Long term outcomes after bare metal stent implantation

Long term outcome data after BMS implant is not available from the Indian subcontinent. This is a prospective observational study which aims to study long term outcomes after BMS implant at a tertiary care centre. 100 consecutive patients underwent BMS implant and were followed up for 20 years. LAD was the most common vessel involved and different types of BMS were implanted. All-cause mortality was noted in 21% (n = 21) whereas cardiac mortality was seen in 16% (n = 16). Cumulative revascularisation free survival at 20 years was 71%. The study showed that long term outcomes after BMS implant were fare and acceptable.     

Individualized 3D-printed templates for high-dose-rate interstitial multicathether brachytherapy in patients with breast cancer

Purpose

High-dose-rate, multicatheter interstitial brachytherapy is technically complex and operator-dependent, requiring lengthy training and specialized skills. Furthermore, until the advent of contouring on computerized tomography (CT) images, difficulties existed in locating the target volume precisely. The present article reports the results of a study that aimed at producing and validating a 3D-printed template to aid in target volume localization for multicatheter interstitial brachytherapy in patients with breast cancer.

The relationship between the anteroposterior and mediolateral margins of stability in able-bodied human walking

BackgroundControl of dynamic balance in human walking is essential to remain stable and can be parameterized by the margins of stability. While frontal and sagittal plane margins of stability are often studied in parallel, they may covary, where increased stability in one plane could lead to decreased stability in the other. Hypothetically, this negative covariation may lead to critically low lateral stability during step lengthening.Research questionIs there a relationship between frontal and sagittal plane margins of stability in able-bodied humans, during normal walking and imposed step lengthening?MethodsFifteen able-bodied adults walked on an instrumented treadmill in a normal walking and a step lengthening condition. During step lengthening, stepping targets were projected onto the treadmill in front of the participant to impose longer step lengths. Covariation between frontal and sagittal plane margins of stability was assessed with linear mixed-effects models for normal walking and step lengthening separately.ResultsWe found a negative covariation between frontal and sagittal plane margins of stability during normal walking, but not during step lengthening.SignificanceThese results indicate that while a decrease in anterior instability may lead to a decrease in lateral stability during normal walking, able-bodied humans can prevent lateral instability due to this covariation in critical situations, such as step lengthening. These findings improve our understanding of adaptive dynamic balance control during walking in able-bodied humans and may be utilized in further research on gait stability in pathological and aging populations.     

目标教学路径在实习护生带教中的应用研究

目的：探讨目标教学路径在实习护生带教中的应用效果及意义。方法护生入科后随机分为对照组和观察组，对照组采用传统带教模式，即根据教学大纲要求带教老师自行安排教学内容；观察组采用目标教学路径模式进行带教。实习结束后，比较两组护生的理论知识、操作技能、临床能力、职业素质及对带教工作的满意度。结果对照组和观察组理论知识得分为（92．85 ± 2．03）分、（95．65 ± 2．19）分，操作技能得分为（88．95 ± 2．84）分、（93．56 ± 2．19）分，临床能力得分为（7．39±0．34）分、（7．95±0．54）分，职业素质得分为（87．12±4．05）分、（89．59 ± 3．81）分，满意度得分为（95．02±4．10）分、（97．91 ± 3．03）分，两组各项评价指标经统计学检验，观察组均优于对照组，差异有统计学意义（P＜0．05）。结论目标教学路径能够统一教学内容，明确教学目标；规范教学行为，保证教学质量；加强职业素养，提高带教满意度。因此，目标教学路径带教模式优于传统带教模式。     

Sustaining program effectiveness after implementation: The case of the self-management of well-being group intervention for older adults

ObjectiveThe Self-Management of Well-being (SMW) group intervention for older women was implemented in health and social care. Our aim was to assess whether effects of the SMW intervention were comparable with the original randomized controlled trial (RCT). Furthermore, we investigated threats to effectiveness, such as participant adherence, group reached, and program fidelity.MethodsIn the implementation study (IMP) 287 and RCT 142 women participated. We compared scores on self-management ability and well-being of the IMP and RCT. For adherence, drop-out rates and session attendance were compared. Regarding reach, we compared participants’ baseline characteristics. Professionals completed questions regarding program fidelity.ResultsNo significant differences were found on effect outcomes and adherence between IMP and RCT (all p ≥ 0.135). Intervention effect sizes were equal (0.47–0.59). IMP participants were significantly less lonely and more likely to be married, but had lower well-being. Most professionals followed the protocol, with only minimal deviations.ConclusionThe effectiveness of the SMW group intervention was reproduced after implementation, with similar participant adherence, minimal changes in the group reached, and high program fidelity.Practice implicationsThe SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted.