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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

One year after a left posterior and thalamic stroke, a 52-year-old male participant was treated with 14 weeks of theta reduction neurofeedback training. Imaging studies revealed left temporal, parietal, occipital, and bilateral thalamic infarctions along the distribution of the posterior cerebral artery. Neuropsychological testing demonstrated severe verbal memory, naming, visual tracking, and fine motor deficits. Additionally, alexia without agraphia was present. A pretraining quantitative electroencephalograph (QEEG) found alpha attenuation, lack of alpha reactivity to eye opening, and excessive theta activity from the left posterior head region. Neurofeedback training to inhibit 4-8 Hz theta activity was conducted for 42 sessions from left hemisphere sites. Over the course of the training, significant reductions in theta amplitude occurred from the training sites as assessed from the post-session baseline periods. Posttraining, a relative normalization of the QEEG was observed from the left posterior head region.

Neurofeedback Training for a Patient With Thalamic and Cortical Infarctions

This paper presents the results of a pilot study investigating the use of the Realizeit adaptive learning platform to deliver a fully online General Psychology course across two semesters. Through mutual cooperation, UCF and vendor (CCKF) researchers examined students’ affective, behavioral, and cognitive reactions to the system. Student survey results indicated that students found the system easy to use and were generally positive about their seamless transition to adaptive learning. While the majority of students were successful, learning outcome metrics utilizing Realizeit indices indicated a potential for early prediction of students who are likely to be at risk in this environment. Recommendations are presented for the benefits of cooperative research between users and vendors.

/pdf/adaptive-learning-in-psychology-wayfinding-in-the-digital-1fiq9lxjso.pdf

Adaptive Learning in Psychology: Wayfinding in the Digital Age

This study validates surface EMG as a measure of pelvic muscle and abdominal activity by showing its high correlation to internal pressure data. Using standardized scores, between-subjects correlation of perineal EMG and intravaginal pressure was r = .75, and the correlation of abdominal EMG and intra-abdominal pressure was r = .72. Discriminant validity was also demonstrated by showing low correlation between standardized abdominal and perineal EMG measurements (r = .10). A repeated measures multivariate analysis of variance demonstrated that visual and auditory biofeedback of EMG during pelvic floor contractions increases intravaginal pressure when compared with trials without biofeedback. Potential benefits of fabric electrodes include reduced invasiveness and risk and the ease with which patients can utilize this technology for home practice.

Validation of surface EMG as a measure of intravaginal and intra-abdominal activity: implications for biofeedback-assisted Kegel exercises.

The present study evaluated patterns of electrophysiological activity associated with sustained vigilance in healthy adults. Quantitative electroencephalographs (QEEG) were recorded during the performance of a Continuous Performance Test (CPT). Participants were divided into low and high vigilance groups based upon their reaction time changes between the early and late portions of the CPT. Coherence measures were calculated from the QEEG across the baseline, early CPT, and late CPT experimental conditions. Participants in the low vigilance group had higher baseline and CPT frontal to posterior coherence in the alpha and beta bands suggestive of a less vigilant state throughout the entire study. Additionally, the low vigilance group had a significantly greater beta 1 band coherence drop from baseline to the initial portion of the CPT than the high vigilance group. The combined groups had significantly lower amounts of right hemisphere frontal to posterior coherence across a number of frequency bands throughout all of the phases of the study when compared to the homologous left hemisphere sites. These interhemispheric coherence differences are consistent with vigilance network theories that implicate the right frontal and parietal lobes in the maintenance of sustained attention (M. I. Posner & M. E. Raichle, 1994).

Electrophysiological correlates of vigilance during a continuous performance test in healthy adults.

This study examined ethnic differences in the use of pain descriptors, comparing standardized pain assessment data from African American and European American patients with heterogeneous chronic pain syndromes. The measure was the Short-Form McGill Pain Questionnaire (SF-MPQ) including the embedded Visual Analog Scale (VAS). Exploratory factor analyses of SF-MPQ data identified differences in factor structure with the VAS loading on a different factor for each group. A 5-factor solution was obtained from the African American group and a 4-factor solution was obtained from the European American group. There was little overlap in the pattern matrices for African American and European American groups. Results suggest that the VAS is as sensitive to ethnic differences as other traditional pain measures.

Jeffrey E. Cassisi

Papers

Neurofeedback Training for a Patient With Thalamic and Cortical Infarctions

Adaptive Learning in Psychology: Wayfinding in the Digital Age

Validation of surface EMG as a measure of intravaginal and intra-abdominal activity: implications for biofeedback-assisted Kegel exercises.

Electrophysiological correlates of vigilance during a continuous performance test in healthy adults.

Patterns of pain descriptor usage in African Americans and European Americans with chronic pain.