QUITE apart from the academic consideration that vital and medical statistics now form an obligatory part of the education of students seeking the University of London's diploma in public health, the demand for information about the methods of vital and medical statistics is increasing. The most casual reader of the newspapers is now aware that population problems are of serious practical importance and that the publications of the General Register Office cannot be ignored. It is scarcely an exaggeration to say that the recently issued preliminary report on the census of 1931 is one of the most sensational documents which has appeared for years, and that he who reads it intelligently will understand what is meant by saying that civilisation is in the melting pot. An Introduction to Medical Statistics. By Hilda M. Woods William T. Russell. Pp. x + 125. (London: P. S. King and Son, Ltd., 1931.) 7s. 6d.

/pdf/an-introduction-to-medical-statistics-58gm2cuxfv.pdf

An Introduction to Medical Statistics

Articles describing motor function in five chronic musculoskeletal pain conditions (temporomandibular disorders, muscle tension headache, fibromyalgia, chronic lower back pain, and postexercise mus...

The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity.

Research has demonstrated the importance of psychological factors in coping, quality of life, and disability in chronic pain. Furthermore, the contributions of psychology in the effectiveness of treatment of chronic pain patients have received empirical support. The authors describe a biopsychosocial model of chronic pain and provide an update on research implicating the importance of people’s appraisals of their symptoms, their ability to self-manage pain and related problems, and their fears about pain and injury that motivate efforts to avoid exacerbation of symptoms and further injury or reinjury. They provide a selected review to illustrate treatment outcome research, methodological issues, practical, and clinical issues to identify promising directions. Although there remain obstacles, there are also opportunities for psychologists to contribute to improved understanding of pain and treatment of people who suffer from chronic pain. The authors conclude by noting that pain has received a tremendous amount of attention culminating in the passage of a law by the U.S. Congress designating the period 2001–2011 as the “The Decade of Pain Control and Research.”

Psychological factors in chronic pain: Evolution and revolution.

Purpose of reviewThe purpose of this review is to highlight recent studies of osteoarthritis epidemiology, including research on prevalence, disease impact, and potential risk factors.Recent findingsOsteoarthritis is highly prevalent in the United States and around the globe. It is a leading cause o

/pdf/epidemiology-of-osteoarthritis-literature-update-5fy66siyxh.pdf

Epidemiology of osteoarthritis: literature update.

Objective The prevalence as well as predictors of psychiatric disorders (Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV] axis I and II) in patients with fibromyalgia syndrome (FMS) was evaluated. Method One-hundred fifteen patients with FMS participated in the Structured Clinical Interview for DSM-IV to assess current mental disorders. In addition, patients completed standardized questionnaires regarding pain, pain impact, anxiety, depression, posttraumatic stress disorder-like symptoms, and sexual and physical abuse. Results Patients were grouped into one of three psychosocial subgroups based on responses to the Multidimensional Pain Inventory (MPI)-Dysfunctional (DYS), Interpersonally Distressed (ID), and Adaptive Copers (AC). Axis I diagnoses were present in 74.8% of the participants overall with the DYS subgroup mainly reporting anxiety and the ID group mood disorders. The AC group showed little comorbidity. Axis II diagnoses were present in only 8.7% of the FMS sample. Conclusion These results suggest that FMS is not a homogeneous diagnosis, but shows varying proportions of comorbid anxiety and depression dependent on psychosocial characteristics of the patients. The results demonstrate the importance of not treating patients with FMS as a homogeneous group. Assessment should not only examine the presence of widespread pain and the number of tender points, but also the presence of affective distress. Treatment should focus both on physical and emotional dysfunction.

Comorbid depression and anxiety in fibromyalgia syndrome: relationship to somatic and psychosocial variables.

Objective. Oral health-related quality of life (OHRQoL) is considered an important aspect of different oral conditions. It has also gained increased attention in temporomandibular disorders (TMDs) in recent years. The purpose of this study was to systematically review the literature on OHRQoL and TMDs. Material and methods. A systematic search of the dental literature was performed using the Medline and Cochrane Library databases, supplemented by a hand search. Various combinations of search terms related to OHRQoL and TMDs were used. Among numerous titles found in Medline, abstracts and eventually full papers of potential interest were reviewed. Twelve papers fulfilled the inclusion criteria and were included in the review. Results. Most studies used the Oral Health Impact Profile, an instrument with good psychometric properties, for evaluation. All articles described a substantial impact on OHRQoL in TMD patients. Only a small proportion of all patients, a few percent, reported no impact at all....

