Understanding chronic pain and disability in young people: a study with catalan schoolchildren

Understanding chronic pain and disability in young people: A study with Catalan schoolchildren Anna Huguet Roselló Tesis doctoral dirigida pel Dr. Jordi Miró Martínez Departament de Psicologia, Universitat Rovira I Virigili, Tarragona Juny, 2007 El dolor crònic i recurrent és un problema molt estès; de fet és considerat un problema de salut pública (Crombie i col., 1999); que requereix d'una atenció especial pel sofriment i la discapacitat que pot generar tant al mateix individu com a les persones més pròximes a aquest (família). El dolor ha estat motiu d'atenció dels éssers humans des dels inicis de la història (veure per exemple, Sabatowski i col., 2004). No obstant, i paradoxalment, el dolor en nens ha estat totalment mancat d'interès fins a la dècada dels 70. Afortunadament, la situació en l'àmbit del dolor pediàtric ha canviat dràsticament. Durant els últims 25 anys, hi ha hagut un augment d'interès per a l'estudi del dolor en nens. Cada vegada més recursos estan sent invertits pel seu tractament, i la recerca paral·lelament també ha anat en augment. Aquest interès, no obstant, no és evident a tot arreu. Per exemple, i tal i com Reinoso-Barbero reconeix (2003), el dolor crònic és encara el germà pobre de la recerca del dolor en adults a Espanya. A pesar de l'elevat número de nens en necessitat de tractament, pocs clínics i investigadors estan donant a aquest problema l'atenció que es mereix. Per tant, la majoria d'aquests no estan rebent el tractament més apropiat perquè els clínics no estan familiaritzats amb aquestes condicions cròniques, mesures d'avaluació, i estratègies d'intervenció. En general, es pot dir que aquests nens han de combatre contra el seu dolor per ells mateixos, la majoria de les vegades sense rebre un tractament apropiat pel seu problema. Al mateix temps, les preocupacions i el sofriment dels pares augmenta perquè el dolor dels nens no remet, i ells no saben què fer. El propòsit d'aquest estudi és ajudar a entendre millor els problemes de dolor en nens i adolescents. Per això la tesi planteja tres objectius generals. (1) Treballar en l'àmbit de l'avaluació del dolor, i desenvolupar, adaptar i estudiar les propietats psicomètriques d'instruments de mesura que contribueixen a fer una avaluació multicontextual de nens catalano-parlants amb problemes de dolor. (2) Treballar en l'àmbit de l'epidemiologia, i aportar dades sobre els índex de prevalença i incidència dels problemes de dolor crònic en la nostra població de nens i adolescents d'entre 8 i 16 anys. I, aportar dades sobre les característiques d'aquests problemes i l'impacte que aquests problemes tenen sobre la vida del mateix nen. (3) Treballar per en l'àmbit de la prevenció secundària, i identificar predictors de tipus psicosocial del dolor crònic i/o la discapacitat. Understanding chronic pain and disability in young people: A study with Catalan schoolchildren Anna Huguet Roselló Tesis doctoral dirigida pel Dr. Jordi Miró Martínez Departament de Psicologia, Universitat Rovira I Virigili, Tarragona Juny, 2007 Recurrent and chronic pain is a widespread problem; in fact it has been considered to be a public health issue (Crombie, et al., 1999), one that requires careful attention due to the enormous amount of suffering and functional disability that it may cause. Pain has attracted attention of the humans since earliest recorded history (see for example, Sabatowski et al., 2004). However, and somewhat paradoxically, pain in children was completely devoid of interest until 1970s. Fortunately, the field of pediatric pain has changed dramatically. Over the last 25 years, there has been an increased interest in the study of pain as it occurs in youth. More and more resources have been invested into its treatment and prevention, research has paralleled growth too. This interest, however, is not so evident everywhere. For example, and as Reinoso-Barbero acknowledged (2003), pediatric pain still seems to be the poor brother of pain research in Spain. That is, despite the significant number of children in need of treatment, few clinicians and researchers are giving the attention to this problem that it deserves. Thus, most of these children do not receive the most appropriate treatment because clinicians are not familiar with these chronic conditions, assessment tools, and intervention strategies. In general, it can be said that children have to fight against their pain on their own, most of the times without receiving an appropriate treatment for their problem. At the same time, parents' concerns and suffering rise because their child's pain does not remit, and they do not know what to do. The propose of this study is to better understand chronic pain problems among the general population of children and adolescents. This thesis has tree aims. (1) To develop and examine the psychometric properties of assessment measure which allow us to understand pain problems from a biopsychosocial perspective. (2) To estimate the prevalence and incidence of chronic pain problems in Catalan schoolchildren aged 8 to 16 years and to examine the impact of pain problems on children's quality of life. (3) To work on the field of the secondary prevention and to identify psychosocial prognostic factors of the children's functioning and/or the course of pain complaints

Estudi d'un receptari manuscrit català del s. XIX

L'objectiu d'aquesta comunicació ésdonar a conèixer les aportacions d'uns receptaris manuscrits catalans inèdits dels s. XVIII i XIX, per la informació que ens aporten de receptes utilitzades per malalties, de teràpia definida amb connotacions populars sorprenents. Són summament interessants per a l'investigador de les ciències mèdiques ja que hi apareixen aspectes inusuals a l'època, tant en un manuscrit com en l'altre que corresponen, àdhuc, sociològica, professional i terapèutica

In-line preconcentration capillary zone electrophoresis for the analysis of haloacetic acids in water

