Yes / Physiotherapy is a dynamic profession that employs various therapeutic strategies to help people regain movement and function in their bodies. Physiotherapists provide comprehensive care for patients with different medical and surgical conditions. This study aimed to assess the perceptions regarding physiotherapy among the general population of Gujrat, Pakistan. Methodology: This descriptive cross-sectional survey was carried out among the general population of Gujrat from March to June 2021. Non-probability sampling technique was used to select the 126 participants >20 years of age. A self-structured Likert scale questionnaire was developed to collect data. The responses were analyzed through Statistical Packages for Social Sciences (SPSS). P-value less than 0.05 was considered as level of significance. Results: Majority of participants (75.4%) were from the age group 20–29 years and 90(71.4%) of the participants had either undergraduate or postgraduation education. Out of 126 participants, 103(81.75%) participants were highly aware and had adequate awareness regarding physiotherapy, whereas 20(50.9%) participants showed moderate awareness and 3(2.4%) of participants showed a deficient level of awareness. No association was seen between awareness and variables including age, gender, socioeconomic status, and education. Conclusion: General population of Gujrat were highly aware of physiotherapy. Education plays an impactful role in better understanding of physiotherapy, so further steps should be taken to increase positive perception in different socioeconomic statuses, including advertisements, social media campaigns and seminars.

Problematic painkiller use is a large and increasing problem worldwide, leading to serious physical, psychological and social consequences. Existing research indicates that accessibility of painkillers and psychological factors could have a role in problematic painkiller use. To clarify, accessibility refers to ease of obtaining painkillers, whilst psychological factors refer to individual-level processes and meanings that influence mental states (Upton, 2013). However, there have been few studies conducted, and these studies have focused mainly on either clinical samples or women with childbirth pain. Hence, the role among the general population is less clear. The aim of the present thesis was therefore to focus on the role of accessibility and psychological factors in problematic painkiller use among the general population. Three studies were conducted: one study compared the general population of the UK (N = 295) and Egypt (N = 420) regarding the role of accessibility of painkillers and psychological factors, including attitudes and beliefs towards pain, painkillers, self-medication and alternative methods of pain relief; another study was a multi-national comparison of these variables among the general population of more countries including Germany (N = 217), USA (N = 146), Australia (N = 93) and China (N = 76); another study focused on the role of psychological factors over time among the UK general population (N = 529), specifically attitudes and beliefs towards painkillers, as well as pain catastrophising, pain acceptance, pain self-efficacy and alexithymia. In these studies, the role of accessibility and psychological factors was investigated using online surveys, with participants aged 18 years or over, who experienced pain in the last month, used over-the-counter (OTC) or prescription painkillers in the last month, and were residents of the countries concerned. An additional study was conducted to develop 14-item versions of the Survey of Pain Attitudes-Brief (SOPA-B-14) and the Pain Medication Attitudes Questionnaire (PMAQ-14), which also tested the validity of these scales. Results Accessibility of painkillers and psychological factors predicted problematic painkiller use. However, there were several differences between the countries regarding the particular role of these factors. In the longitudinal study of the UK general population, changes in psychological factors were found over time, but attitudes and beliefs about withdrawal from painkillers was the only psychological factor that predicted problematic painkiller use over time. In addition, testing the validity of the SOPA-B-14 and PMAQ-14 showed that these scales were valid. The present research provided understanding regarding the role of accessibility and psychological factors in problematic painkiller use among the general population, and the role of psychological factors over time. Based on this understanding, interventions focusing on accessibility and psychological factors should be developed to reduce problematic painkiller use, but tailored to the particular factors that were predictors for each country. The present research also developed a valid SOPA-B-14 and PMAQ-14, therefore these scales can be used rather than the full versions to make assessment easier.

