Patient Pathway Coordination (PPC) improves patient care quality and safety, particularly in oncology. PPC roles, such as nurse coordinators (NCs), have positively impacted the quality of patient care and reduced financial costs. However, NCs and their real activities in Health Care Organizations (HCOs) are unclear. Our aim was to identify, quantify, and compare all activities performed by NCs in oncology care settings from an organizational approach. Methods: We used qualitative and quantitative approaches based on case study principles. We accumulated 325 observation hours by shadowing and timing the activities of 14 NCs in four French HCO in oncology. Data analysis was conducted using an analytical framework to investigate the Activity of PAtient PAthway Nurse Coordinators in Oncology (APANCO). Results: Our research generated important findings: (1) NC roles and job titles are not standardized. (2) Non-coordination related activities are important in NC work content. Non-coordination times were consistent with distribution times between ward NCs and NCs in centralized structures. Ward NCs had higher non-coordination activities when compared with NCs in centralized structures. (3) PPC times varied for both ward NCs and NCs in centralized structures. Ward NCs performed less design coordination when compared with NCs in centralized structures, and this latter group also performed more external coordination than ward NCs. Conclusions: NCs do not just perform PPC activities. Their position in HCO structures, wards, or centralized structures, influence their work content. Centralized structures allow NCs to focus on their PPC roles. We also highlight different dimensions of NC work and training requirements. Our study could help managers and decision-makers develop PPC roles in oncology.

BACKGROUND: Childhood injury has been identified as a grave public health problem globally as well as in India. Most studies have reported injuries to have occurred while the child was at home, though injuries while on road, school, or playground also commonly occurred.
OBJECTIVE: The objective of the study is to find the association between unintentional childhood injury and the activity and location of the child at the time of injury.
METHODS: The present study is part of a larger study for preventing childhood injuries, conducted from August 2017 to January 2019 in Delhi, and reports the activity and location of the children at the time of injury. A total of 173 injuries that occurred during the total study duration were included in the analysis. Data regarding activity and location of the subjects were collected and analyzed by case-crossover study design, during \"case/hazard period\" and two \"control/reference periods.\"
RESULTS: Majority of the injuries occurred while the subjects were at home and engaged in activities other than normal activity. When various locations and activities were combined, unmatched odds ratios (ORs) were raised for activity other than normal activity (statistically significant) and for location other than at home. Similar results were obtained for matched Mantel-Haenszel OR, with activity other than normal being significantly more risk for injury (P = 0.000).
CONCLUSIONS: Majority of unintentional injuries occurred in children and adolescents, while the subjects were away from home and engaged in any activity other than normal daily activities. This indicates the importance of teaching safety behavior to children so that they can prevent being injured wherever they go and whatever activity they perform.

BACKGROUND: To promote the successful and sustainable inclusion of people with disabilities in different activities such as work, more precise job matching efforts may be of value, especially because people with disabilities are employed at a lower rate than people without disabilities. Requirement profiles as well as profile comparisons have not yet been recorded for horticultural work processes.
OBJECTIVE: The aim of this study was to document precisely the work process of the cuttings production of the flower tradescantia and to compare the capabilities of people with disabilities with the requirements for this work process for the purpose of verifying that the tool employed was usable.
METHODS: A skilled worker performed the cuttings production of tradescantias according to good horticultural practice. Additionally, five people with disabilities participated in this study. On the one hand, a structured questionnaire was used to collect the data. On the other hand, the work processes were documented with video recordings and described related to REFA (Association for Work Design, Business Organization and Corporate Development) and evaluated according to IMBA (Integration of People with Disabilities into the Working Environment).
RESULTS: Apart from the too long working hours, the work in the cuttings production was feasible for the five subjects who had different types of disabilities. There were situations of underchallenges of different degrees, but no overchallenges. It was necessary to assess each subject individually for the risk of accident.
CONCLUSIONS: IMBA proved to be an effective tool to evaluate and analyse work activities for the purpose of including people with disabilities into horticultural work processes. Thus, it has the potential to facilitate a socially sustainable and skill-oriented work participation for persons with disabilities.

