A Study of the Feasibility of a Centralized Instructional Television Production Facility for Higher Education Institutions in Utah.

ERIC Educational Resources Information Center

Toyn, Thomas David

The author sought to evaluate the feasibility of developing a centralized instructional television (ITV) production facility for institutions of higher learning in the state of Utah. He considered economic factors, availability of qualified personnel, space and physical plant, potential to provide the required service, and the degree of acceptance…

[Sauveur-Henri-Victor Bouvier (1799-1877): orthopaedist, surgeon and promoter of physical education].

PubMed

Monet, Jacques; Quin, Grégory

2013-01-01

This article establishes the biography of a little known physician of the 19th century., whose commitment with orthopaedics and formulation of medical gymnastics was important: the surgeon-orthopaedist Sauveur-Henri-Victor Bouvier. Several constitutive processes of the medical field of the 19th century are analysed: specialization (around orthopaedics), professionalization and development of various therapeutic and hygienic methods (among them medical gymnastics). Bouvier's biography is particularly instructive and sheds new light on these different processes, as well as on the institutionalization of orthopaedics from the 1820's up to the 1870's, at the intersection between medical and educative fields, between hospital, medical faculty and teaching of gymnastics.

Efficacy of Bobath versus orthopaedic approach on impairment and function at different motor recovery stages after stroke: a randomized controlled study.

PubMed

Wang, Ray-Yau; Chen, Hsiu-I; Chen, Chen-Yin; Yang, Yea-Ru

2005-03-01

To investigate the effectiveness of Bobath on stroke patients at different motor stages by comparing their treatment with orthopaedic treatment. A single-blind study, with random assignment to Bobath or orthopaedic group. Physical therapy department of a medical centre. Twenty-one patients with stroke with spasticity and 23 patients with stroke at relative recovery stages participated. Twenty sessions of Bobath programme or orthopaedic treatment programme given in four weeks. Stroke Impairment Assessment Set (SIAS), Motor Assessment Scale (MAS), Berg Balance Scale (BBS) and Stroke Impact Scale (SIS) for impairment and functional limitation level. Participants with spasticity showed greater improvement in tone control (change score: 1.20 +/- 1.03 versus 0.08 +/- 0.67, p = 0.006), MAS (change score: 7.64 +/- 4.03 versus 4.00 +/- 1.95, p = 0.011), and SIS (change score: 7.30 +/- 6.24 versus 1.25 +/- 5.33, p = 0.023) after 20 sessions of Bobath treatment than with orthopaedic treatment. Participants with relative recovery receiving Bobath treatment showed greater improvement in MAS (change score: 6.14 +/- 5.55 versus 2.77 +/- 9.89, p = 0.007), BBS (change score: 19.18 +/- 15.94 versus 6.85 +/- 5.23, p = 0.015), and SIS scores (change score: 8.50 +/- 3.41 versus 3.62 +/- 4.07, p = 0.006) than those with orthopaedic treatment. Bobath or orthopaedic treatment paired with spontaneous recovery resulted in improvements in impairment and functional levels for patient with stroke. Patients benefit more from the Bobath treatment in MAS and SIS scores than from the orthopaedic treatment programme regardless of their motor recovery stages.

Where Are the Women in Orthopaedic Surgery?

PubMed

Rohde, Rachel S; Wolf, Jennifer Moriatis; Adams, Julie E

2016-09-01

Although women account for approximately half of the medical students in the United States, they represent only 13% of orthopaedic surgery residents and 4% of members of the American Academy of Orthopaedic Surgeons (AAOS). Furthermore, a smaller relative percentage of women pursue careers in orthopaedic surgery than in any other subspecialty. Formal investigations regarding the gender discrepancy in choice of orthopaedic surgery are lacking. (1) What reasons do women orthopaedic surgeons cite for why they chose this specialty? (2) What perceptions do women orthopaedic surgeons think might deter other women from pursuing this field? (3) What role does early exposure to orthopaedics and mentorship play in this choice? (4) What professional and personal choices do women in orthopaedics make, and how might this inform students who are choosing a career path? A 21-question survey was emailed to all active, candidate, and resident members of the Ruth Jackson Orthopaedic Society (RJOS, n = 556). RJOS is the oldest surgical women's organization incorporated in the United States. An independent orthopaedic specialty society, RJOS supports leadership training, mentorship, grant opportunities, and advocacy for its members and promotes sex-related musculoskeletal research. Although not all women in orthopaedic practice or training belong to RJOS, it is estimated that 42% of women AAOS fellows are RJOS members. Questions were formulated to determine demographics, practice patterns, and lifestyle choices of women who chose orthopaedic surgery as a specialty. Specifically, we evaluated the respondents' decisions about their careers and their opinions of why more women do not choose this field. For the purpose of this analysis, the influences and dissuaders were divided into three major categories: personal attributes, experience/exposure, and work/life considerations. The most common reasons cited for having chosen orthopaedic surgery were enjoyment of manual tasks (165 of 232 [71%]), professional satisfaction (125 of 232 [54%]), and intellectual stimulation (123 of 232 [53%]). The most common reasons indicated for why women might not choose orthopaedics included perceived inability to have a good work/life balance (182 of 232 [78%]), perception that too much physical strength is required (171 of 232 [74%]), and lack of strong mentorship in medical school or earlier (161 of 232 [69%]). Respondents frequently (29 of 45 [64%]) commented that their role models, mentors, and early exposure to musculoskeletal medicine were influential, but far fewer (62 of 231 [27%]) acknowledged these in their top five influences than they did the more "internal" motivators. To our knowledge, this is the largest study of women orthopaedic surgeons regarding factors influencing their professional and personal choices. Our data suggest that the relatively few women currently practicing orthopaedics were attracted to the field because of their individual personal affinity for its nature despite the lack of role models and exposure. The latter factors may impact the continued paucity of women pursuing this field. Programs designed to improve mentorship and increase early exposure to orthopaedics and orthopaedic surgeons may increase personal interest in the field and will be important to attract a diverse group of trainees to our specialty in the future.

Poverty-related factors associated with obesity prevention policies in Utah secondary schools.

PubMed

Nanney, Marilyn S; Bohner, Claudia; Friedrichs, Michael

2008-07-01

To address the childhood obesity epidemic, numerous national agencies have outlined specific school policy recommendations for nutrition and physical activity. The extent to which current policies differ by socioeconomic status and geographic location is yet to be determined. This cross-sectional study examined select school nutrition and physical activity policies by markers for poverty among 209 middle and high schools in Utah (82% response rate). The results show that students' opportunities to establish healthful dietary and physical activity patterns differed by economic circumstances and geographic location. Schools with the highest percentage of free and reduced-price lunch enrollment and schools in rural areas were both less likely to offer a variety of healthful foods outside of the school meal program (ie, competitive foods and drinks) and intramural activities or physical activity clubs. Schools with highest free and reduced-price lunch enrollment were more likely to allow the purchase of unhealthful snacks during lunchtimes than schools with low enrollment (28.4% vs 7.6%, P=0.01). Schools in rural communities were less likely to promote walking and bicycling to school compared with other locations (47.4% rural vs 67.1% urban and 63.6% suburban, P=0.06). Current school policies related to nutrition and physical activity may not be conducive to reducing the childhood overweight problem among children attending schools in areas with increased risk factors due to poverty or rural location in Utah.

Muscle, bone, and the Utah paradigm: a 1999 overview.

PubMed

Frost, H M

2000-05-01

The still-evolving Utah paradigm of skeletal physiology supplements former ideas about the control of postnatal bone strength and "mass" in health and disease, on earth and in orbit, and as functions of physical activities including sports. In its view, peak muscle forces on bone dominate control of the biologic mechanisms that control changes in our postnatal whole-bone strength and mass. This contrasts with former ideas that chiefly nonmechanical factors dominate that control and mechanical factors have little influence on it. The newer view begs the question of how such a bone-muscle relationship would work, and the Utah paradigm offers plausible explanations for that. Whereas many biomechanicians, orthopedists, and sports medicine experts might find the newer view sensible, some people in other disciplines may not. This article summarizes some evidence that support the Utah paradigm and the above-stated view and explores some of the paradigm's features and implications.

Rapid prototyping in orthopaedic surgery: a user's guide.

PubMed

Frame, Mark; Huntley, James S

2012-01-01

Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce precise models for preoperative planning and procedure rehearsal. We describe the method with an illustrative case.

Tar sand extraction by steam stimulation and steam drive: measurement of physical properties

DOE Office of Scientific and Technical Information (OSTI.GOV)

Linberg, W.R.

The measurement of the following thermophysical properties of Utah tar sands is in progress: thermal conductivity, specific heat relative permeability, and viscosity (of the recovered bitumen). During the report period (October 1, 1978 to November 1, 1979), experimental procedures have been developed and a basic data set has been measured. Additionally, standard core analysis has been performed for four drill sites in the Asphalt Ridge, Utah area.

Paediatric obesity, physical activity and the musculoskeletal system.

PubMed

Shultz, S P; Anner, J; Hills, A P

2009-09-01

The current epidemic of paediatric obesity is consistent with a myriad of health-related comorbid conditions. Despite the higher prevalence of orthopaedic conditions in overweight children, a paucity of published research has considered the influence of these conditions on the ability to undertake physical activity. As physical activity participation is directly related to improvements in physical fitness, skeletal health and metabolic conditions, higher levels of physical activity are encouraged, and exercise is commonly prescribed in the treatment and management of childhood obesity. However, research has not correlated orthopaedic conditions, including the increased joint pain and discomfort that is commonly reported by overweight children, with decreases in physical activity. Research has confirmed that overweight children typically display a slower, more tentative walking pattern with increased forces to the hip, knee and ankle during 'normal' gait. This research, combined with anthropometric data indicating a higher prevalence of musculoskeletal malalignment in overweight children, suggests that such individuals are poorly equipped to undertake certain forms of physical activity. Concomitant increases in obesity and decreases in physical activity level strongly support the need to better understand the musculoskeletal factors associated with the performance of motor tasks by overweight and obese children.

JOSPT Experiences Tremendous Growth, Change in 14 Years With Editor-in-Chief Simoneau in Charge.

PubMed

Nyland, John A

2015-12-01

As Editor-in-Chief, Dr Guy G. Simoneau and his editorial board have taken JOSPT from an acceptable US-based journal to a highly influential worldwide force behind contemporary orthopaedic and sports physical therapy research and practice. Today, the bridge Dr Simoneau constructed spans the orthopaedic and sports physical therapy globe for the betterment of clinical practice and research. His work fully supports JOSPT's latest strategic plan to provide value-added knowledge translation, develop a broader authorship and readership, increase global marketing of the JOSPT brand, and expand current relationships to new partners and stakeholders. The bridge places JOSPT on very firm footing, tying its rich history to the promise of an exciting and successful future.

Postinjury anxiety and social support among collegiate athletes: a comparison between orthopaedic injuries and concussions.

PubMed

Covassin, Tracey; Crutcher, Bryan; Bleecker, Alisha; Heiden, Erin O; Dailey, Alexander; Yang, Jingzhen

2014-01-01

When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury. To compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries. Cross-sectional study. Athletic training room. A total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athlete's sex, sport, and time loss due to injury. Clinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire. The group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = -1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (β = -4.21, P = .0001). Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed more significant predictor models of social support on state anxiety at return to play.

Life-space mobility and social support in elderly adults with orthopaedic disorders.

PubMed

Suzuki, Tomoko; Kitaike, Tadashi; Ikezaki, Sumie

2014-03-01

The purpose of this cross-sectional survey was to explore relationships between life-space mobility and the related factors in elderly Japanese people who attend orthopaedic clinics. The study measures included surveys of life-space mobility (Life-space Assessment (LSA) score), social support (social network diversity and social ties), physical ability (instrumental self-maintenance, intellectual activity, social role), orthopaedic factors (diseases and symptoms) and demographic information. The questionnaire was distributed to 156 subjects; 152 persons responded, yielding 140 valid responses. Mean age of the sample was 76.0 ± 6.4 (range, 65-96 years), with 57.9% women (n = 81). In a multiple regression analysis, the six factors were significantly associated with LSA. Standardized partial regression coefficients (β) were gender (0.342), instrumental self-maintenance (0.297), social network diversity (0.217), age (-0.170), difficulty of motion (-0.156) and intellectual activity (0.150), with an adjusted R(2) = 0.488. These results suggest that outpatient health-care providers need to intervene in not only addressing orthopaedic factors but also promoting social support among elderly Japanese. © 2014 Wiley Publishing Asia Pty Ltd.

Mechanical compatibility of sol-gel annealing with titanium for orthopaedic prostheses.

PubMed

Greer, Andrew I M; Lim, Teoh S; Brydone, Alistair S; Gadegaard, Nikolaj

2016-01-01

Sol-gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol-gel technology to orthopaedics. Primarily, the annealing stage required to transform the sol-gel into a ceramic may compromise the physical integrity of the underlying metal. Secondly, loose particles on medical implants can be carcinogenic and cause inflammation so the coating needs to be strongly bonded to the implant. These concerns are addressed in this paper. Titanium, the dominant material for orthopaedics at present, is examined before and after sol-gel processing for changes in hardness and flexural modulus. Wear resistance, bending and pull tests are also performed to evaluate the ceramic coating. The findings suggest that sol-gel coatings will be compatible with titanium implants for an optimum temperature of 500 °C.

Adverse effects as a consequence of being the subject of orthopaedic manual therapy training, a worldwide retrospective survey.

PubMed

Thoomes-de Graaf, M; Thoomes, E; Carlesso, L; Kerry, R; Rushton, A

2017-06-01

Physical therapists (PTs) use a range of manual therapy techniques developed to an advanced level through postgraduate orthopaedic manipulative physical therapy (OMPT) programmes. The aim of this study was to describe the adverse effects experienced by students after having techniques performed on them as part of their OMPT training. A descriptive online survey of current students and recent graduates (≤5 years)m of OMPT programmes across the 22 Member Organisations of the International Federation of Orthopaedic Manipulative Physical Therapists. The questionnaire was completed by 1640 respondents across 22 countries (1263 graduates, 377 students. Some 60% of respondents reported never having experienced adverse effects during their manual therapy training. Of the 40% who did, 66.4% reported neck pain, 50.9% headache and 32% low back pain. Most reports of neck pain started after a manipulation and/or mobilisation, of which 53.4% lasted ≤24 h, 38.1% > 24 h but <3 months and 13.7% still experienced neck pain to date. A small percentage of respondents (3.3%) reported knowing of a fellow student experiencing a major adverse effect. Mild to moderate adverse effects after practising manual therapy techniques are commonly reported, but usually resolve within 24 h. However, this survey has identified the reported occurrence of major adverse effects that warrant further investigation. Copyright © 2017 Elsevier Ltd. All rights reserved.

Rapid Prototyping in Orthopaedic Surgery: A User's Guide

PubMed Central

Frame, Mark; Huntley, James S.

2012-01-01

Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce precise models for preoperative planning and procedure rehearsal. We describe the method with an illustrative case. PMID:22666160

Physical and mental health correlates of adverse childhood experiences among low-income women.

PubMed

Cambron, Christopher; Gringeri, Christina; Vogel-Ferguson, Mary Beth

2014-11-01

The present study used secondary data gathered from a statewide random sample of 1,073 adult women enrolled in Utah's single-parent cash assistance program and logistic regression to examine associations between self-reported physical, emotional, and sexual abuse during childhood and later life physical and mental health indicators. Results demonstrated significant associations between low-income women's self-reports of physical, emotional, or sexual abuse in childhood, and current and lifetime anxiety disorder, domestic violence, current posttraumatic stress disorder, bipolar disorder, physical health or mental health issues, and any mental health diagnosis. These results build on previous research to paint a fuller picture of the associations between childhood abuse and physical and mental health for low-income women in Utah. Consistent with research by the Centers for Disease Control and Prevention, findings suggest the applicability of conceptualizing childhood abuse as a public health issue. Social workers can play an integral role in promoting and implementing broader screening practices, connecting affected individuals with long-term interventions, and applying research findings to the design and provision of services within a public health model.

Studies to Improve the Science in the GAIM - Full Physics Model

DTIC Science & Technology

2014-01-01

Hromsco, J. J., Sensitivity of IFM /GAIM-GM Model to High Cadence Kp and F10.7 Input, Utah State University/Air Force Institute of Technology, M . S ...Institute of Technology, M . S . Thesis; March, 2011. Nava, O. A ., Analysis of plasma bubble signatures in the ionosphere, Utah State University/Air...Force Institute of Technology, M . S . Thesis; March, 2011. Scherliess, L., R. W. Schunk and D. C. Thompson, Data assimilation models: A ’new’ tool for

Full-Text Publication of Abstract-Presented Work in Physical Therapy: Do Therapists Publish What They Preach?

PubMed Central

Smith, Heather D.; Bogenschutz, Elizabeth D.; Bayliss, Amy J.; Altenburger, Peter A.

2011-01-01

Background and Objective Professional meetings, such as the American Physical Therapy Association's (APTA's) Combined Sections Meeting (CSM), provide forums for sharing information relevant to physical therapy. An indicator of whether therapists fully disseminate their work is the number of full-text peer-reviewed publications that result. The purposes of this study were: (1) to determine the full-text publication rate of work presented in abstract form at CSM and (2) to investigate factors influencing this rate. Methods A systematic search was undertaken to locate full-text publications of work presented in abstract form within the Orthopaedic and Sports Physical Therapy sections at CSM between 2000 and 2004. Eligible publications were published within 5 years following abstract presentation. The influences of APTA section, year of abstract presentation, institution of origin, study design, sample size, study significance, reporting of a funding source, and presentation type on full-text publication rate were assessed. Characteristics of full-text publications were explored. Results Work presented in 1 out of 4 abstracts (25.4%) progressed to full-text publication. Odds of full-text publication increased if the abstract originated from a doctorate-granting or “other” institution, reported findings of an experimental study, reported a statistically significant finding, included a larger sample size, disclosed a funding source, or was presented as a platform presentation. More than one third (37.8%) of full-text publications were published in the Journal of Orthopaedic and Sports Physical Therapy or Physical Therapy, and 4 out of 10 full-text publications (39.2%) contained at least one major change from information presented in abstract form. Conclusions The full-text publication rate for information presented in abstract form within the Orthopaedic and Sports Physical Therapy sections at CSM is low relative to comparative disciplines. Caution should be exercised when translating information presented at CSM into practice. PMID:21169423

Quality and Variability of Online Available Physical Therapy Protocols From Academic Orthopaedic Surgery Programs for Anterior Cruciate Ligament Reconstruction.

PubMed

Makhni, Eric C; Crump, Erica K; Steinhaus, Michael E; Verma, Nikhil N; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

2016-08-01

To assess the quality and variability found across anterior cruciate ligament (ACL) rehabilitation protocols published online by academic orthopaedic programs. Web-based ACL physical therapy protocols from United States academic orthopaedic programs available online were included for review. Main exclusion criteria included concomitant meniscus repair, protocols aimed at pediatric patients, and failure to provide time points for the commencement or recommended completion of any protocol components. A comprehensive, custom scoring rubric was created that was used to assess each protocol for the presence or absence of various rehabilitation components, as well as when those activities were allowed to be initiated in each protocol. Forty-two protocols were included for review from 155 U.S. academic orthopaedic programs. Only 13 protocols (31%) recommended a prehabilitation program. Five protocols (12%) recommended continuous passive motion postoperatively. Eleven protocols (26%) recommended routine partial or non-weight bearing immediately postoperatively. Ten protocols (24%) mentioned utilization of a secondary/functional brace. There was considerable variation in range of desired full-weight-bearing initiation (9 weeks), as well as in the types of strength and proprioception exercises specifically recommended. Only 8 different protocols (19%) recommended return to sport after achieving certain strength and activity criteria. Many ACL rehabilitation protocols recommend treatment modalities not supported by current reports. Moreover, high variability in the composition and time ranges of rehabilitation components may lead to confusion among patients and therapists. Level II. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Manual physical therapy: we speak gibberish.

PubMed

Flynn, Timothy W; Childs, John D; Bell, Stephania; Magel, Jake S; Rowe, Robert H; Plock, Haideh

2008-03-01

In December of 2006, the American Academy of Orthopaedic Manual Physical Therapists (AAOMPT) convened a task force to create a framework for standardizing manual physical therapy procedures. The impetus came from many years of frustration with our ability to precisely communicate to each other, as well as to stakeholders outside our profession. To this end, a contribution titled "A Model for Standardizing Manipulation Terminology In Physical Therapy Practice" is published in this issue of the Journal.

Using your shoulder after surgery

MedlinePlus

... and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 45. ... KE, eds. Physical Rehabilitation of the Injured Athlete . 4th ed. Philadelphia, PA: Elsevier Saunders; 2012: chap 12.

The Quality of Open-Access Video-Based Orthopaedic Instructional Content for the Shoulder Physical Exam is Inconsistent.

PubMed

Urch, Ekaterina; Taylor, Samuel A; Cody, Elizabeth; Fabricant, Peter D; Burket, Jayme C; O'Brien, Stephen J; Dines, David M; Dines, Joshua S

2016-10-01

The internet has an increasing role in both patient and physician education. While several recent studies critically appraised the quality and accuracy of web-based written information available to patients, no studies have evaluated such parameters for open-access video content designed for provider use. The primary goal of the study was to determine the accuracy of internet-based instructional videos featuring the shoulder physical examination. An assessment of quality and accuracy of said video content was performed using the basic shoulder examination as a surrogate for the "best-case scenario" due to its widely accepted components that are stable over time. Three search terms ("shoulder," "examination," and "shoulder exam") were entered into the four online video resources most commonly accessed by orthopaedic surgery residents (VuMedi, G9MD, Orthobullets, and YouTube). Videos were captured and independently reviewed by three orthopaedic surgeons. Quality and accuracy were assessed in accordance with previously published standards. Of the 39 video tutorials reviewed, 61% were rated as fair or poor. Specific maneuvers such as the Hawkins test, O'Brien sign, and Neer impingement test were accurately demonstrated in 50, 36, and 27% of videos, respectively. Inter-rater reliability was excellent (mean kappa 0.80, range 0.79-0.81). Our results suggest that information presented in open-access video tutorials featuring the physical examination of the shoulder is inconsistent. Trainee exposure to such potentially inaccurate information may have a significant impact on trainee education.

Postinjury Anxiety and Social Support Among Collegiate Athletes: A Comparison Between Orthopaedic Injuries and Concussions

PubMed Central

Covassin, Tracey; Crutcher, Bryan; Bleecker, Alisha; Heiden, Erin O.; Dailey, Alexander; Yang, Jingzhen

2014-01-01

Context: When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury. Objective: To compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries. Design: Cross-sectional study. Setting: Athletic training room. Patients or Other Participants: A total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athlete's sex, sport, and time loss due to injury. Main Outcome Measure(s): Clinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire. Results: The group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = −1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (β = −4.21, P = .0001). Conclusions: Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed more significant predictor models of social support on state anxiety at return to play. PMID:24673237

Ultrastructural study of iron oxide precipitates: implications for the search for biosignatures in the Meridiani hematite concretions, Mars.

PubMed

Souza-Egipsy, Virginia; Ormö, Jens; Beitler Bowen, Brenda; Chan, Marjorie A; Komatsu, Goro

2006-08-01

Two terrestrial environments that have been proposed as analogs for the iron oxide precipitation in the Meridiani Planum region of Mars include the Rio Tinto precipitates and southern Utah marble concretions. Samples of two typical Utah iron oxide concretions and iron oxide precipitates in contact with biofilms from Rio Tinto have been studied to determine whether evidence could be found for biomediation in the precipitation process and to identify likely locations for fossil microorganisms. Scanning electron microscopy, energy dispersive X-ray, and gas chromatography-mass spectrometry (GC-MS) were used to search for biosignatures in the Utah marbles. The precipitation of iron oxides resembles known biosignatures, though organic compounds could not be confirmed with GC-MS analysis. In contrast, textural variations induced by biological activity are abundant in the modern Rio Tinto samples. Although no compelling evidence of direct or indirect biomediation was found in the Utah marbles, the ultrastructure of the iron oxide cement in the concretion suggests an inward growth during concretion precipitation from an initially spherical redox front. No indication for growth from a physical nucleus was found.

