Establishing the prognostic profile of patients with work-related musculoskeletal disorders: Development and acceptability of the MAPS questionnaire

PURPOSE

Work-related musculoskeletal disorders (WRMD) are the most common causes of disability worldwide and are associated with significant use of healthcare. One way to optimize the clinical outcomes of injured workers receiving rehabilitation is to identify and address individual prognostic factors (PF), which can facilitate the personalization of the treatment plan. As there is no pragmatic and systematic method to collect prognostic-related data, the purpose of the study was to develop and assess the acceptability of a set of questionnaires to establish the "prognostic profile" of workers with WRMD.

METHODS

We utilized a multistep process to inform the acceptability of the Measures Associated to PrognoStic (MAPS) questionnaire. During STEP-1, a preliminary version of the was developed through a literature search followed by an expert consensus including a patient-advisor. During STEP-2, future users (rehabilitation professionals, healthcare administrators and compensation officers) were consulted through an online survey and were asked to rate the relevance of each content item; items that obtained ≥80% of "totally agree" answers were included. They were also asked to prioritize PF according to their usefulness for clinical decision-making, as well as perceived efficacy to enhance the treatment plan.

RESULTS

The questionnaire was developed with three categories: the outcome predicted, the unique PF, and prognostic tools. Personal PF (i.e.: coping strategies, fear-avoidance beliefs), pain related PF (i.e.: pain intensity/severity, duration of pain), and work-related PF (i.e.: work physical demands, work accommodations) were identified to be totally relevant and included in the questionnaire. 84% of the respondents agreed that their patients could complete the MAPS questionnaire in their clinical setting, while 75% totally agreed that the questionnaire is useful to personalize rehabilitation interventions.

CONCLUSION

The MAPS questionnaire was deemed acceptable to establish the "prognostic profile" of injured workers and help the clinicians in the treatment decision-making process.

A simple quality test for self-consistent-field atomic orbitals

A quality test is proposed for SCF atomic orbitals, [Formula: see text] approximated as finite linear combinations of suitable basis functions [Formula: see text] The key is in a function, readily derived from the Hartree–Fock equation [Formula: see text] which is identically zero for true Hartree–Fock spin orbitals and not so for approximate orbitals. In this way, our test measures how closely approximate orbital descriptions approach the true Hartree–Fock limit and thus provides a quality ordering of orbital bases with respect to one another and with respect to that limit, in a scale uniquely defined by the latter. Moreover, this analysis also holds for atomic subspaces of our choice, e.g., the valence region. Examples are offered for representative collections of Slater- and Gaussian-type orbital expansions.

Valence and core region energies of atoms in Hartree–Fock theory

The subdivision of an atom into an inner core and an outer valence region reveals an interesting statistical aspect about the Hartree–Fock (HF) eigenvalues, εi, and the electron populations in the valence region, [Formula: see text] namely [Formula: see text] where Tv and [Formula: see text] are, respectively, the kinetic energy and the nuclear-electronic potential energy of the [Formula: see text] valence electrons, [Formula: see text] the interelectronic repulsion confined within the valence region, while [Formula: see text] is the repulsion between the core electrons and those of the valence region. This relationship (and a similar one for the core region) holds for any number of electrons arbitrarily assigned to the core, but is accurate only for HF (or near-HF) wave functions. This leads to a definition of the valence region energy, [Formula: see text] which, however, cannot be compared to the energy actually required for the removal of the outer electrons, because relaxation is not accounted for. An accurate energy expression has also been derived, [Formula: see text] which measures the actual withdrawal of the valence electrons. The latter expression requires the use of discrete values of Nc, the number of electrons assigned to the core, namely Nc = 2 for the first-row and Nc = 10 e for the second-row elements. Keywords: atoms, core–valence separation.