bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tuberculosis screening in migrants in selected European countries shows wide disparities
Authors: Coker R. , Bell A. , Pitman R. , Zellweger J-P. , Heldal E. , Hayward A. , Skulberg A. , Bothamley G. , Whitfield R. , de Vries G. , Watson J. M. 
Published: April 2006

Well-established tuberculosis screening units in Western Europe were selectively sampled. Three screening units in Norway, two in the UK, one in the Netherlands and one in Switzerland were evaluated. The aim of this study was to describe a range of service models used at a number of individual tuberculosis units for the screening of new entrants into Europe.Semi-structured interviews were conducted with clinicians, nurses and administrators from a selected sample of European tuberculosis screening units. An outline of key themes to be addressed was forwarded to units ahead of scheduled interviews. Themes included the history of the unit, structure, processes and outputs involved in screening new entrants for tuberculosis.Considerable variation in screening services exists in the approaches studied. Units are sited in transit camps or as units within hospital facilities. Staff capacity and administration varies from one clinic per week with few dedicated staff to fully dedicated units. Only one site recorded symptoms; tuberculin testing was universal in children, but varied in adults; chest radiograph screening was universal except at one site where a positive tuberculin skin test or symptoms were required in those <35 yrs of age before ordering a radiograph. Few output data are routinely and systematically collected, which hinders comparison and determination of effectiveness and efficiency.Service models for screening new immigrants for tuberculosis appear to vary in Western Europe. The systematic collection of data would make international comparisons between units easier and help draw conclusions that might usefully inform service development.
Strapping the hemiplegic shoulder prevents development of pain during rehabilitation: a randomized controlled trial
Authors: Griffin Amy , Bernhardt Julie 
Published: April 2006

Objective: To determine whether strapping (therapeutic or placebo) the ‘at risk’ shoulder prevented or delayed development of hemiplegic shoulder pain better than standard care. Design: Randomized controlled trial. Setting: Three inpatient rehabilitation hospitals, Melbourne, Australia. Patients: Thirty-three patients ‘at risk’ of developing hemiplegic shoulder pain were randomized, one withdrew. Patients at risk were considered to be those with low or no muscle function around the shoulder (Motor Assessment Scale, upper arm score B<3). Interventions: Standard care for control group. Therapeutic strapping or placebo strapping with lightweight adhesive tape. All strapping was maintained over four weeks. Main outcome measures: The primary outcome was number of pain-free days measured on Ritchie Articular Index. Secondary outcome measures included range of movement, function (Motor Assessment Scale, upper arm component) and affected arm muscle tone (Modified Ashworth Scale). Results: Only one patient in the therapeutic strapping group developed pain. One-way ANOVA revealed that mean number of pain-free days over the 28-day period was significantly different (P=0.02), with the difference between the therapeutic strapping and the control group. Patients in the therapeutic strapping group had a mean of 26.2 pain-free days, while those in the placebo group and control group had a mean of 19.1 and 15.9 pain-free days respectively. Range of movement and function improved between admission and discharge but were not significantly different between groups. Conclusions: Therapeutic strapping limited development of hemiplegic shoulder pain during rehabilitation in at risk stroke patients. Placebo strapping has an effect, with a larger study (n=30 per group) needed to detect whether there are differences between therapeutic and placebo strapping.
The effect of a task-oriented intervention on arm function in people with stroke: a randomized controlled trial
Authors: Higgins Johanne , Salbach Nancy M , Wood-Dauphinee Sharon , Richards Carol L , Côté Robert , Mayo Nancy E 
Published: April 2006

