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PubMed2001

Interventions for treating melioidosis.

BACKGROUND: Melioidosis is an infectious disease caused by a bacterium (Burkholderia pseudomallei) found particularly in some areas in the tropics. It is a serious condition which can be fatal. Beta lactam antibiotics have dramatically reduced the risk of death, but mortality still remains high. OBJECTIVES: To summarise evidence from randomised trials on the effects of treatment regimens on death and relapse. SEARCH STRATEGY: Cochrane Controlled Trials Register, MEDLINE, EMBASE, BIOSIS from 1966 to September 2000 using MeSH terms "pseudomallei", "melioidosis" together with the terms "randomized-controlled-trial", "random allocation"; reference lists in articles on melioidosis; contact with trialists. SELECTION CRITERIA: Randomised and quasi-randomised trials assessing treatments in patients with melioidosis. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality was assessed by two reviewers independently. MAIN RESULTS: For intravenous therapy in the acute phase, we identified five trials with a total of 519 patients. Chloramphenicol, doxycycline, and co-trimoxazole (trimethoprim-sulphamethoxazole) combination regimens were associated with a mortality of 50% or more (two studies). Patients randomised to regimens that included ceftazidime were more likely to survive (relative risk [RR] 0.46, 95% confidence interval [CI] 0.30 to 0.71). When ceftazidime-containing regimens were compared with beta lactam or alternative beta lactamase inhibitor regimens such as co-amoxiclav (amoxycillin-clavulanic acid) and cefoperazone-sulbactam, mortality rates were similar (RR 1.10, 95% CI 0.83 to 1.46), as was the case in one trial of imipenem. For oral therapy in the maintenance phase, we found two trials of 188 participants. Results showed that treatment with the conventional regimen (chloramphenicol, doxycycline, and trimethoprim-sulphamethoxazole) resulted in fewer fatalities in patients compared to a regimen of amoxycillin-clavulanic acid and doxycycline alone. REVIEWER'S CONCLUSIONS: Regimens for the acute phase of illness should contain ceftazidime or imipenem. It is not yet clear if combinations of treatments in the early phase reduce relapse. For oral therapy after the acute phase of treatment, trials suggest that conventional four drug regimens can be used for treatment.

Administration, Oral↗

PubMed2006

Memory of ordinal number categories in macaque monkeys.

What mechanism underlies serial order memory? Studying preverbal serial memory shows that macaque monkeys reproducing a sequence of items can acquire knowledge of item ordinal position. In our previous experiment, macaques were repeatedly presented with image lists (first shown sequentially and then simultaneously on a touch screen together with a distractor chosen randomly from other lists). The task was to touch list images in the correct order. The monkeys' natural tendency was to categorize images by their ordinal position or number because their most common error was touching the distractor when it had the same ordinal number (in its own list) as the correct image. Item-to-item associations were used to complete the categorization strategy. Proposing a dynamic image-salience hypothesis for serial recall (based on category-to-image influence and a salience computation for identifying touch targets), we now study the category label characteristics in the context of this hypothesis. We found that these category labels are absolute, ordinal-number-based categories (first, second, etc.), not relative memorized as relative distance from the beginning and the end of the list, and not based on fixed ranking of reward contingency/image familiarity. Even isolated from item-item associations, the categories demonstrate category tuning (as well as the corresponding overlap of adjacent ordinal number codes). Moreover, monkeys choose images by proximity of their category to the current touch number, irrespective of the accuracy of the preceding choice. Category tuning itself is symmetric relative to correct ordinal position, but is skewed by other factors (reward, etc.). Tuning width increases with list length, with a concurrent increased use of item-to-item associations for determining touch order.

Animals↗

PubMed1983

Recognition memory for pictures as a function of poststimulus interval: an empirical clarification of existing literature.

Shaffer and Shiffrin (1972) found no effect of the duration of a blank poststimulus interval on recognition memory for visual scenes. The majority of subsequent studies, however, have found a positive relationship between interval duration and recognition accuracy. The present experiments were conducted to clarify these contradictory outcomes. Experiment 1 determined that Shaffer and Shiffrin's results are replicable with the method that they used in which stimulus durations and poststimulus-interval durations vary randomly within the study list. Experiments 2-3 showed that this random intermixing of durations is the critical factor that results in poststimulus interval having no effect. The results were interpreted in terms of a voluntary rehearsal process that is abandoned when there is uncertainty regarding the time of onset and offset of the stimuli.