Two in-line enrichment procedures (large volume sample stacking (LVSS) and field amplified sample injection (FASI)) have been evaluated for the capillary zone electrophoresis (CZE) analysis of haloacetic acids (HAAs) in drinking water. For LVSS, separation on normal polarity by using 20 mM acetic acid-ammonium acetate (pH 5.5) containing 20% acetonitrile as BGE was required. For FASI, the optimum conditions were 25 s hydrodynamic injection (3.5 kPa) of a water plug followed by 25 s electrokinetic injection (-10 kV) of the sample, and 200 mM formic acid-ammonium formate buffer at pH 3.0 as BGE. For both FASI and LVSS methods, linear calibration curves (r2>0.992), limit of detection (LOD) on standards prepared in Milli-Q water (49.1-200 µg/L for LVSS and 4.2-48 µg/L for FASI), and both run-to-run and day-to-day precisions (RSD values up to 15.8% for concentration) were established. Due to the higher sensitive enhancement (up to 310-fold) achieved with FASI-CZE this method was selected for the analysis of HAAs in drinking water. However, for an optimal FASI application sample salinity was removed by solid phase extraction (SPE) using Oasis WAX cartridges. With SPE-FASI-CZE, method detection limits in the range 0.05-0.8 µg/L were obtained, with recoveries, in general, higher than 90% (around 65% for monochloroacetic and monobromoacetic acids). The applicability of the SPE-FASI-CZE method was evaluated by analyzing a drinking tap water from Barcelona where seven HAAs were found at concentration levels between 3-13 µg/L

Undergraduate psychology students' perceptions about the use of ICT for health purposes

Objective: Information and communication technologies (ICT) have great potential for health care. In this study we explore undergraduate psychology students' perceptions about different specific uses of ICT for health (i.e. online interventions, health information websites, telehealth and online social networks). A total of 113 students answered an online survey designed to gather their perceptions about the use of these four types of interventions for health purposes. Results: Results showed that online interventions and telehealth were assessed as the best ways of using ICT for health, while the worst way was using social networks for health. The most frequently mentioned advantages were related to the fact that ICT can help with access to information and/or treatments, and that they are comfortable. The most frequently mentioned disadvantages were related to the quality of the information (for social networks and health information websites) and the fact that they were considered impersonal (for telehealth and online interventions). Conclusions: Students were not very enthusiastic about the use of ICT for health. Education is needed to change these perceptions and increase the likelihood that they will incorporate ICT in their future practice

Design and Validation of a Questionnaire to Measure the Perception of Nursing Degree Students about the Learning Process in Primary Care

The aim of this study was to develop a tool for the evaluation of the learning process of the clinical practicum in primary care. The study was carried out in two phases: (1) identification of the categories that determine the perception of the nursing degree students about the learning process in the clinical practicum in primary care and the items for each category; and (2) cross-sectional study in a sample of 475 nursing degree students. The psychometric properties in terms of reliability (internal consistency) and construct validity were analyzed through a confirmatory factor analysis. Cronbach's alpha coefficient of internal consistency for the entire questionnaire was 0.93, and that for each of the categories was above 0.70 in all cases. The chi-squared test was statistically significant (2.84; p < 0.001). The confirmatory factor analysis produced a model of 6 dimensions and 41 items. The parameters were estimated through the least squares method. All saturations were statistically significant (p < 0.05). In view of the results of this study, it can be asserted that the questionnaire to measure the perception of the nursing degree students about the learning process in the community clinical practicum (QPCLP) presents good properties in terms of internal consistency and validity

A systematic review and meta-analysis on the efficacy of Internet-delivered behavioral activation

Behavioral activation (BA) is an evidence-based treatment for depression which has attracted interest and started to accumulate evidence for other conditions when delivered face-to-face. Due to its parsimoniousness, it is suitable to be delivered via the Internet. The goal of this systematic review and meta-analysis was to examine evidence from randomized controlled trials (RCTs) to determine the efficacy of Internet-based BA and assess the quality of this evidence.Studies were identified from electronic databases (EMBASE, ISI Web of Knowledge, Medline, CINHAL, PsychINFO, Cochrane) and reference lists of included studies. Two reviewers independently screened articles for inclusion and extracted data. They assessed the quality of evidence for each outcome using The Grading of Recommendations Assessment, Development and Evaluation framework.Nine RCTs on different forms of depression were included with 2157 adult participants. Random effects meta-analyses showed that in non-clinical settings, guided Internet-based BA was non-inferior to other forms of behavioral therapy and mindfulness (mainly very low to low quality evidence) and superior to physical activity (very low quality evidence), psychoeducation/treatment as usual (moderate quality evidence) and waitlist (low quality evidence) at reducing depression and anxiety outcomes at post-treatment and short follow-up.The poor quality of some of the findings means that results should be cautiously interpreted.Evidence for the efficacy of Internet-based BA as a treatment for depression is promising. However, high quality studies with longer follow-ups are needed to increase confidence in findings and determine its efficacy in clinical settings and other conditions

Treatment of Knee Osteoarthritis With Autologous Mesenchymal Stem Cells: Two-Year Follow-up Results

Producción CientíficaOsteoarthritis is the most prevalent joint disease and a frequent cause of joint pain, functional loss, and disability (1). Osteoarthritis often becomes chronic, and conventional treatments have demonstrated only modest clinical benefits, without lesion reversal (2). Cellbased therapies have shown encouraging results in both animal studies and a few human case reports.We have recently published the results of a pilot clinical trial designed to assess the feasibility and safety of osteoarthritis treatment with bone marrowYderived mesenchymal stromal cells (MSCs) in 12 patients with chronic knee pain unresponsive to conservative treatments and radiologic evidence of osteoarthritis (3). The patients were treated with autologous expanded bone marrow MSCs by intraarticular injection (40 106 cells), and clinical outcomes, including evaluations of pain, disability, and quality of life, were followed up for 1 year. Articular cartilage quality was assessed by quantitative magnetic resonance imaging (MRI) T2 mapping (3).2015-09-3