@article{pmid36444387,

title = {Distinct care trajectories among persons living with arthritic conditions: A two-year state sequence analysis},

author = {H. L. Nguena Nguefack and M. G. Pag\'{e} and M. Choini\`{e}re and A. Vanasse and S. Deslauriers and A. Angarita-Fonseca and M. A. Blanchette and A. Lacasse},

doi = {10.3389/fpain.2022.1014793},

issn = {2673-561X},

year  = {2022},

date = {2022-11-12},

urldate = {2022-01-01},

journal = {Front Pain Res (Lausanne)},

volume = {3},

pages = {1014793},

abstract = {OBJECTIVES: Developing solutions to optimize care trajectories (CareTs) requires examining patient journeys through the health care system. This study aimed to describe CareTs among people living with arthritis and evaluate their association with self-reported health outcomes.



METHODS: Analyses were conducted using the TorSaDE Cohort ( = 102,148), which connects the 2007 to 2016 Canadian Community Health Surveys (CCHS) with Quebec administrative databases (longitudinal claims). CareTs of participants living with arthritis according to CCHS ( = 16,631), over the two years before CCHS completion, were clustered using state sequence analysis (months as a time unit). CareT group membership was then put in association with self-reported outcomes (pain intensity and interference, self-perceived general and mental health).



RESULTS: The analysis revealed five CareT groups characterized predominantly by: (1) arthritis-related visits to a specialist ( = 2,756; 16.6%), (2) arthritis-related emergency department visits ( = 2,928; 17.6%), (3) very high all-cause health care utilization and arthritis-related hospitalizations ( = 1,570; 9.4%), (4) arthritis-related medical visits to general practitioners and specialists ( = 2,708; 16.3%), (5) low all-cause health care utilization ( = 6,669; 40.1%). Multivariable results revealed that CareT group membership was associated with higher levels of pain interference (CareT group #3 vs. #5: OR: 1.4, 95%CI: 1.1-1.8) and fair/poor self-perceived general health (CareT group #1 vs. #5: OR: 1.551, 95%CI: 1.319-1.824; #2 vs. #5: OR: 1.244, 95%CI: 1.062-1.457; #3 vs. #5: OR: 1.771, 95%CI: 1.451-2.162; #4 vs. #5: OR: 1.481, 95%CI: 1.265-1.735).



DISCUSSION: Sate sequence analysis is an innovative method of studying CareTs and valuable for making evidence-based decisions taking into account inter- and intra-individual variability.},

keywords = {Health services, Musculoskeletal system, Trends},

pubstate = {published},

tppubtype = {article}

}

@article{JA0622,

title = {Handgrip strength is associated with risk of falls in physically active older women},

author = {P. C. VillamizarPita and A. Angarita-Fonseca and H. C. Dutra de Souza and R. Mart\'{i}nez-Rueda and M. C. Villamizar-Garc\'{i}a and J. C. S\'{a}nchez-Delgado},

doi = {10.1080/07399332.2022.2055759},

year  = {2022},

date = {2022-05-13},

urldate = {2022-05-13},

journal = {Health care for women international},

pages = {1-14},

abstract = {The authors of this study inquire about the association between handgrip strength (HGS) and the risk of falls in physically active older women. A cross-sectional study was conducted on 135 women between 50 and 90 years of age who were referred for the follow-up evaluations of HGS using dynamometry and the Tinetti scale to determine the risk of falls. The mean age was 68.8 ± 8.5 years. A total of 31.9% of women had a high risk of falls, and 55% reported five or more falls in the past six months. In addition, our results indicated that grip strength decreases as risk of falls increases (minimal risk = 42.8, 95% confidence interval [CI]: 39.8, 45.8; moderate risk = 31.3, 95% CI: 29.1, 33.5; high risk = 21.9, 95% CI: 19.3, 24.6). It should be considered that in physically active women aged over 50 years, the grip strength could be a predictor of falls and risk of falls. Evaluation of grip strength is a low-cost type of assessment that can be included as a part of physical tests.},

