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排序方式: 共有600条查询结果,搜索用时 15 毫秒
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Douglas P. Gross Alexander K. Asante Maxi Miciak Michele C. Battié Linda J. Carroll Ambrose Sun Marti Mikalsky Rene Huellstrung Riikka Niemeläinen 《Journal of occupational rehabilitation》2014,24(4):617-630
Purpose Functional capacity evaluations (FCE) are used to identify work abilities and are commonly integrated into rehabilitation programs. We studied whether integrating FCE into rehabilitation leads to better outcomes for injured workers. Methods A cluster randomised controlled trial was conducted at a workers’ compensation rehabilitation facility (registration ISRCTN61284905). Clinicians were randomised into 2 groups: 1 group used FCE while another conducted semi-structured functional interviews. Outcomes included recommendations following assessment, rehabilitation program outcomes including functional work levels and pain intensity, as well as compensation outcomes at 1, 3, and 6 months after assessment. Analysis included Mann–Whitney U, Chi square and t tests. Results Subjects included 225 claimants of whom 105 were tested with FCE. Subjects were predominantly employed (84 %) males (63 %) with sub-acute musculoskeletal conditions (median duration 67 days). Claimants undergoing FCE had ~15 % higher average functional work levels recommended at time of assessment (Mann–Whitney U = 4,391.0, p < 0.001) but differences at other follow-up times were smaller (0–8 %), in favour of functional interviewing, and not statistically significant. Clinically important improvement during rehabilitation in functional work level (0.9/4, SRM = 0.94), pain intensity (2.0/10, SRM = 0.88) and self-reported disability (21.8/100, SRM = 1.45) were only observed in those undergoing the functional interview. Conclusions Performance-based FCE integrated into occupational rehabilitation appears to lead to higher baseline functional work levels compared to a semi-structured functional interview, but not improved RTW rates or functional work levels at follow-up. Functional interviewing has potential for efficiency gains and higher likelihood of clinically important improvement following rehabilitation, however further research is needed. 相似文献
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Mikkelsson J Eskola M Nikus K Pietilä K Karhunen PJ Niemelä K 《Annals of medicine》2004,36(6):474-479
OBJECTIVE: We set out to study the effect of the location of the culprit coronary lesion on myocardial infarction (MI) fatality by combining data from MI survivors in the coronary care unit (CCU) and autopsied patients with pre-hospital fatal MI. DESIGN: We studied two simultaneous series of men under 70 years with fatal pre-hospital MI (n = 36) and men admitted for acute ST-elevation-MI (n = 92). The culprit lesion was identified by the presence of thrombus at autopsy and by coronary angiography in patients admitted to the CCU. RESULTS: The culprit lesion was located in the right coronary artery (RCA) in 22 (61%) of 36 men with fatal MI compared to 30 (33%) of 92 men with non-fatal MI (P = 0.01). Seventy-three percent of fatal RCA occlusions were proximal as opposed to only 30% of non-fatal RCA occlusions (P < 0.001). Forty-four percent of all fatal MI were due to proximal RCA occlusion as opposed to only 10% of non-fatal MI (P < 0.005). CONCLUSIONS: Proximal RCA occlusions were very often found among men with fatal pre-hospital MI, whereas left-sided coronary occlusions were significantly more frequent in hospital-admitted survivors of MI. Left-sided coronary occlusions may be associated with a more favourable pre-hospital phase of acute MI compared to proximal RCA occlusions. 相似文献
94.
Niini Tarmo Laakso Aki Tanskanen Päivi Niemelä Mika Luostarinen Teemu 《Neurocritical care》2019,31(2):346-356
Neurocritical Care - We reviewed retrospectively the perioperative treatment of microsurgically resected brain arteriovenous malformations (bAVMs) at the neurosurgical department of Helsinki... 相似文献
95.
Lauri Puustinen Sonja Boyd Harri Mustonen Perttu Arkkila Johanna Arola Martti Färkkilä 《Scandinavian journal of gastroenterology》2017,52(3):321-327
Objective: In autoimmune hepatitis, data on the prognostic value of baseline liver biopsy and the sequential histology is controversial. Our aim was to evaluate the prognostic value of clinical variables and biopsy at the time of diagnosis and during the disease course.Materials and methods: All 98 patients in our hospital during 1995–2012 were included. Sequential biopsies were available in 66 patients. Analyses based on clinical and histological variables were performed to find parameters predicting the progression of fibrosis, and development of cirrhosis.Results: At the time of diagnosis, 7% were cirrhotic. Fibrosis progressed in 28 (42%) patients, remained stable in 26 (39%) and resolved in 12 (18%) patients. Findings which predicted fibrosis progression, were baseline total inflammation (odds ratio 1.7, 95% CI 1.01–2.8), cumulative total inflammation (1.8, 95% CI 1.01–3.2, rosette formation (2.8, 95% CI 1.1–7.1), absence of pericholangitis (0.4, 95% CI 0.1–1.0) and necrosis (1.4, 95% CI 1.0–2.0). Risk factors for the development of cirrhosis were cholestasis (4.6, 95% CI 1.2–16.9), interphase inflammation (3.4, 95% CI 1.1–10.4), and necrosis (3.3, 95% CI 1.2–9.7). In a cumulative model, cumulative total inflammation (4.5, 95% CI 1.4–15.0), necrosis (6.7, 95% CI 1.3–34.6), or cumulative immunoglobulin G load (61.8, 95% CI 2.0–1954.3) were risk factors. None of the patients with histological pericholangitis or granulomas developed cirrhosis.Conclusions: The histology provides prognostic information regarding progression of fibrosis or the development of cirrhosis. The total cumulative inflammatory activity predicts the progression of fibrosis, whereas baseline fibrosis, interphase inflammation, cholestasis, necrosis, as well as the cumulative total inflammation and cumulative immunoglobulin G, are risk factors for cirrhosis. 相似文献
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Liesbeth De Donder Minna-Liisa Luoma Bridget Penhale Gert Lang Ana J. Santos Ilona Tamutiene Mira Koivusilta Anna Schopf Jos�� Ferreira Alves Jolanta Reingarde Sirkka Perttu Tiina Savola Dominique Vert�� 《European journal of ageing》2011,8(2):129-143
This article aims to map existing prevalence research on abuse and neglect of older people and to provide a critical overview of existing methodologies, which have been adopted to survey the prevalence rates of abuse against elders. This article is part of the prevalence study of Abuse and Violence against Older Women (AVOW) study, which was conducted in five European countries (Austria, Belgium, Finland, Lithuania, and Portugal). The article provides an overview of the state of the art of prevalence data, survey designs and methods, instruments and results in Europe. Therefore, this draws on an extensive literature search and qualitative content analysis, which was conducted as an early part of the AVOW study. Results indicate that some EU countries have a rich history of prevalence research, whereas other countries have just begun to tackle this aspect of research on of elder abuse. One of the lacunae concerns reliable numbers on the prevalence rates of elder abuse. Research about where, when and how often elder abuse occurs, is inadequate and inconsistent. Data in some cases are based on professionals’ reports rather than on information from older people themselves. Surveying elders about such a sensitive topic, however, implies the need for an adequate research instrument (questionnaire) and research design, and an adapted data collection method. In conclusion, substantial attention is paid to outlining possible guidelines for future research. 相似文献
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