Psychometric characteristics of the Spanish version of instruments to measure neck pain disability

Background: The NDI, COM and NPQ are evaluation instruments for disability due to NP. There was no Spanish version of NDI or COM for which psychometric characteristics were known. The objectives of this study were to translate and culturally adapt the Spanish version of the Neck Disability Index Questionnaire (NDI), and the Core Outcome Measure (COM), to validate its use in Spanish speaking patients with non-specific neck pain (NP), and to compare their psychometric characteristics with those of the Spanish version of the Northwick Pain Questionnaire (NPQ).Methods: Translation/re-translation of the English versions of the NDI and the COM was done blindly and independently by a multidisciplinary team. The study was done in 9 primary care Centers and 12 specialty services from 9 regions in Spain, with 221 acute, subacute and chronic patients who visited their physician for NP: 54 in the pilot phase and 167 in the validation phase. Neck pain (VAS), referred pain (VAS), disability (NDI, COM and NPQ), catastrophizing (CSQ) and quality of life (SF-12) were measured on their first visit and 14 days later. Patients' self-assessment was used as the external criterion for pain and disability. In the pilot phase, patients' understanding of each item in the NDI and COM was assessed, and on day 1 test-retest reliability was estimated by giving a second NDI and COM in which the name of the questionnaires and the order of the items had been changed.Results: Comprehensibility of NDI and COM were good. Minutes needed to fill out the questionnaires [median, (P25, P75)]: NDI. 4 (2.2, 10.0), COM: 2.1 (1.0, 4.9). Reliability: [ICC, (95%CI)]: NDI: 0.88 (0.80, 0.93). COM: 0.85 (0.75,0.91). Sensitivity to change: Effect size for patients having worsened, not changed and improved between days 1 and 15, according to the external criterion for disability: NDI: -0.24, 0.15, 0.66; NPQ: -0.14, 0.06, 0.67; COM: 0.05, 0.19, 0.92. Validity: Results of NDI, NPQ and COM were consistent with the external criterion for disability, whereas only those from NDI were consistent with the one for pain. Correlations with VAS, CSQ and SF-12 were similar for NDI and NPQ (absolute values between 0.36 and 0.50 on day 1, between 0.38 and 0.70 on day 15), and slightly lower for COM (between 0.36 and 0.48 on day 1, and between 0.33 and 0.61 on day 15). Correlation between NDI and NPQ: r = 0.84 on day 1, r = 0.91 on day 15. Correlation between COM and NPQ: r = 0.63 on day 1, r = 0.71 on day 15.Conclusion: Although most psychometric characteristics of NDI, NPQ and COM are similar, those from the latter one are worse and its use may lead to patients' evolution seeming more positive than it actually is. NDI seems to be the best instrument for measuring NP-related disability, since its results are the most consistent with patient's assessment of their own clinical status and evolution. It takes two more minutes to answer the NDI than to answer the COM, but it can be reliably filled out by the patient without assistance.

Energy transfer mechanism and Auger effect in Er3+ coupled silicon nanoparticle samples

We report a spectroscopic study about the energy transfer mechanism among silicon nanoparticles (Si-np), both amorphous and crystalline, and Er ions in a silicon dioxide matrix. From infrared spectroscopic analysis, we have determined that the physics of the transfer mechanism does not depend on the Si-np nature, finding a fast (< 200 ns) energy transfer in both cases, while the amorphous nanoclusters reveal a larger transfer efficiency than the nanocrystals. Moreover, the detailed spectroscopic results in the visible range here reported are essential to understand the physics behind the sensitization effect, whose knowledge assumes a crucial role to enhance the transfer rate and possibly employing the material in optical amplifier devices. Joining the experimental data, performed with pulsed and continuous-wave excitation, we develop a model in which the internal intraband recombination within Si-np is competitive with the transfer process via an Auger electron"recycling" effect. Posing a different light on some detrimental mechanism such as Auger processes, our findings clearly recast the role of Si-np in the sensitization scheme, where they are able to excite very efficiently ions in close proximity to their surface. (C) 2010 American Institute of Physics.