keywords = {Muscle Strength, Physical Activity, Women's health, Women's health},

pubstate = {published},

tppubtype = {article}

}

@article{JA0522,

title = {Gender differences in medication adverse effects experienced by people living with chronic pain},

author = {H. L. Nguena Nguefack and M. G. Pag\'{e} and L. Gu\'{e}nette and L. Blais and M. Diallo and M. Godbout-Parent and A. Angarita-Fonseca and A. Lacasse},

doi = {10.3389/fpain.2022.830153},

year  = {2022},

date = {2022-05-10},

journal = {Frontiers in Pain Research},

volume = {3},

number = {830153},

abstract = {Objectives: Understanding gender differences in chronic pain (CP) outcome research is essential to optimal treatment delivery. This study explored the associations between gender identity, gender roles, and the number of non-life-threatening pain medication adverse effects reported as severe by people living with CP.



Methods: The analyses were conducted using the COPE Cohort, a dataset generated through a web-based recruitment of adults with CP. Participants were asked how they identified themselves (women, men, unknown, unspecified) and gender roles were measured using the Bem Sex-Role Inventory (subgroups were formed applying the median split method). Pain medication adverse effects were assessed using a standardized checklist (none/mild/moderate/severe). A zero-inflated Poisson model was used to assess gender identity, gender roles and their interaction as potential predictors of the number of pain medication adverse effects.



Results: A total of 1,343 participants reported using pain medications. Adjusting for potential confounders, both gender identity (men vs. women: \ss = −0.32, p = 0.0024) and gender roles (androgynous vs. undifferentiated: \ss = 0.26, p = 0.0030) were associated with the number of pain medication adverse effects reported as severe, and they interacted with each other. The stratified analysis by gender roles showed that women reported a greater number of severe adverse effects than men among those classified as masculine and androgynous.



Discussion: Although we are unable to confirm whether the associations can be explained by differences in the experience or in the reporting of effects, gender identity and gender roles should both be explored when studying pain medication adverse effects.},

key = {sex, gender, chronic pain, adverse effects, side effects},

keywords = {Chronic Pain, Pharmacoepidemiology, Women's health},

pubstate = {published},

tppubtype = {article}

}

@article{JA0422,

title = {Prevalence of Cannabis Use for Pain Management in Quebec: A Post-Legalization Estimate Among Generations Living with Chronic Pain},

author = {M. Godbout-Parent and H. L. Nguena Nguefack and A. Angarita-Fonseca and C. Audet and A. Bernier and G. Zahlan and N. Julien and M. G. Pag\'{e} and L Guenette and L. Blais and A. Lacasse},

url = {https://www.tandfonline.com/doi/epub/10.1080/24740527.2022.2051112?needAccess=true, CJP},

doi = {https://doi.org/10.1080/24740527.2022.2051112},

year  = {2022},

date = {2022-03-30},

urldate = {2022-03-30},

journal = {Canadian Journal of Pain},

abstract = {Background

While medical cannabis has been legal in Canada since 2001, recreational cannabis was legalized in October 2018 which has led to a widespread increase in the accessibility of cannabis products.

Aims

This study aimed to estimate the prevalence of cannabis use among adults living with chronic pain (CP) and investigate the relationship between age and cannabis use for CP management.

Methods

A cross-sectional analysis of the COPE Cohort dataset, a large Quebec sample of 1,935 adults living with CP, was conducted. Participants completed a web-based questionnaire in 2019 that contained three yes/no questions about past-year use of cannabis (i.e., for pain management, management of other health-related conditions, recreational purposes).