Chronic pain is associated with substantial decreases in physical and emotional health. Psychosocial and physical restoration interventions, although potentially helpful, typically show small-to-moderate improvements that are limited to the short term, and often exhibit problematic adherence. Here, we present GetActive-Fitbit, a novel 10-week group program that integrates mind-body skills, pain coping and gradual increases in activity reinforced by a commercially available digital monitoring device (Fitbit). We illustrate the program among a group of 4 adults with heterogeneous chronic pain. We also highlight pre to post-program improvements in physical function (objective, performance-based and self-report), emotional function (depression and anxiety) and other relevant outcomes targeted by the program (e.g., pain intensity, catastrophizing, mindfulness, coping, kinesiophobia, emotional support, social isolation, pain resilience, program satisfaction and impression of change). Group participants\' experiences suggest that GetActive-Fitbit is credible, useful, and shows potential to improve physical and emotional function among this challenging population.Clinical trial number: NCT03412916.

Rehabilitation is crucial for maximizing recovery after stroke. Rehabilitation activities that are fun and rewarding by themselves can be more effective than those who are not. Gamification with virtual reality (VR) exploits this principle. This single-case design study probes the potential for using commercial off-the-shelf, room-scale head-mounted virtual reality for upper extremity rehabilitation in individuals with chronic stroke, the insights of which can inform further research.
A heterogeneous volunteer sample of seven participants living with stroke were recruited through advertisement. A single-case design was employed with a 5-week baseline (A), followed by a 10-week intervention (B) and a 6-month follow-up. Upper extremity motor function was assessed with validated kinematic analysis of drinking task. Activity capacity was assessed with Action Research Arm Test, Box and Block Test and ABILHAND questionnaire. Assessments were done weekly and at follow-up. Playing games on a VR-system with head-mounted display (HTC Vive) was used as rehabilitation intervention. Approximately 300 games were screened and 6 tested. Visual analysis and Tau-U statistics were used to interpret the results.
Visual analysis of trend, level shift and overlap as well as Tau-U statistics indicated improvement of Action Research Arm Test in six participants. Four of these had at least a moderate Tau-U score (0.50-0.92), in at least half of the assessed outcomes. These four participants trained a total of 361 to 935 min. Two out of four participants who were able to perform the drinking task, had the highest training dose (> 900 min) and showed also improvements in kinematics. The predominant game played was Beat Saber. No serious adverse effects related to the study were observed, one participant interrupted the intervention phase due to a fall at home.
This first study of combining commercial games, a commercial head-mounted VR, and commercial haptic hand controls, showed promising results for upper extremity rehabilitation in individuals with chronic stroke. By being affordable yet having high production values, as well as being an easily accessible off-the-shelf product, this variant of VR technology might facilitate widespread adaption. Insights garnered in this study can facilitate the execution of future studies. Trial registration The study was registered at researchweb.org (project number 262331, registered 2019-01-30, https://www.researchweb.org/is/vgr/project/262331 ) prior to participant enrolment.

BACKGROUND: Mobile and wearable devices are increasingly being used to support our everyday lives and track our behavior. Since daily support and behavior tracking are two core components of cognitive rehabilitation, such personal devices could be employed in rehabilitation approaches aimed at improving independence and engagement among people with dementia.
OBJECTIVE: The aim of this work was to investigate the feasibility of using smartphones and smartwatches to augment rehabilitation by providing adaptable, personalized support and objective, continuous measures of mobility and activity behavior.
METHODS: A feasibility study comprising 6 in-depth case studies was carried out among people with early-stage dementia and their caregivers. Participants used a smartphone and smartwatch for 8 weeks for personalized support and followed goals for quality of life. Data were collected from device sensors and logs, mobile self-reports, assessments, weekly phone calls, and interviews. This data were analyzed to evaluate the utility of sensor data generated by devices used by people with dementia in an everyday life context; this was done to compare objective measures with subjective reports of mobility and activity and to examine technology acceptance focusing on usefulness and health efficacy.
RESULTS: Adequate sensor data was generated to reveal behavioral patterns, even for minimal device use. Objective mobility and activity measures reflecting fluctuations in participants\' self-reported behavior, especially when combined, may be advantageous in revealing gradual trends and could provide detailed insights regarding goal attainment ratings. Personalized support benefited all participants to varying degrees by addressing functional, memory, safety, and psychosocial needs. A total of 4 of 6 (67%) participants felt motivated to be active by tracking their step count. One participant described a highly positive impact on mobility, anxiety, mood, and caregiver burden, mainly as a result of navigation support and location-tracking tools.
CONCLUSIONS: Smartphones and wearables could provide beneficial and pervasive support and monitoring for rehabilitation among people with dementia. These results substantiate the need for further investigation on a larger scale, especially considering the inevitable presence of mobile and wearable technology in our everyday lives for years to come.