Musculoskeletal pain in female asylum seekers and hypovitaminosis D3

Résumé de l'article L'hypovitaminose D3 est bien connue et courante chez la population âgée en Occident. Toutefois, elle est probablement sous-diagnostiquée chez les jeunes femmes immigrantes, bien qu'elle soit bien documentée, principalement en Angleterre dans la population Indo-Pakistanaise. Lorsque ce déficit est diagnostiqué, le traitement substitutif est simple et bon marché. Nous avons suspecté une haute prévalence chez de jeunes femmes requérantes d'asile, surtout chez celles provenant de cultures différant quant à l'exposition solaire et la diète. Nous publions donc une série de 11 cas de patientes avec une hypovitaminose D symptomatique issues de la consultation générale de la Policlinique Médicale Universitaire. Toutes les patientes présentaient une anamnèse d'une faible exposition solaire et de douleurs osseuses diffuses, d'une fatigue, d'une faiblesse musculaire ou des modifications de la marche. Toutefois, les premiers diagnostics évoqués par les médecins étaient une possible somatisation (3 patientes), des douleurs dorso-lombaires chroniques (4 patientes) et des symptômes somatiques multiples et inexpliqués (3 patientes). Le diagnostic a été posé d'emblée chez une patiente seulement. La durée moyenne des plaintes avant la pose du diagnostic était de 38 mois et 5 jours. Avec le traitement de cholecalciférol et de calcium, les symptômes disparaissaient entre 1 et 3 mois, chez une patiente ils ont duré sept mois. Le taux moyen de 250H vitamine D3 était de 10.9 nmol/l (IR 21-131). Le taux moyen de calcium était de 2.19 mmol/l (2.15-2.55) et quatre patientes présentaient une hypocalcémie. Nous pensons donc que les femmes requérantes d'asile sont à risque d'une durée prolongée de symptômes, de part la possible haute prévalence de cette condition et la difficulté chez les médecins à la reconnaître. Le diagnostic d'hypovitaminose devrait être recherché chez les femmes requérantes d'asile souffrant de douleurs musculo-squelettiques de longue durée. Le premier diagnostic souvent évoqué, dans un contexte psychosocial souvent difficile, était de l'ordre d'un trouble somatoforme douloureux ou de somatisations. Toutefois, les douleurs liées à l'hypovitaminose D3 sont relativement bien définies ; elles sont symétriques, osseuses, débutent souvent dans la région lombaire pour ensuite s'étendre au bassin, aux membres inférieures proximalement et à la cage thoracique. Le traitement substitutif est simple, peu onéreux et il serait judicieux d'initier d'autres études pour évaluer le besoin d'une substitution de routine dans la population présentée. Abstract: Deficiency of vitamin D, which can lead to osteomalacia, is common in elderly patients in Western countries. However, it is still widely underdiagnosed in young immigrant women, even though the condition has been extensively reported in the immigrant Indo- Asian population in the United Kingdom since the 1960s. A recent study reports an average 59 months before diagnosis was established, and another study found a prevalence of 78% of hypovitaminosis D3 (compared with 58% in controls) in an Indo-Asian population attending a UK rheumatology clinic. When recognised, hypovitaminosis D3 is easily treatable. A study on osteomalacic myopathy in veiled Arabic women in Denmark found that muscle strength returned to normal (except in maximal voluntary con-traction) after six months' treatment. We expected to see this disease in female asylum seekers, especially in those from societies with different customs regarding exposure to sunlight and diet We report 11 cases of symptomatic hypovitaminosis D3 in female asylum seekers (table 1). We focus on the pathology encountered by the primary care doctors caring for these 11 patients, the length of time between the appearance of symptoms, and the establishment of the diagnosis of hypovitaminosis D3 as well as the women's response to treatment by the improvement of a wide range of clinical symptoms-bone pain, muscular weakness, and fatigue.

The maximun and the addition of assigment games

[cat] En el context dels mercats a dues bandes, considerem, en primer lloc, que els jugadors poden escollir on dur a terme les seves transaccions. Mostrem que el joc corresponent a aquesta situació, que es representa pel màxim d’un conjunt finit de jocs d’assignació, pot ser un joc no equilibrat. Aleshores proporcionem condicions per a l’equilibri del joc i, per aquest cas, analitzem algunes propietats del core del joc. En segon lloc, considerem que els jugadors poden fer transaccions en diversos mercats simultàniament i, llavors, sumar els guanys obtinguts. El joc corresponent, representat per la suma d’un conjunt finit de jocs d’assignació, és equilibrat. A més a més, sota certes condicions, la suma dels cores dels dos jocs d’assignació coincideix amb el core del joc suma.