Results

Among the 1,344 participants who completed the cannabis use section of the questionnaire, the overall prevalence of cannabis use for pain management was 30.1% (95%CI:27.7-32.7). Differences were found between age groups with the highest prevalence among participants aged ≤26 years (36.5%) and lowest for those aged ≥74 years (8.8%). A multivariable logistic model revealed that age, region of residence, generalized pain, use of medications or non-pharmacological approaches for pain management, alcohol/drug consumption, and smoking were associated with the likelihood of using cannabis for pain management.

Conclusions

Cannabis is a common treatment for the management of CP, especially in younger generations. The high prevalence of use emphasizes the importance of better knowledge translation for people living with CP, rapidly generating evidence regarding the safety and efficacy of cannabis, and clinicians’ involvement in supporting people who use cannabis for pain management.},

keywords = {Chronic Pain, Pharmacoepidemiology},

pubstate = {published},

tppubtype = {article}

}

@article{JA0322,

title = {Low back pain definitions: effect on patient inclusion and clinical profiles},

author = {H. Mass\'{e}-Alarie and A. Angarita-Fonseca and A. Lacasse and M. G. Pag\'{e} and P. T\'{e}treault and M. Fortin and L. S. Stone and Roy J. S. and Quebec Low Back Pain Consortium },

editor = {A. Angarita-Fonseca},

url = {https://journals.lww.com/painrpts/Fulltext/2022/04000/Low_back_pain_definitions__effect_on_patient.11.aspx, Pain Reports},

doi = {http://dx.doi.org/10.1097/PR9.0000000000000997},

year  = {2022},

date = {2022-03-22},

urldate = {2022-03-22},

journal = {Pain Reports},

volume = {7},

issue = {2},

pages = {e997},

abstract = {Introduction: 

Numerous definitions of acute low back pain (aLBP) exist. The use of different definitions results in variability in reported prevalence or incidence, conflicting data regarding factors associated with the transition to chronic LBP (cLBP), and hampers comparability among studies.



Objective: 

Here, we compare the impact of 3 aLBP definitions on the number of aLBP cases and participants' characteristics and explore the distribution of participants across definitions.



Methods: 

A sample of 1264 participants from the Quebec Low Back Pain Study was included. Three definitions of aLBP were used: (1) not meeting the National Institutes of Health (NIH) cLBP definition (“nonchronic”), (2) pain beginning \<3 months ago (“acute”), and (3) pain beginning \<3 months with a preceding LBP-free period (“new episode”).



Results: 

There were 847, 842, and 489 aLBP cases meeting the criteria for the 3 definitions, respectively. Participants included in the “nonchronic” had lower pain interference, greater physical function scores, and fewer participants reporting \>5 years of pain than in the other definitions. Half the participants meeting the “acute” definition and one-third of participants meeting the “new episode” definition were also classified as cLBP based on the NIH definition.



Conclusions: 

Our results highlight the importance of the definition used for aLBP. Different definitions influence the sample size and clinical profiles (group's characteristics). We recommended that cohort studies examining the transition from aLBP to cLBP ensure that the definitions selected are mutually exclusive (ie, participants included [aLBP] differ from the expected outcome [cLBP]).},

keywords = {Chronic Pain, Low Back Pain, Musculoskeletal system},

pubstate = {published},

tppubtype = {article}

}

@article{JA2022a,

title = {Examining Facilitators and Barriers to Cardiac Rehabilitation Adherence in a Low-Resource Setting in Latin America from Multiple Perspectives},

author = {D. M. Rangel-cubillos and A. V. Vega-Silva and Y. F. Corzo-Vargas and M. C. Molano-Tordecilla and Y. P. Pe\~{n}uela-Ar\'{e}valo and K. M. Lagos-Pe\~{n}a and A. M. J\'{a}come-Hort\'{u}a and C. J. Villamizar Jaimes and S. L. Grace and H. C. Dutra de Souza and A. Angarita-Fonseca and J. C. S\'{a}nchez Delgado },

