Evaluation of the Antibacterial and Prebiotic Potential of Ascophyllum nodosum and Its Extracts Using Selected Bacterial Members of the Pig Gastrointestinal Microbiota.

Ascophyllum nodosum and its extracts are promising antibacterial and prebiotic dietary supplements for pigs. The objectives of this study were to evaluate the effects of the increasing concentrations of: (1) two whole biomass samples of A. nodosum with different harvest seasons, February (ANWB-F) and November (ANWB-N), in a weaned pig faecal batch fermentation assay, and (2) A. nodosum extracts produced using four different extraction conditions of a hydrothermal-assisted extraction methodology (ANE1-4) and conventional extraction methods with water (ANWE) and ethanol (ANEE) as solvent in individual pure culture growth assays using a panel of beneficial and pathogenic bacterial strains. In the batch fermentation assay, ANWB-F reduced Bifidobacterium spp. counts (p < 0.05) while ANWB-N increased total bacterial counts and reduced Bifidobacterium spp. and Enterobacteriaceae counts (p < 0.05). Of the ANE1-4, produced from ANWB-F, ANWE and ANEE that were evaluated in the pure culture growth assays, the most interesting extracts were the ANE1 that reduced Salmonella Typhimurium, enterotoxigenic Escherichia coli and B. thermophilum counts and the ANE4 that stimulated B. thermophilum growth (p < 0.05). In conclusion, the extraction method and conditions influenced the bioactivities of the A. nodosum extracts with ANE1 and ANE4 exhibiting distinct antibacterial and prebiotic properties in vitro, respectively, that merit further exploration.

Effect of a Laminarin Rich Macroalgal Extract on the Caecal and Colonic Microbiota in the Post-Weaned Pig.

Dietary supplementation with 300 ppm of a laminarin rich macroalgal extract reduces post-weaning intestinal dysfunction in pigs. A comprehensive analysis of the impact of laminarin on the intestinal microbiome during this period is essential to inform on the mode of action of this bioactivity. The objective of this study was to evaluate the effects of supplementing the diet of newly weaned pigs with 300 ppm of a laminarin rich extract, on animal performance, volatile fatty acids, and the intestinal microbiota using 16S rRNA gene sequencing. Pigs fed the laminarin-supplemented diet had higher average daily feed intake, growth rate, and body weight compared to pigs fed the control diet (p < 0.05). Pigs fed the laminarin-supplemented diet had reduced abundance of OTUs assigned to Enterobacteriaceae and increased abundance of OTUs assigned to the genus Prevotella (p < 0.05) compared to pigs fed the control diet. Enterobacteriaceae had negative relationships (p < 0.05) with average daily feed intake (ADFI), average daily gain (ADG), and butyric acid concentrations. In contrast, Prevotellaceae were positively correlated (p < 0.05) with ADFI, ADG, total VFA, acetic, propionic, butyric acids, and negatively correlated with isovaleric acid. Hence supplementation with a laminarin enriched extract potentially improves performance during the post-weaning period by promoting the proliferation of bacterial taxa such as Prevotella that favourably enhance nutrient digestion while reducing the load of potentially pathogenic bacterial taxa including Enterobacteriaceae.

In Vitro Evaluation of Brown Seaweed Laminaria spp. as a Source of Antibacterial and Prebiotic Extracts That Could Modulate the Gastrointestinal Microbiota of Weaned Pigs.

