Miracle-dz/UniFAR-FTUs huggingface dataset:
Outcome of multidisciplinary investigations of long-term sickness absentees

Objective. The aim was to investigate the results of multidisciplinary investigations of long-term sickness absentees regarding diagnoses, degree and prognoses of work incapacity, and need of rehabilitation measures and whether this was associated with socio-demographic factors. Method. A cross-sectional study of 545 long-term (>1 year) sickness absentees referred to multidisciplinary investigations by the Social Insurance Office. Data was obtained from questionnaires and medical records. The patients were examined by specialists in psychiatry, orthopaedic surgery, and rehabilitation medicine who afterwards agreed on diagnoses, work incapacity, time to return to work (RTW), and rehabilitation measures. Descriptive statistics and logistic regression were used for description and analyses of data. Data on age, country of birth, education, employment and marital status were included. Results. The prevalence of psychiatric diagnoses was 72%, and 58% of the patients had that in combination with somatic diagnoses. Most patients were assessed to be capable of RTW within 6 – 24 months after further rehabilitation measures. Higher age was associated with a negative prognosis of RTW and those patients were less often recommended additional rehabilitation. Conclusion. Despite long-term sickness absence and high rates of psychiatric and somatic diagnoses in combination, RTW was considered possible for most patients after further rehabilitation measures.
Identifying Medical Concepts in Free Text Chief Complaint Data

Objectives: A controlled vocabulary for chief complaint (CC) will facilitate clinical guidelines, emergency department (ED) surveillance, and third-party claims review. In an earlier pilot study, automated efforts to develop a CC vocabulary were conducted using natural language processing (NLP) of free text ED CC terms. The resulting standardized terms were then compared to the controlled vocabularies in the Unified Medical Language System (UMLS); only 14% of the ED CC free text terms matched a UMLS concept. The objective of this study was to apply and evaluate a combination of automated and manual methods for processing ED CC terms, in order to improve the match rate with UMLS concepts. Methods: In this retrospective secondary data analysis, we used corpus linguistics methods to collocate free text CC data from 3 university tertiary referral center EDs (rural, urban, and suburban) for all ED visits during 1/01. First, we evaluated how many CC terms matched a UMLS concept prior to any processing. The terms that did not match a UMLS concept were then manually examined by the investigator, who used domain knowledge to identify patterns in the data. NLP techniques were then applied, moving from simple to more aggressive techniques. The resulting CC terms were again compared to the UMLS to determine the match rate with standard concepts. Results: There were 6,900 visits, and 6,054 unique CC terms recorded during the 1/01. Prior to any processing, 22% of the terms matched a UMLS concept. 3 patterns in the data were identified: punctuation (N/V/D), acronyms (BRBPR), and modifiers (mild/moderate/severe). After addressing the patterns with NLP techniques, 35% of the remaining CC terms then matched a UMLS concept. Conclusions: We increased the match rate of CC terms with UMLS concepts with a combination of manual and automated techniques. Additional review by domain experts and further NLP are needed to identify concepts for the nonmatched ED CC terms. This study provides the foundation for a controlled ED CC vocabulary.
California—Mexico Collaborations on Social Marketing Campaigns Targeting Mexican Immigrants

This pilot study examined whether California public health agencies collaborate with Mexican counterparts when developing and implementing social marketing campaigns that target Mexican immigrants in California. We also examined barriers to collaboration and factors contributing to successful partnerships. We recruited 13 and conducted 8 qualitative interviews (62% response rate) with social marketing staff from California public health agencies and contractors whose activities spanned four priority health areas for Mexican immigrants. Results include a desire to collaborate with Mexican counterparts but limited actual collaboration. Factors stated to affect the quality of binational social marketing collaborations included (1) the importance of communication and a working relationship between both parties, (2) funding issues, (3) evaluation activities, (4) administrative issues, especially travel restrictions, and (5) social stigmatization of the target audience. Policy recommendations include increasing funding available for binational collaborations, reducing administrative barriers, and building capacity on both sides of the U.S.—Mexico border. Such efforts may promote binational discussions that may benefit Mexican immigrants in new and established receiving communities in the United States while potentially promoting continuity of social marketing messages and campaigns. Our data suggest that binational social marketing campaigns may be feasible, though several barriers to their execution must be addressed.
A multiplexed, particle‐based flow cytometric assay identified plasma matrix metalloproteinase‐7 to be associated with cancer‐related death among patients with bladder cancer

