ABSTRACT
Background: Enabling, supporting and promoting positive health-related behaviours is critical in addressing the major public health challenges of our time, and the multifaceted nature of behaviours requires an evidence-based approach. This statement seeks to suggest how a much-needed enhanced use of behavioural and cultural science and insights for health could be advanced. Study design and methods: and methods: Public health authorities of Europe and Central Asia and international partner organizations in September 2023 met in Copenhagen, Denmark, to discuss the way forward. Drawing on 1) country reporting to WHO, 2) interview study with public health authorities and 3) the meeting deliberations, this meeting statement was developed. Results: The meeting statement presents a joint call for step-change accelerated use of evidence-based approaches for health behaviours. Actionable next steps for public health authorities and international and regional development partners in health are presented. Conclusions: The way forward involves increased resource allocation, integration of behavioural insights into health strategies, advocacy through case and cost-effectiveness examples and capacity building.
ABSTRACT
Patients with complex regional pain syndrome (CRPS) report cognitive difficulties, affecting the ability to represent, perceive and use their affected limb. Moseley, Gallace & Spence (2009) observed that CRPS patients tend to bias the perception of tactile stimulation away from the pathological limb. Interestingly, this bias was reversed when CRPS patients were asked to cross their arms, implying that this bias is embedded in a complex representation of the body that takes into account the position of body-parts. Other studies have failed to replicate this finding (Filbrich et al., 2017) or have even found a bias in the opposite direction (Sumitani et al., 2007). Moreover, perceptual biases in CRPS patients have not often been compared to these of other chronic pain patients. Chronic pain patients are often characterized by an excessive focus of attention for bodily sensations. We might therefore expect that non-CRPS pain patients would show a bias towards instead of away from their affected limb. The aim of this study was to replicate the study of Moseley, Gallace & Spence (2009) and to extend it by comparing perceptual biases in a CRPS group with two non-CRPS pain control groups (i.e., chronic unilateral wrist and shoulder pain patients). In a temporal order judgment (TOJ) task, participants reported which of two tactile stimuli, one applied to either hand at various intervals, was perceived as occurring first. TOJs were made, either with the arms in a normal (uncrossed) position, or with the arms crossed over the body midline. We found no consistent perceptual biases in either of the patient groups and in either of the conditions (crossed/uncrossed). Individual differences were large and might, at least partly, be explained by other variables, such as pain duration and temperature differences between the pathological and non-pathological hand. Additional studies need to take these variables into account by, for example, comparing biases in CRPS (and non-CRPS) patients in an acute versus a chronic pain state.
ABSTRACT
During medical examinations, doctors regularly investigate a patient's somatosensory system by approaching the patient with a medical device (e.g. Von Frey hairs, algometer) or with their hands. It is assumed that the obtained results reflect the true capacities of the somatosensory system. However, evidence from crossmodal spatial research suggests that sensory experiences in one modality (e.g. touch) can be influenced by concurrent information from other modalities (e.g. vision), especially near the body (i.e. in peripersonal space). Hence, we hypothesized that seeing someone approaching your body could alter tactile sensitivity in that body-part. In the In Vivo Approaching Object (IVAO) paradigm, participants detected and localized threshold-level vibrotactile stimuli administered on the left of right hand (=tactile targets). In Experiment 1, this was always preceded by the experimenter approaching the same (congruent trials) or the other (incongruent trials) hand with a pen (=visual cue). In Experiment 2, a condition was added in which a point further away from the hands (also left vs. right) was approached. Response Accuracy was calculated for congruent and incongruent trials (Experiment 1 & 2) and compared between the close and far condition (Experiment 2). As expected, Response Accuracy was higher in congruent trials compared to incongruent trials, but only near the body. As a result, evidence was found for a crossmodal interaction effect between visual and tactile information in peripersonal space. These results suggest that somatosensory evaluations-both medical or research-based-may be biased by viewing an object approaching the body.
