[Pain and pain-related behavior during orthopedic rehabilitation]. / Schmerzempfinden und -verhalten während der orthopädischen Rehabilitation.

BACKGROUND: Problems concerning the sustainability of medical rehabilitation are well known. Persistent avoidance behavior might be a potential cause. The present study is designed to determine the relationship between pain and pain-related behavior (resignation, distraction, avoidance) during the rehabilitation process. In addition, the impact of gender, age, level of chronicity, and location of ailments are investigated. METHODS: Pain (German pain perception scale, SES) and pain-related behavior (German pain control questionnaire, FSR) were measured in 309 orthopedic rehabilitation patients. RESULTS: Affective pain, resignation and distraction are more pronounced in women than in men. Participants with highly increased levels of chronicity have more affective and sensory pain and higher values of avoidance and resignation. During the rehabilitation process, there was a decrease in affective pain, sensory pain and resignation. The difference values correlate significantly. CONCLUSION: Rehabilitation is effective for pain reduction. However, only limited changes in pain-related behavior were detected.

Evaluation of the difference of eight model applications to assess diffuse annual nutrient losses from agricultural land.

The capability of eight nutrient models to predict annual nutrient losses (nitrogen and phosphorus) at catchment scale have been studied in the EUROHARP project. The methodologies involved in these models differ profoundly in their complexity, level of process representation and data requirements. This evaluation is focused on model performance in three core catchments: the Vansjø-Hobøl (Norway), the Ouse (Yorkshire, UK) and the Enza (Italy). These three different model applications have been evaluated by comparing calculated annual nutrient loads (total N or nitrate and total P), based on observed flow and total nitrogen or nitrate and total phosphorus concentrations, and the annual nutrient loads that were simulated by the eight nutrient models. Four statistics have been applied for this purpose: the root mean squared error (RMSE), the mean absolute error (MAE), the mean error (ME), and Nash-Sutcliffe's model efficiency (NS). The results show that all model approaches can predict the calculated annual discharges. Depending on the observed statistics (RMSE, MAE, ME and NS) the scores of the model application differed, therefore no overall 'best model' could be identified. Although the water and nutrient loads from (sub)catchments can be predicted, the modelled pathways of nutrients within agricultural land and the nutrient losses to surface waters from agricultural land vary among the catchments and among those model approaches which are able to make this distinction.

[Physical complaints, emotional stress and locus of control in the course of orthopaedic rehabilitation]. / Körperliche Beschwerden, emotionale Belastung und Kontrollüberzeugung im Verlauf der orthopädischen Rehabilitation.

OBJECTIVES: Based on the biopsychosocial model, the present paper investigates the interactions between physical complaints and psychological parameters under the terms of a rehabilitation procedure. METHOD: In 309 participants of orthopaedic rehabilitation, the course of physical complaints (GBB-24), emotional stress (HADS-D) and locus of control (KU-WS) were recorded using a pre-post design. Additionally, the impact of the factors gender, age and level of chronicity as well as the interactions between the variables were analysed. RESULTS: Compared to the general population, the rehabilitation participants had significantly higher levels of fatigue, limb pain and pressure caused by complaints as well as anxiety and depression. Definite changes under the terms of rehabilitation were found for all single parameters of physical complaints and emotional stress; however, the scales with initially significantly increased values did not reach the levels of the general population. The reduction of physical complaints was significantly correlated with the reduction of emotional stress. The relationship between physical complaints and locus of control was much lower. CONCLUSION: The present paper confirms the strong interaction between biological and psychological factors under the terms of a rehabilitation process.