Background: Chronic pain is prevalent worldwide and is estimated to range from 2% to 55% in the general population. There is a limited understanding of the prevalence and incidence of chronic pain in Canada. Furthermore, our understanding of the sociodemographic predictors of chronic pain is limited; thus we are poorly positioned to identify potential populations at risk. Objectives: The primary objectives for this study included: 1) to determine the prevalence and incidence of chronic pain and pain-related interference in Canada over time and, 2) to determine the influence of sociodemographic predictors on the development of chronic pain by sex in the Canadian adult population over 12 years. Methods: Using data from the cross-sectional components of the National Population Health Survey (NPHS) (1994/95, 1996/97, 1998/99) and the Canadian Community Health Survey (2000/01, 2003, 2005, 2007/08), we examined the prevalence and interference of chronic pain. The longitudinal component of the NPHS was used to determine the incidence and sociodemographic predictors of chronic pain. Chronic pain was defined as the presence of “usual pain”. Results: The prevalence in the cross-sectional samples ranged from 15.1% to 18.9%. In the longitudinal sample, the incidence ranged from 5.4% to 7.8% and the prevalence ranged from 15.3% to 19.5%. Women, compared to men, had a higher prevalence, but not incidence of chronic pain each year. Of those individuals reporting chronic pain, the majority reported at least a few activities prevented. Women who were older, with lower education, and widowed, separated, or divorced were more likely to develop chronic pain. There were no sociodemographic risk factors for chronic pain in men. Conclusion/Implications: This population-based study supports previous research findings indicating that chronic pain affects daily activities of many Canadians. Furthermore, this is the first population-based prospective study examining the incidence and sociodemographic predictors of chronic pain in Canadians. Further study with more detailed definitions of pain and pain-related interference is warranted. Moreover, our findings suggest that older women are more likely to develop chronic pain and that men and women may have different risk factors for chronic pain, suggesting the need for gender-based preventative interventions. / Thesis (Master, Nursing) -- Queen's University, 2010-07-20 13:38:13.996

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Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Existem evidências de que as manifestações psicóticas não são vivenciadas apenas por pessoas diagnosticadas com transtornos mentais, mas também por pessoas saudáveis da população geral, as denominadas experiências tipo-psicóticas. A Escala de Avaliação das Experiências Psíquicas na Comunidade (CAPE) é um instrumento usado em pesquisas epidemiológicas e foi desenvolvido especificamente para a detecção e avaliação da frequência de experiências tipo-psicóticas na população geral. A CAPE, em sua apresentação original é composta por 42 itens, distribuídos em três dimensões: positiva, negativa e depressiva. O objetivo deste estudo foi verificar as evidências de fidedignidade e validade da CAPE em uma amostra brasileira e investigar a associação de traumas na infância e uso de cannabis com a ocorrência de experiências tipo-psicóticas em indivíduos da população geral. A amostra foi composta por 217 pacientes em primeiro episódio psicótico, 104 irmãos de pacientes psicóticos e 319 controles de base populacional, todos residentes na área de cobertura do Departamento Regional de Saúde do Estado de São Paulo (DRS XIII). Os participantes responderam a instrumentos de avaliação e diagnósticos, incluindo a Entrevista Clínica Estruturada para o DSM IV (SCID), o Questionário sobre Traumas na Infância (CTQ), Questionário de Experiências com Maconha (CEQ), além da CAPE. Os dados clínicos foram analisados por meio do pacote estatístico SPSS e as evidências psicométricas por meio do software AMOS. Após a retirada de nove itens, a CAPE, com 33 itens, mostrou bons índices de ajustamento [CFI = 0,895; GFI = 0,822; PGFI = 0,761; RMSEA = 0,055 p (rmsea <= 0,05) = 0,04] e boa consistência interna (> 0,70) em todos as suas dimensões. Nas