aspects of returning to work with the current ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=4082344 Mon, 18 Oct 2010 18:37:07 +0100 4082344 http://www.medworm.com/index.php?rid=4013604&cid=t_103259_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=3969196&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F15%2Fthe-tigger-effect-resilience-emotion-regulation%2F Tigger. That orange-furred, black-striped, tiger character originally introduced in A. A. Milne’s book The House at Pooh Corner. Tigger is a very bouncy fella. Tigger is amongst the most exuberant creatures in the 100 Acre Wood, and his most stand out and well-known feature is his very springy tail. Tigger has resilience. The wonderful thing about Tiggers…..Is Tiggers are wonderful things…..Their tops are made out of rubber…..The bottoms are made out of springs…..They’re bouncy, trouncy, flouncy, pouncy…..Fun, fun, fun, fun, fun…..But the most wonderful thing about Tiggers is…..I’m the only one…..The wonderful thing about Tiggers…..Is Tiggers are wonderful chaps…..They’re loaded with vim and vigor…..T... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3969196 Wed, 15 Sep 2010 09:22:49 +0100 3969196 http://www.medworm.com/index.php?rid=3969197&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F15%2Fwhat-to-do-when-feeling-low-grumpy-or-fatigued%2F Yesterday I wrote about emotion regulation and how this is seen as an essential part of achieving good mental health.  Emotion regulation is about being able to monitor, judge, and work with emotional responses in order to achieve goals. People with chronic pain often experience a range of negative emotions – pain itself is characterised as being a negative emotional and sensory experience. At the same time we know there is an interaction between feeling low and experiencing pain that makes both experiences feel worse. Three of the more troublesome emotions that people experience when they have chronic pain is low mood (not always depression, often ‘demoralisation’ or simply feeling sad and down); frustration and anger; and fatigue. Fatigue you say? Is that an emotion? W... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3969197 Tue, 14 Sep 2010 19:40:31 +0100 3969197 http://www.medworm.com/index.php?rid=3929461&cid=t_103259_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Fsexual-response-and-aging-2%2F Many people in recovery are in the older age groups. Either starting recovery or well along the road sexual activity and responses can be different to what they remember or may have a different spiritual meaning. By understanding age changes one can accommodate new experiences rather than be confused or disheartened. Women and men have the capacity for sexual desire and sexual activity throughout their lives. There is no reason why one cannot express one’s sexuality well beyond the “reproductive years” (the ages during which men and women are fertile). In fact, women and men who have been sexually active throughout their adult lives seem to be more sexually responsive in old age than those who have not. The key to maintaining sexual function in later years is to continue a patter... Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3929461 Thu, 02 Sep 2010 17:31:00 +0100 3929461 http://www.medworm.com/index.php?rid=3921093&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F09%2F01%2Fmeasuring-changes-during-graded-exposure-acceptance-treatment%2F I have been pondering about the best way to monitor ‘Matt’s progress during graded exposure therapy for his avoidance of activities involving back movement. I introduced you to Matt yesterday. He’s a ‘man’s man’, a real bloke who, for the past four years since he had surgery for a prolapsed disc, has avoided things like mowing the lawns, making the bed, fishing and whitebaiting and even golf. Yesterday I described how we went through 100 photographs of activities of daily living, and of these, Matt identified 67 of the photographs as things he wouldn’t do because of his concern about both the impact on his pain and the ‘strain’ on his back. I have used a simple count of the number of photographs a person decides is in the ‘avoided... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3921093 Tue, 31 Aug 2010 19:35:59 +0100 3921093 http://www.medworm.com/index.php?rid=3890474&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdr-frank-ryans-death-what-we-can-learn-from-it%2F2010.08.21 I’ll be honest — I’d never heard of Dr. Frank Ryan, a Hollywood plastic surgeon, until his tragic motor vehicle accident recently. Clients included actress Heidi Montag and boxer Oscar De La Hoya. Although the California Highway Patrol investigation isn’t complete, rumors have suggested that Dr. Ryan may have been text messaging when driving. If this is true and an intelligent, well-trained doctor can fall prey to the allure of technology, then what does it mean for the rest of us? First, realize that we can’t multitask. You have one brain. You can focus at one task at a time. Though laws allow hands-free cellphone calls, the issue isn’t trying to dial the phone but rather that the mind is engaged in the conversation and not on the road. Yes, we ar... Better Health blogs http://www.medworm.com/rss/comments.php?id=3890474 Sat, 21 Aug 2010 20:00:00 +0100 3890474 http://www.medworm.com/index.php?rid=3876912&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F18%2Fexercise-questions%2F If there is one finding that has remained pretty solid over the past 10 – 15 years, it’s the one that says being active is a good thing for managing chronic pain.  I’m not sure how many papers I’ve read where ‘exercise’ and some form of cognitive behavioural approach have been found to produce improvements in disability, mood and even pain – and the benefits are often maintained for 12 months or more.  But we have a problem, Houston.  The problem is this – many of these studies treat ‘exercise’ in much the same way as ‘interdisciplinary pain management’ – a black box that no-one really knows exactly what goes on in there, but hey it works. This is a real problem when we come to put the research findings to wor... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3876912 Tue, 17 Aug 2010 19:36:07 +0100 3876912 http://www.medworm.com/index.php?rid=3865264&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffeeding-tubes-in-the-elderly-demented%2F2010.08.13 An article in [last] week’s New York Times entitled Feeding Demented Patients with Dignity suggests that hand feeding dementia patients may be a better option than tube feeding them. My God, are we really putting feeding tubes in the elderly demented? When did this happen? During college, I worked as a nurses aide in a nursing home outside Philadelphia. For 20 hours a week (40 hours in the summer) for two years, I cared for patients in all stages of dementia, from the walking confused through to the end stage, stiffened victims confined to wheelchairs or beds. But in all that time, I never, ever saw anyone with a feeding tube. (more…) *This blog post was originally published at The Blog that Ate Manhattan* (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3865264 Fri, 13 Aug 2010 20:00:00 +0100 3865264 http://www.medworm.com/index.php?rid=3854500&cid=t_103259_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fsleep-or-food-which-is-more-important-according-to-tony-schwartz-founder-of-the-energy-project%2F photo: Thinkstock If you’re Tony Schwartz – former journalist, author of the new book The Way We’re Working Isn’t Working, and founder of The Energy Project, which uses science to help employees and employers harness high-performance strategies in order to become more productive, efficient, and satisfied (and not just exist in the “survival zone”) – the answer is, without question, sleep. Was that your answer? The reasoning behind it is that people can survive for several weeks without food, but not sleep. We need it. Badly. In order to think, function, create, and produce. And most of us aren’t getting nearly enough of it in our daily lives. This was just one of the many seemingly simple yet fascinating subjects Tony enlightened us about during his ... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3854500 Tue, 10 Aug 2010 16:29:04 +0100 3854500 http://www.medworm.com/index.php?rid=3845187&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FuaJVh6D6qUc%2F I was really interested in the recent critique of the BBC brain training experiment by Dr. Elizabeth Zelinski. I think Owens et al (2010) was a critical piece of research which was not conducted in the right way and was focusing on the wrong sample population.  I totally agree with the comments by Dr. Zelinski regarding the potential for sample bias and the use of some questionable cognitive measures. However, I would like to take this critique further and question whether the study was value for money when there are other studies which cannot achieve funding but would, in my opinion, show the criticism/scepticism of the use-it-or-lose-it theory. I think there is not enough criticism about the age of the sample population used in Owens et al. (2010). We have conclusive cognitive and neuro... