Interventions sur les facteurs de risque psychosociaux dans la lombalgie aiguë ou subaiguë en soins primaires : revue de littérature

Contexte. La lombalgie chronique est un problème récurrent en médecine générale. Des facteurs psychosociaux semblent impliqués dans le passage à la chronicité. L’objectif principal de cette revue était d’identifier et de décrire les études traitant d’interventions sur des facteurs psychosociaux dans la lombalgie (sub)aiguë en soins primaires. L’objectif secondaire était d’en analyser l’efficacité.Méthode. Une recherche systématique a été réalisée dans les principales bases de données biomédicales, et les articles pertinents ont été sélectionnés. Les caractéristiques des interventions ont été décrites, et les principaux résultats analysés. Résultats. Parmi les 513 études identifiées, 10 ont été retenues. Toutes les interventions comprenaient une part éducationnelle, surtout fondée sur une brochure : le « Back Book ». Certaines reposaient, en plus, sur une thérapie à orientation cognitivo-comportementale. Une autre était centrée sur la coordination en milieu de travail. Dans ces articles, la description des interventions et de la théorie sous-jacente était souvent insuffisante. Leur impact était modeste sur le pronostic des patients. Conclusion. Les recommandations actuelles sur la prise en charge de la lombalgie (sub)aiguë en soins primaires n’intègrent pas encore les résultats de ces études, mais cette revue apporte peu d’arguments pour les modifier en faveur des interventions identifiées. Des interventions plus individualisées pourraient être une autre voie pour améliorer le pronostic des patients ayant des facteurs de risque psychosociaux

Interventions focusing on psychosocial risk factors for patients with non-chronic low back pain in primary care--a systematic review

BACKGROUND: Low back pain (LBP) is a problem that is frequently encountered in primary care, and current guidelines encourage care providers to take into account psychosocial risk factors in order to avoid transition from acute to chronic LBP. OBJECTIVE: To review the effectiveness of interventions focusing on psychosocial risk factors for patients with non-chronic LBP in primary care. METHODS: A systematic search was undertaken for controlled trials focusing on psychosocial factors in adult patients with non-chronic, non-specific LBP in primary care by exploring Medline, Embase, PsycInfo, Francis, Web of Sciences and The Cochrane Library. The methodological quality of the studies included was assessed before analysing their findings. RESULTS: Thirteen studies were selected, seven being considered as having a low risk of bias. Information strategies were assessed by eight trials, with high-quality evidence of no effectiveness for pain, function, work issues and health care use, low-quality evidence of no effectiveness for self-rated overall improvement, satisfaction and pain beliefs and lack of evidence in terms of quality of life. Cognitive behavioural therapy was assessed by three trials, with very low-quality evidence of moderate effectiveness for pain, function, quality of life, work issues and health care use. There was lack of evidence concerning the effectiveness of individual and group education intervention or work coordination. CONCLUSION: Among the wide range of psychosocial risk factors, research has focused mainly on pain beliefs and coping skills, with disappointing results. Extended theoretical models integrating several psychosocial factors and multicomponent interventions are probably required to meet the challenge of LBP

Global maps of soil temperature.

Research in global change ecology relies heavily on global climatic grids derived from estimates of air temperature in open areas at around 2 m above the ground. These climatic grids do not reflect conditions below vegetation canopies and near the ground surface, where critical ecosystem functions occur and most terrestrial species reside. Here, we provide global maps of soil temperature and bioclimatic variables at a 1-km <sup>2</sup> resolution for 0-5 and 5-15 cm soil depth. These maps were created by calculating the difference (i.e. offset) between in situ soil temperature measurements, based on time series from over 1200 1-km <sup>2</sup> pixels (summarized from 8519 unique temperature sensors) across all the world's major terrestrial biomes, and coarse-grained air temperature estimates from ERA5-Land (an atmospheric reanalysis by the European Centre for Medium-Range Weather Forecasts). We show that mean annual soil temperature differs markedly from the corresponding gridded air temperature, by up to 10°C (mean = 3.0 ± 2.1°C), with substantial variation across biomes and seasons. Over the year, soils in cold and/or dry biomes are substantially warmer (+3.6 ± 2.3°C) than gridded air temperature, whereas soils in warm and humid environments are on average slightly cooler (-0.7 ± 2.3°C). The observed substantial and biome-specific offsets emphasize that the projected impacts of climate and climate change on near-surface biodiversity and ecosystem functioning are inaccurately assessed when air rather than soil temperature is used, especially in cold environments. The global soil-related bioclimatic variables provided here are an important step forward for any application in ecology and related disciplines. Nevertheless, we highlight the need to fill remaining geographic gaps by collecting more in situ measurements of microclimate conditions to further enhance the spatiotemporal resolution of global soil temperature products for ecological applications