Search

Objective: Metabolic syndrome (MS) is highly prevalent in schizophrenia and often a consequence of unhealthy behaviour. Reward‐related brain areas might be associated with MS, since they play a major role in regulating health behaviour. This study examined the relationship between MS and brain volumes related to the reward system in schizophrenia. Method: We included patients with schizophrenia, with MS (MS+; n = 23), patients with schizophrenia, without MS (MS−; n = 48), and healthy controls (n = 54). Global brain volumes and volumes of (sub)cortical areas, part of the reward circuit, were compared between patients and controls. In case of a significant brain volume difference between patients and controls, the impact of MS in schizophrenia was examined. Results: Patients had smaller total brain (TB; P = 0.001), GM (P = 0.010), larger ventricles (P = 0.026), and smaller reward circuit volume (P < 0.001) than controls. MS+ had smaller TB (P = 0.017), GM (P = 0.008), larger ventricles (P = 0.015), and smaller reward circuit volume (P = 0.002) than MS−. MS+ had smaller orbitofrontal cortex (OFC; P = 0.002) and insula volumes (P = 0.005) and smaller OFC (P = 0.008) and insula cortical surface area (P = 0.025) compared to MS−. Conclusion: In schizophrenia, structural brain volume reductions in areas of the reward circuitry appear to be related to comorbid MS. [ABSTRACT FROM AUTHOR]

This paper describes a study of the effect of an external electric field on the behavior of positrons in metal-oxide-silicon (MOS) systems. Doppler broadening measurements of the annihilation radiation were performed on capacitors with identical thermally grown SiO[sub 2] layers and with Al, W and Au layers as a gate. The data were analyzed by the combined use of the shape- and wing-parameters of the photo peak. The observed effects of the electric field are due to the field-driven transport of positrons through the SiO[sub 2], silicon and the interfaces. By applying a field of the order of 1 MV/cm the positrons can be efficiently transported through the approximately 100 nm thick SiO[sub 2] layer. From the transport behavior of the positrons it is concluded that the positron affinity is higher for SiO[sub 2] than for silicon and for the gate metal. By properly choosing the direction of the field, the positrons implanted into the SiO[sub 2] layer are collected either at the Si/SiO[sub 2] interface or at the SiO[sub 2]/gate interface. For negative gate bias the positrons implanted into the substrate, that diffuse back to the SiO[sub 2], are transported through the oxide layer and injected into the gate metal. This is the first time that field-assisted transport of positrons across an insulating layer has been demonstrated. [ABSTRACT FROM AUTHOR]

Presents an approach for the analysis of positron beam Doppler broadening data by the use of shape and wing-parameters. Advantages in the use of shape and wing-parameters; Application of the shape and wing-parameters in a metal-oxide-silicon system; Positron-related parameters derived by several methods for helium-implanted silicon.

Deals with a study which examined the generation of slow interface states by vacuum ultraviolet irradiation on metal-oxide-silicon samples and a transparent aluminum gate. Experimental procedure; Results; Discussion; Conclusions.

Studies the degradation of the thermal oxide of the silicon/silicon dioxide/aluminum system due to vacuum ultraviolet irradiation. Method of the study; Results and discussion; Conclusion.

Presents a study that examined the fabrication of conventional and electromagnetically casted multicrystalline silicon solar cells using different passivation schemes. Implementation of plasma-enhanced chemical-vapor-deposition; Information on multicrystalline silicon; Discussion on hydrogen plasma passivation.

Deals with the instability and recovery of the large negative midgap voltage induced in metal-thermally grown silicon dioxide-silicon capacitors with transparent aluminum gate. Cause of the midgap voltage instability; Mechanisms which contribute to the gradual recovery of the samples; Types of defects which are attributed to the instabilities and the recovery of the samples.

Presents a study which investigated the effect of fluorination on the electrical properties of the silicon/silicon oxide/aluminum system, including their degradation. Defects in the silicon/silicon oxide system; Methods; Conclusion.

Focuses on a study which detailed the calculation of the interaction energy of arrays of dislocations with nonperiodic distribution. Reason for conducting the calculations; Focus of studies on strain relaxation in pseudomorphic epilayers; Situation in which the calculated rate of strain relaxation on annealing the metastable layers at higher temperatures is increased.

