Prevalence rates of UTI varied by age, gender, race, and circumcision status. Uncircumcised male infants less than 3 months of age and females less than 12 months of age had the highest baseline prevalence of UTI. Prevalence estimates can help clinicians make informed decisions regarding diagnostic testing in children presenting with signs and symptoms of urinary tract infection.

The objectives of this pilot study were to assess the feasibility of recruitment and adherence to an eight-session mindfulness meditation program for community-dwelling older adults with chronic low back pain (CLBP) and to develop initial estimates of treatment effects. It was designed as a randomized, controlled clinical trial. Participants were 37 community-dwelling older adults aged 65 years and older with CLBP of moderate intensity occurring daily or almost every day. Participants were randomized to an 8-week mindfulness-based meditation program or to a wait-list control group. Baseline, 8-week and 3-month follow-up measures of pain, physical function, attention, and quality of life were assessed. Eighty-nine older adults were screened and 37 found to be eligible and randomized within a 6-month period. The mean age of the sample was 74.9 years, 21/37 (57%) of participants were female and 33/37 (89%) were white. At the end of the intervention 30/37 (81%) participants completed 8-week assessments. Average class attendance of the intervention arm was 6.7 out of 8. They meditated an average of 4.3 days a week and the average minutes per day was 31.6. Compared to the control group, the intervention group displayed significant improvement in the Chronic Pain Acceptance Questionnaire Total Score and Activities Engagement subscale (P = . 008, P = .004) and SF-36 Physical Function (P = .03). An 8-week mindfulness-based meditation program is feasible for older adults with CLBP. The program may lead to improvement in pain acceptance and physical function.

Objectives Determine the impact of an 8-week mindfulness meditation program on disability, psychological function, and pain severity in community-dwelling older adults with chronic low back pain, and to test the education control program for feasibility. Design Randomized controlled trial. Participants Forty community-dwelling older adults with moderate low back pain or greater for at least the previous 3 months. Intervention Participants were randomized to an 8-week meditation program or an 8-week education control program. Outcome Measures Disability, psychological function, and pain severity were assessed. The same measures were obtained for both groups at baseline, at the end of the program, and 4 months after program completion. Results Sixteen participants (80%) completed the meditation program and 19 (95%) completed the education program. Both the meditation and control group improved on measures of disability, pain, and psychological function, both at program completion and 4-month follow-up. The differences between the two groups did not reach statistical significance. The meditation group practiced mindfulness meditation a mean of 5 days/week (range 1–7) and mean of 31 minutes/session (range 22–48). At 4 months follow-up 14/16 (88%) participants continued to meditate. Conclusion Both the intervention group and the education control group improved on outcome measures suggesting both programs had a beneficial effect. Participants continued to meditate on 4-month follow-up. The control program was feasible but not inert. Piloting the control program in mind–body research can inform the design of larger clinical trials.

In clinical practice pain as the 5th vital sign has proven to be more complex to assess, evaluate, and manage than originally anticipated. It has also had some serious consequences which were never intended. Associated with the national push to adequately manage patients in pain has been a rise in prescription opioids as well as a rise in opioid related death. Guided by pain as the 5th vital sign mandates, patients report pain and expect their providers to respond. Many clinicians do not know what the appropriate response is because they lack adequate education in the approach, examination, and management of patients in pain. Pain education starting in medical school and through postgraduate training usually involves piecemeal incorporation of pain topics into existing curricula or clinical rotations, without devoted stand-alone class-time. The net effect has been a serious deficit in clinical skills for the evaluation and management of the patient in pain. When both patients and clinicians view pain as purely a sensory experience then management is necessarily limited to managing the sensation (and the increased prescription of pain medications). This is likely to result in a suboptimal patient response, especially when managing chronic pain. Pain evaluation and management is further complicated in the older adult who requires a different approach to take into account comorbidities, including dementia, and increased adverse consequences of prescription medications. Expanding pain education and training is critical to remedying these problems. Attention must move beyond the focus of pain as a 5th vital sign to a focus on education and training in the evaluation, examination, and management of the patient’s pain report.