Physical quality of an Oxisol cultivated with maize submited to cover crops in the pre-cropping period

The intensive use of land alters the distribution of the pore size which imparts consequences on the soil physical quality. The Least Limiting Water Range (LLWR) allows for the visualization of the effects of management systems upon either the improvement or the degradation of the soil physical quality. The objective of this study was to evaluate the physical quality of a Red Latosol (Oxisol) submited to cover crops in the period prior to the maize crop in a no-tillage and conventional tillage system, using porosity, soil bulk density and the LLWR as attributes. The treatments were: conventional tillage (CT) and a no-tillage system with the following cover crops: sunn hemp (Crotalaria juncea L.) (NS), pearl millet (Pennisetum americanum (L.) Leeke) (NP) and lablab (Dolichos lablab L.) (NL). The experimental design was randomized blocks in subdivided plots with six replications, with the plots being constituted by the treatments and the subplots by the layers analyzed. The no-tillage systems showed higher total porosity and soil organic matter at the 0-0.5 m layer for the CT. The CT did not differ from the NL or NS in relation to macroporosity. The NP showed the greater porosity, while CT and NS presented lower soil bulk density. No < 10 % airing porosity was found for the treatments evaluated, and value for water content where soil aeration is critical (θPA) was found above estimated water content at field capacity (θFC) for all densities. Critical soil bulk density was of 1.36 and 1.43 Mg m-3 for NP and CT, respectively. The LLWR in the no-tillage systems was limited in the upper part by the θFC, and in the bottom part, by the water content from which soil resistance to penetration is limiting (θPR). By means of LLWR it was observed that the soil presented good physical quality.

Petróleo y gas en África: viejas realidades, nuevos escenarios

[cat] En els últims temps es parla molt del nou paper dels hidrocarburs d'Àfrica, fins i tot s'al·ludeix a un oil rush o a un african oil scramble , que inevitablement desembocarà en una confrontació bipolar entre la Xina i els Estats Units, pel control de les reserves de petroli del subsòl del continent africà. Així, el propòsit d'aquest text és, en primer lloc, realitzar una anàlisi descriptiva que ajudi a valorar la hipòtesi d'aquest african oil scramble. A continuación, amb les dades obtingudes, es discutirà sobre la possibilitat de que aquest fenomen desemboqui en un escenari de confrontació xinoamericana. Aquesta especulació ens durà a concloure que hi ha suficients indicis per a argumentar que el joc petrolífer africà podria desenvolupar-se en un escenari marcat per la multilateralitat.

Hay competencia en el mercado europeo de transporte aéreo?: el caso español

La liberalización del transporte aéreo que se llevó a término en la Unión Europea a principios de los años noventa ha tenido efectos positivos sobre el bienestar del viajero. No obstante, existe un consenso en la literatura académica que estos efectos dependen de la existencia de una competencia efectiva en el nivel de la ruta. En este sentido, se plantea el problema que puede llegar a suponer las ventajas de escalera de las compañías dominantes en cada mercado interior. Además, se pretende capturar la diferenciación de productos como característica esencial de la industria del transporte aéreo. El análisis de estas cuestiones se realiza de la forma siguiente. En primer lugar, se hace referencia a los principales aspectos económicos que condicionan la competencia en el transporte aéreo. Y en segundo lugar, se implementa un modelo empírico basado en un sistema de tres ecuaciones, que se estima mediante la técnica de las variables instrumentales. La muestra utilizada hace referencia al año 2001 para la mayoría de las rutas del mercado interior español de vuelos regulares en dónde hay competencia. Los resultados de la estimación muestran la existencia de unas condiciones de competencia diferentes según el segmento del mercado al cual se dirigen las compañías aéreas. Efectivamente, la competencia en precios (calidad) parece ser predominante en el segmento de viajeros por motivos personales (negocios). Adicionalmente, el dominio que la compañía dominante tiene sobre la mayoría de las rutas parece descansar en las ventajas competitivas, tanto en términos de costes como en términos de demanda, que le proporciona el control de la red aeroportuaria nacional. De todo esto se puede inferir que el mantenimiento y/o aumento de los beneficios de la liberalización de los servicios de transporte aéreo exige extender la liberalización al uso del aeropuertos así como descentralizar su gestión.