url = {https://www.mdpi.com/1660-4601/19/4/1911 Journal},

doi = {https://doi.org/10.3390/ijerph19041911},

year  = {2022},

date = {2022-02-09},

urldate = {2022-02-09},

journal = {Int. J. Environ. Res. Public Health},

volume = {19},

number = {4},

pages = {1911},

abstract = {Cardiac rehabilitation (CR) is under-used, particularly in low-resource settings. There are few studies of barriers and facilitators to CR adherence in these settings, particularly considering multiple perspectives. In this multiple-method study, a cross-sectional survey including the Cardiac Rehabilitation Barriers Scale (each item scored on a five-point Likert scale) was administered to patients treated between February and July, 2019, in three CR centers in Colombia. A random subsample of 50 participants was invited to a focus group, along with an accompanying relative. Physiotherapists from the programs were invited to an interview, with a similar interview guide. Audio-recordings were transcribed and analyzed using interpretive description. A total of 210 patients completed the survey, and 9 patients, together with 3 of their relatives and 3 physiotherapists, were interviewed. The greatest barriers identified were costs (mean = 2.8 ± 1.6), distance (2.6 ± 1.6) and transportation (2.5 ± 1.6); the logistical subscale was highest. Six themes were identified, pertaining to well-being, life roles, weather, financial factors, healthcare professionals and health system factors. The main facilitators were encouragement from physiotherapists, relatives and other patients. The development of hybrid programs where patients transition from supervised to unsupervised sessions when appropriate should be considered, if health insurers were to reimburse them. Programs should consider the implications regarding policies of family inclusion.},

keywords = {Cardiac Rehabilitation, Hearth diseases, Rehabilitation, Treatment adherence},

pubstate = {published},

tppubtype = {article}

}

@article{JA2201,

title = {Use of Moodle to strengthen citizenship competencies in physiotherapy students: a pretest-posttest design},

author = {M. C. Boneth-Collante and J. Salazar-Rodr\'{i}guez and A. Angarita-Fonseca},

url = {https://recyt.fecyt.es/index.php/retos/article/view/82517/66783, Retos},

doi = {10.47197/retos.v44i0.82517},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Retos},

volume = {44},

number = {2},

pages = {242-251},

abstract = {Introduction: Moodle is a learning information and communication technology widely used worldwide and has been little used to strengthen citizenship competencies. 



Objective: To improve citizenship competencies through a pedagogical strategy in the Moodle platform in students registered in the training courses of clinical/administrative physiotherapy practice at the University of Santander, Bucaramanga, Colombia. 



Methods: A pretest-posttest design was carried out. The educational intervention consisted of a pedagogical activity available online 24 hours a day in Moodle for ten weeks. A sample of 41 students completed a questionnaire before and after the educational intervention, which consisted of 25 questions distributed in five dimensions: political constitution, multi-perspective, systemic and reflective thinking, argumentation, and ethics. The total score per dimension ranged from 0 to 100. 



Results: The average knowledge score was 60.8 ± 12.9 in the pretest and 65.1 ± 15.4 in the posttest (p = 0.0665). After the educational intervention, there were positive changes in eight of the 25 questions (p \<0.005), three of which corresponded to the multi-perspective dimension. In the analysis by subgroups, it was found that those who obtained a score equal to or less than 60 in the initial evaluation significantly improved their knowledge [pretest = 51.6 (9.9), posttest = 60 (15.1), p-value = 0.018]. 



