The influence of cognitive factors in relation to the patients' treatment adherence for non-specific chronic low-back pain. A case series.

INTRODUCTION: The positive effects of exercise programs in relation to chronic low-back pain have been long established and patient adherence has a fundamental role in the impact of the resulting benefits. On the other hand, cognitive factors have shown to be the predictors of poor outcomes in patient suffering from this condition to the point of possibly affecting adherence. OBJECTIVE: To determine the influence of cognitive factors on the adherence to a home exercise program, the patient's pain intensity and their level of disability at a two-month follow-up, specifically regarding patients with non-specific chronic low-back pain (NSCLBP). METHOD: ology: Ten patients with NSLBP underwent a home exercise program. This study was undertaken to assess their adherence rate after two months. The assessment tools included the Visual Analogue Scale (VAS), the Oswestry Disability Index pre-follow-up and post-follow-up (ODI1 and ODI2), the Tampa Kinesiophobia Scale (TSK-11), the Pain Catastrophism Scale (PCS), the Fear-Avoidance Beliefs Questionnaire (FABQ) and the General Self-efficacy Scale (GSS) respectively. RESULTS: There were no significant associations found between adherence and the selected cognitive factors. There was an association between GSS and VAS (R = 0.68, p = 0.031). A clinically relevant improvement of 6.8 points in the mean of ODI2 in relation to ODI1 was observed. CONCLUSION: The influence of cognitive factors on adherence has not been ruled out because the study had a low sample size. Future studies should replicate the evaluation protocol in a larger population.

Evaluation of a pulsed-xenon ultraviolet room disinfection device for impact on contamination levels of methicillin-resistant Staphylococcus aureus.

BACKGROUND: Healthcare-acquired infections with methicillin-resistant Staphylococcus aureus (MRSA) are a significant cause of increased mortality, morbidity and additional health care costs in United States. Surface decontamination technologies that utilize pulsed xenon ultraviolet light (PPX-UV) may be effective at reducing microbial burden. The purpose of this study was to compare standard manual room-cleaning to PPX-UV disinfection technology for MRSA and bacterial heterotrophic plate counts (HPC) on high-touch surfaces in patient rooms. METHODS: Rooms vacated by patients that had a MRSA-positive polymerase chain reaction or culture during the current hospitalization and at least a 2-day stay were studied. 20 rooms were then treated according to one of two protocols: standard manual cleaning or PPX-UV. This study evaluated the reduction of MRSA and HPC taken from five high-touch surfaces in rooms vacated by MRSA-positive patients, as a function of cleaning by standard manual methods vs a PPX-UV area disinfection device. RESULTS: Colony counts in 20 rooms (10 per arm) prior to cleaning varied by cleaning protocol: for HPC, manual (mean = 255, median = 278, q1-q3 132-304) vs PPX-UV (mean = 449, median = 365, q1-q3 332-530), and for MRSA, manual (mean = 127; median = 28.5; q1-q3 8-143) vs PPX-UV (mean = 108; median = 123; q1-q3 14-183). PPX-UV was superior to manual cleaning for MRSA (adjusted incident rate ratio [IRR] = 7; 95% CI <1-41) and for HPC (IRR = 13; 95% CI 4-48). CONCLUSION: PPX-UV technology appears to be superior to manual cleaning alone for MRSA and HPC. Incorporating 15 minutes of PPX-UV exposure time to current hospital room cleaning practice can improve the overall cleanliness of patient rooms with respect to selected micro-organisms.