análises realizadas apenas com a amostra de base populacional, não foram encontradas diferenças significativas entre as pontuações totais da CAPE-33 e das suas três dimensões quanto a intervalos de idade, estado civil e escolaridade. Mulheres apresentaram pontuações significativamente mais elevadas do que os homens no escore total (p<0,001) e nas dimensões negativa (p < 0,001) e depressiva (p < 0,001). A vivência de traumas na infância (abuso emocional, abuso físico, abuso sexual, negligência emocional, negligência física) associou-se com pontuações mais elevadas no escore total da CAPE (p <0,001) e nas suas três dimensões (positiva p = 0.001, negativa p = 0,004, depressiva p < 0,001). Indivíduos que relataram uso de cannabis alguma vez na vida apresentaram maiores pontuações na dimensão positiva da CAPE-33, em comparação às pessoas que nunca usaram a substância (p = 0,016). A CAPE adaptada para o Brasil (CAPE-33) mostrou bons índices de ajustamento e consistência interna, como encontrado em outras culturas. Presença de trauma precoce e uso de cannabis associaram-se à ocorrência de experiências tipo-psicóticas, à semelhança do que os estudos epidemiológicos mostram para a esquizofrenia. Nossos dados corroboram a abordagem dimensional das psicoses, com frequência e gravidade das manifestações se distribuindo num continnum na população geral. / There is evidence that psychotic manifestation is not experienced only by people diagnosed with mental disorders but also by healthy people in the general population, known as psychotic-like experiences. The Community Assessment Psychic Experiences (CAPE) is an instrument used in epidemiological research and was developed specifically for the detection and evaluation of the frequency of psychotic-like experiences in the general population. The CAPE, in its original submission, is composed of 42 items, distributed in three dimensions: positive, negative and depressive. The objective of this study was to verify the evidence of reliability and validity the CAPE in a brazilian sample and to investigate the association of childhood traumas and cannabis use with the occurrence of psychotic-like experiences in individuals of the general population. The sample consisted of 217 patients in the first psychotic episode, 104 siblings of psychotic patients and 319 population-based controls, all residents in the coverage area of the São Paulo Regional Health Department (DRS XIII). Participants responded to assessment and diagnostic tools, including the Structured Clinical Interview for DSM IV (SCID), the Childhood Trauma Questionnaire (CTQ), the Cannabis Experience Questionnaire (CEQ), and CAPE. Clinical data were analyzed using SPSS statistical package and the psychometric evidence using AMOS software. After the removal of nine items, CAPE, with 33 items, showed good adjustment indices [CFI = 0.895; GFI = 0.822; PGFI = 0.761; RMSEA = 0.055 p (rmsea <= 0.05) = 0.04] and good internal consistency (> 0.70) in all its dimensions. In the analyzes performed only with the population-based sample, no significant differences were found between the CAPE-33 total scores and its three dimensions regarding age, marital status and schooling intervals. Women presented scores significantly higher than men in the total score (p <0.001) and in the negative (p <0.001) and depressive (p <0.001) dimensions. The experience of childhood traumas (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) was associated with higher scores in the CAPE total score (p <0.001) and its three dimensions (positive p = 0.001, negative p = 0.004, depressive p <0.001). Individuals who reported cannabis use in their lifetime had higher scores in the positive dimension of the CAPE-33 compared to people who had never used the substance (p = 0.016). The CAPE adapted to Brazil (CAPE-33) showed good adjustment indices and internal consistency, as found in other cultures. Presence of early trauma and use of cannabis were associated with the occurrence of psychotic-like experiences, in accordance with what epidemiological studies show for schizophrenia. Our data corroborate the dimensional approach of the psychoses, with frequency and severity of the manifestations being distributed in a continnum in the general population.