Objective: To evaluate the efficacy of a task-oriented intervention in enhancing arm function in people with stroke. Design: Two-centre, observer-blinded, stratified, block-randomized controlled trial. Setting: General community. Patients: Ninety-one individuals within one year of a first or recurrent stroke consented to participate between May 2000 and February 2003. Interventions: The experimental intervention involved practice of functional, unilateral and bilateral tasks that were designed to improve gross and fine manual dexterity whereas the control intervention was composed of walking tasks. Members in both groups participated in three sessions a week for six weeks. Main outcome measure(s): The primary test of arm function was the Box and Block Test. Secondary tests included the Nine-Hole Peg Test, maximal grip strength, the Test d'Evaluation des Membres supé rieurs des Personnes Agées (TEMPA) and the Stroke Rehabilitation Assessment of Movement. Results: Results are for the more affected arm. Baseline performance on the Box and Block Test was an average of 26 blocks (standard deviation (SD=16) in the experimental group (n=47) and 26 blocks (Sd=18) in the control group (n=44). These values represent approximately 40% of age-predicted values. Values for the postintervention evaluation were an average of 28 (SD=17) and 28 (SD=19) blocks for the experimental and control group respectively. No meaningful change on other measures of arm function was observed. Conclusions: A task-oriented intervention did not improve voluntary movement or manual dexterity of the affected arm in people with chronic stroke.
Nutritional supplementation and resistance training in nutritionally at risk older adults following lower limb fracture: a randomized controlled trial
Authors: Miller Michelle D , Crotty Maria , Whitehead Craig , Bannerman Elaine , Daniels Lynne A 
Published: April 2006

Objective: To describe the independent and combined effects of oral nutrition supplementation and resistance training on health outcomes in nutritionally at risk older adults following lower limb fracture. Design: Randomized controlled trial with 12-week masked outcome assessment. Setting: Teaching hospital. Participants: One hundred nutritionally at risk older adults hospitalized following a fall-related lower limb fracture. Intervention: Commenced seven days after injury. Consisted of daily multinutrient energy-dense oral supplement (6.3 kJ/mL) individually prescribed for six weeks (n =25), tri-weekly resistance training for 12 weeks (n =25), combined treatment (n =24) or attention control plus usual care and general nutrition and exercise advice (n =26). Measurements: Weight change, quadriceps strength, gait speed, quality of life and health care utilization at completion of the 12-week intervention. Results: At 12 weeks, all groups lost weight: nutrition -6.2% (-8.4, -4.0); resistance training -6.3% (-8.3, -4.3); nutrition and resistance training -4.7% (-7.4, -2.0); attention control -5.2% (-9.0, -1.5). Those receiving resistance training alone lost more weight than those receiving the combined treatment (P = 0.029). Significant weight loss was prevented if supplement was consumed for at least 35 days. Groups were no different at 12 weeks for any other outcome. Conclusion: Frail, undernourished older adults with a fall-related lower limb fracture experience clinically significant weight loss that is unable to be reversed with oral nutritional supplements. Those receiving a programme of resistance training without concurrent nutrition support are at increased risk of weight loss compared with those who receive a combined nutrition and resistance training intervention. In this high-risk patient group it is possible to prevent further decline in nutritional status using oral nutritional supplements if strategies are implemented to ensure prescription is adequate to meet energy requirements and levels of adherence are high.
A programme of static positional stretches does not reduce hemiplegic shoulder pain or maintain shoulder range of motion -a randomized controlled trial
Authors: Gustafsson Louise , McKenna Kryss 
Published: April 2006

Objective: To evaluate the effectiveness of a programme of static positional stretches and positioning of the stroke-affected shoulder for maintaining shoulder external rotation and decreasing hemiplegic shoulder pain. Design: Randomized controlled trial with pretest and posttest design. Setting: Inpatient rehabilitation unit. Subjects: Thirty-two participants (17 treatment, 15 comparison) with a first time stroke who were admitted for rehabilitation. Interventions: Treatment participants completed a programme of static positional stretches of the stroke-affected shoulder twice daily and positioned the stroke affected upper limb in an armrest support at all other times when seated. Main measures: The main outcome measures were pain-free range of motion into external rotation, pain in the stroke-affected shoulder at rest and with movement, motor recovery and functional independence. Results: All participants demonstrated a significant loss of external rotation (P=0.005) with no significant group differences. All participants demonstrated a significant improvement in motor recovery (P<0.01) and functional independence (P<0.01) with no significant group differences. There were no significant effects for pain. The comparison group recorded a decrease in mean pain reported with movement from admission to discharge, and the treatment group recorded an increase. Conclusions: Participation in the management programme did not result in improved outcomes. The results of this study do not support the application of the programme of static positional stretches to maintain range of motion in the shoulder. The effect of increasing pain for the treatment group requires further investigation.
Determinants of physical health in frail older people: the importance of self-efficacy
Authors: Stretton Caroline M , Latham Nancy K , Carter Kristie N , Lee Arier C , Anderson Craig S 
Published: April 2006

