PriSUD-Nordic-Diagnosing and Treating Substance Use Disorders in the Prison Population: Protocol for a Mixed Methods Study

Background

A large proportion of the prison population experiences substance use disorders (SUDs), which are associated with poor physical and mental health, social marginalization, and economic disadvantage. Despite the global situation characterized by the incarceration of large numbers of people with SUD and the health problems associated with SUD, people in prison are underrepresented in public health research.

Objective

The overall objective of the PriSUD (Diagnosing and Treating Substance Use Disorders in Prison)-Nordic project is to develop new knowledge that will contribute to better mental and physical health, improved quality of life, and better life expectancies among people with SUD in prison.

Methods

PriSUD-Nordic is based on a multidisciplinary mixed method approach, including the methodological perspectives of both quantitative and qualitative methods. The qualitative part includes ethnographic fieldwork and semistructured interviews. The quantitative part is a registry-based cohort study including national registry data from Norway, Denmark, and Sweden. The national prison cohorts will comprise approximately 500,000 individuals and include all people imprisoned in Norway, Sweden, and Demark during the period from 2000 to 2019. The project will investigate the prison population during three different time periods: before imprisonment, during imprisonment, and after release.

Results

PriSUD-Nordic was funded by The Research Council of Norway in December 2019, and funding started in 2020. Data collection is ongoing and will be completed in the first quarter of 2022. Data will be analyzed in spring 2022 and the results will be disseminated in 2022-2023. The PriSUD-Nordic project has formal ethical approval related to all work packages.

Conclusions

PriSUD-Nordic will be the first research project to investigate the epidemiology and the lived experiences of people with SUD in the Nordic prison population. Successful research in this field will have the potential to identify significant areas of benefit and will have important implications for ongoing policy related to interventions for SUD in the prison population.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35182

Prognostic values of physical examination findings in patients with chronic low back pain treated conservatively: a systematic literature review

BACKGROUND

Most patients undergo physical examination. However, low back pain can only rarely be clearly diagnosed as having an irrefutable pathoanatomic cause on the basis of the classical battery of noninvasive physical examination procedures. However, physical examination findings are also used to predict the prognosis of treatment of chronic low back pain. A systematic review of the clinical literature is needed for an understanding of findings in this area.

OBJECTIVES

To establish whether various physical examination procedures can be used to predict treatment outcome in the conservative (noninvasive) treatment of chronic low back pain.

DATA SOURCES

From 910 titles published between 1986 and 1998, 10 original research reports were selected. These were obtained by means of a computerized MEDLINE search through use of various combinations of the key words low back pain, treatment, physical findings, predictors, prognosis, prognostic factors, prognostic indicators, and predictors and outcome(s); manual search strategies were also used.

DATA SYNTHESIS

Articles that fitted the objectives of this review were retained and systematically reviewed for the prognostic value of the relevant tests/observations. In addition, results were studied in relation to type of outcome variable and type of treatment.

RESULTS

The most commonly investigated tests were lumbar range-of-motion tests, which were found to have a clear-cut significant predictive value in 3 of 9 studies. Further analyses in relation to definition of outcome (back-to-work or reduction of symptoms) were not possible because study results were usually not clearly reported for each definition and because therapies were multimodal rather than distinctly well defined.

CONCLUSIONS

This area has not been fully investigated. Therefore, there is no satisfactory answer to the question of whether some physical examination tests have a prognostic value in the conservative treatment of chronic low back pain.