Directions for advancing the study of work transitions in the 21st century.

Objectives: The purpose of this article is to share the details, outcomes and deliverables from an international workshop on work transitions in London, Ontario, Canada.

Participants: Researchers, graduate students, and community group members met to identity ways to advance the knowledge base of strategies to enhance work participation for those in the most disadvantaged groups within society.

Methods: A participatory approach was used in this workshop with presentations by researchers and graduate students.

Exploring the capacity to ambulate after a period of prolonged mechanical ventilation.

Purpose: The purposes were to assess the functional recovery of those who survived a prolonged intensive care unit (ICU) stay by reporting the proportion who were able to ambulate independently at hospital discharge and also to examine if the time duration between admission and when the patient first stood impacted on their capacity to ambulate at discharge.

Materials And Methods: A retrospective review was conducted of medical records of ICU patients in 2007 to 2008, who were mechanically ventilated for 168 hours or more, and survived their acute care stay. Main outcome measures were (1) ambulation status before admission and at time of hospital discharge and (2) time between admission to the ICU and when the patient first stood.

Information needs across the colorectal cancer care continuum: scoping the literature.

Because cancer care requires a multifaceted approach, providing useful and timely information to people with colorectal cancer may be fragmented and inconsistent. Our interest was in examining what has and has not captured the attention of researchers speaking to the information needs of people with colorectal cancer. We followed Arksey and O'Malley's framework for the methodology of scoping review.

Ventilator versus manual hyperinflation in clearing sputum in ventilated intensive care unit patients.

The aim of hyperinflation in the ventilated intensive care unit patient is to increase oxygenation, reverse lung collapse and clear sputum. The efficacy and consistency of manual hyperventilation is well supported in the literature, but there is limited published evidence supporting hyperventilation utilising a ventilator. Despite this, a recent survey established that almost 40% of Australian tertiary intensive care units utilise ventilator hyperinflation.

Control-matched computational evaluation of tendo-femoral contact in patients with posterior-stabilized total knee arthroplasty.

Painful patellar crepitus is a potential complication in up to 14% of patients following posterior-stabilized (PS) total knee arthroplasty (TKA). A recent clinical study identified influential patient and surgical variables by comparing a group of crepitus patients with controls matched for age, sex, and body mass index. The purpose of our study was to evaluate effects of variables identified as significant in the clinical study, including patellar ligament length, femoral component flexion, patellar button size, and position of the joint line, on contact between the quadriceps tendon and the PS femoral component.

A water-damaged home and health of occupants: a case study.

A family of five and pet dog who rented a water-damaged home and developed multiple health problems. The home was analyzed for species of mold and bacteria. The diagnostics included MRI for chronic sinusitis with ENT and sinus surgery, and neurological testing for neurocognitive deficits.

Helping adults who are homeless gain disability benefits: the SSI/SSDI Outreach, Access, and Recovery (SOAR) program.

Objective: Approval rates for first-time applications for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) among adults who are homeless can be as low as 10%. This study examined approval rates among applicants who were assisted by SSI/SSDI Outreach, Access, and Recovery (SOAR), a federal initiative to increase access to disability benefits among people who are homeless or at risk of homelessness and who have mental illness or other co-occurring disorders.

Methods: Data were collected in 37 states that had participated in SOAR for at least one year.

Factors affecting modular acetabular ceramic liner insertion: a biomechanical analysis.

Background: Ceramic liner fracture is a concern in THA. However, it is unclear what factors influence the risk of facture. To study these factors under controlled conditions, we created a laboratory model to avoid fractures in vitro.

Can a high-flexion total knee arthroplasty relieve pain and restore function without premature failure?

Background: High-flexion TKA prostheses are designed to improve flexion and clinical outcomes. Increased knee flexion can increase implant loads and fixation stresses, creating concerns of premature failure. Whether these goals can be achieved without premature failures is unclear.

The incidence of falls in intensive care survivors.

Background: Falling among adults in acute care is an important problem with falls rates in tertiary hospitals ranging from 2% to 5%. Factors that increase the risk of falling, such as advanced age, altered mental status, medications that act on the central nervous system and poor mobility, often characterise individuals who survive a prolonged intensive care unit (ICU) admission.

Purpose: To measure the incidence of falls and describe the characteristics of fallers among intensive care survivors.

Nutritional and psychosocial status of colorectal cancer patients referred to an outpatient oncology clinic.

Purpose: Malnutrition and psychological distress are associated with poorer outcomes following treatment for colorectal cancer. Screening for issues such as malnutrition, depression, and anxiety is being adopted in some oncology settings, but its effectiveness or the relationship between these risk factors in this population are not well understood.

Methods: A retrospective chart review was conducted of 836 health assessment forms provided to colorectal cancer patients referred to an outpatient oncology clinic.

Protecting your reputation in a digital world.