The current study was conducted to demonstrate the utility of a multiplexed, particle‐based flow cytometric assay for the simultaneous analysis of a panel of matrix metalloproteinases (MMPs) using small volumes of plasma samples from patients with bladder cancer. In addition, the authors attempted to test the hypothesis that plasma levels of MMPs are associated with time to cancer‐related death.
Meeting the mental health needs of people with multiple sclerosis: a qualitative study of patients and professionals

Abstract Purpose: To explore perspectives and experiences of people with multiple sclerosis (MS) and health care professionals of mental health support for MS in the UK. Method: 24 people with MS, 13 practice nurses, 12 general practitioners (GPs) and 9 MS specialist nurses were recruited through community groups and primary care practices across North West England. Semi-structured interviews were conducted, and data analyzed thematically using constant comparative analysis within and across the data sets. The theoretical framework of candidacy was used to interrogate data. Results: Four themes were identified: candidates for care, management choices, defining roles, and permeability and responsiveness. Discussion: Candidacy for care, and symptom management, depended on the framing of symptoms through a social or medical model of depression. Normalizing symptoms could prevent help-seeking by patients. Reported referral behavior varied by professional group, based on perceived remit, competency and training needs. GPs were perceived by patients and other professionals as central for management of mental health needs in MS, but may not perceive this role themselves, suggesting a need for increased knowledge, training, and improved access to specialist care. Implications for Rehabilitation Anxiety and depression are common in people with MS. Management of mental health needs in people with MS relies on complex decisions made by both people with MS and health care professionals. General practitioners may play a key role in the ongoing management of mental health needs of people with MS.
The profile of social functioning in children with Down syndrome

Abstract Background: Practitioners and researchers have asserted for decades that social functioning is a strength in children with Down syndrome (DS). Nevertheless, some studies have concluded that children with DS may be at greater risk of impaired social functioning compared to typically developing controls. This cross-sectional study explores the profile of social functioning (social capabilities and social problems) in six-year-old children with DS, compares it with that of typically developing children and reveals possible differences in predictors between groups. Method: Parental reports and clinical tests were utilized. Results: The children with DS had generally weaker social capabilities compared to nonverbal mental age-matched controls, but no significant differences were found for social interactive play, community functioning and prosocial behaviour. No significant differences in predictors for social capabilities between the groups were found. The children with DS had more social problems than the typically developing controls with a similar chronological age and those with a similar nonverbal mental age, but no significant differences in emotional symptoms were found between the children with DS and either comparison group. Vocabulary was a more important predictor of social problems in the children with DS than in the typically developing control groups. Conclusion: Interventions for children with DS should strongly focus on integrating vocabulary skills and social functioning starting at an early age. Implications for Rehabilitation Children with Down syndrome need help and support in social functioning. Systematic training to optimize social capabilities and to prevent social problems should be prioritized. Structured and explicit learning of words important for social interaction with peers and for conflict solutions should be emphasized. Integrated interventions focusing on social functioning and vocabulary should begin in preschool to prepare children for participation in mainstream education.
Selecting relevant and feasible measurement instruments for the revised Dutch clinical practice guideline for physical therapy in patients after stroke

Abstract Purpose: To select relevant and feasible instruments for the revision of the Dutch clinical practice guideline for physical therapy in patients with stroke. Methods: In this implementation study a comprehensive proposal for ICF categories and matching instruments was developed, based on reliability and validity. Relevant instruments were then selected in a consensus round by 11 knowledge brokers who were responsible for the implementation of the selected instruments. The feasibility of the selected instruments was tested by 36 physical therapists at different work settings within stroke services. Finally, instruments that were deemed relevant and feasible were included in the revised guideline. Results: A total of 28 instruments were recommended for inclusion in the revised guideline. Nineteen instruments were retained from the previous guideline. Ten new instruments were tested in clinical practice, seven of which were found feasible. Two more instruments were added after critical appraisal of the set of the measurement instruments. Conclusions: The revised guideline contains 28 relevant and feasible instrument selected and tested in clinical practice by physical therapists. Further education and implementation is needed to integrate instruments in clinical practice. Further research is proposed for developing and implementing a core set of measurement instruments to be used at fixed time points to establish data registries that allow for continuous improvement of rehabilitation for stroke patients. Implications for Rehabilitation The revised Dutch Stroke Physical Therapy Guideline recommends a total of 28 instruments, that are relevant and feasible for clinical practice of physical therapist in the different settings of stroke rehabilitation. The selection of instrument in daily practice should be part of the clinical reasoning process of PTs and be tailored to individual patients’ needs and the degree of priority of the affected ICF category. Suggested education strategies for further integration of instruments in of the daily practice of PTs in Stroke Rehabilitation are: ‘Training on the job’ and ‘peer assessment in clinical situations’.
Quality of life in hypertension management using olmesartan in primary care