The effect of preoperative counseling on duration of postoperative opiate use in orthopaedic trauma surgery: a surgeon-based comparative cohort study.

PubMed

Holman, Joel E; Stoddard, Gregory J; Horwitz, Daniel S; Higgins, Thomas F

2014-09-01

The prudent use of prescription opiates is a central aspect of current postsurgical pain management, but surgeons have no guidelines on appropriate duration of opiate treatment. Furthermore, there are no established data on the effect of physician counseling on the duration of opiate use postoperatively. Retrospective surgeon-controlled cohort study. Level I regional academic trauma center. All Utah residents admitted to the orthopaedic trauma service with isolated operative musculoskeletal injury. One group of patients was instructed at the time of index procedure that they would receive prescription opiates for a maximum of 6 weeks. The remaining patients were not counseled preoperatively on duration of opiate use postoperatively. The presence and frequency of prescription opiate use before injury, cessation of opiate use by 6 weeks postoperatively, cessation of opiates by 12 weeks postoperatively, and continuation of prescription opiates greater than 12 weeks postoperatively. Six hundred thirteen patients met inclusion criteria. Those counseled preoperatively to cease opiate use by 6 weeks were significantly more likely to do so than those who did not receive counseling (73% and 64%, respectively; P = 0.012). By 12 weeks, this effect was no longer seen, and patients were just as likely to have stopped (80% and 80%, respectively; P = 0.90). The orthopaedic trauma population is significantly more likely than the general population to be using prescription opiates before injury. Physician discussion of 6-week opiate prescription limitation at the time of injury seems to lead to a lower rate of use at the 6-week postoperative mark but has no effect on rates of longer-term use. Twenty percent of patients in either group will continue to use opiates after 12 weeks, compared with 15% before injury. Given the scope of prescription opiate use in the United States, surgeons may want to consider preoperative discussion of this issue, but it may not have any effect on usage rates at longer intervals. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Utah's Mobile Earth Science Outreach Vehicle

NASA Astrophysics Data System (ADS)

Schoessow, F. S.; Christian, L.

2016-12-01

Students at Utah State University's College of Natural Resources have engineered the first mobile Earth Science outreach platform capable of delivering high-tech and interactive solar-powered educational resources to the traditionally-underserved, remote communities of rural Utah. By retrofitting and modifying an industrial box-truck, this project effectively created a highly mobile and energy independent "school in a box" which seeks to help change the way that Earth science is communicated, eliminate traditional barriers, and increase science accessibility - both physically and conceptually. The project's education platform is focused on developing a more effective, sustainable, and engaging platform for presenting Earth science outreach curricula to community members of all ages in an engaging fashion. Furthermore, this project affords university students the opportunity to demonstrate innovative science communication techniques, translating vital university research into educational outreach operations aimed at doing real, measurable good for local communities.

Science choices and preferences of middle and secondary school students in Utah

NASA Astrophysics Data System (ADS)

Baird, J. Hugh; Lazarowitz, Reuven; Allman, Verl

This research sought to answer two questions: (1) What are Utah junior and senior high school students' preferences and choices regarding science subjects? (2) Could preferences and choices be related to the type of school, age or gender? Two thousand students from grades six through twelve participated in this study. Findings show that zoology and human anatomy and physiology were most preferred. Ecology was least prefered. Topics in the physical sciences were also low. There was a trend among girls to prefer natural sciences such as botany while boys tended to prefer the physical sciences. Generally, students' choices were limited to those subjects presently taught in the formal school curriculum. They appeared unaware of the many science related subjects outside the texts or the approved course of study.

Management of temporomandibular disorders by Ministry of Public Health dentists in Central Thailand.

PubMed

Chanton, Supang; Vicheinnet, Supranee; Hosanguan, Chanchai; Mutirangura, Wantanee

2017-10-01

Very little is known about the ability of dentists to diagnose and treat temporomandibular disorders (TMDs). The aims of this study were to investigate whether dentists in Central Thailand diagnosed TMD subcategories before initiating treatment for TMDs and to explore the frequency of corresponding treatments. A questionnaire covering TMD management was developed and posted to all Ministry of Public Health dentists (n = 969) in Central Thailand. The data were analysed using descriptive statistics. The respondents (n = 502) comprised 109 (21.7%) male and 393 (78.3%) female dentists between 23 and 59 years of age (mean age = 34.7 years). In the preceding year, 427 (85.1%) reported encountering patients with TMDs, 356 (70.9%) had treated patients who had TMDs and 176 (49.4%) had diagnosed TMD subcategories. Most respondents regularly treated patients by providing patient education and encouraging self-care. The respondents who did not diagnose subcategories primarily treated TMDs with pharmacotherapy and physical therapy; orthopaedic appliances and occlusal therapy were used less often. Respondents who diagnosed TMD subcategories did not often use orthopaedic appliances or occlusal therapy to treat muscle disorders. For the treatment of derangement disorders, respondents used fewer pharmacotherapy, physical therapy and occlusal therapy techniques. For the treatment of osteoarthritis, respondents used less physical therapy and fewer orthopaedic appliances. Most Ministry of Public Health dentists in the Central Thailand region encounter and treat patients with TMDs. Approximately 50% of the respondents diagnosed TMD subcategories before providing treatment for TMDs. © 2017 FDI World Dental Federation.

Nanoscale Surface Modifications of Orthopaedic Implants: State of the Art and Perspectives

PubMed Central

Staruch, RMT; Griffin, MF; Butler, PEM

2016-01-01

Background: Orthopaedic implants such as the total hip or total knee replacement are examples of surgical interventions with postoperative success rates of over 90% at 10 years. Implant failure is associated with wear particles and pain that requires surgical revision. Improving the implant - bone surface interface is a key area for biomaterial research for future clinical applications. Current implants utilise mechanical, chemical or physical methods for surface modification. Methods: A review of all literature concerning the nanoscale surface modification of orthopaedic implant technology was conducted. Results: The techniques and fabrication methods of nanoscale surface modifications are discussed in detail, including benefits and potential pitfalls. Future directions for nanoscale surface technology are explored. Conclusion: Future understanding of the role of mechanical cues and protein adsorption will enable greater flexibility in surface control. The aim of this review is to investigate and summarise the current concepts and future directions for controlling the implant nanosurface to improve interactions. PMID:28217214

Burden incurred by patients and their caregivers after outpatient surgery: a prospective observational study.

PubMed

Manohar, Asha; Cheung, Kristin; Wu, Christopher L; Stierer, Tracey S

2014-05-01

The burden of patients and their caregivers after outpatient surgery has not been fully examined. The number of outpatient surgeries has dramatically increased in the last several years, particularly in the orthopaedic sector. Patients undergoing outpatient orthopaedic procedures may be expected to have more postdischarge pain than those undergoing nonorthopaedic outpatient procedures. In light of this, assessment of patient and caregiver expectations and actual burden after discharge is of importance. We assessed the impact of outpatient surgery on recovery of patients and their caregivers in the postoperative period by determining (1) expected versus actual time to resume daily activities, including work; (2) expected versus actual recovery at 7 and 30 days postoperatively; and (3) the number of caregivers that felt emotional or physical disturbances from caring for outpatients. Forty-four adult patients undergoing outpatient surgical procedures and their primary caregivers were enrolled in this prospective survey study, of which 30% were orthopaedic patients. Surveys assessing postoperative recovery were given to patients at six time points, on Postoperative Days 0 to 3, 7, and 30. Surveys assessing the burden of informal caregiving were given to each patient's primary caregiver at four time points, on Postoperative Days 1 to 3 and 7. The enrollment rate was 79% (44 enrolled of 56 approached) and the survey response rate was 100% for patients and 93% (41 of 44) for caregivers. We found that 16 of 44 patients (36%) needed more time than originally anticipated to resume their daily activities and three of 29 patients (10%) needed more time off from work than originally anticipated. Patients were approximately 66% and 88% fully recovered 7 and 30 days after surgery, respectively. The primary caregivers noted disturbances in emotional (nine of 43, 21%) and physical (17 of 43, 40%) aspects of their daily lives while providing care for patients. Our surveyed patients were from multiple surgical services; however, our results may be generalized to an orthopaedic population, although they may underestimate actual results for this population given their generally higher pain scores. Patients may take longer to recover from outpatient surgery than previously recognized. As increased pain and prolonged recovery may be associated with increased caregiver burden, these data are of particular significance to the outpatient orthopaedic surgical population. Informal caregiving after outpatient surgery may be an unrecognized physical and psychologic burden and may have a significant societal impact. Level II, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

Formation and retention of methane in coal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hucka, V.J.; Bodily, D.M.; Huang, H.

1992-05-15

The formation and retention of methane in coalbeds was studied for ten Utah coal samples, one Colorado coal sample and eight coal samples from the Argonne Premium Coal Sample Bank.Methane gas content of the Utah and Colorado coals varied from zero to 9 cm{sup 3}/g. The Utah coals were all high volatile bituminous coals. The Colorado coal was a gassy medium volatile bituminous coal. The Argonne coals cover a range or rank from lignite to low volatile bituminous coal and were used to determine the effect of rank in laboratory studies. The methane content of six selected Utah coal seamsmore » and the Colorado coal seam was measured in situ using a special sample collection device and a bubble desorbometer. Coal samples were collected at each measurement site for laboratory analysis. The cleat and joint system was evaluated for the coal and surrounding rocks and geological conditions were noted. Permeability measurements were performed on selected samples and all samples were analyzed for proximate and ultimate analysis, petrographic analysis, {sup 13}C NMR dipolar-dephasing spectroscopy, and density analysis. The observed methane adsorption behavior was correlated with the chemical structure and physical properties of the coals.« less

Formation and retention of methane in coal. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hucka, V.J.; Bodily, D.M.; Huang, H.

1992-05-15

The formation and retention of methane in coalbeds was studied for ten Utah coal samples, one Colorado coal sample and eight coal samples from the Argonne Premium Coal Sample Bank.Methane gas content of the Utah and Colorado coals varied from zero to 9 cm{sup 3}/g. The Utah coals were all high volatile bituminous coals. The Colorado coal was a gassy medium volatile bituminous coal. The Argonne coals cover a range or rank from lignite to low volatile bituminous coal and were used to determine the effect of rank in laboratory studies. The methane content of six selected Utah coal seamsmore » and the Colorado coal seam was measured in situ using a special sample collection device and a bubble desorbometer. Coal samples were collected at each measurement site for laboratory analysis. The cleat and joint system was evaluated for the coal and surrounding rocks and geological conditions were noted. Permeability measurements were performed on selected samples and all samples were analyzed for proximate and ultimate analysis, petrographic analysis, {sup 13}C NMR dipolar-dephasing spectroscopy, and density analysis. The observed methane adsorption behavior was correlated with the chemical structure and physical properties of the coals.« less

Physical characteristics and chemical quality of selected springs in parts of Juab, Millard, Tooele, and Utah counties, Utah

USGS Publications Warehouse

Wilberg, D.E.; Stolp, B.J.

1985-01-01

Hydrologic, geologic, and partial water quality data were collected at 90 selected springs in west-central Utah, and chemical analyses performed on water samples from 62 of the springs. Descriptions of the physiographic and geologic conditions, climate, and vegetation patterns for the study area are included. Allowable limits of certain chemical constituents in water for human and livestock consumption are included with the water quality data. Three classifications of springs were established based on physical characteristics of the springs, and chemical composition of the springflow: (1) mountain springs; (2) non-thermal valley springs, and (3) thermal valley springs. Mountain springs are in and near recharge areas, have seasonal variations of discharge and temperature, typically discharge from extrusive and metamorphic geohydrologic units, and generally discharge freshwater. Non-thermal valley springs are peripheral to recharge areas, have seasonal variations of discharge and temperature, typically discharge from a variety of geohydrologic units, and have variable water composition. Thermal valley springs are near topographic low areas of valleys , and have little seasonal variation of discharge or temperature. They typically discharge from unconsolidated deposits (but the discharge probably has flowed through buried carbonate geohydrologic units). They also have a considerable range of water composition that reflects the relative complexity of the groundwater system. (Author 's abstract)

Burnout in Orthopaedic Surgeons: A Challenge for Leaders, Learners, and Colleagues: AOA Critical Issues.

PubMed

Ames, S Elizabeth; Cowan, James B; Kenter, Keith; Emery, Sanford; Halsey, David

2017-07-19

Burnout, depression, suicidal ideation, and dissatisfaction with work-life balance have been reported in all medical specialties and at all stages of medical education and practice experience. Burnout consists of progressive emotional, attitudinal, and physical exhaustion. Physicians with burnout may treat patients as objects and feel emotionally depleted. Burnout is characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization), and a low sense of personal accomplishment. The most complete study of emotional burnout among different medical specialties demonstrated that orthopaedic surgery is one of the specialties with the highest burnout rate. Qualitative descriptive studies are available. There was a 45.8% burnout rate among physicians in the U.S. in 2012, and a 2014 update suggested even higher rates. Burnout has a correlation with medical education. Burnout rates are similar to those in the general population when medical students enter school, and increase steadily through medical education prior to residency. Burnout rates in residents are high, reported to be between 41% and 74% across multiple specialties. This impacts our young physician workforce in orthopaedics. The purpose of this review is to provide the available information that characterizes burnout and addresses the issues inherent to preventing burnout, and to build awareness in orthopaedic surgeons. Wellness "goes beyond merely the absence of distress and includes being challenged, thriving, and achieving success in various aspects of personal and professional life." The challenge for the orthopaedic community is to develop interventions and strategies that are personalized to the individuals in this specialty.

Effects of a Movement Integration Program on Elementary School Children's Physical Activity, Fitness Levels, and On-Task Behavior and Teachers' Implementation Experiences

ERIC Educational Resources Information Center

Goh, Tan Leng

2014-01-01

Physical inactivity is an increasing problem among children and adolescents. The TAKE 10!® program, which integrates physical activity (PA) into academic subjects, was implemented in one elementary school in Magna, Utah to increase children's daily in-school PA. A three-study approach was used to examine: (a) effects of TAKE 10!® on elementary…

Treatment-Based Classification versus Usual Care for Management of Low Back Pain

DTIC Science & Technology

2014-08-01

Doctoral Fellowship in Orthopaedic Manual Physical Therapy , San Antonio Military Medical Center, Fort Sam Hous- ton, Texas. N.W. Gill, PT, DSc, OCS, FAAOMPT...US Army–Baylor Uni- versity Doctor of Physical Therapy Program, Fort Sam Houston, Texas. [Rhon DI, Deyle GD, Gill NW. Clin- ical reasoning and...1234–1243.] © 2013 American Physical Therapy Association Published Ahead of Print: February 7, 2013 Accepted: February 4, 2013 Submitted: March 30, 2012

Can a Strategic Pipeline Initiative Increase the Number of Women and Underrepresented Minorities in Orthopaedic Surgery?

PubMed

Mason, Bonnie S; Ross, William; Ortega, Gezzer; Chambers, Monique C; Parks, Michael L

2016-09-01

Women and minorities remain underrepresented in orthopaedic surgery. In an attempt to increase the diversity of those entering the physician workforce, Nth Dimensions implemented a targeted pipeline curriculum that includes the Orthopaedic Summer Internship Program. The program exposes medical students to the specialty of orthopaedic surgery and equips students to be competitive applicants to orthopaedic surgery residency programs. The effect of this program on women and underrepresented minority applicants to orthopaedic residencies is highlighted in this article. (1) For women we asked: is completing the Orthopaedic Summer Internship Program associated with higher odds of applying to orthopaedic surgery residency? (2) For underrepresented minorities, is completing the Orthopaedic Summer Internship Program associated with higher odds of applying to orthopaedic residency? Between 2005 and 2012, 118 students completed the Nth Dimensions/American Academy of Orthopaedic Surgeons Orthopaedic Summer Internship Program. The summer internship consisted of an 8-week clinical and research program between the first and second years of medical school and included a series of musculoskeletal lectures, hands-on, practical workshops, presentation of a completed research project, ongoing mentoring, professional development, and counselling through each participant's subsequent years of medical school. In correlation with available national application data, residency application data were obtained for those Orthopaedic Summer Internship Program participants who applied to the match between 2011 through 2014. For these 4 cohort years, we evaluated whether this program was associated with increased odds of applying to orthopaedic surgery residency compared with national controls. For the same four cohorts, we evaluated whether underrepresented minority students who completed the program had increased odds of applying to an orthopaedic surgery residency compared with national controls. Fifty Orthopaedic Summer Internship scholars applied for an orthopaedic residency position. For women, completion of the Orthopaedic Summer Internship was associated with increased odds of applying to orthopaedic surgery residency (after summer internship: nine of 17 [35%]; national controls: 800 of 78,316 [1%]; odds ratio [OR], 51.3; 95% confidence interval [CI], 21.1-122.0; p < 0.001). Similarly, for underrepresented minorities, Orthopaedic Summer Internship completion was also associated with increased odds of orthopaedic applications from 2011 to 2014 (after Orthopaedic Summer Internship: 15 of 48 [31%]; non-Orthopaedic Summer Internship applicants nationally: 782 of 25,676 [3%]; OR, 14.5 [7.3-27.5]; p < 0.001). Completion of the Nth Dimensions Orthopaedic Summer Internship Program has a positive impact on increasing the odds of each student participant applying to an orthopaedic surgery residency program. This program may be a key factor in contributing to the pipeline of women and underrepresented minorities into orthopaedic surgery. Level III, therapeutic study.

History of orthopaedics in China: a brief review.

PubMed

Li, Jia; Zhang, Yingze

2018-03-01

Chinese orthopaedic surgeons have made a substantial contribution to the development of orthopaedics worldwide, and traditional Chinese medicine (TCM) in orthopaedics has a very long history in China. We make a brief review of the development of orthopaedics in China, intending to pave the way for further understanding of Chinese orthopaedics for scholars all over the world. The description of fractures firstly appeared in 3600 years ago in China, and the theories, experience, and treatment strategies of TCM still play important roles in clinical diagnosis and treatment of orthopaedic disorders in our country. Western orthopaedics was first introduced into China in the early twentieth century. After decades of development, Chinese scholars have made some gratifying achievements in orthopaedics. Orthopaedics is constantly evolving, and we need to strengthen the ability of independent innovation to achieve orthopaedic surgeons' Chinese dream, and better serve our patients.

A manual physical therapy approach versus subacromial corticosteroid injection for treatment of shoulder impingement syndrome: a protocol for a randomised clinical trial

PubMed Central

Boyles, Robert E; Cleland, Joshua A; Brown, David L

2011-01-01

Introduction Corticosteroid injections (CSI) are a recommended and often-used first-line intervention for shoulder impingement syndrome (SIS) in primary care and orthopaedic settings. Manual physical therapy (MPT) offers a non-invasive approach with negligible risk for managing SIS. There is limited evidence to suggest significant long-term improvements in pain, strength and disability with the use of MPT, and there are conflicting reports from systematic reviews that question the long-term efficacy of CSI. Specifically, the primary objective is to compare the effect of CSI and MPT on pain and disability in subjects with SIS at 12 months. Design This pragmatic randomised clinical trial will be a mixed-model 2×5 factorial design. The independent variables are treatment (MPT and CSI) and time with five levels from baseline to 1 year. The primary dependent variable is the Shoulder Pain and Disability Index, and the secondary outcome measures are the Global Rating of Change and the Numeric Pain Rating Scale. For each ANOVA, the hypothesis of interest will be the two-way group-by-time interaction. Methods and analysis The authors plan to recruit 104 participants meeting established impingement criteria. Following examination and enrolment, eligible participants will be randomly allocated to receive a pragmatic approach of either CSI or MPT. The MPT intervention will consist of six sessions, and the CSI intervention will consist of one to three sessions. All subjects will continue to receive usual care. Subjects will be followed for 12 months. Dissemination and ethics The protocol was approved by the Madigan Army Medical Center Institutional Review Board. The results may have an impact on clinical practice guidelines. This study was funded in part by the Orthopaedic Physical Therapy Products Grant through the American Academy of Orthopaedic Manual Physical Therapists. Trial Registration http://clinicaltrials.gov/ NCT01190891. PMID:22021870

Quality and Variability of Online Physical Therapy Protocols for Isolated Meniscal Repairs.

PubMed

Trofa, David P; Parisien, Robert L; Noticewala, Manish S; Noback, Peter C; Ahmad, Christopher S; Moutzouros, Vasilios; Makhni, Eric C

2018-05-31

The ideal meniscal repair postoperative rehabilitation protocol has yet to be determined. Further, patients are attempting to access health care content online at a precipitously increasing rate given the efficiency of modern search engines. The purpose of this investigation was to assess the quality and variability of meniscal repair rehabilitation protocols published online with the hypothesis that there would be a high degree of variability found across available protocols. To this end, Web-based meniscal repair physical therapy protocols from U.S. academic orthopaedic programs as well as the first 10 protocols identified by the Google search engine for the term "meniscal repair physical therapy protocol" were reviewed and assessed via a custom scoring rubric. Twenty protocols were identified from 155 U.S. academic orthopaedic programs for a total of 30 protocols. Twenty-six protocols (86.6%) recommended immediate postoperative bracing. Twelve (40.0%) protocols permitted immediate weight-bearing as tolerated (WBAT) postoperatively, while the remaining protocols permitted WBAT at an average of 4.0 (range, 1-7) weeks. There was considerable variation in range of motion (ROM) goals, with most protocols (73.3%) initiating immediate passive ROM to 90°. The types and timing of strength, proprioception, agility, and pivoting exercises advised were extremely diverse. Only five protocols (16.7%) employed functional testing as a marker for return to athletics. The results of this study indicate that only a minority of academic orthopaedic programs publish meniscal repair physical therapy protocols online and that within the most readily available online protocols there are significant disparities in regards to brace use, ROM, weight-bearing, and strengthening and proprioception exercises. These discrepancies reflect the fact that the best rehabilitation practices after a meniscal repair have yet to be elucidated. This represents a significant area for improved patient care through standardization. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vitamin D Supplementation for Prevention of Post-Traumatic Osteoarthritis: Evaluation in Animal and Clinical Models

DTIC Science & Technology

2015-10-01

Orthopaedics. Sargent School of Physical Therapy , Boston University, November 6, 2001, Boston, Massachusetts. 4. Foot and Ankle Injuries. Sargent School...of Physical Therapy , Boston University, November 13, 2001, Boston, Massachusetts. 39 5. Triceps Rupture and Reconstruction: Case Report and Review...treatment of de Quervain syndrome. J Hand Surg 38: 2247-2249, 2013. 57. Judson C, Wolf JM. Lateral epicondylitis: injection therapies . Orthop Clin

Hang Them High: A Hands-Free Technique for Upper Extremity Limb Holding During Surgical Preparation.

PubMed

Aneja, Arun; Leung, Patrick; Marquez-Lara, Alejandro

Lifting and holding upper and lower limbs during the "prep and drape" portion of certain orthopaedic procedures exert strong forces on the holder and may lead to musculoskeletal disorders. To address these challenges during upper extremity procedures, this article describes a hand-free elevation and traction technique of the upper limbs during preoperative skin preparation with the use of items readily available within the operating room (OR). This technique is particularly useful for heavy or fractured limbs that may impose a physical challenge to lift and maintain in a stable position. Implementation of this technique reduces the risk to nurses, OR personnel, and caregivers of developing work-related musculoskeletal injuries while lifting and holding limbs in the orthopaedic OR.

77 FR 67858 - Utah Disaster #UT-00021

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-14

.... Physical Loan Application Deadline Date: 01/02/2013. Economic Injury (EIDL) Loan Application Deadline Date... provide essential services of governmental nature may file disaster loan applications at the address... Without Credit Available 3.000 Elsewhere For Economic Injury: Non-Profit Organizations Without Credit...

Whole-Person Impairment in Younger Retired NFL Players: The Orthopaedic Toll of a Professional Football Career.

