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1.  What do general practitioners think about an online self-regulation programme for health promotion? Focus group interviews 
BMC Family Practice  2015;16:3.
Chronic diseases may be prevented through programmes that promote physical activity and healthy nutrition. Computer-tailoring programmes are effective in changing behaviour in the short- and long-term. An important issue is the implementation of these programmes in general practice. However, there are several barriers that hinder the adoption of eHealth programmes in general practice. This study explored the feasibility of an eHealth programme that was designed, using self-regulation principles.
Seven focus group interviews (a total of 62 GPs) were organized to explore GPs’ opinions about the feasibility of the eHealth programme for prevention in general practice. At the beginning of each focus group, GPs were informed about the principles of the self-regulation programme ‘My Plan’. Open-ended questions were used to assess the opinion of GPs about the content and the use of the programme. The focus groups discussions were audio-taped, transcribed and thematically analysed via NVivo software.
The majority of the GPs was positive about the use of self-regulation strategies and about the use of computer-tailored programmes in general practice. There were contradictory results about the delivery mode of the programme. GPs also indicated that the programme might be less suited for patients with a low educational level or for old patients.
Overall, GPs are positive about the adoption of self-regulation techniques for health promotion in their practice. However, they raised doubts about the adoption in general practice. This barrier may be addressed (1) by offering various ways to deliver the programme, and (2) by allowing flexibility to match different work flow systems. GPs also believed that the acceptability and usability of the programme was low for patients who are old or with low education. The issues raised by GPs will need to be taken into account when developing and implementing an eHealth programme in general practice.
Electronic supplementary material
The online version of this article (doi:10.1186/s12875-014-0214-5) contains supplementary material, which is available to authorized users.
PMCID: PMC4311516  PMID: 25608851
Health promotion; Physical activity; Healthy nutrition; General practitioners; Self-regulation; eHealth; Tablets; Computer tailoring; Feasibility
2.  Spirometry-related pain and distress in adolescents and young adults with cystic fibrosis: The role of acceptance 
To investigate the occurrence of spirometry-related pain and distress in adolescents and young adults with cystic fibrosis (CF), and to investigate the role of acceptance of illness in spirometry-related pain and distress.
A total of 36 adolescents and young adults with CF (12 to 22 years of age) completed a questionnaire assessing acceptance of illness. Spirometry-related distress was assessed using self-report (ie, anxiety/worry about the procedure) and physiological outcomes (ie, heart rate and heart rate variability) before spirometry. Spirometry-related pain was assessed using self-report (ie, expected pain and pain-related thoughts). Self-reported distress and pain during spirometry were also assessed.
Eighty-nine per cent of subjects reported distress before spirometry, 67% experienced distress during spirometry, 28% expected pain during spirometry and 22% actually experienced pain. Interestingly, partial correlations revealed that more acceptance was related to less expected pain and pain-related thoughts. Acceptance, however, was unrelated to distress, anxiety and pain during spirometry.
The present study suggests that a non-negligible number of adolescents and young adults with CF experience pain and distress during spirometry. Furthermore, results indicate that acceptance may play a protective role in the more indirect consequences of CF such as expected pain and pain-related thoughts during medical procedures. Acceptance, however, was not related to distress before and during spirometry, nor to experienced pain. These findings contribute to the increasing evidence that acceptance may play a protective role in managing the consequences of living with CF.
PMCID: PMC3917791  PMID: 23985580
Acceptance; Cystic fibrosis; Distress; HRV; Pain
3.  Observing another in pain facilitates vicarious experiences and modulates somatosensory experiences 
Objective: This study investigated whether individuals reporting vicarious pain in daily life (e.g., the self-reported vicarious pain group) display vicarious experiences during an experimental paradigm, and also show an improved detection of somatosensory stimuli while observing another in pain. Furthermore, this study investigated the stability of these phenomena. Finally, this study explored the putative modulating role of dispositional empathy and hypervigilance for pain.