Laminaria spp. and their extracts have preventative potential as dietary supplements during weaning in pigs. The first objective of this study was to evaluate increasing concentrations of four whole seaweed biomass samples from two different Laminaria species harvested in two different months in a weaned pig faecal batch fermentation assay. Particularly, February and November whole seaweed biomass samples of L. hyperborea (LHWB-F and LHWB-N) and L. digitata (LDWB-F and LDWB-N) were used. In the next part of the study, the increasing concentrations of four extracts produced from L. hyperborea (LHE1-4) and L. digitata (LDE1-4) were evaluated in individual pure-culture growth assays using a panel of beneficial and pathogenic bacterial strains (second objective). The LHE1-4 and LDE1-4 were obtained using different combinations of temperature, incubation time and volume of solvent within a hydrothermal-assisted extraction methodology (E1-4). In the batch fermentation assay, the L. hyperborea biomass samples, LHWB-F and LHWB-N, lowered Bifidobacterium spp. counts compared to the L. digitata biomass samples, LDWB-F and LDWB-N (p < 0.05). LHWB-F and LDWB-N reduced Enterobacteriaceae counts (p < 0.05). LHWB-F and LDWB-F were selected as the most and least promising sources of antibacterial extracts from which to produce LHE1-4 and LDE1-4. In the pure-culture growth assays, E1- and E4-produced extracts were predominantly associated with antibacterial and bifidogenic activities, respectively. LHE1 reduced both Salmonella Typhimurium and Enterotoxigenic Escherichia coli with LDE1 having a similar effect on both of these pathogenic strains, albeit to a lesser extent (p < 0.05). Both LHE1 and LDE1 reduced B. thermophilum counts (p < 0.05). LDE4 exhibited strong bifidogenic activity (p < 0.05), whereas LHE4 increased Bifidobacterium thermophilum and Lactiplantibacillus plantarum counts (p < 0.05). In conclusion, antibacterial and bifidogenic extracts of Laminaria spp. were identified in vitro with the potential to alleviate gastrointestinal dysbiosis in newly weaned pigs.

Evaluation of carvacrol for the control of Escherichia coli O157 on cattle hide and carcass cuts.

The antimicrobial activity of carvacrol against Escherichia coli O157 was assessed on cattle hide and beef carcass cuts. Carvacrol (0, 10, 20, and 30 mg/mL) was applied using a spray bottle to cattle hide and beef carcass cuts, inoculated with a cocktail of E. coli O157 (5-6 log(10) CFU/cm(2)) and left in contact for 10 min. Following treatment, hide and carcass cuts were sampled using a swab method, and E. coli O157 were enumerated by plate counts on selective media. Carvacrol (30 mg/mL) significantly (p < 0.05) reduced inoculated E. coli O157 (1.4 and 1.58 log(10) CFU/cm(2)) compared to the no wash and water wash (0 mg/mL) controls on both carcass cuts and hide respectively. This preliminary study shows that carvacrol has the potential to control E. coli O157 on bovine hide and carcass cuts, but further research with larger scale trials is needed.

What constitutes torture?: psychological impediments to an objective evaluation of enhanced interrogation tactics.

Torture is prohibited by statutes worldwide, yet the legal definition of torture is almost invariably based on an inherently subjective judgment involving pain severity. In four experiments, we demonstrate that judgments of whether specific interrogation tactics constitute torture are subject to an empathy gap: People who are experiencing even a mild version of the specific pain produced by an interrogation tactic are more likely to classify that tactic as torture or as unethical than are those who are not experiencing pain. This discrepancy could result from an overestimation of the pain of torture by people in pain, an underestimation of the pain of torture by those not in pain, or both. The fourth experiment shows that the discrepancy results from an underestimation of pain by people who are not experiencing it. Given that legal standards guiding torture are typically established by people who are not in pain, this research suggests that practices that do constitute torture are likely to not be classified as such.

Evaluation of the in vitro effects of the increasing inclusion levels of yeast ß-glucan, a casein hydrolysate and its 5 kDa retentate on selected bacterial populations and strains commonly found in the gastrointestinal tract of pigs.

