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Using Multivariate Statistics

Study design The Oswestry Disability Index (ODI) has become one of the principal condition-specific outcome measures used in the management of spinal disorders. This review is based on publications using the ODI identified from the authors' personal databases, the Science Citation Index, and hand searches of Spine and current textbooks of spinal disorders. Objectives To review the versions of this instrument, document methods by which it has been validated, collate data from scores found in normal and back pain populations, provide curves for power calculations in studies using the ODI, and maintain the ODI as a gold standard outcome measure. Summary of background data It has now been 20 years since its original publication. More than 200 citations exist in the Science Citation Index. The authors have a large correspondence file relating to the ODI, that is cited in most of the large textbooks related to spinal disorders. Methods All the published versions of the questionnaire were identified. A systematic review of this literature was made. The various reports of validation were collated and related to a version. Results Four versions of the ODI are available in English and nine in other languages. Some published versions contain misprints, and many omit the scoring system. At least 114 studies contain usable data. These data provide both validation and standards for other users and indicate the power of the instrument for detecting change in sample populations. Conclusions The ODI remains a valid and vigorous measure and has been a worthwhile outcome measure. The process of using the ODI is reviewed and should be the subject of further research. The receiver operating characteristics should be explored in a population with higher self-report disabilities. The behavior of the instrument is incompletely understood, particularly in sensitivity to real change.

https://womenshealthapta.org/wp-content/uploads/2013/12/oswestry-fairbanks.pdf

The Oswestry Disability Index.

Perceived discrimination has been studied with regard to its impact on several types of health effects. This meta-analysis provides a comprehensive account of the relationships between multiple forms of perceived discrimination and both mental and physical health outcomes. In addition, this meta-analysis examines potential mechanisms by which perceiving discrimination may affect health, including through psychological and physiological stress responses and health behaviors. Analysis of 134 samples suggests that when weighting each study's contribution by sample size, perceived discrimination has a significant negative effect on both mental and physical health. Perceived discrimination also produces significantly heightened stress responses and is related to participation in unhealthy and nonparticipation in healthy behaviors. These findings suggest potential pathways linking perceived discrimination to negative health outcomes.

/pdf/perceived-discrimination-and-health-a-meta-analytic-review-4aai112ban.pdf

Perceived discrimination and health: a meta-analytic review.

Naturally occurring variations in maternal care alter the expression of genes that regulate behavioral and endocrine responses to stress, as well as hippocampal synaptic development. These effects form the basis for the development of stable, individual differences in stress reactivity and certain forms of cognition. Maternal care also influences the maternal behavior of female offspring, an effect that appears to be related to oxytocin receptor gene expression, and which forms the basis for the intergenerational transmission of individual differences in stress reactivity. Patterns of maternal care that increase stress reactivity in offspring are enhanced by stressors imposed on the mother. These findings provide evidence for the importance of parental care as a mediator of the effects of environmental adversity on neural development.

Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations.

www.mobilehealthmap.org 617‐442‐3200 New research shows that mobile health clinics improve health outcomes for hard to reach populations in cost‐effective and culturally competent ways . A Harvard Medical School study determined that for every dollar invested in a mobile health clinic, the US healthcare system saves $30 on average. Mobile health clinics, which offer a range of services from preventive screenings to asthma treatment, leverage their mobility to treat people in the convenience of their own communities. For example, a mobile health clinic in Baltimore, MD, has documented savings of $3,500 per child seen due to reduced asthma‐related hospitalizations. The estimated 2,000 mobile health clinics across the country are providing similarly cost‐effective access to healthcare for a wide range of populations. Many successful mobile health clinics cite their ability to foster trusting relationships. Qualitative research in such mobile health clinics has found that patients value the informal, familiar environment in a convenient location, with staff who “are easy to talk to,” and that the staff’s “marriage of professional and personal discourses” provides patients the space to disclose information themselves. A communications academic argued that mobile health clinics’ unique use of space is important in facilitating these relationships. Mobile health clinics park in the heart of the community in familiar spaces, like shopping centers or bus stations, which lend themselves to the local community atmosphere.

