Miracle-dz/UniFAR-FTUs huggingface dataset:
Neurodynamic mobilization in a collegiate long jumper with exercise-induced lateral leg and ankle pain: A case report

ABSTRACT Study Design: Case Report. Background: The purpose of this case report is to describe nerve mobilization in the treatment of lower extremity neuropathic pain in a female collegiate long jumper. Case Description: A 21 year-old long jumper presented 7 months after onset of ankle and leg pain. She complained of “aching” pain over the lateral ankle, radiating proximally to just superior to the lateral knee. Neurodynamic testing of the sural and superficial branch of the fibular nerves was positive. Interventions/Outcomes: Persistent neuropathic pain which impeded sport participation in a collegiate athlete did not improve using traditional rehabilitation intervention, but did ameliorate as a result of an intervention which included self-administered, supervised nerve mobilization of the sural and superficial branch of fibular nerve. The patient improved in all outcome measures including the Lower Extremity Functional Scale (LEFS), Numerical Pain Rating Scale (NPRS), and the Global Rating of Change (GROC). Discussion: In a female collegiate athlete with persistent neuropathic pain, initial improvements were achieved with traditional rehabilitation, but her pain continued. Considerable additional improvements were achieved following the addition of self-administered, supervised nerve mobilization. Neurodynamic testing should be performed on patients with possible peripheral nerve involvement and treatment commenced if positive.
Apparent diffusion coefficients and T2 relaxation time measurements to evaluate disc degeneration: A quantitative MR study of young patients with previous vertebral fracture

Purpose: To assess the suitability of apparent diffusion coefficient (ADC) measurements to evaluate degeneration processes of the vertebral disc and to compare the results with T2 relaxation time measurements in both degenerated and normal intervertebral discs. Material and Methods: Fourteen young patients (8.8-20.8 years old) who had had a vertebral compression fracture at least 1 year earlier, underwent MR studies with diffusion imaging in three orthogonal directions and T2 relaxation time measurements. ADC values and T2 relaxation times of both degenerated and normal intervertebral discs were compared to the values of 20 healthy young asymptomatic control subjects. Results: In the degenerated discs of patients, the ADCx and ADCy values were decreased compared to earlier determined values of healthy controls. ADC values in the z-direction in degenerated discs did not differ significantly from the values of controls. T2 relaxation times were shorter in the degenerated discs of patients compared to the values of controls. The greatest changes in both these values were observed in degenerated discs followed by discs with normal signal intensity adjacent to primary trauma area and secondary trauma area. Conclusion: We suggest that decreased ADC values reflect the lost integrity of the intervertebral disc. ADC measurements at MR may prove sensitive depicting of early degenerative changes in vertebral discs.
Patterns of adaptation in patients living long term with advanced cancer

With improved treatment, increasing proportions of patients with advanced cancer are surviving longer with their disease: into a second year after diagnosis and beyond. These longer term survivors face continuing challenges in selecting and shifting personal life goals and goals of care over years (rather than months) of life with incurable cancer. Studies are needed to explore adaptation over time in patients who are living longer term with late‐stage cancer, including anxiety, depression, and spiritual well being, which are conceptualized as indicators of psychospiritual well being in patients with advanced cancer.
Comparison of the Behavioural Inattention Test and the Catherine Bergego Scale in assessment of hemispatial neglect

The objective of the study was to correlate visual and behavioural assessments of hemispatial neglect caused by cerebrovascular accident. We assessed 17 consecutive right-hemisphere stroke patients with hemispatial neglect: the Catherine Bergego Scale (CBS) was used to evaluate neglect in spontaneous behaviour and the conventional subtests of the Behavioural Inattention Test (BIT C) were used to assess visual neglect. The proportional severity of both visual and behavioural neglect was calculated in each individual patient. Dissociations were found between mild neglect in visual screening tasks and moderate or severe neglect in behaviour, although in most patients, neglect was equally evident in both tests. Only the line bisection subtest from the BIT correlated significantly with the CBS, yet both tests showed good internal consistency. The line bisection test and several items of the CBS were especially sensitive in detecting the combination of visual field deficit and hemispatial neglect. In conclusion, we propose that visual fields should always be assessed in patients with neglect because neglect may be exacerbated by a visual field deficit and this can cause prolonged functional disability in everyday life situations. Specific rehabilitation methods might also be needed in neglect with or without hemianopia.
Applying the transtheoretical model to the readiness to change blood-borne virus transmission behaviors among drug-dependent inmates.