Discrimination Learning↗

PubMed2004

Random number generation in patients with symptomatic and presymptomatic Huntington's disease.

Random number generation (RNG), which involves producing lists of numbers at random, requires response selection and inhibition, which are aspects of executive function mediated by the frontal lobe. This study examined RNG performance in a group of mild to moderate Huntington's disease (HD) patients, asymptomatic gene-positive HD patients, and controls. The HD symptomatic group was significantly less random in their choices than controls. The gene-positive asymptomatic HD patients also showed a tendency toward abnormal RNG measures compared with controls, although this did not reach statistical significance after correction for multiple comparisons. However, analyzing the HD group as a whole showed that the frequency of errors, preferential selection of favorite numbers, and counting in 1's correlated significantly with the degree of symptom severity. Furthermore, counting in 1's correlated with degree of vulnerability to symptoms. A subset of patients and controls were retested 6 months later, and all RNG measures showed high correlations over time, highlighting the robust reliability of this test. The data therefore suggest that RNG is a useful, brief and reliable test of executive function and may be of value in studies investigating the longitudinal effects of disease-modifying treatment in HD.

Adult↗

PubMed2001

Aerobic exercise: effects on parameters related to fatigue, dyspnea, weight and body composition in HIV-infected adults.

OBJECTIVES: The purpose of the study was to examine the effects of aerobic exercise on physiological fatigue (time on treadmill), dyspnea [rate of perceived exertion (RPE) and forced expiratory volume at 1 s (FEV1)], weight, and body composition in HIV-1-infected adults (200-499 x 106 CD4+ cells/l). DESIGN: The study was a randomized, wait-listed, controlled clinical trial of aerobic exercise in HIV-1-infected adults on signs and symptoms associated with HIV-1 infection or its treatment. METHODS: Sixty subjects were recruited and randomized to two groups. Experimental subjects completed a 12-week supervised exercise program. Control subjects continued usual activity from baseline to week 12 and were then were enrolled in the exercise program. RESULTS: At baseline, the groups were similar in age, weight, body mass index [mean body mass index (BMI) > 27], time since diagnosis, number of symptoms, CD4+ cell count, and number on protease inhibitor therapy (n = 7). Despite disproportionate attrition from the exercise group (38%), exercise subjects were able to remain on the treadmill longer, lost weight, decreased BMI, subcutaneous fat, and abdominal girth when compared to controls. The improvement in weight and body composition occurred without a decrease in kilocalories consumed. Exercise did not seem to have an effect on RPE, a surrogate for dyspnea, and FEV1. There was no significant difference in either the change in CD4+ cell count, percentage or copies of plasma HIV-1 RNA between groups. CONCLUSIONS: We conclude that supervised aerobic exercise training safely decreases fatigue, weight, BMI, subcutaneous fat and abdominal girth (central fat) in HIV-1-infected individuals. It did not appear to have an effect on dyspnea.

Adult↗

PubMed1994

Canadian study of health and aging: study methods and prevalence of dementia.

OBJECTIVE: To estimate the prevalence of dementia and its subtypes by sex and age group for five regions of Canada. DESIGN: Prevalence survey. SETTING: Community and institutional settings in Canada, excluding those in the two territories, Indian reserves and military units. PARTICIPANTS: Representative sample of people aged 65 and over interviewed between February 1991 and May 1992. Those in the community (9008 subjects) were chosen randomly from medicare lists in nine provinces or from the Enumeration Composite Record in Ontario. People in institutions (1255) were randomly selected from residents in stratified random samples of institutions in each region. INTERVENTIONS: Screening with the Modified Mini-Mental State (3MS) Examination to identify cognitive impairment. Clinical examination of all those in institutions, those in the community with a 3MS score of less than 78 and a sample of those in the community with a 3MS score of 78 or more to diagnose dementia. Dementia and Alzheimer's disease were defined according to established criteria. MAIN OUTCOME MEASURES: Prevalence of dementia of all types, by region, sex and age group, the estimated number of cases in the population by type of dementia and the age-standardized rate per 1000 population. RESULTS: The prevalence estimates suggested that 252,600 (8.0%) of all Canadians aged 65 and over met the criteria for dementia (95% confidence interval [CI] 236,800 to 268,400). These were divided roughly equally between the community and institutional samples; the female:male ratio was 2:1. The age-standardized rate ranged from 2.4%, among those aged 65 to 74 years, to 34.5%, among those aged 85 and over. The corresponding figures for Alzheimer's disease were 5.1% overall (161,000 cases; 95% CI 148,100 to 173,900), ranging from 1.0% to 26.0%; for vascular dementia it was 1.5% overall, ranging from 0.6% to 4.8%. If the prevalence estimates remain constant, the number of Canadians with dementia will rise to 592,000 by 2021. CONCLUSIONS: These Canadian estimates of the prevalence of dementia fall toward the upper end of the ranges in other studies, whereas the estimates for Alzheimer's disease fall in the middle of the ranges. This may suggest an unusual balance between Alzheimer's and other forms of dementia in the Canadian population.

