The objective of the current study was to examine the relative efficacy of two exercise techniques-a multidimensional treatment (MDT) and a traditional senior exercise therapy treatment (TET)-in older adults diagnosed with chronic low back pain (CLBP). Participants (N = 16) were randomly assigned to either the MDT (n = 8) or TET (n = 8) groups after meeting the requirements for the presence of CLBP. Participants in the MDT group received an individualized exercise program, while participants in the TET participated in a group exercise program. A Mann-Whitney test was conducted to determine differences between psychosocial and physical variables pre- and post-intervention. Statistical analyses indicated no significant differences in physical or psychosocial variables at pre-intervention assessment. However, participants in the MDT group reported a decrease in fatigue and pain interference, with an increase in physical functioning, when compared to the TET group. Additionally, the MDT group displayed a significant decrease pain interference, while the TET group had an increase grip strength. Patients who received the MDT reported less fatigue and pain interference, and an increase in their overall physical functioning. Overall, the MDT was a more efficacious method to manage CLBP.
Purpose The success of any organization is highly dependent on how it attracts, recruits, motivates, and retains a high-performing workforce. The reason is that performance as a phenomenon is closely related to aspects of effectiveness, knowledge management and quality from one side and to management, financing and development of the organization from the other. Especially for hospital physicians, job performance issues are inextricably linked to patient safety. Explaining the factors that influence employee performance remain a fundamental question for human resources management practitioners. The literature shows that a large number of factors influence job performance such as satisfaction from the profession, work environment, compensation policies, quality of work life, ability, effort, motivation, attitude, personality, and competence. This study looked at selected employee related factors, namely job security, organizational support, and job satisfaction. The purpose of this study is to examine the effect of job security and organizational support on hospital physician's job performance and the mediating role of job satisfaction on these relationships. Methods A cross-sectional quantitative approach was employed for this study. Hospital physicians working in public and private hospitals of Pakistan were selected. The sample comprised of 361 hospital physicians who were approached using the self-administered technique. To outline and explain the relationship of job security and organizational support with job performance and how job satisfaction could mediate these relationship, the data were analyzed using partial least squares-structural equation model (PLS-SEM). Results The results indicated that job security and organizational support positively affected job performance of hospital physicians. Moreover, job satisfaction mediated the link between job security and job performance as well as between organizational support and job performance. Conclusions We conclude that by providing job security and organizational support to hospital physicians, their job performance can be boosted. Physician satisfaction impacts physician behavior and, consequently, the quality of medical care. Physician satisfaction needs to be measured and monitored to improve working conditions and increase employment stability in the healthcare sector. Due to the health workforce crisis, knowledge regarding physician satisfaction and job security is essential to healthcare managers and policy makers for more effective human resources management.
Purpose: We examined how heterogeneity in the patterns of adolescent experiences of different types and severity of peer victimization is associated with concurrent and longitudinal mental health, substance use, and physical health. Method: Data come from a randomly recruited community-based sample of youth (T1 ages 12-18; N = 662; 52% female) followed biennially across 10 years (T6 ages 22-29; n = 478; 55% female). Results: Using latent class analysis, we identified four classes of adolescent peer victimization: Low victimization (63%), Physical victimization only (15%), Relational victimization only (17%), and Poly-victimization (6%). Youth in the Poly-victimization class reported the most detrimental health consequences in adolescence (e.g., internalizing and externalizing symptoms, illicit drug use, physical symptoms, poor physical self-concept, physical activity) and in young adulthood (e.g., depressive symptoms, sleep problems). Youth in the Relational and Physical victimization classes also reported health problems, some of which persisted into young adulthood. Youth in the Low victimization class reported the fewest health concerns. Conclusions: Findings add to our understanding of how different types of adolescent victimization are related to mental health, substance use, and physical health problems both within adolescence and long-term.