PubMed

Domb, Benjamin G; Carter, Chris; Finch, Nathan A; Hammarstedt, Jon E; Dunne, Kevin F; Stake, Christine E

2014-05-01

Professional American football is a physically demanding, high-impact sport with an elevated risk of injury. Orthopaedic injuries may impose acute, short-term or cumulative consequences throughout a player's lifetime. Several studies have addressed health and psychosocial concerns of an older, retired population of players in the National Football League (NFL); however, minimal research has examined the orthopaedic toll on younger, retired players. This study reports total whole-person impairment (WPI) percentages in a cohort of younger, retired NFL players who presented for disability evaluations based on the use of standardized American Medical Association (AMA) impairment guidelines. Case series; Level of evidence, 4. During the study period of February 2011 to August 2013, 65 younger retired NFL players presented for impairment evaluations. The mean time between retirement and impairment evaluation was 3.1 years (range, 0.3-16.4 years). A complete history and physical examination was performed on all symptomatic joints. A retrospective chart review was conducted on 100% of presenting players to assess orthopaedic burden. Body-part impairment (BPI) percentage for each affected joint was generated. The impairment data for each extremity were then combined with spine impairment data to create WPI percentage. Player demographics, including age, position, and playing time, were also recorded. The average WPI percentage was 37% (range, 19%-53%). Players participating in >30 games (n = 54) had a higher mean WPI percentage (38%) than those playing in <30 games (31%; n = 11) (P = .004). Players competing in >5 seasons (n = 46) were 2.4 times more likely to have a WPI of at least 37% (P = .007). The most common joints players reported as symptomatic were lumbar (n = 63; 97%) and cervical spine (n = 58; 89%). The mean age at evaluation was 33.5 years (range, 27-42 years), and the mean number of seasons played was 7.5 (range, 3-14 seasons). The mean number of games played was 98.4 (range, 2-236 games). This study demonstrated high WPI percentages related to symptomatic joints in a cohort of younger, retired NFL players. Further research is warranted to study potential cumulative physical and quality of life factors related to high impairment percentages in younger, retired NFL players.

Roots of Physical Medicine, Physical Therapy, and Mechanotherapy in the Netherlands in the 19th Century: A Disputed Area within the Healthcare Domain

PubMed Central

Terlouw, Thomas J.A.

2007-01-01

Physical medicine, which in the context of this article includes mechanotherapy, hydrotherapy, balneotherapy, electrotherapy, light therapy, air therapy, and thermotherapy, became a new field of labor in the healthcare domain in the Netherlands around 1900. This article gives an account of the introduction and development of mechanotherapy as a professional activity in the Netherlands in the 19th century. Mechanotherapy, which historically included exercises, manipulations, and massage, was introduced in this country around 1840 and became one of the core elements of physical medicine towards the end of that century. In contrast to what one might expect, mostly physical education teachers, referred to as “heilgymnasts,” dedicated themselves to this kind of treatment, whereas only a few physicians were active in this field until the 1880s. When, in the last quarter of the 19th century, differentiation and specialization within the medical profession took place, physicians specializing in physical medicine and orthopaedics began to claim the field of mechanotherapy exclusively for themselves. This led to tensions between them and the group of heilgymnasts that had already been active in this field for decades. The focus of attention in this article is on interprofessional relationships, on the roles played by the different professional organizations in the fields of physical education and medicine, the local and national governments, and the judicial system, and on the social, political, and cultural circumstances under which developments in the field of mechanotherapy took place. The article concludes with the hypothesis that the intra- and inter-occupational rivalries discussed have had a negative impact on the academic development of physical medicine, orthopaedics, and heilgymnastics/physical therapy in the Netherlands in the first half of the 20th century. PMID:19066646

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda.

PubMed

Bouchard, Maryse; Kohler, Jillian C; Orbinski, James; Howard, Andrew

2012-05-03

Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants' experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher wages and benefits for workers could be important and initial steps in improving access orthopaedic care and OMDs, and managing the global injury burden.

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

PubMed Central

2012-01-01

Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher wages and benefits for workers could be important and initial steps in improving access orthopaedic care and OMDs, and managing the global injury burden. PMID:22554349

An assessment of the inter-rater reliability of the ASA physical status score in the orthopaedic trauma population.

PubMed

Ihejirika, Rivka C; Thakore, Rachel V; Sathiyakumar, Vasanth; Ehrenfeld, Jesse M; Obremskey, William T; Sethi, Manish K

2015-04-01

Although recent literature has demonstrated the utility of the ASA score in predicting postoperative length of stay, complication risk and potential utilization of other hospital resources, the ASA score has been inconsistently assigned by anaesthesia providers. This study tested the reliability of assignment of the ASA score classification by both attending anaesthesiologists and anaesthesia residents specifically among the orthopaedic trauma patient population. Nine case-based scenarios were created involving preoperative patients with isolated operative orthopaedic trauma injuries. The cases were created and assigned a reference score by both an attending anaesthesiologist and orthopaedic trauma surgeon. Attending and resident anaesthesiologists were asked to assign an ASA score for each case. Rater versus reference and inter-rater agreement amongst respondents was then analyzed utilizing Fleiss's Kappa and weighted and unweighted Cohen's Kappa. Thirty three individuals provided ASA scores for each of the scenarios. The average rater versus reference reliability was substantial (Kw=0.78, SD=0.131, 95% CI=0.73-0.83). The average rater versus reference Kuw was also substantial (Kuw=0.64, SD=0.21, 95% CI=0.56-0.71). The inter-rater reliability as evaluated by Fleiss's Kappa was moderate (K=0.51, p<.001). An inter-rater comparison within the group of attendings (K=0.50, p<.001) and within the group of residents were both moderate (K=0.55, p<.001). There was a significant increase in the level of inter-rater reliability from the self-reported 'very uncomfortable' participants to the 'very comfortable' participants (uncomfortable K=0.43, comfortable K=0.59, p<.001). This study shows substantial agreement strength for reliability of the ASA score among anaesthesiologists when evaluating orthopaedic trauma patients. The significant increase in inter-rater reliability based on anaesthesiologists' comfort with the ASA scoring method implies a need for further evaluation of ASA assessment training and routine use on the ground. These findings support the use of the ASA score as a statistically reliable tool in orthopaedic trauma. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Bone Health Intervention for Chinese Immigrants in Santa Clara County.

PubMed

Zou, Joanne; Hampton, Michelle DeCoux; Shade, Kate; Kaku, Leonard

Among Chinese immigrants, osteoporosis is undertreated, misdiagnosed, and a leading cause of fragility fractures. In orthopaedic surgery departments, prevention education and health behavior change programs are necessary to improve their bone health. The purpose of this study was to examine the effectiveness of an osteoporosis prevention education program on participants' self-efficacy with regard to exercise and nutrition when provided by an orthopaedic surgery team during an annual Chinese Health Fair in Santa Clara County, CA. This pilot study used a single-group pretest and posttest design. Chinese immigrants at risk of osteoporosis were recruited during a 1-day health fair. The Bone Health Intervention (BHI) included orthopaedic surgeon consultation, visual aids including osteoporosis images and bone models, a video that included a discussion on calcium and vitamin D in the Chinese diet and culturally-acceptable exercise, and osteoporosis educational handouts. The Osteoporosis Self-Efficacy Scale (OSES) was utilized to measure participants' confidence in the ability to participate in self-care behaviors related to physical activity and calcium intake before and after the intervention. Paired t tests were used to compare participants' OSES scores pre- and postintervention. There was a significant increase in mean OSES scores postintervention, indicating that the intervention could be an effective method of increasing participants' self-efficacy regarding calcium intake and time spent in exercising. These results indicate that a culturally meaningful education program can potentially reduce fragility fracture risk. Orthopaedic health providers are ideal candidates to deliver preventive care education to improve outcomes for Chinese immigrants.

75 FR 12562 - Central Utah Project Completion Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-16

... DEPARTMENT OF THE INTERIOR THE UTAH RECLAMATION MITIGATION AND CONSERVATION COMMISSION Central...-- Water and Science; Utah Reclamation Mitigation and Conservation Commission; and the Central Utah Water... of Public Scoping for the proposed Provo River Delta Restoration, Utah County, Utah. SUMMARY...

[Orthopaedics' megalomania - myth or mobbing?

PubMed

Gundtoft, Per Hviid; Brand, Eske; Klit, Jakob; Weisskirchner, Kristoffer Barfod

2016-12-12

It is a general impression in the world of medicine that orthopaedic surgeons differ from doctors of other specialities in terms of intellect and self-confidence. The purpose of this study was to evaluate the self-confidence of orthopaedics. We asked doctors from 30 different specialities to fill out a questionnaire. In addition to this, the participating orthopaedics were asked to rate their self-perceived surgical skills. In all, 120 orthopaedics and 416 non-orthopaedic doctors completed the questionnaire. There was no difference in GSE scores between orthopaedics and other doctors (p = 0.58). 98% of young orthopaedics estimated that their surgical talent was average or above average when compared with their colleagues on the same level of education. 72% believed that they were "equally talented", "more talented", or "far more talented" than their colleagues on a higher level of education. 76% believed that when assisting a senior surgeon the patients would "sometimes" (60%), "often" (14%) or "always" (2%) be better off if they were the ones performing the operation. More orthopaedics than non-orthopaedics believed that their speciality was regarded as one of the least important specialities in the world of medicine (p = 0.001). Orthopaedic surgeons in general are not more self-confident than other doctors or the average population, but young orthopaedic surgeons have a very high level of confidence in their own operation skills. none. none.

Surgical timing of treating injured extremities: an evolving concept of urgency.

PubMed

Crist, Brett D; Ferguson, Tania; Murtha, Yvonne M; Lee, Mark A

2013-01-01

The management of some orthopaedic extremity injuries has changed over the past decade because of changing resource availability and the risks of complications. It is helpful to review the current literature regarding orthopaedic extremity emergencies and urgencies. The effects of the techniques of damage control orthopaedic techniques and the concept of the orthopaedic trauma room have also affected the management of these injuries. The available literature indicates that the remaining true orthopaedic extremity emergencies include compartment syndrome and vascular injuries associated with fractures and dislocations. Orthopaedic urgencies include open fracture management, femoral neck fractures in young patients treated with open reduction and internal fixation, and talus fractures that are open or those with impending skin compromise. Deciding when the definitive management of orthopaedic extremity injuries will occur has evolved as the concept of damage control orthopaedics has become more commonly accepted. Patient survival rates have improved with current resuscitative protocols. Definitive fixation of extremity injuries should be delayed until the patient's physiologic and extremity soft-tissue status allows for appropriate definitive management while minimizing the risks of complications. In patients with semiurgent orthopaedic injuries, the use of an orthopaedic trauma room has led to more efficient care of patients, fewer complications, and better time management for surgeons who perform on-call service for patients with traumatic orthopaedic injuries.

Laser-induced modification of structure and shape of cartilage in otolaryngology and orthopaedics

NASA Astrophysics Data System (ADS)

Sobol', E. N.; Baum, O. I.; Omel'chenko, A. I.; Soshnikova, Yu. M.; Yuzhakov, A. V.; Kas'yanenko, E. M.; Tokareva, A. V.; Baskov, A. V.; Svistushkin, V. M.; Selezneva, L. V.; Shekhter, A. B.

2017-11-01

We present the results of basic research in laser modification of tissues in otolaryngology (correcting the shape of nasal septum and larynx cartilages), cosmetology (correcting ear and nose shape), orthopaedics and spinal surgery (treatment of diseases of spine disc and joints). The physical processes and mechanisms of laser-induced relaxation of stresses and regeneration of tissues are considered. New results of studies in this fast-developing field of laser surgery are presented, in particular, the results of laser correction of costal cartilage shape in the process of making implants for the treatment of larynx stenosis and controlled regeneration of the hyaline articular cartilage. Presented at the Fundamentals of Laser Assisted Micro- and Nanotechnologies (FLAMN-2016) International Symposium (Pushkin, Leningrad oblast, 27 June to 1 July 2016).

High-tech and low-tech orthopaedic surgery in Sub-Saharan Africa.

PubMed

Kluge, Wolfram H; Bauer, Heike I

2002-01-01

BACKGROUND: Zambia's governmental health system suffers from shortage of surgical supplies and poor management skills for the sparse resources at hand. The situation has been worsened by the dual epidemics of HIV disease and tuberculosis. On the other hand the private medical sector has benefited greatly from less bureaucracy under the goverment of the Movement for Multi-party Democracy. DISCUSSION: The Zambian-Italian Orthopaedic Hospital in Lusaka is a well organized small unit providing free treatment of physically disabled children. The running costs are met from the fees charged for private consultations, supplemented by donations. State of the art surgical techniques are being used for congenital and acquired musculo-skeletal abnormalities. Last year 513 patients were operated upon free of charge and 320 operations were performed on private patients.

Developing Orthopaedic Trauma Capacity in Uganda: Considerations From the Uganda Sustainable Trauma Orthopaedic Program.

PubMed

OʼHara, Nathan N; OʼBrien, Peter J; Blachut, Piotr A

2015-10-01

Uganda, like many low-income countries, has a tremendous volume of orthopaedic trauma injuries. The Uganda Sustainable Trauma Orthopaedic Program (USTOP) is a partnership between the University of British Columbia and Makerere University that was initiated in 2007 to reduce the consequences of neglected orthopaedic trauma in Uganda. USTOP works with local collaborators to build orthopaedic trauma capacity through clinical training, skills workshops, system support, technology development, and research. USTOP has maintained a multidisciplinary approach to training, involving colleagues in anaesthesia, nursing, rehabilitation, and sterile reprocessing. Since the program's inception, the number of trained orthopaedic surgeons practicing in Uganda has more than doubled. Many of these newly trained surgeons provide clinical care in the previously underserved regional hospitals. The program has also worked with collaborators to develop several technologies aimed at reducing the cost of providing orthopaedic care without compromising quality. As orthopaedic trauma capacity in Uganda advances, USTOP strives to continually evolve and provide relevant support to colleagues in Uganda.

Mechanical model of orthopaedic drilling for augmented-haptics-based training.

PubMed

Pourkand, Ashkan; Zamani, Naghmeh; Grow, David

2017-10-01

In this study, augmented-haptic feedback is used to combine a physical object with virtual elements in order to simulate anatomic variability in bone. This requires generating levels of force/torque consistent with clinical bone drilling, which exceed the capabilities of commercially available haptic devices. Accurate total force generation is facilitated by a predictive model of axial force during simulated orthopaedic drilling. This model is informed by kinematic data collected while drilling into synthetic bone samples using an instrumented linkage attached to the orthopaedic drill. Axial force is measured using a force sensor incorporated into the bone fixture. A nonlinear function, relating force to axial position and velocity, was used to fit the data. The normalized root-mean-square error (RMSE) of forces predicted by the model compared to those measured experimentally was 0.11 N across various bones with significant differences in geometry and density. This suggests that a predictive model can be used to capture relevant variations in the thickness and hardness of cortical and cancellous bone. The practical performance of this approach is measured using the Phantom Premium haptic device, with some required customizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Translating orthopaedic basic science into clinical relevance.

PubMed

Madry, Henning

2014-12-01

In orthopaedic and trauma surgery, the rapid evolution of biomedical research has fundamentally changed the perception of the musculoskeletal system. Here, the rigor of basic science and the art of musculoskeletal surgery have come together to create a new discipline -experimental orthopaedics- that holds great promise for the causative cure of many orthopaedic conditions. The Journal of Experimental Orthopaedics intends to bridge the gap between orthopaedic basic science and clinical relevance, to allow for a fruitful clinical translation of excellent and important investigations in the field of the entire musculoskeletal system.

Computerized Adaptive Tests Detect Change Following Orthopaedic Surgery in Youth with Cerebral Palsy.

PubMed

Mulcahey, M J; Slavin, Mary D; Ni, Pengsheng; Vogel, Lawrence C; Kozin, Scott H; Haley, Stephen M; Jette, Alan M

2015-09-16

The Cerebral Palsy Computerized Adaptive Test (CP-CAT) is a parent-reported outcomes instrument for measuring lower and upper-extremity function, activity, and global health across impairment levels and a broad age range of children with cerebral palsy (CP). This study was performed to examine whether the Lower Extremity/Mobility (LE) CP-CAT detects change in mobility following orthopaedic surgery in children with CP. This multicenter, longitudinal study involved administration of the LE CP-CAT, the Pediatric Outcomes Data Collection Instrument (PODCI) Transfer/Mobility and Sports/Physical Functioning domains, and the Timed "Up & Go" test (TUG) before and after elective orthopaedic surgery in a convenience sample of 255 children, four to twenty years of age, who had CP and a Gross Motor Function Classification System (GMFCS) level of I, II, or III. Standardized response means (SRMs) and 95% confidence intervals (CIs) were calculated for all measures at six, twelve, and twenty-four months following surgery. SRM estimates for the LE CP-CAT were significantly greater than the SRM estimates for the PODCI Transfer/Mobility domain at twelve months, the PODCI Sports/Physical Functioning domain at twelve months, and the TUG at twelve and twenty-four months. When the results for the children at GMFCS levels I, II, and III were grouped together, the improvements in function detected by the LE CP-CAT at twelve and twenty-four months were found to be greater than the changes detected by the PODCI Transfer/Mobility and Sports/Physical Functioning scales. The LE CP-CAT outperformed the PODCI scales for GMFCS levels I and III at both of these follow-up intervals; none of the scales performed well for patients with GMFCS level II. The results of this study showed that the LE CP-CAT displayed superior sensitivity to change than the PODCI and TUG scales after musculoskeletal surgery in children with CP. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Industry Financial Relationships in Orthopaedic Surgery: Analysis of the Sunshine Act Open Payments Database and Comparison with Other Surgical Subspecialties.

PubMed

Cvetanovich, Gregory L; Chalmers, Peter N; Bach, Bernard R

2015-08-05

Industry financial relationships for orthopaedic surgeons in the United States are now publicly reported in the Sunshine Act Open Payments database. We sought to present these data in a more easily understandable format and to describe how industry relationships in orthopaedic surgery compare with other surgical subspecialties. The Open Payments database was searched for all records of industry financial relationships for orthopaedic surgeons. Data analyzed included the value of reported financial relationships per surgeon, the type of financial relationship, and geographic region. Similar analytics were collected for neurological surgery, urology, plastic surgery, and otolaryngology. Data were normalized to the overall number of providers in each subspecialty in the United States from the American Medical Association 2012 data. For 12,320 orthopaedic surgeons, 58,127 industry financial relationships were reported, with a total value of $80.2 million. Royalties or licensing fees, which were received by 1.7% of U.S. orthopaedic surgeons, accounted for 69.5% of the total monetary value of payments to orthopaedic surgeons. Between August and December 2013, 50.1% of U.S. orthopaedic surgeons had a reported financial relationship. Orthopaedics had the second lowest percentage of physicians with industry financial relationships among the five surgical subspecialties studied. The overall value of payments per orthopaedic surgeon was higher than in the other subspecialties, driven by the large value of royalties and licensing. One-half of U.S. orthopaedic surgeons have industry financial relationships reported in the Open Payments database. Orthopaedic surgeons are less likely than most surgical subspecialists to receive industry payments, and the majority of the overall value of orthopaedic financial relationships is driven by a small number of orthopaedic surgeons receiving royalties and licensing for reimbursable innovation within the field. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Leadership and business education in orthopaedic residency training programs.

PubMed

Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

2011-01-01

Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

Value of Pediatric Orthopaedic Surgery.

PubMed

Kocher, Mininder S

2015-01-01

Value has become the buzzword of contemporaneous health care reform. Value is defined as outcomes relative to costs. Orthopaedic surgery has come under increasing scrutiny due to high procedural costs. However, orthopaedic surgery may actually be a great value given the benefits of treatment. The American Academy of Orthopaedic Surgeons (AAOS) Value Project team was tasked to develop a model for assessing the benefits of orthopaedic surgery including indirect costs related to productivity and health-related quality of life. This model was applied to 5 orthopaedic conditions demonstrating robust societal and economic value. In all cost-effectiveness models, younger patients demonstrated greater cost-effectiveness given increased lifespan and productivity. This has tremendous implications within the field of pediatric orthopedic surgery. Pediatric orthopaedics may be the best value in medicine!

ATTITUDE OF CLEFT CARE SPECIALISTS IN AFRICA TOWARDS PRESURGICAL ORTHOPAEDICS.

PubMed

Adeyemi, A T; Bankole, O O

2012-12-01

To determine the attitude of cleft care specialists working in Africa towards pre-surgical orthopaedics. A cross sectional study. Pan-African conference on cleft lip and palate in Nigeria. Sixty cleft care specialists working in Africa. The general attitude towards pre-surgicalorthopaedics was positive. Majority of the specialists employ pre-surgical orthopaedics before surgical repair. Fifty four (91%) of the specialists use plaster strapping for cases of bilateral cleft, five (8.3%) use nasoalveolar molding and one (2%) use feeding plate. Half of the specialists (50%) felt that pre-surgical orthopaedics is to be managed by orthodontists alone. There were significant difference in attitude towards pre-surgical orthopaedics between providers (p < 0.05). Orthodontists had a strong positive attitude towards pre-surgical orthopaedics than other specialists. Younger specialists had a more positive attitude towards pre-surgical orthopaedics than older specialists. Cleft care specialists in Africa have a positive attitude towards pre-surgical orthopaedics. Majority of them use plaster strapping technique. Younger specialists have a more favorable attitude towards pre-surgical orthopaedics than older specialists.

78 FR 54478 - Endangered and Threatened Wildlife and Plants; Permits; Low-Effect Habitat Conservation Plan for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-04

... the Utah Prairie Dog in Iron County, Utah AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice... Draft Low-effect Habitat Conservation Plan for the Utah prairie dog in Iron County, Utah, for review and... Conservation Plan for the Utah prairie dog in Iron County, Utah. The Iron County Commission has prepared a...

Scatter of orthopaedic research: can orthopods stay up-to-date with research?

PubMed

Wijenayake, Lahann; Conroy, Sophie; Turner, Douglas; Thorning, Sarah; Glasziou, Paul

2015-06-01

The volume of orthopaedic literature is increasing exponentially, becoming more widely scattered among journals. The rate of increase in orthopaedics is greater than other specialties. We aimed to identify the number of different journals an orthopaedic surgeon would need to read to stay up-to-date with current evidence. We searched PubMed for all orthopaedic-related systematic reviews (SR) and randomized controlled trials (RCT) published in 2011 using MESH (Medical Subject Headings) terms. The search was based on the Australian Orthopaedic Association syllabus of March 2011. The results of the search were exported to EndNote, then Microsoft Excel. We then calculated the least number of journals needed to read 25%, 50% and 100% of the articles. This was done separately for SRs and RCTs. We found 1400 orthopaedic RCTs spread over 392 journals. Ten journals contained 25% of the articles, 36 journals contained 50% and 114 journals contained 75%. Three hundred journals contained three or fewer RCTs. We found 354 orthopaedic-relevant SRs spread over 152 journals. Six journals contained 25% of the articles, 23 journals contained 50% and 63 journals contained 75%. Ninety-three journals contained only one SR. Our results demonstrate the vast scatter of orthopaedic research. Four orthopaedic RCTs are published every day. To read even 25% of the new RCTs and SRs published in orthopaedics, a surgeon would require a subscription to 13 different journals monthly, a costly and time-consuming endeavour. © 2014 Royal Australasian College of Surgeons.

Records of wells in sandstone and alluvial aquifers and chemical data for water from selected wells in the Navajo aquifer in the vicinity ofthe Greater Aneth Oil Field, San Juan County, Utah

USGS Publications Warehouse

Spangler, Lawrence E.

1992-01-01

This report contains hydrologic data for wells finished in sandstone and alluvial aquifers in southeastern San Juan County, Utah, and chemical data for water from selected wells in the Navajo aquifer. Temperature, specific conductance, pH, and discharge data from 1989-91 for water from selected wells in all aquifers are also presented.Data presented in this report were compiled from previously published reports (Goode, 1958; Sumsion, 1975; Avery, 1986; Kimball, 1987; Howells, 1990); data bases of the U.S. Geological Survey, the Navajo Tribe, the U.S. Bureau of Land Management, the Utah Division of Water Rights, and the Utah Division of Oil, Gas, and Mining; and from information obtained from oil companies in the Greater Aneth Oil Field. Results of investigations by Avery (1986) during 1982-83 indicated that water from many wells in the Navajo aquifer in the vicinity of the Greater Aneth Oil Field was moderately saline and that in some wells, salinity appeared to increase over time. The purpose of this study is to assess the physical extent and concentration of saline water in the Navajo and other aquifers in this area. The purpose of this report is to present available water-quality data for water from wells in the Navajo aquifer and present records for selected wells in the Navajo and other aquifers.