Age Distribution↗

PubMed1991

Potential drug interactions in an ambulatory geriatric population.

Drug interactions are a common cause of iatrogenic disease in geriatric patients. Computer programs now exist which allow one to analyse groups of drugs for potential interactions. In an audit of charts of 100 geriatric patients seen in the Family Practice Center at Barberton Citizens Hospital, a computer printout was obtained, listing all patients aged 60 years and over who were seen at the Center during 1989. Names were selected randomly from this list by the head nurse and their charts were obtained for review, generating information on patient identification number, age, sex, diagnoses, medications, and allergies. The medications were analysed using the Hansten Drug Interaction Knowledge Base Program, which identified 27 patients as being on a combination of medications which had one or more potential drug interactions. A total of 37 potential drug interactions were identified in this group of 27 patients. Relative risk ratios were determined using the computer program, 'Epi Info,' for sex (female versus male), age (greater than or equal to 75 vs. 60-75 years), number of diagnoses greater than or equal to 3 vs. 0-2), and number of medications (greater than or equal to 4 vs. 0-3). The five medications, or groups of medications, which were most likely to be involved in potential drug interactions were digoxin, beta-blockers, oestrogen, oral hypoglycaemic agents, and diuretics.

Aged↗

PubMed2001

Physical therapy is effective for patients with osteoarthritis of the knee: a randomized controlled clinical trial.

OBJECTIVE: To assess the effectiveness of physical therapy, given either as an individually attended treatment or in a small group format, in terms of pain, physical function, and health related quality of life for patients with osteoarthritis (OA) of the knee. METHODS: After 2 baseline assessments, 126 patients were randomized into one of 3 allocation arms: individual treatments (n = 43), small group format program (n = 40), and waiting list control (n = 43). After reassessment at 8 weeks, patients allocated to waiting list control were randomized into one of the 2 active treatment arms. Assessments included both self-report measures (WOMAC, SF-36) and objective measures of physical performance (gait analysis and muscle strength). RESULTS: Both physical therapy treatment allocations resulted in significant improvements in pain, physical function, and health related quality of life above the control group (standardized response mean 0.36 to 0.65). Improvements in the self-report measures were substantiated by significant correlated improvements in knee extensor strength and fast walking speed (rho 0.36-0.42). There were no significant differences in effectiveness between the 2 physical therapy allocations for any of the measured outcomes. Improvements gained were maintained for at least 2 months. Responsiveness to treatment was modified by loss of medial joint space width, the interaction being significant for physical function, gait, and knee extensor strength. CONCLUSION: Physical therapy, either as an individually delivered treatment or in a small group format, is an effective intervention for patients with knee OA. Responsiveness to this 8 week intervention was modified by loss of medial joint space width.

Aged↗

PubMed2006

Survey return rates as a function of priority versus first-class mailing.

Prior research indicates survey procedures that signal significance and individualized mailings have higher response rates. Thus, it was hypothesized that surveys delivered via Priority mail would result in higher return rates than surveys delivered via First-Class. 260 surveys were sent to individuals randomly selected from lists of licensed physical and behavioral healthcare providers in Alaska and New Mexico. Half of the selected individuals were assigned randomly to receive mailings using Priority mail, the other half received First-Class mailings. Return rate was 39% for First-Class and 35% for Priority. Z tests of proportion indicated no statistically significant differences between methods. Given increased costs with no resultant increase in response rate, sending surveys to potential participants via Priority mail does not appear warranted.

