Improving implant training for physicians and their teams in under-represented regions.

The burden of cardiovascular disease is increasing globally, with low- and middle-income countries (LMICs) absorbing most of the burden while lacking the necessary healthcare infrastructure to combat the increase. In particular, the disparity in pacemaker implants between high-income countries and LMICs is glaring, partially spurned by reduced numbers of physicians and supporting staff who are trained in pacemaker implant technique. Herein, we will discuss current pacemaker implant training models, outline training frameworks that can be applied to underserved regions, and review adjunctive training techniques that can help supplement traditional training models in LMICs.

Work-related musculoskeletal disorders among Pakistani construction workers: Prevalence, characteristics, and associated risk factors.

BACKGROUND: Worldwide, approximately 350 million people are currently employed in the construction industry. OBJECTIVE: To determine the prevalence, pain characteristics, and associated risk factors for musculoskeletal disorders (MSDs) among construction workers in Pakistan. METHODS: This study was a cross-sectional survey conducted from February to August 2019 among 666 construction workers. The data were collected using a questionnaire consisting of 4 sections: demographic information, a numerical pain intensity rating scale, a Nordic questionnaire to report prevalence, and pain characteristics. SPSS was used for data entry and analysis. RESULTS: The mean age of the construction workers was 34.49 years. Participants who reported pain were 397 out of 666 and 269 were those who reported no pain. The 12-month prevalence of pain among construction workers in more than one body area was 89% (n = 591) and the 7-day prevalence was 52% (n = 343); lower back pain was the most common type of pain with a 12-month prevalence of 27% (n = 180) and a 7-day prevalence of 17% (n = 112). Regarding the characteristics of the pain, 26% (173) of the workers suffered pain occasionally, 27% (180) participants had pain for≤2 hours per day, and 32.9% (219) had dull pain. Moreover, a significant relationship was found (p < 0.05) between MSDs and age, lifestyle, work experience, smoking habits, and absence from work. CONCLUSION: Musculoskeletal pain is highly prevalent, with lower back pain being the most commonly reported type. Absence from work and disability in performing normal daily activities have been reported as consequences of musculoskeletal pain. Moreover, this study underscores the importance of targeted preventive healthcare measures for construction workers.

Factors influencing the community integration of patients following traumatic spinal cord injury: a systematic review.

BACKGROUND: Spinal cord injury (SCI) is a high-cost disabling condition, which brings a huge number of changes in individual's life. The emphasis of rehabilitation has moved from medical administration to issues that affect quality of life and community integration. This systematic review was conducted to identify the factors associated with community reintegration of patients with spinal cord injury. . METHODS: Google Scholar, PEDro, Pakmedinet, AMED, BIOMED central, Cochrane Library, MEDLINE, PsychoINFO, PUBMED, ScienceDIRECT, Scirus and Wiley Online Library databses were searched by using key words 'Spinal cord injury' 'Paraplegia' or 'Spinal Cord Lesion' or Tetraplegia. They were cross-linked with 'Community reintegration', 'Community participation' and 'Community access'. The methodological quality of the studies included was analysed by using McMaster University Tool and Thomas Tool. The data extracted included sample size, intervention, duration, results, outcome measures, and follow-up period. RESULTS: A total of 11 relevant studies were located. The evidence extracted was classified into four groups; health-related barriers or facilitators, environment-related barriers or facilitators, psychological barriers and social barriers that are associated with community reintegration of such individuals. CONCLUSIONS: The review revealed that there were more barriers in the form of health-related issues, personal and environmental, psychological and social issues that hinder the community reintegration of individuals with spinal cord injury compared to facilitators. Most studies identified special challenges related to environment in the sense of accessibility of home and public buildings and transportation. Removing barriers related to health, environment, and psychological and social factors can enhance community reintegration of such patients.