Objective: There is continued uncertainty regarding the strength of association between performance-based and self-report measures of physical functioning, and of their relationship to self-efficacy and health-related quality of life (HRQoL). This study assessed the inter-relationships between such measures, and the predictors of ‘physical’ aspects of HRQoL in frail older patients. Design: We used statistical models to determine the predictors of ‘physical’ HRQoL, according to the physical component summary score and the physical functioning domain of the 36-item short form (SF-36) questionnaire. Setting: Patients were recruited from hospitals in Australia and New Zealand and followed up in their homes. Subjects: Two hundred and forty-three frail older patients. Main measures: Physical functioning was assessed using three performance-based measures (Timed Up and Go Test, gait speed and the Berg Balance Scale) and five self-report measures, including the modified falls self-efficacy scale, at three and six months after registration. Results: A moderate association (r=0.48=0.55) was found between each of the performance-based and self-report measures, including the SF-36 physical component summary score. Multiple linear regression analyses showed that the performance-based measures and falls self-efficacy predicted 33% of the SF-36 physical component summary score. Falls self-efficacy was the single highest predictor of both the SF-36 physical component summary score and SF-36 physical functioning domain. A curvilinear relationship was found between the SF-36 physical functioning domain and two variables: falls self-efficacy and the Berg Balance Scale. Conclusions: Although performance-based and self-report measures provide complementary but distinct measures of physical function, psychosocial factors such as self-efficacy have a strong influence on the HRQoL of frail older people.
Validation of self-reported fall events in intervention studies
Authors: Mackenzie Lynette , Byles Julie , D'Este Catherine 
Published: April 2006

Objective: To determine if self-reported data recalling at least one fall over a sixmonth recall period could be used as a reliable measure of falls by comparing retrospective self-report with a ‘gold standard' method of reporting these events using a prospective calendar-reported method. Design: Prospective study. Setting: Community-dwelling older people living in New South Wales (NSW) and Queensland in Australia. Subjects: A stratified sample of 264 randomly selected participants from a concurrent randomized controlled trial (RCT) of preventive health assessment for people over the age of 70 years. Interventions: Intervention and control group participants in the RCT kept a calendar of fall events for a six-month validation substudy. At the end of six months, participants were asked to retrospectively report their falls over the six-month period. Main results: Results indicated that percentage agreement between retrospective self-report and the calendar report of falls was 84%, however, sensitivity was 56% (95% confidence interval (CI) 44.1−67.5). Ten participants (4%) gave false positive self-reports of falls, and 33 (13%) participants gave false negative self-reports of falls. Therefore, retrospective self-reported fall rates were likely to involve under-reporting of falls. Significant differences were found in the sensitivity of retrospectively selfreported falls reported by the intervention group participants (sensitivity=71%; 95% CI 56.6−85.5) compared with the control group (sensitivity=40.5%; 95% CI 24.7−56.4, P =0.008). Validity of self-reported injuries as a result of a fall was less accurate (71% agreement; sensitivity 24% (95% CI 16.0−33.6). Conclusions: As recall of falls was more accurate in the intervention group than in the control group, it could appear that the intervention had the effect of increasing falls compared to the control group. Using these results, a method was devised to weight self-reported retrospective data to compensate for the poorer recall demonstrated in the control group, so that a more accurate estimate of falls could be derived from the self-reported data.
Statistical methods for analysing Barthel scores in trials of poststroke interventions: a review and computer simulations
Authors: Song Fujian , Jerosch-Herold Christina , Holland Richard , Drachler Maria de Lourdes , Mares Kath , Harvey Ian 
Published: April 2006