Adult↗

PubMed2005

The clinical effectiveness of guided self-help versus waiting-list control in the management of anxiety and depression: a randomized controlled trial.

BACKGROUND: There are significant barriers to accessing effective psychological therapy in primary care resulting from a lack of suitably trained therapists to meet current demand. More efficient service delivery using minimal interventions (such as bibliotherapy) provided by paraprofessional therapists may be one method of overcoming these problems, and is the subject of attention in the UK and elsewhere. A randomized trial was conducted to test the clinical effectiveness of this model. Assistant psychologists delivered a guided self-help intervention to patients with anxiety and depression who were currently waiting for psychological therapy. METHOD: A total of 114 patients were randomized either to guided self-help or a waiting-list control group. All patients were followed up 3 months later, prior to starting conventional psychological therapy. Measures included self-reported adherence to the intervention, anxiety and depressive symptoms, social functioning and patient satisfaction. RESULTS: Adherence to the guided self-help intervention was acceptable and patients reported satisfaction with the intervention. However, there were no statistically significant differences between groups in anxiety and depression symptoms at 3 months. CONCLUSIONS: The results demonstrate that this model of guided self-help did not provide additional benefit to patients on a waiting list for psychological therapy. The results are considered in the context of possible internal and external validity threats, and compared with previous trials of minimal interventions. The implications of the results for the design of future minimal interventions are considered.

Adult↗

PubMed2004

The age at menopause and associated factors at the health center area in Ankara, Turkey.

OBJECTIVES: This study is performed in one health center area in Ankara, Turkey on a women population of 50-65 years in order to demonstrate menopausal status of women, age at menopause and factors related with the age at menopause. METHODS: This is a cross-sectional study which has been performed on a women population of 50-65 years. The local population was 17,153 in this area by 2001. All of the household determining forms are screened in order to detect the all of the women who were in 50-65 years group, then name and addresses of the these women's are listed. There were 1089 women aged 50-65 years who were constituting 7% of the population. After choosing the first name randomly from the list of the women, 1/3 systematic sampling method was used and, the number of the women in the sampling was 363 (95% C.I., +/-5% S.E.). The response rate among those eligible women who were contactable during the study was 99% (360/363). Data were collected by interviews through questionnaires. The questionnaire consisted of a series of questions concerning age at menopause, socioeconomic status, age at menarche, age at first pregnancy, regularity of menstrual cycles, parity, duration of breast feeding, use of OCs, BMI, smoking habit, age at menopause of the mother and the sister. Chi-square and t-test methods were used for statistical analyses. RESULTS: 4.2% of the women were in premenopause, 13.3% were in perimenopause, 72.8% were in natural menopause and 9.7% were in surgical menopause. Average age at natural menopause was 47+/-4.2 years. Education, age at menarche, smoking, age at menopause of the mother and the sister were found to be related with the age at menopause. CONCLUSIONS: Ninety-six percent of the women over age of 50 years, are at menopause or perimenopause. The results of this study suggest that, for factors of genetic and age at menarche, there are not many possibilities for the lifestyle changes that would modify age at menopause with the subsequent reduction in risk for chronic diseases, but daughters or sisters of women with an early menopause and women who smoked or less educated could be counselled with respect to family timing.

Age Distribution↗

PubMed2006

Cost-effectiveness of multidisciplinary treatment in sick-listed patients with upper extremity musculoskeletal disorders: a randomized, controlled trial with one-year follow-up.

OBJECTIVE: To determine the effectiveness and cost-effectiveness of a return-to-work outpatient multidisciplinary treatment programme for sick-listed workers with non-specific upper extremity musculoskeletal complaints. METHODS: A randomized controlled trial with a 1-year follow-up was carried out. Thirty-eight subjects were allocated to multidisciplinary treatment (intervention, n=23), or to usual care provided by occupational health services (n=15). The intervention consisted of psychological and physical sessions provided by a medical specialist, a psychologist, a physiotherapist and an occupational therapist. It aims at reconditioning, "de-medicalizing", unrestrained moving and return-to-work. The intervention process was evaluated on compliance to the protocol and the effectiveness of its components. The individual outcome variable was the severity of complaints. The societal outcomes included return-to-work and costs. Measurements were performed at baseline and after 2, 6 and 12 months. Mixed model analyses were used for analysis. RESULTS: The intervention achieves its aims: physical disabilities (P=0.039), kinesiophobia (P<0.001) and physical functioning (P=0.016) improved significantly as compared to usual care. In addition, the intervention was significantly more effective in reducing the severity of complaints than usual care. The intervention was equally effective compared to usual care in terms of return-to-work (86% in the intervention group vs. 73% in the usual care group). The extra total costs and the extra gains in terms of return-to-work were not significantly higher for the intervention as compared to usual care after 12 months. CONCLUSION: Multidisciplinary treatment affects individuals positively, but shows no significant difference in (cost-) effectiveness on the societal level as compared to usual care.