Our study set out to assess readiness to change blood-borne virus transmission behaviors using the Transtheoretical Model among inmates in a court-ordered detention center. A cross-sectional descriptive study was conducted in southern Taiwan. All men convicted of illicit drug use and sentenced to undergo the 6-month detoxification program were invited to participate. Half of the 172 participating inmates described themselves as being in the contemplation stage of change. The length of residency in the detoxification program was not associated with self-reported readiness to change, chi(2)= 6.53, p = . 16. Inmates in the precontemplation stage had increased rates for high-risk behaviors than those in the contemplation and action stages (p < .001). The efficacy of forced-abstinence detention programs on readiness to change risky behaviors needs to be reevaluated.
Depressive symptoms in acute stroke: A cross-sectional study of their association with sociodemographics and clinical factors

The aim of the study was to estimate the prevalence of post-stroke depression (PSD) in the acute phase following first-ever stroke, and to identify its sociodemographic and clinical correlates. Data were collected in a cross-sectional correlational study from face-to-face interviews using structured questionnaires and patients' medical records. The sample consisted of 109 patients with first-ever stroke. Depressive symptoms after stroke were measured with Beck Depression Inventory II. Mild, moderate or severe depressive symptoms were reported by 27% of the participants. PSD was uniquely associated with post-stroke fatigue, sleep latency and sleep disturbance. Patients with PSD also reported slightly more bodily pain. Stroke type, stroke location, and the sociodemographic characteristics we examined were unrelated to PSD. Further research is needed to assess the role sleep changes, fatigue and bodily pain might have in relation to depression in the acute phase after stroke.
Does feedback influence awareness following traumatic brain injury?

This study examined the relationship between the nature of feedback provided by close-others and self-awareness in individuals with traumatic brain injury (TBI). Using a cross-sectional design, 69 individuals with mild-to-severe TBI and their close-others completed the Awareness Questionnaire, Hospital Anxiety and Depression Scale, Trail Making Test–Part B and Feedback about Cognitive Difficulties Questionnaire, between 3 months and 20 years post-injury. Results showed cognitive and/or behavioural issues post-injury were identified in 97% of individuals with TBI and over 80% of these were provided with feedback by close-others at least sometimes after making errors. Close-others reported two main reasons for not providing feedback about problems: (1) not wanting to hurt the feelings of the injured individual and (2) pointing out errors would be detrimental to the injured individual's rehabilitation. Whilst nearly 60% of the individuals with TBI were reported to detect an error once they received feedback, they showed low levels of acceptance/acknowledgement in response to feedback. Analyses including injury-related and emotional variables failed to identify any mediated or moderated relations between frequency of feedback and self-awareness. The high rates of feedback by close-others but low acceptance/acknowledgement of that feedback by individuals with TBI suggests that clinicians may need to work in partnership with close-others to facilitate supportive relationships for effective delivery of feedback.
The educationally influential physician