Methods: Vicarious pain responders (i.e., reporting vicarious pain in daily life; N = 16) and controls (N = 19) were selected from a large sample, and viewed videos depicting pain-related (hands being pricked) and non-pain related scenes, whilst occasionally experiencing vibrotactile stimuli themselves on the left, right or both hands. Participants reported the location at which they felt a somatosensory stimulus. We calculated the number of vicarious errors (i.e., the number of trials in which an illusionary sensation was reported while observing pain-related scenes) and detection accuracy. Thirty-three participants (94.29%) took part in the same experiment 5 months later to investigate the temporal stability of the outcomes.
Results: The vicarious pain group reported more vicarious errors compared with controls and this effect proved to be stable over time. Detection was facilitated while observing pain-related scenes compared with non-pain related scenes. Observers' characteristics, i.e., dispositional empathy and hypervigilance for pain, did not modulate the effects.
Conclusion: Observing pain facilitates the detection of tactile stimuli, both in vicarious pain responders and controls. Interestingly, vicarious pain responders reported more vicarious errors during the experimental paradigm compared to controls and this effect remained stable over time.
PMCID: PMC4138445  PMID: 25191251
vicarious pain responders; synesthesia; visuotactile; multimodal; somatic contagion; pain contagion
4.  Controlling Attention to Nociceptive Stimuli with Working Memory 
PLoS ONE  2011;6(6):e20926.
Because pain often signals the occurrence of potential tissue damage, a nociceptive stimulus has the capacity to involuntarily capture attention and take priority over other sensory inputs. Whether distraction by nociception actually occurs may depend upon the cognitive characteristics of the ongoing activities. The present study tested the role of working memory in controlling the attentional capture by nociception.
Methodology and Principal Findings
Participants performed visual discrimination and matching tasks in which visual targets were shortly preceded by a tactile distracter. The two tasks were chosen because of the different effects the involvement of working memory produces on performance, in order to dissociate the specific role of working memory in the control of attention from the effect of general resource demands. Occasionally (i.e. 17% of the trials), tactile distracters were replaced by a novel nociceptive stimulus in order to distract participants from the visual tasks. Indeed, in the control conditions (no working memory), reaction times to visual targets were increased when the target was preceded by a novel nociceptive distracter as compared to the target preceded by a frequent tactile distracter, suggesting attentional capture by the novel nociceptive stimulus. However, when the task required an active rehearsal of the visual target in working memory, the novel nociceptive stimulus no longer induced a lengthening of reaction times to visual targets, indicating a reduction of the distraction produced by the novel nociceptive stimulus. This effect was independent of the overall task demands.
Conclusion and Significance
Loading working memory with pain-unrelated information may reduce the ability of nociceptive input to involuntarily capture attention, and shields cognitive processing from nociceptive distraction. An efficient control of attention over pain is best guaranteed by the ability to maintain active goal priorities during achievement of cognitive activities and to keep pain-related information out of task settings.
PMCID: PMC3110248  PMID: 21687745
5.  Concern About Falls Elicits Changes in Gait Parameters in Conditions of Postural Threat in Older People 
Previous studies have indicated that gait patterns in older people may be affected by concern about falling. The aim of this study was to examine the effects of concern about falling and physiological falls risk on gait performance using a paradigm in which concern about falling was experimentally induced.
Forty-four community-living older adults (17 men, 27 women) with a mean age of 76.8 (standard deviation = 5.2) years walked at self-selected speeds on the floor and on a 60-cm elevated walkway in normal and dim lighting conditions. Temporal and spatial gait parameters, muscle activity, measures of physiological arousal, physiological falls risk, and concern about falls were assessed.
Physiological falls risk was associated with slower walking speeds in all conditions including the optimal (floor) condition (p = .029). In the elevated walkway conditions, concern about falls (both self-report and as indicated by physiological arousal) was increased and participants walked more slowly, took shorter steps, decreased their cadence, and spent more time in double support (p < .005). Disproportionately large reductions in walking speed were evident in participants with greater concern about falling (p = .018).
