Markclifford1300

5). There was no significant difference in sedentary time between weekdays and weekends. At the weekend, participants spent 8.4 min less time walking (95% CI, -12.1 to -4.6) taking 624 fewer steps/day (95% CI, -951 to -296) than during the week. Activity patterns showed greatest upright time in the morning during the week. Afternoon and evening activities were low on all days. Sedentary time did not change across the 7-day rehabilitation week, but less walking activity occurred on the weekend. There are opportunities for stroke survivors to increase physical activity during afternoons and evenings and on weekend mornings during rehabilitation.The International Classification of Functioning, Disability and Health (ICF) Rehabilitation Set was proposed by the WHO ICF Research branch as a minimum standard for assessing and reporting functioning in a wide range of clinical settings. selleck chemicals This study investigates the psychometric properties of ICF Rehabilitation Set using Rasch analysis. It was a multicenter, cross-sectional study involving 515 inpatients in the subacute or chronic phase of recovery from various health conditions selected by quota sampling (stratified by neurological, cardiopulmonary, musculoskeletal and other conditions). Registered physicians or nurses used the developed operational items of the ICF Rehabilitation Set to rate patients' functioning. A Rasch model was performed in assessing the psychometric properties of the ICF Rehabilitation Set. Good reliability was observed in the activity and participation components, but the body functions component needs additional items to distinguish among people with moderate or severe problems. After recalibration, the body functions, activities and participation components showed fit to the Rasch model. However, deletions mandated by the Rasch model decreased the functioning information reflected by the ICF Rehabilitation Set.

To identify risk factors for posttraumatic stress disorder (PTSD) after traumatic injury.

Single urban Level I trauma center.

Prospective.

Three hundred men (66%) and 152 women treated for traumatic injuries were administered the PTSD checklist for a Diagnostic and Statistical Manual of Mental Disorders fifth edition (PCL-5) survey during their first post-hospital visit over a 15-month period.

Screening for PTSD in trauma patients.

The prevalence of disease and risk factors for the development of PTSD based on demographic, medical, injury, and treatment variables.

One hundred three patients screened positive for PTSD (26%) after a mean of 86 days after injury. Age less than 45 years was an independent risk factor for the development of PTSD [odds ratio (OR) 2.64, 95% confidence interval (CI) (1.40-4.99)]. Mechanisms of injury associated with the development of PTSD included pedestrians struck by motor vehicles [OR 7.35, 95% CI (1.58-34.19)], motorcycle/all terrain vehicle crash [OR 3.17, 95% CI (1.04-9.65)], and victims of crime [OR 3.49, 95% CI (0.99-9.20)]. Patients sustaining high-energy mechanism injuries and those who were victims of crime scored higher on the PCL-5 [OR 2.39, 95% CI (1.35-4.22); OR 4.50, 95% CI (2.52-8.05), respectively].

One quarter of trauma patients screened positive for PTSD at 3 months after their injury. A mechanism of injury is a risk factor for PTSD, and younger adults, victims of crime, and pedestrians struck by motor vehicles are at higher risk. These findings offer the potential to more effectively target and refer vulnerable patient populations to appropriate treatment.

Prognostic Level II. See Instructions for Authors for a compete description of levels of evidence.

Prognostic Level II. See Instructions for Authors for a compete description of levels of evidence.

This study aims to evaluate the accessible area of the talar dome via two standard posterior approaches (posteromedial; PM, and posterolateral; PL) with and without distraction.

A standard PM or PL approach was performed with and without external fixator distraction on 12 through-knee cadaveric legs (six matched-pairs). The accessible area of the talar dome was outlined and imaged in a Micro-CT scanner to achieve 3-D reconstructions of the accessible surface area. The study outcomes were accessible surface area of the talar dome in (1) total surface area and (2) sagittal plane distance of the talar dome at predetermined intervals.

The PM approach provided significantly more access to the talar dome than did the PL approach both with and without distraction (p<0.001). The PM approach allowed access to 15.8% (SD=4.7) of the talar dome without distraction and 26.4% (SD= 8.0, p<0.001) of the talar dome with distraction. The PL approach provided access to 6.69% (SD=2.69, p=0.006 compared to PM) and 14.talar dome surgical access for treatment of posterior talus fractures and help determine when an approach that includes an osteotomy can be avoided.

Reducing environmental noise has become a priority for many health systems. Following a 10-week preparation period, our health system transitioned from an overhead-activated to a silently activated in-hospital code team notification system. The goal of this initiative was to reduce environmental noise and support code team communication and function without adversely affecting response time, provider availability, or key quality metrics.

Transitioning from overhead to silently activated events involved a three-step quality improvement approach. Input from key stakeholders and preimplementation education were of key importance. Multiple timed trials and a full in situ simulation were completed before going live with the new process.

Evaluation of 6-month pre- and postimplementation quality metrics showed no significant difference in compliance with defibrillating shockable rhythms within two minutes, event survival, or survival to discharge. Provider survey data and Hospital Consumer Assessment of Healthcare Providers and Systems "quiet at night" scores were not significantly different.

By utilizing a multistep implementation approach, transitioning from overhead pages to a silently activated system for in-hospital code team activation was feasible and safe. Abandoning the overhead paging system did not lead to a decrease in key quality metrics nor impair team perception of code function.

By utilizing a multistep implementation approach, transitioning from overhead pages to a silently activated system for in-hospital code team activation was feasible and safe. Abandoning the overhead paging system did not lead to a decrease in key quality metrics nor impair team perception of code function.