Miracle-dz/UniFAR-FTUs huggingface dataset:
Lumbar Traction for Managing Low Back Pain: A Survey of Physical Therapists in the United States.

STUDY DESIGN Cross-sectional survey. OBJECTIVES To examine how many physical therapists use traction, the patients for whom traction is used, the preferred delivery modes/parameters of traction, the supplemental interventions used with traction, and whether professional characteristics influence traction usage. BACKGROUND Several systematic reviews and clinical guidelines have questioned the effectiveness of traction for managing low back pain, yet some patients may benefit from lumbar traction. While traction usage among physical therapists in other countries has been described, usage among physical therapists in the United States has not been examined. METHODS We surveyed a random sample of 4000 Orthopaedic Section members of the American Physical Therapy Association. Associations among respondents' professional characteristics and survey responses were explored with chi-square analyses (α = .05). RESULTS The response rate was 25.5% (n = 1001), and 76.6% (n = 767) of respondents reported using traction. Most (58.4%) of the respondents used traction for patients with signs of nerve root compression, though many (31.4%) did not. Common delivery modes included manual methods (68.3%) and mechanical tables (44.9%), most often supplemental to other interventions (eg, stabilization exercises, postural education). Levels of professional preparation (doctoral/masters level versus bachelors/certificate level) were associated with many variables, as was attainment of an orthopaedic specialist certification. CONCLUSION Most of the orthopaedic physical therapists in the United States who responded to our survey reported that they used lumbar traction, though not necessarily consistent with proposed criteria that identify patients most likely to benefit from traction. They used various traction delivery modes/parameters and used traction within comprehensive plans of care incorporating multiple interventions. Professional characteristics (education levels and clinical specialist credentialing) were associated with traction usage.
Deploying centres of excellence in government agencies

Government agencies increasingly adopt strategic management ideas from the private sector. One such idea is the organisation of professional and advisory services into centres of excellence. The strategic management literature includes normative guidelines on how to deploy such centres. However, previous research has shown that organisations usually not just adopt management ideas in their entireties but translate them in line with individual contexts. Applying a case-study approach, this paper explores how the Swedish public-sector context influences the deployment of centres of excellence. It finds that none of the adopting agencies follow the guidelines outlined in the literature, fully utilise the idea nor benefit from it as initially proposed. The main reason for this divergence is the discrepancy between the government agencies' context and the original idea, including barriers such as job security, decentralisation and regulations. Contextual modifications are suggested to allow agencies benefit more fully from deploying centres of excellence.
John Caffey award. MR imaging determination of the location of the normal conus medullaris throughout childhood

This retrospective study was designed to determine the location of the conus medullaris in normal children by reviewing a series of MR images of the lumbar spine. The study group consisted of 184 children ranging in age from newborn to 20 years who had a normal conus level as reported by the radiologist of record. The range of conus levels for the entire group of normal children was T12 to L3. The range for the 0-2-year-old group was T12 to L2-L3 with an average of L1-L2. The range of conus levels for the 19-20-year-old group was L1 to L2 with an average of L1-L2. We conclude that the conus medullaris does not ascend throughout childhood as stated by previous authors but attains the adult level sometime during the first few months of life. A conus level at L2-L3 or above should be considered normal at any age. A conus level at L3 is indeterminate, since it is possible for a normal or a tethered conus to be located at this level.
Movement-Pattern Training to Improve Function in People With Chronic Hip Joint Pain: A Feasibility Randomized Clinical Trial.

