\n\nSTUDY DESIGN/SETTING: A prospective cohort study conducted at an academic out patient

clinic.\n\nPATIENT SAMPLE: One hundred forty-one patients undergoing surgery for lumbar or cervical degenerative Selleck KU-57788 conditions.\n\nOUTCOME MEASURES: Self-reported pain and disability were measured with the Brief Pain Inventory and the Oswestry Disability Index/Neck Disability Index, respectively. The physical composite scale of the 12-Item Short-Form Health Survey (SF-12) measured physical health.\n\nMETHODS: Data collection occurred preoperatively and at 6 weeks and 6 months following surgery. Fear of movement was measured with the Tampa Scale for Kinesiophobia and depression with the Prime-MD PHQ-9.\n\nRESULTS: One hundred and twenty patients (85% follow-up) completed the 6-month postoperative assessment. Multivariable mixed-method linear regression analyses found that early postoperative fear of movement (6 weeks) predicted pain intensity, pain interference, disability, and physical health at 6-month follow-up (p<.05). Preoperative and early postoperative depression predicted pain interference, disability, and physical health.\n\nCONCLUSION:

Results provide support for the fear-avoidance model in a postsurgical LDK378 spine population. Early postoperative screening for fear of movement and depressive symptoms that do not acutely improve following surgical intervention appears warranted. Cognitive and behavioral strategies may be beneficial for postsurgical patients with

high fear of movement and/or depressive symptoms. (C) 2014 Elsevier Inc. All rights reserved.”
“ObjectiveTo illustrate the variability in the use of antibiotic prophylaxis for caesarean section, and its effect on the prevention of postoperative infections.\n\nDesignSecondary analysis of a cross-sectional study.\n\nSettingTwenty-nine countries participating in the World Health Organization Multicountry Survey on Maternal and Newborn ABT-263 nmr Health.\n\nPopulationThree hundred and fifty-nine health facilities with the capacity to perform caesarean section.\n\nMethodsDescriptive analysis and effect estimates using multilevel logistic regression.\n\nMain outcome measuresCoverage of antibiotic prophylaxis for caesarean section.\n\nResultsA total of 89 121 caesarean sections were performed in 332 of the 359 facilities included in the survey; 87% under prophylactic antibiotic coverage. Thirty five facilities provided 0-49% coverage and 77 facilities provided 50-89% coverage. Institutional coverage of prophylactic antibiotics varied greatly within most countries, and was related to guideline use and the practice of clinical audits, but not to the size, location of the institution or development index of the country. Mothers with complications, such as HIV infection, anaemia, or pre-eclampsia/eclampsia, were more likely to receive antibiotic prophylaxis.