Previously, the 5 kDa retentate (5kDaR) of a casein hydrolysate (CH) and yeast ß-glucan (YBG) were identified as promising anti-inflammatory dietary supplements for supporting intestinal health in pigs post-weaning. However, their direct effects on intestinal bacterial populations are less well-known. The main objectives of this study were to determine if the increasing concentrations of the CH, 5kDaR and YBG individually, can: (1) alter the bacterial and short-chain fatty acid profiles in a weaned pig faecal batch fermentation assay, and (2) directly influence the growth of selected beneficial (Lactobacillus plantarum, L. reuteri, Bifidobacterium thermophilum) and pathogenic (Enterotoxigenic Escherichia coli, Salmonella Typhimurium) bacterial strains in individual pure culture growth assays. The potential of CH as a comparable 5kDaR substitute was also evaluated. The 5kDaR increased lactobacilli counts and butyrate concentration in the batch fermentation assay (P < 0.05) and increased L. plantarum (linear, P < 0.05), L. reuteri (quadratic, P < 0.05) and B. thermophilum (linear, P < 0.05) counts and reduced S. typhimurium (quadratic, P = 0.058) counts in the pure culture growth assays. CH increased butyrate concentration (P < 0.05) in the batch fermentation assay. YBG reduced Prevotella spp. counts (P < 0.05) and butyrate concentration (P < 0.05) in the batch fermentation assay. Both CH and YBG had no major effects in the pure culture growth assays. In conclusion, the 5kDaR had the most beneficial effects associated with increased counts of Lactobacillus and Bifidobacterium genera and butyrate production and reduced S. typhimurium counts in vitro indicating its potential to promote gastrointestinal health.

In vivo and ex vivo evaluations of bacteriophages e11/2 and e4/1c for use in the control of Escherichia coli O157:H7.

This study investigated the effect of bacteriophages (phages) e11/2 and e4/1c against Escherichia coli O157:H7 in an ex vivo rumen model and in cattle in vivo. In the ex vivo rumen model, samples were inoculated with either 10³ or 106 CFU/ml inoculum of E. coli O157:H7 and challenged separately with each bacteriophage. In the presence of phage e11/2, the numbers of E. coli O157:H7 bacteria were significantly (P < 0.05) reduced to below the limit of detection within 1 h. Phage e4/1c significantly (P < 0.05) reduced E. coli O157:H7 numbers within 2 h of incubation, but the number of surviving E. coli O157:H7 bacteria then remained unchanged over a further 22-h incubation period. The ability of a phage cocktail of e11/2 and e4/1c to reduce the fecal shedding of E. coli O157:H7 in experimentally inoculated cattle was then investigated in two cattle trials. Cattle (yearlings, n = 20 for trial one; adult fistulated cattle, n = 2 for trial two) were orally inoculated with 10(10) CFU of E. coli O157:H7. Animals (n = 10 for trial one; n = 1 for trial two) were dosed daily with a bacteriophage cocktail of 10(11) PFU for 3 days postinoculation. E. coli O157:H7 and phage numbers in fecal and/or rumen samples were determined over 7 days postinoculation. E. coli O157:H7 numbers rapidly declined in all animals within 24 to 48 h; however, there was no significant difference (P > 0.05) between the numbers of E. coli O157:H7 bacteria shed by the phage-treated or control animals. Phages were recovered from the rumen but not from the feces of the adult fistulated animal in trial two but were recovered from the feces of the yearling animals in trial one. While the results from the rumen model suggest that phages are effective in the rumen, further research is required to improve the antimicrobial effectiveness of phages for the elimination of E. coli O157:H7 in vivo.

SHIFT: speedy histological-to-immunofluorescent translation of a tumor signature enabled by deep learning.

Spatially-resolved molecular profiling by immunostaining tissue sections is a key feature in cancer diagnosis, subtyping, and treatment, where it complements routine histopathological evaluation by clarifying tumor phenotypes. In this work, we present a deep learning-based method called speedy histological-to-immunofluorescent translation (SHIFT) which takes histologic images of hematoxylin and eosin (H&E)-stained tissue as input, then in near-real time returns inferred virtual immunofluorescence (IF) images that estimate the underlying distribution of the tumor cell marker pan-cytokeratin (panCK). To build a dataset suitable for learning this task, we developed a serial staining protocol which allows IF and H&E images from the same tissue to be spatially registered. We show that deep learning-extracted morphological feature representations of histological images can guide representative sample selection, which improved SHIFT generalizability in a small but heterogenous set of human pancreatic cancer samples. With validation in larger cohorts, SHIFT could serve as an efficient preliminary, auxiliary, or substitute for panCK IF by delivering virtual panCK IF images for a fraction of the cost and in a fraction of the time required by traditional IF.