Study Design Feasibility randomized clinical trial. Background Rehabilitation may be an appropriate treatment strategy for patients with chronic hip joint pain; however, the evidence related to the effectiveness of rehabilitation is limited. Objectives To assess feasibility of performing a randomized clinical trial to investigate the effectiveness of movement-pattern training (MPT) to improve function in people with chronic hip joint pain. Methods Thirty-five patients with chronic hip joint pain were randomized into a treatment (MPT) group or a control (wait-list) group. The MPT program included 6 one-hour supervised sessions and incorporated (1) task-specific training for basic functional tasks and symptom-provoking tasks, and (2) strengthening of hip musculature. The wait-list group received no treatment. Primary outcomes for feasibility were patient retention and adherence. Secondary outcomes to assess treatment effects were patient-reported function (Hip disability and Osteoarthritis Outcome Score), lower extremity kinematics, and hip muscle strength. Results Retention rates did not differ between the MPT (89%) and wait-list groups (94%, P = 1.0). Sixteen of the 18 patients (89%) in the MPT group attended at least 80% of the treatment sessions. For the home exercise program, 89% of patients reported performing their home program at least once per day. Secondary outcomes support the rationale for conduct of a superiority randomized clinical trial. Conclusion Based on retention and adherence rates, a larger randomized clinical trial appears feasible and warranted to assess treatment effects more precisely. Data from this feasibility study will inform our future clinical trial. Level of Evidence Therapy, level 2b-. J Orthop Sports Phys Ther 2016;46(6):452-461. Epub 26 Apr 2016. doi:10.2519/jospt.2016. 6279.
The needs and criteria of kiosks in supporting e-government

This paper aims to understand/identify the needs and criteria to provide self-service kiosks in supporting of e-government environment in the Royal Malaysian Customs Department (RMCD). The methodology of the study is a survey of 196 respondents at the Royal Malaysian Customs Department in Selangor with a concentration on the West Port area. The findings show that the customers required a self-service kiosk as a channel to access information and services in this department. However, it is found that the level of the kiosk access depends on the benefits and features of the kiosk and the types of the kiosk services. There is a significant relationship between the need for a self-service kiosk provision and the need to access information through the kiosk.
Strength Measurements in Acute Hamstring Injuries: Intertester Reliability and Prognostic Value of Handheld Dynamometry.

Study Design Cohort study, repeated measures. Background Although hamstring strength measurements are used for assessing prognosis and monitoring recovery after hamstring injury, their actual clinical relevance has not been established. Handheld dynamometry (HHD) is a commonly used method of measuring muscle strength. The reliability of HHD has not been determined in athletes with acute hamstring injuries. Objectives To determine the intertester reliability and the prognostic value of hamstring HHD strength measurement in acute hamstring injuries. Methods We measured knee flexion strength with HHD in 75 athletes at 2 visits, at baseline (within 5 days of hamstring injury) and follow-up (5 to 7 days after the baseline measurement). We assessed isometric hamstring strength in 15° and 90° of knee flexion. Reliability analysis testing was performed by 2 testers independently at the follow-up visit. We recorded the time needed to return to play (RTP) up to 6 months following baseline. Results The intraclass correlation coefficients of the strength measurements in injured hamstrings were between 0.75 and 0.83. There was a statistically significant but weak correlation between the time to RTP and the strength deficit at 15° of knee flexion measured at baseline (Spearman r = 0.25, P = .045) and at the follow-up visit (Spearman r = 0.26, P = .034). Up to 7% of the variance in time to RTP is explained by this strength deficit. None of the other strength variables were significantly correlated with time to RTP. Conclusion Hamstring strength can be reliably measured with HHD in athletes with acute hamstring injuries. The prognostic value of strength measurements is limited, as there is only a weak association between the time to RTP and hamstring strength deficit after acute injury. Level of Evidence Prognosis, level 4. J Orthop Sports Phys Ther 2016;46(8):689-696. Epub 12 May 2016. doi:10.2519/jospt.2016. 6363.
Traqueobroncomegalia (síndrome de Mounier-Kuhn): relato de caso e revisão da literatura

Tracheobronchomegaly is a rare condition of uncertain etiology characterized by marked dilatation of the trachea and main bronchi, bronchiectasis and recurrent respiratory tract infections. Clinical presentation is nonspecific and the diagnosis is usually made by imaging methods. We report a case of a patient with tracheobronchomegaly. Diagnosis was confirmed by plain x-ray films and computed tomography of the chest.
Plasma and Red Cell Magnesium Levels in Black African Women with Hypertensive Disorders of Pregnancy