Preseason Perceived Physical Capability and Previous Injury.

PubMed

Sciascia, Aaron; Haegele, Lauren E; Lucas, Jean; Uhl, Timothy L

2015-09-01

Patient opinion about the ability to perform athletic maneuvers is important after injury; however, prospective assessment of self-perceived physical capability for athletes before the beginning of a season is lacking. To perform a descriptive analysis of knee, shoulder, and elbow self-perceived measures of physical capability specific to athletics and to compare the measures between athletes with and without a history of injury. Cross-sectional study. Preparticipation physical examinations. A total of 738 collegiate athletes (486 men, 251 women; age = 19 ± 1 years) were administered questionnaires after receiving medical clearance to participate in their sports. Of those athletes, 350 reported a history of injury. Athletes self-reported a history of knee, shoulder, or elbow injury. Perceived physical capability of the 3 joints was evaluated using the Knee Injury and Osteoarthritis Outcome Score Sport and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score. We conducted nonparametric analysis to determine if scores differed between athletes with and without a history of injury. Median values for the Knee Injury and Osteoarthritis Outcome Score Sports and Recreation Function and Knee-Related Quality of Life subscales and the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score for all athletes were 100. Median values for perceived physical capability of athletes with a history of injury were 3 to 12 points lower for each questionnaire before the start of the season (P < .001). Our study provided descriptive values for individual perceived knee, shoulder, and elbow physical capability of collegiate athletes participating in 19 sports. Athletes who did not report previous injuries perceived their physical capabilities to be nearly perfect, which could set the goal for these athletes to return to participation after injury. Athletes reporting previous injuries perceived less physical capability before the competitive season. Self-assessment of joint-specific capability may supplement preseason physical examinations, identifying particular athletes needing further monitoring or care during a season.

The effects of fitness on the aging process.

PubMed

Vopat, Bryan G; Klinge, Stephen A; McClure, Philip K; Fadale, Paul D

2014-09-01

Decades of research support the fact that much age-related deterioration is the result of the effects of sedentary lifestyles and the development of medical conditions rather than of aging itself. Elite older athletes, who demonstrate enhanced performance compared with historic cohorts and even some younger peers, are models of this paradigm. Many non-elite middle-aged adults and older adults continue to remain increasingly active throughout middle age and beyond. A continually growing body of basic science and clinical evidence demonstrates how active persons modulate physical decline through training. An updated understanding of how active adults defy age helps orthopaedic surgeons not only manage their patients' performance but also improve their lives. A large segment of sedentary older adults will benefit from counseling that encourages the pursuit of more active and healthier lifestyles. Copyright 2014 by the American Academy of Orthopaedic Surgeons.

Task-shifting of orthopaedic surgery to non-physician clinicians in Malawi: effective and safe?

PubMed

Wilhelm, Torsten J; Dzimbiri, Kondwani; Sembereka, Victoria; Gumeni, Martin; Bach, Olaf; Mothes, Henning

2017-10-01

There is a shortage of orthopaedic surgeons in Malawi. Orthopaedic clinical officers (OCOs) treat trauma patients and occasionally perform major orthopaedic surgery. No studies have assessed the efficacy and safety of their work. The aim of this study was to evaluate their contribution to major orthopaedic surgery at Zomba Central Hospital. Data about orthopaedic procedures during 2006-2010 were collected from theatre books. We selected major amputations and open reductions and plating for outcome analysis and collected details from files. We compared patients operated by OCOs alone ('OCOs alone' group) and by surgeons or OCOs assisted by surgeons ('Surgeon present' group). OCOs performed 463/1010 major (45.8%) and 1600/1765 minor operations (90.7%) alone. There was no difference in perioperative outcome between both groups. OCOs carry out a large proportion of orthopaedic procedures with good clinical results. Shifting of clinical tasks including major orthopaedic surgery can be safe. Further prospective studies are recommended.

75 FR 71726 - Central Utah Project Completion Act

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

... DEPARTMENT OF THE INTERIOR Central Utah Project Completion Act AGENCY: Department of the Interior..., Orem, Utah 84058-7303. Department of the Interior, Central Utah Project Completion Act Office, 302 East....cupcao.gov . FOR FURTHER INFORMATION: Contact Mr. Lee Baxter, Central Utah Project Completion Act Office...

The Perry Initiative's Medical Student Outreach Program Recruits Women Into Orthopaedic Residency.

PubMed

Lattanza, Lisa L; Meszaros-Dearolf, Laurie; O'Connor, Mary I; Ladd, Amy; Bucha, Amy; Trauth-Nare, Amy; Buckley, Jenni M

2016-09-01

Orthopaedic surgery lags behind other surgical specialties in terms of gender diversity. The percentage of women entering orthopaedic residency persistently remains at 14% despite near equal ratios of women to men in medical school classes. This trend has been attributed to negative perceptions among women medical students of workplace culture and lifestyle in orthopaedics as well as lack of exposure, particularly during medical school when most women decide to enter the field. Since 2012, The Perry Initiative, a nonprofit organization that is focused on recruiting and retaining women in orthopaedics, had conducted extracurricular outreach programs for first- and second-year female medical students to provide exposure and mentoring opportunities specific to orthopaedics. This program, called the Medical Student Outreach Program (MSOP), is ongoing at medical centers nationwide and has reached over 300 medical students in its first 3 program years (2012-2014). (1) What percentage of MSOP participants eventually match into orthopaedic surgery residency? (2) Does MSOP impact participants' perceptions of the orthopaedics profession as well as intellectual interest in the field? The percentage of program alumnae who matched into orthopaedics was determined by annual followup for our first two cohorts who graduated from medical school. All program participants completed a survey immediately before and after the program that assessed the impact of MSOP on the student's intention to pursue orthopaedics as well as perceptions of the field and intellectual interest in the discipline. The orthopaedic surgery match rate for program participants was 31% in our first graduating class (five of 16 participants in 2015) and 28% in our second class (20 of 72 participants in 2016). Pre/post program comparisons showed that the MSOP influenced students' perceptions of the orthopaedics profession as well as overall intellectual interest in the field. The results of our study suggest that The Perry Initiative's MSOP positively influences women to choose orthopaedic surgery as a profession. The match rate for program alumnae is twice the percentage of females in current orthopaedic residency classes. Given these positive results, MSOP can serve as a model, both in its curricular content and logistic framework, for other diversity initiatives in the field.

The uneven distribution of women in orthopaedic surgery resident training programs in the United States.

PubMed

Van Heest, Ann E; Agel, Julie

2012-01-18

Although women represented 58% of undergraduate students and 48% of medical students in the U.S. in the 2008-2009 academic year, only 13% of orthopaedic residents and only 4% of American Academy of Orthopaedic Surgeons (AAOS) Fellows in 2009 were women. Are all orthopaedic surgery programs in the U.S. equal in their ability to attract female medical students and train female orthopaedic surgeons? This study was undertaken to test the hypothesis that all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery residency programs in the U.S. train a similar number of female residents. Data for all ACGME-accredited orthopaedic surgery residency training programs in the U.S. for five academic years (2004-2005 through 2008-2009) were collected with use of the Graduate Medical Education (GME) Track database. Orthopaedic residency programs in the U.S. do not train women at an equal frequency. In the academic years from 2004-2005 through 2008-2009, forty-five programs had no female residents during at least one of the five academic years reviewed, and nine programs had no female residents during any of the years. More than fifty orthopaedic residency programs in the U.S. had an average of <10% female trainees over the five-year period, and more than ten programs had an average of >20%. There was no significant change in the distribution among these categories over the five years examined (p = 0.234). Significant differences in the representation of women exist among orthopaedic residency training programs in the U.S. Further examination of the characteristics of orthopaedic residency programs that are successful in attracting female residents, particularly the composition of their faculty as role models, will be important in furthering our understanding of how orthopaedic surgery can continue to attract the best and the brightest individuals. Changes in the cultural experiences in programs that have not trained female orthopaedic surgeons, such as an increased number of female faculty, and policies that emphasize diversity may provide a greater opportunity for our orthopaedic profession to attract female medical students.

The Hubble Space Telescope Cluster Supernova Survey. III. Correlated

Science.gov Websites

Properties SAO/NASA ADS Astronomy Abstract Service Title: The Hubble Space Telescope Cluster Street, Cambridge, MA 02138, USA), AF(Department of Physics and Astronomy, University of Utah, Salt Lake , USA), AH(Institute of Astronomy, Graduate School of Science, University of Tokyo, 2-21-1 Osawa, Mitaka

Merging long range transportation planning with public health: a case study from Utah's Wasatch Front.

PubMed

Burbidge, Shaunna K

2010-01-01

US transportation systems have been identified as a problem for public health, as they often encourage automobile transportation and discourage physical activity. This paper provides a case study examination of the Public Health Component of the Wasatch Front Regional Council's Regional Transportation Plan. This plan provides an example of what transportation planners at Utah's largest metropolitan planning organization (MPO) are doing to encourage physical activity through transportation. Existing active living research was used to guide recommendations using a process that included a comprehensive literature review and a review of existing state programs, advisory group and stakeholder meetings, and policy recommendations based on existing local conditions. Stakeholders from a diversity of background and interests came together with one common goal: to improve public health. Based on this collaborative process, nine policy approaches were specifically recommended for approval and integration in the Wasatch Front Regional Transportation Plan. By using current research as a guide and integrating a variety of interests, the Wasatch Front Regional Council is setting a new standard for a collaborative multi-modal focus in transportation planning, which can be replicated nationwide.

6. Photocopied from unnumbered drawing, Drawings folder, Engineering Department, Utah ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photocopied from unnumbered drawing, Drawings folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. 'THE TELLURIDE POWER CO. LABORATORY EXTENSION. SOUTH ELEVATION. PROVO, UTAH. NOV. 9, 1909.' - Telluride Power Company, Nunn Hydroelectric Plant, Southeast side of Provo River, 300 feet West of US Route 189, Orem, Utah County, UT

Women and minorities in orthopaedic residency programs.

PubMed

Templeton, Kimberly; Wood, V Jamaica; Haynes, Richard

2007-01-01

Women and underrepresented minorities make up smaller proportions of orthopaedic residency programs than their numbers in medical school would predict, according to our evaluation of self-reported orthopaedic residency data from 1998 and 2001, as well as information on medical students published in 2002. Based on race, ethnicity, and sex, comparisons were made between students entering and graduating from medical school and those in orthopaedic residency programs. With few exceptions, the percentages of women and underrepresented minorities were statistically significantly lower among those training in orthopaedic residency programs compared with those same groups entering and graduating from medical school. The percentage of women and minorities in orthopaedic residency programs remained constant between 1998 and 2001. Further study is necessary to determine whether fewer students of color and women apply to orthopaedic residency programs because of lack of interest, lack of appropriate mentoring and role models, or other factors.

[Prof. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery at Kyoto University and his achievements in orthopaedic surgery in the Meiji era of Japan (Part 5, Faculty members and training of doctors from Nagoya)].

PubMed

Hirotani, Hayato

2010-09-01

During the years when Dr. M. Matsuoka was professor of the Department of Orthopaedic Surgery, Kyoto Medical School, Kyoto Imperial University (June, 1907-January, 1914), seven doctors worked as his faculty members and founded the base of the current development and reputation of the Department. After resignation from their academic positions, they served in orthopaedic practice in several areas in Japan where orthopaedic surgery was not well recognized. In addition, Prof. Matsuoka trained three doctors from the Aichi Prefectural Medical College (School of Medicine, Nagoya University) in the orthopaedic practice, including x-ray technique and they contributed to the development of orthopaedic surgery in the areas of Nagoya city and Tokai. Backgrounds and achievements of these ten doctors are described.

75 FR 33995 - Safety Zone; Michigan Orthopaedic Society 50th Anniversary Fireworks, Lake Huron, Mackinac Island...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

...-AA00 Safety Zone; Michigan Orthopaedic Society 50th Anniversary Fireworks, Lake Huron, Mackinac Island... from a portion of Lake Huron during the Michigan Orthopaedic Society 50th Anniversary Fireworks display... launching of fireworks in conjunction with the Michigan Orthopaedic Society 50th Anniversary Fireworks...

Professionalism in 21st century professional practice: autonomy and accountability in orthopaedic surgery.

PubMed

Schneller, Eugene S; Wilson, Natalia A

2009-10-01

Orthopaedic surgical practice is becoming increasingly complex. The rapid change in pace associated with new information and technologies, the physician-supplier relationship, the growing costs and growing gap between costs and reimbursements for orthopaedic surgical procedures, and the influences of advertising on the patient, challenge all involved in the delivery of orthopaedic care. This paper assesses the concepts of professionalism, autonomy, and accountability in the 21st century practice of orthopaedic surgery. These concepts are considered within the context of the complex value chain surrounding orthopaedic surgery and the changing forces influencing clinical decision making by the surgeon. A leading impetus for challenge to the autonomy of the orthopaedic surgeon has been cost. Mistrust and lack of understanding have characterized the physician-hospital relationship. Resource dependency has characterized the physician-supplier relationship. Accountability for the surgeon has increased. We suggest implant surgery involves shared decision making and "coproduction" between the orthopaedic surgeon and other stakeholders. The challenge for the profession is to redefine professionalism, accountability, and autonomy in the face of these changes and challenges.

Orthopaedic Trauma Care Capacity Assessment and Strategic Planning in Ghana: Mapping a Way Forward.

PubMed

Stewart, Barclay T; Gyedu, Adam; Tansley, Gavin; Yeboah, Dominic; Amponsah-Manu, Forster; Mock, Charles; Labi-Addo, Wilfred; Quansah, Robert

2016-12-07

Orthopaedic conditions incur more than 52 million disability-adjusted life years annually worldwide. This burden disproportionately affects low and middle-income countries, which are least equipped to provide orthopaedic care. We aimed to assess orthopaedic capacity in Ghana, describe spatial access to orthopaedic care, and identify hospitals that would most improve access to care if their capacity was improved. Seventeen perioperative and orthopaedic trauma care-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with hospital staff were used to assess resource availability and factors contributing to deficiencies at 40 purposively sampled facilities. Cost-distance analyses described population-level spatial access to orthopaedic trauma care. Facilities for targeted capability improvement were identified through location-allocation modeling. Orthopaedic trauma care assessment demonstrated marked deficiencies. Some deficient resources were low cost (e.g., spinal immobilization, closed reduction capabilities, and prosthetics for amputees). Resource nonavailability resulted from several contributing factors (e.g., absence of equipment, technology breakage, lack of training). Implants were commonly prohibitively expensive. Building basic orthopaedic care capacity at 15 hospitals without such capacity would improve spatial access to basic care from 74.9% to 83.0% of the population (uncertainty interval [UI] of 81.2% to 83.6%), providing access for an additional 2,169,714 Ghanaians. The availability of several low-cost resources could be better supplied by improvements in organization and training for orthopaedic trauma care. There is a critical need to advocate and provide funding for orthopaedic resources. These initiatives might be particularly effective if aimed at hospitals that could provide care to a large proportion of the population.

The orthopaedic error index: development and application of a novel national indicator for assessing the relative safety of hospital care using a cross-sectional approach.

PubMed

Panesar, Sukhmeet S; Netuveli, Gopalakrishnan; Carson-Stevens, Andrew; Javad, Sundas; Patel, Bhavesh; Parry, Gareth; Donaldson, Liam J; Sheikh, Aziz

2013-11-21

The Orthopaedic Error Index for hospitals aims to provide the first national assessment of the relative safety of provision of orthopaedic surgery. Cross-sectional study (retrospective analysis of records in a database). The National Reporting and Learning System is the largest national repository of patient-safety incidents in the world with over eight million error reports. It offers a unique opportunity to develop novel approaches to enhancing patient safety, including investigating the relative safety of different healthcare providers and specialties. We extracted all orthopaedic error reports from the system over 1 year (2009-2010). The Orthopaedic Error Index was calculated as a sum of the error propensity and severity. All relevant hospitals offering orthopaedic surgery in England were then ranked by this metric to identify possible outliers that warrant further attention. 155 hospitals reported 48 971 orthopaedic-related patient-safety incidents. The mean Orthopaedic Error Index was 7.09/year (SD 2.72); five hospitals were identified as outliers. Three of these units were specialist tertiary hospitals carrying out complex surgery; the remaining two outlier hospitals had unusually high Orthopaedic Error Indexes: mean 14.46 (SD 0.29) and 15.29 (SD 0.51), respectively. The Orthopaedic Error Index has enabled identification of hospitals that may be putting patients at disproportionate risk of orthopaedic-related iatrogenic harm and which therefore warrant further investigation. It provides the prototype of a summary index of harm to enable surveillance of unsafe care over time across institutions. Further validation and scrutiny of the method will be required to assess its potential to be extended to other hospital specialties in the UK and also internationally to other health systems that have comparable national databases of patient-safety incidents.

The Core Competencies for General Orthopaedic Surgeons.

PubMed

Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R

2017-01-18

With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These competencies provide many stakeholders, including orthopaedic educators and orthopaedists, with what may be the minimum knowledge and competencies necessary to deliver acute and general orthopaedic care. This document is the first step in defining a practice-based standard for training programs and certification groups.

The case for orthopaedic medicine in Israel

PubMed Central

2013-01-01

Background Musculoskeletal complaints are probably the most frequent reasons for visiting a doctor. They comprise more than a quarter of the complaints to primary practitioners and are also the most common reason for referral to secondary or tertiary medicine. The clinicians most frequently consulted on musculoskeletal problems, and probably perceived to know most on the topic are orthopaedic surgeons. But in Israel, there is significant ambivalence with various aspects of the consultations provided by orthopaedic surgeons, both among the public and among various groups of clinicians, particularly family practitioners and physiotherapists. Methods In order to understand this problem we integrate new data we have collected with previously published data. New data include the rates of visits to orthopaedic surgeons per annum in one of Israel’s large non-profit HMO’s, and the domains of the visits to an orthopaedic surgeon. Results Orthopaedic surgeons are the third most frequently contracted secondary specialists in one of the Israeli HMO’s. Between 2009 and 2012 there was a 1.7% increase in visits to orthopaedists per annum (P < 0.0001, after correction for population growth). Almost 80% of the domains of the problems presented to an orthopaedic surgeon were in fields orthopaedic surgeons have limited formal training. Discussion While orthopaedic surgeons are clearly the authority on surgical problems of the musculoskeletal system, most musculoskeletal problems are not surgical, and the orthopaedic surgeon often lacks training in these areas which might be termed orthopaedic medicine. Furthermore, in Israel and in many other developed countries there is no accessible medical specialty that studies these problems, trains medical students in the subject and focuses on treating these problems. The neglect of this area which can be called the “Orthopaedic Medicine Lacuna” is responsible for inadequate treatment of non-surgical problems of the musculoskeletal system with immense financial implications. We present a preliminary probe into possible solutions which could be relevant to many developed countries. PMID:24245773

Medical School Experiences Shape Women Students' Interest in Orthopaedic Surgery.

PubMed

O'Connor, Mary I

2016-09-01

Orthopaedic surgery now has the lowest percentage of women in residency programs of any surgical specialty. Understanding factors, particularly those related to the medical school experience, that contribute to the specialty's inability to draw from the best women students is crucial to improving diversity in the profession. (1) Does required medical school exposure to orthopaedic surgery increase the proportion of women choosing the specialty? (2) Do negative perceptions deter women from choosing orthopaedic surgery? (3) What proportion of orthopaedic faculty members are women, and what proportion of residents are women? (4) To what degree has gender bias been identified in the application/interview process? Two PubMed searches of articles between 2005 and 2015 were performed using a combination of medical subject headings. The first search combined "Orthopaedics" with "Physicians, women" and phrases "women surgeons" or "female surgeons" and the second combined "Orthopedics" with "Internship & Residency" or "exp Education, Medical" and "Sex Ratio" or "Sex Factors", resulting in 46 publications of which all abstracts were reviewed resulting in 11 manuscripts that were related to the research questions. The Google Scholar search of "women in orthopaedic surgery" identified one additional publication. These 12 manuscripts were read and bibliographies of each reviewed with two additional publications identified and included. Required exposure to orthopaedics was found to be positively associated with the number of women applicants to the field, whereas negative perceptions have been reported to deter women from choosing orthopaedic surgery. Orthopaedics has the lowest percentage of women faculty and women residents (14%) compared with other specialties; this suggests that same gender mentorship opportunities are limited. For women applying to orthopaedics, gender bias is most evident through illegal interview questions, in which women are asked such questions more often than men (such as family planning questions, asked to 61% of women versus 8% of men). Successful recruitment of women to orthopaedic surgery may be improved by early exposure and access to role models, both of which will help women students' perceptions of their role in field of orthopaedic surgery.

(Mis)perceptions about intimate partner violence in women presenting for orthopaedic care: a survey of Canadian orthopaedic surgeons.

PubMed

Bhandari, Mohit; Sprague, Sheila; Tornetta, Paul; D'Aurora, Valerie; Schemitsch, Emil; Shearer, Heather; Brink, Ole; Mathews, David; Dosanjh, Sonia

2008-07-01

Domestic violence is the most common cause of nonfatal injury to women in North America. In a review of 144 such injuries, the second most common manifestation of intimate partner violence was musculoskeletal injuries (28%). The American Academy of Orthopaedic Surgeons is explicit that orthopaedic surgeons should play a role in the screening and appropriate identification of victims. We aimed to identify the perceptions, attitudes, and knowledge of Canadian orthopaedic surgeons with regard to intimate partner violence. We surveyed members of the Canadian Orthopaedic Association to identify attitudes toward intimate partner violence. With use of a systematic random sample, 362 surgeons were mailed questionnaires. The questionnaire consisted of three sections: (1) the general attitude of the orthopaedic surgeon toward intimate partner violence, (2) the attitude of the orthopaedic surgeon toward victims and batterers, and (3) the clinical relevance of intimate partner violence in orthopaedic surgery. Up to three follow-up mailings were performed to enhance response rates. A total of 186 orthopaedic surgeons responded (a response rate of 51%), and 167 (91%) of them were men. Most orthopaedic surgeons (95%) estimated that <10% of their patients were victims of intimate partner violence, and most respondents (80%) believed that it was exceedingly rare (a prevalence of <1%). The concept of mandatory screening for intimate partner violence was met with uncertainty by 116 surgeons (64%). Misconceptions were perpetuated by surgeons who believed that inquiring about intimate partner violence was an invasion of the victim's privacy, that investigating intimate partner violence was not part of their duty, that victims choose to be a victim, and that victims play a proactive role in causing their abuse. By the completion of the survey, the majority of surgeons (91%) believed that knowledge about intimate partner violence was relevant to their surgical practice. Discomfort with the issue and lack of education have led to misconceptions among Canadian orthopaedic surgeons about intimate partner violence. The relevance of intimate partner violence to surgical practice is well understood, but studies regarding its prevalence are needed as a first step to change the current paradigm in orthopaedic surgery.

Short-term effect of back school based on cognitive behavioral therapy involving multidisciplinary collaboration.

PubMed

Motoya, Ryo; Otani, Koji; Nikaido, Takuya; Ono, Yoko; Matsumoto, Takatomo; Yamagishi, Ryohei; Yabuki, Shoji; Konno, Shin-Ichi; Niwa, Shin-Ichi; Yabe, Hirooki

2017-08-09

ObjectivesThe purpose of this study was to develop a comprehensive back school program that included elements of CBT (Cognitive Behavioral Therapy), implement this through multidisciplinary collaboration, and ascertain its effectiveness as a pilot study. DesignThis school was implemented in the form of five 90-minute group sessions held every other week.MethodsParticipants comprised 7 chronic low back pain patients with poor improvement in the usual treatment. Practitioners were orthopaedic surgeon, physical therapist, and a clinical psychologist. This school contents were patient education, self-monitoring, back exercise, relaxation, stress management, cognitive restructuring, activity pacing, and exposure. ResultsFrom the Wilcoxon signed-rank test, each score of four scales or items (sense of control, PCS (pain catastrophizing), PASS-20 (escape/avoidance), FFD (finger-floor distance)) after this program significantly improved. Results of calculating the effect size, sense of control (d=0.55) is 'moderate', the PCS (d=1.12) and the PASS-20 (d=1.64) were 'large'.ConclusionsThis back school may be useful for physical function and psychological variables which much related to pain management and daily disabilities in patients with poor respond to standard orthopaedic treatment.

