Domain Specific Self-Efficacy Mediates the Impact of Pain Catastrophizing on Pain and Disability in Overweight and Obese Osteoarthritis Patients

This study examined whether self-efficacy mediated the relationship between pain catastrophizing and pain and disability. Participants were 192 individuals diagnosed with osteoarthritis (OA) of the knees who were overweight or obese. Multiple mediator analyses were conducted to simultaneously test self-efficacy for pain control, physical function, and emotional symptoms as mediators while controlling for demographic and medical status variables. Higher pain catastrophizing was associated with lower self-efficacy in all three domains (ps< .05). Self-efficacy for pain control fully mediated the relationship between pain catastrophizing and pain (Beta=.08, Sobel test Z=1.97, p<.05). The relationship between pain catastrophizing and physical disability was fully mediated by self-efficacy for physical function (Beta=.06, Sobel test Z=1.95, p=.05). Self-efficacy for emotional symptoms partially mediated the relationship between pain catastrophizing and psychological disability (Beta=. 12, Sobel test Z=2.92, p<.05). These results indicate that higher pain catastrophizing contributed to greater pain and disability via lower domain-specific self-efficacy. Efforts to reduce pain and improve functioning in OA patients should consider addressing pain catastrophizing and domain specific selfefficacy. Pain catastrophizing may be addressed through cognitive therapy techniques and selfefficacy may be enhanced through practice of relevant skills and personal accomplishments. Perspective- This paper found that higher pain catastrophizing contributed to great pain and disability via domain specific self-efficacy. These results suggest that treatment efforts to reduce pain and improve functioning in OA patients who are overweight or obese should consider addressing both pain catastrophizing and self-efficacy. Originally published Journal of Pain, Vol. 9, No. 10, Oct 200

Comparison of the repercussions of cLBP in four French-speaking countries

AbstractIntroductionSociocultural factors may influence the impact of chronic low back pain (cLBP) on patients. The goal of this study was to compare pain and disability levels, and psychobehavioural parameters in four French-speaking countries in patients with cLBP.MethodsTwo hundred and seventy-eight patients were included: 83 in France, 36 in Morocco, 75 in the Ivory Coast and 84 in Tunisia. Demographic data were collected; pain was assessed using a visual analogue scale (VAS), disability with the Quebec scale, psychobehavioural factors by the hospital anxiety depression scale (HAD), the fear and avoidance beliefs questionnaire (FABQ) and the coping strategy questionnaire (CSQ). A Student t-test was used to compare means. Anova (covariance) was used to test for a “Country Effect”, i.e. the incidence of country on outcomes.OutcomesThere was no difference in disability levels between countries. A “country effect” was found (p<0.001) for pain (F=2.707), anxiety (F=3.467), depression (F=5.137), fear and avoidance beliefs regarding professional activity (F=1.974) and physical activity (F=5.076), strategy of distraction, dramatization, efforts to ignore pain, prayer, seeking social support and reinterpretation (p<0.01). Pain level was higher in Morocco (p<0.05); anxiety, depression, fear and avoidance beliefs about physical activities were higher in Tunisia (p<0.05) and fear and avoidance beliefs about professional activities were higher in the Ivory Coast (p<0.01). Among the coping strategies used, distraction, dramatization, prayer and search for social support were used more in the Ivory Coast; reinterpretation in Tunisia; seeking social support was less common in France.ConclusionIn this population of patients with cLBP, despite similar disability levels across the four French-speaking countries, there were considerable variations in pain level and psychobehavioural repercussions

A comparison of the survival of fibre posts cemented with two different composite resin systems

Objectives To evaluate the outcomes of a fibre post cemented with two different luting agents. Methods A single type of tooth coloured fibre post (Fibre-White Parapost, Coltene Whaledent) was used along with two different types of luting cement. A total of 129 teeth were treated in this retrospective audit: 79 treated were luted with Calibra Aesthetic Dental Resin Cement ( Dentsply) and 50 with Panavia F 2.0 (Kuraray). All teeth were treated by the same operator and had a minimum ferrule of 2 mm and a ParaCore ( Coltene Whaledent) composite core placed over the post. Where Calibra Aesthetic Dental Resin Cement was used, all the restorations were undertaken between June 2002 and October 2003 and were reviewed for a period of 38 to 54 months. Where Panavia had been used, all restorations were placed between February 2004 and December 2005 and reviewed for a period of 28 to 50 months. Results The results for the Calibra cemented posts were: 64 returned for recall and of these 23 were classed as failed. The causes were: root fracture ( 2), decementation ( 3), fracture at post-core interface ( 6), endodontic failure ( 8) and marginal caries ( 4). The results for the Panavia cemented posts were: 44 returned for recall and 9 were classed as failed; the causes of failure were fracture at post-core interface ( 6), endodontic failure ( 1) and marginal caries ( 2). Conclusions For posts cemented with Calibra, a success rate of 64.1% was determined over a period of 38 to 54 months. The use of Panavia resulted in fewer post failures with a reported success rate of 79.5% over an evaluation period of 28 to 50 months. Mechanical failures by means of fractures occurring anywhere along the length of the post-core complex were the major cause of lack of success. Significantly higher failure rates were observed to occur in partially dentate patients, in those with parafunctional habits and also amongst anterior teeth. While the majority of the mechanical failures were amenable to repair, the latter mode of failure appears to be a major downfall when considering the routine use of fibre resin posts in restorative dentistry. The choice of cement appears to have a significant role in improving prognostic outcome