A Randomized, Double-Blind, Placebo-Controlled Study of HLD200, a Delayed-Release and Extended-Release Methylphenidate, in Children with Attention-Deficit/Hyperactivity Disorder: An Evaluation of Safety and Efficacy Throughout the Day and Across Settings.

Objectives: HLD200, a once-daily, evening-dosed, delayed-release and extended-release methylphenidate (DR/ER-MPH), was designed to provide therapeutic effect beginning upon awakening and lasting into the evening. This pivotal, randomized, double-blind, multicenter, placebo-controlled, phase 3 trial assessed improvements in functional impairment across the day using multiple validated measures tailored for different settings and time of day in children (6-12 years) with attention-deficit/hyperactivity disorder (ADHD). Methods: Following a 6-week, open-label titration of DR/ER-MPH to an optimal dose (20, 40, 60, 80, or 100 mg/day) and dosing time (8:00 PM ±1.5 hours), participants were randomized to treatment-optimized DR/ER-MPH or placebo for 1 week. The primary endpoint was the model-adjusted average of postdose Swanson, Kotkin, Agler, M-Flynn, and Pelham Scale combined scores (SKAMP CS) over a 12-hour laboratory classroom day (8:00 AM to 8:00 PM). The key secondary endpoint was the Parent Rating of Evening and Morning Behavior-Revised, Morning (PREMB-R AM) subscale. Secondary/exploratory measures included the PREMB-R Evening (PREMB-R PM) subscale and Permanent Product Measure of Performance (Attempted [PERMP-A] and Correct [PERMP-C]). Safety endpoints included treatment-emergent adverse events (TEAEs). Results: After the treatment-optimization phase, the mean optimized dose was 66.2 mg and the most common prescribed dosing time was 8:00 PM. Double-blind DR/ER-MPH treatment significantly improved functional impairment versus placebo in the early morning (PREMB-R AM: p < 0.001), averaged over the classroom day (SKAMP CS: p < 0.001), and in the late afternoon/evening (PREMB-R PM: p = 0.003) in the intent-to-treat population (N = 117). Average PERMP-A (p = 0.006) and PERMP-C (p = 0.009) also indicated improved classroom performance with DR/ER-MPH versus placebo. In the double-blind phase, TEAEs did not differ between DR/ER-MPH and placebo groups and no serious TEAEs or TEAEs leading to discontinuation were reported. Conclusion: DR/ER-MPH was well tolerated and demonstrated significant improvements versus placebo in functional impairment throughout the day across different settings in children with ADHD.

An analysis of the palliative care education needs of RGNs and HCAs in nursing homes in Ireland.

AIM: To identify the palliative care education needs of registered general nurses (RGNs) and health-care assistants (HCAs) working in care of the older person units (nursing homes). METHOD: A questionnaire was sent to all RGNs and HCAs working in nursing homes run by the Health Service Executive (HSE) in one health-care region in Ireland. RESULTS: RGNs identified eight specific educational needs: understanding of the dying process; pain and symptom management; improved communication skills; nutritional assessment issues; practical skills; the appropriate use and management of syringe drivers; and the role of complementary therapies. HCAs identified a need to improve their communication skills and clarify their role. Both groups identified the need for support when caring for dying patients and the need to improve their understanding of palliative care and the role of specialist palliative care (SPC) services. There was a significant difference between the RGNs' and the HCAs' level of understanding of palliative care (P = 0.00). CONCLUSION: This study demonstrated that RGNs and HCAs working in care of the older person settings have palliative care educational needs. It also established a difference in the educational background and palliative care understanding of RGNs and HCAs. This study therefore identified the need to develop separate education programmes.

Influence of scapular position on cervical rotation range of motion.