&NA; The existence of physicians who were educationally influential to their peers was confirmed by a series of studies in the 1960s. Methodology to facilitate their identification led to several studies that confirmed their role in the dissemination of information. It was originally thought that the educationally influential physician had its greatest use in continuing medical education. The changes in undergraduate and graduate medical education curriculum now suggest that the educationally influential physician may be operational across the continuum of medical education. The use of small group discussions and reliance on community‐based practitioners demands that the concepts of information dissemination be integrated into curricula for medical students and house officers. Depending on location, specialties, practice type, and learning style, different approaches to information dissemination are possible. As educators strive to incorporate the concepts of evidence‐based medicine and lifelong learning into the curriculum, they need to make students aware of the resources that are available to facilitate their learning.
CENTERIS 2014 - Conference on ENTERprise Information Systems / ProjMAN 2014 - International Conference on Project MANagement / HCIST 2014 - International Conference on Health and Social Care Information Systems and Technologies Improving Quality of Electronic Health Records with SNOMED

The use of classifications, standards and terminology proves to be of particular importance to classify therapist techniques, clinical and nursing procedures and formulate diagnoses. This work shows a different implementation than usual, the application developed doesn’t depend of platform of medical record. The Department of pathological anatomy was chosen as a pilot service to enter the SNOMED system, to produce reports and to evaluate the benefits of its use in a real context. The successful implementation is directly related to the success of interoperability between information and the use of electronic health record systems. It is the first step to extend the system to the whole hospital and to the success of clinical research, to provide alerts and prevention systems and reduce medical errors. © 2014 The Authors. Published by Elsevier Ltd. Peer-review under responsibility of the Organizing Committees of CENTERIS/ProjMAN/HCIST 2014
Long-term effects of executive process training in young and old adults

Prior studies have examined the magnitude of training and transfer effects after process-based training in early and late adulthood. However, little is known about how long-lasting these effects are. Here we investigate the degree of stability of training gains and transfer effects in younger and older adults 18 months after completion of executive process training, tapping updating, inhibition, and shifting. From the original sample, 24 out of 30 older participants, and 19 out of 29 young adults, returned for follow-up assessment at which the criterion and transfer tests from pre- and post-test were re-administered. The results demonstrated stability of training gains in the updating criterion task (Letter Memory Running Span), and in a near transfer updating task (Number Memory Running Span) for both age groups. The young adults improved performance in two complex working memory tasks immediately after training. These transfer effects did not survive across time. Our results provide evidence that executive process training has its greatest effect on transfer tasks with a substantial process overlap with the trained tasks: only those effects are maintained over an 18 month period in both early and late adulthood.
Computerised cognitive training in acquired brain injury: A systematic review of outcomes using the International Classification of Functioning (ICF)

ABSTRACT Computerised cognitive training (CCT) is an increasingly popular intervention for people experiencing cognitive symptoms. This systematic review evaluated the evidence for CCT in adults with acquired brain injury (ABI), focusing on how outcome measures used reflect efficacy across components of the International Classification of Functioning, Disability and Health. Database searches were conducted of studies investigating CCT to treat cognitive symptoms in adult ABI. Scientific quality was rated using the PEDro-P and RoBiNT Scales. Ninety-six studies met the criteria. Most studies examined outcomes using measures of mental functions (93/96, 97%); fewer studies included measures of activities/participation (41/96, 43%) or body structures (8/96, 8%). Only 14 studies (15%) provided Level 1 evidence (randomised controlled trials with a PEDro-P score ≥ 6/10), with these studies suggesting strong evidence for CCT improving processing speed in multiple sclerosis (MS) and moderate evidence for improving memory in MS and brain tumour populations. There is a large body of research examining the efficacy of CCT, but relatively few Level 1 studies and evidence is largely limited to body function outcomes. The routine use of outcome measures of activities/participation would provide more meaningful evidence for the efficacy of CCT. The use of body structure outcome measures (e.g., neuroimaging) is a newly emerging area, with potential to increase understanding of mechanisms of action for CCT.
G-Protein β3 Subunit and α-Adducin Polymorphisms and Risk of Subclinical and Clinical Stroke

