Biologic Association Annual Summit: 2020 Report

Interest and research in biologic approaches for tissue healing are exponentially growing for a variety of musculoskeletal conditions. The recent hype concerning musculoskeletal biological therapies (including viscosupplementation, platelet-rich plasma, and cellular therapies, or “stem cells”) is driven by several factors, including demand by patients promising regenerative evidence supported by substantial basic and translational work, as well as commercial endeavors that complicate the scientific and lay understanding of biological therapy outcomes. While significant improvements have been made in the field, further basic and preclinical research and well-designed randomized clinical trials are needed to better elucidate the optimal indications, processing techniques, delivery, and outcome assessment. Furthermore, biologic treatments may have potential devastating complications when proper methods or techniques are ignored. For these reasons, an association comprising several scientific societies, named the Biologic Association (BA), was created to foster coordinated efforts and speak with a unified voice, advocating for the responsible use of biologics in the musculoskeletal environment in clinical practice, spearheading the development of standards for treatment and outcomes assessment, and reporting on the safety and efficacy of biologic interventions. This article will introduce the BA and its purpose, provide a summary of the 2020 first annual Biologic Association Summit, and outline the future strategic plan for the BA.

Perceptions of Political Deviants: A Lay Theory of Subjective Group Dynamics

People who deviate from group norms pose problems for their ingroup, but not all forms are deviance are equivalent. Four experiments (N=1,063) investigated whether people hold a lay understanding of these subjective group dynamics by assessing people’s beliefs about how others would perceive two types of deviants within U.S. political parties—political moderates and extremes. Participants thought both Democrats (Experiment 1) and Republicans (Experiment 2) would view moderate political candidates more negatively (e.g., less loyal, less principled, less typical, and more likely to defect) than extreme candidates. Moreover, these relatively negative evaluations of moderates extended to rank and file members of the Democratic (Experiment 3) and Republican (Experiment 4) Parties. These findings suggest that people intuitively understand subjective group dynamics and, when applied to politics, this understanding may have important consequences for how people with moderate and extreme beliefs engage in political discourse.

Lay Meanings and Associated Experiences of Nonattachment (Anasakti): A Study From India

Anasakti, translated as “nonattachment” in English, is one of the important philosophical concepts of Hinduism and Buddhism. It has also been studied in contemporary psychology using various measures of anasakti. However, there is a dearth of studies that have qualitatively investigated anasakti from the lay or “folk” perspective. This mixed-method study aimed to uncover subjective meanings and personal belief systems related to anasakti, as well as practices and experiences related to the lay understanding of anasakti among a sample of 240 urban educated adults (female = 104, male = 136) in India. Three structured scales (Test of asakti –anasakti, Scale of anasakti, Nonattachment Scale) were used to assess the levels of anasakti, while a semistructured questionnaire elicited personal meanings, experiences, and associated behaviors and beliefs related to anasakti. Thematic analysis revealed five broad thematic categories covering the qualitative data: personal meanings of anasakti, experiences, benefits, efficacy, and pathways. Roles of desire and attachment were also discussed. Quantitative results indicated higher levels of anasakti in older age groups, suggesting that anasakti may progress with age. These findings have several implications for future research and interventions.

World of Echo

Between late antiquity and the fifteenth century, theologians, philosophers, and poets struggled to articulate the correct relationship between sound and sense, creating taxonomies of sounds based on their capacity to carry meaning. This book traces how medieval thinkers adopted the concept of noise as a mode of lay understanding grounded in the body and the senses. With a broadly interdisciplinary approach, the book examines a range of literary genres to highlight the poetic and social effects of this vibrant discourse, offering close readings of works by Geoffrey Chaucer and William Langland, as well as the mystics Richard Rolle and Margery Kempe. Each of these writers embraced an embodied experience of language resistant to clear articulation, even as their work reflects inherited anxieties about the appeal of such sensations. A preoccupation with the sound of language emerged in the form of poetic soundplay at the same time that mysticism and other forms of lay piety began to flower in England. As the book shows, the presence of such emphatic aural texture amplified the cognitive importance of feeling in conjunction with reason and was a means for the laity — including lay women — to cultivate embodied forms of knowledge on their own terms, in precarious relation to existing clerical models of instruction. The book offers a deep history of the cultural and social hierarchies that coalesce around aesthetic experience and gives voice to alternate ways of knowing.