Purpose This study examined whether social and physical peer victimization in adolescence led to changes in psychological and physical health outcomes. Methods One hundred and twenty adolescents (boys = 54) and a parent completed measures of peer victimization and health approximately 2 years apart. Results Results indicated that both social and physical victimization were related to increases in the frequency and severity of health problems over the assessment period. Conclusions Increases in social, but not physical victimization, were related to more internalizing problems as well as greater frequency and severity of health problems at the second assessment. Anxious depression and severity of health problems at the first assessment were related to increases in social, but not physical forms of victimization over the 2-year period. These results continue to shed light on the notion that being peer victimized is not a normal part of life and is not necessarily something that adolescents will reconcile with time.
Over 20 years of research has shown that social exclusion is a pervasive and powerful form of social threat. Social exclusion causes a wide variety of negative outcomes including negative emotions and threats to fundamental human needs (i.e., self-esteem). Most importantly, experiencing exclusion during childhood or adolescence can provoke long-term negative effects such as depression and anxiety disorders. Despite the growing interest in this domain, only recent studies have started to examine possible coping strategies to contrast the negative effects of exclusion. In this article, we first review the empirical findings concerning the consequences of social exclusion in children and adolescent populations. Second, we focus on cognitive and socio-emotional strategies that children and adolescents can use to deal with exclusion when it has occurred. Implications and future directions are discussed.
Purpose To summarize the literature linking peer victimization to cortisol production in children and adolescents, with the goals of improving how these constructs are assessed and clarifying implications for health outcomes. Methods A systematic search was conducted across four online databases. Searches included studies examining any association between peer victimization, or bullying, and cortisol among school-age youth (ages 5-17 years). Results A thorough search of multiple online databases and careful consideration of inclusion and exclusion criteria following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines yielded 20 studies for detailed review. Peer victimization was consistently associated with blunted cortisol reactivity and diurnal cortisol slope, and least often associated with the cortisol awakening response. Conclusions Studies that expand the range of biomarkers and the diversity of youth included in the samples; that use appropriate covariates, adequate quantities of biological samples, and reliable measures; and that test theoretically grounded pathways through which peer victimization is linked to biological stress responses will advance scholarship in this field.
Aim People suffering with chronic pain have a decreased quality of life in both the physical and psychosocial dimensions. Popular treatment methods for a chronic pain patient are opioid prescriptions and surgery, which may not be beneficial to long-term outcomes in chronic pain patients, and may actually result in reducing a patient's overall health. Purpose This review will examine the role of the physical therapist in treating chronic pain patients in regard to the biopsychosocial model. Reviewing chronic pain through a biopsychosocial perspective, screening, evaluation, intervention selection, and problems with programs adherence in regard to chronic pain patients in physical therapy will be discussed. Psychosocial components of chronic pain including fear of movement and depression are also examined in how they can hinder or interfere with physical therapy treatment and evaluation. Conclusion When treating chronic pain patients, applying the biopsychosocial perspective to physical therapy with a focus on restoring physical function could provide the least invasive treatment for chronic pain patients with optimal outcomes.
In an earlier Special Issue in the Journal of Applied Biobehavioral Research (JABR), Gatchel ( Journal of Applied Biobehavioral Research , 2017, 22[1], e12088) addressed the construct of pain catastrophizing (PC). The present article is meant to extend those reviews within a biopsychosocial context, as well as update recent research on PC with a specific concentration on genetic factors. An overview of biological factors as they relate to PC and epigenetics are reviewed first (brain areas associated with pain and how they adapt neurochemically to chronic noxious stimuli, polymorphism of various genes, etc.), proceeded by the discussion of psychological (depression, anxiety, and the genomic link to neuroticism) and social influences (reason people engage in PC, age's impact on neuronal restructuring) as they corroborate the argument of PC's link to genetic factors. Finally, this article concludes by providing future directions for research concerning PC such as examining the efficacy of Pain Neurobiology Education, as well as gene therapy.