Focuses on a study which determined the properties of doped and undoped amorphous silicon films deposited by the homogenous chemical vapor deposition (HOMOCVD) technique. Information on HOMOCVD; Methodology of the study; Results and discussion.

Focuses on a study which determined the characterization of silicon-on-insulator structures formed by a buried silicon-nitride layer through spectroscopic ellipsometry. Implantation of nitrogen ions; Methodology of the study; Results and discussion.

Chronicity and recurrence in musculoskeletal shoulder pain are highly prevalent and can possibly be attributed to the concept of central sensitization. Available studies suggest a role for central sensitization in explaining chronic shoulder pain, but so far a comprehensive quantitative sensory testing (QST) protocol has not been used. The aim of this study was to gain knowledge on sensory processing and central pain modulatory mechanisms in patients suffering from chronic shoulder pain using such a QST protocol. Fifty study participants, including chronic shoulder pain patients and healthy controls, underwent a standardized, comprehensive psychophysical testing procedure. A static adapted QST protocol (including pressure algometry, vibration and mechanical detection) was applied. Thereafter, all subjects underwent dynamic measures of temporal summation and conditioned pain modulation. Questionnaires assessing psychosocial factors were completed by each subject. No significant differences (P >= .05) were found between patients and controls based on pressure algometry, vibration detection, mechanical detection, temporal summation, and conditioned pain modulation. Moderate positive correlations (r = .5) were found between pressure pain thresholds (PPTs) and the amount of sports participation. Weak‐to‐moderate negative correlations (r = −.3 à −.5) were found between PPTs and psychosocial factors such as pain catastrophizing. Based on these findings, we can conclude that central sensitization is no characteristic feature in chronic musculo‐skeletal shoulder pain but can be present in individual cases. [ABSTRACT FROM AUTHOR]

Introduction: In 2013, a study showed low guideline adherence regarding chronic low back pain (CLBP) in physiotherapy students concerning activity and work recommendations (47% and 16%)1. The aim of this study is to investigate if the 2020' physiotherapy students'attitudes and beliefs regarding CLBP and osteoarthritis (OA) and the guideline adherence have changed since 2013, by using the same protocol. Methods: Physiotherapy students in their 2nd and 4th year of education from 6 Belgian and 2 Dutch institutions participated. The attitudes and beliefs regarding CLBP and OA were measured using the Pain attitudes and beliefs scale (BAPS), the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and a questionnaire regarding therapeutic exercise and knee OA. A clinical case vignette was used to measure the guideline adherence regarding CLBP. Results: In total, 2738 students participated, 1624 in 2013 and 1114 in 2020. Compared to 2013, students in 2020 scored lower on a biomedical orientation (p < 0.001) and higher on psychosocial orientations (p < 0.001) regarding CLBP and OA. Medium effect size (cohens'd = 0.548) was found on the psychosocial orientation of the PABS, other differences only had small effect sizes. In 2020, 54% provided clinical guidelines' consistent recommendations for activity and 28% for work, which significantly improved compared to 2013. Discussion: A positive shift occurred towards a more biopsychosocial approach between students of 2013 and 2020. However, the improved guideline adherence concerning activity and work recommendations remains low. Process evaluation: Additional clinical case vignette to measure clinical recommendations regarding OA would have strengthen this study. [ABSTRACT FROM AUTHOR]