A randomized trial of spiritual assessment of outpatients with schizophrenia: Patients' and clinicians' experience

Objective: Recovery-oriented care for patients with schizophrenia involves consideration of cultural issues, such as religion and spirituality. However, there is evidence that psychiatrists rarely address such topics. This study examined acceptance of a spiritual assessment by patients and clinicians, suggestions for treatment that arose from the assessment, and patient outcomes-in terms of treatment compliance and satisfaction with care (as measured by treatment alliance). Methods: Outpatients with psychosis were randomly assigned to two groups: an intervention group that received traditional treatment and a religious and spiritual assessment (N=40) and a control group that received only traditional treatment (N=38). Eight psychiatrists were trained to administer the assessment to their established and stable patients. After each administration, the psychiatrist attended a supervision session with a psychiatrist and a psychologist of religion. Baseline and three-month data were collected. Results: The spiritual assessment was well accepted by patients. During supervision, psychiatrists reported potential clinical uses for the assessment information for 67% of patients. No between-group differences in medication adherence and satisfaction with care were found at three months, although patients in the in- tervention group had significantly better appointment attendance dur- ing the follow-up period. Their interest in discussing religion and spirituality with their psychiatrists remained high. The process was not as well accepted by psychiatrists. Conclusions: Spiritual assessment can raise important clinical issues in the treatment of patients with chronic schizophrenia. Cultural factors, such as religion and spirituality, should be considered early in clinical training, because many clinicians are not at ease addressing such topics with patients.

Crescimento e absorção de nutrientes pelo feijoeiro adubado com cama de aves e fertilizantes minerais

O feijoeiro é tradicionalmente cultivado em pequenas propriedades, onde é comum o uso de dejetos animais para adubação das culturas. Como é uma cultura de ciclo curto, os nutrientes precisam estar disponíveis logo após a germinação, o que nem sempre acontece quando a fertilização ocorre a partir de fertilizantes orgânicos. Neste trabalho, objetivou-se avaliar a eficiência de diferentes camas de aves em relação aos fertilizantes minerais na produção de matéria seca e na liberação de nutrientes para o feijoeiro, em casa de vegetação. O experimento foi conduzido em 2010, com amostras de um Latossolo Vermelho distroférrico com 16 g kg-1 de matéria orgânica, 1,9 e 84 mg dm-3 de P e K, respectivamente, e pH 6,0. Adotou-se delineamento experimental de blocos casualizados com 10 tratamentos e cinco repetições. As unidades experimentais foram constituídas por vasos com 14 dm³ de solo e cinco plantas de feijão, do cultivar BRS Requinte, durante 60 dias. Os tratamentos consistiram de cinco camas de aves compostas pelos seguintes materiais: palha de milho, bagaço de cana-de-açúcar, palha de pastagem natural, areia ou acícula de Pinus, formulações de nutrientes (NPK, NP, PK e NK) e um testemunha, sem nenhum fertilizante. Os fertilizantes minerais com P proporcionaram maior produção de matéria seca da parte aérea (MSPA) e de raízes (MSRA) do feijoeiro do que as camas de aves, por causa da maior liberação para o solo de N e P disponíveis. Dentre as camas estudadas, aquela constituída por areia foi a que proporcionou os maiores valores de MSPA e de MSRA. As plantas fertilizadas com as camas de aves acumularam, em média, 58,6 % do N e 59,0 % do P, em relação às fertilizadas com os tratamentos que continham N e P minerais. A taxa de recuperação pelas plantas de N e K foi maior para os nutrientes aplicados na forma mineral do que na orgânica. As camas de aves podem ser utilizadas como fertilizantes para a cultura do feijoeiro desde que sejam suplementadas com N e P minerais.

