Geertsendolan1238

An amendment to this paper has been published and can be accessed via the original article.

To assess the association between walking speed (WS) and its improvement on hospitalization rates and costs in outpatients with cardiovascular disease.

Six hundred forty-nine patients participating in an exercise-based secondary prevention program were studied. Patients were divided at baseline into two groups characterized by low and high WS based on the average WS maintained during a moderate 1-km treadmill-walking test. WS and other covariates were grouped into three domains (demographic factors, medical history and risk factors), and used to estimate a propensity score, in order to create homogeneous groups of patients. All-cause hospitalization was assessed 3 years after baseline as a function of WS. Hospitalization and related costs were also assessed during the fourth-to-sixth years after enrollment. To test whether the hospitalization costs were related to changes in WS after 36 months, a multistrata permutation test was performed by combining within strata partial tests.

The results support the hypothesis that hospitalization costs are significantly reduced in accordance with an improvement in WS. This effect is most evident among older patients, overweight or obese, smokers, and those without a history of coronary artery bypass surgery.

The present study supports growing evidence of an inverse association between WS, risk of hospitalization and consequent health-care costs. The joint use of propensity score and multistrata permutation approaches represent a flexible and robust testing method which avoids the possible effects of several confounding factors typical of these studies.

The present study supports growing evidence of an inverse association between WS, risk of hospitalization and consequent health-care costs. BMS-387032 The joint use of propensity score and multistrata permutation approaches represent a flexible and robust testing method which avoids the possible effects of several confounding factors typical of these studies.

Ensuring the current public health workforce has appropriate competencies to fulfill essential public health functions is challenging in many low- and middle-income countries. The absence of an agreed set of core competencies to provide a basis for developing and assessing knowledge, skills, abilities, and attitudes contributes to this challenge. This study aims to identify the requisite core competencies for practicing health professionals in mid-level supervisory and program management roles to effectively perform their public health responsibilities in the resource-poor setting of Uttar Pradesh (UP), India.

We used a multi-step, interactive Delphi technique to develop an agreed set of public health competencies. A narrative review of core competency frameworks and key informant interviews with human resources for health experts in India were conducted to prepare an initial list of 40 competency statements in eight domains. We then organized a day-long workshop with 22 Indian public health experts and gess competencies of public health professionals and revise or develop new training programs to address desired competencies. Findings can also be used to support workforce development by informing competency-based job descriptions for recruitment and performance management in the Indian context, and potentially can be adapted for use in resource-poor settings globally.

This study produced a consensus set of core competencies and domains in public health that can be used to assess competencies of public health professionals and revise or develop new training programs to address desired competencies. Findings can also be used to support workforce development by informing competency-based job descriptions for recruitment and performance management in the Indian context, and potentially can be adapted for use in resource-poor settings globally.

To evaluate the biomechanical properties of short-segment Schanz screw implanted in an oblique downward direction for the treatment of lumbar 1 burst fracture using a finite element analysis.

The Universal Spine System (USS) fixation model for adjacent upper and lower vertebrae (T12 and L2) of lumbar 1 vertebra burst fracture was established. During flexion/extension, lateral bending, and rotation, the screw stress and the displacement of bone defect area of the injured vertebrae were evaluated when the downward inserted angle between the long axis of the screws and superior endplate of the adjacent vertebrae was set to 0° (group A), 5° (group B), 10° (group C), and 15°(group D). There were 6 models in each group.

There were no significant differences in the maximum screw stress among all the groups during flexion/extension, lateral bending, and rotation (P > 0.05). There were no significant differences in the maximum displacement of the bone defect area of the injured vertebrae among all the groups during flexion/extension, lateral bending, and rotation (P > 0.05).

Short-segment Schanz screw implanted in an oblique downward direction with different angles (0°/parellel, 5°, 10°, and 15°) did not change the maximum stress of the screws, and there was a lower risk of screw breakage in all groups during flexion/extension, lateral bending, and rotation. In addition, the displacement of the injured vertebra defect area had no significant changes with the change of angles.

Short-segment Schanz screw implanted in an oblique downward direction with different angles (0°/parellel, 5°, 10°, and 15°) did not change the maximum stress of the screws, and there was a lower risk of screw breakage in all groups during flexion/extension, lateral bending, and rotation. In addition, the displacement of the injured vertebra defect area had no significant changes with the change of angles.

Ischemic stroke patients with a good outcome in terms of motor functioning and communication are likely to be discharged home without further rehabilitation. A significant number of these patients experience cognitive and emotional problems resulting in lower quality of life and decreased participation in society. This paper presents the protocol of a study examining the clinical effectiveness, cost-effectiveness and implementation of an intervention focused on screening and patient-tailored care for cognitive and emotional problems as compared to usual care in patients discharged home after ischemic stroke.

A multicenter, patient-blinded, cluster randomized controlled trial will be performed. Centers will be randomized (11) to the intervention group or the usual care group. Patients (> 18 years old) with a neurological confirmed diagnosis of ischemic stroke who can be discharged home without follow-up treatment at an outpatient rehabilitation clinic will be included. In the intervention group, patients will receive a short, individualized, semi-structured consultation by specialized nurses in addition to usual care.