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Miro J.,Unit for the Study and Treatment of Pain ALGOS | Miro J.,Institute dInvestigacio Sanitaria Pere Virgili | Miro J.,Rovira i Virgili University | Huguet A.,Unit for the Study and Treatment of Pain ALGOS | Jensen M.P.,University of Washington
Pain Medicine (United States)

Objective: Pain attitudes and beliefs are hypothesized to influence pain and adjustment to pain. Valid and reliable measures of these beliefs are necessary to test their hypothesized associations with outcomes. The Pediatric version of the Survey of Pain Attitudes (Peds-SOPA) is a new measure with limited evidence regarding its psychometric properties. This study sought to: 1) evaluate the predictive validity, reliability, and factor structure of the Peds-SOPA; and 2) determine if there are sex- or age-related differences in children's attitudes toward pain. Design: Longitudinal study. Participants: Five hundred and sixty-one schoolchildren between 8 and 16 years old participated in this study. Results: Factor analyses supported the seven-factor structure described by the original authors. The Peds-SOPA showed acceptable reliability with Cronbach alpha values ranging from 0.68 to 0.80. The Peds-SOPA scales also demonstrated prospective predictive validity via their associations with pain intensity, and pain status at 1-year follow-up. The findings also showed some few sex- and age-specific differences in the Peds-SOPA scores. Conclusions: The current findings provide additional support for the reliability and validity of the Peds-SOPA, and suggest that children's pain attitudes and beliefs might be important intervention targets in pain treatment. © 2014 American Academy of Pain Medicine. Source

Guix J.,Servei Regional al Camp de Tarragona | Guix J.,Rovira i Virgili University | Guix J.,Institute dInvestigacio Sanitaria Pere Virgili | Bocio A.,Servei Regional al Camp de Tarragona | And 7 more authors.
Gaceta Sanitaria

Public health action on a territory is complex and requires the involvement of multiple actors, who do not always act coordinately. Networks of organizations structures including the whole of the local actors facilitate the generation of synergies and enable greater effectiveness and efficiency of the joint action from the different actors on a same landscape. We present 3 years experience of four Public Health Committees in a region of Catalonia (Spain), composed by the main actors in public health planning. Each of the committees is organized on a plenary and working groups on issues arising from the regional health diagnosis, and coincident with the Health Plan of the Region. Coordination in no case implies the loss or dilution of the firm of the actor generator of intervention initiative in public health, but their empowerment and collaboration by the other actors. In conclusion welcomes the creation of a culture of collaboration and synergies between the different organizations concerned. Lack of specificity is observed in establishing operational objectives, and the need for greater coordination and involvement of the components of the various working groups. © 2012 SESPAS. Source

Miro J.,Unit for the Study and Treatment of Pain ALGOS | Miro J.,Research Center for Behavior Assessment | Miro J.,Institute dInvestigacio Sanitaria Pere Virgili | de la Vega R.,Unit for the Study and Treatment of Pain ALGOS | And 11 more authors.
Disability and Rehabilitation

Purpose: The purpose of this study is to identify the cutoffs that are most suitable for classifying average and worst pain intensity as being mild, moderate, or severe in young people with physical disabilities. Method: Survey study using a convenience sample of 113 young people (mean age = 14.19; SD = 2.9; age range: 8–20) with physical disabilities (namely, spinal cord injury, cerebral palsy, spina bifida, limb deficiency (acquired or congenital), or neuromuscular disease). Results: The findings support a non-linear association between pain intensity and pain interference. In addition, the optimal cutoffs for classifying average and worst pain as mild, moderate, or severe differed. For average pain, the best cutoffs were the following: 0–3 for mild, 4–6 for moderate, and 7–10 for severe pain, whereas the optimal classification for worst pain was 0–4 for mild, 5–6 for moderate, and 7–10 for severe pain. Conclusions: The findings provide important information that may be used to help make decisions regarding pain treatment in young people with disabilities and also highlight the need to use different cutoffs for classifying pain intensity in young people with disabilities than those that have been suggested for adults with chronic pain.Implications for rehabilitationMost clinical guidelines make treatment recommendations based on classifications of pain intensity as being mild, moderate, and severe that do not have a clear cut association with pain intensity ratings.Cutoffs that are deemed to be the most appropriate for classifying pain intensity as mild, moderate, and severe appear to depend, at least in part, on the pain population that is being studied and pain domain that is being used.This work helps to advance our knowledge regarding the meaning of pain intensity ratings in young people with physical disabilities.Clinicians can use this information to make empirically guided decisions regarding when to intervene in young people with disabilities and chronic pain. © 2016 Informa UK Limited, trading as Taylor & Francis Group Source

