Publications by authors named "Flavia P Kapos"

Background: Low back pain (LBP) is the leading cause of disability for individuals and societies globally. Prior investigations have predominantly centered around biological and psychological factors. Addressing social determinants is critical for enhancing the effectiveness and equity of pain interventions.

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The transition from acute to chronic low back pain (LBP) in community settings is not well understood. The purpose of this study was to assess the feasibility of recruitment and estimate the transition and continuation of chronic LBP. We also explored characteristics associated with this transition to chronic LBP.

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Introduction: Acute low back pain (LBP) is a common experience; however, the associated pain severity, pain frequency, and characteristics of individuals with acute LBP in community settings have yet to be well understood. In this manuscript, two acute-LBP severity categorization definitions were developed: 1) pain impact frequency (impact-based) and 2) pain intensity (intensity-based) severity categories. The purpose of this manuscript is to describe and then compare these acute-LBP severity groups in the following characteristics: 1) sociodemographic, 2) general and physical health, and 3) psychological using a feasibility cohort study.

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Despite wide endorsement of a biopsychosocial framework for pain, social aspects of pain remain rarely addressed in the context of pain prevention and management. In this review, we aim to 1) examine the broad scope of social determinants and consequences of pain and their interactions across multiple levels of organization, and 2) provide a framework synthesizing existing concepts and potential areas for future work on social aspects of pain, drawing upon socioecological, intersectional, and life course approaches. Integrating interdisciplinary theory and evidence, we outline pathways through which multilevel social factors and pain may affect each other over time.

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Introduction: This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents.

Methods: This retrospective cohort study utilized electronic health records of individuals aged 5-18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers.

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Objectives: Understanding adolescent perspectives on prescribed opioids in the context of medical care for acute pain is needed to prevent opioid-related adverse outcomes. We explored factors that may influence opioid decision-making and use behaviors among adolescents prescribed opioids for acute pain.

Methods: We conducted semistructured interviews with 19 adolescents (63% females, ages 12 to 17) prescribed opioids upon discharge from surgery or intensive care unit admission.

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Background: The aim of this study was to describe whether certain occupations were over- or underrepresented and to compare biopsychosocial functioning by types of occupation and employment status among adults seeking orofacial pain (OFP) treatment.

Methods: The authors extracted self-reported employment status, occupation, and biopsychosocial functioning from initial appointment records of 444 treatment-seeking adults at a university-affiliated OFP clinic. The authors categorized occupations in major and minor occupational groups according to the 2018 Standard Occupational Classification.

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Acute low back pain (LBP) is a common experience, however, the associated pain severity, pain frequency, and characteristics of individuals with acute LBP in community settings have yet to be well understood. In this manuscript, three acute LBP severity categorization definitions were used based on LBP frequency combined with either 1) pain impact frequency (impact-based) or 2) pain intensity (intensity-based), as well as LBP pain interference frequency (interference only-based) severity categories. The purpose of this manuscript is to describe and then compare these acute LBP severity groups in the following characteristics: 1) sociodemographic, 2) general and physical health, and 3) psychological.

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The coronavirus disease 19 (COVID-19) pandemic negatively affected children's health in the United States (US), with more severe disruption for marginalized groups. However, potential impact on pediatric chronic pain has not been assessed at the population level. This study aimed to (1) estimate differences in the US national prevalence of pediatric chronic pain during the first year of the COVID-19 pandemic (2020), relative to one year earlier (2019); (2) determine whether differences in prevalence varied across sociodemographic groups; and (3) explore changes in child, caregiver, and family factors associated with chronic pain prevalence.

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Real-world data (RWD) like electronic health records (EHR) has great potential for secondary use by health systems and researchers. However, collected primarily for efficient health care, EHR data may not equitably represent local regions and populations, impacting the generalizability of insights learned from it. We assessed the geospatial representativeness of regions in a large health system EHR data using a spatial analysis workflow, which provides a data-driven way to quantify geospatial representation and identify adequately represented regions.

