The Maltese version of the DN4 questionnaire : initial validation to assess neuropathic pain in patients with chronic spinal or spinal-radicular pain

Background: Neuropathic pain is frequently encountered in patients with spinal and spinal-related pain which needs specific treatment. Therefore, the objective of this study was to do an initial linguistic translation and validation of the Maltese DN4 questionnaire to diagnose neuropathic pain in this population. Methods: The study was designed as a single-blinded, observational, prospective collected data and retrospective analysis. The English and French DN4 questionnaires underwent forward and backward translation, literal assessment and adaptation of the semantic equivalence into the Maltese language, followed by assessment of the Maltese DN4 during the initial patient assessment in patients who met the inclusion criteria. Results: The total Maltese DN4 score obtained a Cronbach’s alpha of 0.735 therefore having satisfactory internal consistency. Test-retest using the Intraclass Correlation Coefficient (95% CI) ranged from 0.975 to 0.991 (p=0.000), while inter-rater agreement using Intraclass Correlation Coefficient (95% CI) ranged from 0.986 to 0.995 (p=0.000). Test-retest reliability yielded an intraclass correlation coefficient (95% CI) ranging from 0.975 to 0.991 (p < 0.001), while inter-rater reliability yielded an intraclass correlation coefficient (95% CI) ranging from 0.986 to 0.995 (p < 0.001). Both the English and the Maltese DN4 questionnaires obtained the same sensitivity and specificity values of 0.422 and 0.941 respectively, and a positive likehood ratio of 7.153 and a negative likehood ratio of 0.614, at a cutoff score of 4. Conclusion: The results of this study support the transcultural internal consistency, inter-rater, test-retest reliability, validity of the Maltese DN4 questionnaire to differentiate between neuropathic and nociceptive pain in patients with chronic spinal and spinal-radicular pain. Therefore, this simple tool can be used both in daily clinical practice but also in the clinical research setting to quickly screen for neuropathic pain.peer-reviewe

Nicotine dependence and the International Association for the Study of Pain neuropathic pain grade in patients with chronic low back pain and radicular pain : is there an association?

Background: This study investigated whether current smoking and a higher nicotine dependency were associated with chronic low back pain (LBP), lumbar related leg pain (sciatica) and/or radicular neuropathic pain.Methods: A cross-sectional study was conducted on 150 patients (mean age, 60.1 ± 13.1 yr). Demographic data, the International Association for the Study of Pain (IASP) neuropathic pain grade, STarT Back tool, and the Fagerström test were com- pleted. A control group (n = 50) was recruited.Results: There was a significant difference between current smokers and non- smokers in the chronic LBP group in the mean pain score (P = 0.025), total STarT Back score (P = 0.015), worst pain location (P = 0.020), most distal pain radiation (P = 0.042), and in the IASP neuropathic pain grade (P = 0.026). There was a significant difference in the mean Fagerström score between the four IASP neuropathic pain grades (P = 0.005). Current smoking yielded an odds ratio (OR) of 3.071 (P = 0.011) for developing chronic LBP and sciatica, and an OR of 4.028 (P = 0.002) for obtaining an IASP “definite/probable” neuropathic pain grade, for both cohorts. The likelihood for chronic LBP and sciatica increased by 40.9% (P = 0.007), while the likelihood for an IASP neuropathic grade of “definite/probable” increased by 50.8% (P = 0.002), for both cohorts, for every one unit increase in the Fagerström score.Conclusions: A current smoking status and higher nicotine dependence increase the odds for chronic LBP, sciatica and radicular neuropathic pain.peer-reviewe

Is chronic low back pain and radicular neuropathic pain associated with smoking and a higher nicotine dependence? A cross-sectional study using the DN4 and the Fagerström test for nicotine dependence

Objectives: To evaluate, if a current smoking status and a higher nicotine dependence were associated with chronic low back pain (LBP) and/or radicular neuropathic leg pain. Methods: The study was designed as a cross-sectional study on the first eligible consecutive 120 patients. Demographic data, pain intensity, worst pain location, most distal pain radiation, the DN4 questionnaire, STarT back tool, and the Fagerström test were collected during the initial examination. An age- and gender-matched control group (n=50), free from chronic LBP was recruited. Results: In the chronic pain group, there was a significant difference between smokers and lifetime non-smokers in the average pain intensity score (p=0.037), total DN4 score (p=0.002), STarT Back tool (p=0.006), worst pain location (p=0.023), and the most distal pain radiation (p=0.049). The mean total DN4 score increased with a corresponding increase in the number of cigarettes smoked daily (p=0.002). Current smokers had an OR of 3.071 (p=0.013) (95% CI 1.268–7.438) for developing chronic LBP and lumbar related leg pain and an OR of 6.484 (p<0.001) (95% CI 2.323–18.099) for developing chronic radicular neuropathic leg pain. For every one-unit increase in the Fagerström test score, the likelihood for chronic LBP and lumbar related leg pain increased by 40.71% (p=0.008) (95% CI 1.095–1.809) and for chronic radicular neuropathic leg pain increased by 71.3% (p<0.001) (95% CI 1.292–2.272). Conclusion: A current smoking status and a nicotine dependence were both independently associated with an increased risk for chronic LBP and/or chronic radicular neuropathic leg pain.peer-reviewe

Unpublished Mediterranean and Black Sea records of marine alien, cryptogenic, and neonative species

To enrich spatio-temporal information on the distribution of alien, cryptogenic, and neonative species in the Mediterranean and the Black Sea, a collective effort by 173 marine scientists was made to provide unpublished records and make them open access to the scientific community. Through this effort, we collected and harmonized a dataset of 12,649 records. It includes 247 taxa, of which 217 are Animalia, 25 Plantae and 5 Chromista, from 23 countries surrounding the Mediterranean and the Black Sea. Chordata was the most abundant taxonomic group, followed by Arthropoda, Mollusca, and Annelida. In terms of species records, Siganus luridus, Siganus rivulatus, Saurida lessepsianus, Pterois miles, Upeneus moluccensis, Charybdis (Archias) longicollis, and Caulerpa cylindracea were the most numerous. The temporal distribution of the records ranges from 1973 to 2022, with 44% of the records in 2020–2021. Lethrinus borbonicus is reported for the first time in the Mediterranean Sea, while Pomatoschistus quagga, Caulerpa cylindracea, Grateloupia turuturu, and Misophria pallida are first records for the Black Sea; Kapraunia schneideri is recorded for the second time in the Mediterranean and for the first time in Israel; Prionospio depauperata and Pseudonereis anomala are reported for the first time from the Sea of Marmara. Many first country records are also included, namely: Amathia verticillata (Montenegro), Ampithoe valida (Italy), Antithamnion amphigeneum (Greece), Clavelina oblonga (Tunisia and Slovenia), Dendostrea cf. folium (Syria), Epinephelus fasciatus (Tunisia), Ganonema farinosum (Montenegro), Macrorhynchia philippina (Tunisia), Marenzelleria neglecta (Romania), Paratapes textilis (Tunisia), and Botrylloides diegensis (Tunisia).peer-reviewe

Associations between sedentary behavior and health and the moderating role of physical activity in young people within a cross-sectional investigation

The purpose of this study was to determine the influence of sedentary behavior (SB) on the frequency of health complaints (fHC) as well as on self-rated health (SRH) and body mass index (BMI), and to determine whether physical activity (PA) moderated this influence. Data were obtained from the Youth Survey Luxembourg 2019 (N = 2,802), a nationally representative stratified random sample of all youths aged 16 to 29 years who were living in Luxembourg. fHC is a composite measure of eight common psychosomatic health complaints, SRH was measured on a five-point scale, and BMI was calculated by dividing participants’ body weight by the square of their body height (kg/m2). PA and SB values were obtained from factor analyses of the relevant questionnaire items. SB was evaluated as both leisure-time SB and gaming-associated SB. Multiple regression analyses adjusted for age, sex, socioeconomic status, and migration status were used to determine the association between SB, fHC, BMI, and SRH. We found that leisure-time SB was positively associated with fHC, but not with SRH or BMI. Gaming-associated SB was positively associated with fHC and BMI but was negatively associated with SRH. PA was negatively associated with fHC, BMI and SRH. No statistically significant moderating effects were observed. We found that both leisure-time and gaming-associated SB showed statistically significant impacts on health. Although PA is known to be beneficial to health, we conclude that its potential to mitigate the negative effects of SB is limited in young people

Associations between sedentary behavior and health and the moderating role of physical activity in young people within a cross-sectional investigation

The purpose of this study was to determine the influence of sedentary behavior (SB) on the frequency of health complaints (fHC) as well as on self-rated health (SRH) and body mass index (BMI), and to determine whether physical activity (PA) moderated this influence. Data were obtained from the Youth Survey Luxembourg 2019 (N = 2,802), a nationally representative stratified random sample of all youths aged 16 to 29 years who were living in Luxembourg. fHC is a composite measure of eight common psychosomatic health complaints, SRH was measured on a five-point scale, and BMI was calculated by dividing participants’ body weight by the square of their body height (kg/m2). PA and SB values were obtained from factor analyses of the relevant questionnaire items. SB was evaluated as both leisure-time SB and gaming-associated SB. Multiple regression analyses adjusted for age, sex, socioeconomic status, and migration status were used to determine the association between SB, fHC, BMI, and SRH. We found that leisure-time SB was positively associated with fHC, but not with SRH or BMI. Gaming-associated SB was positively associated with fHC and BMI but was negatively associated with SRH. PA was negatively associated with fHC, BMI and SRH. No statistically significant moderating effects were observed. We found that both leisure-time and gaming-associated SB showed statistically significant impacts on health. Although PA is known to be beneficial to health, we conclude that its potential to mitigate the negative effects of SB is limited in young people

Does Physical Activity Moderate The Influence Of Sedentary Behavior On Health In Young People?