Introduction: Therapeutic alliance (TA) is a necessity for optimal physiotherapy treatment for patients with musculoskeletal (MSK) pain1,2. Mutual understanding and open communication are important in building strong TA1,2. Building TA with patients from socio-cultural vulnerable groups seems to be difficult and might be related with higher risk on poor treatment outcomes3. Therefore, the aims of this study are to: (1) determine facilitators and barriers for building optimal TA with patients with MSK pain from socio-cultural vulnerable groups (2) develop and implement interventions to optimize TA. Methods: This participatory action research consists of multiple cycles of five phases in which researchers, clinicians and patients work closely together to investigate and optimize TA. Both observational research and semi-structured interviews will be conducted to gather data for reflection and deep understanding. Preliminary results will be used to collectively develop and implement interventions to optimize TA. This cycle of data collection and reflection will be repeated until optimal outcomes in TA are achieved from both therapist and patient perspective. Results: Diverse facilitators and barriers in TA are expected such as communication styles, language barriers, and expectations of treatment. Working together with patients and physiotherapists as co-researchers creates the ability to jointly investigate and optimize TA. Discussion: Since MSK pain is a frequent and debilitating health problem in patients from socio-cultural vulnerable groups, research into improving TA is important. By using participatory action research, knowledge about barriers and facilitators for TA can be obtained and changes in current physiotherapy practice may be facilitated. Process evaluation: Currently, the research design and practical preparations are being finalized. [ABSTRACT FROM AUTHOR]

Introduction: Up to >50% of individuals with symptomatic knee osteoarthritis (KOA) also report insomnia. Research suggests that the insomnia-pain link is bi-directional and complex with other factors like anxiety and mood being relevant. Network analysis allows to estimate these dynamic system interactions and to illustrate them graphically. This is an advantage over traditional statistical models (e.g. regression models) which investigate aspects of systems in isolation1. However, network analysis has not yet been utilized in the field of KOA and insomnia. Methods: We will use baseline data from a randomized controlled trial to estimate a cross-sectional network model connecting insomnia and pain in patients with KOA. The network structure will be estimated using Gaussian Graphical models with LASSO-regularization2. Established measures for sleep, pain, depression, anxiety, physical activity, pain catastrophizing and fatigue will be included. We will further analyse global network density and node centrality1. Results: The results will provide us a better understanding of how the network connecting pain and insomnia is built and which factors are most influential. Discussion: Our study will be the first that uses network analysis to understand the connection between KOA pain and insomnia. This will provide relevant clinical insights and interest other researchers in this exciting area of research. Process evaluation: Network analyses are new to me and there are not many examples in the field of chronic pain. It took me some time to understand the basics but the more I read the more excited I get about the opportunities these methods offer. [ABSTRACT FROM AUTHOR]

Introduction: Chronic pain in breast cancer survivors (BCSs) impacts the health-related quality of life (HRQoL) and participation in activities of daily living tremendously[1-5]. Over the past decades, the use of pain neuroscience education (PNE) has been shown to be effective in reducing pain[6-8]. Since PNE alone has relatively small effect sizes, it should ideally be combined with a physical component[6], such as behavioural graded activity (BGA)[9,10]. Therefore, this study aims to investigate the effectiveness of PNE with BGA compared to usual care on chronic pain in BCSs. Methods: Two hundred BCSs with chronic pain will be randomly assigned to the intervention or usual care group. The intervention group will receive a 12-week treatment program consisting of 6 sessions, in which PNE and BGA are integrated. Whereas the usual care group will receive an information leaflet regarding "Pain in and after cancer". The primary outcome is pain, and the secondary outcomes are endogenous hyperalgesia and HRQoL. Explanatory variables such as pain cognitions, sleep, depression will be inventoried as well. All variables will be assessed at baseline, immediate, 3-and, 12-months post-treatment. To examine the added effect of PNE and BGA, a linear mixed model for repeated measurements will be conducted[11,12]. Results: We hypothesise that PNE with BGA will lead to more beneficial outcomes compared to usual care in BCSs with chronic pain. Discussion: PNE with BGA might lead to proper non-pharmacological treatment for pain in BCS. Process evaluation: Currently, 82/200 participants were recruited. The recruitment was delayed due to the COVID-19 outbreak. [ABSTRACT FROM AUTHOR]

