Churchill R.S.,Aurora Medical Center Grafton |
Chuinard C.,Great Lakes Orthopaedic Center |
Wiater J.M.,Beaumont Health |
Friedman R.,Medical University of South Carolina |
And 8 more authors.
Journal of Bone and Joint Surgery - American Volume | Year: 2016
Background: Stemmed humeral components have been used since the 1950s; canal-sparing (also known as stemless) humeral components became commercially available in Europe in 2004. The Simpliciti total shoulder system (Wright Medical, formerly Tornier) is a press-fit, porous-coated, canal-sparing humeral implant that relies on metaphyseal fixation only. This prospective, single-arm, multicenter study was performed to evaluate the two-year clinical and radiographic results of the Simpliciti prosthesis in the U.S. Methods: One hundred and fifty-seven patients with glenohumeral arthritis were enrolled at fourteen U.S. sites between July 2011 and November 2012 in a U.S. Food and Drug Administration (FDA) Investigational Device Exemption (IDE)- approved protocol. Their range of motion, strength, pain level, Constant score, Simple Shoulder Test (SST) score, and American Shoulder and Elbow Surgeons (ASES) score were compared between the preoperative and two-year postoperative evaluations. Statistical analyses were performed with the Student t test with 95% confidence intervals. Radiographic evaluation was performed at two weeks and one and two years postoperatively. Results: One hundred and forty-nine of the 157 patients were followed for a minimum of two years. The mean age and sex-adjusted Constant, SST, and ASES scores improved from 56% preoperatively to 104% at two years (p < 0.0001), from 4 points preoperatively to 11 points at two years (p < 0.0001), and from 38 points preoperatively to 92 points at two years (p < 0.0001), respectively. The mean forward elevation improved from 103° ± 27° to 147° ± 24° (p < 0.0001) and the mean external rotation, from 31° ± 20° to 56° ± 15° (p < 0.0001). The mean strength in elevation, as recorded with a dynamometer, improved from 12.5 to 15.7 lb (5.7 to 7.1 kg) (p < 0.0001), and the mean pain level, as measured with a visual analog scale, decreased from 5.9 to 0.5 (p < 0.0001). There were three postoperative complications that resulted in revision surgery: infection, glenoid component loosening, and failure of a subscapularis repair. There was no evidence of migration, subsidence, osteolysis, or loosening of the humeral components or surviving glenoid components. Conclusions: The study demonstrated good results at a minimum of two years following use of the Simpliciti canalsparing humeral component. Clinical results including the range of motion and the Constant, SST, and ASES scores improved significantly, and radiographic analysis showed no signs of loosening, osteolysis, or subsidence of the humeral components or surviving glenoid components. © 2016 BY THE JOURNAL OF BONE AND JOINT SURGERY, INCORPORATED.
Chapel D.B.,Columbia University |
Sorensen J.A.,Northeast Center for Occupational Health and Safety in Agriculture |
Tinc P.J.,Northeast Center for Occupational Health and Safety in Agriculture |
Fiske T.,Northeast Center for Occupational Health and Safety in Agriculture |
And 2 more authors.
Journal of Agricultural Safety and Health | Year: 2015
Despite the substantial contribution of power take-off (PTO) entanglements to workplace morbidity and mortality among agricultural workers, the degree of proper PTO shielding on U.S. farms remains poorly characterized. Sampling from the New York data of the USDA National Agricultural Statistical Service (NASS), at least 200 each of dairy, livestock, crop, fruit, and vegetable farms were surveyed by phone to determine the extent of proper PTO shielding. In the same year, on-site audits were performed at 211 randomly selected New York livestock and dairy farms using a four-point scale to assess PTO shielding. Supplemental data were gathered on farm acreage, number of livestock, principal commodity, and operator experience. The phone survey data for livestock and dairy farms were then compared to the on-farm audit data. In the phone survey, 72.5% of farms reported having shields on all implements. The mean percentage of implements reported to be shielded was 90.2%. By on-farm audit, 10% of farms had all implements properly shielded, and the mean percentage of properly shielded implements was 56.7%, with shielding rates differing widely for different classes of implements. No significant predictors of PTO shielding were identified. The phone survey greatly overestimated proper PTO shielding rates when compared with the on-farm audits. These data suggest a lower level of proper shielding among farmers than is mandated by current industry safety standards. The results also identify a principal weakness of phone surveys in accurately assessing the true magnitude of on-farm risk for PTO entanglement. © 2015 ASABE.
PubMed | Bassett Healthcare Network Research Institute and Columbia University
Type: Journal Article | Journal: Evaluation & the health professions | Year: 2016
We validated three single-item measures for emotional exhaustion (EE) and depersonalization (DP) among rural physician/nonphysician practitioners. We linked cross-sectional survey data (on provider demographics, satisfaction, resilience, and burnout) with administrative information from an integrated health care network (1 academic medical center, 6 community hospitals, 31 clinics, and 19 school-based health centers) in an eight-county underserved area of upstate New York. In total, 308 physicians and advanced-practice clinicians completed a self-administered, multi-instrument questionnaire (65.1% response rate). Significant proportions of respondents reported high EE (36.1%) and DP (9.9%). In multivariable linear mixed models, scores on EE/DP subscales of the Maslach Burnout Inventory were regressed on each single-item measure. The Physician Work-Life Studys single-item measure (classifying 32.8% of respondents as burning out/completely burned out) was correlated with EE and DP (Spearmans = .72 and .41, p < .0001; Kruskal-Wallis (2) = 149.9 and 56.5, p < .0001, respectively). In multivariable models, it predicted high EE (but neither low EE nor low/high DP). EE/DP single items were correlated with parent subscales (Spearmans = .89 and .81, p < .0001; Kruskal-Wallis (2) = 230.98 and 197.84, p < .0001, respectively). In multivariable models, the EE item predicted high/low EE, whereas the DP item predicted only low DP. Therefore, the three single-item measures tested varied in effectiveness as screeners for EE/DP dimensions of burnout.
Jenkins P.L.,Bassett Healthcare Network Research Institute |
Sorensen J.A.,Bassett Healthcare Network Research Institute |
Yoder A.,Bassett Healthcare Network Research Institute |
Myers M.,Bassett Healthcare Network Research Institute |
And 5 more authors.
Journal of Agricultural Safety and Health | Year: 2012
Tractor overturns contribute significantly to the number of work-related deaths that occur every year on U.S. farms. Although the agriculture, forestry, and fishing industries have the highest fatality rates of any industries, researchers predict that the elimination of tractor overturn fatalities could result in a noticeable reduction in the farm fatality rate. Rollover protection structures (ROPS) are 99% effective in preventing overturn fatalities. However, roughly 50% of U.S. tractors do not have a ROPS. In order to identify prominent barriers and motivators to installing ROPS, a phone survey was conducted with a random sample of farmers (n= 327) in Vermont and Pennsylvania, two states interested in developing ROPS installation programs. Results indicated that cost and perceived need were the most frequently highly rated barriers to ROPS installation in both states, while working near hills or ditches and concerns regarding liability were the most frequently highly rated motivators for installing ROPS. Additionally, older farmers identified limited use of a tractor as a highly rated barrier. © 2012 ASABE.