Effect and safety of listening to music or audiobooks as a coadjuvant treatment for chronic pain patients under opioid treatment: a study protocol for an open-label, parallel-group, randomised, controlled, proof-of-concept clinical trial in a tertiary hospital in the Barcelona South Metropolitan area.

BACKGROUND: Chronic non-cancer pain (CNCP) treatment's primary goal is to maintain physical and mental functioning while improving quality of life. Opioid use in CNCP patients has increased in recent years, and non-pharmacological interventions such as music listening have been proposed to counter it. Unlike other auditive stimuli, music can activate emotional-regulating and reward-regulating circuits, making it a potential tool to modulate attentional processes and regulate mood. This study's primary objective is to provide the first evidence on the distinct (separate) effects of music listening as a coadjuvant maintenance analgesic treatment in CNCP patients undergoing opioid analgesia. METHODS AND ANALYSIS: This will be a single-centre, phase II, open-label, parallel-group, proof-of-concept randomised clinical trial with CNCP patients under a minimum 4-week regular opioid treatment. We plan to include 70 consecutive patients, which will be randomised (1:1) to either the experimental group (active music listening) or the control group (active audiobooks listening). During 28 days, both groups will listen daily (for at least 30 min and up to 1 hour) to preset playlists tailored to individual preferences.Pain intensity scores at each visit, the changes (differences) from baseline and the proportions of responders according to various definitions based on pain intensity differences will be described and compared between study arms. We will apply longitudinal data assessment methods (mixed generalised linear models) taking the patient as a cluster to assess and compare the endpoints' evolution. We will also use the mediation analysis framework to adjust for the effects of additional therapeutic measures and obtain estimates of effect with a causal interpretation. ETHICS AND DISSEMINATION: The study protocol has been reviewed, and ethics approval has been obtained from the Bellvitge University Hospital Institutional Review Board, L'Hospitalet de Llobregat, Barcelona, Spain. The results from this study will be actively disseminated through manuscript publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT05726266.

Occupational balance of Spanish occupational therapists - a challenge.

BACKGROUND: Occupational balance is a central aspect in occupational therapy. Awareness of occupational balance/imbalance among occupational therapists could influence the orientation of their professional interventions. OBJECTIVE: To describe and compare the occupational balance status of occupational therapists working in Spain. MATERIAL AND METHODS: Cross-sectional descriptive study using an online questionnaire. Participants were occupational therapists working in Spain who answered a questionnaire including 22 questions on the sociodemographic and employment data and the Spanish version of the Occupational Balance Questionnaire (OBQ-E) ranging 0-65 where higher ratings equal better occupational balance. RESULTS: A total of 648 currently working occupational therapists participated. Mostly women, with median age of 32 years, without partner, children, or dependents. The median OBQ-E was 37 (IQR = 27; 45). Statistically significant differences were found between the medians of participants varying in the categories 'hired as an occupational therapist', weekly work hours, and population working with children and adults. CONCLUSIONS AND SIGNIFICANCE: Spanish occupational therapists presented a moderate occupational balance that varied between subgroups. Professional recognition, working hours, and the population they attend are aspects that influence their occupational balance. Knowledge of occupational therapists' occupational balance could contribute to the development of policies aimed at promoting it.

Intervenciones basadas en el ejercicio y el entorno para la prevención de caídas en personas con deterioro cognitivo que viven en centros de cuidado: revisión sistemática y metaanálisis / Interventions based on exercise and physical environment for preventing falls in cognitively impaired older people living in long-term care facilities: a systematic review and meta-analysis

Esta revisión evalúa la efectividad de las intervenciones que utilizan el ejercicio y/o la modificación ambiental para la prevención de caídas en ancianos institucionalizados con deterioro cognitivo. Durante julio de 2014 se consultaron las principales bases bibliográficas y recursos especializados sobre el tema. Se seleccionaron ensayos controlados aleatorizados sobre intervenciones destinadas a prevenir caídas, que incluían el ejercicio físico y/o modificaciones del entorno, aplicadas en esta población. Dos revisores valoraron independientemente la elegibilidad y la calidad metodológica de los estudios. Se agruparon los datos cuando fue adecuado. Se identificaron 14 estudios con 3.539 participantes que utilizaban el ejercicio y/o la modificación ambiental de forma única o combinada con otras intervenciones. Ambas intervenciones demostraron efectividad en la reducción del número de caídas, desde un enfoque combinado. No obstante, hacen falta más estudios para asegurar la efectividad del uso del ejercicio y del entorno para la prevención de caídas en esta población (AU)

This systematic review aims to report the effectiveness of interventions based on exercise and/or physical environment for reducing falls in cognitively impaired older adults living in long-term care facilities. In July 2014, a literature search was conducted using main databases and specialised sources. Randomised controlled trials assessing the effectiveness of fall prevention interventions, which used exercise or physical environment among elderly people with cognitive impairment living in long-term care facilities, were selected. Two independent reviewers checked the eligibility of the studies, and evaluated their methodological quality. If it was adequate, data were gathered. Fourteen studies with 3,539 participants using exercise and/or physical environment by a single or combined approach were included. The data gathered from studies that used both interventions showed a significant reduction in fall rate. Further research is needed to demonstrate the effectiveness of those interventions for preventing falls in the elderly with cognitive impairment living in long-term care establishments (AU)

[Interventions based on exercise and physical environment for preventing falls in cognitively impaired older people living in long-term care facilities: A systematic review and meta-analysis]. / Intervenciones basadas en el ejercicio y el entorno para la prevención de caídas en personas con deterioro cognitivo que viven en centros de cuidado: revisión sistemática y metaanálisis.

This systematic review aims to report the effectiveness of interventions based on exercise and/or physical environment for reducing falls in cognitively impaired older adults living in long-term care facilities. In July 2014, a literature search was conducted using main databases and specialised sources. Randomised controlled trials assessing the effectiveness of fall prevention interventions, which used exercise or physical environment among elderly people with cognitive impairment living in long-term care facilities, were selected. Two independent reviewers checked the eligibility of the studies, and evaluated their methodological quality. If it was adequate, data were gathered. Fourteen studies with 3,539 participants using exercise and/or physical environment by a single or combined approach were included. The data gathered from studies that used both interventions showed a significant reduction in fall rate. Further research is needed to demonstrate the effectiveness of those interventions for preventing falls in the elderly with cognitive impairment living in long-term care establishments.