Psychometric Properties of the Norwegian Acceptance and Action Questionnaire in a Non-clinical Sample

The Acceptance and Action Questionnaire second version (AAQ-II) is a widely used measure of experiential avoidance and has been translated into several languages. Previous examinations ofthe psychometric properties have shown a correlated measurement error (CME) between item 1 and 4, and in some studies also items 2 and 3. Allowing for CME in confirmatory factor analysis may introduce biases and move the results away from the true population model. The purpose of this study was (1) to examine the factor structure of the Norwegian AAQ-II (NAAQ), without allowing CME, and (2) to test the hypothesis that more experiential avoidance is related to the use of more maladaptive and less adaptive emotion regulation strategies. We recruited and assessed 233 (data et 1) and 395 (data set 2) participants with the NAAQ, and the second sample was also assessed with the Emotion Regulation Questionnaire. Our results show that five items best represented NAAQ. Further, our hypothesis about the relationship between experiential avoidance and emotion regulation strategies was supported. Experiential avoidance correlated negatively with reappraisal and positively with expression suppression. We conclude that the NAAQ is a valid measure of experiential avoidance in a non-clinical sample and that there is a juxtaposition between experiential avoidance and emotion regulation, and thus between acceptance and commitment therapy and emotion regulation theory (AU)

Low molecular weight heparin (tinzaparin) vs. placebo in the treatment of mild to moderately active ulcerative colitis.

BACKGROUND: Heparin has anti-inflammatory and immunomodulatory activity which may be of therapeutic benefit in the treatment of ulcerative colitis. AIM: To test whether low molecular weight heparin, given subcutaneously, would provide a significant therapeutic response compared with placebo in the treatment of mild to moderate ulcerative colitis. STUDY DESIGN: A prospective, double-blind, randomized, placebo-controlled, multi-centre trial comparing tinzaparin 175 anti-Xa IU/kg/day (innohep, LEO Pharma) subcutaneously for 14 days followed by tinzaparin 4500 anti-Xa IU/day subcutaneously for 28 days with placebo, administered subcutaneously once daily for up to 42 days. The primary outcome measure was the mean change in colitis activity from baseline to the end of study treatment assessed by the sum of scores of stool frequency, rectal bleeding, sigmoidoscopic appearance and histology. Secondary outcome measures included changes in individual activity indices and laboratory parameters. Patients were assessed at weekly intervals for 6 weeks and within 1 week of completing treatment. RESULTS: One hundred patients with active ulcerative colitis (up to six bloody stools per day, no fever, no tachycardia or systemic disturbances) were randomized. Forty-eight received tinzaparin and 52 received placebo. The difference in the mean percentage change in colitis activity from baseline to end of treatment (tinzaparin-placebo) was not statistically significant (P = 0.84). There was no difference between tinzaparin and placebo in any secondary outcome measure. One major bleed (rectal), occurred in a patient receiving placebo. CONCLUSION: This is the largest trial to date of heparin in ulcerative colitis. The results show no benefit of low molecular weight heparin over placebo in mild to moderately active ulcerative colitis.

Bilateral asymmetric dissociated vertical deviation masquerading as unilateral double elevator palsy. A report of four cases.

PURPOSE: To illuminate this difficult clinical situation and assist and improve in its diagnosis and management. METHODS AND STUDY: Record Review. All 4 patients had a unilateral DEP and increased hyperdeviation upon tilting the head to the contralateral shoulder. Two patients had surgery to the eye with the presumed diagnosis of DEP, consisting of recession of the inferior rectus muscle in one patient and a Knapp procedure in the second patient. The other two patients had weakening surgery of the superior rectus muscle of the contralateral eye. RESULTS: The marked limitation of elevation in the eye with pseudo- DEP was either restored to normal or very satisfactorily improved. Bilateral DVD appeared in all four patients immediately after surgery. CONCLUSION: Bilateral asymmetric DVD can masquerade as unilateral DEP due to inhibitional palsy of the elevators. Meticulous diagnostic tests can reveal the DVDs.