PURPOSE: High level of sedentary behavior (SB) may cause a number of health complaints (nHC) and lead to reduced self-rated health (SRH) in young people. The purpose of this study was to determine the relationship between SB, the magnitude of nHC, SRH, body mass index (BMI), and whether the amount of physical activity (PA) moderates this relationship. METHODS: The data was obtained from Youth Survey Luxembourg 2019 (N = 2802). The population characteristics include sociodemographic data such as age, gender, and socio-economics status (SES) (0 = low to 18 = high). The severity of nHC was the sum score of headaches, stomach aches, back aches, depression, irritableness, nervousness, dizziness, and difficulty falling asleep (0 = low to 32 = high). BMI was calculated by dividing body weight to the square of body height (kg/m2). SRH was measured on a 5-point scale (1 = very good to 5 = very bad). PA and SB were generated from factor analyses of the questionnaire items. SB is separated between leisure and gaming. Multiple regression analysis, adjusted for age, gender, and SES, was used to determine the relationships between SB, nHC, BMI, and SRH, and the moderating effect of PA. RESULTS: Out of the participants, 54% were female and 46% were male with the mean age of 22 ± 4 years (16-29 years). The mean SES was 9.3 ± 2.2 (1-13), BMI was 23 ± 4 kg/m2 (14-47 kg/m2), severity of the nHC was 9 ± 6 (0-32), and SRH was 1.8 ± 0.6 (1-5). The multiple regression analysis shows that high SB through leisure is associated with more severe nHC (unstandardized coefficient b = .49, p < .01). However, PA can decrease nHC (b = .39, p < .01) for participants with high leisure SB. No association has been found between SRH, BMI, and leisure SB. Furthermore, an increase in SB through gaming is associated with higher BMI (b = .35, p < .01) and worse SRH (b = .09, p < .00). A relationship between the severity of nHC and gaming is not found. In all cases, a higher PA shows a significantly better nHC, SRH, and BMI. CONCLUSIONS: The results show that PA has a positive moderating effect of the relationship on leisure SB and nHC in young people in Luxembourg. Increased SB causes higher nHC, worse SRH, and higher BMI and young people who do more PA have lower severity in nHC, and better BMI and SRH. Therefore, it is important for young people to reduce SB and implement a sufficient amount of PA to improve overall health

Gesellschaftliche Kontextbedingungen für das Wohlbefinden und die Gesundheit von Jugendlichen in Luxemburg

WICHTIGE ERGEBNISSE AUS KAPITEL 3 - Gesamtgesellschaftliche und wohlfahrtsstaatliche Strukturen sind für das subjektive Wohlbefinden und die Gesundheit von Jugendlichen von zentraler Bedeutung und stehen im Zentrum dieses Kapitels. - Die luxemburgische Gesellschaft ist durch einen hohen Wohlstand, Migration und kulturelle Diversität, Mehrsprachigkeit und einen dynamischen, internationalen Arbeitsmarkt gekennzeichnet. - Der luxemburgische Wohlfahrtsstaat verfügt über ein gut ausgebautes Gesundheitswesen und ist durch ein hohes „Investment“ in Soziales und Gesundheit gekennzeichnet. - In den vergangenen Jahren ist in der luxemburgischen Bevölkerung ein starker Anstieg an hohen Bildungsabschlüssen zu verzeichnen. Dieser Trend zeigt sich besonders deutlich in den jüngeren Altersgruppen. - Der demografische Wandel schreitet in Luxemburg langsamer voran als in vielen anderen Nachbarländern, der Anteil Jugendlicher an der Gesamtbevölkerung ist vergleichsweise hoch. - In Luxemburg existiert ein hoher allgemeiner Lebensstandard, allerdings sind Einkommen ungleich verteilt, die Lebenshaltungskosten (vor allem die Wohnkosten) sind hoch und das Armutsrisiko für unterschiedliche Gruppen, insbesondere auch für Jugendliche, ist hoch. - Die Jugendarbeitslosigkeit ist im Verhältnis zur allgemeinen Arbeitslosigkeit stärker ausgeprägt. - In der Folge von Covid-19 hat sich die wirtschaftliche Lage verschlechtert und die Jugendarbeitslosigkeit ist angestiegen