Maleït platonisme! Pell, carn i cos de persones concretes: etapes d'un combat lliurat -i guanyat- en la poesia de Miquel Àngel Riera

L'objectiu d'aquest article és mostrar com, tot al llarg de la poesia de Miquel Àngel Riera, s'hi detecta una evident sensibilitat antimetafísica que el dur a lloar la pell, la carn i el cos de les persones concretes, tot defugint qualsevulla vivència platònica o idealista de l'amor. La lectura acurada dels seus poemes permet descobrir, en opinió de l¿autor, Plató i el platonisme occidental com un dels grans responsables del menyspreu de l¿amor carnal, causa indubtable de patiment humà pel fet de no voler reconèixer la dimensió somàtica d¿eros.

Interlaboratory comparison of size measurements on nanoparticles using nanoparticle tracking analysis (NTA)

One of the key challenges in the field of nanoparticle (NP) analysis is in producing reliable and reproducible characterisation data for nanomaterials. This study looks at the reproducibility using a relatively new, but rapidly adopted, technique, Nanoparticle Tracking Analysis (NTA) on a range of particle sizes and materials in several different media. It describes the protocol development and presents both the data and analysis of results obtained from 12 laboratories, mostly based in Europe, who are primarily QualityNano members. QualityNano is an EU FP7 funded Research Infrastructure that integrates 28 European analytical and experimental facilities in nanotechnology, medicine and natural sciences with the goal of developing and implementing best practice and quality in all aspects of nanosafety assessment. This study looks at both the development of the protocol and how this leads to highly reproducible results amongst participants. In this study, the parameter being measured is the modal particle size.

Epidémiologie de la psychiatrie de consultation-liaison du Centre Psychosocial Neuchâtelois dans le service de Médecine interne de l'Hôpital de la Chaux-de-Fonds en 1994 et 1998 : Interactions et régulations

Résumé La psychiatrie de consultation-liaison (CL) connaît depuis une décennie un essor majeur en Europe sous l'impulsion des recherches multicentriques du groupe European Consultation Liaison Psychiatry - ECLVV (Huyse). En Suisse, la discipline reste à développer par manque de consultants spécialisés selon le rapport 2000 de l'Association des professeurs titulaires de chaires. Néanmoins une harmonisation progressive des standards européens de documentation et d'évaluation apparaît progressivement, notamment dans les travaux du Service de Psychiatrie de Liaison du Centre Hospitalier Universitaire Vaudois. Afin d'améliorer sa pratique de consultation-liaison qui restait jusqu'alors frustrante par un sentiment de débordement et d'absence de feed-back des interventions, le Centre Psychosocial Neuchâtelois de La Chaux-de-Fonds (CPS) a constitué une base de données informatisée de CL à des fins de recherche-action selon les recommandations du groupe ECLVV. Nous avons comparé les valeurs de prévalence de notre activité de CL dans le service de médecine interne de l'Hôpital de La Chaux-de-Fonds en 1994, année du début de l'informatisation des données du CPS, et en 1998, année des plus récents résultats exploitables. La taille de l'échantillon était de 78 cas pour 1994 et de 108 cas pour 1998. Les résultats de notre étude épidémiologique rétrospective et descriptive montraient une augmentation en volume des demandes de CL, une diversification et une complexification des cas. Cette charge croissante sur la psychiatrie de consultation-liaison s'observait également dans les données de la littérature. La réponse psychiatrique du CPS montrait une modestie de moyens et du pragmatisme dans le style des interventions. Ces dernières étaient essentiellement de nature de psychiatrie générale et d'urgence, focalisée sur les tentatives de suicides. Les tentamens, ici comme ailleurs, restent le noyau dur de toute pratique de psychiatrie à l'hôpital général. L'état de lieu de notre pratique de consultation-liaison issu de ce travail a permis de créer une base de données simplifée étendue à l'ensemble des demandes de consultation au CPS afin de réguler le flux de toutes ses interventions face aux demandes toujours croissantes. Dans ce sens, notre étude a montré la nécessité de formaliser les demandes de consultation psychiatrique à l'hôpital général afin d'optimaliser les réponses des consultants.