Utah Educational Quality Indicators. The Sixth in the Report Series: "How Good Are Utah Public Schools." Executive Summary.

ERIC Educational Resources Information Center

Nelson, David E.

For nearly 20 years, Utah's Office of Education has been systematically monitoring the academic performance and other characteristics of Utah's students. This executive summary, an overview of the sixth major report since 1967, examines several measures describing educational quality in Utah schools. The first section covers students' achievement…

76 FR 69296 - University of Utah, University of Utah TRIGA Nuclear Reactor, Notice of Issuance of Renewed...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... NUCLEAR REGULATORY COMMISSION [Docket No. 50-407, NRC-2011-0153] University of Utah, University of Utah TRIGA Nuclear Reactor, Notice of Issuance of Renewed Facility Operating License No. R-126 AGENCY... University of Utah (UU, the licensee), which authorizes continued operation of the UU TRIGA Nuclear Reactor...

78 FR 62646 - Endangered and Threatened Wildlife and Plants; Permits; Low-Effect Habitat Conservation Plan for...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-22

... the Utah Prairie Dog in Garfield County, Utah AGENCY: Fish and Wildlife Service, Interior. ACTION... Draft Low-effect Habitat Conservation Plan (HCP) for the Utah prairie dog in Garfield County, Utah, for... review and comment of the Draft Low-effect Habitat Conservation Plan for the Utah prairie dog in Garfield...

Orthopaedics in Germany under the influence of National-Socialist healt-politic in the years 1933-1945.

PubMed

von Grabowski, Michał T W

2015-01-01

In the paper the health-care of physically disabled patients in Germany before, during and after the II world war are discussed. The circumstances of introduction of "Racial-Hygiene" - laws and orthopedic indications for the sterilization and euthanasia are described. Patients with severe physical and mental disabilities were potential candidates for annihilation. The tragic fate of jewish physicians is remembered. The activity of board of the German Orthopeadic Society (DOG) in the years 1933-1945 is described and critically analysed.

Jean-Louis Petit (1674-1750): a pioneer anatomist and surgeon and his contribution to orthopaedic surgery and trauma surgery.

PubMed

Markatos, Konstantinos; Androutsos, Georgios; Karamanou, Marianna; Tzagkarakis, Georgios; Kaseta, Maria; Mavrogenis, Andreas

2018-05-11

The purpose of this review is to summarize the life and work of Jean-Louis Petit, his inventions, his discoveries, and his impact on the evolution of surgery of his era. A thorough search of the literature was undertaken in PubMed and Google Scholar as well as in physical books in libraries to summarize current and classic literature on Petit. Jean-Louis Petit (1674-1750) was an eminent anatomist and surgeon of his era with an invaluable contribution to clinical knowledge, surgical technique, and instrumentation as well as innovative therapeutic modalities and basic scientific discoveries. Jean-Louis Petit was an innovative anatomist and surgeon as well as an excellent clinician of his era. He revolutionized the surgical technique of his era with a significant contribution to what would later become orthopaedic surgery.

The Development of an Integrated Science Core Curriculum for Allied Health Students

ERIC Educational Resources Information Center

Sesney, John; And Others

1977-01-01

The article describes the development of BioMedical Sciences Core at Weber State College in Ogden, Utah for introductory level allied health students. The design of the "Core" curriculum is to integrate the disciplines of physics, chemistry, anatomy, physiology, and microbiology as they relate to the human body rather than teaching the traditional…

An Intensive Hubble Space Telescope Survey for z>1 Type Ia Supernovae by

Science.gov Websites

Targ SAO/NASA ADS Astronomy Abstract Service Title: An Intensive Hubble Space Telescope Survey Physics and Astronomy, University of Utah, Salt Lake City, UT 84112, USA; E. O. Lawrence Berkeley National , Clinton, NY 13323, USA), AH(National Optical Astronomy Observatory, Tucson, AZ 85726-6732, USA), AI

Walkable Route Perceptions and Physical Features: Converging Evidence for En Route Walking Experiences

ERIC Educational Resources Information Center

Brown, Barbara B.; Werner, Carol M.; Amburgey, Jonathan W.; Szalay, Caitlin

2007-01-01

Guided walks near a light rail stop in downtown Salt Lake City, Utah, were examined using a 2 (gender) x 3 (route walkability: low-mixed-, or high-walkability features) design. Trained raters confirmed that more walkable segments had more traffic, environmental, and social safety; pleasing aesthetics; natural features; pedestrian amenities; and…

Reducing Ethnic Stereotypes among Adolescents with a Cultural Approach to World Geography.

ERIC Educational Resources Information Center

Johnson, Phaedra Lynn

The purpose of this study was to implement a curriculum that emphasized a cultural approach rather than a physical approach to World Geography. Through the implementation of this curriculum at Kearns Junior High School (Kearns, Utah), the students developed a broader understanding of diverse cultures. The project involved 62 ninth graders, and was…

The Nation's Report Card Science 2009 State Snapshot Report. Utah. Grade 8, Public Schools

ERIC Educational Resources Information Center

National Center for Education Statistics, 2011

2011-01-01

Guided by a new framework, the NAEP science assessment was updated in 2009 to keep the content current with key developments in science, curriculum standards, assessments, and research. The 2009 framework organizes science content into three broad content areas. Physical science includes concepts related to properties and changes of matter, forms…

Levels of Evidence in Orthopaedic Trauma Literature.

PubMed

Scheschuk, Joseph P; Mostello, Andrew J; Lombardi, Nicholas J; Maltenfort, Mitchell G; Freedman, Kevin B; Tjoumakaris, Fotios P

2016-07-01

To review and critically assess trends observed regarding the levels of evidence in published articles in orthopaedic traumatology literature. The Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery-American, and Clinical Orthopaedics and Related Research. All articles from the years 1998, 2003, 2008, and 2013 in The Journal of Orthopaedic Trauma (JOT) and orthopaedic trauma-related articles from The Journal of Bone and Joint Surgery-American (JBJS-A) and Clinical Orthopaedics and Related Research (CORR) were analyzed. Articles were categorized by type and ranked for level of evidence according to guidelines from the Centre for Evidence-Based Medicine. Study type and standardized level of evidence were determined for each article. Articles were subcategorized as high-level evidence (I, II), moderate-level evidence (III), and low-level evidence (IV, V). During the study period, Journal of Bone and Joint Surgery-American reduced its low-level studies from 80% to 40% (P = 0.00015), Clinical Orthopaedics and Related Research decreased its low-level studies from 70% to 27%, and Journal of Orthopaedic Trauma decreased its low-level studies from 78% to 45%. Level IV and V therapeutic, prognostic, and diagnostic studies demonstrated significant decreases during the study period (P = 0.0046, P < 0.0001, P = 0.026). The percentage of high-level studies increased from 13% to 19%; however, this was not significant (P = 0.42). There was a trend showing an increase in level I and II studies for therapeutic, prognostic, and diagnostic studies (P = 0.06). There has been a statistically significant decrease in lower level of evidence studies published in the orthopaedic traumatology literature over the past 15 years.

Patient Perceptions of Athletic Trainers and Orthopaedic Medical Residents as Primary Clinical Support Staff in Sports Medicine Practice: A Randomized, Double-Blinded Prospective Survey.

PubMed

Pecha, Forrest Q; Nicolello, Timothy S; Xerogeanes, John W; Karas, Spero; Labib, Sameh A

2015-01-01

Orthopaedic sports medicine practices utilize a variety of healthcare professionals to assist physicians in the clinic. The purpose of this study was to investigate patients' perception of orthopaedic knowledge and clinical care provided by orthopaedic medical residents and athletic trainers (ATs). ATs will be perceived similarly to orthopaedic medical residents in overall patient care and perceived education level. Randomized, double-blind survey. 2. New patients were randomly selected to receive the survey to complete during an office visit. The survey included 8 questions which rated the patient's perceived level of orthopaedic knowledge and level of patient care provided by the AT and orthopaedic medical residents. A total of 110 surveys were collected during the 2-year study period. The data were analyzed using a multivariate analysis of variance (MANOVA). The multivariate effect (Pillai's trace) was not significant between clinicians, F(8,111)=0.122, p=0.695, partial η2=0.106. Univariate tests showed a significance between patient perceived level of clinician education, F(1,118)=5.361, p=0.632, partial η2=0.043. Univariate test showed no significant differences on any other dependent variables. There is no evidence that patients' perception is different when comparing ATs and orthopaedic medical residents in orthopaedic knowledge and clinical care. Although a statistically significant difference was found in the perceived highest level of education attained, orthopaedic medical residents and ATs were each perceived to have a master's degree level of education. Physicians should continue to use ATs in their practices.

Multi-investigator collaboration in orthopaedic surgery research compared to other medical fields.

PubMed

Brophy, Robert H; Smith, Matthew V; Latterman, Christian; Jones, Morgan H; Reinke, Emily K; Flanigan, David C; Wright, Rick W; Wolf, Brian R

2012-10-01

An increasing emphasis has been placed across health care on evidence-based medicine with higher level studies, such as randomized trials and prospective cohort studies. Historically, clinical research in orthopaedic surgery has been dominated by studies with low patient numbers from a limited number of surgeons. The purpose of this study was to test our hypothesis that orthopaedics has fewer multi-center collaborative studies as compared to other medical disciplines. We chose three leading journals from general medicine, a leading journal from the surgical subspecialties of obstetrics and gynecology, ophthalmology and otolaryngology, and three leading journals from orthopaedic surgery based on highest impact factor. We compared the percentage of collaborative studies and the number of contributing institutions and authors in original research manuscripts published in 2009 between general medical, surgical subspecialty and orthopaedic surgery journals. A significantly higher percentage of manuscripts resulted from multicenter collaborative efforts in the general medical literature (p < 0.000001) and the other surgical subspecialty literature (p < 0.000001) compared to the orthopaedic surgery literature. Manuscripts published in the general medical journals came from more institutions (p < 0.0001) and had significantly more authors (p < 0.000001) than those published in the orthopaedic surgery journals. There is an opportunity to stimulate greater multicenter collaborative research, which correlates with increased patient numbers, a higher level of evidence and more generalizable findings, in the orthopaedic surgery community. These efforts can be supported through increased funding, surgeon participation, and appropriate expansion of authorship for multicenter studies in orthopaedic journals. Copyright © 2012 Orthopaedic Research Society.

New design of care: Assessment of an interdisciplinary orthopaedic clinic with a pivot nurse in the province of Quebec.

PubMed

Poder, Thomas G; Bellemare, Christian; Bédard, Suzanne K; He, Jie; Lemieux, Renald

2010-01-01

New designs of care in orthopaedic clinics are needed to cope with the shortage of orthopaedic surgeons and the lengthening of waiting times. To assess the effectiveness of an interdisciplinary orthopaedic clinic with a pivot nurse in the Canadian province of Quebec with regard to accessibility, quality of care, efficacy and efficiency of the clinic, and patient's quality of life. Two strategies were developed: (1) a selected cohort of new patients attending an orthopaedic service from February to September 2008 were entered into a database recording patient details, source of referral, diagnosis, satisfaction, and quality of life (36-Item Short Form Health Survey version 2). In this setting, 2 sets of questionnaires were administered to the patients: the first one during the first visit and the second one, 2 months later. A total of 243 patients from the case control were compared with 89 patients of the case study, where an interdisciplinary orthopaedic clinic with a pivot nurse has been developed; (2) costs per patient were calculated using the staff timesheets provided by the two orthopaedic clinics. The results showed a significant reduction in the waiting-list duration (accessibility) in the case study clinic owing to a strong decrease in the inappropriate consultations with the orthopaedic consultant. The quality of care remained high, and the target surgeries for total hip and knee replacement were reached, despite a strong shortage of orthopaedic doctors. Interdisciplinary orthopaedic clinic with a pivot nurse is a new approach in the province of Quebec and first results are encouraging.

Orthopaedic research and education foundation and industry.

PubMed

Wurth, Gene R; Sherr, Judy H; Coffman, Thomas M

2003-07-01

Members of orthopaedic industry commit a significant amount of funds each year to support research and education programs that are directly related to their product(s). In addition, industry supports organizations such as the Orthopaedic Research and Education Foundation. The relationship between the Orthopaedic Research and Education Foundation and industry began in the early 1980s. The support to the Orthopaedic Research and Education Foundation from industry primarily has come in the form of unrestricted grants. These grants best can be looked at as an investment rather than a contribution. This form of giving, once called corporate philanthropy is more accurately referred to as strategic philanthropy. Members of industry make these investments to enhance their reputations, build brand awareness, market their products and services, improve employee morale, increase customer loyalty, and establish strategic alliances. The specialty of orthopaedics is among the leaders in medicine in the amount of funding raised within the specialty for research and education programs. This is because of the amount of support from members of industry and the surgeons. During the past 15 years, 40% of the annual support to the Orthopaedic Research and Education Foundation has come from industry and the balance has come from surgeons and members of lay public. Future industry support of the Orthopaedic Research and Education Foundation and other organizations within the specialty of orthopaedics will be dependent on the continued demonstration of tangible returns in areas described.

The orthopaedic workforce in Queensland now and into the twenty-first century.

PubMed

Licina, P; McGuire, T P

1993-06-01

The objectives of this study were to determine the number and distribution of orthopaedic surgeons in Queensland at present and to assess the adequacy of trainee intake for the future. Characteristics of the orthopaedic workforce in Queensland in 1990 were analysed with regard to the total number of orthopaedic surgeons, their regional distribution, their ratio to the population and their age distribution. Similar statistics were derived for the years 1981 and 1986 and trends were examined. By projecting these trends, the number of surgeons likely to be practising in 2001 was estimated. Using projected population figures, the number of orthopaedic surgeons required in 2001 was calculated, assuming an optimum ratio of surgeons to population of one per 25,000. It was found that in 1990 sufficient orthopaedic surgeons were practising in Queensland but that there was some maldistribution. With the increased intake of five new training registrars per year, the number of orthopaedic surgeons in Queensland in 2001 should be appropriate, as long as current trends continue.

Are cost differences between specialist and general hospitals compensated by the prospective payment system?

PubMed

Longo, Francesco; Siciliani, Luigi; Street, Andrew

2017-10-23

Prospective payment systems fund hospitals based on a fixed-price regime that does not directly distinguish between specialist and general hospitals. We investigate whether current prospective payments in England compensate for differences in costs between specialist orthopaedic hospitals and trauma and orthopaedics departments in general hospitals. We employ reference cost data for a sample of hospitals providing services in the trauma and orthopaedics specialty. Our regression results suggest that specialist orthopaedic hospitals have on average 13% lower profit margins. Under the assumption of break-even for the average trauma and orthopaedics department, two of the three specialist orthopaedic hospitals appear to make a loss on their activity. The same holds true for 33% of departments in our sample. Patient age and severity are the main drivers of such differences.

Ecological studies of a regulated stream: Huntington River, Emery County, Utah

DOE Office of Scientific and Technical Information (OSTI.GOV)

Winget, R.N.

1984-04-30

A 36.9 x 10/sup 6/ m/sup 3/ reservoir constructed on Huntington River, Emery County, Utah, resulted in changes in physical habitat, water quality, temperature, and flow regime. The greatest changes in physical habitat resulted from: (1) sediment additions from dam and road construction plus erosion of reservoir basin during filling; and (2) changing stream flow from a spring high runoff regime to a moderated flow regime. Elimination of spring nutrient concentration peaks and overall reduction of total dissolved nutrient availability in the river plus moderate reductions in pH were the most apparent water quality changes below the reservoir. Water temperaturemore » changes were an increased diurnal and seasonal constancy, summer depression, and winter elevation, generally limited to a 10-12 km reach below the dam. Physical and chemical changes altered macroinvertebrate community structure, with changes greatest near the dam and progressively less as distance downstream increased. Below the dam: (1) more environmentally tolerant taxa increased their dominance; (2) relative numbers of smaller sized individuals increased in relation to larger individuals; and (3) filter feeding, collector/gatherers, and scapers gained an advantage over shredders. Macroinvertebrate taxa with small instar larvae present from late summer to early fall were negatively impacted by the unnaturally high July and August flows. The reservoir became a physical barrier to downstream larval drift and upcanyon and downcanyon immigration of adults, resulting in reduced numbers of several species above and below the reservoir. 50 references, 12 figures, 3 tables.« less

The impact of sport on health status, psychological well-being and physical performance of adults with haemophilia.

PubMed

von Mackensen, S; Harrington, C; Tuddenham, E; Littley, A; Will, A; Fareh, M; Hay, C R M; Khair, K

2016-07-01

There is increasing recognition that sport is important for individuals with haemophilia; however, there remains a paucity of data of the importance of this in adults, many of whom already have joint pathology related to childhood bleeds and treatment access. This multicentre, cross-sectional study presents the impact of sport on health-related quality of life (HRQoL), physical performance and clinical outcomes in adults with haemophilia. Fifty adults aged 35.12±14.7 with mild (n = 12), moderate (n = 10), or severe (n = 28) haemophilia A (70%) or B (30%) from four haemophilia centres across the United Kingdom participated in the study. A total of 64% were overweight/obese according to their BMI; median orthopaedic joint scores using the WFH Orthopaedic Joint Score (OJS) were 6 (range 0-48). On a VAS pain scale (range of 0-10), patients reported mean score of 5.66 ± 2.4. 36% of participants reported not doing any sport, mainly due to their physical condition. However, 64% of participants reported undertaking sporting activity including contact sports, mostly twice per week in average 4 h week(-1) . Participating in sport did not have a statistically significant impact on HRQoL; except in the domain 'sport and leisure' of the Haem-A-QoL. Patients doing more sport reported significantly better HRQoL than those doing less sport (P < 0.005). Those doing sport for more than 4 h week(-1) had a significantly better physical performance than patients doing less sport (assessed with Hep-Test-Q). Encouraging physical activity and sport in older patients with haemophilia may have a direct impact on their HRQoL; thus, education about sport activity should be incorporated into routine haemophilia care. © 2016 John Wiley & Sons Ltd.

Complementary and alternative medicine use amongst Malaysian orthopaedic oncology patients.

PubMed

Dhanoa, Amreeta; Yong, Tze Lek; Yeap, Stephanie Jin Leng; Lee, Isaac Shi Zhung; Singh, Vivek Ajit

2014-10-17

Although studies have shown that a large proportion of cancer patients use CAM, no study on CAM use amongst orthopaedic oncology patients has been published. Therefore, this study aims to determine the prevalence, characteristics and factors associated with CAM use amongst orthopaedic oncology patients. All consecutive consenting patients/parents who presented at the Orthopaedic Oncology Clinic, University Malaya Medical Centre (1st January to 31st December 2013) were interviewed using a structured questionnaire. Overall, one hundred sixty-eight of the 274 patients recruited (61.3%) had used CAM at some time during their current illness. The prevalence of CAM used was 68% (123/181) for patients with malignant tumours and 48.4% (45/93) for patients with benign tumours. The most popular CAMs were biological-based therapies (90.5%), followed by mind-body techniques (40.5%). The most frequently used biological therapies were mega/multivitamins (31%), snakehead (Chana striatus) (28%) and sea cucumber (Stichopus horrens) (18%); whereas prayers (31%) and holy water (13%) dominated the mind-body category. Common reasons for CAM use were to improve physical well-being (60.1%), try out everything that would help (59.5%) and to enhance wound-healing (39.3%). Independent predictors for CAM use in multivariate analysis were paediatric patients [OR 2.46; 95% CI 0.99-6.06; p = 0.05], malignant tumours [OR 1.90; 95% CI 1.12-3.25; p = 0.018] and patients who underwent surgery [OR 2.06; 95% CI 1.15-3.69; p = 0.015]. Majority patients started taking CAMs following suggestions from family members (53%) and friends (49%). Sixty-six percent of patients felt they actually benefitted from CAM and 83.3% were satisfied/very satisfied. Only 5 patients reported side-effects. Majority of CAM users planned to continue CAM use or recommend it to others. However, only 31.5% of patients disclosed their CAM usage to their doctors. This survey revealed a high prevalence of CAM usage amongst orthopaedic oncology patients, with majority patients expressing satisfaction towards CAM. Oncologists should proactively ask patients about CAM to prevent potential adverse effects, as most patients do not share this information with them.

Utah State University's T2 ODV mobility analysis

NASA Astrophysics Data System (ADS)

Davidson, Morgan E.; Bahl, Vikas; Wood, Carl G.

2000-07-01

In response to ultra-high maneuverability vehicle requirements, Utah State University (USU) has developed an autonomous vehicle with unique mobility and maneuverability capabilities. This paper describes a study of the mobility of the USU T2 Omni-Directional Vehicle (ODV). The T2 vehicle is a mid-scale (625 kg), second-generation ODV mobile robot with six independently driven and steered wheel assemblies. The six wheel, independent steering system is capable of unlimited steering rotation, presenting a unique solution to enhanced vehicle mobility requirements. This mobility study focuses on energy consumption in three basic experiments, comparing two modes of steering: Ackerman and ODV. The experiments are all performed on the same vehicle without any physical changes to the vehicle itself, providing a direct comparison these two steering methodologies. A computer simulation of the T2 mechanical and control system dynamics is described.

Women in Orthopaedic Fellowships: What Is Their Match Rate, and What Specialties Do They Choose?

PubMed

Cannada, Lisa K

2016-09-01

Orthopaedic fellowship training is a common step before becoming a practicing orthopaedic surgeon. In the past, fellowship decisions in orthopaedics were made early in the residency and without a formal match. The process was disorganized, often not fair to the applicants or fellowship programs. More recently, there has been an organized match process for nine different disciplines in orthopaedics. Although the numbers of women applicants into orthopaedic residency has been reported and is the target of efforts to continue to improve gender diversity in orthopaedics, the numbers regarding women in orthopaedic fellowships have not been known. Other details including if there is a difference in match rate between male and female fellowship applicants and what discipline they choose to pursue across orthopaedic surgery has not been reported. (1) How have the numbers of women applying to orthopaedic fellowships changed over a 5-year period? (2) Is gender associated with fellowship match success? (3) Which subspecialties have greater proportions of female applicants? Available orthopaedic residency match data regarding number of applicants and number of female residents between 2010 and 2014 were obtained. For fellowship data, our method was a review of the applicants who submitted rank lists and the number of applicants who matched in all subspecialties through San Francisco Match and from the American Shoulder and Elbow Society from 2010 to 2014. For each year, the number of females versus males applying was abstracted. The total number of females versus males who matched was then obtained. For each subspecialty represented in this article, the number of female applicants and matches was compared with the male applicants and matches. The proportion of fellowship applicants who are female ranged from 7% to 10% annually, and the percentage of matched female applicants ranged from 8% to 12%. Overall, combining results from 2010 to 2014, female fellowship applicants had a higher proportion of match success when compared with men (women: 320 of 335 [96%]; men: 2696 of 3325 [81%]; p < 0.001). Pediatric orthopaedic fellowships had the highest proportion of women (79 of 318 [25%] followed by foot and ankle (42 of 311 [14%]; spine had the lowest (15 of 525 [3%]). Women applicants for advanced orthopaedic training matched at a higher proportion than men in fellowship training. Pediatrics has a higher proportion of women applicants and fellows. Orthopaedics should be a model for other surgical specialties by encouraging women to successfully pursue advanced training.

Plug in to the Utah Library Network, Reach Out to the World. Utah Library Network and Internet Training Handbook [for DOS]. Information Forum Publication #7.

ERIC Educational Resources Information Center

Reinwand, Louis; And Others

This manual is designed to assist public libraries in Utah in their use of the Internet. Many of the examples used were created specifically to explain the use of products that the Utah Library Network provides for public libraries in Utah. The introduction provides background history and general information about the Internet and general…

Experimental Tests of Micro-concretion Nucleation in Porous Media: A Laboratory Analog for Formation of Hematite Concretions on Mars

NASA Astrophysics Data System (ADS)

Barge, L. M.; Petruska, J.