Conclusion: A educational intervention with Moodle increased the knowledge of some citizenship competencies among physiotherapy students, especially in the multi-perspective dimension.},

keywords = {Competency-Based Education, Education, Educational Assessment, Knowledge, Learning, Physiotherapy, Students, Technology},

pubstate = {published},

tppubtype = {article}

}

@article{JA2021,

title = {International continuing education for rehabilitation workers in Honduras: a pre-test-post-test evaluation},

author = {A. Angarita-Fonseca and S. Lovo and I. C. Gomez-Diaz and J. Bidonde and M. L. Hijuelos C\'{a}rdenas and M. Basualdo and K. Premkumar and M. Urbina and A. Busch},

doi = {10.47985/dcidj.451},

year  = {2021},

date = {2021-12-31},

urldate = {2021-12-31},

journal = {Disability, CBR \& Inclusive Development},

volume = {32},

number = {4},

pages = {13-39},

abstract = {Background: The knowledge of Honduran healthcare workers who deliver rehabilitation services can be enhanced by support from community-engaged academic collaborations outside the country.



Objective: This study aimed to evaluate reactions and learning linked to two continuing education workshops for rehabilitation workers in northern Honduras.



Method: A pre-test post-test study design was used. In September 2017, faculty from Canada and Colombia, together with health professionals from Honduras, facilitated two neurorehabilitation workshops - one in a rehabilitation centre and the other in a family support organisation located in northern Honduras. The participants were physiotherapists, physicians, nurses and educational professionals, as well as a psychologist, kinesiologist, and non-professionals trained onsite. Seventeen participants attended the ‘Acquired brain injury/spinal cord injury workshop’ (adult workshop), and 15 attended the ‘Rehabilitation for children with impaired neuromotor development workshop’ (paediatric workshop). They completed three questionnaires before the workshops: one on sociodemographic information; one related to knowledge; and, the Modified Stages of Learning Questionnaires (MSLQs). Three questionnaires were completed after the workshops: the Modified Kirkpatrick; a knowledge questionnaire; and, the MSLQ.



Results: Most of the participants agreed that the workshops had positive effects in two of the four Kirkpatrick levels that were evaluated: reaction and learning. In the MSLQs of the paediatric workshop, there was a statistically significant change in the percentage of participants who moved from scanning/evaluation stages in the pre-test to learning/gaining experience in the post-test, in three of the six topics. Three of the knowledge questions showed important learning effects.



Conclusion and Implications: Workshops offered through an international collaboration resulted in enhancing learning and knowledge of neurological rehabilitation workers in Honduras.  This initiative has the potential to improve the quality of care for people with neurological conditions in the region. Participants evaluated the workshops as relevant and held very positive attitudes about the perceived outcomes. The inclusion of local practitioners in planning the workshops and selecting the topics appeared to have aided their relevance. It is recommended that workshop planners take adequate time to ensure relevancy.},

key = {Physical therapy specialty, rehabilitation, nervous system diseases, health education, global health},

keywords = {Continuing Education, Educational Assessment, Global Health, Neurological Rehabilitation, Rehabilitation},

pubstate = {published},

tppubtype = {article}

}

@article{JA5821,

title = {Continuing Education and Professional Networks Workshops among Rehabilitation Workers in Honduras},

author = {A. Angarita-Fonseca and I. C. Gomez-Diaz and E. Pedrozo Araque and L. M. Uribe Calder\'{o}n and V. Umaefulam and K. Premkumar and M. Urbina and M. L. Hijuelos-C\'{a}rdenas and A. Busch and J. Bidonde},

url = {https://sites.google.com/view/revistakinesiologia/n\'{u}meros-previos/n\'{u}mero-4-2021-vol-40/talleres-de-educaci\'{o}n-continua-y-redes-profesionales-entre-los-trabajadores, Revista Kinesiologia},