This article is not a substitute for professional services, nor is it meant to be a comprehensive list. It is intended to be a primer in helping you protect your greatest asset, your reputation. Be proactive in the way you treat your patients.

The incidence of femoral component version change in primary THA using the S-ROM femoral component.

Although use of modular femoral components in revision total hip arthroplasty (THA) is widely accepted, many still question the need for modular versatility in primary THA. This study examined a large cohort of primary THA patients implanted with a modular S-ROM femoral component (DePuy Orthopaedics, Warsaw, Indiana) to determine the percentage of hips in which the surgeon changed version of the femoral component to increase the intraoperative stability of the THA construct and/or to maximize hip range of motion without impingement.In a group of 1000 routine, primary THAs, femoral component version was changed in 479 hips (47.

Measurement of ethanol in gaseous breath using a miniature gas chromatograph.

We designed and built a novel, miniature gas chromatograph (mGC) to use exhaled breath to estimate blood ethanol concentrations that may offer GC quality sensitivity and specificity, but with portability, reduced size, and decreased cost. We hypothesized that the mGC would accurately estimate the serum ethanol concentration using exhaled breath. Human subjects (n = 8) were dosed with ethanol employing the Widmark criteria, targeting a blood concentration of 0.

How do Australian ICU survivors fare functionally 6 months after admission?

Objectives: To determine the extent to which physical function is restored 6 months after intensive care unit admission, and whether this is associated with short or long ICU length of stay (LOS).

Design, Setting And Participants: We conducted a prospective observational study between April and June 2010. All patients admitted for more than 48 hours to the general ICU at Sir Charles Gairdner Hospital, Perth, Western Australia, were eligible for inclusion.

The biomechanics of varied proximal locking screw configurations in a synthetic model of proximal third tibial fracture fixation.

Objective: To determine if 1) angularly stable devices created by compressing ("locking") proximal locking screws to intramedullary nails using end caps or compression screws or 2) increasing the number of proximal screws from two to three increases the stiffness of intramedullary constructs that stabilize proximal third tibia fractures in a nonosteopenic bone model.

Methods: Four proximal locking screw configurations were examined in a synthetic composite tibia model with a 2-cm gap simulating a comminuted proximal third tibia fracture with no bony contact: 1) two proximal screws not compressed to the nail; 2) one of two proximal screws compressed to the nail; 3) two proximal screws compressed to the nail; and 4) three proximal screws with only the most proximal screw compressed to the nail. An 11-mm tibial nail with two distal locking screws was used.

A survey of the use of ventilator hyperinflation in Australian tertiary intensive care units.

Objective: To ascertain the prevalence of use of ventilator hyperinflation (VHI) by physiotherapists practising in tertiary Australian intensive care units in the management of artificially ventilated patients, and whether standard protocols are in place in these facilities.

Design, Setting And Participants: A prospective, multicentre prevalence survey of 64 Australian hospitals with tertiary ICU facilities and physiotherapists. The cohort was compiled from details provided by the Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation.

The John Insall Award: control-matched evaluation of painful patellar Crepitus after total knee arthroplasty.

Background: Patellar crepitus (PC) is reported in up to 14% of subjects implanted with cruciate-substituting total knee arthroplasty (TKA). Numerous etiologies of PC have been proposed.

Questions/purposes: We determined when painful PC typically occurs postoperatively and compared patients undergoing primary TKA who developed painful PC requiring subsequent surgery with a matched group without this complication to identify clinical, radiographic, and surgical variables associated with this complication.

Technical challenges of total knee arthroplasty in skeletal dysplasia.

Background: Total knee arthroplasty (TKA) in patients with skeletal dysplasias is particularly challenging as a result of the anatomic variances and substantial bony deformities. Little has been written regarding technical considerations that should be made when performing TKA in skeletal dysplasia.

Questions/purposes: We describe special operative considerations that must be made when performing TKA on patients with skeletal dysplasia, including implant selection and ligamentous balancing.

Mobile-bearing total knee arthroplasty: a meta-analysis.

An extensive database search was completed to perform a meta-analysis of outcomes of mobile-bearing total knee arthroplasty. Nineteen manuscripts encompassing 3506 total knee arthroplasty met criteria for analysis (average follow-up, 8.6 years).

Thromboelastographic and pharmacokinetic profiles of micro- and macro-emulsions of propofol in swine.

Purpose: Compared with traditional macroemulsion propofol formulations currently in clinical use, microemulsion formulations of this common intravenous anesthetic may offer advantages. The pharmacokinetics and coagulation effects as assessed by thromboelastography of these formulations were characterized in swine.

Methods: Yorkshire swine (20-30 kg, either sex, n=15) were sedated, anesthetized with isoflurane, and instrumented to obtain a tracheostomy, internal jugular access and carotid artery catheterization.