Existem evidências de que as manifestações psicóticas não são vivenciadas apenas por pessoas diagnosticadas com transtornos mentais, mas também por pessoas saudáveis da população geral, as denominadas experiências tipo-psicóticas. A Escala de Avaliação das Experiências Psíquicas na Comunidade (CAPE) é um instrumento usado em pesquisas epidemiológicas e foi desenvolvido especificamente para a detecção e avaliação da frequência de experiências tipo-psicóticas na população geral. A CAPE, em sua apresentação original é composta por 42 itens, distribuídos em três dimensões: positiva, negativa e depressiva. O objetivo deste estudo foi verificar as evidências de fidedignidade e validade da CAPE em uma amostra brasileira e investigar a associação de traumas na infância e uso de cannabis com a ocorrência de experiências tipo-psicóticas em indivíduos da população geral. A amostra foi composta por 217 pacientes em primeiro episódio psicótico, 104 irmãos de pacientes psicóticos e 319 controles de base populacional, todos residentes na área de cobertura do Departamento Regional de Saúde do Estado de São Paulo (DRS XIII). Os participantes responderam a instrumentos de avaliação e diagnósticos, incluindo a Entrevista Clínica Estruturada para o DSM IV (SCID), o Questionário sobre Traumas na Infância (CTQ), Questionário de Experiências com Maconha (CEQ), além da CAPE. Os dados clínicos foram analisados por meio do pacote estatístico SPSS e as evidências psicométricas por meio do software AMOS. Após a retirada de nove itens, a CAPE, com 33 itens, mostrou bons índices de ajustamento [CFI = 0,895; GFI = 0,822; PGFI = 0,761; RMSEA = 0,055 p (rmsea <= 0,05) = 0,04] e boa consistência interna (> 0,70) em todos as suas dimensões. Nas análises realizadas apenas com a amostra de base populacional, não foram encontradas diferenças significativas entre as pontuações totais da CAPE-33 e das suas três dimensões quanto a intervalos de idade, estado civil e escolaridade. Mulheres apresentaram pontuações significativamente mais elevadas do que os homens no escore total (p<0,001) e nas dimensões negativa (p < 0,001) e depressiva (p < 0,001). A vivência de traumas na infância (abuso emocional, abuso físico, abuso sexual, negligência emocional, negligência física) associou-se com pontuações mais elevadas no escore total da CAPE (p <0,001) e nas suas três dimensões (positiva p = 0.001, negativa p = 0,004, depressiva p < 0,001). Indivíduos que relataram uso de cannabis alguma vez na vida apresentaram maiores pontuações na dimensão positiva da CAPE-33, em comparação às pessoas que nunca usaram a substância (p = 0,016). A CAPE adaptada para o Brasil (CAPE-33) mostrou bons índices de ajustamento e consistência interna, como encontrado em outras culturas. Presença de trauma precoce e uso de cannabis associaram-se à ocorrência de experiências tipo-psicóticas, à semelhança do que os estudos epidemiológicos mostram para a esquizofrenia. Nossos dados corroboram a abordagem dimensional das psicoses, com frequência e gravidade das manifestações se distribuindo num continnum na população geral. / There is evidence that psychotic manifestation is not experienced only by people diagnosed with mental disorders but also by healthy people in the general population, known as psychotic-like experiences. The Community Assessment Psychic Experiences (CAPE) is an instrument used in epidemiological research and was developed specifically for the detection and evaluation of the frequency of psychotic-like experiences in the general population. The CAPE, in its original submission, is composed of 42 items, distributed in three dimensions: positive, negative and depressive. The objective of this study was to verify the evidence of reliability and validity the CAPE in a brazilian sample and to investigate the association of childhood traumas and cannabis use with the occurrence of psychotic-like experiences in individuals of the general population. The sample consisted of 217 patients in the first psychotic episode, 104 siblings of psychotic patients and 319 population-based controls, all residents in the coverage area of the São Paulo Regional Health Department (DRS XIII). Participants responded to assessment and diagnostic tools, including the Structured Clinical Interview for DSM IV (SCID), the Childhood Trauma Questionnaire (CTQ), the Cannabis Experience Questionnaire (CEQ), and CAPE. Clinical data were analyzed using SPSS statistical package and the psychometric evidence using AMOS software. After the removal of nine items, CAPE, with 33 items, showed good adjustment indices [CFI = 0.895; GFI = 0.822; PGFI = 0.761; RMSEA = 0.055 p (rmsea <= 0.05) = 0.04] and good internal consistency (> 0.70) in all its dimensions. In the analyzes performed only with the population-based sample, no significant differences were found between the CAPE-33 total scores and its three dimensions regarding age, marital status and schooling intervals. Women presented scores significantly higher than men in the total score (p <0.001) and in the negative (p <0.001) and depressive (p <0.001) dimensions. The experience of childhood traumas (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) was associated with higher scores in the CAPE total score (p <0.001) and its three dimensions (positive p = 0.001, negative p = 0.004, depressive p <0.001). Individuals who reported cannabis use in their lifetime had higher scores in the positive dimension of the CAPE-33 compared to people who had never used the substance (p = 0.016). The CAPE adapted to Brazil (CAPE-33) showed good adjustment indices and internal consistency, as found in other cultures. Presence of early trauma and use of cannabis were associated with the occurrence of psychotic-like experiences, in accordance with what epidemiological studies show for schizophrenia. Our data corroborate the dimensional approach of the psychoses, with frequency and severity of the manifestations being distributed in a continnum in the general population.