Temporomandibular disorders and oral health-related quality of life. A systematic review.

Psychological homogeneity in temporomandibular disorders (TMD) is not conclusive. The multidimensional pain inventory (MPI) has previously identified 3 cognitive-behavioral profiles in TMD and chronic pain patients. Our aims were to replicate these findings in another cultural setting and relate the profiles to the diagnosis and to the treatment demand and outcome. The MPI was administered to 112 referrals comprising 6 categories of patients diagnosed with TMD or intractable orofacial pain. Dysfunctional profiles (high in pain and distress) were most common in patients with orofacial pain of obscure origin and more common in myofascial pain patients than in patients with other TMD diagnoses. Interpersonally-distressed profiles were found in all categories. Among patients with disk displacement, the 3rd profile (adaptive copers with low pain and distress and high control and activity) was most common in earlier successfully diskectomized patients and least common in those about to undergo invasive interventions. A dysfunctional profile was associated with treatment failure, conservative or surgical, and with the demand for radical therapy. Some support for a cyclical causality between pain and psychological factors was found. It is concluded that the robustness of the MPI as a relevant assessment instrument was further strengthened.

Cognitive-behavioral profiles among different categories of orofacial pain patients: diagnostic and treatment implications

In order to evaluate and compare the effects of biofeedback and occlusal splint therapy on mandibular dysfunction, 30 patients were randomly divided into two treatment groups. The patients were women aged 20--40 years without any obvious organic reasons for their symptoms. There were no significant differences between the two groups before the start of treatment in respect of signs and symptoms of mandibular dysfunction. One group used full coverage splints at night for 6 weeks. The other group received biofeedback training up to six times, 30 min per session. One month after completion of the therapy the patients were re-examined. Both groups showed a significant reduction in symptoms, both subjectively and clinically. No significant differences between the groups were found. The two treatments were thus equally effective in the short-term perspective in patients with signs and symptoms of mandibular dysfunction.

Comparison of effects of electromyographic biofeedback and occlusal splint therapy on mandibular dysfunction.

Surface electromyographic (EMG) recordings from the left and right masseteric areas during physical and psychological induced stress were obtained from 20 patients with mandibular dysfunction and 20 healthy controls Integrated electromyographic activity was not significantly different for the two sides but was higher for patients than for controls during both stress and relaxation Anxiety level, as measured with the Taylor Manifest Anxiety Scale, was higher for patients Biofeedback treatment for the patients resulted in significantly reduced signs and symptoms of mandibular dysfunction When the test procedures were repeated, the controls had not changed in their electromyographic responses during stress, whereas the patients showed a significant decrease in this respect The results obtained are discussed in terms of a systems-oriented etiological concept

Stress-induced muscular activity in mandibular dysfunction: effects of biofeedback training.

Twenty patients with mandibular dysfunction, all women, aged 17-41 years, were randomized for treatment with either a bite plate with a frontal plateau or a full-coverage stabilization splint. The occlusal appliances were used at night for 6 weeks to compare clinical and electromyographic effects (EMGs). Integrated EMGs were recorded bilaterally from the anterior and posterior parts of the temporal muscle and the masseter muscle in the rest position and during gentle and maximal biting before and after treatment without the appliances in situ. Initially recorded EMG activity in the temporal muscle was correlated to signs of dysfunction in the rest position. Compared with previously investigated healthy subjects, the patients had lower EMG activity in the anterior part of the temporal muscle and in the masseter muscle during maximal biting. Use of occlusal appliances at night for 6 weeks did not change the EMG activity in the rest position or during maximal biting. The clinical signs improved, significantly in the splint group. The subjective symptoms improved in both groups, significantly more in the splint group.

Lars Dahlström

Papers

Temporomandibular disorders and oral health-related quality of life. A systematic review.

Cognitive-behavioral profiles among different categories of orofacial pain patients: diagnostic and treatment implications

Comparison of effects of electromyographic biofeedback and occlusal splint therapy on mandibular dysfunction.

Stress-induced muscular activity in mandibular dysfunction: effects of biofeedback training.

Bite plates and stabilization splints in mandibular dysfunction. A clinical and electromyographic comparison.