2009-04-01

We present the results of diffusion experiments in combined glass bead and gel media that produced silver chromate precipitates under a variety of conditions. Precipitates took various forms including finger fluid fronts, rhythmic (Liesegang) bands, and mm-size spheroidal "concretions". The silver chromate spherules produced in our experiments are morphologically similar to spheroidal HFO "mini-concretions" that are commonly found in the Jurassic Navajo Sandstone, Utah (USA), which are considered a terrestrial analog for the hematite concretions ("blueberries") discovered at Meridiani Planum, Mars (Chan et al. 2004, Nature). Like the Utah and Martian concretions, the spherules formed in our experiments exhibit a self-organized distribution, lack of an obvious macro nucleus, and ability to form "twin" morphologies. In all cases, the spheroidal precipitates nucleated under diffusion-controlled conditions, and some growth occurred although advection was not present. Other forms of precipitate such as periodic banding and fluid fronts were produced in our experiments as well, which also resemble types of iron mineral precipitation that are observed in the Navajo Sandstone, although thus far only spheroidal self-organized precipitates are seen on Mars. The presence of self-organized precipitates in the Utah and Martian environments most likely resulted from nucleation in a diffusion-controlled environment, and the specific morphology of iron oxide precipitates in porous and permeable systems is likely determined by chemical and physical parameters of the fluid environment in which they precipitated. Although the chemical conditions in our precipitation experiments are obviously very different from what would be expected in the Navajo Sandstone or on Mars, we show in this work how the morphology of self-organized mineral precipitates in a porous/permeable medium is affected by specific physical and chemical parameters.

Proteomic Analysis of Trauma-Induced Heterotopic Ossification Formation

DTIC Science & Technology

2016-10-01

60% of these patients go on to form abnormal bone within the soft tissue of their injured limbs. This condition, known as Heterotopic Ossification... psychological and physical damage sustained as a result of multiple orthopaedic surgical procedures. As a result, the effort, time, and cost of wounded...third year of this research project has continued to integrate productive and complementary activities across four distinct campuses. Critical

Agreement between a physiotherapist and an orthopaedic surgeon regarding management and prescription of corticosteroid injection for patients with shoulder pain.

PubMed

Marks, Darryn; Comans, Tracy; Thomas, Michael; Ng, Shu Kay; O'Leary, Shaun; Conaghan, Philip G; Scuffham, Paul A; Bisset, Leanne

2016-12-01

Physiotherapists increasingly manage shoulder referrals in place of orthopaedic doctors. Better understanding the agreement between these professionals will help inform the safety, quality and potential costs of these care models. To establish the level of agreement between a physiotherapist and an orthopaedic surgeon regarding diagnosis, management and corticosteroid injection, in a representative sample of orthopaedic shoulder referrals. Blinded inter-rater agreement study. 274 public orthopaedic shoulder patients were independently assessed by a physiotherapist and an orthopaedic surgeon. Management, subacromial corticosteroid injection, diagnosis and investigation decisions were compared using inter-rater reliability statistics. Agreement between the physiotherapist and the orthopaedic surgeon was near perfect for surgical versus nonsurgical management (Gwets agreement coefficient AC1 = 0.93, 95%CI: 0.90-0.93), safety of injection (AC1 = 0.85, CI: 0.79-0.91) and investigations requested (AC1 = 0.87, CI: 0.83-0.91); substantial for the presence of subacromial pain (AC1 = 0.74, CI: 0.66-0.81) and diagnosis (AC1 = 0.72, CI: 0.66-0.78); and moderate regarding delivery of subacromial corticosteroid injection as an immediate treatment (AC1 = 0.48, CI 0.33-0.53), with the physiotherapist less inclined to select corticosteroid injection as the first intervention. In this study a physiotherapist with prescribing and injection training made decisions analogous to those of an orthopaedic surgeon at initial consultation for orthopaedic shoulder pain, including the safe identification of patients for subacromial injection, without prior screening of referrals by orthopaedic doctors. Australia and New Zealand Clinical Trials Registry, number 12612000532808. Copyright © 2016 Elsevier Ltd. All rights reserved.

International patients on operation vacation – perspectives of patients travelling to Hungary for orthopaedic treatments

PubMed Central

Kovacs, Eszter; Szocska, Gabor; Knai, Cécile

2014-01-01

Background: The importance of cross-border healthcare, medical and health tourism plays a significant role in the European health policy and health management. After dentistry, orthopaedic treatments are the leading motivation for seeking care in Hungary, as patients with rheumatic and motion diseases are drawn to the thermal spas and well-established orthopaedic centres. This paper aims to gain insight into foreign patients’ perspectives on their experience of having sought medical tourism in orthopaedic care in Hungary. Methods: A patient survey was conducted in 2012 on motivations for seeking treatment abroad, orthopaedic care received and overall satisfaction. In addition, health professionals’ interviews, and 17 phone interviews were conducted in 2013 with Romanian patients who had orthopaedic treatment in Hungary. Finally, medical records of foreign patients were analysed. Results: The survey was completed by 115 participants – 61.1% females, mean age= 41.9, 87% Romanian origin. Most of the patients came to Hungary for orthopaedic surgeries, e.g. arthroscopy, knee/hip prosthesis or spinal surgery. 72.6% chose Hungary because of related to perceived better quality and longstanding culture of Hungarian orthopaedic care. Over 57% of patients reported being ‘very satisfied’ with care received and 41.6% ‘satisfied’. The follow-up interviews further reflected this level of satisfaction, therefore many respondents stating they have already recommended the Hungarian healthcare to others. Conclusion: Based on the findings, patients from neighbouring regions are increasingly seeking orthopaedic care in Hungary. Patients having orthopaedic care are highly satisfied with the quality of care, the whole treatment process from the availability of information to discharge summaries and would consider returning for further treatments. PMID:25396209

Cost-Effectiveness Analysis of the Residential Provisions of the 2015 IECC for Utah

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mendon, Vrushali V.; Zhao, Mingjie; Taylor, Zachary T.

The 2015 IECC provides cost-effective savings for residential buildings in Utah. Moving to the 2015 IECC from the 2012 Utah State Code base code is cost-effective for residential buildings in all climate zones in Utah.

Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery.

PubMed

Ó Mír, M; O'Sullivan, C

2018-02-01

One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services. There is a gap in the literature with regard to APP in paediatric orthopaedics. In this review, we investigate demands on paediatric orthopaedic services, examine the literature regarding APP in paediatric orthopaedics and explore the value the role has to offer current outpatient services. Paediatric orthopaedic services are under-resourced with concurrent long wait times. Approximately 50% of referrals are for normal variants, which do not require specialist intervention. Poor musculoskeletal examination skills and low diagnostic confidence amongst primary care physicians have been identified as a cause of inappropriate referrals. APP clinics for normal variants have reported independent management rate and discharge rates of 95% and marked reduction in patient wait times. There is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution.

[Prof. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements in orthopaedic surgery in the Meiji Era of Japan (part 1: establishment of the department)].

PubMed

Hirotani, Hayato

2005-09-01

The Department of Orthopaedic and Musculoskeletal Surgery, Graduate School of Medicine, Kyoto University (formerly the Department of Orthopaedic Surgery, Kyoto Medical School, Kyoto Imperial University) was founded by Imperial Ordinance, Article No. 89 issued on April 23, 1906. On May 4, 1906, Dr. Shinichiro Asahara, Assistant Professor of the Department of Surgery, was appointed as the first director of the Department of Orthopaedic Surgery, Kyoto Medical School, Kyoto Imperial University. Dr. Michiharu Matsuoka, Assistant Doctor of the Department of Surgery, Tokyo Medical School, Imperial University of Tokyo, was appointed Assistant Professor of Surgery, Kyoto Medical School, Kyoto Imperial University in March 1901. From August 1903 to May 1906, he studied orthopaedic surgery in Germany and returned on May 5, 1906. Dr. Matsuoka was appointed as the director and chief of the Department on May 13, 1906 and took over Dr. Asahara's position. On June 18, 1906, Dr. Matsuoka started his clinic and began giving lectures on orthopaedic surgery. This was the first department of orthopaedic surgery among the Japanese medical schools. Dr. Matsuoka was appointed as Professor in 1907. He had to overcome several obstacles to establish the medical department of a new discipline that had never existed in Japanese medical schools. This article discusses Dr. Matsuoka's contributions to establishing and developing orthopaedic surgery in Japan in the Meiji-era.

75 FR 60375 - Utah Regulatory Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

... DEPARTMENT OF THE INTERIOR Office of Surface Mining Reclamation and Enforcement 30 CFR Part 944 [SATS No. UT-047-FOR; Docket ID OSM-2010-0012] Utah Regulatory Program AGENCY: Office of Surface Mining... amendment to the Utah regulatory program (hereinafter, the ``Utah program'') under the Surface Mining...

Preoperative Planning in Orthopaedic Surgery. Current Practice and Evolving Applications.

PubMed

Atesok, Kivanc; Galos, David; Jazrawi, Laith M; Egol, Kenneth A

2015-12-01

Preoperative planning is an essential prerequisite for the success of orthopaedic procedures. Traditionally, the exercise has involved the written down, step by step "blueprint" of the surgical procedure. Preoperative planning of the technical aspects of the orthopaedic procedure has been performed on hardcopy radiographs using various methods such as copying the radiographic image on tracing papers to practice the planned interventions. This method has become less practical due to variability in radiographic magnification and increasing implementation of digital imaging systems. Advances in technology along with recognition of the importance of surgical safety protocols resulted in widespread changes in orthopaedic preoperative planning approaches. Nowadays, perioperative "briefings" have gained particular importance and novel planning methods have started to integrate into orthopaedic practice. These methods include using software that enables surgeons to perform preoperative planning on digital radiographs and to construct 3D digital models or prototypes of various orthopaedic pathologies from a patient's CT scans to practice preoperatively. Evidence-to-date suggests that preoperative planning and briefings are effective means of favorably influencing the outcomes of orthopaedic procedures.

Surgical simulation in orthopaedic skills training.

PubMed

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

A comprehensive guide to fuel management practices for dry mixed conifer forests in the northwestern United States

Treesearch

Theresa B. Jain; Mike A. Battaglia; Han-Sup Han; Russell T. Graham; Christopher R. Keyes; Jeremy S. Fried; Jonathan E. Sandquist

2012-01-01

This guide describes the benefits, opportunities, and trade-offs concerning fuel treatments in the dry mixed conifer forests of northern California and the Klamath Mountains, Pacific Northwest Interior, northern and central Rocky Mountains, and Utah. Multiple interacting disturbances and diverse physical settings have created a forest mosaic with historically low- to...

Hubble Space Telescope Discovery of a z = 3.9 Multiply Imaged Galaxy Behind

Science.gov Websites

the SAO/NASA ADS Astronomy Abstract Service Title: Hubble Space Telescope Discovery of a z College, Clinton, NY 13323, USA), AI(Department of Physics and Astronomy, University of Utah, Salt Lake City, UT 84112, USA), AJ(Institute of Astronomy, Graduate School of Science, University of Tokyo 2-21-1

Evaluation Comparison of Online and Classroom Instruction for HEPE 129--Fitness and Lifestyle Management Course.

ERIC Educational Resources Information Center

Davies, Randall S.; Mendenhall, Robert

This evaluation compared online (i.e., World Wide Web-based) and classroom instructional delivery methods for the Health Education/Physical Education course, "Fitness and Lifestyle Management," at Brigham Young University (Utah). The results of the study were intended to add to the discussion on the value of web-based courses as a means…

Physical, Chemical, Ecological, and Age Data and Trench Logs from Surficial Deposits at Hatch Point, Southeastern Utah

USGS Publications Warehouse

Goldstein, Harland L.; Miller, Mark E.; Yount, James C.; Reheis, Marith C.; Reynolds, Richard L.; Belnap, Jayne; Lamothe, Paul J.; McGeehan, John P.

2009-01-01

This report presents data and describes the methodology for physical, chemical and ecological measurements of sediment, soil, and vegetation, as well as age determinations of surficial deposits at Hatch Point, Canyon Rims area, Colorado Plateau, southeastern Utah. The results presented in this report support a study that examines geomorphic and soil factors that may influence boundaries between shrubland and grassland ecosystems in the study area. Shrubland ecosystems dominated by sagebrush (Artemisia tridentata) and grassland ecosystems dominated by native perennial grasses (for example, Hilaria jamesii and Sporabolis sp.) are high-priority conservation targets for the Federal Bureau of Land Management (BLM) and other resource managers because of their diversity, productivity, and vital importance as wildlife habitat. These ecosystems have been recognized as imperiled on a regional scale since at least the mid-1990s due to habitat loss (type conversions), land-use practices, and invasive exotic plants. In the Intermountain West, the exotic annual cheatgrass (Bromus tectorum) is recognized as one of the most pervasive and serious threats to the health of native sagebrush and grassland ecosystems through effects on fire regimes and resource conditions experienced by native species.

Orthopaedic Surgeons Receive the Most Industry Payments to Physicians but Large Disparities are Seen in Sunshine Act Data.

PubMed

Samuel, Andre M; Webb, Matthew L; Lukasiewicz, Adam M; Bohl, Daniel D; Basques, Bryce A; Russo, Glenn S; Rathi, Vinay K; Grauer, Jonathan N

2015-10-01

Industry payments made to physicians by drug and device manufacturers or group purchasing organizations are now reported to the Centers for Medicare and Medicaid Services (CMS) as a part of the Physician Payments Sunshine Act. Initial reports from the program show that orthopaedic surgeons lead all physician specialties in total and average industry payments. However, before further discussion of these payments and their implications can take place, it remains to be seen whether these figures are a true reflection of the field of orthopaedic surgery in general, rather than the result of a few outlier physicians in the field. In addition, the nature and sources of these funds should be determined to better inform the national dialogue surrounding these payments. We asked: (1) How do industry payments to orthopaedic surgeons compare with payments to physicians and surgeons in other fields, in terms of median payments and the Gini index of disparity? (2) How much do payments to the highest-receiving orthopaedic surgeons contribute to total payments? (3) What kind of industry payments are orthopaedic surgeons receiving? (4) How much do the highest-paying manufacturers contribute to total payments to orthopaedic surgeons? We reviewed the most recent version of the CMS Sunshine Act Open Payments database released on December 19, 2014, containing data on payments made between August 1, 2013 and December 31, 2013. Data on total payments to individual physicians, physician specialty, the types of payments made, and the manufacturers making payments were reviewed. The Gini index of statistical dispersion was calculated for payments made to orthopaedic surgeons and compared with payments made to physicians and surgeons in all other medical specialties. A Gini index of 0 indicates complete equality of payments to everyone in the population, whereas an index of 1 indicates complete inequality, or all income going to one individual. A total of 15,376 orthopaedic surgeons receiving payments during the 5-month period were identified, accounting for USD 109,846,482. The median payment to orthopaedic surgeons receiving payments was USD 121 (interquartile range, USD 34-619). The top 10% of orthopaedic surgeons receiving payments (1538 surgeons) received at least USD 4160 and accounted for 95% of total payments. Royalties and patent licenses accounted for 69% of all industry payments to orthopaedic surgeons. Even as a relatively small specialty, orthopaedic surgeons received substantial payments from industry (more than USD 110 million) during the 5-month study period. Whether there is a true return of value from these payments remains to be seen; however, future ethical and policy discussions regarding industry payments to orthopaedic surgeons should take into account the large disparities in payments that are present and also the nature of the payments being made. It is possible that patients and policymakers may view industry payments to orthopaedic surgeons more positively in light of these new findings. Level III, Economic and Decision Analysis.

How many referrals to a pediatric orthopaedic hospital specialty clinic are primary care problems?

PubMed

Hsu, Eric Y; Schwend, Richard M; Julia, Leamon

2012-01-01

Many primary care physicians believe that there are too few pediatric orthopaedic specialists available to meet their patients' needs. However, a recent survey by the Practice Management Committee of the Pediatric Orthopaedic Society of North America found that new referrals were often for cases that could have been managed by primary care practitioners. We wished to determine how many new referral cases seen by pediatric orthopaedic surgeons are in fact conditions that can be readily managed by a primary care physician should he/she chose to do so. We prospectively studied all new referrals to our hospital-based orthopaedic clinic during August 2010. Each new referral was evaluated for whether it met the American Board of Pediatrics criteria for being a condition that could be managed by a primary care pediatrician. Each referral was also evaluated for whether it met the American Academy of Pediatrics Surgery Advisory Panel guidelines recommending referral to an orthopaedic specialist, regardless of whether it is for general orthopaedics or pediatric orthopaedics. On the basis of these criteria, we classified conditions as either a condition manageable by primary care physicians or a condition that should be referred to an orthopaedic surgeon or a pediatric orthopaedic surgeon. We used these guidelines not to identify diagnosis that primary care physicians should treat but, rather, to compare the guideline-delineated referrals with the actual referrals our specialty pediatric orthopaedic clinic received over a period of 1 month. A total of 529 new patient referrals were seen during August 2010. A total of 246 (47%) were considered primary care conditions and 283 (53%) orthopaedic specialty conditions. The most common primary care condition was a nondisplaced phalanx fracture (25/246, 10.1%) and the most common specialty condition was a displaced single-bone upper extremity fracture needing reduction (36/283, 13%). Only 77 (14.6%) of the total cases met the strict American Academy of Pediatrics Surgery Advisory Panel guidelines recommending referral to pediatric orthopaedics, with scoliosis being the most frequent condition. For 38 (7.2%) cases, surgical treatment was required or recommended. Patient age, referral source, or type of insurance did not influence whether the condition was a primary care or a specialty care case. A total of 134 (25%) cases were referred without having an initial diagnosis made by the referring clinician. These patients were more likely to have been referred from a primary care practitioner than from a tertiary care practitioner whether the diagnosis eventually made was considered to be a primary care condition (P=0.03; relative risk, 1.9; 95% confidence interval, 96-3.86). Almost half of all new referrals to a tertiary pediatric orthopaedic clinic were for conditions considered to be manageable by primary care physicians should they chose to do so. This has implications for pediatric orthopaedic workforce availability, reimbursement under the Affordable Care Act, and pediatric musculoskeletal training needs for providers of primary care.

Protocol for determining the diagnostic validity of physical examination maneuvers for shoulder pathology.

PubMed

Somerville, Lyndsay; Bryant, Dianne; Willits, Kevin; Johnson, Andrew

2013-02-08

Shoulder complaints are the third most common musculoskeletal problem in the general population. There are an abundance of physical examination maneuvers for diagnosing shoulder pathology. The validity of these maneuvers has not been adequately addressed. We propose a large Phase III study to investigate the accuracy of these tests in an orthopaedic setting. We will recruit consecutive new shoulder patients who are referred to two tertiary orthopaedic clinics. We will select which physical examination tests to include using a modified Delphi process. The physician will take a thorough history from the patient and indicate their certainty about each possible diagnosis (certain the diagnosis is absent, present or requires further testing). The clinician will only perform the physical examination maneuvers for diagnoses where uncertainty remains. We will consider arthroscopy the reference standard for patients who undergo surgery within 8 months of physical examination and magnetic resonance imaging with arthrogram for patients who do not. We will calculate the sensitivity, specificity and positive and negative likelihood ratios and investigate whether combinations of the top tests provide stronger predictions of the presence or absence of disease. There are several considerations when performing a diagnostic study to ensure that the results are applicable in a clinical setting. These include, 1) including a representative sample, 2) selecting an appropriate reference standard, 3) avoiding verification bias, 4) blinding the interpreters of the physical examination tests to the interpretation of the gold standard and, 5) blinding the interpreters of the gold standard to the interpretation of the physical examination tests. The results of this study will inform clinicians of which tests, or combination of tests, successfully reduce diagnostic uncertainty, which tests are misleading and how physical examination may affect the magnitude of the confidence the clinician feels about their diagnosis. The results of this study may reduce the number of costly and invasive imaging studies (MRI, CT or arthrography) that are requisitioned when uncertainty about diagnosis remains following history and physical exam. We also hope to reduce the variability between specialists in which maneuvers are used during physical examination and how they are used, all of which will assist in improving consistency of care between centres.

Orthopaedic Snafus: When Adverse Events Happen in Orthopaedics.

PubMed

Smith, Mary Atkinson; Walsh, Colleen; Levin, Barbara; Eaten, Kathyrn; Yager, Melissa

The potential for adverse events exists when treating and managing orthopaedic patients in the intraoperative or postoperative environments, especially when it comes to falls, surgical site infections, venous thromboembolism, and injuries to nerves and blood vessels. Orthopaedic nurses play a vital role in the promotion and use of evidence-based interventions to decrease the incidence of these adverse events, improve quality of care, and minimize the financial burden related to these adverse events.

Utah's New Mathematics Core

ERIC Educational Resources Information Center

Utah State Office of Education, 2011

2011-01-01

Utah has adopted more rigorous mathematics standards known as the Utah Mathematics Core Standards. They are the foundation of the mathematics curriculum for the State of Utah. The standards include the skills and understanding students need to succeed in college and careers. They include rigorous content and application of knowledge and reflect…

21. Photocopied from blueprint, Olmstead Station Miscellaneous Drawings Folder, Engineering ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

21. Photocopied from blueprint, Olmstead Station Miscellaneous Drawings Folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. 'STATION GROUNDS, TELLURIDE POWER CO., PROVO, UTAH.' MAP,1903. - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

78 FR 35956 - Utah Resource Advisory Council Subgroup Conference Call

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-14

... BLM-Utah's draft three-year National Conservation Lands Strategy. In May 2013, the RAC provided the BLM-Utah State Director with recommended changes to the draft strategy and this meeting was held to discuss how BLM-Utah has incorporated their recommendations into a revised draft strategy. A public...

“In vitro” Implantation Technique Based on 3D Printed Prosthetic Prototypes

NASA Astrophysics Data System (ADS)

Tarnita, D.; Boborelu, C.; Geonea, I.; Malciu, R.; Grigorie, L.; Tarnita, D. N.

2018-06-01

In this paper, Rapid Prototyping ZCorp 310 system, based on high-performance composite powder and on resin-high strength infiltration system and three-dimensional printing as a manufacturing method are used to obtain physical prototypes of orthopaedic implants and prototypes of complex functional prosthetic systems directly from the 3D CAD data. These prototypes are useful for in vitro experimental tests and measurements to optimize and obtain final physical prototypes. Using a new elbow prosthesis model prototype obtained by 3D printing, the surgical technique of implantation is established. Surgical implantation was performed on male corpse elbow joint.

Smartphone apps for orthopaedic sports medicine - a smart move?

PubMed

Wong, Seng Juong; Robertson, Greg A; Connor, Katie L; Brady, Richard R; Wood, Alexander M

2015-01-01

With the advent of smartphones together with their downloadable applications (apps), there is increasing opportunities for doctors, including orthopaedic sports surgeons, to integrate such technology into clinical practice. However, the clinical reliability of these medical apps remains questionable. We reviewed available apps themed specifically towards Orthopaedic Sports Medicine and related conditions and assessed the level of medical professional involvement in their design and content, along with a review of these apps. The most popular smartphone app stores (Android, Apple, Blackberry, Windows, Samsung, Nokia) were searched for Orthopaedic Sports medicine themed apps, using the search terms; Orthopaedic Sports Medicine, Orthopaedics, Sports medicine, Knee Injury, Shoulder Injury, Anterior Cruciate Ligament Tear, Medial Collateral Ligament Tear, Rotator Cuff Tear, Meniscal Tear, Tennis Elbow. All English language apps related to orthopaedic sports medicine were included. A total of 76 individual Orthopaedic Sports Medicine themed apps were identified. According to app store classifications, there were 45 (59 %) medical themed apps, 28 (37 %) health and fitness themed apps, 1 (1 %) business app, 1 (1 %) reference app and 1 (1 %) sports app. Forty-nine (64 %) apps were available for download free of charge. For those that charged access, the prices ranged from £0.69 to £69.99. Only 51 % of sports medicine apps had customer satisfaction ratings and 39 % had named medical professional involvement in their development or content. We found the majority of Orthopaedic Sports Medicine apps had no named medical professional involvement, raising concerns over their content and evidence-base. We recommend increased regulation of such apps to improve the accountability of app content.