Background and Purpose—Essential hypertension is a significant risk factor for stroke. Genes contributing to interindividual variation in blood pressure levels and essential hypertension status may play a role in the etiology of stroke either through their effects on blood pressure levels or through separate pathways. For this reason, we sought to examine the association between the α-adducin (ADD1) G/W460 and G-protein β3 subunit (GNβ3) 825C/T polymorphisms and subclinical and clinical stroke in the Atherosclerosis Risk in Communities (ARIC) Study. Methods—Subclinical stroke was determined by cerebral MRI. Subclinical cerebral infarct cases (n=202) were compared with a stratified random sample (MRI-CRS) identified from individuals participating in the MRI examination (n=211). Incidence of clinical ischemic stroke was determined by following the ARIC cohort for an average of 7.2 years for potential cerebrovascular events; 231 validated clinical ischemic strokes were identified. A stratified random sample .
Acute effects of heroin on emotions in heroin-dependent patients.

BACKGROUND Euphoria has been described in heroin-dependent individuals after heroin administration. However, affective disturbances and disorders are common in heroin dependence. The present study examined the acute effects of heroin on emotions in heroin-dependent patients. METHODS This randomized controlled crossover trial included 28 heroin-dependent patients (67.9% male, n = 19) in stable heroin-assisted treatment and 20 healthy controls. The patients were administered heroin or saline (placebo), the controls were administered saline. Data measuring mood, affects and heroin craving (BDI, AMRS, STAI, STAXI, and HCQ) were assessed before and 60 minutes after substance injection. RESULTS Before substance injection, heroin-dependent patients showed significantly higher levels of anxiety and depression than healthy controls (p < .0001). Heroin administration-but not placebo administration-was associated with a significant decrease in all negative emotions, including craving, and a significant increase in emotional well-being (p < .0001), irrespective of perceived intoxication and sedation. After the experiment, the patients did not differ from healthy controls in their emotions, once they had received heroin. CONCLUSIONS Heroin dampens craving, negative emotions, and increases positive emotions. These findings indicate that heroin regulates emotions and underscore the clinical benefit of opioid substitution treatment for heroin-dependent patients.
Outcome instruments in moderate-to-severe adult traumatic brain injury: recommendations for use in psychosocial research

ABSTRACT Background: Traumatic brain injury (TBI) can reduce psychosocial functioning, causing relationship, family, and employment difficulties. The present study by Moving Ahead: Centre for Research Excellence (CRE) in Brain Recovery aimed to identify a set of adult outcome instruments for moderate-to-severe TBI psychosocial research. Procedure: A review of 115 instruments (identified through nomination, literature search, and international expert opinion) was conducted over a 15-month period. Eleven psychosocial areas were examined: Global Outcome, Communication, Social Cognition, Behavioural and Executive Function, Other Neuropsychological Functioning, Psychological Status, TBI-related Symptoms, Activities and Participation, Support and Relationships, Sense of Self, and Health-related Quality of Life. Individual instruments were considered against selection guidelines, and specific measures that best met the guidelines were identified as core (common across all studies), supplemental (dependent on study type) or emerging. Results: The final recommendations, organised in accordance with the World Health Organisation’s International Classification of Functioning taxonomy, comprised 56 instruments for use in early recovery, outcome, and intervention studies. Conclusion: These recommendations provide a coherent framework along with identified outcome instruments to guide psychosocial research in moderate-to-severe TBI. Adherence to the recommendations will enable data-pooling and comparison across studies and research settings facilitating consistent measurement across the lifespan.
Topical steroidal and nonsteroidal antiinflammatory drugs for the treatment of cystoid macular edema in retinitis pigmentosa.