OBJECTIVE: Atrial fibrillation (AF) is associated with increased mortality, but the temporal relationship between AF burden (AFB) and death among patients with cardiac implanted electronic devices is unknown. We sought to characterize the timing and progression of AFB before death.
RESULTS: Using Merlin.netTM remote monitoring (RM) data, we analysed weekly AFB in patients age ≥55 years implanted with dual-chamber pacemaker, implantable cardioverter-defibrillator, or cardiac resynchronization therapy devices whose death was verified in the Social Security Death Index and who had continuous RM from 1 year to 4 weeks preceding death. Atrial fibrillation burden was defined as amount of time per week atrial rate exceeded a set threshold of 180 b.p.m. Case-crossover analysis was used to compare the AFB at every week to 6 control weeks at the start of the year before death. There were 3131 patients meeting analysis criteria (age at death 76 ± 8 years, 70% men). Weekly increase in AFB >6 h was associated with increased odds of death, which was greatest at 4 weeks before death [odds ratio (OR) 2.30, 95% confidence interval (CI) 2.09-2.53; P < 0.001]. Atrial fibrillation progression week-to-week >24 h was associated with the greatest odds of death (OR 12.95, 95% 8.72-19.22; P < 0.001). A combination of AFB >6 h per week and activity <0.5 h per day was associated with an increased odds of death.
CONCLUSIONS: In this large patient cohort, AFB progression accelerated in the weeks leading to death. Continuous monitoring of AFB may help identify device patients who may be at risk for adverse outcomes, including death.

UNASSIGNED: Femoral neck modularity in total hip arthroplasty (THA) affords the surgeon the ability to optimize femoral neck length, offset, and version, thereby theoretically improving restoration of patient anatomy and biomechanics. The effect of activity on serum metal ion levels in patients with a THA with a mixed-metal modular neck design has not yet been described.
UNASSIGNED: A 63-year-old male underwent THA utilizing a femoral stem with a mixed-metal modular femoral neck. After the stem was voluntarily recalled, he was indicated to be monitored for manifestations ofmodular junction corrosion and development of adverse local tissue reactions (ALTR). An association between activity levels and serial serum cobalt levels was demonstrated.
UNASSIGNED: In this patient with a THA incorporating a mixed-metal modular femoral neck, modification of activity intensity may have played a role in altered corrosion generation, as indicated by serum metal ion levels. In turn, this may play a role in the progression of ALTR.

OBJECTIVE: The objective of this study is to identify any correlation between the maternal protein S (PS) activity, which decreases spontaneously during normal pregnancy, and the pregnancy outcome, especially the amount of bleeding during caesarean section (CS).
METHODS: We analyzed 129 pregnant women who received elective CS at our hospital which is a tertiary perinatal center. The relationship between the amount of intraoperative hemorrhage and PS activity was estimated by simple linear regression. Univariate and multivariate analyses were also performed to determine whether or not the maternal PS activity was associated with massive hemorrhage (>1000 g).
RESULTS: The maternal PS activity correlated with the amount of intraoperative hemorrhage (p = .048, r = 0.175) and could be an independent predictor of massive hemorrhage (odds ratio 1.06; 95% confidence interval 1.01-1.12; p = .013).
CONCLUSIONS: Maternal PS activity was associated with the amount of hemorrhage during CS and the occurrence of massive hemorrhage. PS activity reduction naturally occurring during pregnancy could contribute to alleviation of massive hemorrhage.

OBJECTIVE: The purpose of this study was to elucidate whether body mass index (BMI), activity level, and other risk factors predispose patients to Achilles tendon ruptures.
METHODS: A retrospective review of 279 subjects was performed (93 with Achilles tendon rupture, matched 1:2 with 186 age/sex matched controls with ankle sprains). Demographic variables and risk factors for rupture were tabulated and compared.
RESULTS: The rupture group mean BMI was 27.77 (95% CI, 26.94-28.49), and the control group mean BMI was 26.66 (95% CI, 26.06-27.27). These populations were found to be statistically equivalent (p=0.047 and p<0.001 by two one-sided t-test). A significantly higher proportion of those suffering ruptures reported regular athletic activity at baseline (74%) versus controls (59%, p=0.013).
CONCLUSIONS: There was no clinically significant difference found in BMI between patients with ruptures and controls. Furthermore, it was found that patients who sustained ruptures were also more likely to be active at baseline than their ankle sprain counterparts.