***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background There has been considerable interest recently in developing and evaluating interventions to increase research use by clinicians . However , most work has focused on medical practice s ; and nursing is not well represented in existing systematic review s. The purpose of this article is to report findings from a systematic review of interventions aim ed at increasing research use in nursing . Objective To assess the evidence on interventions aim ed at increasing research use in nursing . Methods A systematic review of research use in nursing was conducted using data bases ( Medline , CINAHL , Healthstar , ERIC , Cochrane Central Register of Controlled Trials , and Psychinfo ) , grey literature , ancestry search ing ( Cochrane Data base of Systematic Review s ) , key informants , and manual search ing of journals . R and omized controlled trials and controlled before- and after- studies were included if they included nurses , if the intervention was explicitly aim ed at increasing research use or evidence -based practice , and if there was an explicit outcome to research use . Method ological quality was assessed using pre-existing tools . Data on interventions and outcomes were extracted and categorized using a pre-established taxonomy . Results Over 8,000 titles were screened . Three r and omized controlled trials and one controlled before- and after- study met the inclusion criteria . The method ological quality of included studies was generally low . Three investigators evaluated single interventions . The most common intervention was education . Investigators measured research use using a combination of surveys ( three studies ) and compliance with guidelines ( one study ) . Research er-led educational meetings were ineffective in two studies . Educational meetings led by a local opinion leader ( one study ) and the formation of multidisciplinary committees ( one study ) were both effective at increasing research use . Conclusion Little is known about how to increase research use in nursing , and the evidence to support or refute specific interventions is inconclusive . To advance the field , we recommend that investigators : ( 1 ) use theoretically informed interventions to increase research use , ( 2 ) measure research use longitudinally using theoretically informed and psychometrically sound measures of research use , as well as , measuring patient outcomes relevant to the intervention , and ( 3 ) use more robust and method ologically sound study design s to evaluate interventions . If investigators aim to establish a link between using research and improved patient outcomes they must first identify those interventions that are effective at increasing research use BACKGROUND AND PURPOSE An active strategy was developed for the implementation of the clinical guidelines on physical therapy for patients with low back pain . The effect of this strategy on patients ' physical functioning , coping strategy , and beliefs regarding their low back pain was studied . SUBJECTS One hundred thirteen primary care physical therapists treated a total of 500 patients . METHODS The physical therapists were r and omly assigned to 1 of 2 groups . The control group received the guidelines by mail ( st and ard passive method of dissemination ) . The intervention group , in contrast , received an additional active training strategy consisting of 2 sessions with education , group discussion , role playing , feedback , and reminders .  Patients with low back pain , treated by the participating therapists , completed question naires on physical functioning , pain , sick leave , coping , and beliefs . RESULTS Physical functioning and pain in the 2 groups improved substantially in the first 12 weeks . Multilevel longitudinal analysis showed no differences between the 2 groups on any outcome measure during follow-up . DISCUSSION AND CONCLUSION The authors found no additional benefit to applying an active strategy to implement the physical therapy guidelines for patients with low back pain . Active implementation strategies are not recommended if patient outcomes are to be improved & NA ; This paper presents the results of a detailed study of the pain epidemiology and health related quality of life ( HRQL ) in 150 chronic non‐malignant pain patients consecutively referred to a Danish multidisciplinary pain center . Mean pain severity was 71.6 ( SD=18.5 ) on the VAS scale . Forty‐two percent reported poor quality of sleep . HRQL was evaluated with the Medical Outcome Study ‐Short Form ( SF‐36 ) , the Hospital Anxiety and Depression scale ( HAD ) and the Psychological General Well‐Being Scale ( PGWB ) . Compared with the normal population ( NP ) both SF‐36 scores and PGWB scores were significantly reduced ( P<0.001 ) indicating that physical , psychological and social well‐being were severely reduced . On the HAD scale 58 % were found to have a depressive or anxiety disorder . Statistically significant but modest correlations were found between pain severity and HRQL . Psychological and social well‐being was closely correlated . Sixty‐three