This study is a feasibility test of whether incorporating trauma-sensitive yoga into group therapy for female victims of partner violence improves symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) beyond that achieved with group therapy alone. Seventeen (9 control, 8 intervention) adult female clients seeking group psychotherapy were enrolled.
A 12-week trauma-sensitive yoga protocol was administered once weekly for 30–40 min at the end of each group therapy session. The control group received typical group psychotherapy. Feasibility was assessed through recruitment and retention rates as well as participants’ self-reported perceptions of the safety and utility of the study. The study enrolled 85% (17/20) of those screened eligible. Loss to follow-up was 30% (5/17). No one reported emotional or physical harm. All of the respondents reported that the study was personally meaningful and that the results would be useful to others.
Objectives
To compare clinical characteristics and patient-reported outcomes in seropositive versus seronegative primary Sjogren’s syndrome patients (pSS) and to investigate the effect of serological status on the prevalence of chronic pain, comorbidity and health quality.
Methods
Pain severity and neuropathic pain symptoms, comorbidity and health status were assessed in 108 pSS patients. Differences between patient groups were assessed by t-test and chi-square tests and adjusted pain-affect associations. The effect of predictor variables on pain severity was examined with multivariate regression.
Results
Pain severity was greater (p=.003) and physical function (p=.023) reduced in the seronegative patients. Prevalence of neuropathic pain, depression, anxiety and disability were similar between groups. Chronic pain, defined as daily pain for greater than 3 months, was reported by 65% of seropositive (N=65) and 75% of seronegative patients (N=40). After adjustment for age, sleep quality and psychological distress, the difference in pain severity between seropositive and seronegative patients remained significant.
Conclusion
Chronic pain is pervasive in both seropositive and seronegative pSS patients, while pain severity and functional impairment is greater in seronegative patients. Neuropathic pain is equally prevalent and is the predominant pain phenotype in patients with moderate to severe pain. Accurate assessment of pain phenotypes is needed for more effective management of chronic pain in pSS. The focus of future research should be to standardize assessment of pain and to identify the factors contributing to more severe pain in seronegative patients.
Portal Hypertension (PHT) is a major cause of morbidity and mortality in pediatric liver diseases. Thus, research into causes and disease modifiers in PHT in these conditions is vitally important. PHT is rarely directly or indirectly measured in the assessment of children with chronic liver disease. A straightforward, reproducible definition of portal hypertension could be invaluable for consistently identifying patients with portal hypertension and for grouping these patients according to their risk of complications from their disease. We propose the term Clinically Evident Portal Hypertension (CEPH) to denote clinical findings that demonstrate evidence of elevated portal pressure. When CEPH criteria are met, PHT is highly likely to be present, although it is likely that PHT exists for variable periods of time prior to meeting CEPH criteria. Use of this research definition of CEPH will allow for consistent identification of these patients by clinicians in nearly any clinical setting and serve as a clinical milepost that may dictate future prognosis in pediatric patients with cirrhosis. Portal hypertension (PHT) is the result of complex pathophysiologic processes that can affect patients across the spectrum of liver disease. Prolonged increases in portal pressure can result in life-threatening complications and lead to an array of chronic morbidities including variceal hemorrhage, hypersplenism, hepatopulmonary syndrome, hepatorenal syndrome, and ascites. PHT occurs as a result of increased portal resistance, increased portal
There are well-defined theoretical differences between the classical test theory (CTT) and item response theory (IRT) frameworks. It is understood that in the CTT framework, person and item statistics are test- and sample-dependent. This is not the perception with IRT. For this reason, the IRT framework is considered to be theoretically superior to the CTT framework for the purpose of estimating person and item parameters. In previous simulation studies, IRT models were used both as generating and as fitting models. Hence, results favoring the IRT framework could be attributed to IRT being the data-generation framework. Moreover, previous studies only considered the traditional CTT framework for the comparison, yet there is considerable literature suggesting that it may be more appropriate to use CTT statistics based on an underlying normal variable (UNV) assumption. The current study relates the class of CTT-based models with the UNV assumption to that of IRT, using confirmatory factor analysis to delineate the connections. A small Monte Carlo study was carried out to assess the comparability between the item and person statistics obtained from the frameworks of IRT and CTT with UNV assumption. Results show the frameworks of IRT and CTT with UNV assumption to be quite comparable, with neither framework showing an advantage over the other.
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