Combined Modality Therapy↗

PubMed1996

[Representations, discourses and practices about drug substitution with opiates. Apropos of a survey conducted in cooperation with 97 French physicians].

In order to analyse the various factors which determine physician's position on the use of opiates in a substitution treatment--as a harm-reducting and heroin dependence treatment tool-, 97 French physicians (i.e. 47 general practioners, 36 psychiatrists, 10 internists, 4 emergency care practioners) answered anonymously 103 closed questions, in presence of a single investigator. Among these 97 physicians, 40 were choosed at random from a list of addiction treatment's practioners, 19 were choosed nominatively for their explicit point of view toward substitution, and 38 were choosed at random from the Herault physicians register. In this latter sample, the survey showed a majority of physicians took an ambivalent position towards substitution, or were favourable without being prescriptors themselves--even though meeting drug users-. General practioners were more favourable to drug substitutes than specialists (50% vs 22%). This practice appeared as legitimate for 70% of physicians; AIDS helped justify this attitude for 26% of the specialists and 5% of the general practioners. Individual or socio-professional factors, the representations of the drug-addict and of his suffering, the perceptions of AIDS contamination risk and the standards of knowledge on the substitution treatments did not differ significatively (p < 0.02) between the groups, determinated according to the expressed practioners point of view toward substitution. Using a method exploring opinion structuration, no description of the typical doctor can be drawn from his position towards substitution. Militant discourses were rare; the main disagreements concerned the status, the negotiation around "the product ... or the medicament" within the drug addict-physician relationship should have. Substitution was considered by some as a mere shift from one object of dependence to another; and to others, as a means of setting up a therapeutic relationship. Ambivalent opinions frequently noticed in the physician's point of view towards substitution appears as a multifactorial phenomenon. Not only does it reveal the physician's difficultie in adapting previous patterns of treatment which are not longer adequate to a critical situation, but it also questions the foundations of the very relationship between the practioner and the drug addict.

Attitude↗

PubMedDate not supplied

[Dispensation of opioids by pharmacists in Tunisia].

This national survey aims to evaluate opioid availability and prescription by pharmacists in Tunisia and to examine pharmacists' attitude regarding Tunisian law. We surveyed a sample of 300 pharmacists randomly selected from the National Council of Pharmacists list and using the random table. This study started in September 1999 by sending to pharmacists a confidential questionnaire asking about the importance, the rate of sale and the availability of analgesics in their pharmacy. It also tried to determine pharmacists' opinions regarding Tunisian law. A total of 157 pharmacists out of 300 responded to the survey (52 per cent), 95 per cent were working in pharmacies and 15 per cent in hospitals. Analgesics were estimated to be important to very important in their work in 84 per cent and less important in 16 per cent of cases. They were given under advice with great importance in 85 per cent of cases and with less importance in 15 per cent of cases. Analgesic self-medication was frequent in 95 per cent of cases and rare in 4 per cent of cases. Analgesics of levels 1 and 2 were often to always available in 97 per cent of cases and rarely available in 1.5 per cent of cases. Some 84.7 per cent of pharmacists had opioid supplies and 8.9 per cent had no opioids in stock and 6.4 per cent hadn't given a response. 30 per cent of pharmacists think that the 7 days law for opioid prescription should be modified and 66 per cent think it should not, fearing illicit use, fraud and dependance. Pharmacists think that the minimal list of opioids to be stocked in a pharmacy is sufficient because of low demand.

Analgesics, Opioid↗

PubMed2000

The prevalence of viral hepatitis (HAV, HBV and HCV) in the Christchurch community.