year  = {2021},

date = {2021-12-15},

urldate = {2021-12-15},

journal = {Kinesiologia},

volume = {40},

number = {4},

pages = {233-242},

abstract = {Introduction. The work of non-medical rehabilitators in Honduras is done in isolated groups that need connectivity. Collaboration and professional networking can help rehab workers with the overwhelming clinical demands they face. Objectives. 1) describe the initial participation in professional networks of rehabilitation therapists and support rehabilitation workers who attended the workshops, and 2) evaluate the indirect effect of continuing education workshops on professional networks among attendees. Methods. A prospective longitudinal study was carried out. Participants in five continuing education workshops on rehabilitation held between 2017 and 2019 in northern Honduras completed a questionnaire made up of the sociodemographic sections and participation in professional networks. Generalized Estimation Equations (EEG) were used to assess the effects of workshop attendance on professional network dimensions (dimensions of clinical support and opportunities for participation in professional networks) adjusted for sociodemographic characteristics and work-related variables. Results. 100 questionnaires filled out by 67 participants were analyzed. Forty-six participants attended a single workshop; 12 attended two and 9 attended three or more workshops. 34.3% worked as a rehabilitation therapist, 62.7% were other professionals, and 3% were rehabilitation assistants. Multivariate EEGs did not show any significant association between attendance at continuing education workshops and the dimensions of participation in professional networks. Rehabilitation therapists presented fewer opportunities to participate in networks than other health professionals. Conclusion. There was no evidence of an effect of workshop attendance on participation in professional networks. Future workshops should include objectives and strategies for developing professional networks.},

keywords = {Continuing Education, Neurological Rehabilitation, Rehabilitation},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34724980,

title = {Patient-important outcomes reported in randomized controlled trials of pharmacologic treatments for COVID-19: a protocol of a META-epidemiological study},

author = {M. A. Jimenez-Mora and A. R. Varela and J. F. Meneses-Echavez and J. Bidonde and A. Angarita-Fonseca and R. A. C. Siemieniuk and D. Zeraatkar and J. J. Bartoszko and R. Brignardello-Petersen and K. Honarmand and B. Rochwerg and G. Guyatt and J. J. Yepes-Nu\~{n}ez},

url = {https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-021-01838-8, Systematic Reviews},

doi = {10.1186/s13643-021-01838-8},

issn = {2046-4053},

year  = {2021},

date = {2021-11-01},

urldate = {2021-11-01},

journal = {Syst Rev},

volume = {10},

number = {1},

pages = {289},

abstract = {BACKGROUND: The coronavirus disease 19 (covid-19) pandemic has underscored the need to expedite clinical research, which may lead investigators to shift away from measuring patient-important outcomes (PIO), limiting research applicability. We aim to investigate if randomized controlled trials (RCTs) of covid-19 pharmacological therapies include PIOs.



METHODS: We will perform a meta-epidemiological study of RCTs that included people at risk for, or with suspected, probable, or confirmed covid-19, examining any pharmacological treatment or blood product aimed at prophylaxis or treatment. We will obtain data from all RCTs identified in a living network metanalysis (NMA). The main data sources are the living WHO covid-19 database up to 1 March 2021 and six additional Chinese databases up to 20 February 2021. Two reviewers independently will review each citation, full-text article, and abstract data. To categorize the outcomes according to their importance to patients, we will adapt a previously defined hierarchy: a) mortality, b) quality of life/ functional status/symptoms, c) morbidity, and d) surrogate outcomes. Outcomes within the category a) and b) will be considered critically important to patients, and outcomes within the category c) will be regarded as important. We will use descriptive statistics to assess the proportion of studies that report each category of outcomes. We will perform univariable and multivariable analysis to explore associations between trial characteristics and the likelihood of reporting PIOs.



DISCUSSION: The findings from this meta-epidemiological study will help health care professionals and researchers understand if the current covid-19 trials are effectively assessing and reporting the outcomes that are important to patients. If a deficiency in capturing PIOs is identified, this information may help inform the development of future RCTs in covid-19.



SYSTEMATIC REVIEW REGISTRATIONS: Open Science Framework registration: osf.io/6xgjz .},

key = {Coronavirus, COVID-19, Patient-important outcome, Prevention, Reporting, Treatment},

keywords = {Coronavirus, COVID-19, Patient-important outcome, Prevention, Reporting, Respiratory system, Treatment},

pubstate = {published},

tppubtype = {article}

}