Quality of Life in Patients with Chronic Low Back Pain and Differences by Sex: A Longitudinal Study.

BACKGROUND: The experience of chronic low back pain has a significant impact on the quality of life of affected people, resulting in difficulties in performing basic activities of daily living. AIM: To study the perceived quality of life of people affected by chronic low back pain and the associated factors by sex. METHODS: A prospective, longitudinal and observational design was used. RESULTS: A total of 129 people (58.1% women) with chronic low back pain were studied. The mean pain intensity scores were of moderate severity (6.42 points), with a modest improvement at follow-up (6.17 points). Epidural nerve blocks were the most effective therapeutic intervention in reducing the intensity of pain. Participants described a negative perception of their health with regard to quality of life, with low scores for the two constructs both at baseline (health index, 0.444; perception of health, 38.76 points) and at follow-up (health index, 0.447; perception of health, 40.43 points). Participants had severe functional limitation scores (50.79 points). The results were significantly better among men. There was an inverse relationship between the average pain intensity (ß = -0.304; p < 0.001), functional limitation (ß = -0.466; p < 0.001) and mental health (ß = -0.565; p < 0.001) and quality of life. CONCLUSIONS: The chronification of low back pain complicates people's biopsychosocial adaptation to life. There is a longitudinal inverse association between pain and functional limitation and health-related quality of life.

Mortality and Quality of Life with Chronic Kidney Disease: A Five-Year Cohort Study with a Sample Initially Receiving Peritoneal Dialysis.

The quality of life, morbidity and mortality of people receiving renal replacement therapy is affected both by the renal disease itself and its treatment. The therapy that best improves renal function and quality of life is transplantation. OBJECTIVES: To study the quality of life, morbidity and mortality of people receiving renal replacement therapy over a five-year period. DESIGN: A longitudinal multicentre study of a cohort of people with chronic kidney disease. METHODS: Patients from the Girona health area receiving peritoneal dialysis were studied, gathering data on sociodemographic and clinical variables through an ad hoc questionnaire, quality of life using the SF-36 questionnaire, and social support with the MOS scale. RESULTS: Mortality was 47.2%. Physical functioning was the variable that worsened most in comparison with the first measurement (p = 0.035). Those receiving peritoneal dialysis (p = 0.068) and transplant recipients (p = 0.083) had a better general health perception. The social functioning of transplant recipients improved (p = 0.008). CONCLUSIONS: People with chronic kidney disease had a high level of mortality. The dimension of physical functioning worsens over the years. Haemodialysis is the therapy that most negatively effects general health perception. Kidney transplantation has a positive effect on the dimensions of energy/vitality, social functioning and general health perception.

Mental Health Screening of Healthcare Professionals Who Are Candidates for Psychological Assistance during the COVID-19 Pandemic.

Healthcare professionals (HCPs) are among those most affected by the COVID-19 health emergency, with many presenting symptoms of anxiety and depression. Research shows that one of the factors involved in mitigating the impact of stressful situations is the use of cognitive emotional regulation mechanisms. The aims of this study were (a) to describe the functional and dysfunctional cognitive emotional regulation mechanisms (FRMs and DRMs) by gender, (b) to screen the main group of healthcare professionals who are candidates to receive psychological assistance based on FRMs and DRMs, and (c) to determine the HCP profile of candidates for psychological assistance. A cross-sectional descriptive study was conducted. Data were obtained from an adhoc questionnaire-the Cognitive Emotional Regulation Questionnaire (CERQ-18), the Generalized Anxiety Disorder scale (GAD-7), and the nine-item Patient Health Questionnaire (PHQ-9). The representative sample comprised 1452 HCPs. The results revealed significant differences between men and women in the use of DRMs. Women showed a higher use of catastrophizing (≤0.001) and rumination (0.008). The screening procedure detected that 7.5% (109 cases) of the HCPs were candidates to receive psychological support. According to the results of this study, age group (30-39 years old), professional activity (being a nurse or nursing assistant), and having psychological symptoms of anxiety and depression are variables that independently increase the probability of requiring psychological assistance. The gender variable was not found to be an independent factor when it comes to receiving psychological support. In conclusion, it is necessary to consider the influence of cognitive emotional regulation strategies employed by HCPs in the screening of candidates for psychological assistance and design effective interventions to reverse the emotional distress caused by COVID-19.

TEMPO-Oxidized Cellulose Nanofibers: A Potential Bio-Based Superabsorbent for Diaper Production.

Single-use plastics are expected to disappear, mainly due to the rise of stricter regulations to combat their impact on the environment. As an example, the recent European Directive on Single-Use-Plastics (SUP) will be implemented between 2021 and 2024 and will directly prohibit the use of some SUP. Baby diapers are one of the most used single-used products in our daily lives, and it is estimated that most of the ~4000 diapers that each baby uses in their life go to landfill. Such diapers usually contain superabsorbent polymers (SAP) that are based on acrylic acid-acrylamide mixtures with high water retention capacity, but they are neither bio-based nor biodegradable. In this work, we have developed bio-based superabsorbent aerogels made of cellulose nanofibers (CNF) and propose their potential use in baby diapers. TEMPO-oxidized CNF at different oxidation degrees were prepared and tested. The obtained CNF exhibited higher free swelling capacity (FSC) than the commercial fluff pulp (ranging from 117.62% to 245.21% higher) and also than the diaper absorbent, except for CNF-5 (ranging from 31.56% to 54.55%), even under compression. Overall, the present work shows a case study where CNF could have a potential application with market opportunities.

Predictors of intentions to use cigarettes and electronic-cigarettes among high school students.