STUDY DESIGN: Cross-sectional study, quasi-experimental design. OBJECTIVES: To compare the active cervical rotation range of motion (ROM) between healthy young subjects with a neutral vertical scapular alignment and subjects with scapular depression, and to examine the influence of modifying the vertical position of the scapulae on active cervical rotation ROM. BACKGROUND: Altered scapular alignment is proposed to be related to neck dysfunction and pain. Changes in the alignment of either the scapulae or the cervical spine can potentially influence the biomechanics of the other by altering the tension at the cervicoscapular muscles. METHODS AND MEASURES: Fifty-eight college age students with neutral vertical scapular alignment (NS group, n = 29) or depressed scapular alignment (DS group, n = 29) volunteered to participate in the study. Cervical rotation ROM was assessed using the CROM device in 2 conditions: condition 1, resting scapular position; condition 2, neutral vertical scapular position with forearms supported. RESULTS: The ANOVA revealed no significant group-by-condition interaction (F = 0.19, df = 1, P = .66). There was a significant main effect of condition (F = 47.16, df = 1, P<.001). For both groups, there was an increase in cervical rotation ROM in condition 2 when compared to condition 1 (mean +/- SD, 10.2 degrees +/- 3.1 degrees; 95% Cl: 4.1 degrees to 16.4 degrees). There was no main effect of group (F = .41, df = 1, P = .53). CONCLUSION: Our results suggest that in a young healthy population the vertical scapular alignment does not influence cervical rotation ROM. Supporting the upper limbs, however, results in a significant and similar increase in cervical rotation ROM for both groups.

Reliability and Validity of the Daily Parent Rating of Evening and Morning Behavior Scale, Revised.

OBJECTIVE: Children with ADHD frequently manifest behavioral difficulties in the morning prior to school. We sought to assess the reliability and validity of the Daily Parent Rating of Evening and Morning Behavior Scale, Revised (DPREMB-R) morning score as a measure of morning behaviors impaired by ADHD. METHOD: We used data from a clinical trial of HLD200 treatment in pediatric participants with ADHD to address our objectives. RESULTS: The DPREMB-R morning score showed significant internal homogeneity, test-retest reliability ( r = .52-.45), and good concurrent validity ( r = .50-.71). CONCLUSION: The DPREMB-R morning score could be a useful instrument for assessing treatment efficacy in the morning before school.

The immediate effect of passive scapular elevation on symptoms with active neck rotation in patients with neck pain.

OBJECTIVE: To examine the effect of elevating the scapulae on symptoms during neck rotation. METHODS: A retrospective analysis of clinical records was conducted. One physical therapist examined 46 patients with neck pain (30 women, 16 men; mean age 45.89+14.39 y) using a standardized examination. Patients had a long-standing history of neck pain with a moderate level of symptoms and disability. Reports of symptoms were obtained in 2 scapulae position conditions: a patient-preferred scapulae position and a passively elevated scapulae position. RESULTS: In the patient-preferred positions, 29 (63%) of the 46 patients reported an increase in symptoms with neck rotation in at least one direction. In the scapulae elevated position, a significant percentage of patients reported a decrease in symptoms with neck rotation, right (82%) and left (76%) (both comparisons, P

A comparison of serratus anterior muscle activation during a wall slide exercise and other traditional exercises.