Influence of digestion methods on the recovery of Iron, Zinc, Nickel, Chromium, Cadmium and Lead contents in 11 organic residues

There are currently many devices and techniques to quantify trace elements (TEs) in various matrices, but their efficacy is dependent on the digestion methods (DMs) employed in the opening of such matrices which, although "organic", present inorganic components which are difficult to solubilize. This study was carried out to evaluate the recovery of Fe, Zn, Cr, Ni, Cd and Pb contents in samples of composts and cattle, horse, chicken, quail, and swine manures, as well as in sewage sludges and peat. The DMs employed were acid digestion in microwaves with HNO3 (EPA 3051A); nitric-perchloric digestion with HNO3 + HClO4 in a digestion block (NP); dry ashing in a muffle furnace and solubilization of residual ash in nitric acid (MDA); digestion by using aqua regia solution (HCl:HNO3) in the digestion block (AR); and acid digestion with HCl and HNO3 + H2O2 (EPA 3050). The dry ashing method led to the greatest recovery of Cd in organic residues, but the EPA 3050 protocol can be an alternative method for the same purpose. The dry ashing should not be employed to determine the concentration of Cr, Fe, Ni, Pb and Zn in the residues. Higher Cr and Fe contents are recovered when NP and EPA 3050 are employed in the opening of organic matrices. For most of the residues analyzed, AR is the most effective method for recovering Ni. Microwave-assisted digestion methods (EPA3051 and 3050) led to the highest recovery of Pb. The choice of the DM that provides maximum recovery of Zn depends on the organic residue and trace element analyzed.

Early co-occurrence of a neurologic-psychiatric disease pattern in Niemann-Pick type C disease: a retrospective Swiss cohort study.

BackgroundNiemann-Pick disease type C (NP-C) is a rare autosomal recessive disorder of lysosomal cholesterol transport. The objective of this retrospective cohort study was to critically analyze the onset and time course of symptoms, and the clinical diagnostic work-up in the Swiss NP-C cohort.MethodsClinical, biochemical and genetic data were assessed for 14 patients derived from 9 families diagnosed with NP-C between 1994 and 2013. We retrospectively evaluated diagnostic delays and period prevalence rates for neurological, psychiatric and visceral symptoms associated with NP-C disease. The NP-C suspicion index was calculated for the time of neurological disease onset and the time of diagnosis.ResultsThe shortest median diagnostic delay was noted for vertical supranuclear gaze palsy (2y). Ataxia, dysarthria, dysphagia, spasticity, cataplexy, seizures and cognitive decline displayed similar median diagnostic delays (4¿5y). The longest median diagnostic delay was associated with hepatosplenomegaly (15y). Highest period prevalence rates were noted for ataxia, dysarthria, vertical supranuclear gaze palsy and cognitive decline. The NP-C suspicion index revealed a median score of 81 points in nine patients at the time of neurological disease onset which is highly suspicious for NP-C disease. At the time of diagnosis, the score increased to 206 points.ConclusionA neurologic-psychiatric disease pattern represents the most characteristic clinical manifestation of NP-C and occurs early in the disease course. Visceral manifestation such as isolated hepatosplenomegaly often fails recognition and thus highlights the importance of a work-up for lysosomal storage disorders. The NP-C suspicion index emphasizes the importance of a multisystem evaluation, but seems to be weak in monosymptomatic and infantile NP-C patients.

The maximun and the addition of assigment games

[cat] En el context dels mercats a dues bandes, considerem, en primer lloc, que els jugadors poden escollir on dur a terme les seves transaccions. Mostrem que el joc corresponent a aquesta situació, que es representa pel màxim d’un conjunt finit de jocs d’assignació, pot ser un joc no equilibrat. Aleshores proporcionem condicions per a l’equilibri del joc i, per aquest cas, analitzem algunes propietats del core del joc. En segon lloc, considerem que els jugadors poden fer transaccions en diversos mercats simultàniament i, llavors, sumar els guanys obtinguts. El joc corresponent, representat per la suma d’un conjunt finit de jocs d’assignació, és equilibrat. A més a més, sota certes condicions, la suma dels cores dels dos jocs d’assignació coincideix amb el core del joc suma.