The purpose of this study was to evaluate the effectiveness of a 12-week multicomponent treatment based on pain neuroscience education, therapeutic exercise, cognitive behavioral therapy, and mindfulness—in addition to treatment as usual—compared with treatment as usual only in patients with fibromyalgia. This randomized controlled trial involved a total of 272 patients who were randomly assigned to either multicomponent treatment (n = 135) or treatment as usual (n = 137). The multicomponent treatment (2-hour weekly sessions) was delivered in groups of 20 participants. Treatment as usual was mainly based on pharmacological treatment according to the predominant symptoms. Data on functional impairment using the Revised Fibromyalgia Impact Questionnaire as the primary outcome were collected as were data for pain, fatigue, kinesiophobia, physical function, anxiety, and depressive symptoms (secondary outcomes) at baseline, 12 weeks, and, for the multicomponent group only, 6 and 9 months. An intention-to-treat approach was used to analyze between-group differences. Baseline differences between responders (>20% Revised Fibromyalgia Impact Questionnaire reduction) and nonresponders also were analyzed, and the number needed to treat was computed. At posttreatment, significant between-group differences with a large effect size (Cohen d > 0.80) in favor of the multicomponent treatment were found in functional impairment, pain, kinesiophobia, and physical function, whereas differences with a moderate size effect (Cohen d > 0.50 and <0.80) were found in fatigue, anxiety, and depressive symptoms. Nonresponders scored higher on depressive symptoms than responders at baseline. The number needed to treat was 2 (95% CI = 1.7–2.3). Compared with usual care, there was evidence of short-term (up to 3 months) positive effects of the multicomponent treatment for fibromyalgia. Some methodological shortcomings (eg, absence of follow-up in the control group and monitoring of treatment adherence, potential research allegiance) preclude robust conclusions regarding the proposed multicomponent program. Despite some methodological shortcomings in the design of this study, the multicomponent therapy FIBROWALK can be considered a novel and effective treatment for patients with fibromyalgia. Physical therapists should detect patients with clinically relevant depression levels prior to treatment because depression can buffer treatment effects. Fibromyalgia is prevalent and can be expensive to treat. This multicomponent treatment could significantly improve the core symptoms of fibromyalgia compared with usual treatment.

A recent study (FIBROWALK) has supported the effectiveness of a multicomponent treatment based on pain neuroscience education (PNE), exercise therapy (TE), cognitive behavioral therapy (CBT), and mindfulness in patients with fibromyalgia. The aim of the present RCT was: (a) to analyze the effectiveness of a 12-week multicomponent treatment (nature activity therapy for fibromyalgia, NAT-FM) based on the same therapeutic components described above plus nature exposure to maximize improvements in functional impairment (primary outcome), as well as pain, fatigue, anxiety-depression, physical functioning, positive and negative affect, self-esteem, and perceived stress (secondary outcomes), and kinesiophobia, pain catastrophizing thoughts, personal perceived competence, and cognitive emotion regulation (process variables) compared with treatment as usual (TAU); (b) to preliminarily assess the effects of the nature-based activities included (yoga, Nordic walking, nature photography, and Shinrin Yoku); and (c) to examine whether the positive effects of TAU + NAT-FM on primary and secondary outcomes at post-treatment were mediated through baseline to six-week changes in process variables. A total of 169 FM patients were randomized into two study arms: TAU + NAT-FM vs. TAU alone. Data were collected at baseline, at six-week of treatment, at post-treatment, and throughout treatment by ecological momentary assessment (EMA). Using an intention to treat (ITT) approach, linear mixed-effects models and mediational models through path analyses were computed. Overall, TAU + NAT-FM was significantly more effective than TAU at posttreatment for the primary and secondary outcomes evaluated, as well as for the process variables. Moderate-to-large effect sizes were achieved at six-weeks for functional impairment, anxiety, kinesiophobia, perceived competence, and positive reappraisal. The number needed to treat (NNT) was 3 (95%CI = 1.6–3.2). The nature activities yielded an improvement in affective valence, arousal, dominance, fatigue, pain, stress, and self-efficacy. Kinesiophobia and perceived competence were the mediators that could explain a significant part of the improvements obtained with TAU + NAT-FM treatment. TAU + NAT-FM is an effective co-adjuvant multicomponent treatment for improving FM-related symptoms.