STUDY DESIGN: Single-group repeated-measures design. OBJECTIVES: To investigate the ability of the wall slide exercise to activate the serratus anterior muscle (SA) at and above 90 degrees of humeral elevation. BACKGROUND: Strengthening of the SA is a critical component of rehabilitation for patients with shoulder impingement syndromes. Traditional SA exercises have included scapular protraction exercises such as the push-up plus. These exercises promote activation of the SA near 90 degrees of humeral elevation, but not in positions above 90 degrees where patients typically experience pain. METHODS AND MEASURES: Twenty healthy subjects were studied performing 3 exercises: (1) wall slide, (2) plus phase of a wall push-up plus, and (3) scapular plane shoulder elevation. Three-dimensional position of the thorax, scapula, and humerus and muscle activity from the SA, upper and lower trapezius, and latissimus dorsi were recorded. The magnitudes of activation for each muscle at 90 degrees, 120 degrees, and 140 degrees of humeral elevation were quantified from EMG records. Repeated-measures analyses of variance were used to determine the degree to which the different exercises activated the SA at the 3 humeral positions. RESULTS: The intensity of SA activity was not significantly different between the 3 exercises at 90 degrees of humeral elevation (P = .40). For the wall slide and scapular plane shoulder elevation exercises, SA activity increased with increasing humeral elevation angle (P = .001), with no significant differences between the 2 exercises (P = .36). CONCLUSION: The wall slide is an effective exercise to activate the SA muscle at and above 90 degrees of shoulder elevation. During this exercise, SA activation is not significantly different from SA activation during the push-up plus and scapular plane shoulder elevation, 2 exercises previously validated in the literature.

Trunk rotation-related impairments in people with low back pain who participated in 2 different types of leisure activities: a secondary analysis.

STUDY DESIGN: Cross-sectional, secondary analysis. OBJECTIVES: To examine whether there were differences in the numbers and types of impairments on examination between 2 groups of people with low back pain (LBP), those who participated in symmetric leisure activities and those who participated in asymmetric leisure activities. BACKGROUND: It has been proposed that people who repeatedly perform an activity that involves trunk movements and alignments in the same direction will develop strategies that are generalized to many activities. The repeated use of these strategies is proposed to contribute to impairments identifiable on examination and to LBP. METHODS AND MEASURES: Forty males and 40 females (mean +/- SD age, 41.4 +/- 13.9 years) with LBP who reported participation in either a symmetric or an asymmetric leisure activity participated in a standardized examination. Responses from 10 trunk-rotation-related impairment tests were analyzed using the Mann-Whitney U and chi-square statistics. RESULTS: Thirty people participated in asymmetric leisure activities and 50 people participated in symmetric leisure activities. The total number of rotation-related impairments was different for the 2 groups (U = 1112, P < .01). The asymmetric group displayed more total rotation-related impairments (median, 4.0; range, 7) than the symmetric group (median, 2.0; range, 6). A greater percentage of the asymmetric group displayed more impairments on 5 out of 10 individual tests, as compared to the symmetric group ( < or = .05 for all comparisons). CONCLUSIONS: Our results provide preliminary data to suggest that trunk-rotation-related impairments, identified on examination, may be related to the general type of movements and alignments used repeatedly by patients with LBP.

Aripiprazole in the treatment of pediatric bipolar disorder: a systematic chart review.

BACKGROUND: Pediatric bipolar disorder is a serious neuropsychiatric disorder associated with high levels of morbidity and disability. OBJECTIVE: This is a systematic chart review of all outpatient youth with the diagnosis of bipolar disorder and bipolar spectrum disorder treated with aripiprazole either alone or as add-on to ongoing treatments. METHOD: Medical records were reviewed to identify all subjects with bipolar and bipolar spectrum disorder prescribed aripiprazole in our clinic. During the chart review, the Clinical Global Impression scale was completed by the treating clinicians to determine usefulness. RESULTS: Forty-one youths (mean age+/-SD: 11.4+/-3.5 years) with bipolar spectrum disorder who had been treated with aripiprazole were identified. These children received a mean daily dose of aripiprazole 16.0+/-7.9 mg over an average of 4.6 months. Using a Clinical Global Impression-Improvement scale score of <2 (very much/much improved) to define robust improvement, 71% showed improvement in manic symptoms. Treatment with aripiprazole was well tolerated. CONCLUSION: This study suggests that aripiprazole may be a useful and well-tolerated treatment for youth with bipolar disorder and it supports the need for controlled clinical trials of this compound in juvenile mania.

A specific exercise program and modification of postural alignment for treatment of cervicogenic headache: a case report.