Introduction: Numerous scientific studies have established the necessity of a biopsychosocial (BPS) approach in the treatment of chronic pain, however, the implementation into clinical practice falls short. The aim of this study is to investigate the effectiveness of a BPS pain educational program for primary healthcare providers (PHCP) on changes in knowledge and attitude, and the guideline adherence. Methods: Within an implementation project of the Belgian Federal Government, a BPS pain educational program was developed based on recent scientific research, and barriers and facilitators formulated by an expert panel. 300 PHCP from various disciplines followed the course which contains two e-learning sessions and two one-day face-to-face trainings. Changes in knowledge and attitudes regarding chronic pain were measured using the KNowledge and Attitudes of Pain (KNAP). Guideline adherence was measured with two clinical case vignettes. Participants were measured pre-course, post-course and at a 6-month follow-up. The satisfaction of participants regarding the training and implementation into practice was measured during the course and at the follow-up. Results: A shift towards the biopsychosocial perspective that is in line with clinical guidelines is expected after completing the chronic pain course. Discussion: The pain course developed in the present study might increase the biopsychosocial perspective and guideline adherence of PHCP. Process evaluation: The selection of adequate evaluation tools to assess multidisciplinary groups was challenging. Furthermore, it remains to be established whether the improvements observed in knowledge and attitude questionnaires and the guideline adherence based on clinical vignettes reflect actual change in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Central sensitization is common in knee osteoarthritis patients (KOAP)1. Exercise therapy is suggested to be beneficial by activating endogenous analgesia2. Therefore, this systematic review aims to summarize the basal and/or acute effects of exercises on endogenous analgesia in KOAP. Methods: PubMed, Web of Science, and Embase were systematically searched. If possible, a meta-analysis was performed. Risk of bias was scored using the Cochrane ROB 2.0 or ROBINS-I and strength of evidence was assessed by the GRADE approach. Results: A total of 19 studies were included: 4 studies investigated pain thresholds after an acute bout of exercise; 15 articles focused on basal levels of endogenous analgesia (as measured by pain thresholds (n = 15), -facilitation (n = 3), and -inhibition (n = 2)). A meta-analysis combining 2 studies demonstrated that KOAP did not become more tolerant for pressure pain than healthy controls immediately after resistance training (p > 0.05). Besides that, one study with moderate quality of evidence showed that exercising KOAP had higher pain thresholds than non-exercising KOAP immediately after exercise (p < 0.05). A meta-analysis combining three studies showed that strength training of 6-12 weeks caused a significant increase in pain thresholds in KOAP compared to non-exercising KOAP (p < 0.05). Discussion: Very low quality of evidence proved that strength training of at least 6 weeks is effective in increasing pain thresholds in KOAP. Moderate quality of evidence demonstrated that an acute bout of exercise effectively increases pain thresholds in KOAP. Process evaluation: Literature about this topic is scarce, especially studies investigating pain facilitation (n = 3) and inhibition (n = 1). [ABSTRACT FROM AUTHOR]

Introduction: Chronic Whiplash Associated Disorders (CWAD) are characterized by long-lasting symptoms of neck pain occurring after an acceleration-deceleration injury. Central sensitization (CS) has been suggested as the possible underlying mechanism for these symptoms, and is characterized by changes in the central nervous system. Besides CS, psychological factors are believed to play an important role in the experience of (chronic) pain. Methods: 72 CWAD patients and 55 healthy controls underwent electrical stimuli-based quantitative sensory testing (QST). Detection and pain thresholds (EPT), temporal summation (TS) and conditioned pain modulation (CPM) were examined. Spearman correlations and linear mixed models analyses were performed to assess respectively the hypothesized associations with and group differences in QST. Results: The Pain Catastrophizing magnification subscale correlated with left wrist EPT (r = -0.332; p = 0.004), and the Pain Anxiety Symptom Scale-20 with left wrist (r = -0.325; p = 0.005) and ankle (r = -0.330; p = 0.005) EPT. TS at the ankle correlated with the CS Inventory (r = 0.303; p = 0.010), Short Form 36 pain subscale (r = -0.325; p = 0.005), and Illness Perception Questionnaire revised consequences subscale (r = 0.325; p = 0.005). EPTs of left (p = 0.011) and right wrist (p = 0.023) were lower in the CWAD group, but CPM and TS did not differ between groups. Discussion: QST outcomes relate to psychological constructs, rather than to self-reported pain intensity and distribution. Local hyperalgesia was found in CWAD patients, but no differences in endogenous pain facilitation nor inhibition. Process evaluation: Both CWAD patients reporting unilateral as bilateral neck pain were included, which complicated the interpretation of distal hyperalgesia. [ABSTRACT FROM AUTHOR]

