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Mounting evidence supports the use of face-to-face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia. A double-blind, multicenter randomized controlled clinical trial with 6-month follow-up was conducted. Patients with FM (n = 114) that consented to participate were randomly allocated to receive either written pain neuroscience education or written relaxation training. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call. The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire were used as outcome measures. Both patients and assessors were blinded. Repeated-measures analyses with last observation carried forward principle were performed. Cohen's d effect sizes (ES) were calculated for all within-group changes and between-group differences. The results reveal that written pain neuroscience education does not change the impact of FM on daily life, catastrophizing, or perceived symptoms of patients with FM. Compared with written relaxation training, written pain neuroscience education improved beliefs in a chronic timeline of FM (P = 0.03; ES = 0.50), but it does not impact upon other domains of illness perceptions. Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life. Face-to-face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM.
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Objective: To explore predictors of dropout of patients with chronic musculoskeletal pain from an interdisciplinary chronic pain management programme, and to develop and validate a multivariable prediction model, based on the Extended Common- Sense Model of Self-Regulation (E-CSM). Methods: In this prospective cohort study consecutive patients with chronic pain were recruited and followed up (July 2013 to May 2015). Possible associations between predictors and dropout were explored by univariate logistic regression analyses. Subsequently, multiple logistic regression analyses were executed to determine the model that best predicted dropout. Results: Of 188 patients who initiated treatment, 35 (19%) were classified as dropouts. The mean age of the dropout group was 47.9 years (standard deviation 9.9). Based on the univariate logistic regression analyses 7 predictors of the 18 potential predictors for dropout were eligible for entry into the multiple logistic regression analyses. Finally, only pain catastrophizing was identified as a significant predictor. Conclusion: Patients with chronic pain who catastrophize were more prone to dropout from this chronic pain management programme. However, due to the exploratory nature of this study no firm conclusions can be drawn about the predictive value of the E-CSM of Self-Regulation for dropout.
A significant proportion of adolescents with chronic musculoskeletal pain (CMP) experience difficulties in physical functioning, mood and social functioning, contributing to diminished quality of life. Generalized joint hypermobility (GJH) is a risk factor for developing CMP with a striking 35-48% of patients with CMP reporting GJH. In case GJH occurs with one or more musculoskeletal manifestations such as chronic pain, trauma, disturbed proprioception and joint instability, it is referred to as generalized hypermobility spectrum disorder (G-HSD). Similar characteristics have been reported in children and adolescents with the hypermobile Ehlers-Danlos Syndrome (hEDS). In the management of CMP, a biopsychosocial approach is recommended as several studies have confirmed the impact of psychosocial factors in the development and maintenance of CMP. The fear-avoidance model (FAM) is a cognitive-behavioural framework that describes the role of pain-related fear as a determinant of CMP-related disability. Pubmed was used to identify existing relevant literature focussing on chronic musculoskeletal pain, generalized joint hypermobility, pain-related fear and disability. Relevant articles were cross-referenced to identify articles possibly missed during the primary screening. In this paper the current state of scientific evidence is presented for each individual component of the FAM in hypermobile adolescents with and without CMP. Based on this overview, the FAM is proposed explaining a possible underlying mechanism in the relations between GJH, pain-related fear and disability. It is assumed that GJH seems to make you more vulnerable for injury and experiencing more frequent musculoskeletal pain. But in addition, a vulnerability for heightened pain-related fear is proposed as an underlying mechanism explaining the relationship between GJH and disability. Further scientific confirmation of this applied FAM is warranted to further unravel the underlying mechanism. In explaining disability in individuals with G-HSD/hEDS, it is important to focus on both the physical components related to joint hypermobility, in tandem with the psychological components such as pain-related fear, catastrophizing thoughts and generalized anxiety.
Society continues to place an exaggerated emphasis on women's skins, judging the value of lives lived within, by the colour and condition of these surfaces. This artistic research will explore how the skin of a painting might unpack this site of judgement, highlight its objectification, and offer women alternative visualizations of their own sense of embodiment. This speculative renovation of traditional concepts of portrayal will explore how painting, as an aesthetic body whose material skin is both its surface and its inner content (its representations) can help us imagine our portrayal in a different way, focusing, not on what we look like to others, but on how we sense, touch, and experience. How might we visualise skin from its ghostly inner side? This feminist enquiry will unfold alongside archival research on The Ten Largest (1906-07), a painting series by Swedish Modernist Hilma af Klint. Initial findings suggest the artist was mapping traditional clothing designs into a spectral, painterly idea of a body in time. Fundamental methods research, and access to newly available Af Klint archives, will expand upon these roots in maps and women’s craft practices and explore them as political acts, linked to Swedish Life Reform, and knowingly sidestepping a non-inclusive art history. Blending archival study with a contemporary practice informed by eco-feminism is an approach to artistic research that re-vivifies an historical paradigm that seems remote today, but which may offer a new understanding of the past that allows us to also re-think our present. This mutuality, and Af Klint’s rhizomatic approach to image-making, will therefore also inform the pedagogical development of a Methods Research programme, as part of this post-doc. This will extend across MA and PhD study, and be further enriched by pedagogy research at Cal-Arts, Los Angeles, and Konstfack, Stockholm.
The PANTOUR consortium builds on previous knowledge and tools produced by the Blueprint for Sectoral Skills project/NTG Alliance and will develop new tools and methodology to address strategic and sustainable approaches and cooperation between vocational education, training, higher education, enterprises of the tourism sector, looking to boost innovation in Europe (in tourism, leisure and hospitality).Societal IssueThe aim of this project is to map and bridge the existing skills gaps in Green, Social and Digital skills of workforce in tourism, leisure and hospitality.Benefit to societyMaking lifelong learning and mobility a reality, developing innovative learning solutions and promoting inclusiveness and access to education. Promoting active citizenship, building equal opportunities and addressing gender equality, diversity and inclusiveness in targeted actions.The consortium aims especially at designing innovative and cooperative solutions to address skills needs in the tourism ecosystem, with the development of outputs such as: the Sectoral Skills Intelligence Monitor, the Tourism Skills Lab, Resource Books for Trainers, the implementation of the National Skills Groups, a Skills Strategy Plan for 2026-2036, among others. With the exploitation of its outputs, PANTOUR seeks to benefit job seekers, unemployed and employed workers from the industry, employers, SMEs and micro entrepreneurs, dedicating a special attention in reskilling and upskilling the workforce on future skills needs in digital, green and social skills.The number of people benefiting from this proposal will be over 10 million that work across the tourism and leisure sector in Europe.The consortium is a multi-disciplinary partnership which comprises 13 European partners: Industry Partners and Tourism Sector Representatives, Universities and Transnational partners. Project lead is CEHAT (Spain). The other partners are GESTLABOR (Spain), Turismo de Portugal (Portugal), Zangador Research Institute (Bulgaria), Technological University Dublin (Ireland), Federturismo Confindustria (Italy), VIMOSZ (Hungary), European Tourism Association ETOA (Transnational), Satakunta University of Applied Sciences (Finland), Ruraltour (Transnational), Landurlaub (Germany), University of the Aegan (Greece).