PURPOSE: Tobacco is the second most commonly used drug by Spanish high school students and e-cigarette use has increased over the last three years among this population. Students who reported smoking tobacco and/or e-cigarette use often have friends and family that also consume these substances. The aims of the present study were to: determine the prevalence of tobacco and electronic cigarette consumption among young adolescents, the age of initiation and the intention to consume both of these substances in the future; study the relationships between their current tobacco and e-cigarette consumption status, intentions to consume these substances in the future and the consumption of these substances by family members living in their home and friend's consumption status; investigate the relationship between their current tobacco and e-cigarette consumption status, friends' consumption status and their intention to consume each substance in the future; analyse the relationship between current consumption status, intentions to consume in the future and perceived risk; identify the main predictors of intentions to use these substances in the future. METHODS: A cross-sectional survey was conducted in 2017. The sample consisted of 468 school students in the first cycle of secondary education in Catalonia, Spain. The participants who were aged between 11 and 15 years old, with 49.4% being female. RESULTS: A stepwise binary logistic regression showed that the best predictors of the intention to smoke tobacco in the future were: having tried tobacco, being a current consumer, having a family member smoking at home and having a low perceived risk of smoking. The best predictors of the intention to use electronic cigarettes in the future were: having tried tobacco, being a current consumer and having friends who smoke or use electronic cigarettes. CONCLUSION: Smoking prevention programs must consider the social network surrounding teenagers, particularly close friends and family. Intervention strategies for delaying the onset of tobacco or e-cigarette consumption are greatly needed.

Case-based learning and simulation: useful tools to enhance nurses' education? Nonrandomized controlled trial.

PURPOSE: To compare skills acquired by undergraduate nursing students enrolled in a medical-surgical course. To compare skills demonstrated by students with no previous clinical practice (undergraduates) and nurses with clinical experience enrolled in continuing professional education (CPE). DESIGN: In a nonrandomized clinical trial, 101 undergraduates enrolled in the "Adult Patients 1" course were assigned to the traditional lecture and discussion (n = 66) or lecture and discussion plus case-based learning (n = 35) arm of the study; 59 CPE nurses constituted a comparison group to assess the effects of previous clinical experience on learning outcomes. METHODS: Scores on an objective structured clinical examination (OSCE), using a human patient simulator and cases validated by the National League for Nursing, were compared for the undergraduate control and intervention groups, and for CPE nurses (Student's t test). FINDINGS: Controls scored lower than the intervention group on patient assessment (6.3 ± 2.3 vs 7.5 ± 1.4, p = .04, mean difference, -1.2 [95% confidence interval (CI) -2.4 to -0.03]) but the intervention group did not differ from CPE nurses (7.5 ± 1.4 vs 8.8 ± 1.5, p = .06, mean difference, -1.3 [95% CI -2.6 to 0.04]). The CPE nurses committed more "rules-based errors" than did undergraduates, specifically patient identifications (77.2% vs 55%, p = .7) and checking allergies before administering medication (68.2% vs 60%, p = .1). CONCLUSIONS: The intervention group developed better patient assessment skills than the control group. Case-based learning helps to standardize the process, which can contribute to quality and consistency in practice: It is essential to correctly identify a problem in order to treat it. Clinical experience of CPE nurses was not associated with better adherence to safety protocols. CLINICAL RELEVANCE: Case-based learning improves the patient assessment skills of undergraduate nursing students, thereby preparing them for clinical practice.

[Cocaine abuse and multiple use of psychoactive substances in university students]. / Consumo de cocaína y policonsumo de sustancias psicoactivas en jóvenes universitarios.

OBJECTIVES: To identify the prevalence of cocaine consumption among university students and to analyse the use of other drugs among the regular cocaine consumers. METHOD: An observational, descriptive and cross-sectional study performed within the Education, Sciences and Psychology Faculties and the Nursing and Polytechnic Schools belonging to the University of Girona. The selected sample included 2139 first year university students. A self-constructed questionnaire was used to obtain the information regarding gender, age, Faculty, and the status of consume. RESULTS: The participants were 47.2% males and 52.8% females, with an age range between 17 and 35 years old (median=21 years, SD=3.14). One per-cent of the participants considered themselves usual cocaine consumers. Nine out of every 10 students also use alcohol (95.2%) and cannabis (90.5%). CONCLUSIONS: It has been shown that university students have health threatening habits, such as cocaine abuse. It is more common the use of other drugs among cocaine users than among non-consumers. Preventive and educational programs at the university may be required to reduce and prevent toxic substances abuse among university students.

[What kind of help do parents with newborns in the neonatal intensive care unit seek?]. / ¿Qué tipo de ayuda demandan los padres de recién nacidos hospitalizados en cuidados intensivos neonatales?

The aim of this article was to identify the kind of help that parents with newborns admitted to the neonatal intensive care unit seek from health professionals in general and from nurses specifically. Two personal interviews were conducted with the parents (father or mother) of four hospitalized neonates. The parents volunteered to participate. Through the use of previously-established, open-ended questions and under conditions facilitating a supportive relationship, the parents were interviewed by a nurse who listened actively, tried to understand, and validated their feelings. During the interview, the parents had the opportunity to express their feelings and experiences. At the same time, these interviews increased the data available on the type of help needed by parents, taking into account both nursing care planning and the type of nursing interventions to be performed in these families. The results show that most of the help required by families is related to their own needs: communication, learning and feeling occupied. We present a standardized care plan that follows the NANDA, NOC and NIC taxonomies and shows how these needs could be managed by nursing professionals, based on a supportive relationship that includes three main elements: respect, understanding, and empathy.