PURPOSE Oral carbonic anhydrase inhibitors have been the treatment of choice for managing cystoid macular edema (CMO) in retinitis pigmentosa. We report a case illustrating the effectiveness of topical steroidal and nonsteroidal antiinflammatory drugs (NSAIDs) in managing CMO in a patient with retinitis pigmentosa, who is unable to take oral carbonic anhydrase inhibitor because of chronic renal impairment. METHODS An 85-year-old woman with retinitis pigmentosa-related CMO in the left eye was prospectively followed up after treatment with a 4 times daily regimen consisting of a topical steroid (prednisolone acetate 1%) and an NSAID (ketorolac trometamol 0.5%). The right eye showed no evidence of CMO. Oral acetazolamide was avoided as the patient had chronic renal impairment. RESULTS Three months after treatment, best-corrected visual acuity in the left eye improved from 20/200 to 20/60, and spectral domain optical coherence tomography showed complete resolution of CMO. Topical steroid and NSAID were therefore stopped. However, 6 months later, left best-corrected visual acuity was reduced to 20/120 and spectral domain optical coherence tomography showed recurrence of CMO. This was managed with the same treatment regimen of topical steroid and NSAID, which resulted in complete resolution of CMO with best-corrected visual acuity in the left eye improving to 20/80 after 3 months. CONCLUSION To our knowledge, this is the first report that demonstrates the effectiveness of topical steroids or NSAIDs in managing CMO in a retinitis pigmentosa patient with chronic renal impairment who is unable to take a carbonic anhydrase inhibitor because of chronic renal impairment.
A feasibility study of working memory training for individuals with paediatric-onset multiple sclerosis

ABSTRACT Objective: To investigate the feasibility and experiences of paediatric-onset multiple sclerosis (MS) patients completing a working memory training programme. Methods: Nine paediatric-onset MS patients (mean age 19.3 ± 4.1 years) identified as having attention and/or working memory difficulties underwent a five-week (five days/week) internet-based working memory training programme (Cogmed™); weekly coaching was provided. Measures of adherence and tolerance were used to establish the feasibility of implementing computerised cognitive training. Qualitative experiences reported by the patients were analysed and factors that may modulate the effects of training were explored. Results: Six of the nine enrolled patients completed the programme within the recommended time, and all individuals, with the exception of one, were considered to tolerate the training well. Eight of the nine participants acknowledged that training was helpful in one or more ways. All but one participant reported improvements in working memory, although evidence for improvement on objective neuropsychological testing was limited. Lower normalised brain volume emerged as a potentially important variable in predicting extent of improvement on the training programme. Conclusion: Selected paediatric-onset MS patients can tolerate and complete an intensive cognitive rehabilitation programme. Future investigation of moderators of training effects and the stability of the findings over time is needed.
Cigarette smoking and drug use among a nationally representative sample of HIV-positive individuals.

BACKGROUND AND OBJECTIVES Among HIV-positive populations, the prevalence of cigarette smoking remains disproportionately high and is associated with significant morbidity and mortality. Little is known about this topic among HIV-positive persons in the general population. METHODS Data came from the 2005 to 2011 National Survey on Drug Use and Health (NSDUH) public use data files. Unadjusted and adjusted multinomial logistic regression analyses explored the associations between socio-demographic, drug and alcohol use, and drug and/or alcohol treatment characteristics with smoking status among HIV-positive individuals (n = 349). RESULTS More than 40% of the sample was current smokers. In adjusted analyses, females (aRRR = .11, 95% CI = .03-.41) and participants who had never been married (aRRR = .19, 95% CI = .05-.58), were more likely to be former smokers than never smokers. Females (aRRR = .37, 95% CI = .14-.96) and individuals older than age 35 (aRRR = .37, 95% CI = .16-.89) were less likely to be current smokers than never smokers. Conversely, previously married persons (aRRR = 5.72, 95% CI = 1.40-23.31), participants reporting binge drinking (aRRR = 5.96, 95% CI = 2.27-15.64), and lifetime drug or alcohol treatment (aRRR = 5.12, 95% CI = 2.09-12.55) were more likely to be current smokers than never smokers. CONCLUSIONS Findings help confirm the high prevalence of smoking among HIV-positive persons suggesting the need for integrated substance use and smoking cessation treatment among HIV-positives. SCIENTIFIC SIGNIFICANCE The present findings have implications for the development and implementation of targeted smoking cessation programs for HIV-positive smokers.