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This study sought to evaluate the psychometric properties of a Spanish version of the PEG scale (PEG-S, whose items assess Pain intensity and pain interference with Enjoyment of life and General activity) in a sample of Spanish-speaking adults receiving care for pain at primary care clinics in the Northwestern United States. We evaluated the PEG-S's 1) internal consistency, 2) convergent validity, and 3) discriminant validity. All participants (n = 200, mean age = 52 years [SD = 15], 76% women, mean PEG-S score = 5.

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Article Synopsis
  • A TMJ Patient-Led RoundTable initiative was formed due to inconsistent reports about TMJ implant outcomes, leading to the need for a Coordinated Registry Network (CRN) to gather and analyze data on temporomandibular disorders (TMD) and their treatment.
  • The study aimed to establish a core minimum dataset for TMD patients, using a Delphi survey to collect and refine data elements based on input from 92 participants, retaining only those with over 75% consensus.
  • Ultimately, 397 data elements were selected for inclusion, with a focus on integrating these into the HIVE web application and CHIOS™ blockchain platform to enhance data reliability and patient consent tracking.
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Importance: Chronic pain risk and prognosis estimates are needed to inform effective interventions.

Objective: To estimate rates of chronic pain and high-impact chronic pain (HICP) incidence and persistence in US adults across demographic groups.

Design, Setting, And Participants: This cohort study examined a nationally representative cohort with 1 year of follow-up (mean [SD], 1.

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Article Synopsis
  • The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) has been adapted for adolescents, filling a gap as no previous version existed for this age group.
  • A Delphi process involving experts led to modifications that make the assessment tools developmentally appropriate for individuals aged 10-19, focusing on physical and psychosocial health.
  • The adapted DC/TMD includes revised questionnaires and additional assessments for anxiety, depression, stress, and sleep disorders, aiming for reliability and validity in clinical and research settings globally.
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  • * Results indicated that children with mild (13.7%) and moderate/severe (20.6%) food insufficiency experienced significantly more chronic pain compared to those from food-sufficient households (6.7%).
  • * After adjusting for various factors, it was found that children facing mild food insufficiency were 1.6 times, and those with moderate/severe insufficiency were 1.9 times more likely to have chronic pain, underlining the
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Article Synopsis
  • - The study presents adaptations of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) specifically designed for children aged 6-9, filling a gap since no previous adaptations existed.
  • - Through expert consultation, developmental changes were made to both Axis I and Axis II, including adjustments in language for questionnaires, incorporation of general health assessments, and new protocols for assessing psychosocial factors like anxiety and sleep disorders.
  • - The newly adapted criteria are suitable for clinical and research use, requiring further reliability and validity testing, and will undergo translation for global application in various languages.
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Article Synopsis
  • There is currently no standardized psychosocial assessment for children and adolescents with temporomandibular disorders (TMD), unlike the established criteria for adults.
  • The study aims to develop a new assessment tool for young patients by adapting existing adult frameworks and incorporating additional measures for psychosocial health.
  • Using a modified Delphi method, experts reached a consensus on the assessment tools needed, resulting in a comprehensive evaluation framework that includes pain-related disability, depression, anxiety, and other psychological factors for children and adolescents with TMD.
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Temporomandibular disorders (TMD) is a collective term for a group of musculoskeletal conditions involving pain and/or dysfunction in the masticatory muscles, temporomandibular joints (TMJ) and associated structures. It is the most common type of non-odontogenic orofacial pain and patients can present with pain affecting the face/head, TMJ and or teeth, limitations in jaw movement, and sounds in the TMJ during jaw movements. Comorbid painful and non-painful conditions are also common among individuals with TMD.

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Article Synopsis
  • The study highlights the need for a standardized approach to diagnosing temporomandibular disorders (TMD) in children and adolescents, as current methods rely heavily on self-reports and proxy reports.* -
  • Using a modified Delphi method, experts from around the world developed and adapted diagnostic criteria specifically for evaluating TMD in younger populations through discussions and surveys.* -
  • Ultimately, the study resulted in two new adapted protocols for diagnosing TMD in children and adolescents, achieving expert consensus on the updated criteria.*
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Background: Orofacial clefts (OFC) have multifactorial aetiology. Established risk factors explain a small proportion of cases.

Objectives: To evaluate OFC risk by maternal rural residence and race/ethnicity, and test whether these associations changed after US-mandated folic acid fortification.

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