Objective: Differences in quality of life (QoL) using antihypertensive drugs may account for differences in compliance, persistence and blood pressure control. As this is the prerequisite for cardiovascular risk reduction, QoL was investigated using highly tolerable drugs (such as olmesartan). Research design/methods: The non-interventional study was carried out in 4252 primary care patients with 6 weeks of follow up. Documentation of patient characteristics included concomitant diseases and antihypertensive medication, blood pressure, pulse pressure, pulse rate and evaluation of QoL using the SF-12 questionnaire. Comparison of data at 6 weeks after adding or switching to olmesartan treatment (median dose: 20 mg) with baseline values. Main outcome measures: Patients had mild-to-moderate hypertension, 52.6% of whom were male and the mean age was 60.5 ± 11.9 years. Dyslipidaemia (38.3%), diabetes (20.9%) and coronary heart disease (16.4%) were the most frequent concomitant diseases. After 6 weeks, blood pressure was reduced by -22.8 ± 14.1/-11.5 ± 8.3 mmHg (p < 0.001 versus baseline). All items of the SF-12 questionnaire and both sum scores improved over the course of treatment (p < 0.001 versus baseline), and were well compatible with non-hypertensive controls. Improvements were higher when switching from α-blockers, calcium channel blockers, β-blockers, diuretics and angiotensin-converting enzyme inhibitors as compared with angiotensin II type 1 receptors blockers (ARBs), in particular on the mental health scale (p < 0.001). Adverse events were rare (0.66%), with dizziness (n = 8; 0.19%) being the most frequent. Conclusions: As was shown in the current study, patients on olmesartan treatment not only achieve adequate blood pressure control but also experienced a substantial improvement of QoL. This may contribute to long-term blood pressure control using ARBs.
LINEAR HYPOTHESIS TESTING IN A RANDOM EFFECTS GROWTH CURVE MODEL

This paper discusses a testing problem of the linear hypothesis for the expectation matrix in a balanced growth curve model with random parameters. We consider this testing problem from an invariance point of view, and obtain a maximal invariant under a group of transformations which leaves the problem invariant. We also derive the likelihood ratio statistic and show that its least favorable distribution is given by •È-distribution.
The impact of stroke on female sexuality

Abstract Purpose: The purpose of this study was to explore the impact of stroke on female sexuality from the perspective of women who have had a stroke. Method: A descriptive qualitative study. Nine female stroke survivors living in metropolitan and surrounding districts of Sydney, Australia took part in semi-structured conversational interviews. The mean length of time from stroke onset to interview was around 6 years and 2 months (range 1 year, 2 months to 15 years, 9 months). The interviews were digitally recorded and transcribed. The transcripts were systematically analysed using inductive thematic analysis. Results: The women experienced many and varied bodily alterations as a consequence of stroke which impacted negatively on their sexuality. These bodily alterations impacted on female sexuality in two ways: one was as an assault on the female sense of self and the other was by limiting possibilities for enacting female sexuality. Conclusion: Stroke impacts on female sexuality through bodily alterations and their consequences and because sexuality is important to female stroke survivors, it should be addressed as part of person-centred rehabilitation. Implications for Rehabilitation Sexuality is about much more than just “having sex” and is important to female stroke survivors. Stroke impacts on female sexuality through bodily alterations and their consequences. Understanding the impact of stroke on female sexuality is a step towards more person-centred rehabilitation.
Evaluation of an Alcohol Risk Reduction Program (PRIME for Life) in Young Swedish Military Conscripts.