Prevalence of obesity and affecting factors in physically disabled adults living in the city centre of Malatya.

PubMed

Bozkir, Çiğdem; Özer, Ali; Pehlivan, Erkan

2016-09-08

The purpose of this study was to investigate the prevalence of obesity, and the risk factors associated with it, in physically disabled adults living in the city centre of Malatya, Turkey. This research was designed as a cross-sectional study conducted on physically disabled people aged 20-65 years living in the city centre of Malatya. The prevalence of obesity in disabled people was within 95% CIs, the power was calculated as 80%, and the sample size of our population was calculated as 258 individuals. The prevalence of obesity was found to be 13.2%. The relationship between disability type and obesity status was found to be significant. The prevalence of obesity was 21.3% in visually impaired people, 17.9% in speech-impaired people, 17.8% in hearing-impaired people and 6.5% in orthopaedically disabled people. Educational interventions on nutrition and lifestyle can be effective considering the high prevalence of obesity in visually impaired people, the prevalence of weakness in orthopaedically disabled people and the risk related to the area in which body fat is localised even when body mass index is within the normal range. Training disabled people in sports appropriate to their disability type and building appropriate facilities for those sports might have a positive effect. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Academic Characteristics of Orthopaedic Surgery Residency Applicants from 2007 to 2014.

PubMed

DePasse, J Mason; Palumbo, Mark A; Eberson, Craig P; Daniels, Alan H

2016-05-04

Based on a relatively stable match rate, several authors have concluded that the competition for orthopaedic residency positions has not changed over the past 3 decades. However, the objective measures of applicant competitiveness have not been quantified in detail. National Resident Matching Program (NRMP) data from 2007 to 2014 for U.S. orthopaedic surgery applicants were compared with data for applicants to all specialties. Trends in the United Stated Medical Licensing Examination (USMLE) Step-1 and Step-2 scores, publications and research experiences, Alpha Omega Alpha (AOA) status, and the presence of an advanced degree are reported. From 2007 to 2014, the match rate for orthopaedic surgery applicants remained stable near 80% (p = 0.14). For orthopaedic applicants who matched, the mean USMLE Step-1 scores increased from 234 points in 2007 to 245 points in 2014 (p = 0.005), and the mean scores increased from 220 points in 2007 to 229 points in 2014 for all applicants (p = 0.019). The mean USMLE Step-2 scores of orthopaedic applicants who matched increased from 235 points in 2007 to 251 points in 2014 (p = 0.005), and the mean scores of all applicants increased from 225 points in 2007 to 242 points in 2014 (p = 0.002). The mean number of research publications, presentations, and abstracts reported by orthopaedic applicants who matched more than doubled from 3.0 in 2007 to 6.7 in 2014 (p = 0.02) and increased less dramatically for all applicants from 2.2 in 2007 to 4.2 in 2014 (p = 0.004). The percentage of orthopaedic applicants elected to AOA or with advanced degrees did not significantly change (p > 0.2). Although orthopaedic applicants with AOA status experienced a very high match rate (97.1% in 2014), those with advanced degrees experienced match rates similar to or slightly lower than the applicant pool (73.7% in 2014). The USMLE Step-1 and 2 scores of U.S. orthopaedic surgery residency applicants have increased significantly from 2007 to 2014. Additionally, the number of publications and presentations reported by orthopaedic applicants has more than doubled. These factors signal an increasing level of academic accomplishment in orthopaedic surgery applicants despite a consistent match rate. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Variability in spine surgery procedures performed during orthopaedic and neurological surgery residency training: an analysis of ACGME case log data.

PubMed

Daniels, Alan H; Ames, Christopher P; Smith, Justin S; Hart, Robert A

2014-12-03

Current spine surgeon training in the United States consists of either an orthopaedic or neurological surgery residency, followed by an optional spine surgery fellowship. Resident spine surgery procedure volume may vary between and within specialties. The Accreditation Council for Graduate Medical Education surgical case logs for graduating orthopaedic surgery and neurosurgery residents from 2009 to 2012 were examined and were compared for spine surgery resident experience. The average number of reported spine surgery procedures performed during residency was 160.2 spine surgery procedures performed by orthopaedic surgery residents and 375.0 procedures performed by neurosurgery residents; the mean difference of 214.8 procedures (95% confidence interval, 196.3 to 231.7 procedures) was significant (p = 0.002). From 2009 to 2012, the average total spinal surgery procedures logged by orthopaedic surgery residents increased 24.3% from 141.1 to 175.4 procedures, and those logged by neurosurgery residents increased 6.5% from 367.9 to 391.8 procedures. There was a significant difference (p < 0.002) in the average number of spinal deformity procedures between graduating orthopaedic surgery residents (9.5 procedures) and graduating neurosurgery residents (2.0 procedures). There was substantial variability in spine surgery exposure within both specialties; when comparing the top 10% and bottom 10% of 2012 graduates for spinal instrumentation or arthrodesis procedures, there was a 13.1-fold difference for orthopaedic surgery residents and an 8.3-fold difference for neurosurgery residents. Spine surgery procedure volumes in orthopaedic and neurosurgery residency training programs vary greatly both within and between specialties. Although orthopaedic surgery residents had an increase in the number of spine procedures that they performed from 2009 to 2012, they averaged less than half of the number of spine procedures performed by neurological surgery residents. However, orthopaedic surgery residents appear to have greater exposure to spinal deformity than neurosurgery residents. Furthermore, orthopaedic spine fellowship training provides additional spine surgery case exposure of approximately 300 to 500 procedures; thus, before entering independent practice, when compared with neurosurgery residents, most orthopaedic spine surgeons complete as many spinal procedures or more. Although case volume is not the sole determinant of surgical skills or clinical decision making, variability in spine surgery procedure volume does exist among residency programs in the United States. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Ground water in Utah - A summary description of the resource and its related physical environment

USGS Publications Warehouse

Price, Don; Arnow, Ted

1985-01-01

Ground water is one of Utah’s most extensive and valuable natural resources. Because of its widespread occurrence in both wet and dry areas, ground water has been, and is a major factor affecting economic growth and development of the State. In some areas, ground water is used to supplement streamflow for irrigation, public supply, and other uses. In other areas, it is the only water available for use. Many communities obtain their entire water supply from ground-water sources (wells and springs) as do numerous rural and suburban households throughout the State.The ground-water reservoirs of Utah contain tremendous quantities of water – many times more than the quantity stored in all the lakes (including Great Salt Lake) and the surface-water reservoirs of the State combined. Water that discharges from those underground reservoirs in seeps and springs is vital in sustaining the flow of streams during dry summer months and in providing the water needed to maintain important wetland habitats. Those same underground reservoirs also provide large quantities of water in carryover storage for use during prolonged droughts.The U.S. Geological survey, under cooperative programs with the Utah department of Natural resources and other Federal, State, and local agencies has been studying Utah’s ground-water resources since 1897. Much information has been gained during those studies about the occurrence, availability, and quality of ground water; the withdrawal and use of the water; and the effects of withdrawal. This report summarizes that information in nontechnical language, which is designed for all readers. Readers interested in more detailed information about ground water in specific areas of Utah are referred to the reports listed by LaPray and Hamblin (1980).

Thank You to All JOSPT Contributors for 2016.

PubMed

Abbott, J Haxby

2016-12-01

On behalf of the many stakeholders in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT), including the Sections and international partners, readers, Editorial Board, and authors, Editor-in-Chief J. Haxby Abbott gives thanks and recognizes all of the many individuals who have contributed to the editorial process and content of JOSPT this past year. J Orthop Sports Phys Ther 2016;46(12):1018-1020. doi:10.2519/jospt.2016.0116.

Thank You to All JOSPT Contributors for 2017.

PubMed

Abbott, J Haxby

2017-12-01

On behalf of the many stakeholders in the Journal of Orthopaedic & Sports Physical Therapy (JOSPT), including the Sections and international partners, readers, Editorial Board, and authors, Editor-in-Chief J. Haxby Abbott gives thanks and recognizes all of the many individuals who have contributed to the editorial process and content of JOSPT this past year. J Orthop Sports Phys Ther 2017;47(12):889-891. doi:10.2519/jospt.2017.0110.

Physical therapy applications of MR fluids and intelligent control

NASA Astrophysics Data System (ADS)

Dong, Shufang; Lu, Ke-Qian; Sun, J. Q.; Rudolph, Katherine

2005-05-01

Resistance exercise has been widely reported to have positive rehabilitation effects for patients with neuromuscular and orthopaedic conditions. This paper presents an optimal design of magneto-rheological fluid dampers for variable resistance exercise devices. Adaptive controls for regulating the resistive force or torque of the device as well as the joint motion are presented. The device provides both isometric and isokinetic strength training for various human joints.

An integrated GIS/remote sensing data base in North Cache soil conservation district, Utah: A pilot project for the Utah Department of Agriculture's RIMS (Resource Inventory and Monitoring System)

NASA Technical Reports Server (NTRS)

Wheeler, D. J.; Ridd, M. K.; Merola, J. A.

1984-01-01

A basic geographic information system (GIS) for the North Cache Soil Conservation District (SCD) was sought for selected resource problems. Since the resource management issues in the North Cache SCD are very complex, it is not feasible in the initial phase to generate all the physical, socioeconomic, and political baseline data needed for resolving all management issues. A selection of critical varables becomes essential. Thus, there are foud specific objectives: (1) assess resource management needs and determine which resource factors ae most fundamental for building a beginning data base; (2) evaluate the variety of data gathering and analysis techniques for the resource factors selected; (3) incorporate the resulting data into a useful and efficient digital data base; and (4) demonstrate the application of the data base to selected real world resoource management issues.

Seismic-refraction survey to the top of salt in the north end of the Salt Valley Anticline, Grand County, Utah

USGS Publications Warehouse

Ackermann, Hans D.

1979-01-01

A seismic-refraction survey, consisting of three lines about 2700, 2760, and 5460 meters long, was made at the north end of the Salt Valley anticline of the Paradox Basin in eastern Utah. The target was the crest of a diapiric salt mass and the overlying, deformed caprock. The interpretations reveal an undulating salt surface with as much as 80 meters of relief. The minimum depth of about 165 meters is near the location of three holes drilled by the U.S. Department of Energy for the purpose of evaluating the Salt Valley anticline as a potential site for radioactive waste storages Caprock properties were difficult to estimate because the contorted nature of these beds invalidated a geologic interpretation in terms of velocity layers. However, laterally varying velocities of the critically refracted rays throughout the area suggest differences in the gross physical properties of the caprock.

Tectonic impact on the dynamics of CO2-rich fluid migration in Utah

NASA Astrophysics Data System (ADS)

Nadine, E. Z.; Jean Luc, F.; Remy, D.; Battani, A.; Olivier, V.

2009-12-01

With the objective to rank the first order parameters acting in the long term CO2 storage, IFP is developing an integrated study based on the analytical results around the natural silici-clastic analogue of the Colorado Plateau in Utah. What are the dominant parameters which governed the fluid/gas migration in front of the Sevier fold-and-thrust Belt, particularly the CO2-enriched ones? Several sites have been investigated in Utah and Idaho provinces; in the Colorado Plateau, East and in front of the Sevier fold-and-thrust belt, as well as in the Basin & Range geological province North and South West of Salt Lake city (Sevier basin). As a first site selection, three distinct structural provinces have been analysed depending on their seal/reservoir characteristics for confinement: the Green River leaking area (Utah), where large WNW-ESE faults (Salt Wash, Little Wash F...) show several water, oil and gas (CO2, HC) seepages; the Basin & Range province (Utah & Idaho provinces) where low-angle normal faults are seismically active (leaking locally); and the Canyonlands zone (Utah), south of the Moab fault, where the system is well confined. The migration pathways used by composite gas and particularly CO2-enriched fluids (in the Green River area) combined with a reducing agent are locally easily recognisable by the bleaching effect where some reservoir levels or the faults pathways have been flushed. The architecture of the paleo and active fluid migration network can thus be mapped. As a second selective ranking, natural gas have been sampled either from oil/gas producing wells in the Moab area and Ferron Valley, or from natural seepages along leaking fault sections or from geysers along the Green-River fault system. The results, based on noble gas isotope analyses (Battani et al, AGU fall meeting 2009) show that 3 distinct provinces can be "isolated", either marked by the occurrence of mantle-derived CO2, or mixed mantle/crustal CO2 signature of varying ratio. How to explain the existence of these distinct provinces? Is it due to the physical properties of the reservoirs, to the evolution of the fracture and fault patterns changing through time in connection with paleostress fields, to the occurrence of a thick salt pillow in the Moab area which has driven the tectonic style and played as local seal, to the shale sealing properties when PCO2 increased at depth to the physical phase of the CO2 during migration or storage (dissolved, super-critical or gas), or finally to the seismic cyclicity. A possible strong linkage between the seismicity and the volcanic activity, corresponding to large CO2-rich gas expel, have been investigated. In order to constrain the architecture of the deep buried reservoirs and traps we analyzed the deformation through analogue models, the models have been acquired with X-Ray tomography at IFP. These parameters have been analysed for the three investigated areas, allowing to propose an integrated model of the local circulation and/or storage of the CO2-enriched fluid for each area.

Utah Career Guide for Adults, 2000-2002.

ERIC Educational Resources Information Center

Blaine, Connie, Ed.

This career guide provides Utah job seekers with information leading to job success. Section 1, Getting Started, provides suggestions for committing to a job search. Section 2, Utah Job Trends, identifies the fastest growing occupations or most openings; top 50 occupations; and new Utah jobs. Section 3, Self-Assessment, covers knowing oneself;…

7. Photocopied from Dwg. 69, Nunns Station Folder, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopied from Dwg. 69, Nunns Station Folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. FLOOR PLANT. (POWER HOUSE IN PROVO CANYON, PROVO, UTAH?) c. 1900. - Telluride Power Company, Nunn Hydroelectric Plant, Southeast side of Provo River, 300 feet West of US Route 189, Orem, Utah County, UT

1. Photocopied from photo 25797, Engineering Dept., Utah Power and ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photocopied from photo 25797, Engineering Dept., Utah Power and Light Co., Salt Lake City, Utah. 'WHEELON HYDRO-ELECTRIC PLANT (1725 KW) STATION, WEST PENSTOCK, 130 KV TRANSFORMERS AND SWITCHYARD AND EAST AND WEST CANALS. NOV 1914.' - Utah Sugar Company, Wheelon Hydoelectric Plant, Bear River, Fielding, Box Elder County, UT

78 FR 26063 - Central Utah Project Completion Act; East Hobble Creek Restoration Project Final Environmental...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-03

... releases, and enhancement of the existing water supply. Dated: April 15, 2013. Reed R. Murray, Program... Environmental Assessment AGENCY: Office of the Assistant Secretary for Water and Science, Interior; Utah...: Central Utah Water Conservancy District, 355 West University Parkway, Orem, Utah 84058-7303 Department of...

Dendrochronology of Utah Juniper (Juniperus osteosperma (Torr.) Little)

Treesearch

R. Justin Derose; Matthew F. Bekker; Roger Kjelgren; Brendan M. Buckley; James H. Speer; Eric B. Allen

2016-01-01

Utah juniper was a foundational species for the discipline of dendrochronology, having been used in the early 20th Century investigations of Mesa Verde, but has been largely ignored by dendrochronologists since. Here we present dendrochronological investigations of Utah juniper core and cross-sectional samples from four sites in northern Utah. We demonstrate that,...

Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit.

PubMed

Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana

2014-01-01

In Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry-led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment. This study audited the first 100 patients to receive an appointment at a new podiatry-led assessment service. The podiatrist triaged 'Category 3' referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non-surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non-surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated. Ninety-five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry-led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting list without requiring an orthopaedic consultation. Two-thirds of patients who had an appointment at the podiatry-led assessment service were discharged without requiring a surgical consultation. The introduction of a podiatry-led service assists with timely provision of patient care and ensures those with the greatest need for orthopaedic surgery have improved access to specialist care.

Sources of information influencing decision-making in orthopaedic surgery - an international online survey of 1147 orthopaedic surgeons.

PubMed

Schulz, Arndt P; Jönsson, Anders; Kasch, Richard; Jettoo, Prithee; Bhandari, Mohit

2013-03-14

Manufacturers of implants and materials in the field of orthopaedics use significant amounts of funding to produce informational material to influence the decision-making process of orthopaedic surgeons with regards to choice between novel implants and techniques. It remains unclear how far orthopaedic surgeons are really influenced by the materials supplied by companies or whether other, evidence-based publications have a higher impact on their decision-making. The objective was to evaluate the subjective usefulness and usage of different sources of information upon which orthopaedic surgeons base their decisions when acquiring new implants or techniques. We undertook an online survey of 1174 orthopaedic surgeons worldwide (of whom n = 305 were head of their department). The questionnaire included 34 items. Sequences were randomized to reduce possible bias. Questions were closed or semi-open with single or multiple answers. The usage and relevance of different sources of information when learning about and selecting orthopaedic treatments were evaluated. Orthopaedic surgeons and trainees were targeted, and were only allowed to respond once over a period of two weeks. Baseline information included country of workplace, level of experience and orthopaedic subspecialisation. The results were statistically evaluated. Independent scientific proof had the highest influence on decisions for treatment while OEM (Original Equipment Manufacturer) driven activities like newsletters, white papers or workshops had the least impact. Comparison of answers from the three best-represented countries in this study (Germany, UK and USA) showed some significant differences: Scientific literature and congresses are significantly more important in the US than in the UK or Germany, although they are very important in all countries. Independent and peer-reviewed sources of information are preferred by surgeons when choosing between methods and implants. Manufacturers of medical devices in orthopaedics employ a considerable workforce to inform or influence hospital managers and leading doctors with marketing activities. Our results indicate that it might be far more effective to channel at least some of these funds into peer-reviewed research projects, thereby assuring significantly higher acceptance of the related products.

Citation classics in pediatric orthopaedics.

PubMed

Varghese, Ranjit A; Dhawale, Arjun A; Zavaglia, Bogard C; Slobogean, Bronwyn L; Mulpuri, Kishore

2013-09-01

The purpose of this study was to identify the clinical pediatric orthopaedic articles with at least 100 citations published in all orthopaedic journals and to examine their characteristics. All journals dedicated to orthopaedics and its subspecialties were selected from the Journal Citation Report 2001 under the subject category "orthopedics." Articles cited 100 times or more were identified using the database of the Science Citation Index Expanded (SCI-EXPANDED, 1900 to present). The articles were ranked in a comprehensive list. Two authors independently reviewed the full text of each article and applied the inclusion and exclusion criteria to the list of articles. The 2 lists were then compared. All disagreements were resolved by consensus with input from the senior author. The final list of pediatric orthopaedic articles was then compiled. There were a total of 49 journals under the search category "orthopedics." Five journals were excluded as they were non-English journals. The remaining 44 journals were screened for articles with at least 100 citations. A total of 135 clinical pediatric orthopaedic articles cited at least 100 times were included. The most cited article was cited 692 times. The mean number of citations per article was 159 (95% confidence interval, 145-173). All the articles were published between 1949 and 2001, with 1980 and 1989 producing the most citation classics (34). The majority (90) originated from the United States, followed by the United Kingdom (12) and Canada (11). Scoliosis/kyphosis was the most common topic with 26 papers. The second most common subject was hip disorders (24). Therapeutic studies were the most common study type (71). Ninety-seven papers were assigned a 4 for level of evidence. The list of citation classics in pediatric orthopaedic articles is useful for several reasons. It identifies important contributions to the field of pediatric orthopaedics and their originators; it facilitates the understanding and discourse of modern pediatric orthopaedic history and reveals trends in pediatric orthopaedics.

Early Career Experience of Pediatric Orthopaedic Fellows: What to Expect and Need for Their Services.

PubMed

Glotzbecker, Michael P; Shore, Benjamin J; Fletcher, Nicholas D; Larson, A Noelle; Hydorn, Christopher R; Sawyer, Jeffery R

2016-06-01

A dramatic increase in the number of pediatric orthopaedic fellows being trained has led to concerns that there may be an oversupply of pediatric orthopaedists. The purpose of this study was to determine whether this perception is accurate and whether the practice expectations of recent pediatric fellowship graduates are being met by surveying recent pediatric fellowship graduates about their early practice experiences. A 36-question survey approved by the Pediatric Orthopaedic Society of North America (POSNA) leadership was electronically distributed to 120 recent graduates of pediatric orthopaedic fellowships; 81 responses were ultimately obtained (67.5% response rate). Almost all (91%) of the respondents were very or extremely satisfied with their fellowship experience. Half of the respondents had at least 1 job offer before they entered their fellowships. After completion of fellowships, 35% received 1 job offer and 62.5% received ≥2 job offers; only 2.5% did not receive a job offer. Most reported a practice consisting almost entirely of pediatric orthopaedics, and 93.5% thought this was in line with their expectations; 87% indicated satisfaction with their current volume of pediatric orthopaedics, and 85% with the complexity of their pediatric orthopaedic cases. Despite the high employment percentages and satisfaction with practice profiles, nearly a third (28%) of respondents replied that too many pediatric orthopaedists are being trained. Positive messages from this survey include the satisfaction of graduates with their fellowship training, the high percentage of graduates who readily found employment, and the satisfaction of graduates with their current practice environments; this indicates that the pediatric orthopaedic job environment is not completely saturated and there are continued opportunities for graduating pediatric fellows despite the increased number of fellows being trained. Although not determined by this study, it may be that the stable demand for pediatric orthopaedic services is being driven by the expansion of the scope of practice as well as subspecialization within the practice of pediatric orthopaedics.

[Scientific output of orthopaedic hospitals in the Netherlands: not all hospitals meet the requirements of the Dutch orthopaedic residency programme].

PubMed

Eshuis, Rienk; Verheyen, Cees C P M; de Gast, Arthur

2011-01-01

To evaluate the feasibility of the requirements for scientific participation in the Dutch orthopaedic residency programme by assessing the numbers of articles published by orthopaedic teaching hospitals. Descriptive. All 29 orthopaedic teaching hospitals in the Netherlands were asked to draw up a list of articles published from 2004 to 2009. The publications were subdivided into papers indexed in PubMed and papers published in the Nederlands Tijdschrift voor Orthopedie (NTvO, Netherlands Journal of Orthopaedics) and the Nederlands Tijdschrift voor Traumatologie (NTvT, Netherlands Journal of Traumatology). There was an overall response rate of 72% (21/29). For the 8 non-responders a search of PubMed and the NTvO-NTvT journal databases was used to compile a list of their publications. The university teaching hospitals (n = 8) published 1150 articles, 1118 of which were indexed in PubMed, 19 published in the NTvO and 13 in the NTvT. Peripheral teaching hospitals (n = 21) published 689 articles: 590 indexed in PubMed, 77 published in the NTvO and 22 in the NTvT. In the peripheral teaching hospitals there was a positive correlation between the number of orthopaedic surgeons and PhD students and the number of published articles. Of the 29 teaching hospitals, 9 (31%) did not meet the requirements for publication specified in the Dutch orthopaedic residency programme guidelines. The number of published articles is related to the numbers of orthopaedic surgeons and PhD students in peripheral teaching hospitals. The requirements for the minimum number of publications could therefore be revised to reflect the proportion of orthopaedic surgeons in each teaching hospital. The introduction of a weighting factor that accounts for the quality of the publications would also result in a more balanced assessment.

The 2016 American Orthopaedic Association-Japanese Orthopaedic Association Traveling Fellowship.

PubMed

Nandi, Sumon; Cho, Samuel K; Freedman, Brett A; Firoozabadi, Reza

2017-06-07

The American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship, which began in 1992 as a collaborative effort between the 2 orthopaedic communities, is aimed at fostering leadership among early-career surgeons through clinical, academic, and cultural exchange. Over 3 weeks, we experienced an extraordinary journey that led us across nearly 800 miles of the picturesque Japanese countryside, with stops at 6 distinguished academic centers. The opportunity to become personally acquainted with orthopaedic leaders in Japan, learn from their experiences, and immerse ourselves in the ancient and storied culture of a beautiful country was one that we will not soon forget. Along the way, we accumulated a wealth of information while enjoying the legendary hospitality of the Japanese people. There is a ubiquitous challenge in delivering cost-effective, accessible health care while maintaining a commitment to education and research. The U.S. orthopaedic community may take solace in the fact that our Japanese colleagues stand with us as partners in this pursuit, and our relationship with them continues to grow stronger through endeavors such as the AOA-JOA Traveling Fellowship. We look forward to honoring our Japanese colleagues in 2017 when we host them in the United States.