These findings suggest that walking performance is influenced by both physiological and psychological factors. Physiological falls risk appears to determine walking speed under optimal conditions, whereas concern about falling elicits greater (possibly excessive) gait adjustments under conditions of postural threat.
PMCID: PMC2655012  PMID: 19196645
Fear of falling; Aging; Elderly; Walking; Behavior
6.  Physical characteristics of the back are not predictive of low back pain in healthy workers: A prospective study 
In the working population, back disorders are an important reason for sick leave and permanent work inability. In the context of fitting the job to the worker, one of the primary tasks of the occupational health physician is to evaluate the balance between work-related and individual variables. Since this evaluation of work capacity often consists of a physical examination of the back, the objective of this study was to investigate whether a physical examination of the low back, which is routinely performed in occupational medicine, predicts the development of low back pain (LBP).
This study is part of the Belgian Low Back Cohort (BelCoBack) Study, a prospective study to identify risk factors for the development of low back disorders in occupational settings. The study population for this paper were 692 young healthcare or distribution workers (mean age of 26 years) with no or limited back antecedents in the year before inclusion. At baseline, these workers underwent a standardised physical examination of the low back. One year later, they completed a questionnaire on the occurrence of LBP and some of its characteristics. To study the respective role of predictors at baseline on the occurrence of LBP, we opted for Cox regression with a constant risk period. Analyses were performed separately for workers without any back antecedents in the year before inclusion ('asymptomatic' workers) and for workers with limited back antecedents in the year before inclusion ('mildly symptomatic' workers).
In the group of 'asymptomatic' workers, obese workers showed a more than twofold-increased risk on the development of LBP as compared to non-obese colleagues (RR 2.57, 95%CI: 1.09 – 6.09). In the group of 'mildly symptomatic' workers, the self-reports of pain before the examination turned out to be most predictive (RR 3.89, 95%CI: 1.20 – 12.64).
This study showed that, in a population of young workers wh no or limited antecedents of LBP at baseline, physical examinations, as routinely assessed in occupational medicine, are not useful to predict workers at risk for the development of back disorders one year later.
PMCID: PMC2630962  PMID: 19123931
7.  Pain catastrophizing scale for francophone adolescents: A preliminary validation 
In adults, it is well known that high levels of pain catastrophizing are related to increased pain and disability as well as to heightened anxiety and depression. However, due to the lack of a measure of pain catastrophizing adapted for francophone adolescents, little is known about the role of catastrophizing in this population.
To adapt the French version of the Pain Catastrophizing Scale (PCS) and to examine the psychometric properties and factorial structure of the PCS for Francophone Adolescents (PCS-Ado).
The French version of the PCS was modified by a group of experts. The format of the questions was modified to be appropriate for adolescents aged between 12 and 18 years. To assess the psychometric properties of the PCS-Ado, 345 adolescents completed the PCS-Ado and questionnaires measuring depression, anxiety and intensity of pain. Twelve to 16 weeks later, participants completed the questionnaires again to examine the test-retest reliability of the PCS-Ado.
Results revealed a three-factor solution similar to the original PCS. In addition, results revealed that PCS-Ado had good internal consistency (PCS-Ado total: 0.85; rumination: 0.72; magnification: 0.66; helplessness: 0.74), and high test-retest reliability (r=0.73). Finally, significant correlations among catastrophizing, depression, anxiety and pain intensity support the construct validity of the PCS-Ado.
The results suggest that the PCS-Ado is valid and reliable with francophone adolescents. Further research is required to assess the validity of the PCS-Ado in clinical settings.
PMCID: PMC2670806  PMID: 18301812
Adolescents; Pain; Pain catastrophizing scale; Psychometric properties

Results 1-7 (7)