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3845187 Mon, 09 Aug 2010 12:14:16 +0100 3845187 http://www.medworm.com/index.php?rid=3845298&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F08%2F09%2Ftop-down-bottom-up-or-both-attention-to-pain%2F I guess we all pretty much know that our brains don’t seem to capture everything that goes on around us – thankfully we can filter out a lot of unnecessary information (no, I don’t want to know what that funny noise outside is right now!) so that we can focus on what is important. When it comes to pain, the limited capacity of our brains to process information has been used to explain why there are times that, despite a large amount of nociceptive input, we can remain pretty much oblivious to it. Clearly it would be wonderful if we could harness this and use it as a form of analgesia. The place to start, I guess, is with recognition that one function of our brain is to keep us focused on important goal-directed activity. Because of this function, some information that is ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3845298 Sun, 08 Aug 2010 19:41:48 +0100 3845298 http://www.medworm.com/index.php?rid=3808857&cid=t_103259_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=3808650&cid=t_103259_87_f&fid=34872&url=http%3A%2F%2Fblisstree.com%2Ffeel%2Fimpulse-buyers-beware-dopamine-is-the-culprit%2F Her dopamine levels are off the charts — you can see it in her eyes. (photo: Thinkstock) If you’ve got a closet full of unworn clothes and a credit card bill through the roof, chances are you’re an impulse shopper. You see something; you want it; you buy it. This could be because your brain has more dopamine in it than your more cautious friends. High levels of dopamine cause people to act rashly, which would explain that pair of hot pink pleather pants in the back of your closet. I only impulse buy when I’m stressed — I wonder what that says about my dopamine levels. How many of you have a really embarrassing impulse buy tale? Please, share — we all love a good shopping horror story. via NPR Post from: BlissTree Impulse Buyers Beware: Dopamine Is the Culprit (Sourc... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=3808650 Fri, 30 Jul 2010 16:45:37 +0100 3808650 http://www.medworm.com/index.php?rid=3794913&cid=t_103259_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F07%2Fjoint-cfa-floyd-et-al-2010-of-wj-iii.html John Garruto took advantage of my offer and thus, now provides his comments regarding the following recently published research study.  John has been a regular guest blogger at IQ's Corner....how about the rest of you!!!!!!!  I am open to any topic, but am particularly interested in guest posts regarding articles that have been FYI-mentioned at this blog (typically under Research Bytes tag)---and I especially would like to encourage graduate students to send me possible guest posts...as a way to get experience with analyzing research and providing brief summaries.  Maybe some of my professorial colleagues could make the submission of one guest blog post a requirement in one of their classes :)Floyd, R. G., Bergeron, R., Hamilton, G. & Parra, G. R. (2010).  How do ex... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3794913 Tue, 27 Jul 2010 17:02:00 +0100 3794913 http://www.medworm.com/index.php?rid=3787135&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F07%2F26%2Fmindfulness-and-exercise%2F Now I know this might seem a strange heading when we think of mindfulness practice normally, but this isn’t ‘treatment as usual’. The definition of mindfulness in this study is ‘The body scan practice involves systematically moving awareness through each part of the body and noticing the presence of sensation in a detailed and precise way. This enables contact with the actual sensations of the body (as opposed to thoughts, ideas or fears about these sensations). Mindful movement involves bringing awareness to physical activity, thus allowing movement of the body within the limits of its physical capability. This is taught by means of a comprehensive sequence of movements based on yoga and Pilates.’ I’n not sure I could find a better description of how I ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3787135 Sun, 25 Jul 2010 19:32:20 +0100 3787135 http://www.medworm.com/index.php?rid=3772345&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FjLsVNwDrhXw%2F This study established the methodologies that made possible the effective scientific study of the efficacy of psychotherapies. The evidence base and of such treatments as CBT, DBT, Motivational Enhancement Treatment and other evidence-based psychotherapies derives directly from this study and its seminal influence. This was a contribution to the science of Clinical Treatment Development research. I would say that my major interest, however, has been in the next step, the science of knowledge transfer. There has been and remains a long and costly (in terms particularly of unnecessary suffering) lag between the development of new knowledge and its common and effective use in practice. In order the help the field moved forward, I have worked for the last 20 years in the development and implem... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3772345 Tue, 20 Jul 2010 10:07:21 +0100 3772345 http://www.medworm.com/index.php?rid=3767338&cid=t_103259_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=3767320&cid=t_103259_151_f&fid=35818&url=http%3A%2F%2Frecoveryissexy.com%2Ffood-for-men%2F This article may help focus in on healthy foods. Foods men should include in their diets to improve health and prevent disease. Men are different from women in all kinds of ways — including their nutritional needs. Just as women need particular nutrients during pregnancy or for protection from breast cancer, men need nutrients that can help them maintain muscle mass, prevent prostate cancer, and more. Many foods that tend to be favorites among men are not the best choices for good health. Yet a healthy diet and regular physical activity can help prevent heart disease and cancer, the No. 1 and No. 2 killers for men over 35. They can also enhance performance, from the boardroom to the bedroom. Christine Gerbstadt, MD, RD, notes that any food that is good for the cardiovascular system i... Recovery Is Sexy.com blogs http://www.medworm.com/rss/comments.php?id=3767320 Sun, 18 Jul 2010 15:02:00 +0100 3767320 http://www.medworm.com/index.php?rid=3750314&cid=t_103259_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=3743735&cid=t_103259_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=3740571&cid=t_103259_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2Fweight-loss-7-ways-to-fight-hunger%2F photo from Flickr user Muffet We’re not big fans of dieting. But sometimes even just watching what you eat sucks. Nothing’s worse than the feeling you get when you want chocolate, but know you can’t have it. (Okay, the BP oil spill, earthquake in Haiti, and wars in Iraq and Afghanistan might be worse.) With these tips to stay full while eating less, you may be able to treat yourself once in a while. 1. Eat protein for breakfast. Eating a lean protein at breakfast keeps you fuller than other nutrients, because your body takes more time to digest and absorb it. Try low-fat yogurt or egg whites. But not mixed — that would be gross. 2. Swallow some spuds. The starch in potatoes resists digestive enzymes, which means it takes longer for your body to break it down. Potat... Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3740571 Fri, 09 Jul 2010 19:52:16 +0100 3740571 http://www.medworm.com/index.php?rid=3730120&cid=t_103259_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=3706638&cid=t_103259_87_f&fid=36050&url=http%3A%2F%2Fblisstree.com%2Flive%2F185764%2F Coffee may prevent Alzheimer’s, but what’s the catch? According to a story yesterday on NPR’s Morning Edition, researchers recorded improvements in lab mice with Alzheimer’s, but only if the critters got a ton of caffeine. Theoretically, the human equivalent would mean drinking at least five cups of regular coffee every day, but at this point these findings are inconclusive. So keep doing your crossword puzzles. Post from: BlissTree (Source: Breastfeeding 1-2-3) Breastfeeding 1-2-3 blogs http://www.medworm.com/rss/comments.php?id=3706638 Mon, 28 Jun 2010 22:19:26 +0100 3706638 http://www.medworm.com/index.php?rid=3707025&cid=t_103259_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_103259_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=3701676&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fdoctor-to-patient-do-you-text-and-drive%2F2010.06.26 It’s time to ask patients whether they text and drive. An important perspective piece from the New England Journal of Medicine urges doctors to include that question during preventive health exams. The data surrounding texting and driving is grim: Although there are many possible distractions for drivers, more than 275 million Americans own cell phones, and 81% of them talk on those phones while driving. The adverse consequences have reached epidemic proportions. Current data suggest that each year, at least 1.6 million traffic accidents (28% of all crashes) in the United States are caused by drivers talking on cell phones or texting. Talking on the phone causes many more accidents than texting, simply because millions more drivers talk than text; moreover, using a hands-free device does... Better Health blogs http://www.medworm.com/rss/comments.php?id=3701676 Sat, 26 Jun 2010 14:00:05 +0100 3701676 http://www.medworm.com/index.php?rid=3687374&cid=t_103259_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=3683912&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F06%2F22%2Fwhat-obstacles-get-in-the-way-of-self-managing-chronic-pain%2F Learning to manage pain using self management strategies ain’t easy – as we know, changing habits and doing things differently is not something any of us do without a bit of effort. It’s especially difficult when life in general is full of challenges, but so much more so when pain is the problem,you have a mood disorder that saps your energy and when other people (even health professionals!) challenge your decision to manage pain independently. There are even some researchers who would say that using self management strategies is not all that important – after all, after about a year, many people don’t use any of the new skills, but still feel differently about pain anyway (Curran, Williams and Potts, 2009). The Stepped Care for Affective Disorders and Musculo... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3683912 Mon, 21 Jun 2010 19:38:18 +0100 3683912 http://www.medworm.com/index.php?rid=3659177&cid=t_103259_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=3656808&cid=t_103259_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fwhen-occams-razor-doesnt-cut-it%2F2010.06.13 Occam’s razor is a well known logical principle often applied in medicine. It states that the simplest explanation for a complaint/symptom is usually the correct one. Most of the time, Occam’s razor serves the diagnostician well, but when the actual problem is complex or unexpected, patients can be sent down expensive and even life-threatening diagnostic rabbit holes. A friend of mine is an 80-pack-year smoker. He was complaining of shortness of breath, worsening over a couple of months, and his primary care physician sent him to a pulmonologist. The assumption was that the shortness of breath was related to COPD from his chronic smoking - and that indeed would have been the most likely explanation. (more…) (Source: Better Health) Better Health blogs http://www.medworm.com/rss/comments.php?id=3656808 Sun, 13 Jun 2010 15:07:02 +0100 3656808 http://www.medworm.com/index.php?rid=3645072&cid=t_103259_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=3641350&cid=t_103259_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_103259_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=3607851&cid=t_103259_167_f&fid=38576&url=http%3A%2F%2Fwww.drbriffa.com%2Fblog%2F2010%2F05%2F28%2F%25e2%2580%2598food-for-thought%25e2%2580%2599-%25e2%2580%2593-nutritional-advice-for-those-preparing-for-and-taking-exams%2F My girlfriend and I have had a guest staying this week. He is Swiss and is in London for an exam which has something to do with international tax law (it’s all a bit above my head, I’m afraid). Last night the three of us were eating together – our last supper before our guest [...] (Source: Dr John Biffa's Blog) Dr John Biffa's Blog blogs http://www.medworm.com/rss/comments.php?id=3607851 Fri, 28 May 2010 14:48:01 +0100 3607851 http://www.medworm.com/index.php?rid=3607663&cid=t_103259_122_f&fid=37835&url=http%3A%2F%2Fwww.iqscorner.com%2F2010%2F05%2Fmore-support-for-working-memory-gsm-mw.html The relationships of working memory, secondary memory, and general fluid intelligence: Working memory is special. By Shelton, Jill Talley; Elliott, Emily M.; Matthews, Russell A.; Hill, B. D.; Gouvier, Wm. DrewJournal of Experimental Psychology: Learning, Memory, and Cognition, Vol 36(3), May 2010, 813-820.AbstractRecent efforts have been made to elucidate the commonly observed link between working memory and reasoning ability. The results have been inconsistent, with some work suggesting that the emphasis placed on retrieval from secondary memory by working memory tests is the driving force behind this association (Mogle, Lovett, Stawski, & Sliwinski, 2008), whereas other research suggests retrieval from secondary memory is only partly responsible for the observed link between working... Intelligent Insights on Intelligence Theories and Tests (aka IQ's Corner) blogs http://www.medworm.com/rss/comments.php?id=3607663 Thu, 27 May 2010 22:28:00 +0100 3607663 http://www.medworm.com/index.php?rid=3607559&cid=t_103259_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F05%2F27%2Faspirin-for-schizophrenia%2F Could inflammation be a contributing factor to some symptoms in schizophrenia? And if inflammation is a significant factor in schizophrenia, could ordinary aspirin help? Researchers (Lann et al., 2010) from the Netherlands (I love researchers from the Netherlands!) set to find out. They looked at 70 inpatients in ten psychiatric hospitals who were already taking antipsychotic medications to help treat their schizophrenia (or a related schizophrenia disorder). They randomly divided the 70 patients into two groups — a control group that received placebo, and another group who received 1,000 mg of aspirin per day. Patient functioning and psychopathology was tested with a common assessment, the Positive and Negative Syndrome Scale (PANSS). The researchers also looked at cognitive functio... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3607559 Thu, 27 May 2010 21:19:03 +0100 3607559 http://www.medworm.com/index.php?rid=3581573&cid=t_103259_87_f&fid=34872&url=http%3A%2F%2Fblisstree.com%2Ffeel%2Fis-caffeine-a-wonder-drug-for-the-brain%2F Photo: Blisstree While too much caffeine can sometimes lead to health issues (eye twitch, anyone?), a new supplement in the Journal of Alzheimer’s Disease explores the preventive effects of caffeine against cognitive decline caused by dementia and Alzheimer’s disease. You could be fighting dementia by drinking countless cups of joe a day – now you can say all those late nights you stayed up friending everyone in your 7th grade class on Facebook were just doctor’s orders. Caffeine has multiple beneficial effects on the brain, particularly to normalize brain function and prevent its degeneration. Caffeine also has a positive impact on memory and cognitive performance. Plus, the drug may be a disease-modifying agent with regard to Alzheimer’s. It could even prove to... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=3581573 Thu, 20 May 2010 12:00:06 +0100 3581573 http://www.medworm.com/index.php?rid=3570085&cid=t_103259_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=3566589&cid=t_103259_87_f&fid=34872&url=http%3A%2F%2Fblisstree.com%2Ffeel%2Fmental-health-give-your-brain-a-workout%2F photo: Thinkstock Sometimes it just feels good to give your brain a rest – to lie back, flip on whatever reruns are playing on TBS, and stop thinking for an hour or two. But after a few days of prime vegging-out time, we need to stretch our brain, just like we do our bodies. And we found some great ideas on how to do just that from iVillage. If you’ve scorned yoga in the past, it might be time to reconsider. Regularly practicing yoga and meditating improve cognitive functions, as well as emotional processing, by increasing cortical thickness, which can happen in just eight weeks. Yoga can also positively affect the parts of your brain that deal with stress, sensory awareness, self-awareness, and judgment. Yoga isn’t the only physical activity you can do that will help your br... Healthbolt blogs http://www.medworm.com/rss/comments.php?id=3566589 Fri, 14 May 2010 22:30:39 +0100 3566589 http://www.medworm.com/index.php?rid=3549592&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F05%2F10%2Fact-ing-well-living-well%2F For some time I’ve been learning more about ACT – Acceptance and Commitment Therapy (normally pronounced ‘act’, not A – C – T).  While I have to admit that I have been flummoxed by relational frame theory, a behavioural theory of human language and cognitionthat underpins ACT (go here for a tutorial that may enlighten somewhat), there are some very simple principles that ACT employs that I’ve found useful in my own life – and in the lives of people I work with. Over the next few days I want to outline a bit more about ACT and how I use it within pain management – I’ll be referring to journal papers that explore the use of ACT in pain management, but a lot of what I’ll cover comes more from my own experiences with moving fro... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3549592 Sun, 09 May 2010 23:33:21 +0100 3549592 http://www.medworm.com/index.php?rid=3519411&cid=t_103259_87_f&fid=34872&url=http%3A%2F%2Fblisstree.com%2Ffeel%2F176586%2F Do Fish Oil Pills Really Help Your Brain? A study published in the American Journal of Clinical Nutrition indicates that fish oil supplements don’t really improve cognitive function. (via TheGloss) Post from: BlissTree (Source: Healthbolt) Healthbolt blogs http://www.medworm.com/rss/comments.php?id=3519411 Thu, 29 Apr 2010 22:05:21 +0100 3519411 http://www.medworm.com/index.php?rid=3515653&cid=t_103259_167_f&fid=38576&url=http%3A%2F%2Fwww.drbriffa.com%2Fblog%2F2010%2F04%2F29%2Fcan-sunlight-and-vitamin-d-help-to-preserve-physical-function-and-independence-as-we-age%2F As we age, we are generally more likely to succumb to illnesses such as heart disease, cancer and type 2 diabetes. On top of this, though, we run the risk of becoming infirm. For some this culminates in disability and loss of independence. What can be done, though, to protect against such physical deterioration? One approach [...] (Source: Dr John Biffa's Blog) Dr John Biffa's Blog blogs http://www.medworm.com/rss/comments.php?id=3515653 Thu, 29 Apr 2010 09:58:56 +0100 3515653 http://www.medworm.com/index.php?rid=3494247&cid=t_103259_83_f&fid=34856&url=http%3A%2F%2Finsidesurgery.com%2F2010%2F04%2Fweight-loss-surgery-improves-asthma-symptoms%2F A new study recently published confirms previously believed trends that bariatric weight loss surgery in obese patients improves respiratory functioning and decreases asthma-like symptoms. The lead study author was Dr. Naveen Sikka at Henry Ford Hospital in Detroit, Michigan. (Source: Inside Surgery) Inside Surgery blogs http://www.medworm.com/rss/comments.php?id=3494247 Wed, 21 Apr 2010 21:58:48 +0100 3494247 http://www.medworm.com/index.php?rid=3479745&cid=t_103259_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2FTIfnuNteMbQ%2F This article explains treating and understanding a spinal cord injury.           The spinal cord is the major bundle of nerves carrying nerve impulses to and from the brain to the rest of the body.  Rings of bone called vertebrae surround the spinal cord.  These bones constitute the spinal column (back bones).  Spinal cord damage results in a loss of function, such as mobility or feeling.  In most people who have spinal cord injury, the spinal cord is intact.  Spinal cord injury is not the same as back injury, which might result from causes such as pinched nerves or ruptured disks.  Even when a person sustains a break in a vertebra or vertebrae, there might not be any spinal cord injury if the spinal cord itself is not affected.  There are two kinds of spinal cord injury &... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3479745 Sat, 17 Apr 2010 15:18:59 +0100 3479745 http://www.medworm.com/index.php?rid=3467839&cid=t_103259_111_f&fid=39123&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2Fnursingcomments%2Ftdtc%2F%7E3%2FcvHo0cow9go%2F GUEST POST BY ANDREW WOLFE, LMP, MMs “Medical Massage Therapy and Insurance Coverage.”  By Andrew Wolfe, LMP, MMs. Medical massage therapy is recognized as a health care provision under rehabilitation outpatient coverage under most major medical plans.  Specific plan coverage’s vary according to the benefit package your plan and/or employer offer.  Medical massage therapy definition is the ability to heal, restore and improve function which was otherwise compromised due to illness, injury, disease or surgery.  It must be a part of a treatment plan your primary care provider recommends as medically necessary to restore lost function. Provisions are also given towards motor vehicle accident (PIP) and worker’s compensation-labor and industry (L&I), job injury reco... Nursing Comments blogs http://www.medworm.com/rss/comments.php?id=3467839 Wed, 14 Apr 2010 13:28:37 +0100 3467839 http://www.medworm.com/index.php?rid=3463878&cid=t_103259_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=4060656&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2010%2F04%2Fthe_essence_of_the_human_experience_what_is_normal.php This is the fifth in a series of articles on Emotional Intelligence for Personal Growth. Probably all of us have asked our self from time to time if our thoughts, feelings, or behavior at any single moment is "normal". Actually, there are different answers for each one of these. Normal behavior is, like it or not, defined by our legal, community (family, neighborhood, social group) and religious institutions. The law is enforced by our local police, and sanctioned by our courts. Religious values might be said to be collectively defined by our church going population and it's leadership. If we are observed behaving outside of legal boundaries, we may find ourselves in a court room facing a judge. If we stretch our community or religious values, we might be ostracized, and separated from t... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060656 Fri, 09 Apr 2010 18:49:27 +0100 4060656 http://www.medworm.com/index.php?rid=3443919&cid=t_103259_131_f&fid=35007&url=http%3A%2F%2Fbooks.mcgraw-hill.com%2Fmedical%2Fommbid%2Fblog%2F%3Fp%3D1309 Certain gliomas have somatic mutation in cytosolic isocitrate dehydrogenase 1. Dang et al. have shown that these mutations confer the enzyme the new ability to transform alpha-ketoglutarate in 2-hydroxyglutarate. This metabolite might be oncogenic, although this is not proven yet. Dang L, White DW, Gross S, et al. Cancer-associated IDH1 mutations produce 2-hydroxyglutarate. Nature 2009;462:739-744 Philippe Campeau (Source: The OMMBID Blog) The OMMBID Blog blogs http://www.medworm.com/rss/comments.php?id=3443919 Wed, 07 Apr 2010 14:40:00 +0100 3443919 http://www.medworm.com/index.php?rid=3408676&cid=t_103259_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=3404168&cid=t_103259_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_103259_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=4060658&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2010%2F03%2Fbuddhas_brain_the_neuroscience_of_selfhelp.php I've been a skeptic about self-help books as have many of my colleagues. Self-help concepts often represent the home grown philosophy of the author. Seldom is there comprehensive research documentation of the foundations of the concepts shared. And so you can never be sure you are reading something that applies real science to every day needs. Cover via Amazon This book is an exception. Buddha's Brain - The Practical Neuroscience of Happiness, Love, and Wisdom. is the catchy title. Actually, there is little about Buddha or Buddhism in the book. Written by Rick Hanson Ph.D. with Richard Mendius MD, it uses some concepts of Buddhism as a frame of every day experience to convey the main themes. It thoroughly summarizes for the layman the latest neuroscience research as it relates to happin... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060658 Sun, 21 Mar 2010 21:57:21 +0100 4060658 http://www.medworm.com/index.php?rid=3391016&cid=t_103259_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=3370706&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F17%2Fsetbacks%2F A couple of days ago I mentioned the satisfaction I feel when a person I’ve been working with faces a setback and manages it successfully on their own for the first time.   Someone replied saying that we all face pain setbacks alone, so what did I mean really – and I thought today I’d quickly expand on what I did mean! Chronic pain persists (goes without saying) but its pattern is to fluctuate from time to time and often without clear provocation – so it’s not very helpful to try and look at what ’caused’ the pain to change.  Yet this is so often what we as clinicians ask about, and more often what the person experiencing the pain tries to do.  Flare-ups happen irrespective of how hard we try to avoid them, so it’s useful IMHO to group fla... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3370706 Tue, 16 Mar 2010 18:23:08 +0100 3370706 http://www.medworm.com/index.php?rid=3366452&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F03%2F15%2Fmaintaining-change%2F This study by Christiansen, Oettingen, Dahme and Klinger, shows an extension of the motivational approaches based on Motivational Interviewing, integrates it with traditional problem solving, drags in a bit of goal achievement theory and ties it all together in two half hour sessions – and produces a significant change in functional outcome.  How so? Importance and confidence The two important drivers of action seem to be how important an activity is and how confident a person is to achieve it.  In this study, a group of patients was asked to rate the importance and confidence to ‘improve physical capacity’.  They were then asked to list four positive aspects associated with making this change – eg getting in shape, having fun, distraction from pain.  They were ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3366452 Sun, 14 Mar 2010 18:20:24 +0100 3366452 http://www.medworm.com/index.php?rid=3362434&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fwww.dare-to-dream.us%2Farchives%2F2010%2F03%2Fselfknowledge_emotional_intelligence_for_personal.php This is the fourth in a series of articles on emotional intelligence for personal growth. Self-knowledge is something we all strive towards. But how many of us have done a complete review of our emotions and how they influence our thoughts and behavior? Most people find that pretty hard to do, especially since they struggle to put their feelings into words. We talk about "will power" as the ultimate motivation. It might surprise you to find out that motivation is really emotion. Emotion in it's simplest form is motivation, "...each emotion offers a distinctive readiness to act; each points us in a direction that has worked well to handle the recurrent challenges of human life." (Goleman, 1995, p4) Entering a state of mindfulness or flow a person reaches "perhaps the ultimate in harnessing... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=3362434 Sat, 13 Mar 2010 01:30:40 +0100 3362434 http://www.medworm.com/index.php?rid=3338252&cid=t_103259_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F03%2F06%2Flearning-about-transcendental-meditation%2F Discussion tab makes clear feuding editors battling for control about tone and focus. I don’t know what to make of transcendental meditation personally, but I find studies like the recently published one interesting. I know people who use it and swear by its positive effects (but I also know people who use other techniques and methods and swear by them as well). I suspect some of the skepticism comes from the pseudo-religious nature of technique, or the fact that it costs money to learn it. But in my experience, many things worth learning cost money (look at my graduate education, for instance). My only concern is that if it is something that is “simple, natural, effortless, and easily learned,” why does it cost $1,500 and an entire day to learn? I’ve read enough t... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3338252 Sat, 06 Mar 2010 13:32:15 +0100 3338252 http://www.medworm.com/index.php?rid=3827171&cid=t_103259_117_f&fid=38815&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FGetPrimed%2F%7E3%2Fr-432LQ8hvo%2F Many mid-life women experience changes in sexual health including vaginal atrophy, vaginal dryness and painful sexual intercourse. Since many women do not discuss these issues, we are conducting an anonymous survey to better understand the types of sexual health issues women are dealing with so we can design appropriate educational materials. We appreciate your responses and will share our results. This survey is powered by SurveyGizmo’s online survey software. Please take my survey now (Source: Get Primed!) Get Primed! blogs http://www.medworm.com/rss/comments.php?id=3827171 Fri, 05 Mar 2010 20:43:00 +0100 3827171 http://www.medworm.com/index.php?rid=3335587&cid=t_103259_167_f&fid=38576&url=http%3A%2F%2Fwww.drbriffa.com%2Fblog%2F2010%2F03%2F04%2Frye-bread-helps-relieve-constipation-and-other-tips-for-bowel-regularity%2F I eat a relatively low-carb diet, and as a result, eat very little bread indeed. I literally cannot remember the last time I ate a sandwich, for instance. And when I do eat bread, I tend to opt for a thin slice or two of dark rye bread. I prefer rye to wheat bread partly [...] (Source: Dr John Biffa's Blog) Dr John Biffa's Blog blogs http://www.medworm.com/rss/comments.php?id=3335587 Thu, 04 Mar 2010 20:52:32 +0100 3335587 http://www.medworm.com/index.php?rid=3311967&cid=t_103259_167_f&fid=38576&url=http%3A%2F%2Fwww.drbriffa.com%2Fblog%2F2010%2F02%2F26%2Firon-supplementation-found-to-improve-brain-function%2F Iron is an essential nutrient for the making of haemoglobin – the component in red blood cells that carries oxygen and delivers it to the tissues. If iron is deficient in the body, haemoglobin levels can fall and eventually cause anaemia (pathologically low haemoglobin). Symptoms of this can include mental and physical fatigue and low [...] (Source: Dr John Biffa's Blog) Dr John Biffa's Blog blogs http://www.medworm.com/rss/comments.php?id=3311967 Fri, 26 Feb 2010 16:14:43 +0100 3311967 http://www.medworm.com/index.php?rid=3302673&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2010%2F02%2F24%2Flow-back-pain-unfit-just-not-doing-much-or-something-else%2F For as long as I’ve been working in pain management (and probably well before), I’ve heard patients being described as ‘deconditioned’. From what we know about the effects of staying in bed because of illness or injury, it makes sense to think that if a person does very little they will become unfit. Common sense really. And from this assumption an industry of gym programmes and fitness initiatives have been instituted as an integral part of back pain rehabilitation. Now before my physiotherapy colleagues start to lynch me, I’m not saying that these programmes should be banished into outer darkness because ‘reactivation’ has been shown to be effective in the recovery from back pain – but maybe it’s effective for quite a different reason... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=3302673 Tue, 23 Feb 2010 18:31:00 +0100 3302673 http://www.medworm.com/index.php?rid=3298460&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FNVho1duYvkc%2F (Editor’s Note: In 1990, Congress designated the 1990s the “Decade of the Brain.” President George H. W. Bush proclaimed, “A new era of discovery is dawning in brain research.” During the ensuing decade, scientists greatly advanced our understanding of the brain. The editors of Cerebrum asked the directors of seven brain-related institutes at the National Institutes of Health (NIH) to identify the biggest advances, greatest disappointments, and missed opportunities of brain research in the past decade—the decade after the “Decade of the Brain.” They also asked them what looks most promising for the coming decade, the 2010s. Experts focused on research that might change how doctors diagnose and treat human brain disorders.) Neuroscience is at a historic turning point. To... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3298460 Tue, 23 Feb 2010 16:54:38 +0100 3298460 http://www.medworm.com/index.php?rid=3269729&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fwww.dare-to-dream.us%2Farchives%2F2010%2F02%2Fted_blogjonathan_haidt_on_how_our_moral_roots_skew.php Our Righteous Minds were designed to unite us into teams, divide us against others, & blind us to the truth -Jon Haidt http://bit.ly/9N7TyU (Source: Ψ Dare To Dream...) Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=3269729 Sat, 13 Feb 2010 06:15:48 +0100 3269729 http://www.medworm.com/index.php?rid=3254753&cid=t_103259_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=3228035&cid=t_103259_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=4060662&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2010%2F01%2Fselfawareness_emotional_intelligence_for_personal.php This is the third in a series of articles on emotional intelligence for personal growth. Self-awareness is one of the most important benefits we get from spending time in a mindful state. The longer we are able to stay mindful, the more we learn about our selves. We come to recognize the ebb and flow of our thoughts, moods, emotions and impulses. We begin to see relationships between our thoughts and feelings and external events.One thing we notice is that our thoughts and feelings often contradict each other. Our emotional selves and our rational selves often have conflicting memories, perspectives, and motivations. On the surface, positive emotions seem helpful, and negative emotions seem to be destructive. There is an old Cherokee folk tale called the "Wolves Within". "An old Grandfat... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060662 Sun, 17 Jan 2010 21:12:51 +0100 4060662 http://www.medworm.com/index.php?rid=4060663&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fblog.davemsw.com%2Farchives%2F2010%2F01%2Fmindfulness_emotional_intelligence_for_personal_gr.php This is the second in a series of articles on emotional intelligence for personal growth. The first part is here. Mindfulness is a non-judgmental, present-centered awareness in which each thought, feeling, or sensation that arises is acknowledged and accepted as it is. It is a skill that is learned by committed practice. The object is to focus one's attention on thoughts, feelings and events in the present moment while remaining curious, open, and accepting whatever occurs. The idea is to take on the role of an observer of your own mind. Notice everything that happens without holding onto anything, having a "Teflon Mind". An important part of observing is putting words to the experience. The effect of naming the experience effectively separates you from it. Thoughts are just thoughts, fe... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=4060663 Fri, 15 Jan 2010 03:39:27 +0100 4060663 http://www.medworm.com/index.php?rid=3175955&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fwww.dare-to-dream.us%2Farchives%2F2010%2F01%2Femotional_intelligence_for_personal_growth.php This is the first in a series of articles on the topic of emotional intelligence for personal growth. I got this quote in one of those anonymous emails that has been forwarded through thousands of inboxes all over the planet: Life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, shouting '..holy sh*t ....what a ride!' Enjoy the ride. There is no return ticket. Image via Wikipedia I had heard something like this decades ago and remember that it had a profound effect on me. It was one of those "Aha!" moments we all have from time to time. I had always been a cautious man and taken great pains to avoid unnecessary risks on my way to building a career. While this new perspective didn't change a lot about what I did, it ... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=3175955 Sun, 10 Jan 2010 01:52:36 +0100 3175955 http://www.medworm.com/index.php?rid=3157534&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fwww.dare-to-dream.us%2Farchives%2F2010%2F01%2Femotional_intelligence_for_personal_growth.php This is the first in a series of articles on the topic of emotional intelligence for personal growth. I got this quote in one of those anonymous emails that has been forwarded through thousands of inboxes all over the planet: Life's journey is not to arrive at the grave safely in a well preserved body, but rather to skid in sideways, totally worn out, shouting '..holy sh*t ....what a ride!' Enjoy the ride. There is no return ticket. Image via Wikipedia I had heard something like this decades ago and remember that it had a profound effect on me. It was one of those "Aha!" moments we all have from time to time. I had always been a cautious man and taken great pains to avoid unnecessary risks on my way to building a career. While this new perspective didn't change a lot about what I did, it ... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=3157534 Sun, 10 Jan 2010 01:52:36 +0100 3157534 http://www.medworm.com/index.php?rid=3827172&cid=t_103259_117_f&fid=38815&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FGetPrimed%2F%7E3%2F3oNSFqX6Pl0%2F In a previous blog post – Sexual Changes during Perimenopause and Beyond – I reviewed some of the sexual changes that may occur with menopause. One of the most common sexual issue for postmenopausal women is vaginal atrophy (atrophic vaginitis), the thinning and inflammation of vaginal walls induced by declining estrogen. Vaginal atrophy can lead to vaginal dryness and painful sexual intercourse. Although many women do not seek help for this condition, estrogen treatment has been proven effective in restoring vaginal health and improving symptoms. Estrogen Options There are a number of low dose hormone therapies available in a variety of forms such as vaginal tablets, rings and creams. These local therapies relieve dryness and painful intercourse by rebuilding the lining of the vagina... Get Primed! blogs http://www.medworm.com/rss/comments.php?id=3827172 Wed, 30 Dec 2009 16:02:00 +0100 3827172 http://www.medworm.com/index.php?rid=3111532&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2F0jq6uCe0MLg%2F We are announcing a new session at SharpBrains Summit (and please remember today, December 22nd, is the last date for early-bird registration fees): Monday January 18th, 2010, 3.30-4pm: The Future of Cognitive Health Tech – Intel’s Perspective Two researchers at Intel Corporation and the Technology Research for Independent Living (TRIL) Centre will provide an overview of why and how Intel Corporation is supporting R&D initiatives to help develop home-based automated applications to assess, monitor and help maintain cognition among older adults. They will also share key lessons learned so far, and outline challenges and potential guidelines for the field at large based on ethnographic research and first-hand product development. * Margaret Morris, Senior Researcher, Intel’s Digita... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3111532 Tue, 22 Dec 2009 14:00:23 +0100 3111532 http://www.medworm.com/index.php?rid=3082499&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2F6b8ykl2M_7o%2F Nice weekend reading material – recent news reiforcing emerging trends on physical, cognitive and emotional fitness, but with new twists. Fit teens could be smarter teens “Researchers from Sweden and USC examined data on 1.2 million Swedish men born between 1950 and 1976 who also enlisted for the country’s mandatory military service. They looked at the participants’ global intelligence scores as well as logical, visuospatial, verbal and technical scores. The greater the cardiovascular fitness, the higher the cognitive scores at age 18. The association between muscle strength and global intelligence, in contrast, was weak.”   UPMC Health Plan Offers Brain Fitness Software to Improve Health “UPMC Health Plan announced today that it has signed an agreement... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=3082499 Sat, 12 Dec 2009 04:28:00 +0100 3082499 http://www.medworm.com/index.php?rid=2999879&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F11%2F17%2Fgoing-with-the-flow-emotion-regulation-and-coping%2F I’m in two minds about attempting to regulate emotions. From ACT, and in particular, mindfulness, I’m learning that trying to control emotions and thoughts is darned near impossible – and unhelpful. From the research on the effect of pain on emotions and subsequently on self regulation, goals and coping, it seems that pain strongly influences emotion and that negative emotions in particular, influence the range of coping strategies and goals we choose – and success or failure in turn generates further emotion, and so on. As Hamilton, Karoly and Kitzman say ‘the primary function of pain is to disrupt other ongoing activities and to direct attention toward the cause of injury or the extent of tissue damage’ – of course, in chronic pain, there may no ... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2999879 Mon, 16 Nov 2009 18:29:34 +0100 2999879 http://www.medworm.com/index.php?rid=2996047&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F11%2F16%2Ftheories-of-emotion-self-regulation-and-pain%2F Can chronic pain be a force that shapes how we go about responding to challenges within our environments? Does chronic pain influence how we feel emotionally about daily activities that contribute to overall goals, and perhaps negatively bias the way we think about the process of setting and achieving goals? I’ve already concluded that having pain doesn’t mean people can’t do what they want to do, but it certainly makes it harder and less enjoyable.  Today’s post will briefly look at two theories that link emotion, cognition and pain.  Once again, I’m drawing from a paper written by Hamilton, Karoly & Kitzman (2004). These authors refer to two theories – the first being a two-factor model developed by Carver and colleagues in which it is proposed... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2996047 Mon, 16 Nov 2009 07:35:42 +0100 2996047 http://www.medworm.com/index.php?rid=2977524&cid=t_103259_135_f&fid=35262&url=http%3A%2F%2Fsurvivinghiv.blogspot.com%2F2009%2F11%2Fmens-health-lecture-two-experts-share.html (Source: Nelson Vergel's HIV Blog) Nelson Vergel's HIV Blog blogs http://www.medworm.com/rss/comments.php?id=2977524 Tue, 10 Nov 2009 17:00:00 +0100 2977524 http://www.medworm.com/index.php?rid=2974233&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F11%2F09%2Fim-so-tired-of-coping-self-regulation-executive-functions-and-chronic-pain%2F Changes take energy – that’s nothing new, I know, but perhaps something as clinicians we might forget when we work with people who have chronic pain. I was thinking about this as I’ve had a week away from regular blogging so I could focus on writing and some self care.  Things are busy and as we enter the run up to Christmas, not likely to slow down any time soon – and yes, this takes energy! Adjusting to living with a chronic health problem is demanding, it’s complex and requires people to reflect on what is important to them, how to achieve important activities all the while maintaining a sense of self.  Self regulation is a term used to refer to the ability to alter thoughts, feelings, and behaviors.  In chronic pain ‘[the] demands cross biopsychos... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2974233 Sun, 08 Nov 2009 18:28:43 +0100 2974233 http://www.medworm.com/index.php?rid=2912264&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fwww.dare-to-dream.us%2Farchives%2F2009%2F10%2Fbarriers_behaviors_subcultures_and_the_homeless_po.php I really enjoy reading the blog Kellevision.com. She says it like it is and seldom misses the point of what she's writing about. She identifies a problem in programming for homelessness and proposes a set of concepts to help clarify the situation. Image via Wikipedia Many of the "barriers" faced by the chronically homeless are not external. They are self-inflicted. Repeatedly failing to pay one's utility bills is not a barrier. It is a behavior. Repeatedly getting into relationships with drug addicts and being evicted because you have allowed your new girlfriend to turn your affordable housing into a crack house is not a barrier. It is a behavior. Choosing to pay your boyfriend's bail instead of the rent is not a barrier, it is a behavior. Consistently refusing to hold down steady employm... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=2912264 Wed, 21 Oct 2009 15:12:07 +0100 2912264 http://www.medworm.com/index.php?rid=2908915&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F10%2F20%2Fthat-old-mind-body-thing-again%2F I am not a philosopher.  Neither am I very conversant in the arguments around consciousness.  But working in pain management means the mind-body debate is something I run into now and again.  Is pain all about the body? Is pain all about the mind? Or is it both?  Which influences the other? This debate can often be pushed to one side in the day-to-day practicalities of helping people live well with their chronic pain, but it is often raised when we’re talking about whether it’s important to focus on reducing the underlying disease process (and hopefully reduce the pain) or whether it’s more important to help people live well despite their pain. IMHO it’s not about which is more important: it’s about when to focus on each aspect. Anyway, suffice to say that... