Occupational and Aerospace Medicine

Rochester, MN, United States

Occupational and Aerospace Medicine

Rochester, MN, United States
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Anderson P.J.,Health Partners Occupational and Environmental Medicine Residency | Bovard R.S.,Health Partners Occupational and Environmental Medicine Residency | Murad M.H.,Occupational and Aerospace Medicine | Beebe T.J.,Robert d Patricia rn Center For The Science Of Health Care Delivery | Wang Z.,Robert d Patricia rn Center For The Science Of Health Care Delivery
BMC Research Notes | Year: 2017

Background: More than two-thirds of Americans are overweight or obese (69%) placing them at high risk for a wide array of chronic diseases. Physical activity anchors most approaches to obesity prevention and weight management, but physical activity levels remain low in the general US population. As a group, citizen athletes who compete in Nordic skiing events such as the American Birkebeiner participate in fitness cultures that promote physical activity. Methods: During October-November 2014, we emailed a 48 question online survey to 23,611 individuals who had participated in the American Birkebeiner ski event, the largest citizen ski race in North America. Descriptive statistics were used to summarize data. Binomial and student t test were used to compare binary and continuous outcomes to health behaviors of the US population. Results: 5433 individuals responded. Obesity prevalence (BMI ≥30) was 3% and average BMI was 24. Skiers reported very good health (88%), higher fitness than peers (99%), freedom from depression (93%) low levels of smoking (3%), high consumption of fruits and vegetables, moderate alcohol use, and high levels of physical activity. Fifteen percent practiced all 4 healthy living characteristics known to reduce cardiovascular event risk. Conclusions: As a group, citizen endurance Nordic skiers enjoy low levels of obesity, below average BMI, and report lifestyle behaviors known to decrease obesity, promote health, and reduce cardiovascular disease risk. Future research should explore hypotheses that explain how the fitness cultures surrounding citizen athletic events support weight loss, cardiovascular fitness, and healthy lifestyle habits. © 2017 The Author(s).

Benkhadra K.,Evidence Based Practice Research Program | Benkhadra K.,Mayo Clinic Robert d Patricia rn Center For The Science Of Health Care Delivery | Adusumalli J.,Evidence Based Practice Research Program | Rajjo T.,Evidence Based Practice Research Program | And 5 more authors.
BMC Health Services Research | Year: 2016

Background: The healthcare needs of physician are not well studied. Methods: We surveyed physicians attending a large primary care conference about their access and perceived barriers to receiving healthcare services. Results: Response rate was 46 % (270/592). The majority were trained in family medicine. The age category of above 60 years was the most common (39 %) and 46 % were women. Important difficulty in accessing healthcare services was reported by 39 % of physicians and the majority (61 %) reported reverting to self-diagnosis and self-treatment. Female physicians reported more difficulties than male physicians (p < 0.001 for difficulty in securing access and p = 0.02 for self-diagnosis and treatment). The barriers cited were finding time for healthcare, concern about confidentiality, and lack of encouragement by employer. Respondents reported experiencing a career threatening illness themselves (20 %) or in a colleague (81 %). Forty-two percent experienced being concerned about a colleague being able to safely practice due to illness. Participants ranked substance abuse as the most common illnesses affecting a physician's ability to practice followed by psychiatric disorders, heart disease, neurological disorders and cancer. Conclusions: Physicians face important barriers to accessing healthcare services. Female physicians report worse access. The identified barriers are modifiable. This survey calls for efforts to improve physicians' health that require collaboration among physicians, employers and policymakers. © 2016 The Author(s).

Kuhle C.S.,Occupational and Aerospace Medicine | Truitt F.,Occupational and Aerospace Medicine | Steffen M.,Occupational and Aerospace Medicine | Undavalli C.,Knowledge and Evaluation Research Unit | And 5 more authors.
Journal of Occupational and Environmental Medicine | Year: 2013

Objective: To improve patient satisfaction with care at an occupational medicine clinic by promoting agenda-setting before the visit. Methods: We distributed agenda-setting form to 77 randomly selected patients attending an occupational health clinic and used another randomly selected sample of 36 patients as control group. Patients completed a survey regarding the acceptability of this procedure and whether they felt clinicians addressed their important concerns. Results: Most patients found the formhelpful (73%) and wanted it offered in future visits (74%). There was no statistically significant difference in terms of the proportion of patients expressing greatest satisfaction by answering, "strongly agree" (intervention [86%], control [97%]; odds ratio, 0.17; 95% confidence interval, 0.02 to 1.38; P = 0.06). Conclusion: Agenda-setting can improve patient experience before occupational visits but does not improve postvisit satisfaction. Copyright © 2013 by American College of Occupational and Environmental Medicine.

Adamson T.L.,Arizona State University | Eusebio F.A.,Arizona State University | Cook C.B.,Occupational and Aerospace Medicine | Labelle J.T.,Arizona State University
Analyst | Year: 2012

Self-monitoring of blood glucose is the standard of care in management of hyperglycemia among patients with diabetes mellitus. To increase the sensitivity and specificity of current devices, a novel method of detecting glucose using electrochemical impedance spectroscopy (EIS) technology is explored. The enzyme glucose oxidase (GOx) was fixed to gold electrodes and a sine wave of sweeping frequencies was induced using a wide range of concentrations of glucose. Each frequency in the impedance sweep was analyzed for the highest response and R-squared value. The frequency with both factors optimized is specific for the glucose-GOx binding interaction and was determined to be 1.17 kHz in purified solutions in both higher and lower ranges of glucose. The correlation between the impedance response and concentration at the low range of detection (0-100 mg dL-1 of glucose) was determined to be 3.53 ohm/ln (mg dL -1) with an R-squared value of 0.90 with a 39 mg dL-1 lower limit of detection. The same frequency of 1.17 kHz was verified in whole blood under the same glucose range. The above data confirm that EIS offers a new method of glucose detection as an alternative to current technology in use by patients. Additionally, the unique frequency response of individual markers allows for modulation of signals so that several other markers important in the management of diabetes could be measured with a single sensor. © 2012 The Royal Society of Chemistry.