Background and purpose: Arguments persist as to whether parametric or nonparametric methods should be used to analyse ordinal data in trials. This paper aims to assess methods used for presenting and analysing an ordinal scale, the Barthel Index, in trials of poststroke interventions. Methods: All randomized controlled trials (RCTs) of poststroke interventions published from 1995 to 2004 in two journals (Strokeand Clinical Rehabilitation) were scrutinized for methods used to present and analyse Barthel scores. Computer simulations were used to compare the type I errors and the statistical power of different statistical methods under a range of assumed circumstances. Results: One hundred and fifty-six RCTs were identified within the two journals. The central tendency of Barthel scores was measured by the median in 47 trials and by the mean in 35 trials. Non-parametric analyses of Barthel scores were conducted in 47 trials and parametric methods used in 18 trials. The results of computer simulations demonstrate that the t-test has a similar type I error rate and statistical power when compared with the rank sum test. However, when a zero final Barthel score is assigned to patients who have died, the statistical power of the t-test is much reduced. The possible maximal statistical power of dichotomization and ordinal regression is usually much lower than that of the rank sum test. Conclusions: To facilitate comparison and meta-analysis, we recommend that mean values (with standard deviations or standard errors) of Barthel scores should be routinely reported in trials of poststroke interventions. The rank sum test appears the most powerful inferential technique for detecting differences in Barthel scores.
A new clinical test of dynamic standing balance in the frontal plane: the side-step test
Authors: Fujisawa Hiroyuki , Takeda Ryoko 
Published: April 2006

Objective: To confirm retest reliability for the side-step test and to investigate the validity of the side-step test by correlating performance on this test with that on other commonly used measures of balance and mobility. Setting: Katta Public Hospital, Miyagi, Japan. Design: Cross-sectional study. Intraclass correlation coefficient was examined by calculating the intra-rater reliability of the side-step test. Moreover, the validity of the test was examined by correlating maximum side-step length with gait parameters. Subjects: This study recruited 28 hemiplegic subjects (17 with left-sided hemiplegia and 11 with right-sided hemiplegia). Measures: We measured balance ability and walking ability as follows: dynamic balance ability was assessed from maximum side-step length from the side-step test, static balance ability from one-footed standing duration, and walking ability from maximum walking speed, stride length and cadence. Balance ability was measured on both the affected and unaffected side. Maximum side-step length was standardized in terms of lower extremity length. Results: Intraclass correlation coefficient of maximum side-step length was 0.97 bilaterally. There was a high linear correlation between maximum side-step length and both maximum walking speed and stride length; Pearson's product-moment correlation coefficient ranged from 0.84 to 0.89. One-footed standing duration was significantly correlated with maximum side-step length, maximum walking speed and stride length, and these relationships were non-linear. Conclusion: The reliability and validity of the side-step test was confirmed.
Immediate effects of an individually designed functional ankle-foot orthosis on stance and gait in hemiparetic patients
Authors: Pohl Marcus , Mehrholz Jan 
Published: April 2006

Objective: To evaluate the immediate effects of individually designed functional in-shoe ankle-foot orthoses (AFO) made of soft and hard cast on balance, standing, and gait parameters in hemiparetic patients. Design: Crossover design with randomized order of the intervention. Setting: A rehabilitation centre for adults with neurological disorders. Subjects: Twenty-eight patients with hemiparesis due to stroke or traumatic brain injury. Measures: Postural sway, standing and gait parameters based on ground reaction forces in two conditions: Patients were randomly assigned to varying sequences of wearing AFO in footwear or wearing footwear alone. Results: AFO significantly improved weight-bearing on the affected leg (affected/ unaffected side symmetry: 2.259 ± 1.5 with AFO versus 3.49 ± 2.5 without AFO, P B ± 0.05) and postural sway in stance (12.5 mm9 ± 5.2 with AFO versus 15.7 mm9 ± 6.7 without AFO, P < ± 0.05), double stance duration (21.19 ± 14.4% of gait cycle with AFO versus 25.99 ± 21.6% of gait cycle without AFO, P < ± 0.05), and symmetry ratios of gait parameters such as stance duration (2.09 ± 1.5 s with AFO versus 3.39 ± 3.6 s without AFO, P < ± 0.05) and deceleration forces (1.69 ± 0.5 with AFO versus 1.99 ± 0.6 without AFO, P < ± 0.05) during gait. No significant differences were observed in all other symmetry ratios of gait parameters. Conclusion: An individually designed functional in-shoe AFO can improve stance and gait parameters, even in a single use, in patients with hemiparesis.
Epilepsy as part of systemic lupus erythematosus and systemic antiphospholipid syndrome (Hughes syndrome)
Authors: Cimaz R , Meroni P L , Shoenfeld Y 
Published: April 2006