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2908915 Mon, 19 Oct 2009 18:31:00 +0100 2908915 http://www.medworm.com/index.php?rid=2894786&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F10%2F15%2Faccepting-low-back-pain-is-it-related-to-a-good-quality-of-life-2%2F This study is another from the Bath University stable, this time from a PhD study carried out by Dr Victoria Mason and supported by Beth Mathias and Dr Suzanne Skevington. Mason’s PhD was around developing a chronic pain component/module to the World Health Organisation’s Quality of Life measure, the WHOQOL, and this study was a part of the larger programme. Quality of life is one of those terms that I’ve never really taken to – it’s always felt quite nebulous. The WHO definition of quality of life is ‘‘‘an individual’s perception of their position in life, in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.’’ Hmmm, suitably broad, so reasonably difficult to me... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2894786 Wed, 14 Oct 2009 18:34:35 +0100 2894786 http://www.medworm.com/index.php?rid=2883228&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F10%2F12%2Facceptance-in-chronic-pain%2F It’s a truism that no-one really wants to have pain (and if they do, we probably need to ‘talk’!).  Accepting pain may be equated with ‘giving up hope’ or ‘giving in’ – perhaps acceptance is thought to be about resignation rather than acknowledgement.  In any event, very few of the people I work with seem to be ready to acknowledge the reality of having pain and at the same time being aware of the ability to also experience joy, peace, fun and all the other good things in life. I’m not entirely surprised by this when I consider the way we’re raised to believe that: (1) pain is bad and must be avoided (2) doctors are all-powerful and can fix anything if only they try hard enough (except the common cold – but we can take ant... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2883228 Sun, 11 Oct 2009 19:26:01 +0100 2883228 http://www.medworm.com/index.php?rid=2812460&cid=t_103259_111_f&fid=36048&url=http%3A%2F%2Ffeeds.b5media.com%2F%7Er%2Fb5media%2FAHeartyLife%2F%7E3%2F5TGcdTrdQmw%2F Losing weight is a good idea for any of us. But a new study says that if you have kidney disease, it’s even more important to get rid of excess baggage. An article in the Clinical Journal of the American Society of Nephrology said “dieting and exercising cut down on proteinuria — the increased output of protein in the urine — while also preventing kidney function from worsening.” Surgery that brings about weight loss is also a benefit to kidney patients as it reduced high filtration rates. Image: sxc.hu. Post from: Blisstree Kidney Disease Patients Should Lose Weight (Source: A Hearty Life) A Hearty Life blogs http://www.medworm.com/rss/comments.php?id=2812460 Sun, 20 Sep 2009 12:50:33 +0100 2812460 http://www.medworm.com/index.php?rid=2800560&cid=t_103259_129_f&fid=36035&url=http%3A%2F%2Fwww.everydayhealth.com%2Fblog%2Flife-with-chronic-pain%2Fwhat-does-quality-of-life-mean-to-you%2F This is a question and a term we often hear bandied about. “I just want her to have quality of life,” or “How am I going to maintain quality of life?” Especially, for those of us who have compromised health, this is a matter of great concern. It’s being used in a political sense these days as people are living longer and maintaining quality in their daily life is often more challenging than it was in times gone by when life expectancy was much shorter. You can be certain that a young pioneer woman who could only expect to live to the ripe old age of 37 didn’t give quality of life much thought. She was too busy trying to make it through daily life, feed her family, scrub her laundry on a scrub board in cold water and survive the various plagues and influenzas that came by on a r... Life with Chronic Pain blogs http://www.medworm.com/rss/comments.php?id=2800560 Tue, 15 Sep 2009 22:05:59 +0100 2800560 http://www.medworm.com/index.php?rid=2800711&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F09%2F16%2Fthe-myth-of-core-stability-part-2%2F Following on from yesterday’s post about core stability, today I want to look at training, back pain prevention and rehabilitation as it relates to core stability. Motor learning moves from conscious attention to make certain movements through to movements that are basically over-learned or automatic. There are considerable differences in how a beginning learner carries out a movement from the way an accomplished or proficient person carries out the same movement – think about how we first learned to drive a car (complete with tongue poking out and bunnyhops!) through to the relatively automatic way we drive to and from work today! Motor learning is specific – so if we want to get good at typing, we need to actually type rather than lift weights. This has important implic... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2800711 Tue, 15 Sep 2009 19:27:55 +0100 2800711 http://www.medworm.com/index.php?rid=2796834&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F09%2F15%2Fthe-myth-of-core-stability%2F Fads come and fads go, and no more so than in managing back pain. One of the more durable fads has been the plethora of exercises to ’strengthen the core’. I’ve been searching for a good review of the literature on core stability, and surprisingly found one in a journal I rarely read: Journal of Bodywork & Movement Therapies. Eyal Lederman has written an extensive critical review of the use of core stability in back pain rehabilitation, and although there is a lot of material covered in the review, it is summarised nicely and the reference list alone is worth getting the article! The basic premise of core stability was a finding that in people with chronic low back pain, there are changes in motor control of the trunk muscles. Along with some of the other underlying b... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2796834 Mon, 14 Sep 2009 19:27:27 +0100 2796834 http://www.medworm.com/index.php?rid=2782255&cid=t_103259_133_f&fid=35129&url=http%3A%2F%2Fwhitterer-autism.blogspot.com%2F2009%2F09%2Fhealth-and-safety-at-play.html “I have an incredibly brilliant solution to the problem,” he announces as he dives into the stationery drawer to rummage around. “I have invented safety improvements.” His toe still bleeds. The supply of band aides is running low. He reaches for the tape dispenser and reels off strip longer than his own arm to wrap around the band aid on his toe. “Dere you go! If life gives you lemons make bloody beef stew.”“!”If you like what you read, send it to someone in 'need.' (Source: Whitterer on Autism) Whitterer on Autism blogs http://www.medworm.com/rss/comments.php?id=2782255 Thu, 10 Sep 2009 06:21:00 +0100 2782255 http://www.medworm.com/index.php?rid=2757937&cid=t_103259_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2009%2F09%2Fpopular-neuroscience-books-for-long.html Looking for reading material for a longish train trip I am about to take, I decided to hit to bookshelves of my Square's Barnes & Noble to see what popular neuroscience titles might be a good diversion (as well as potential supplementary 'lighter' references, should I re-teach an introductory course to neuroscience sometime over the next year).I chose three.The first is by Elkhonon Goldberg, a revision of an earlier work, which is titled "The New Executive Brain: Frontal Lobes in a Complex World" and is available in paperback by Oxford University Press. I first met the author when I was a graduate student, so I am looking forward to reading up on what he's been up to.The second is about glial cells and is entitled, "The Root of Thought: Unlocking Glia" by Andrew Koob. Five years ago, if so... BrainBlog blogs http://www.medworm.com/rss/comments.php?id=2757937 Tue, 01 Sep 2009 19:03:00 +0100 2757937 http://www.medworm.com/index.php?rid=2752229&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F09%2F01%2Ftake-the-pain-away-and-the-other-problems-go-too%2F There are some days I despair that the biopsychosocial model will EVER take hold in the died-in-the-wool medical interventionist strongholds. This quote from a discussion with a colleague might help you join in my pity party…The conversation is about a case of a young woman with 18 month history of neck pain post-MVA, she has been to pain management and ‘while this has helped her understand and manage her pain better, the pain persists to the point that she is becoming increasingly frustrated, with deterioration in her work, personal and social environment.’ In my discussion with my colleague, he stated that ‘…the reasons that the patient is frustrated is that she still has pain.  Take that away (if it is possible) and the other problems go too.’ He wen... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2752229 Mon, 31 Aug 2009 21:24:14 +0100 2752229 http://www.medworm.com/index.php?rid=2730383&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F08%2F25%2Freal-world-outcomes-still-matter-why-medical-and-psychological-is-not-enough-in-pain-management%2F NB: The following rant does not reflect the opinions of my employers, colleagues, family or pets! It is MY opinion! I feel rather weary today, having come to a realisation that although pain management as a field of work has become much more recognised, there are some serious differences of opinion around approach and priorities between various members of the health care team.  