The panorama of future sick-leave diagnoses among young adults initially long-term sickness absent due to neck, shoulder, or back diagnoses. An 11-year prospective cohort study

<p>Abstract</p> <p>Background</p> <p>Little is known about future sick-leave diagnoses among individuals on long-term sickness absence. The aim of this study was to describe the panorama of sick-leave diagnoses over time among young adults initially sick-listed for ≥ 28 days due to back, neck, or shoulder diagnoses</p> <p>Methods</p> <p>An 11-year prospective population-based cohort study including all 213 individuals in a Swedish municipality who, in 1985, were aged 25–34 years and had a new sick-leave spell ≥ 28 days due to neck, shoulder, or back diagnoses.</p> <p>Results</p> <p>Over the 11-year period, the young adults in this cohort had 176,825 sick-leave days in 7,878 sick-leave periods (in 4,610 sick-leave spells) due to disorders in 17 of the 18 ICD-8 diagnostic categories (International Classification of Diseases, Revision 8). Musculoskeletal or mental diagnoses accounted for most of the sick-leave days, whereas most of the sick-leave periods were due to musculoskeletal, respiratory, or infectious disorders, or to unclassified symptoms. Most cohort members had had four to eight different sick-leave diagnoses over the 11 years, although some had had up to 11 diagnoses. Only two individuals (1%) had been sickness absent solely due to musculoskeletal diagnoses.</p> <p>Conclusion</p> <p>Although the young adults initially were sick listed with back, neck, or shoulder diagnoses, their sickness absence during the follow up were due to a wide variety of other medical diagnoses. It might be that the ill-health content of sickness absence due to back pain is greater than usually assumed. More research on prognoses of sick-leave diagnoses among long-term sick listed is warranted.</p

Markov Chain Methods For Analyzing Complex Transport Networks

We have developed a steady state theory of complex transport networks used to model the flow of commodity, information, viruses, opinions, or traffic. Our approach is based on the use of the Markov chains defined on the graph representations of transport networks allowing for the effective network design, network performance evaluation, embedding, partitioning, and network fault tolerance analysis. Random walks embed graphs into Euclidean space in which distances and angles acquire a clear statistical interpretation. Being defined on the dual graph representations of transport networks random walks describe the equilibrium configurations of not random commodity flows on primary graphs. This theory unifies many network concepts into one framework and can also be elegantly extended to describe networks represented by directed graphs and multiple interacting networks.Comment: 26 pages, 4 figure

Sickness absence due to specific mental diagnoses and all-cause and cause-specific mortality: a cohort study of 4.9 million inhabitants of Sweden.

Despite the magnitude and increase of sickness absence due to mental diagnoses, little is known regarding long-term health outcomes. The aim of this nationwide population-based, prospective cohort study was to investigate the association between sickness absence due to specific mental diagnoses and the risk of all-cause and cause-specific mortality

Is There an Association between Long-Term Sick Leave and Disability Pension and Unemployment beyond the Effect of Health Status? – A Cohort Study

Background: Studies have shown that long-term sick leave is a strong predictor of disability pension. However, few have aimed to disentangle the effect of sick leave and of health status. The objective of this study was to investigate whether there is an association between long-term sick leave and disability pension and unemployment, when taking health status into account. Methods/Principal Findings: The study was based on the Stockholm Public Health Cohort, restricted to 13,027 employed individuals (45.9 % men) aged 18–59 in 2002 and followed until 2007. Hazard ratios (HR) with 95 % Confidence Interval (CI) were estimated by Cox regression models adjusting for socio-demographic factors and five measures of health status. Having been on long-term sick leave increased the risk of disability pension (HR 4.01; 95 % CI 3.19–5.05) and longterm unemployment (HR 1.45; 95 % CI 1.05–2.00), after adjustment for health status. The analyses of long-term sick leave due to specific illness showed that the increased risk for long-term unemployment was confined to the group on sick leave due to musculoskeletal (HR 1.70 95 % CI 1.00–2.89) and mental illness (HR 1.80 95 % CI 1.13–2.88) and further that there was an increased risk for short-term unemployment in the group on sick leave due to mental illness (HR1.57 95%CI 1.09–2.26). Conclusions/Significance: Long-term sick leave increases the risks of both disability pension and unemployment even when taking health status into account. The results support the hypothesis that long-term sick leave may start a process o