El presente trabajo expone parte de los resultados del proyecto internacional To Tradition to Innovation in Teacher Training Institutions (TO-INN). En él participaron 13939 estudiantes universitarios de Europa y América Latina, que cursaban sus estudios en diferentes ámbitos de las Ciencias de la Educación. El objetivo del estudio fue trazar su perfil motivacional, así como detectar aquellas variables sociodemográficas y de satisfacción con la experiencia universitaria capaces de explicar y predecir la motivación académica. Para ello, se empleó un cuestionario compuesto por 33 ítems, que exploraba la dimensión social de estos estudiantes, indagando tanto variables sociodemográficas y de caracterización estudiantil, como de satisfacción con diferentes elementos de la experiencia universitaria, la participación universitaria y social y, finalmente, diferentes determinantes motivacionales intrínsecos y extrínsecos. Los cuestionarios fueron administrados online en 3 instituciones educativas europeas y 7 latinoamericanas. Los resultados sugieren un perfil sociodemográfico mayoritariamente femenino, con una media de edad próxima a los 25 años, de origen familiar socioeconómicamente medio o bajo, y que precisa de compaginar sus estudios con el trabajo. Respecto a los motivos para elegir la carrera, los intrínsecos asociados a la afiliación y el logro (ajuste a las propias capacidades, mejora del entorno social y placer por el estudio) son más determinantes para la elección de la carrera que los motivos extrínsecos, como el estatus social. Ambos tipos de motivación se asociaron de forma diferencial con diversos elementos de satisfacción académica. El modelo de regresión lineal mostró que las variables predictoras de la motivación fueron la edad, el nivel educativo y laboral de los progenitores, y el hecho de trabajar mientras estudiaban. Finalmente, se discuten las limitaciones del trabajo y se sugieren futuras líneas de investigación, especialmente en cuanto a la institución educativa como medio de promoción social, o el rol del género en la motivación académica.

The identification of general population groups particularly vulnerable to the impact of COVID-19 lockdown measures on mental health and the development of healthcare policies are priority challenges in the current and future pandemics. This study aimed to identify the personal and social determinants of the impact of COVID-19 lockdown measures on mental health in a large sample of the Colombian population. In this cross-sectional study, an anonymous online survey was answered by 18,061 participants from the general population residing in Colombia during the first wave of the COVID-19 outbreak (from 20 May to 20 June 2020). The risk of depression, anxiety, and somatization disorders were measured using the Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder Scale (GAD-2), and Somatic Symptom Questionnaire (SSQ-5), respectively. Overall, 35% of participants showed risk of depression, 29% of anxiety, and 31% of somatization. According to the analysis of social determinants of health, the most affected groups were people with low incomes, students, and young adults (18–29 years). Specifically, low-income young females were the most at-risk population group. These findings show how the lockdown measures affected the general population’s mental health in Colombia and highlight some social risk factors in health.

The Self-Assessment Manikin (SAM) is one of the most extensively used instruments in the situational assessment of the emotional state in experimental or clinical contexts of emotional induction. However, there is no instrument of this kind adapted for blind or visually impaired people. In this paper, we present the results of the preliminary validation of a tactile adaptation of the SAM, the Tactile Self-Assessment Manikin (T-SAM). For this purpose, 5 people with visual disabilities participated in a focus group in which the usability of this adaptation was evaluated, as well as its usefulness in representing the valence and arousal subscales of the original instrument. The analysis of the content of this focus group suggests a pertinent content validity, while the participants correctly understood both the purpose of the instrument, and the tactile representations of valence and activation constructs created by the research team. However, the difficulty of blind people from birth to understand the graphic representation of an emotional facial expression was detected, which represents a limitation to control in future steps in the validation of T-SAM.