percent of the referred patients had neurogenic pain conditions . Of these , only 25 % were treated with antidepressants or anticonvulsants at referral . Seventy‐three percent were treated with opioids at referral . Mean opioid consumption was 64 mg of morphine per day ( range 1–280 mg ) . Compared with the NP the chronic pain patients had used the health care system five times more often in the years prior to referral ( P<0.001 ) . The study confirms the severe multidimensional impact of chronic pain and demonstrates that HRQL of chronic non‐malignant pain patients is among the lowest observed for any medical condition Purpose The Canadian STOP-PAIN Project was design ed to document the human and economic burden of chronic pain in individuals on waitlists of Multidisciplinary Pain Treatment Facilities ( MPTF ) . This paper describes the societal costs of their pain . Methods A subgroup of 370 patients was selected r and omly from The Canadian STOP-PAIN Project . Participants completed a self-administered costing tool ( the Ambulatory and Home Care Record ) on a daily basis for three months . They provided information about publicly financed re sources , such as health care professional consultations and diagnostic tests as well as privately financed costs , including out-of-pocket expenditures and time devoted to seeking , receiving , and providing care . To determine the cost of care , re sources were valued using various costing methods , and multivariate linear regression was used to predict total cost . Results Overall , the median monthly cost of care was $ 1,462 ( CDN ) per study participant . Ninety-five percent of the total expenditures were privately financed . The final regression model consisted of the following determinants : educational level , employment status , province , pain duration , depression , and health-related quality of life . This model accounted for 35 % of the variance in total expenditure ( P < 0.001 ) . Conclusion The economic burden of chronic pain is substantial in patients on waitlists of MPTFs . Consequently , it is essential to consider this burden when making decisions regarding re source allocation and waitlist assignment for a MPTF . Re source allocation decision-making should include the economic implication s of having patients wait for an assessment and for care . RésuméObjectifLe projet canadien STOP-PAIN a été élaboré afin de documenter le fardeau humain et économique que représentait la douleur chronique pour les personnes se trouvant sur les listes d’attente des établissements pluridisciplinaires de traitement de la douleur ( MPTF – Multidisciplinary Pain Treatment Facilities ) . Cet article décrit les coûts sociétaux de leur douleur . MéthodeUn sous-groupe de 370 patients a été aléatoirement choisi parmi les participants au projet canadien STOP-PAIN . Les participants ont rempli quotidiennement un outil auto-administré de calcul des coûts ( le fichier de soins ambulatoires et à domicile - Ambulatory and Home Care Record ) pendant trois mois . Ils ont fourni des renseignements concernant les res sources financées par le secteur public , comme par exemple les consultations auprès de professionnels de la santé et les tests diagnostiques , ainsi que les coûts privés , notamment les sorties effectives d’argent et le temps consacré à chercher , recevoir et fournir des soins . Afin de déterminer le coût des soins , les res sources ont été estimées à l’aide de plusieurs méthodes de calcul des coûts , et une analyse par régression linéaire multivariée a été appliquée afin d’estimer le coût total . RésultatsGlobalement , le coût mensuel moyen des soins était de 1462 $ ( CDN ) par participant à l’étude . Quatre-vingt-quinze pour cent des dépenses totales étaient prises en charge de façon privée . Le modèle de régression final était composé des déterminantes suivantes : niveau d’éducation , situation d’emploi , province , durée de la douleur , dépression , et qualité de vie par rapport à la santé . Ce modèle a justifié 35 % de la variance des dépenses totales ( P < 0,001 ) . Conclusion Le fardeau économique que représente la douleur chronique est substantiel pour les patients sur les listes d’attente des MPTF . Pour cette raison , il est nécessaire de tenir compte de ce fardeau lors de la prise de décision concernant l’attribution des res sources et l’affectation à la liste d’attente d’un MPTF . La prise de décision concernant l’attribution des res sources devrait inclure les implication s économiques liées à l’attente des patients pour une évaluation de leur état et pour les soins Study Design . A r and omized clinical trial . Objectives . To evaluate long-term clinical and economical effects of a light mobilization program on the duration of sick leave for patients with subacute low back pain . Summary of Background Data . Twelve-month follow-up results from a previous study showed that early intervention with examination at a spine clinic , giving the patients information , reassurance , and encouragement to engage in physical activity as normal as possible had significant effect in reducing sick leave . At 12-month follow-up , 