Responsiveness to exercise training in juvenile dermatomyositis: a twin case study

<p>Abstract</p> <p>Background</p> <p>Patients with juvenile dermatomyositis (JDM) often present strong exercise intolerance and muscle weakness. However, the role of exercise training in this disease has not been investigated.</p> <p>Purpose</p> <p>this longitudinal case study reports on the effects of exercise training on a 7-year-old patient with JDM and on her unaffected monozygotic twin sister, who served as a control.</p> <p>Methods</p> <p>Both the patient who was diagnosed with JDM as well as her healthy twin underwent a 16-week exercise training program comprising aerobic and strengthening exercises. We assessed one repetition-maximum (1-RM) leg-press and bench-press strength, balance, mobility and muscle function, blood markers of inflammation and muscle enzymes, aerobic conditioning, and disease activity scores. As a result, the healthy child had an overall greater absolute strength, muscle function and aerobic conditioning compared to her JDM twin pair at baseline and after the trial. However, the twins presented comparable relative improvements in 1-RM bench press, 1-RM leg press, VO_2peak, and time-to-exhaustion. The healthy child had greater relative increments in low-back strength and handgrip, whereas the child with JDM presented a higher relative increase in ventilatory anaerobic threshold parameters and functional tests. Quality of life, inflammation, muscle damage and disease activity scores remained unchanged.</p> <p>Results and Conclusion</p> <p>this was the first report to describe the training response of a patient with non-active JDM following an exercise training regimen. The child with JDM exhibited improved strength, muscle function and aerobic conditioning without presenting an exacerbation of the disease.</p

Status of Early-Career Academic Cardiology, A Global Perspective

Early career academic cardiologists, whom many believe are an important component of the future of cardiovascular care, face a myriad of challenges. The Early Career Section Academic Working Group of the American College of Cardiology (ACC) along with senior leadership support, assessed the progress of this cohort from 2013–2016 with a global perspective. Data consisted of accessing National Heart Lung and Blood Institute (NHLBI) public information, American Heart Association and international organizations providing data, and a membership-wide survey. Although NHBLI increased funding of career development grants, only a small number of early career ACC members have benefited as funding of the entire cohort has decreased. Personal motivation, institutional support, and collaborators continued to be positive influential factors. Surprisingly, mentoring ceased to correlate positively with obtaining external grants. Totality of findings suggests that the status of early career academic cardiologists remain challenging; therefore, we recommend a set of attainable solutions

Polyhedra Circuits and Their Applications

To better compute the volume and count the lattice points in geometric objects, we propose polyhedral circuits. Each polyhedral circuit characterizes a geometric region in Rd . They can be applied to represent a rich class of geometric objects, which include all polyhedra and the union of a finite number of polyhedron. They can be also used to approximate a large class of d-dimensional manifolds in Rd . Barvinok [3] developed polynomial time algorithms to compute the volume of a rational polyhedron, and to count the number of lattice points in a rational polyhedron in Rd with a fixed dimensional number d. Let d be a fixed dimensional number, TV(d,n) be polynomial time in n to compute the volume of a rational polyhedron, TL(d,n) be polynomial time in n to count the number of lattice points in a rational polyhedron, where n is the total number of linear inequalities from input polyhedra, and TI(d,n) be polynomial time in n to solve integer linear programming problem with n be the total number of input linear inequalities. We develop algorithms to count the number of lattice points in geometric region determined by a polyhedral circuit in O(nd⋅rd(n)⋅TV(d,n)) time and to compute the volume of geometric region determined by a polyhedral circuit in O(n⋅rd(n)⋅TI(d,n)+rd(n)TL(d,n)) time, where rd(n) is the maximum number of atomic regions that n hyperplanes partition Rd . The applications to continuous polyhedra maximum coverage problem, polyhedra maximum lattice coverage problem, polyhedra (1−β) -lattice set cover problem, and (1−β) -continuous polyhedra set cover problem are discussed. We also show the NP-hardness of the geometric version of maximum coverage problem and set cover problem when each set is represented as union of polyhedra