Introduction: Research about perceived injustice (PI) in people with pain is expanding1. PI predicts adverse pain-related and disability outcomes2, and increases the risk of long-term opioid use potentially leading to side-effects3. Therefore, understanding PI in people with pain is necessary to target interventions and prevent pain chronicity. Methods: A systematic search was conducted. Two independent reviewers screened and evaluated the literature and extracted the data. Meta-analyses were performed for prevalence rates and factors associated with PI in people with pain. Results: Fifty-four studies were found eligible. Prevalence of PI ranged between 23-77% (I² = 99%). Significant associations were found with pain catastrophizing, posttraumatic stress, anger, anxiety, pain acceptance, depressive symptoms, kinesiophobia, academic functioning, disability, emotional functioning, pain interference, state anger, mental functioning, central sensitization, social functioning, physical functioning, pain perceptions, trait anger, pain intensity, and anger inhibition. Discussion: Prevalence was =33 in 75% of the studies. Considering PI in the treatment of people with pain is important due to its association with adverse pain, psychological, and quality of life characteristics. Process evaluation: This is the first systematic review estimating the prevalence and factors associated with PI. Methodologically, not all association measures (e.g., odds-ratios, beta-coefficients) could be included in the meta-analyses. Since we focussed on associations, we cannot draw any conclusions on causal interactions between PI and related factors in people with pain. [ABSTRACT FROM AUTHOR]

The stress field in laterally small strained semiconductor epilayers has been studied by the finite element method. The reaction of the epilayer on the substrate and the bulging-out effect caused by shear forces in the side wall boundaries play an important role. Analytical approximate methods are shown to be deficient. The normal stresses relax faster than a simple exponential with height z and virtually complete relaxation occurs at a height heff≊ [Square_Root]ab/2 (where a and b are the width and length, respectively, of the parallellopipidial epilayer) which is in good agreement with recent experiments. An equivalent lattice spacing fm as a function of z/[Square_Root]ab is defined and calculated. [ABSTRACT FROM AUTHOR]

Objective More than 40% of patients with schizophrenia have an additional diagnosis of the metabolic syndrome ( MS), possibly related to poor cognition. This study investigated premorbid and current cognitive functioning in schizophrenia and co-occurrence of MS. Method A total of 104 participants with schizophrenia with MS and 142 without MS were included. Neuropsychological assessment was carried out using the Wechsler Adult Intelligence Scale- III, Word Learning Task, and Continuous Performance Test- HQ. Premorbid functioning was assessed retrospectively with the Premorbid Adjustment Scale. anovas were used to examine differences between participants with and without MS. Results Subjects with and without MS did not differ concerning current, lifetime and amount substance use, duration/severity of illness, parental socioeconomic status (SES), and type/amount of antipsychotic medication. We found that poor school performance between the ages 12 and 16 is associated with MS in schizophrenia. Educational level and current cognitive functioning in participants with MS deviate as compared to those without MS. Conclusion Subjects with MS had impaired premorbid cognition in adolescence and lower educational achievement, irrespective of parental SES. This suggests poor premorbid cognitive functioning is a risk factor for metabolic complications later in life. Future studies are needed to examine whether cognitive interventions have beneficial effects on general health in schizophrenia. [ABSTRACT FROM AUTHOR]

Docetaxel is extensively used in chemotherapy for the treatment of breast cancer. Little attention has been given to oedema as a possible side effect of docetaxel-containing therapies. Until now, no review was conducted to evaluate docetaxel-containing therapies versus docetaxel-free therapies on the magnitude of the risk of developing oedema. In this systematic review, we investigated the risk of developing oedema in patients being treated for breast cancer with or without docetaxel. In this systematic literature review, we searched Pub Med and Web of Knowledge for studies on breast cancer patients treated with chemotherapy containing docetaxel. We included clinical trials comparing docetaxel versus docetaxel-free chemotherapy. Oedema had to be reported and measured as a key outcome or an adverse effect. Methodological checklists were used to assess the risk of bias within the selected studies. Seven randomised clinical trials were included. Six trials were of moderate methodological quality. All trials showed an increased rate of oedema in the docetaxel- treatment arm. The trial of weakest methodological quality reported the highest incidence of oedema. The results moderately suggest that adjuvant chemotherapy containing docetaxel is related to a significantly increased risk of developing oedema, compared with docetaxel-free chemotherapy. [ABSTRACT FROM AUTHOR]