Purpose – The purpose of this paper is to evaluate the effectiveness of the PRIME for Life risk reduction program in reducing alcohol consumption and improving knowledge and attitudes towards alcohol use in male Swedish military conscripts, aged 18 to 22 years.Design/methodology/approach – A quasi‐experimental design was used in which 1,371 military conscripts from ten regimens were assigned to either a control or program intervention group. Changes in alcohol consumption, knowledge and attitudes towards alcohol use were assessed with self‐report questionnaires at baseline, and again 5 months and 20 months after the program.Findings – Pre to post program reductions in total alcohol consumption and “high risk” consumption were reported in both the control and intervention group. There were no statistically significant group interactions over time, indicating that factors beyond the intervention alone were responsible for the reductions in alcohol consumption. Attitudes towards consumption improved signific.
Getting help quickly: older people and community worker perspectives of contingency planning for falls management

Abstract Purpose: Older people living in the community need to plan for getting help quickly if they have a fall. In this paper planning for falls is referred to as contingency planning and is not a falls prevention strategy but rather a falls management strategy. This research explored the perspectives of older people and community workers (CWs) about contingency planning for a fall. Method: Using a qualitative descriptive approach, participants were recruited through a community agency that supports older people. In-depth interviews were conducted with seven older people (67–89 years of age) and a focus group was held with seven workers of mixed disciplines from the same agency. Older people who hadn’t fallen were included but were assumed to be at risk of falls because they were in receipt of services. Thematic analysis and concept mapping combined the data from the two participant groups. Results: Four themes including preconceptions about planning ahead for falling, a fall changes perception, giving, and receiving advice about contingency plans and what to do about falling. Conclusion: Both CWs and older people agree contingency planning requires understanding of individual identity and circumstances. CWs have limited knowledge about contingency planning and may be directive, informative, or conservative. Implications for Rehabilitation Falls can result in serious consequences for older people. There is an evidence-practice gap as availability of and access to contingency planning does not necessarily mean older people will use it in a falls emergency. Older people prefer community workers to be directive or informative about contingency planning options but they do want choice and control. Increased community workers knowledge of, and collaborative decision-making about, contingency planning may promote patient-centered services and assist in closing the evidence-practice gap.
Mathematical Guide to Minimize Donor Size in Full‐Thickness Skin Grafting

BACKGROUND Full‐thickness skin grafting is a common repair option in dermatologic surgery. Generally, a 3:1 ellipse is designed for the donor area. This results in occasional large donor site defects. A new formula to guide donor site design would potentially create smaller donor defects. OBJECTIVE To design a mathematical formula to facilitate smaller donor incisions. METHODS A geometric analysis was undertaken to design a practical formula to create smaller defects. This strategy was then used in a case series of 23 patients with large (average 11 cm in diameter) defects [This sentence was corrected after online publication on June 29, 2009: (average 16 × 11 cm) changed to read (average 11 cm in diameter). ]. A geometrical analysis was used to design the best way to divide donor grafts to minimize tissue loss. RESULTS A formula called for the diameter of the primary defect to be multiplied by 3/2 and 2/3 to design a donor ellipse length and width, respectively. The resulting graft was divided into two equal sizes, using a tangential acute angle. The width and the area of the donor were significantly smaller, so the donor site was repaired using a shorter and faster repair. CONCLUSION Skin graft harvest may be accomplished using a smaller donor graft than previously described using the formula reported here. This will probably reduce surgical morbidity, time, and expense.
Graft–Recipient Collagen Lamellar Axis Discrepancy Is Compatible With Excellent Visual Acuity After Descemet Stripping Automated Endothelial Keratoplasty

Purpose: To evaluate whether a discrepancy between the orientation of graft and recipient collagen lamellae can significantly limit the visual acuity after Descemet stripping automated endothelial keratoplasty (DSAEK). Methods: A multicenter cohort study of eyes that underwent DSAEK for Fuchs endothelial dystrophy or pseudophakic bullous keratopathy at Villa Serena-Villa Igea private Hospitals (Forlì, Italy) and at Santa Maria Nuova public hospital (Reggio Emilia, Italy), which were scheduled for a postoperative examination between July and September 2014. We have included eyes with a distance-corrected visual acuity of 8/10 or better, no ocular comorbidities, and a clear cornea. The main outcome measure was graft–recipient axis discrepancy of lamellar orientation around the visual axis as assessed by polarimetric interferometry. Results: Twelve eyes were included in this study. Eight eyes had a spectacle-corrected distance visual acuity of 8/10, 3 eyes had 9/10, and 1 eye had 10/10. In 8/12 (66.7%) eyes, 2 discernible axes of collagen lamellar orientation were identified and were all 30 degrees or more apart (range 30–90). In 2 eyes, only 1 axis was identified and in another 2 eyes, 2 axes 20 and 17 degrees apart were identified. The eye with 10/10 visual acuity presented a discrepancy of 17 degrees between lamellar axes. Conclusions: A discrepancy between the lamellar orientation of the graft and the recipient is compatible with excellent visual acuity after DSAEK.