Purpose A healthy lifestyle following a cancer diagnosis is associated with reduced risk for a cancer recurrence. Better understanding the interrelationships between multiple health behaviors (HB) in cancer survivors could inform the development of more effective interventions to promote a healthy lifestyle. Methods This prospective study assessed the longitudinal interrelationships between smoking, physical activity, alcohol intake, and caffeine consumption among patients with mixed cancer sites at the peri-operative period and 2, 6, 10, 14, and 18 months later. A cross-lagged design and structural equation modeling were used to assess the relationships between all four HBs over time. Results The study included 962 participants. The model showed a good fit to the data. For all four HBs, continuity paths consistently indicated that one particular health behavior was significantly predicted by the same health behavior at the previous time point. However, no consistent pattern of cross-lagged relationships between HBs emerged. Physical activity at 14- and 18-month evaluations was the HB most consistently involved either as a predictor as a predicted variable. Conclusion Overall, this study indicates that HBs assessed following cancer surgery are mostly independent and that interventions promoting HB changes during the cancer treatment trajectory need to target each health behavior separately.
Purpose This pilot study evaluated whether a brief, 5-min single-session of mindfulness meditation (MM) training could lessen cardiovascular and affective reactivity to speech and anger recall. Moreover, we tested if trait levels of perseverative cognitions (PCs) moderated these relationships. Methods Participants completed online survey measures including PCs; thereafter, they completed a 5-min resting baseline, 2-min speech task, and 5-min anger recall task while measures of BP were collected. The experimental group received a 5-min MM training session before the resting baseline period. Results Repeated measures ANOVA were conducted for condition (MM vs. control) and period (repeated: baseline, speech, anger recall) on blood pressure (BP). The MM group showed less systolic and diastolic BP reactivity during speech and anger recall than the control group. There were no effects observed for negative affect nor did PCs moderate the BP findings. Conclusion Thus, even 5 min of MM training can have momentary cardiovascular benefits, having important implications for the training and implementation of MM programs.
Purpose: To examine the prospective associations among peer victimization and somatic symptoms across 5 years of adolescence using multiple informants and disaggregating effects at the within-person and between-person level. Methods: From age 13-17 years, 612 Canadian children (54% girls; 76% White) completed measures of peer victimization and somatic symptoms. Parents (89% mothers) reported on their child's somatic symptoms. We built autoregressive latent trajectory models with structured residuals, controlling for diagnosed medical and psychiatric conditions, sex, race/ethnicity, and socioeconomic status. Results: Within-person, self-reported somatic symptoms were stable across time and there were bidirectional associations between peer victimization and somatic symptoms across the 5-year period. The magnitude of effect was strongest from somatic symptoms to peer victimization. Between-person, being a girl or having a psychiatric diagnosis predicted higher mean levels and rising trajectories of somatic symptoms and higher mean levels of peer victimization. The level of peer victimization among non-White participants increased over time. In the parent-reported model, somatic symptoms were less stable and did not predict peer victimization. Conclusions: The results highlight the dynamic processes between peer victimization and somatic symptoms. Increased effort is needed to protect adolescents with psychiatric problems, girls, and ethnic minorities from peer abuse.
Purpose It has become more apparent that studies focusing on the effect of sex steroids on orofacial pain in humans and animals require careful attention to the methods of hormone replacement. As a result, the purpose of this review is to highlight differences in estrogen concentration and its effects on temporomandibular joint (TMJ) pain and behavior. Methods This literature review searched keywords TMJ, orofacial, pain, nociception sex steroids, estrous cycle, menstrual cycle estradiol, and progesterone. Results In the case of estrogen, the change in concentration was a consideration, as a rise in estrogen can lead to protective effects and a decrease in estrogen appears to exacerbate the pain response. The dosage and timing was important when administering sex steroids as many orofacial pain studies conducted on animals have used large pharmacologic dosages and/or have given the hormone in a nonphysiologic way that does not mimic natural secretion patterns. Conclusions The results demonstrate that when performing studies or experiments these factors can result in alteration of the pain or behavioral response, as well as, joint structure and inflammatory response. Therefore, these factors must be considered when designing experiments focused on determining the mechanisms of action for sex steroids.