Diaz-Lopez A.,Institute dInvestigacio Sanitaria Pere Virgili | Diaz-Lopez A.,CIBER ISCIII | Bullo M.,Institute dInvestigacio Sanitaria Pere Virgili | Bullo M.,CIBER ISCIII | And 11 more authors.
Journal of Clinical Endocrinology and Metabolism

Context and Objective: Because it has been suggested that osteocalcin (OC), an osteoblast-derived hormone, is a new link between bone and glucose metabolism, we tested whether serum carboxylated osteocalcin (cOC) and undercarboxylated osteocalcin (ucOC) levels are independently associated with the development of type 2 diabetes in subjects at high cardiovascular risk. Design, Setting, and Participants: A prospective, nested case-control study was conducted using datafromthe Prevención con Dieta Mediterrá nea(PREDIMED)study.Weincluded 153 case subjects with newly diagnosed diabetes and 306 individually matched control subjects free of diabetes identified during a mean 5-year follow-up. Conditional logistic regression models were used to estimate matched odds ratios for incident diabetes according to categories of both forms of OC measured by ELISAs. Results: Baseline serum concentrations of both forms ofOCwere significantly lower in case subjects than in control subjects. In subjects with incident cases of diabetes, concentrations of cOC, but not of ucOC, were inversely and significantly associated with homeostasis model assessment of insulin resistance levels (β = -0.335) and with fasting glucose concentrations (β = -0.044) in control subjects, independent of other relevant confounders. In the conditional logistic model that took into account the matching factors, the odds ratios for diabetes incidence in the lowest vs the highest tertile of cOC and ucOC were 2.03 (95% confidence interval, 1.32-3.13) and 1.88 (1.23- 2.85), respectively. Further adjustment for family history of diabetes, lifestyle, and other confounding factors did not appreciably change the magnitude of these associations. Conclusion: In a population at high cardiovascular risk, low concentrations of serum cOC and ucOC were strongly associated with an increased risk of incident diabetes. Copyright © 2013 by The Endocrine Society. Source

Llaurado-Serra M.,Institute dInvestigacio Sanitaria Pere Virgili | Llaurado-Serra M.,University Hospital Joan | Llaurado-Serra M.,Rovira i Virgili University | Ulldemolins M.,Autonomous University of Barcelona | And 27 more authors.
Medicina Intensiva

Objectives: To evaluate head-of-bed elevation (HOBE) compliance in mechanically ventilated (MV) patients during different time periods, in order to identify factors that may influence compliance and to compare direct-observation compliance with checklist-reported compliance. Design and setting: A prospective observational study was carried out in a polyvalent Intensive Care Unit. Patients: All consecutive patients with MV and no contraindication for semi-recumbency were studied. Intervention and variables: HOBE was observed during four periods of one month each for one year, the first period being blinded. HOBE was measured with an electronic device three times daily. Main variables were HOBE, type of airway device, type of bed, nursing shift, day of the week and checklist-reported compliance. No patient characteristics were collected. Results: During the four periods, 2639 observations were collected. Global HOBE compliance was 24.0%, and the median angle head-of-bed elevation (M-HOBE) was 24.0° (IQR 18.8-30.0). HOBE compliance and M-HOBE by periods were as follows: blinded period: 13.8% and 21.1° (IQR 16.3-24.4); period 1: 25.5% and 24.3° (IQR 18.8-30.2); period 2: 22.7% and 24.4° (IQR 18.9-29.6); and period 3: 31.4% and 26.7° (IQR 21.3-32.6) (p<. 0.001). An overestimation of 50-60% was found when comparing self-reported compliance using a checklist versus direct-observation compliance (p<. 0.001).Multivariate logistic regression analysis found the presence of an endotracheal tube (ET) and bed without HOBE measuring device to be independently associated to greater compliance (p<. 0.05). Conclusions: Although compliance increased significantly during the study period, it was still not optimal. Checklist-reported compliance significantly overestimated HOBE compliance. The presence of an ET and a bed without HOBE measuring device was associated to greater compliance. © 2014 Elsevier España, S.L.U. and SEMICYUC. Source

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