Objective: To measure plasma and red cell magnesium levels in black African women with hypertensive disorders of pregnancy.Methods: Plasma and red cell magnesium levels were analyzed using atomic absorption spectrophotometer in 27 patients presenting with severe hypertension in pregnancy, 27 patients with mild hypertension in pregnancy, and 27 healthy normotensive pregnant women.Results: There were no significant differences in plasma magnesium concentrations between the hypertensive groups compared to the normotensive group [mild vs. normotensive (0.82 ± 0.03 vs. 0.84 ± 0.03 mmol/L; P = 0.12); severe hypertension vs. normotensive (0.80 ± 0.03 vs. 0.84 ± 0.03 mmol/L; P = 0.15)]. There were not statistical differences in plasma magnesium levels between the hypertensive groups.There was a significant difference in the red cell magnesium concentrations between normotensive women and those with mild hypertension (2.3 ± 0.3 vs. 2.6 ± 0.5 mmol/L; P < 0.05) and those with severe hypertension in pregnancy (1.35 ±.
Usefulness of the Berg Balance Scale in Stroke Rehabilitation: A Systematic Review

Background: In a recent study of 655 physical therapists working with a stroke population, the Berg Balance Scale (BBS) was identified as the most commonly used assessment tool across the continuum of stroke rehabilitation. Given the widespread popularity of the BBS, it is important to critically appraise the BBS for its use with a stroke population. Objective: The purposes of this study were to conduct a systematic review of the psychometric properties of the BBS specific to stroke and to identify strengths and weaknesses in its usefulness for stroke rehabilitation. Results: Twenty-one studies examining the psychometric properties of the BBS with a stroke population were retrieved. Internal consistency was excellent (Cronbach alpha=.92–.98) as was interrater reliability (intraclass correlation coefficients [ICCs]=.95–.98), intrarater reliability (ICC=.97), and test-retest reliability (ICC=.98). Sixteen studies focused on validity and generally found excellent correlations with the Barthel Index, the Postural Assessment Scale for Stroke Patients, Functional Reach Test, the balance subscale of Fugl-Meyer Assessment, the Functional Independence Measure, the Rivermead Mobility Index (except for weight shift and step-up items), and gait speed. Berg Balance Scale scores predicted length of stay, discharge destination, motor ability at 180 days poststroke, and disability level at 90 days, but these scores were not predictive of falls. Eight studies focused on responsiveness; all reported moderate to excellent sensitivity. Three studies found floor or ceiling effects. Discussion and Conclusion: The BBS is a psychometrically sound measure of balance impairment for use in poststroke assessment. Given the floor and ceiling effects, clinicians may want to use the BBS in conjunction with other balance measures.
Age Affects the Attentional Demands of Stair Ambulation: Evidence From a Dual-Task Approach

Background: Approximately 75% of all injury-producing falls on steps for people of all ages occur in people 65 years of age and older. Diminished attentional capacity contributes to fall risk in older adults, particularly when task demands are high. Objective: The purpose of this study was to compare the attentional demands of ascending and descending a set of stairs (stair ambulation) in older adults and younger adults. Design: This was a nonblinded, prospective, single-site, observational cohort study. Methods: Ten older (>65 years of age) and 10 younger (21–33 years of age) adults without disabilities were recruited. A dual-task approach was used for 2 task conditions: the first task was standing and responding verbally to an unanticipated auditory tone as quickly as possible (probe task), and the second task was ascending or descending a set of stairs with the same probe task. A 2-factor (group × task) analysis of variance with repeated measures on task (standing and stair ambulation) was performed for voice response time (VRT). Significance for the analysis was set at P<. 05. Results: The group × task interaction was significant for VRT. Post hoc analyses indicated that during stair ambulation, the VRT for older adults was significantly longer than that for younger adults. For the standing task, the VRTs (X̄±SD) were similar for younger (322±65 milliseconds) and older (306±22 milliseconds) participants. For stair ascent and descent, the average VRTs were more than 100 milliseconds longer for older participants (493±113 and 470±127 milliseconds, respectively) than for younger participants (365±56 and 356±67 milliseconds, respectively). Limitations: Because of the small sample size and generally fit older group, generalization of findings to older people at risk for falls is not recommended until further research is done. Conclusions: The results demonstrated that although both older and younger adults required similar attentional resources for the standing task, older adults required significantly more resources during stair ambulation. The findings suggested that the dual-task method used here provided a clinically useful measure for detecting important changes in attentional demands in older adults who are healthy.
β-Endorphin Modulates Adenosine Provoked Chest Pain in Men, But Not in Women—A Comparison Between Patients With Ischemic Heart Disease and Healthy Volunteers