Purpose Physical therapists play a crucial role in managing persistent pain and disability. Since psychosocial factors are important predictors of poor patient outcomes, it is essential that clinicians understand how to utilize validated instruments to assess psychosocial profile in the clinical setting. The following article reviews the psychometric properties and clinical application of the Keele Subgroups for Targeted Treatment Back Screening Tool (SBT), Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF), Pain Catastrophizing Scale (PCS), Tampa Scale of Kinesiophobia (TSK), Pain Self-Efficacy Questionnaire (PSEQ), and Patient Health Questionnaire (PHQ). Results Multidimensional screening tools, such as the SBT and OSPRO-YF, are useful prognostic indicators of long-term disability and the presence of yellow flags that may be contributing to patient presentation, respectively. This can guide both the treatment and administration of specific, unidimensional psychosocial assessment tools. The following cutoffs are identified as moderate elevation of psychosocial profile which can be used to inform clinical practice: PCS >= 20, TSK >37, PSEQ >= 40, and PHQ-9 >= 10. Conclusion Valid and reliable unidimensional and multidimensional psychosocial assessment tools provide important prognostic information to inform a patient's psychosocial profile and subsequently improve clinical efficiency and patient outcomes.
This work was funded in part by the Department of Defense through the Peer Reviewed Orthopaedic Research Program of the Congressional Directed Medical Research Programs (CDMRP) under Award No. W81XWH-16-2-0060. Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense.
Purpose Victimization by peers is known to have a detrimental effect on emotional and educational adjustment. Yet, there is also a sparser research literature on the potential negative effects of peer victimization on physical health. Our purpose was to draw from meta-analyses and studies of peer victimization and physical health (including psychosomatic symptoms, sleep, and body weight) to highlight key findings and future directions in the area. We also briefly summarize research findings that associate peer victimization with stress physiology. Method Narrative research summary. Results Peer victimization is associated with poorer physical health among youth, including more somatic complaints (e.g., health concerns, pain) and disrupted sleep. Also, victimized youth are at more risk than other youth for increasing weight problems. These effects seem to be both immediate and long-term, with associations found into later adolescence and even adulthood. Conclusion Future directions for research are proposed that take a biopsychosocial perspective, by integrating the domains of physiology, mental health, and physical health, in order to test holistic models that better illuminate the negative effects of peer victimization. Additionally, future research should continue to address potential mechanisms, such as neurophysiological reactions and recovery from stressful events.
Purpose This study examined whether the age, ethnicity, sex, and weight of children influenced weight-based biases. Methods Elementary school children (N = 367; boys = 177; M-age = 9.31 years) provided their perceptions of thin, average, and heavy target children. The age and ethnicity as well as the actual height and weight of each participant was also collected. Results Children rated heavier child targets more negatively than average or thin counterparts. Participant and target ethnicity did not moderate weight biases. Boys were more likely than girls to stigmatize overweight targets regardless of the target's sex. Girls were more likely to stigmatize overweight boys. Young children and those who were thinner were less biased than older and heavier children, but still rated heavier targets negatively. Conclusion The ubiquity of a negative weight bias, even in children, underscores the need for constructing plans in which to not only deal the health concerns associated with obesity but also develop strategies for children who might be physically and/or psychologically struggling with the biases associated with being overweight.
Purpose Utilizing data from an online comprehensive occupational health survey, this study aimed to systematically evaluate the factors most strongly associated with intent-to-quit the profession for public school teachers. Methods A total of 2,588 teachers from 46 Texas school districts responded to a comprehensive occupational health survey. Univariate and multivariate analyses were conducted to identify specific demographic, occupational, and health factors associated with intentions to quit the teaching profession within 1 year. Results Teachers with fewer years' experience and alternative certificates were more likely to quit the profession. Teachers with lower organizational commitment, lower job involvement, lower perceived support, lower job control, poorer school climate, and more school problems indicated higher likelihood of leaving the profession. Poorer mental quality of life, higher levels of stress, and the presence of major depression, panic disorder, anxiety disorder, and somatization disorder were significantly related to higher intentions to quit (all ps < 0.05). The key factors related to intent-to-quit to be low organizational commitment, low job control, female gender, and the presence of major depressive disorder. Conclusions While some of the factors associated with intent-to-quit are not modifiable, interventions focusing on improving workplace factors, decreasing stress, and improving mental health may help reduce attrition for public school teachers.