I could list my current gripes and take up more than one screen on this blog, but I’ll try and confine myself to whining about just one: the lack of recognition of  ‘real world’ functional outcomes. What I mean is this – we can have the widest range of self report questionnaires covering all the variables in the world from pain intensity, pain quality, pain location to self efficacy, depres... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2730383 Tue, 25 Aug 2009 06:03:48 +0100 2730383 http://www.medworm.com/index.php?rid=2720002&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F08%2F21%2Ffunctional-capacity-evaluations-my-take-on-them%2F Functional capacity evaluations There are many forms of functional assessment available.  These range from a series of structured activities carried out in the home or work environment over a period of days or weeks to those that are carried out in a very precise manner in a clinic and often under the supervision of an occupational therapist or physiotherapist.  Both commercial (ie standardised and franchised) ‘Functional capacity evaluations’ (FCE) are available, as well as semi-structured or individualised assessments. The term functional capacity evaluation has been criticised, because it can suggest that it is able to assess ‘capacity’ or ‘can do’, while most commentators believe that functional assessments can only assess what a person ‘will do’ (e.g. Battie & Ma... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2720002 Thu, 20 Aug 2009 19:16:43 +0100 2720002 http://www.medworm.com/index.php?rid=2709252&cid=t_103259_122_f&fid=34755&url=http%3A%2F%2Fneuropsychological.blogspot.com%2F2009%2F08%2Fidentification-of-possible-or-probable.html Settling in in my coffeehouse for a reading of an interesting new publication by Dr. Brian Brooks and his colleagues on the topic of "Minimizing Misdiagnosis: Psychometric Criteria for Possible or Probable Memory Impairment." The authors seek to develop new psychometric criteria for identification of memory problems in older individuals. This has both clinical and research implications; my primary interest at this time is the accuracy of such identification for including or excluding individuals in clinical trials that test potential drug treatments for Alzheimer's and related dementias. (Source: BrainBlog) BrainBlog blogs http://www.medworm.com/rss/comments.php?id=2709252 Mon, 17 Aug 2009 15:27:00 +0100 2709252 http://www.medworm.com/index.php?rid=2695660&cid=t_103259_165_f&fid=37959&url=http%3A%2F%2Fhealthskills.wordpress.com%2F2009%2F08%2F13%2Ffunctional-capacity-evaluations-do-they-predict-function-in-the-real-world%2F What do you do when a client has a goal ‘to establish functional abilities for work’, spends a lot of time looking at setting baselines at home, develops a good knowledge of how to maintain consistency, starts to work and sustains abilities in a specific workplace, then completes a functional capacity evaluation that says he can do more than what he’s identified he can? I’ve had a long-standing interest in whether functional assessments carried out in a clinic or work setting over a single session (or even two-day period) can predict sustainable function in a ‘real world’ setting such as work. There are many different types of ‘work sampling’ methods that purport to measure functional ability, ranging from specialised machines and standardise... HealthSkills Weblog blogs http://www.medworm.com/rss/comments.php?id=2695660 Thu, 13 Aug 2009 08:32:49 +0100 2695660 http://www.medworm.com/index.php?rid=2670949&cid=t_103259_122_f&fid=36582&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FSharpBrains%2F%7E3%2FrZYUDP-BGt4%2F Good article today in the NYT on "chemo brain" - some typical short-term and long-term cognitive consequences of chemotherapy. The Fog That Follows Chemotherapy (New York Times) One quote is critical - for chemo brain and also for a variety of clinical conditions that present associated cognitive impairments: "Controlling for brain function before cancer treatment begins can help determine cause and effect. In one study, cancer patients took a battery of neuropsychological tests before starting chemotherapy, three weeks after completing treatment, and again one year later. Although a third of the patients had signs of cognitive impairment before therapy began, the number jumped to 61 percent after treatment, and half remained impaired a year later." As we have discussed... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=2670949 Wed, 05 Aug 2009 02:47:22 +0100 2670949 http://www.medworm.com/index.php?rid=2641449&cid=t_103259_131_f&fid=35007&url=http%3A%2F%2Fbooks.mcgraw-hill.com%2Fmedical%2Fommbid%2Fblog%2F%3Fp%3D1303 Mutations in a gene encoding a protein essential for the assembly of succinate dehydrogenase has been implicated in an infantile leukoencephalopathy. Nat Genet. 2009 May 24. [Epub ahead of print] SDHAF1, encoding a LYR complex-II specific assembly factor, is mutated in SDH-defective infantile leukoencephalopathy. Ghezzi D et al. Click this link to see the most recent online abstracts of major genetics journals. Philippe Campeau (Source: The OMMBID Blog) The OMMBID Blog blogs http://www.medworm.com/rss/comments.php?id=2641449 Mon, 27 Jul 2009 11:41:20 +0100 2641449 http://www.medworm.com/index.php?rid=2641450&cid=t_103259_131_f&fid=35007&url=http%3A%2F%2Fbooks.mcgraw-hill.com%2Fmedical%2Fommbid%2Fblog%2F%3Fp%3D1302 Nat Genet. 2009 Jun;41(6):651-3. Epub 2009 May 3. Mutations in mitochondrial carrier family gene SLC25A38 cause nonsyndromic autosomal recessive congenital sideroblastic anemia. Guernsey DL et al. These investigators form Nova Scotia describe a new form of sideroblastic anemia caused by a mutation in a mitochondrial carrier. The gene was identified by positional cloning. Click this link to see the most recent online abstracts of major genetics journals. Philippe Campeau (Source: The OMMBID Blog) The OMMBID Blog blogs http://www.medworm.com/rss/comments.php?id=2641450 Mon, 27 Jul 2009 11:40:45 +0100 2641450 http://www.medworm.com/index.php?rid=2641451&cid=t_103259_131_f&fid=35007&url=http%3A%2F%2Fbooks.mcgraw-hill.com%2Fmedical%2Fommbid%2Fblog%2F%3Fp%3D1301 Am J Hum Genet. 2009 May;84(5):558-66. Epub 2009 Apr 16. A nonsense mutation in COQ9 causes autosomal-recessive neonatal-onset primary coenzyme Q10 deficiency: a potentially treatable form of mitochondrial disease. Duncan AJ et al. This group from the UK describes a new form of coQ10 deficiency, a potentially treatable condition. Click this link to see the most recent online abstracts of major genetics journals. Philippe Campeau (Source: The OMMBID Blog) The OMMBID Blog blogs http://www.medworm.com/rss/comments.php?id=2641451 Mon, 27 Jul 2009 11:39:57 +0100 2641451 http://www.medworm.com/index.php?rid=2602201&cid=t_103259_137_f&fid=35426&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FTheAlzheimersReadingRoom%2F%7E3%2FQquVM3_o-cE%2Fmoderate-long-term-physical-activity.html "Our results suggest that long-term strenuous activity may increase the risk of cognitive impairment in recently postmenopausal women," Tierney said. "On the other hand, moderate long-term physical activity may improve later life cognition. These preliminary findings have important implications for women's health and support the need for large-scale studies including both women and men."For more Insight into Alzheimer's DiseaseSubscribe to The Alzheimer's Reading RoomModerate Long-Term Physical Activity May Improve Late Life Cognition; Long-Term Strenuous Activity May Increase Risk of Cognitive Impairment Long-term strenuous physical activity has been shown to decrease lifetime exposure to ovarian hormones in women and has been found to play a protective role against breast cancer. However... Alzheimer's Reading Room, The blogs http://www.medworm.com/rss/comments.php?id=2602201 Tue, 14 Jul 2009 18:25:28 +0100 2602201 http://www.medworm.com/index.php?rid=2594471&cid=t_103259_109_f&fid=34859&url=http%3A%2F%2Fwww.dare-to-dream.us%2Farchives%2F2009%2F07%2Ffinding_meaning_in_research.php Image via Wikipedia I very much enjoyed recent exchange on Psychotherapy Brown Bag. I find myself frequently thinking of the implications of our approach to research and how it contributes to our understanding of psychology. Intuition is, by no means, useless. A half-century ago, Karl Popper (1959) gave an answer to this that today remains powerfully compelling. Intuition, inductive reasoning, and philosophical theories are extremely valuable as the first step of a multi-step process. He termed this step the "context of discovery." His point was that we need creative thought, outside-the-box thinking, and alternative perspectives in order to drive progress, but that our thoughts, no matter how elegant, can not be the end point. We need to follow up this stage with deductive reasoning - ... Ψ Dare To Dream... blogs http://www.medworm.com/rss/comments.php?id=2594471 Mon, 13 Jul 2009 00:51:29 +0100 2594471