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The Distress Risk Assessment Method (DRAM) was presented by Main, Wood and Hillis in 1992 as a simple means of assessing the risk of failure due to psychosocial factors in spine surgery. To our knowledge, it has not been used in our setting. The aim of this study was to analyse the usefulness of the Spanish translation of this instrument to predict poor outcomes., Methods: A prospective blind study was conducted including 65 patients undergoing spine surgery. We created two groups of patients based on DRAM score: not distressed (NDRAM) or distressed (DDRAM). A visual analogue scale for pain and the 12-Item Short Form Health Survey (SF-12) were used at baseline, 6 weeks and 6 months., Results: 24 patients were classified as DDRAM and 38 as NDRAM, with 3 patients not completing the questionnaires. The analysis found no significant differences in the demographic or clinical variables at baseline. At 6 weeks and 6 months, the NDRAM group showed improvements in low back pain ( p < 0.001; p = 0.005), leg pain ( p < 0.001; p = 0.017), physical health ( p = 0.031; p = 0.003) and mental health ( p = 0.137; p = 0.049). In contrast, in the DDRAM group, though leg pain score improved ( p < 0.001; p = 0.002), there was no improvement at 6 weeks or 6 months in low back pain ( p = 0.108; p = 0.287), physical health ( p = 0.620; p = 0.263) or mental health ( p = 0.185; p = 0.329)., Conclusions: In our setting, the DRAM is a useful screening tool, and it has allowed the creation of a program between psychiatry and spine surgery.

Background: The aims of this study were to analyze the evolution of plasma lipid and lipoprotein levels in school children of Cuenca city, Spain, between 1992 and 1996; and to study pubertal changes in 1992 cohort., Subjects and Methods: A longitudinal observational study was made in 642 schoolchildren 9-16 years old recruited in three public schools of Cuenca city. In 1992, 307 schoolchildren 9-16 years old were examined. On a second examination made in 1996 were examined children of the cohort of 1992 as well as other children who were 9-11 years old in 1996; and belonged to the same schools were recruited. Socio-demographics variables, weight, height, body mass index, systolic blood pressure, diastolic blood pressure and fasting plasma total cholesterol, LDL-C, HDL-C and triglyceride concentrations were determined (and in addition, the apoproteins A-I and B100 and lipoprotein (a) were determined in the second examination)., Results: Between the years 1992 and 1996 there has been a falling in total cholesterol concentrations of schoolchildren of the cohort of 1992 due to a decreasing in LDL-C and HDL-C levels, the levels total cholesterol ranged from 183.0 mg/dl to 163.3 mg/dl. Comparing the lipid concentrations of the schoolchildren who were 9 to 11 years old in the cohort of 1992 with the lipid concentrations who were 9 to 11 years old in the cohort of 1992 with the lipid concentrations of 1996 it has been found evidence of an important decreasing of total cholesterol and LDL-C, and a moderate increasing in the HDL-C, whereas triglycerides are stable., Conclusions: Due to the decreasing of total cholesterol and LDL-C levels and the increasing of HDL-C, the lipid profile in schoolchildren of Cuenca city has improved during the 1992-1996 years. Total cholesterol and HDL-C concentrations of 1992 cohort have been a falling during the puberty.

Objectives: Our aim was to evaluate the validity and reliability of a questionnaire to measure the functional capacity in older people., Design: Observational cross-sectional study., Setting: Community level. Three basic health areas., Participants: 519 individuals over 64 selected by systematic random sampling taking as sampling units a list of household living at least an individual over 64 years., Measurements and Main Results: A new questionnaire was developed starting from the OARS-MFAQ, the CVA. This new questionnaire is shorter but it maintains the same structure. Ten interviews were recorded in a videotape and subsequently analyzed and marked by four different observers to evaluate the inter-observer agreement. To assess the criterion validity the rates of 40 individuals in the CVA were compared with the rates assigned to the same individuals by experts in each area of the questionnaire (physical health, mental health, daily activities, economic resources, and social support). The criterion validity of the version to proxies of CVA (CVA-I) was studied comparing the answers in the CVA of 31 individuals and the answers given in the CVA-I by proxies of the same 31 individuals. The internal consistency in both versions of the questionnaire was studied in 519 individuals, agreement showed values of kappa coefficient between 0.43 and 0.69. Correlation coefficients Interobserver between expert's rates showed values between 0.54 and 0.74. Correlation coefficients between CVA and CVA-I showed values between 0.60 and 0.74 except in the social support dimension (0.16). The Cronbach alpha coefficient were 0.73 for CVA and 0.62 for CVA-I., Conclusions: The CVA questionnaire showed an acceptable validity and reliability except in the social support dimension of the CVA-I.