The impact of international videoconferencing among older adults and secondary students.

This study explores young adults' emotional affect and attitudes towards ageing, as well as older adults' emotional affect and self-esteem following participation in the intergenerational videoconferencing programme Smile Connect (SC). The sample consisted of 94 participants (46 older Spanish adults living in a care home in Spain and 48 young Italian adults -secondary students- learning Spanish at school in Italy). Each age group was divided into an intervention and control group. SC consists of twelve 30-minute chat sessions conducted via Skype between the target groups over six weeks. Pre and post evaluations were made to assess the affect level in both groups, self-esteem among older people, and the level of negative stereotypes about ageing among young adults. At the end of the SC, the intervention group of older adults recorded significantly improved scores in self-esteem compared to the control group. Young adults recorded a reduction in their negative stereotypes about old age after taking part in the SC programme compared to those who did not. These findings suggest that involvement in the SC programme helps to improve the emotional affect of older adults living in care homes, as well as change the negative stereotypes about ageing among young adults.

Manejo del dolor oncológico: revisión sistemática y valoración crítica de las guías de práctica clínica / Cancer pain management: systematic review and critical appraisal of clinical practice guidelines

Objetivo. La incidencia del manejo inadecuado del dolor oncológico es muy elevada a pesar de la multitud de guías de práctica clínica creadas. El objetivo es revisar de forma sistemática las guías de práctica clínica actuales sobre el manejo del dolor oncológico, analizar su metodología y contenido de forma crítica, y conocer su calidad y validez. Material y métodos. Revisión sistemática en las principales bases de datos en inglés, francés y español entre 2008 y 2013. Se realizó un análisis de la calidad metodológica con AGREE-II, incluyendo fiabilidad interobservador. Se extrajeron las recomendaciones, clasificándolas por categorías y nivel de evidencia, con el fin de realizar un análisis de la variabilidad entre las guías y de la validez de su contenido. Resultados. Seis guías fueron incluidas en el análisis, existiendo gran variabilidad tanto en la calidad formal y metodológica, como en el contenido y el nivel de evidencia de sus recomendaciones. La guía de Scottish Intercollegiate Guidelines Network fue la mejor valorada en AGREE-II mientras que la de la Sociedad Española de Oncología Médica resultó la peor valorada. La guía del Ministerio de Salud de Malasia fue la que contó con mayor validez, seguida por la Scottish Intercollegiate Guidelines Network. Conclusiones. Las guías actuales para el manejo del dolor en pacientes con cáncer presentan importantes limitaciones en su calidad y contenido. Entre las existentes, se recomiendan las del Ministerio de Salud de Malasia y Scottish Intercollegiate Guidelines Network, mientras que la de la Sociedad Española de Oncología Médica presenta oportunidades de mejora frente a estas (AU)

Objective. Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue. Materials and methods. A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness. Results. Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one. Conclusions. The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve (AU)

[Cancer pain management: Systematic review and critical appraisal of clinical practice guidelines]. / Manejo del dolor oncológico: revisión sistemática y valoración crítica de las guías de práctica clínica.

OBJECTIVE: Although several clinical practice guidelines have been developed in the last decades, cancer pain management is still deficient. The purpose of this work was to carry out a comprehensive and systematic literature review of current clinical practice guidelines on cancer pain management, and critically appraise their methodology and content in order to evaluate their quality and validity to cope with this public health issue. MATERIALS AND METHODS: A systematic review was performed in the main databases, using English, French and Spanish as languages, from 2008 to 2013. Reporting and methodological quality was rated with the Appraisal of Guidelines, Research and Evaluation II (AGREE-II) tool, including an inter-rater reliability analysis. Guideline recommendations were extracted and classified into several categories and levels of evidence, aiming to analyse guidelines variability and evidence-based content comprehensiveness. RESULTS: Six guidelines were included. A wide variability was found in both reporting and methodological quality of guidelines, as well as in the content and the level of evidence of their recommendations. The Scottish Intercollegiate Guidelines Network guideline was the best rated using AGREE-II, while the Sociedad Española de Oncología Médica guideline was the worst rated. The Ministry of Health Malaysia guideline was the most comprehensive, and the Scottish Intercollegiate Guidelines Network guideline was the second one. CONCLUSIONS: The current guidelines on cancer pain management have limited quality and content. We recommend Ministry of Health Malaysia and Scottish Intercollegiate Guidelines Network guidelines, whilst Sociedad Española de Oncología Médica guideline still needs to improve.