The antiphospholipid syndrome (APS) is defined by the presence of antiphospholipid antibodies (aPL), demonstrated by ELISAs for antibodies against phospholipids and associated phospholipid-binding cofactor proteins and/or a circulating lupus anticoagulant (LA) together with diverse systemic clinical manifestations such as thrombosis, and recurrent spontaneous abortions. According to the criteria set out in Sydney1 the only neurological manifestations that can be suitable as APS classification criteria are ischemic events (stroke and transient ischemic attacks). However, other neurological manifestations, including seizures in particular, have been repeatedly reported in APS patients.2 The present review will summarize recent research on the association of aPL, as well as other autoantibodies, with seizure disorders, with or without concomitant SLE.
High risk of tuberculosis in systemic lupus erythematosus?
Authors: Erdozain J-G , Ruiz-Irastorza G , Egurbide M-V , Martinez-Berriotxoa A , Aguirre C 
Published: April 2006

The incidence and severity of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE) varies greatly among different series. In addition, prospective data are scarce. The aim of this study is to analyse the frequency and severity of TB in our cohort of lupus patients. We analysed data from a prospective database of a single center cohort of 232 patients with SLE (ACR criteria). Prophylaxis with isoniazid was not regularly administered. We identified all cases of TB diagnosed during 10 years (January 1994 to December 2003). The following variables were analysed: annual incidence of TB, location of infection and response to therapy. Data from published series reporting on the incidence of TB among SLE patients were extracted. Three patients (1.3%) suffered clinically manifest TB in 1603 patient-years of follow-up, resulting in an incidence of 187 cases/100 000 patient-years (95% CI 39-547). The pooled annual incidence of TB infection in our area during this period was 30/100 000 individuals. We recorded two cases of pulmonary TB and one case of tuberculous pleurisy. All patients had good response to therapy. The annual incidence of TB among SLE patients in other series, most of them from developing countries, varied between 150/100 000 patients in Turkey and 2450/100 000 patients in India. Of note, high prevalence of extrapulmonary forms as well as elevated TB-associated mortality was reported in most series. TB was more frequent in SLE patients than expected in the general population. We did not see any cases of disseminated infection and all patients had good response to treatment. Our data compare favourably in terms of incidence, severity and outcome with those from highly endemic areas.
Cognitive impairment in patients with multiple sclerosis using the Brief Repeatable Battery-Neuropsychology test
Authors: Sepulcre J , Vanotti S , Hernández R , Sandoval G , Cáceres F , Garcea O , Villoslada P 
Published: April 2006

Aims To assess the cognitive impairment of multiple sclerosis (MS) patients using the Brief Repeatable Battery-Neuropsychology (BRB-N) test. Methods The performance of 59 patients with MS in the BRB-N test was assessed and compared with 152 matched healthy controls (HC). Results In most tests, MS patients performed worse than controls. Age and educational level strongly influenced the performance of the subjects. The Symbol Digit Modality Test (SDMT) best correlated with the other individual tests and contributed most to the general BRB-N factor. Furthermore, a correlation between physical disability and performance in some BRB-N tests was observed. Indeed, patients with progressive MS and greater physical disability performed worse in some tests than less disabled patients with relapsing MS. By creating a global BRB-N Z score, we found that patients generally performed 0.7 standard deviation (SD) below the level of controls. We obtained cut-off values stratified by age and education to determinate cognitive impairment in MS patients. Conclusions Our data show that cognitive impairment is prevalent amongst MS patients, and that a single cognitive measurement might be useful for monitoring patients during the progression of this illness.