Healthcare (Basel, Switzerland)
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Because of the great prevalence of chronic pain, it is not surprising that there have been a number of influential reports by the Institute of Medicine, National Institutes of Health, and the World Health Organization that have documented the medical, social and economic problems caused by it, and the need for better pain-management programs. The present article briefly reviews these reports, and then focuses on three important areas that need to be considered when addressing the continuing and growing epidemic of one of the most prevalent types of chronic pain [chronic low back pain (CLBP)]: the biopsychosocial model of chronic pain; the paradigm shift in medicine from a disease model to an illness model of CLBP; and a review of the treatment- and cost-effectiveness of interdisciplinary chronic pain management programs. This overview will serve as an important prelude to other topics related to low back pain included in this Special Issue of Healthcare. Topics covered will range from assessment and treatment approaches, to important psychosocial mediators/moderators such as coping and pain beliefs.
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Malnutrition is common in older adults and often goes unrecognised and untreated. Australian evidence-based guidelines for the management of malnutrition indicate that only the Mini Nutritional Assessment short form (MNA-sf) and Rapid Screen are recommended for use as malnutrition screening tools in the rehabilitation setting. The aim of this secondary analysis was to assess the validity and reliability of two malnutrition screening tools, validated in other adult sub-groups, in a rehabilitation population aged ≥60 years. ⋯ Assessment of reliability indicated significant slight to fair agreement between MNA with CNAQ (κ = 0.309, p < 0.001) and SNAQ (κ = 0.176, p < 0.001). Neither the CNAQ nor the SNAQ have a high level of validity or reliability in this elderly population and are therefore not recommended for use in the ambulatory rehabilitation setting. Further work is necessary to assess the validity and reliability of other malnutrition screening tools to establish their usefulness in this population.