STUDY DESIGN: Case report. OBJECTIVE: To describe an intervention approach consisting of a specific active-exercise program and modification of postural alignment for an individual with cervicogenic headache. BACKGROUND: The patient was a 46-year-old male with a 7-year history of cervicogenic headache. He reported constant symptoms with an average intensity of 5/10 on a visual analogue scale where 0 indicated no pain and 10 the worst pain imaginable. Average pain intensity in the week prior to the initial evaluation was 3/10 secondary to trigger point injections. The patient's headache symptoms worsened with activities that involved use of his arms and prolonged sitting. METHODS AND MEASURES: The patient was treated 7 times over a 3-month period. Impairments of alignment, muscle function, and movement of the cervical, scapulothoracic, and lumbar regions were identified. Outcome measurements included headache frequency, intensity, and the Neck Disability Index (NDI) questionnaire. Intervention included modification of alignment and movement during active cervical and upper extremity movements. The patient also received functional instructions focused on diminishing the effect of the weight of the upper extremities on the cervical spine. RESULTS: The patient reported a decrease in headache frequency and intensity (1 headache in 3 weeks, intensity 1/10) and a decrease in his NDI score from 31 (severe disability) to 11 (mild disability). The patient also demonstrated improvement in upper cervical joint mobility, cervical range of motion, scapular alignment, and scapulothoracic muscle strength. CONCLUSION: Interventions that included modification of alignment in the cervical, scapulothoracic, and lumbar region, along with instruction in a specific active-exercise program to address movement impairments in these 3 regions, appeared to have been successful in relieving headaches and improving function in this patient.

Having "been there" doesn't mean I care: when prior experience reduces compassion for emotional distress.

The current research found that participants who had previously endured an emotionally distressing event (e.g., bullying) more harshly evaluated another person's failure to endure a similar distressing event compared with participants with no experience enduring the event or those currently enduring the event. These effects emerged for naturally occurring (Studies 1, 3, and 4) and experimentally induced (Study 2) distressing events. This effect was driven by the tendency for those who previously endured the distressing event to view the event as less difficult to overcome (Study 3). Moreover, we demonstrate that the effect is specific to evaluations of perceived failure: Compared with those with no experience, people who previously endured a distressing event made less favorable evaluations of an individual failing to endure the event, but made more favorable evaluations of an individual managing to endure the event (Study 4). Finally, we found that people failed to anticipate this effect of enduring distress, instead believing that individuals who have previously endured emotionally distressing events would most favorably evaluate others' failures to endure (Study 5). Taken together, these findings present a paradox such that, in the face of struggle or defeat, the people we seek for advice or comfort may be the least likely to provide it.

Movement system impairment-based categories for low back pain: stage 1 validation.

STUDY DESIGN: Cross-sectional study of patients with mechanical low back pain (MLBP). OBJECTIVE: To test the construct validity of 3 categories of a movement system impairment-based classification proposed for use with patients with MLBP. BACKGROUND: A pathoanatomic basis for directing treatment has not proven useful in a wide variety of patients with MLBP. In addition, there is a paucity of data describing the movement system impairments that characterize many of the pathoanatomically based MLBP diagnoses. Because of the mechanical nature of MLBP, a system based on groups of signs and symptoms relevant to conservative management needs to be developed. METHODS AND MEASURES: A movement system impairment-based classification was proposed that defined 5 categories of MLBP based on the findings from a standardized examination. Using the examination, 5 physical therapists examined a total of 188 patients with MLBP. A principal components analysis with an oblique rotation was conducted. Eigenvalues were plotted and a scree test was used to determine the number of factors to retain. A split-sample cross-validation procedure was conducted to verify the factor structure. RESULTS: Three factors were identified in both samples: 2 factors related to symptoms with lumbar rotation and lumbar extension alignments or movements, and 1 factor related to signs of lumbar rotation with different alignments and movements. CONCLUSION: Our results provide support for 3 factors related to 3 of the 5 proposed categories: lumbar rotation with extension, lumbar rotation, and lumbar extension. The existence of these 3 factors provides preliminary evidence for specific clusters of tests of alignment and movement impairments that could be used in classifying patients with MLBP into movement-system-related categories.