AIM: To determine the prevalence of hepatitis A (HAV), hepatitis B (HBV) and hepatitis C (HCV) in adults randomly selected from the Christchurch community. METHODS: A list of names was randomly generated from the Christchurch electoral roll and subjects were sequentially contacted and invited to participate. A blood sample was taken and tested for hepatitis A (IgG anti-HAV antibody), hepatitis B (HBsAg and anti-HBc) and HCV (anti-HCV antibody) using Abbott Elisa kits. Subjects positive for HBsAg were also tested for HBeAg/HBV DNA. Those positive for anti-HBc were tested for anti-HBs. HCV antibody positive samples were tested for HCV RNA using PCR. RESULTS: 1064 subjects (30.3% of those invited) participated in the study. The prevalence of HAV antibodies was 27.9%, and increased with age. The overall prevalence of HBV markers was 42/1064 (4.2%), and of these 0.3% were HBsAg positive and 3.9% were considered immune. No gender or ethnic differences in these proportions were observed. The seroprevalence of HVC antibody was 3/1064 (0.3%), two of whom were also PCR positive for HCV RNA. CONCLUSION: In the Christchurch community there was a high prevalence of antibodies to HAV, which increased with age. The prevalence of HBsAg and antibody to HCV were both low at 0.3%.

Adult↗

PubMed2002

Free recall and organization as a function of varying relational encoding in action memory.

A new approach was taken to study the question whether the free recall advantage of enacting actions (SPT), over only listening to their verbal descriptions (VT), is due to better relational encoding of SPTs than of VTs. The approach consisted of studying related lists and manipulating the degree of relational encoding by repeated list presentation in Experiment 1 and by presenting the list items at random or blocked in Experiment 2. In both experiments, free recall and adjusted ratio of clustering (ARC) scores increased as to be expected with repeated list presentation and blocking. However, these effects proved to be independent of the type of encoding. There was a clear SPT effect in free recall, but in contrast a slight though nonsignificant advantage of VTs over SPTs in ARC scores. Altogether, the experiments show that the SPT effect in free recall is not due to better relational encoding in SPTs than in VTs, in line with the assumption that this effect is due to good item-specific encoding.

Adult↗

PubMed2005

Fellow eye comparison between the 1CU accommodative intraocular lens and the Acrysof MA30 monofocal intraocular lens.

PURPOSE: To examine the near visual clinical performance of an accommodative intraocular lens (IOL) when compared with a standard monofocal IOL in a fellow eye comparison. DESIGN: Prospective, randomized fellow eye comparison. METHODS: Thirty patients (60 eyes) with bilateral cataracts but otherwise normal eyes were recruited from a single university hospital cataract waiting list. Patients were randomized to receive either the 1CU accommodative IOL in their first eye or the Acrysof MA30 monofocal IOL. The alternative lens was then implanted in the second eye 4 to 6 weeks later. At all follow-up visits, a full assessment was made of distance, near and reading visual performance, and accommodative amplitude. RESULTS: Data are available for all patients at 6 months and 20 patients at 1 year. At 6 months, no difference was found in distance-corrected visual acuity between the two IOLs. Of the 1CU eyes, nine patients (30%) could read J6 or better at a reading speed of 80 words/min or better. In these nine patients, the mean difference in the amplitude of accommodation between the two eyes was 0.71 diopters. CONCLUSIONS: No measurable variable distinguished eyes that developed functional reading vision from those that did not. The accommodative IOL appears to produce improved near vision in some eyes, but it does not work in all eyes, and in eyes where there is apparent accommodation, there is a discrepancy between subjective reading performance and the modest measured increase of accommodative amplitude.

Accommodation, Ocular↗

PubMed1990

[Assessment of the effectiveness of inpatient rehabilitation measures in patients with chronic low back pain: a prospective, randomized, controlled study].

Chronic low-back pain is a frequent symptom causing considerable socioeconomic costs in many countries. Outpatient treatment of low-back pain often remains unsatisfactory. In our prospective study, one hundred patients on the five months waiting list were allocated randomly to attending the hospital either four months or six months later, the latter serving as a control group for those undergoing treatment. Health status was assessed using a multidimensional questionnaire, which had proven a reliable, valid and sensitive instrument in former studies. After four to six weeks of multidisciplinary inpatient treatment, a significant decrease in pain, anxiety and depression was found, whereas no improvement was observed in the control group. Multidisciplinary inpatient treatment therefore at least has short-term positive effects on patients' health status.

Back Pain↗