IntroductionIncreasing evidence suggests the existence of sex differences in pain perception. Adenosine, an early messenger for myocardial ischemia induces angina pectorislike symptoms in healthy volunteers and in patients with ischemic heart disease. AimsTo study whether sex influences adenosine-provoked chest pain and the analgesic effect of the opioid receptor agonist β-endorphin. Materials and MethodsTwenty patients (10 male and 10 female) with significant coronary artery disease and 20 healthy volunteers (10 male and 10 female) were studied. Both the hand algometer and Borg CR-10 scale were used to estimate chest pain. Chest pain was provoked double-blind by injections of placebo, 1/3, 2/3, 3/3 of maximal tolerable dose of adenosine twice in randomized order. This procedure was repeated after bolus injection of β-endorphin followed by infusion and repeated a third time after bolus injection of naloxone 0.8 mg. Central chest pain and physiologic responses were quantified using hemodynamic and psychophysical methods. ResultsPain estimate by hand algometer and the Borg CR-10 scale was correlated (r=0.77, P<0.001). Both sexes reported a dose-dependent increase of adenosine-provoked chest pain with no differences for maximum tolerable dose of adenosine per kilogram. β-Endorphin administration lowered adenosine-provoked pain in both male patients and male healthy volunteers (P=0.02) but not in women. Naloxone tended to increase the pain perception in male patients (P=0.052) and male healthy volunteers (P=0.054), but did not have any significant effect on pain modalities in female. ConclusionsIn conclusion, women were resistant to β-endorphin modulation of adenosine-provoked chest pain. In male patients, β-endorphin induced analgesia.
Screening for Elevated Levels of Fear-Avoidance Beliefs Regarding Work or Physical Activities in People Receiving Outpatient Therapy

Background: Screening people for elevated levels of fear-avoidance beliefs is uncommon, but elevated levels of fear could worsen outcomes. Developing short screening tools might reduce the data collection burden and facilitate screening, which could prompt further testing or management strategy modifications to improve outcomes. Objective: The purpose of this study was to develop efficient yet accurate screening methods for identifying elevated levels of fear-avoidance beliefs regarding work or physical activities in people receiving outpatient rehabilitation. Design: A secondary analysis of data collected prospectively from people with a variety of common neuromusculoskeletal diagnoses was conducted. Methods: Intake Fear-Avoidance Beliefs Questionnaire (FABQ) data were collected from 17,804 people who had common neuromusculoskeletal conditions and were receiving outpatient rehabilitation in 121 clinics in 26 states (in the United States). Item response theory (IRT) methods were used to analyze the FABQ data, with particular emphasis on differential item functioning among clinically logical groups of subjects, and to identify screening items. The accuracy of screening items for identifying subjects with elevated levels of fear was assessed with receiver operating characteristic analyses. Results: Three items for fear of physical activities and 10 items for fear of work activities represented unidimensional scales with adequate IRT model fit. Differential item functioning was negligible for variables known to affect functional status outcomes: sex, age, symptom acuity, surgical history, pain intensity, condition severity, and impairment. Items that provided maximum information at the median for the FABQ scales were selected as screening items to dichotomize subjects by high versus low levels of fear. The accuracy of the screening items was supported for both scales. Limitations: This study represents a retrospective analysis, which should be replicated using prospective designs. Future prospective studies should assess the reliability and validity of using one FABQ item to screen people for high levels of fear-avoidance beliefs. Conclusions: The lack of differential item functioning in the FABQ scales in the sample tested in this study suggested that FABQ screening could be useful in routine clinical practice and allowed the development of single-item screening for fear-avoidance beliefs that accurately identified subjects with elevated levels of fear. Because screening was accurate and efficient, single IRT-based FABQ screening items are recommended to facilitate improved evaluation and care of heterogeneous populations of people receiving outpatient rehabilitation.
Quality Indicators of Children's Mental Health Services: Do They Predict Improved Client Outcomes?