Background: Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients with severe respiratory failure. Indirect calorimetry (IC) is a safe and non-invasive method for measuring resting energy expenditure (REE). No data exist on the use of IC in ECMO-treated patients as oxygen uptake and carbon dioxide elimination are divided between mechanical ventilation and the artificial lung. We report our preliminary clinical experience with a theoretical model that derives REE from IC measurements obtained separately on the ventilator and on the artificial lung.Methods: A patient undergoing veno-venous ECMO for acute respiratory failure due to bilateral pneumonia was studied. The calorimeter was first connected to the ventilator and oxygen consumption (VO2 ) and carbon dioxide transport (VCO2 ) were measured until steady state was reached. Subsequently, the IC was connected to the membrane oxygenator and similar gas analysis was performed. VO2 and VCO2 values at the native and artificial lung were summed and incorporated in the Weir equation to obtain a REEcomposite .Results: At the ventilator level, VO2 and VCO2 were 29.5 ml/min and 16 ml/min. VO2 and VCO2 at the artificial lung level were 213 ml/min and 187 ml/min. Based on these values, a REEcomposite of 1703 kcal/day was obtained. The Faisy-Fagon and Harris-Benedict equations calculated a REE of 1373 and 1563 kcal/day.Conclusion: We present IC-acquired gas analysis in ECMO patients. We propose to insert individually obtained IC measurements at the native and the artificial lung in the Weir equation for retrieving a measured REEcomposite . [ABSTRACT FROM AUTHOR]

Introduction: Psychological factors and changes in sensory system play a role in low back pain (LBP). Psychological factors are examined by questionnaires and the sensory system by quantitative sensory testing (QST). Questionnaires Start Back screening Tool (SBT) and Central Sensitization Inventory (CSI) subgroup patients into risk respectively severity levels. The aim of this study was investigating the linear trend across the risk and severity levels based on the SBT and CSI for various psychological factors and sensitivity changes in the sensory system. Methods: Participants with LBP were recruited. Demographic information was taken, psychological questionnaires were filled in. Comprehensive QST was taken and linear contrast analysis was conducted in this cross-sectional study. Results: Psychological variables (e.g. kinesiophobia, catastrophizing) show significant positive linear trends across the risk levels of the SBT (p < 0.001) and severity levels of the CSI. Several QST-measurements show significant linear trends between the risk and severity levels based on the SBT (e.g. heat pain thresholdlow leg, p = 0.005) and CSI (e.g. pressure pain thresholdL4, p = 0.012). Discussion: Psychological factors increase as risk and severity levels increase. As the risk and/or severity levels increase some responsiveness of nociceptive neurons increased measured by pressure pain thresholds and heat pain thresholds. Temporal summation and conditioned pain modulation show no significant linear trends. Process evaluation: Recruiting people with LBP in primary care was challenging. Patients do not have often time to participate in research. It is helpful to actively approach different physiotherapists and to recruit participant in one's own working environment. [ABSTRACT FROM AUTHOR]