Aim: The overall aim of this thesis was to study prognostic factors for prolonged disability in back pain in the general population and physiotherapists’ screening for prolonged disability, applying a social cognitive learning perspective. Methods and results: Studies I and II were based on a survey in the general population in Sweden. Study I included 1024 individuals aged 20-50 years, reporting non-specific back pain. Four groups (n = 100, 215, 172 and 537) based on duration and recurrence of back pain were formed and compared. After controlling for pain intensity, catastrophising and expectations of future pain were positively correlated to pain duration. Perceived social support was negatively correlated to pain duration. Study II was longitudinal over 12 months and analysed one group reporting first-episode back pain (n = 77), and one group reporting long-term back pain (n = 302). Future pain intensity and disability were predicted by initial levels of pain and disability and pain-related cognitions in both groups. Study III examined the inter-rater reliability of a research protocol for assessment of physiotherapists’ telephone screening for prolonged disability. The results demonstrated sufficient inter-rater reliability. Study IV evaluated the effect of a tailored skills training intervention on physiotherapists’ screening for prolonged disability in back pain. Four physiotherapists in primary care participated in four quasi-experimental single-subject studies. Effects were seen in all participants, with increased screening of prognostic factors and less time spent on detailed discussions about back pain. Conclusions: The identification of mainly cognitive explanatory variables indicates the relevance of a social cognitive perspective of back pain-related disability (studies I and II). Physiotherapists’ telephone screening for prolonged disability in back can be reliably assessed (study III). It is suggested that interventions based on social cognitive theory are effective in producing change in specified clinical behaviours in physiotherapists (study IV).

Obstructive sleep apnea syndrome (OSAS) is characterized by snoring, apneas and excessive daytime sleepiness (EDS). Obesity is a risk factor for snoring and sleep apnea, but data on other factors in relation to obesity are ambiguous. Symptoms of sleep apnea in women have not been fully elucidated. OSAS is an important risk factor for cardiovascular disease (CVD). A common feature in patients with CVD and sleep apnea is an increase in systemic inflammation. From the general population 7,051 women ≥ 20 years answered a questionnaire on snoring and sleep disturbances. Habitual snoring was found in 8% of the total population, and influenced by age, obesity and smoking. The highest prevalence (14%) was found in women 50-59 years. In lean women, alcohol dependence was associated with snoring, while physical inactivity was a risk factor for snoring in obese women. Further, 230 snoring women and 170 women regardless of snoring status were investigated with polysomnography, blood sampling and anthropometric measurements. Of these, 132 participants underwent an ocular and endoscopic examination of their upper airways. Several findings in the upper airways characterised normal-weight women with an apnea-hypopnea index (AHI) ≥ 10. In women with BMI of &gt; 25, no pharyngeal characteristics predicted sleep apnea. When adjusting for age, obesity, smoking, AHI and sleep parameters, several aspects of daytime sleepiness correlated to snoring independently of AHI (EDS, falling asleep involuntarily during day, waking up unrefreshed and fatigue). No symptoms correlated to AHI independently of snoring. Blood samples were analysed for systemic inflammation (CRP, TNFα, IL-6, myeloperoxidase (MPO) and lysozyme). Strong correlations were found between obesity and inflammatory markers. AHI and nocturnal hypoxia correlated to all markers except MPO. When adjusting for age, obesity and smoking, only IL-6 and TNFα were independently associated with nocturnal hypoxia. In conclusion, age and obesity influence the prevalence of snoring and sleep apnea in women from the general population. Other risk factors differ according to BMI. Daytime symptoms are independently related to snoring per se. Despite a strong correlation between obesity and inflammation, an independent relationship between sleep apnea and inflammatory markers was found.

No description available.