Pain vs. comfort diary: A fully remote app-based experiment

Linking physical activity to workers' low back pain, back health, and theory-based psychological variables: study protocol of the workHealth intensive longitudinal observational study

BACKGROUND

The high prevalence of low back pain (LBP) in today's working population and its substantial impact on quality of life call for preventive and sustainable strategies. Physical activity (PA), especially during leisure-time (LTPA), has been proposed as one of the few promising, active preventive measures against the onset of LBP. This is the protocol for the prospective observational study workHealth that aims to describe the patterns of PA among workers (including back posture and movement), examine the link between PA, LBP and back health and identify theory-based psychological determinants of LTPA.

METHODS

The proposed study is a longitudinal observational study taking place over 2 months with an intensive-longitudinal ecological momentary assessment (EMA) phase. A sample of 252 adults will be recruited from two working populations, sedentary workers, and manually working physiotherapists. At baseline, participants complete a self-report questionnaire and undergo an objective measurement of their back posture and mobility. At 2, 4, and 8 weeks after baseline, participants fill in the follow-up questionnaires. Starting at baseline, participants will also wear an accelerometer and will complete three daily questionnaires for the following 14 days. In addition to the main study, a sub-sample of 8 observational N-of-1 studies will have an extended EMA phase of 68 days and a data-driven exit interview. The primary outcome is moderate-to-vigorous LTPA. Data will be analyzed using regression and multi-level models. For the N-of-1 studies, a mixed-methods approach will be used including dynamic regressions.

DISCUSSION

Rather than solely examining LBP from a pathological perspective, workHealth is one of the first studies to investigate psychological, behavioral and biomechanical risk factors and protective resources against LBP. The study will offer insight into theory-based, psychological determinants of LTPA and its relationship to both low back pain and back health. Between-person and within-person level analyses will provide insight on group comparisons of average effects and individual patterns of physical activity in daily life, respectively. Understanding these relationships can inform future behavioral interventions and ultimately contribute to prevention efforts against LBP and the promotion of back health.

TRIAL REGISTRATION

German Clinical Trials Register DRKS00025296|| https://drks.de/ || Registration date 28/06/2021.

Parental anxiety and depression are associated with adverse mental health in children with special needs during the COVID-19 pandemic

Introduction

The coronavirus disease 2019 (COVID-19) pandemic has led to restrictions in various areas of life, including social life, work, leisure, health, and education. Vulnerable groups, such as children with special needs and their parents, may be at increased risk of experiencing exacerbated mental health problems during stressful periods such as the COVID-19 lockdowns.

Materials and methods

Telephone interviews were conducted with 954 parents of children with special needs. We assessed parental levels of generalized anxiety and depression using the validated GAD-7 and PHQ-8 scales. Parents were asked to rate family burden and their worry about the COVID-19 crisis, as well as their children's adverse mental health symptoms and health behaviors. Parents also reported their children's worries about the COVID-19 crisis. We conducted regressions to examine the relationship between parents' mental health problems and their children's adverse mental health symptoms and health behaviors. Qualitative data from open-ended questions were coded thematically and major themes of parental worry about the COVID-19 crisis were identified.

Results

Parental anxiety and depression symptoms predicted adverse mental health symptoms and behaviors in children with special needs. Criteria for current depression were met by 7.9% of parents of children with special needs, whereas 4.7% of the general population in Vorarlberg met the criteria for current depression according to data from the Austrian Health Interview Survey in 2019. Parental self-ratings of both depression and anxiety were highly correlated. The majority of parents reported being burdened (79.1%) or worried (67.8%) about the COVID-19 crisis. The main themes of parental worry about the COVID-19 crisis included COVID-19 infection (40.6%), economic situation (13.1%), uncertainty (8.4%), lack of social contact with family and friends (8.1%), family health status (7.5%), and school life (7.5%).

Discussion

Mental health symptoms in parents of children with special needs were strongly associated with increased adverse mental health symptoms and health behaviors in their children. Parents of children with special needs were more likely to be depressed during the COVID-19 pandemic than adults in 2019. We call for additional mental health support to reduce the mental health burden in families with children with special needs.

Pain Assessment in Oral Medicine through Its Different Dimensions: A Comprehensive Review

Orofacial pain is a complex experience made up of different features and involving various aspects of life. It has demonstrated a connection, especially when chronic, with conditions such as anxiety, depression, and sleep disorders, through paths that still have not been completely clarified. A deep understanding of orofacial pain and its impact on an individual's life is critical for planning accurate diagnostic and therapeutic approaches. This review seeks to provide a comprehensive overview of the components constituting the pain experience, its implications in an individual's life, the different tools for multidimensional pain assessment, and the specific applications for each tool. A comprehensive review was performed using the PubMed, Scopus, and Web of Science electronic databases. Ninety-five studies, including observational studies, clinical trials, case-control studies, and case reports, were included and analyzed in this review. Orofacial pain assessment exploits several methods, ranging from clinical evaluation to rating scales, questionnaires, and daily diaries. The choice of the correct instrument requires an evaluation of the type of pain experienced, of the patient's characteristics and abilities to complete particular tasks, and finally, of the assessment tool features.