Introduction: Surgery, the cornerstone of most cancer treatments, is associated with considerable postoperative complications1. Adjusting patients' health behavior before surgery may have beneficial effects on postoperative outcomes. The objective of this trial is to investigate the feasibility and safety of, and patient-satisfaction and adherence with, patient-centered teleprehabilitation in patients undergoing breast cancer (BC) surgery. Methods: Women (n = 50) who will undergo breast surgery because of stage I-III BC are eligible. All participants will receive multimodal patient-centered teleprehabilitation comprising of motivational interviewing, education, exercise therapy, and stress management. Feasibility, participation rate, patient satisfaction, intervention safety, and treatment adherence will be monitored as primary outcomes. Fatigue, pain, quality of life (QoL), self-efficacy, and healthcare utilization will be assessed by self-reported questionnaires at baseline, 0-, 2-, and 6-months post-intervention. Results: Proof of concept for using telecommunication and exercise therapy in prehabilitation prior to BC surgery is available2,3. We expect the proposed intervention to be feasible and effective at reducing fatigue, pain, and healthcare use, and at improving treatment adherence, QoL, and self-efficacy. Discussion: Effective prehabilitation interventions can reduce the long-term symptoms that arise/persist beyond treatment completion, improving patients' QoL. By using telecommunication technologies, socio-economic barriers can be reduced, making care accessible to all. Process evaluation: With timely recruitment being the greatest challenge, a thorough mitigation strategy was put in place. Recruitment, drop-out, and loss-to-follow-up will constantly be monitored. Additional study centers confirmed their willingness to participate, and other study centers can easily be contacted through our collaboration with the Belgian Society of Medical Oncology. [ABSTRACT FROM AUTHOR]

Introduction: Insomnia is a common sleep disorder in people with knee osteoarthritis (KOA), adversely affecting daily function and general health1. It represents a barrier for effective conservative management. Clinical guidelines for KOA recommend integrating comorbidity-specific interventions as a part of patient-centred care2. However, insomnia is rarely addressed in the often joint-targeted KOA treatment. Methods: A two-arm randomized controlled trial (RCT) will be conducted on 128 patients with KOA and insomnia in a community setting. Subjects will randomly be allocated to the intervention group (cognitive behavioral therapy for insomnia (CBT-I) additional to best-practice KOA-care (education and exercise therapy)) or to the control group (best-practice KOA-care). The physiotherapist-led programme for both treatment arms will contain 18 sessions within 14 weeks, 30 minutes each. The primary outcome is pain intensity. Pain interference, sleep-related outcomes and physical activity/function are secondary outcomes. The tertiary outcomes are inflammation and healthcare utilisation. Blinded assessment will be conducted at baseline, post-intervention, and at 3 months, 6 months, and 12 months follow-up. Results: The results will give insights into the clinical and cost-effectiveness of CBT-I combined with best-practice physiotherapy. Discussion: This will be the first RCT integrating CBT-I in best-practice KOA-care in KOA patients with established insomnia whereby inflammation and sleep will be objectively assessed. This could help to improve the outcomes of a large proportion of KOA patients. Process evaluation: Being involved as a therapist in the trial and in the meanwhile developing my skills as a researcher, seems challenging. Is it all about getting the balance right? [ABSTRACT FROM AUTHOR]

Introduction: Numerous variables are associated with the physical activity level (PAL) and health-related quality of life (HRQOL) in various populations with chronic pain and fatigue. This study aims to identify transdiagnostic and disease-specific determinants of HRQOL and PAL in two distinct patient groups experiencing chronic pain and fatigue: patients with chronic fatigue syndrome (CFS) and multiple osteochondromas (MO). Methods: Data on sociodemographic, symptomatology, psychosocial variables, HRQOL and the PAL of patients with MO (n = 342) were collected at OLVG Amsterdam through a survey. The same data was collected at Vrije Universiteit Brussel of patients with CFS (n = 103). Determinants of HRQOL and PAL are explored with multiple linear regression models. Results: Preliminary results showed that both groups have a significantly lower HRQOL and PAL (p = 0.001) than the general population. PAL is expected to be positively associated with HRQOL in both groups. Pain and fatigue intensity and depression are hypothesized to be negatively associated with HRQOL and the PAL. The level of catastrophizing is lower in patients with MO; catastrophizing is hypothesized to be negatively associated with the PAL and HRQOL in patients with CFS, but not MO. Discussion: These results are expected to assist research and clinical practice in the development of evidence-based interventions aimed at maximizing HRQOL for patients with CFS and/or MO. Process evaluation: Explanatory variables are not measured with the same measurement instruments in both groups and require recoding. We need to compare associated variables between patient groups, dummy coding for the chronic condition seems the most appropriate procedure. [ABSTRACT FROM AUTHOR]