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care

Objectives:This study aimed to assess patient satisfaction with behavioral health consultation in a primary and specialty care setting and to gauge patient interest in other behavioral health services.Methods:We surveyed patients with type 2 diabetes mellitus (N = 65), following a brief behavioral health consultation about their satisfaction with the experience and their interest in various behavioral health services. Doctoral students with master’s degrees in clinical psychology provided the consultations.Results:Patients were highly satisfied with behavioral health consultations and expressed moderate to high interest in various potential behavioral health services. Patients with more diabetes-related concerns were less satisfied with brief behavioral health consultations but reported greater interest in other behavioral health services.Conclusions:Results were used to build stakeholder support and guide expansion of integrated behavioral health services. Examining patient experience can help identify p...

https://journals.sagepub.com/doi/pdf/10.1177/2374373515615976

Integration of Behavioral Health and Medical Services: Using Patient Experience as a Guide

Effects of cue-controlled relaxation on the control of heterosocial performance anxiety among shy males

Background:The Cancer Support Community developed the Cancer Support Source (CSS) to assess the needs of cancer patients with distress. Each item on this self-administered questionnaire represents ...

https://journals.sagepub.com/doi/pdf/10.1177/2374373518808309

Optimizing Community and Hospital Services Using the Cancer Support Source Program.

Research on lifestyle programs for patients with coronary artery disease (CAD) has largely recruited from hospitals and/or recruited following acute coronary syndrome. By contrast, this study evaluated a 3-session behavioral health program for patients with stable CAD treated in an outpatient cardiology clinic. Thirty-three patients were randomized to the behavioral lifestyle intervention or to Treatment as Usual (TAU). A priori feasibility and acceptability criteria were met, and reliable change analyses revealed that at post-treatment and 30-day follow-up, significantly more intervention participants than TAU participants exhibited increased self-efficacy compared with baseline.

A randomized trial of a brief behavioral health lifestyle program for outpatient cardiology clinics.

Background Medical tattooing is often applied in the context of plastic, aesthetic, and reconstructive surgery to help achieve the best cosmetic outcome. Objectives This article reviews various conditions that medical tattooing has been empirically studied in terms of patient satisfaction outcomes, makes practice recommendations, and suggests future directions for research. Methods This review was performed following the PRISMA guidelines. Studies were included if the tattooing application was associated with a medical condition and if outcome data were provided using at least a case series methodology. Where no cohort or clinical series exist, case examples are used from the literature and the author's practice to illustrate emerging medical tattooing applications that need further evaluation. Results Eighteen studies met the inclusion criteria and addressed the following conditions: baldness, vitiligo, scars from incisions, lacerations or burns, and nipple-areola complex reconstruction. Conclusions The application of medical tattooing has shown high levels of patient satisfaction across conditions. The practice recommendation grade is "B" or recommend since the level of evidence for these interventions ranged from III to IV according to the American Society of Plastic Surgeons guidelines. This means clinicians can consider this treatment alternative, but they should be alert to new information and be sensitive to patient preferences. Recommendations are made for reporting future research including clearly describing procedural details, identifying the professional performing the procedure, increased use of standardized outcome measures, and that satisfaction ratings be assessed by someone independent of the health service provider. Further research using randomized controlled trial methodology with waitlist controls is needed. Level of Evidence 4

/pdf/applications-of-medical-tattooing-a-systematic-review-of-xaf1v1zwyr.pdf

Jeffrey E. Cassisi

Papers

Integration of Behavioral Health and Medical Services: Using Patient Experience as a Guide

Effects of cue-controlled relaxation on the control of heterosocial performance anxiety among shy males

Optimizing Community and Hospital Services Using the Cancer Support Source Program.

A randomized trial of a brief behavioral health lifestyle program for outpatient cardiology clinics.

Applications of Medical Tattooing: A Systematic Review of Patient Satisfaction Outcomes and Emerging Trends.