[Clinical approach to chronic lumbar pain: a systematic review of recommendations included in existing practice guidelines]. / Abordaje clínico del dolor lumbar crónico: síntesis de recomendaciones basadas en la evidencia de las guías de práctica clínica existentes.

This paper presents a systematic review of clinical practice guidelines based on evidence, with explicit recommendations on the treatment of chronic low back pain. The main objective was to analyze their content and provide a synthesis in order to improve the translation of this evidence into practice. The recommendations were analyzed and then classified by treatment; evidence level and strength of recommendation were identified and translated into our gradation system. Eight guidelines met the inclusion criteria. Exercise and back school treatment are shown as the best therapies. Pharmacotherapy is indicated during short periods of time. The guidelines analyzed show similar therapeutic approaches. The recommendations have been synthesized in order to allow clinical selection of the best treatment and avoid bad practices with their corresponding costs, providing a more efficient management of the patient.

Abordaje clínico del dolor lumbar crónico: síntesis de recomendaciones basadas en la evidencia de las guías de práctica clínica existentes / Clinical approach to chronic lumbar pain: a systematic review of recommendations included in existing practice guidelines

Se realizó una revisión sistemática de guías de práctica clínica basadas en evidencia que tuvieran recomendaciones explícitas sobre el tratamiento del dolor lumbar crónico, con el objetivo de analizar su contenido y proveer una síntesis que sirviese para su traslación a la práctica. Las recomendaciones se analizaron y clasificaron según el tipo de tratamiento; se identificó el nivel de evidencia y fuerza de recomendación de las mismas, traduciéndolos a un sistema de gradación común. Ocho guías cumplieron los criterios de inclusión. El ejercicio y la escuela de espalda se perfilan como la terapia más efectiva. La farmacoterapia está indicada durante cortos periodos. Las guías analizadas ofrecen vías de acción similares frente a los principales tratamientos. Se han resumido las recomendaciones de forma clara y estructurada para permitir una elección clínica de los tratamientos más adecuados, evitar gastos y recursos en tratamientos inútiles y una recuperación del paciente más eficiente (AU)

This paper presents a systematic review of clinical practice guidelines based on evidence, with explicit recommendations on the treatment of chronic low back pain. The main objective was to analyze their content and provide a synthesis in order to improve the translation of this evidence into practice. The recommendations were analyzed and then classified by treatment; evidence level and strength of recommendation were identified and translated into our gradation system. Eight guidelines met the inclusion criteria. Exercise and back school treatment are shown as the best therapies. Pharmacotherapy is indicated during short periods of time. The guidelines analyzed show similar therapeutic approaches. The recommendations have been synthesized in order to allow clinical selection of the best treatment and avoid bad practices with their corresponding costs, providing a more efficient management of the patient (AU)

Development and pilot test of a new set of good practice indicators for chronic cancer pain management.

BACKGROUND: Pain is among the most important symptoms in terms of prevalence and cause of distress for cancer patients and their families. However, there is a lack of clearly defined measures of quality pain management to identify problems and monitor changes in improvement initiatives. METHODS: We built a comprehensive set of evidence-based indicators following a four-step model: (1) review and systematization of existing guidelines to list evidence-based recommendations; (2) review and systematization of existing indicators matching the recommendations; (3) development of new indicators to complete a set of measures for the identified recommendations; and (4) pilot test (in hospital and primary care settings) for feasibility, reliability (kappa), and usefulness for the identification of quality problems using the lot quality acceptance sampling (LQAS) method and estimates of compliance. RESULTS: Twenty-two indicators were eventually pilot tested. Seventeen were feasible in hospitals and 12 in all settings. Feasibility barriers included difficulties in identifying target patients, deficient clinical records and low prevalence of cases for some indicators. Reliability was mostly very good or excellent (k > 0.8). Four indicators, all of them related to medication and prevention of side effects, had acceptable compliance at 75%/40% LQAS level. Other important medication-related indicators (i.e., adjustment to pain intensity, prescription for breakthrough pain) and indicators concerning patient-centred care (i.e., attention to psychological distress and educational needs) had very low compliance, highlighting specific quality gaps. CONCLUSIONS: A set of good practice indicators has been built and pilot tested as a feasible, reliable and useful quality monitoring tool, and underscoring particular and important areas for improvement.