The current study examined the impact of perceived calling on nurses' organizational commitment, organizational citizenship behavior, workplace deviant behavior, and turnover intentions. Moreover, the mediating role of career commitment and the moderating role of living a calling are also investigated. This paper posits a mediated moderation model wherein calling and living a calling interact to predict organizational commitment, organizational citizenship behavior, workplace deviant behavior, and turnover intentions with career commitment mediating the effect of the interaction on the three outcome variables. Data were collected from 294 registered nurses who had worked for a minimum of 6 months in the public or private health care system. Correlation and regression analyses were used to test the proposed hypotheses. Living a calling moderated the effect of calling on career commitment, such that these relations were more robust for nurses with a stronger sense of living a calling. Furthermore, career commitment fully mediated the effect of calling on organizational commitment, organizational citizenship behavior, workplace deviant behavior, and turnover intentions. The indirect effects of career commitment were only significant for nurses with high levels of living a calling. These results imply that possessing a sense of calling brings greater career commitment, which evidently leads to stronger organizational commitment and organizational citizenship behaviors, and lower workplace deviant behavior and turnover intentions. More specifically, nurse's sense of calling could lead to voluntary acts of helping colleagues and participation in organizational activities due to features associated with having a sense of calling, including pro-social intention and other-oriented thoughts. Calling might also decrease turnover intentions and deviant behaviors among nurses. Research about the dynamics of calling in nursing and medical professionals is limited. Recognizing the need, the present research has widened the scope of calling research by investigating the relationships between calling and various work-related variables within Asian nursing context.
Although studies have shown that increases in the frequency of social media use may be associated with increases in depressive symptoms of individuals with depression, the current study aimed to identify specific social media behaviors related to major depressive disorder (MDD). Millennials ( N = 504) who actively use Facebook, Twitter, Instagram, and/or Snapchat participated in an online survey assessing major depression and specific social media behaviors. Univariate and multivariate analyses were conducted to identify specific social media behaviors associated with the presence of MDD. The results identified five key social media factors associated with MDD. Individuals who were more likely to compare themselves to others better off than they were ( p = 0.005), those who indicated that they would be more bothered by being tagged in unflattering pictures ( p = 0.011), and those less likely to post pictures of themselves along with other people ( p = 0.015) were more likely to meet the criteria for MDD. Participants following 300 + Twitter accounts were less likely to have MDD ( p = 0.041), and those with higher scores on the Social Media Addiction scale were significantly more likely to meet the criteria for MDD ( p = 0.031). Participating in negative social media behaviors is associated with a higher likelihood of having MDD. Research and clinical implications are considered.
Purpose To summarize evidence on preoperative and postoperative psychologically informed physical therapy (PIPT) for improving outcomes after degenerative spine, hip, or knee surgery. Methods Four electronic databases were searched. Randomized trials were included if they examined the efficacy of a preoperative or postoperative intervention involving the delivery of psychologically based strategies by a physical therapist for improving function/disability, pain, quality of life, or psychological factors. Outcomes at 12 months or longer were considered long-term. Results Twelve articles representing 10 unique studies (total N = 1,127 patients, 636 (56.4%) females) in lumbar (n = 7) or cervical spine surgery (n = 1), total knee arthroplasty (n = 1), and total knee/hip arthroplasty (n = 1) were included. The most common PIPT components were coping skills training, psychoeducation, and positive reinforcement. Greater improvements following PIPT were reported in 5 (56%) studies for function/disability, 6 (60%) for pain, 5 (71%) for quality of life, and 7 (70%) for psychological factors. Of these, greater long-term benefit was reported in three studies for function/disability, two for pain or quality of life, and four for psychological factors. Conclusion When examining postoperative effects, there is no clear superiority of PIPT after surgery. However, the data illustrate potential for further development of PIPT in the context of surgery.