68.4 % in the intervention group were off sick leave , as compared with 56.4 % in the control group . Patients in this study were followed-up for a period of 3 years to investigate possible long-term effects . Material s and Methods . Four hundred fifty-seven patients placed on a sick list for 8 to 12 weeks for low back pain were r and omized into two groups : an  intervention group ( n = 237 ) and a control group ( n = 220 ) . The intervention group was examined at a spine clinic and given information and advice to stay active . The control group was not examined at the clinic but was treated within the primary health care . Results . Over the 3 years of observation , the intervention group had significantly fewer days of sickness compensation ( average 125.7 d/person ) than the control group ( 169.6 d/person ) . This difference is mainly caused by a more rapid return to work during the first year . There was no significant difference for the second or third year . In particular , there is no increased risk for reoccurrence of illness from early return to work . At 6-month follow-up , patients in the intervention group were less likely to use bed rest and more likely to use stretching and walking to cope with their back pain compared with the control group . This effect diminished . At 12-month follow-up , the only significant difference between the groups was in the use of stretching . Economic returns of the intervention were calculated in terms of increases in the net present value of production for the society because of the reduction in number of days on sick leave . Net benefits accumulated over 3 years of treating the 237 patients in the intervention group amount to approximately $ 2,822 per person . Conclusions . For patients with subacute low back pain , a brief and simple early intervention with examination , information , reassurance , and encouragement to engage in physical activity as normal as possible had economic gains for the society . The effect occurred during the first year after intervention . There were no significant long-term effects of the intervention . The initial gain obtained during the first year does not lead to any increased costs or increased risks for reoccurrence of illness over the next 2 years OBJECTIVE To assess the prevalence , treatment and impact of chronic pain in Canada . METHODS A stratified r and om sample of 2012 adult Canadians ( weighted by sex , age and region according to 1996 census data ) was surveyed by telephone in 2001 to determine the prevalence of chronic pain , defined as continuous or intermittent pain for at least six months . A second sample of 340 chronic pain sufferers who were taking prescription medication for their pain was studied in detail to determine current therapeutic approaches and to assess the social and economic impact of chronic pain . RESULTS Chronic noncancer pain was reported by 29 % of the respondents , with increased frequency in women and older age groups . The average duration of pain was 10.7 years and the average intensity was 6.3 ( on a scale from 1 to 10 ) , with 80 % reporting moderate or severe pain . Anti-inflammatory agents were prescribed for 49 % of respondents and opioid analgesics were prescribed for 22 % ( two-thirds of these were codeine ) . Almost 70 % were worried about addiction potential , and one-third felt that strong analgesics should be reserved for terminal illnesses . Almost one-half were unable to attend social and family events , and the mean number of days absent from work in the past year due to chronic pain was 9.3 . INTERPRETATION Chronic noncancer pain is common in Canadian adults and has a major social and economic impact . Despite growing evidence supporting the efficacy and safety of major opioid analgesics for chronic noncancer pain , less than 10 % of chronic pain patients taking prescription medication were treated with a major opioid . Chronic pain is undertreated in Canada , and major opioid analgesics are probably underutilized in the management of moderate to severe pain as part of a multidisciplinary treatment program BACKGROUND Similar to other countries worldwide , Scotl and lacked a national view of whether the quality of the physiotherapy management of low back pain was compliant with national guidelines . Anecdotal evidence suggested that st and ards of care varied considerably despite the wide availability of clinical guidelines to clinicians . AIM To develop a framework that supports National Health Service ( NHS ) Scotl and in providing consist 
    Output:
    
Interactive KT education for health care providers has a positive effect on  patients ' function , but its benefits for other health provider- and patient-related outcomes are inconsistent .
Interactive education for patients leads to improvements in knowledge and function .
Little research evidence supports the effectiveness of structural changes in health systems and quality improvement processes or coordination of care .
CONCLUSIONS KT interventions incorporating interactive education in chronic noncancer pain led to positive effects on  patients ' function and knowledge about pain .