Demonstrations of high-quality services have surpassed cost control as the primary task of health care. In this study we evaluated the relationship between several traditionally accepted standards of quality of children's mental health care and client mental health outcomes. Three customary performance guidelines (therapeutic relationship, satisfaction, and parent involvement) that are believed to be indicators of quality care were tested for their ability to account for improvement of mental health outcomes among adolescent clients. In addition, we examined service utilization to determine whether it represents an intermediate outcome of the treatment process.The results showed statistically significant, yet weak and inconsistent, relationships between these commonly accepted measures of quality and client outcomes among adolescents receiving outpatient treatment. We did not find service utilization to be a mediator. Limitations of the study and implications of the results are discussed.
Drinking goal selection and treatment outcome in out-patients with mild—moderate alcohol dependence

Selection of drinking goal is examined at baseline, post-treatment and at 6 months follow-up for a sample of mild-moderate alcohol-dependent out-patients. Drinking goal is identified as abstinent or controlled drinking, with the latter group being asked to further specify per session and per week drinking limits. Group comparisons for drinking goal post-treatment show those who were not assigned motivational enhancement therapy, had more drinking days and lower scores on the Alcohol Problems Questionnaire and Internal Motivation were more likely to choose controlled drinking. The only variable to predict independently whether or not the controlled drinking goal was within the promoted drinking guidelines was age, with younger participants more likely to choose a goal above this limit. Goal selection was significantly related to drinking outcome, with those aiming to drink within guidelines having better outcome than those aiming for higher limits. There was no significant difference in drinking outcome ca.
Dysmenorrhoea and Premenstrual Syndrome: Frequency and effect on daily activities of adolescent girls in rural areas of Bangalore -

Background: There are several problems associated with menstruation. Common problems are dysmenorrhea, premenstrual syndrome (PMS) and menstrual irregularities. These problems significantly lower the quality of life in adolescents. Aims & Objectives: Present study was undertaken with the objective of assessing the frequency of dysmenorrhea and PMS and the effect of dysmenorrhea and PMS on school attendance and daily activities of adolescent girls and their treatment seeking pattern. Materials and Methods: A descriptive study was carried out in Government high schools in rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore, India. All girls studying in high schools who had attained menarche were included in the study. Totally 304 subjects fulfilled inclusion criteria and participated in the study. Statistical analysis was done using descriptive statistics, chi square test and odds ratio. Results: Dysmenorrhea was reported by 183 (60.19%) study subjects and PMS was reported by 159 (52.30%) subjects. During menstruation, 208 (68.42%) study subjects reported that they could not attend school, 196 (65.13%) reported that they could not concentrate on studies, 181 (60%) reported inability to participate in sport activities. Whereas 235 (77.30%) reported inability to carry out household activities like cooking and 76 (25%) study subjects did not attend any social gatherings. Conclusion: More than half of study subjects suffered from dysmenorrhea and PMS which significantly affected school attendance and daily routine activities. Comprehensive health education regarding menstruation, awareness regarding menstrual problems and the treatment available for these problems should be provided at schools.