Adamson T.L.,Arizona State University | Cook C.B.,Occupational and Aerospace Medicine | LaBelle J.T.,Arizona State University
Journal of Diabetes Science and Technology | Year: 2014

Multiple markers are used to assess glycemic control in patients with diabetes mellitus (DM). New technology that permits simultaneous detection of multiple biomarkers combined with those used at the point of care indicative of glycemic control, including glycemic variability determined from 1,5-anhydroglucitol measurement, could provide better management and further insight into the disease. This platform was based on previous research involving glucose detection and uses electrochemical impedance spectroscopy to detect a range of 1,5-anhydroglucitol concentrations at an optimal binding frequency. The enzyme pyranose oxidase was fixed to gold electrodes while a sine wave of sweeping frequencies was induced in purified solutions and in variable presence of whole blood. The optimal binding frequency for the detection of 1,5-anhydroglucitol was found to be 3.71 kHz. The impedance response compared to the concentration of target present was found to have a logarithmic slope of 7.04 with an R-squared value of 0.96. This response includes 2 experimental sets, a single test of a low concentration range and a high concentration range with 5 replicates. The relative standard deviation of the high range varied from 28% to 27% from lowest to highest concentrations. Best detection in complex solutions was found in lower blood concentrations of 0.5% and 1%, but maintained relatively high accuracy in concentrations 5% and 10%. The sensor platform was successfully evaluated at a high dynamic range of 1,5-AG in purified solutions. In the presence of whole blood, lowest percentages yielded the best results indicating that filtering interferents may be necessary in final device architecture. © 2014 Diabetes Technology Society.

Karlin N.J.,Occupational and Aerospace Medicine | Dueck A.C.,Occupational and Aerospace Medicine | Cook C.B.,Occupational and Aerospace Medicine
Endocrine Practice | Year: 2012

Objective: To determine the prevalence of diabetes mellitus, glycemic control, and impact of diabetes on overall survival in an academic oncology practice. Methods: Data on cancer patients (1999 to 2008) were retrieved from the institutional cancer registry and linked to electronic files to obtain diabetes status and hemoglobin A1c (A1C) values within the first 6 months of cancer diagnosis. Overall survival by cancer type with and without diabetes was compared using Cox regression. Results: Excluding skin and hematologic malignancies, 15,951 cancer cases were identified. Overall diabetes prevalence was 6.8% (n = 1,090), declining over time (P<0.001). Diabetes was common among patients with pancreatic (9.8% [61 of 624]), colorectal (7.7% [89 of 1,151]), or bladder cancers (7.6% [68 of 899]). Patients with diabetes were older (mean age, 70 versus 66 years; P<0.001) and more likely to be male (66.3% [723 of 1,090] versus 60.2% [8,949 of 14,858]; P<0.001). The mean A1C among diabetic cancer patients was 6.8% and did not differ across cancer types (P = 0.80). Only 58.6% (331 of 565) of diabetic cancer patients had all A1C <7.0% during the first 6 months following cancer diagnosis. Pancreatic cancer patients with coexisting diabetes had better overall survival than pancreatic cancer patients without diabetes (hazard ratio, 0.60; 95% confidence interval 0.44 to 0.80; P<0.001). Conversely, diabetic prostate cancer patients had worse overall survival than prostate cancer patients without diabetes (hazard ratio, 1.36; 95% confidence interval 1.05 to 1.76; P = 0.02). Conclusion: In this academic oncology practice, diabetes was common, glycemic control often was suboptimal, and survival varied by cancer type. Additional study is needed to optimize glucose management and investigate mechanisms underlying age, sex, and survival differences. Copyright © 2012 AACE.

Newcomb R.D.,Occupational and Aerospace Medicine | Molella R.G.,Occupational and Aerospace Medicine | Varkey P.,Occupational and Aerospace Medicine | Sturchio G.M.,Occupational and Aerospace Medicine | And 3 more authors.
Journal of Occupational and Environmental Medicine | Year: 2012

Objectives: To determine whether preplacement recommendations following an occupationally focused medical history is different from those following an occupational consultation. Methods: This was a retrospective cohort study of 172 applicants to our institution. Results: Following provider review of occupational history survey alone, none of the applicants had restrictions recommended. In comparison, only 163 applicants (94.7%) were recommended to be hired without restrictions following provider review of the same patient's occupational history and examination (P = 0.0078). Conclusion: A well-designed questionnaire is useful for screening applicants for preplacement examinations and assures sufficient detail to allow for a large proportion of individuals to proceed to employment without an occupational examination. However, in this study, a small but statistically significant portion (5%) of applicants required occupational examinations for appropriate work recommendations. Copyright © 2012 by American College of Occupational and Environmental Medicine.

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