Just Deserts

This chapter argues that the lay understanding of games as fair and unbiased allowed World War II military officials to invoke game theory to resolve the thorny contradictions of imprisoning American citizens on racial grounds. A branch of applied mathematics which would eventually form the backbone of U.S. Cold War foreign policy as a “scientific” means of predicting enemy behavior, game theory has often been considered a defining discourse of Cold War America. Juxtaposing internment-era novels and military correspondence alongside game theory textbooks and popular media accounts, this chapter reveals, however, that a decade before it was applied to the “red menace,” a prefiguration of game theory amplified and then neutralized the threat posed by the “inscrutable intentions” of one hundred thousand Japanese Americans by reframing their fervent claims of U.S. loyalty as little more than a bluff.

PP24 Lay understanding of head injury and when an ambulance might be needed: a mixed methods study

BackgroundHead injury results in a high use of emergency services, although most people with head injuries do not require hospitalisation. Conversely, some evidence suggests that lay recognition of the seriousness of head injury can be problematic, for example in sports settings.AimTo investigate how members of the public - parents of young children, school staff, sports coaches, informal carers of older adults, young adults and other adults - understood head injury terminology and when an emergency ambulance/999 call was required for head injury, against UK public guidance.MethodsA mixed methods exploratory study, comprising of electronic and paper self-completion surveys across the UK and focus groups or interviews. Survey data were analysed statistically against the outcomes of understanding of terms and selection of the correct action by symptom. Focus group/interview data were analysed thematically.ResultsWe received 520 survey responses, with respondents from across gender, age group, ethnicity and first aid experience. Out of 19 given signs and symptoms of head injury, participants could differentiate the most serious (e.g. unconsciousness 92% call 999) from those that could be observed (e.g. nausea 5%, and altered behaviour 5–30% call 999). The proportion of ‘correct’ actions ranged from just below half to almost 100%. Those aged 18–24 had a lower percentage of correct answers. Focus groups and/or interviews were held with 44 participants. Hypothetical scenarios elicited a range of responses, from calling 999 in any instance, to not calling in serious situations. Participants described ‘life experience’ as influential in the decision whether to call 999 or feel confident to observe.ConclusionDistinguishing severity of head injury was reported as difficult and confidence about the best course of action was low. The study was limited by regional recruitment biases, but supports the need for public health guidance in head injury.

O conhecimento de idosos portadores de doenças crônicas não transmissíveis acerca de seu tratamento polimedicamentoso

OBJECTIVE: To evaluate the knowledge of elderly patients with chronic noncommunicable diseases about their treatment. METHODOLOGY: A descriptive exploratory study with a qualitative approach. The study sample was intentional, composed of 14 elderly patients, of both sexes, linked to the Diabetic Adult Nursing (EAD) agenda of the ambulatory of the Clinical Hospital of Porto Alegre. Data collection was carried out between September and December 2017.Results: The analysis resulted in two categories: Knowledge about the disease and pharmacological treatment and Use of medicinal plants. The results showed that: all had three or more noncommunicable diseases, with prevalence for Diabetes Mellitus and Systemic Arterial Hypertension; more than half used eight or more concomitant medications; all used medicinal plants concomitant with drug treatment. CONCLUSIONS: Patients have shown a lay understanding of their illnesses and a poor understanding of drug treatment, which may result in the risk of non-adherence to treatment and increased chances of adverse drug reactions.

University students’ understanding and perceptions of schizophrenia in the UK: a qualitative study

ObjectiveTo explore lay understanding and perceptions of schizophrenia in university students.DesignQualitative study using semi-structured interviews and thematic analysis.SettingThe University of Birmingham, West Midlands.Participants20 UK home students of white British (n=5), Indian (n=5), Pakistani (n=5), African Caribbean (n=4) and dual white British and African Caribbean ethnicity (n=1).ResultsFindings revealed a lack of knowledge about schizophrenia, particularly the negative symptoms that were not mentioned. There were mixed ideas on the causes and sources of available help for schizophrenia; however, positively many said they would consult their general practitioner. While there was a general misconception among the students that schizophrenia caused multiple personalities and was a dangerous illness, there were some differences in perceptions and understanding between ethnic groups, with more Indian students perceiving upbringing as a causal factor in the development of the illness and more Pakistani students perceiving possession by a spirit as a cause.ConclusionsThe university students interviewed lacked knowledge about schizophrenia and stigma was widespread, both of which may delay help-seeking. Public health campaigns educating young people about schizophrenia are required to improve early identification and intervention and improve outcomes. Further research exploring ways to effectively tackle stigma is also required.

Indeed, not really a brain disorder: Implications for reductionist accounts of addiction

Borsboom et al.’s formulation provides an opportunity for a fundamental rethink about the “brain disease model” of addiction that dominates research, treatment, policy, and lay understanding of addiction. We also demonstrate how the American opioid crisis provides a contemporary example of how “brain disease” is not moderated by the environmental context but is instead crucially dependent upon it.