Prevalence and factors of burnout among Australian orthopaedic trainees: a cross-sectional study.

PubMed

Arora, Manit; Diwan, Ashish D; Harris, Ian A

2014-12-01

To assess the prevalence and factors of burnout among Australian orthopaedic trainees. 236 orthopaedic registrars of the Australian Orthopaedic Association were invited to participate in a 32-item survey by email. The questionnaire assessed potential factors associated with burnout, satisfaction with the choice of orthopaedics as a career and work-life balance, and subjective overall health, as well as 3 subscales of the Maslach Burnout Inventory - Human Services Survey for assessing burnout: emotional exhaustion, depersonalisation, and personal accomplishment. Participants with high levels of either emotional exhaustion or depersonalisation were defined as having burnout. Those with and without burnout were compared. 51 (22%) of the 236 trainees completed the questionnaire. Of whom, 88% were satisfied with their choice of orthopaedics as a career, whereas 27% were satisfied with their work-life balance. 27 (53%) respondents were considered burned out. Compared with those who did not burn out, those who burned out were less satisfied with their careers (p=0.004) and work-life balance (p=0.021). 53% of Australian orthopaedic trainees were burned out. Burnout trainees were more likely to be dissatisfied with their career choice and worklife balance. Active interventions to combat burnout and improve work-life balance are needed.

A comparison of two approaches to modelling snow cover dynamics at the Polish Polar Station at Hornsund

NASA Astrophysics Data System (ADS)

Luks, B.; Osuch, M.; Romanowicz, R. J.

2012-04-01

We compare two approaches to modelling snow cover dynamics at the Polish Polar Station at Hornsund. In the first approach we apply physically-based Utah Energy Balance Snow Accumulation and Melt Model (UEB) (Tarboton et al., 1995; Tarboton and Luce, 1996). The model uses a lumped representation of the snowpack with two primary state variables: snow water equivalence and energy. Its main driving inputs are: air temperature, precipitation, wind speed, humidity and radiation (estimated from the diurnal temperature range). Those variables are used for physically-based calculations of radiative, sensible, latent and advective heat exchanges with a 3 hours time step. The second method is an application of a statistically efficient lumped parameter time series approach to modelling the dynamics of snow cover , based on daily meteorological measurements from the same area. A dynamic Stochastic Transfer Function model is developed that follows the Data Based Mechanistic approach, where a stochastic data-based identification of model structure and an estimation of its parameters are followed by a physical interpretation. We focus on the analysis of uncertainty of both model outputs. In the time series approach, the applied techniques also provide estimates of the modeling errors and the uncertainty of the model parameters. In the first, physically-based approach the applied UEB model is deterministic. It assumes that the observations are without errors and that the model structure perfectly describes the processes within the snowpack. To take into account the model and observation errors, we applied a version of the Generalized Likelihood Uncertainty Estimation technique (GLUE). This technique also provide estimates of the modelling errors and the uncertainty of the model parameters. The observed snowpack water equivalent values are compared with those simulated with 95% confidence bounds. This work was supported by National Science Centre of Poland (grant no. 7879/B/P01/2011/40). Tarboton, D. G., T. G. Chowdhury and T. H. Jackson, 1995. A Spatially Distributed Energy Balance Snowmelt Model. In K. A. Tonnessen, M. W. Williams and M. Tranter (Ed.), Proceedings of a Boulder Symposium, July 3-14, IAHS Publ. no. 228, pp. 141-155. Tarboton, D. G. and C. H. Luce, 1996. Utah Energy Balance Snow Accumulation and Melt Model (UEB). Computer model technical description and users guide, Utah Water Research Laboratory and USDA Forest Service Intermountain Research Station (http://www.engineering.usu.edu/dtarb/). 64 pp.

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests.

PubMed

Décary, Simon; Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Prospective diagnostic study. Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Not applicable. History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians' composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0-92.5). Combining a history of trauma during a pivot with a "popping" sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6-17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8-31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03-0.24). Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders.

Utah Educational Quality Indicators. The Sixth in the Report Series: "How Good Are Utah Public Schools."

ERIC Educational Resources Information Center

Nelson, David E.

Since 1967, the Utah State Office of Education has compiled and reported pertinent information concerning statewide student performance. This report, the sixth in the "How Good Are Utah Public Schools?" series, summarizes results from a variety of ongoing and special studies. Since 1975, statewide assessment programs have encompassed…

5. Photocopied from drawing 70, Nunns Station Folder, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photocopied from drawing 70, Nunns Station Folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. 'TILE TELLURIDE POWER TRANSMISSION CO. POWER HOUSE IN PROVO CANYON, PROVO, UTAH' SECTION, c. 1900. - Telluride Power Company, Nunn Hydroelectric Plant, Southeast side of Provo River, 300 feet West of US Route 189, Orem, Utah County, UT

75 FR 57055 - Endangered and Threatened Wildlife and Plants; Draft Revised Recovery Plan for Utah Prairie Dog

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-17

...] Endangered and Threatened Wildlife and Plants; Draft Revised Recovery Plan for Utah Prairie Dog AGENCY: Fish... recovery plan for the Utah prairie dog (Cynomys parvidens). This species is federally listed as threatened... and peer reviewers in an appendix to the approved recovery plan. The Utah prairie dog (Cynomys...

77 FR 24975 - Endangered and Threatened Wildlife and Plants; Revised Recovery Plan for the Utah Prairie Dog

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

...-FF06E00000] Endangered and Threatened Wildlife and Plants; Revised Recovery Plan for the Utah Prairie Dog... Utah prairie dog (Cynomys parvidens). This species is federally listed as threatened under the... recovery plan for the Utah prairie dog. The Service and other Federal agencies also will take these...

75 FR 57288 - Notice of Inventory Completion: Utah Museum of Natural History, Salt Lake City, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-20

... the human remains was made by the Utah Museum of Natural History professional staff and a report sent... DEPARTMENT OF THE INTERIOR National Park Service Notice of Inventory Completion: Utah Museum of... possession and control of the Utah Museum of Natural History, Salt Lake City, UT. The human remains and...

College Participation and Completion of Utah High School Graduates: Cohorts 2007-2012

ERIC Educational Resources Information Center

Ma, David

2017-01-01

Relying on the data from Utah System of Higher Education (USHE), Utah State Board of Education (USBE), and National Student Clearinghouse (NSC), this report examines college participation rates of Utah high school graduates (cohorts 2007-2012) with a focus on the gap in college participation between Whites and minorities. The report also includes…

Map showing selected surface-water data for the Alton-Kolob coal-fields area, Utah

USGS Publications Warehouse

Price, Don

1982-01-01

This is one of a series of maps that describe the geology and related natural resources of the Alton-Kolob coal-fields area, Utah. Streamflow records used to compile the map and the following table were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Transportation. The principal runoff-producing areas were delineated form a work map (scale 1:250,000) compiled to estimate water yields in Utah (Bagley and others, 1964).

Pathological Differences in Heterodera schachtii Populations

PubMed Central

Griffin, G. D.

1981-01-01

Five populations of Heterodera schachtii Schm. from Oregon, Idaho, and Utah did not differ significantly in seedling penetration and rate of emergence and virulence. Another Utah H. schachtii population (Utah 2), however, differed from these five populations in all of the above-mentioned characteristics. More H. schachtii larvae of the Utah 2 population than the other populations penetrated sugarbeet seedlings at 10, 15, 20, and 25 C. Root and top weights of sugarbeet plants were signiticantly less when roots were parasitized by the Utah 2 population than when they were parasitized by larvae of the other nematode populations under similar experimental conditions. Also, the period of larval emergence was shorter in the Utah 2 population than in any of the other H. schachtii populations. PMID:19300743

Feasibility of and Rationale for the Collection of Orthopaedic Trauma Surgery Quality of Care Metrics.

PubMed

Miller, Anna N; Kozar, Rosemary; Wolinsky, Philip

2017-06-01

Reproducible metrics are needed to evaluate the delivery of orthopaedic trauma care, national care, norms, and outliers. The American College of Surgeons (ACS) is uniquely positioned to collect and evaluate the data needed to evaluate orthopaedic trauma care via the Committee on Trauma and the Trauma Quality Improvement Project. We evaluated the first quality metrics the ACS has collected for orthopaedic trauma surgery to determine whether these metrics can be appropriately collected with accuracy and completeness. The metrics include the time to administration of the first dose of antibiotics for open fractures, the time to surgical irrigation and débridement of open tibial fractures, and the percentage of patients who undergo stabilization of femoral fractures at trauma centers nationwide. These metrics were analyzed to evaluate for variances in the delivery of orthopaedic care across the country. The data showed wide variances for all metrics, and many centers had incomplete ability to collect the orthopaedic trauma care metrics. There was a large variability in the results of the metrics collected among different trauma center levels, as well as among centers of a particular level. The ACS has successfully begun tracking orthopaedic trauma care performance measures, which will help inform reevaluation of the goals and continued work on data collection and improvement of patient care. Future areas of research may link these performance measures with patient outcomes, such as long-term tracking, to assess nonunion and function. This information can provide insight into center performance and its effect on patient outcomes. The ACS was able to successfully collect and evaluate the data for three metrics used to assess the quality of orthopaedic trauma care. However, additional research is needed to determine whether these metrics are suitable for evaluating orthopaedic trauma care and cutoff values for each metric.

Orthopaedic research in Australia: a bibliographic analysis of the publication rates in the top 15 journals.

PubMed

Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin

2017-09-01

To investigate the publications rates and characteristics of the authors for manuscripts originating from Australia in the 15 highest ranked orthopaedic journals over a 5-year period. The 15 highest ranked journals in orthopaedics, based on their 2015 impact factor, were used to establish the total number of publications and cumulative impact factor points between January 2010 and December 2014. The affiliations of the primary author and co-authors were used to determine the involvement of Australian trained orthopaedic surgeons. Study location, research topic and anatomic areas were recorded. A total of 478 publications were identified; 110 of these manuscripts were principally authored by Australian trained orthopaedic surgeons or medical professionals affiliated with orthopaedics. In addition, 158 articles were published with orthopaedic surgery involvement where one of the co-authors was an Australian trained surgeon. Australian orthopaedic surgeon (FRACS) involvement was most commonly observed in the knee (n = 90; 33.6%) followed by the hip (n = 69; 25.7%) and basic sciences (n = 27; 10.1%). Surgeons in Sydney had the highest number of publications (n = 95; 35.4%), followed by Adelaide (n = 55; 20.5%) and Melbourne (n = 54; 20.1%). The results of this study demonstrate that the minority (23%) of the publications originating from Australia in the 15 highest-ranking orthopaedic journals were principally authored by either an Australian trained surgeon or a trainee surgeon. A total of 59% of the publications focused on the hip and knee. Sydney was the leading region, followed by Adelaide and Melbourne. These three regions published 76% of all manuscripts identified during the 5-year study period. © 2017 Royal Australasian College of Surgeons.

Quality Measures in Orthopaedic Sports Medicine: A Systematic Review.

PubMed

Abrams, Geoffrey D; Greenberg, Daniel R; Dragoo, Jason L; Safran, Marc R; Kamal, Robin N

2017-10-01

To report the current quality measures that are applicable to orthopaedic sports medicine physicians. Six databases were searched with a customized search term to identify quality measures relevant to orthopaedic sports medicine surgeons: MEDLINE/PubMed, EMBASE, the National Quality Forum (NQF) Quality Positioning System (QPS), the Agency for Healthcare Research and Quality (AHRQ) National Quality Measures Clearinghouse (NQMC), the Physician Quality Reporting System (PQRS) database, and the American Academy of Orthopaedic Surgeons (AAOS) website. Results were screened by 2 Board-certified orthopaedic surgeons with fellowship training in sports medicine and dichotomized based on sports medicine-specific or general orthopaedic (nonarthroplasty) categories. Hip and knee arthroplasty measures were excluded. Included quality measures were further categorized based on Donabedian's domains and the Center for Medicare and Medicaid (CMS) National Quality Strategy priorities. A total of 1,292 quality measures were screened and 66 unique quality measures were included. A total of 47 were sports medicine-specific and 19 related to the general practice of orthopaedics for a fellowship-trained sports medicine specialist. Nineteen (29%) quality measures were collected within PQRS, with 5 of them relating to sports medicine and 14 relating to general orthopaedics. AAOS Clinical Practice Guidelines (CPGs) comprised 40 (60%) of the included measures and were all within sports medicine. Five (8%) additional measures were collected within AHRQ and 2 (3%) within NQF. Most quality measures consist of process rather than outcome or structural measures. No measures addressing concussions were identified. There are many existing quality measures relating to the practice of orthopaedic sports medicine. Most quality measures are process measures described within PQRS or AAOS CPGs. Knowledge of quality measures are important as they may be used to improve care, are increasingly being used to determine physician reimbursement, and can inform future quality measure development efforts. Published by Elsevier Inc.

Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.

PubMed

Kuo, Calvin C; Robb, William J

2013-06-01

The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

"Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application.

PubMed

Datillo, Jonathan R; Gittings, Daniel J; Sloan, Matthew; Hardaker, William M; Deasey, Matthew J; Sheth, Neil P

2017-08-16

Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application. We surveyed patients in an orthopaedic practice in an urban academic center to assess demographics, access to and patterns of Internet and Smartphone use, and preferences for features in a smartphone app. A total of 310 surveys were completed. Eighty percent of patients reported Internet access, and 62% used the Internet for health information. Seventy-seven percent owned smartphones, 45% used them for health information, and 28% owned health apps. Only 11% were referred to an app by a physician. The highest ranked features were appointment reminders, ability to view test results, communication with physicians, and discharge instructions. General orthopaedic information and pictures or videos explaining surgery were the 2 lowest ranked features. Seventy-one percent of patients felt an app with some of the described features would improve their healthcare experiences, and 40% would pay for the app. The smartphone is an under-utilized tool to enhance patient-physician communication, increase satisfaction, and improve quality of care. Patients were enthusiastic about app features that are often included in patient health portals, but ranked orthopaedic educational features lowest. Further study is required to elucidate how best to use orthopaedic apps as physician-directed educational opportunities to promote patient satisfaction and quality of care.

Floor Effect of PROMIS Depression CAT Associated With Hasty Completion in Orthopaedic Surgery Patients.

PubMed

Guattery, Jason M; Dardas, Agnes Z; Kelly, Michael; Chamberlain, Aaron; McAndrew, Christopher; Calfee, Ryan P

2018-04-01

The Patient Reported Outcomes Measurement Information System (PROMIS) was developed to provide valid, reliable, and standardized measures to gather patient-reported outcomes for many health domains, including depression, independent of patient condition. Most studies confirming the performance of these measures were conducted with a consented, volunteer study population for testing. Using a study population that has undergone the process of informed consent may be differentiated from the validation group because they are educated specifically as to the purpose of the questions and they will not have answers recorded in their permanent health record. (1) When given as part of routine practice to an orthopaedic population, do PROMIS Physical Function and Depression item banks produce score distributions different than those produced by the populations used to calibrate and validate the item banks? (2) Does the presence of a nonnormal distribution in the PROMIS Depression scores in a clinical population reflect a deliberately hasty answering of questions by patients? (3) Are patients who are reporting minimal depressive symptoms by scoring the minimum score on the PROMIS Depression Computer Adaptive Testing (CAT) distinct from other patients according to demographic data or their scores on other PROMIS assessments? Univariate descriptive statistics and graphic histograms were used to describe the frequency distribution of scores for the Physical Function and Depression item banks for all orthopaedic patients 18 years or older who had an outpatient visit between June 2015 and December 2016. The study population was then broken into two groups based on whether they indicated a lack of depressive symptoms and scored the minimum score (34.2) on the Depression CAT assessment (Floor Group) or not (Standard Group). The distribution of Physical Function CAT scores was compared between the two groups. Finally, a time-per-question value was calculated for both the Physical Function and Depression CATs and was compared between assessments within each group as well as between the two groups. Bivariate statistics compared the demographic data between the two groups. Physical Function CAT scores in musculoskeletal patients were normally distributed like the distribution calibration population; however, the score distribution of the Depression CAT in musculoskeletal patients was nonnormal with a spike in the floor score. After excluding the floor spike, the distribution of the Depression CAT scores was not different from the population control group. Patients who scored the floor score on the Depression CAT took slightly less time per question for Physical Function CAT when compared with other musculoskeletal patients (floor patients: 11 ± 9 seconds; normally distributed patients: 12 ± 10 seconds; mean difference: 1 second [0.8-1.1]; p < 0.001 but not clinically relevant). They spent a substantially shorter amount of time per question on the Depression CAT (Floor Group: 4 ± 3 seconds; Standard Group: 7 ± 7 seconds; mean difference: 3 [2.9-3.2]; p < 0.001). Patients who scored the minimum score on the PROMIS Depression CAT were younger than other patients (Floor Group: 50 ± 18 SD; Standard Group: 55 ± 16 SD; mean difference: 4.5 [4.2-4.7]; p < 0.001) with a larger percentage of men (Floor Group: 48.8%; Standard Group 40.0%; odds ratio 0.6 [0.6-0.7]; p < 0.001) and minor differences in racial breakdown (Floor Group: white 85.2%, black 11.9%, other 0.03%; Standard Group: white 83.9%, black 13.7%, other 0.02%). In an orthopaedic surgery population that is given PROMIS CAT as part of routine practice, the Physical Function item bank had a normal performance, but there is a group of patients who hastily complete Depression questions producing a strong floor effect and calling into question the validity of those floor scores that indicate minimal depression. Level II, diagnostic study.

An innovative care model coordinated by a physical therapist and nurse practitioner for osteoarthritis of the hip and knee in specialist care: a prospective study.

PubMed

Voorn, Veronique M A; Vermeulen, Henricus M; Nelissen, Rob G H H; Kloppenburg, Margreet; Huizinga, Tom W J; Leijerzapf, Nicolette A C; Kroon, Herman M; Vliet Vlieland, Thea P M; van der Linden, Henrica M J

2013-07-01

The subject of the study is to investigate whether health-related quality of life (HRQoL), pain and function of patients with hip or knee osteoarthritis (OA) improves after a specialist care intervention coordinated by a physical therapist and a nurse practitioner (NP) and to assess satisfaction with this care at 12 weeks. This observational study included all consecutive patients with hip or knee OA referred to an outpatient orthopaedics clinic. The intervention consisted of a single, standardized visit (assessment and individually tailored management advice, to be executed in primary care) and a telephone follow-up, coordinated by a physical therapist and a NP, in cooperation with an orthopaedic surgeon. Assessments at baseline and 10 weeks thereafter included the short form-36 (SF-36), EuroQol 5D (EQ-5D), hip or knee disability and osteoarthritis outcome score (HOOS or KOOS), the intermittent and constant osteoarthritis pain questionnaire (ICOAP) for hip or knee and a multidimensional satisfaction questionnaire (23 items; 4 point scale). Eighty-seven patients (57 female), mean age 68 years (SD 10.9) were included, with follow-up data available in 63 patients (72 %). Statistically significant improvements were seen regarding the SF-36 physical summary component score, the EQ-5D, the ICOAP scores for hip and knee, the HOOS subscale sports and the KOOS subscales pain, symptoms and activities of daily living. The proportions of patients reporting to be satisfied ranged from 79 to 98 % per item. In patients with hip and knee OA pain, function and HRQoL improved significantly after a single-visit multidisciplinary OA management intervention in specialist care, with high patient satisfaction.

Validation of PROMIS ® Physical Function computerized adaptive tests for orthopaedic foot and ankle outcome research.

PubMed

Hung, Man; Baumhauer, Judith F; Latt, L Daniel; Saltzman, Charles L; SooHoo, Nelson F; Hunt, Kenneth J

2013-11-01

In 2012, the American Orthopaedic Foot & Ankle Society(®) established a national network for collecting and sharing data on treatment outcomes and improving patient care. One of the network's initiatives is to explore the use of computerized adaptive tests (CATs) for patient-level outcome reporting. We determined whether the CAT from the NIH Patient Reported Outcome Measurement Information System(®) (PROMIS(®)) Physical Function (PF) item bank provides efficient, reliable, valid, precise, and adequately covered point estimates of patients' physical function. After informed consent, 288 patients with a mean age of 51 years (range, 18-81 years) undergoing surgery for common foot and ankle problems completed a web-based questionnaire. Efficiency was determined by time for test administration. Reliability was assessed with person and item reliability estimates. Validity evaluation included content validity from expert review and construct validity measured against the PROMIS(®) Pain CAT and patient responses based on tradeoff perceptions. Precision was assessed by standard error of measurement (SEM) across patients' physical function levels. Instrument coverage was based on a person-item map. Average time of test administration was 47 seconds. Reliability was 0.96 for person and 0.99 for item. Construct validity against the Pain CAT had an r value of -0.657 (p < 0.001). Precision had an SEM of less than 3.3 (equivalent to a Cronbach's alpha of ≥ 0.90) across a broad range of function. Concerning coverage, the ceiling effect was 0.32% and there was no floor effect. The PROMIS(®) PF CAT appears to be an excellent method for measuring outcomes for patients with foot and ankle surgery. Further validation of the PROMIS(®) item banks may ultimately provide a valid and reliable tool for measuring patient-reported outcomes after injuries and treatment.

Physical Therapy Protocols for Arthroscopic Bankart Repair.

PubMed

DeFroda, Steven F; Mehta, Nabil; Owens, Brett D

Outcomes after arthroscopic Bankart repair can be highly dependent on compliance and participation in physical therapy. Additionally, there are many variations in physician-recommended physical therapy protocols. The rehabilitation protocols of academic orthopaedic surgery departments vary widely despite the presence of consensus protocols. Descriptive epidemiology study. Level 3. Web-based arthroscopic Bankart rehabilitation protocols available online from Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic surgery programs were included for review. Individual protocols were reviewed to evaluate for the presence or absence of recommended therapies, goals for completion of ranges of motion, functional milestones, exercise start times, and recommended time to return to sport. Thirty protocols from 27 (16.4%) total institutions were identified out of 164 eligible for review. Overall, 9 (30%) protocols recommended an initial period of strict immobilization. Variability existed between the recommended time periods for sling immobilization (mean, 4.8 ± 1.8 weeks). The types of exercises and their start dates were also inconsistent. Goals to full passive range of motion (mean, 9.2 ± 2.8 weeks) and full active range of motion (mean, 12.2 ± 2.8 weeks) were consistent with other published protocols; however, wide ranges existed within the reviewed protocols as a whole. Only 10 protocols (33.3%) included a timeline for return to sport, and only 3 (10%) gave an estimate for return to game competition. Variation also existed when compared with the American Society of Shoulder and Elbow Therapists' (ASSET) consensus protocol. Rehabilitation protocols after arthroscopic Bankart repair were found to be highly variable. They also varied with regard to published consensus protocols. This discrepancy may lead to confusion among therapists and patients. This study highlights the importance of attending surgeons being very clear and specific with regard to their physical therapy instructions to patients and therapists.

Nanobiotechnology Perspectives on Prevention and Treatment of Ortho-paedic Implant Associated Infection.

PubMed

Borse, Vivek; Pawar, Vaishali; Shetty, Gautam; Mullaji, Arun; Srivastava, Rohit

2016-01-01

Implants are an inevitable part of orthopaedic surgery. However, implant associated infection remains a major challenge for orthopaedic surgeons and researchers. This review focuses on current options available for prevention of implant associated infection, their drawbacks and future promising applications of nanotechnology-based approaches. Nanobiotechnology has shown remarkable progress in recent years especially in biomaterials, diagnostics, and drug delivery system. Although several applications of nanobiotechnology in orthopaedics have been described, few have elaborated their role in the prevention of implant related infection in orthopaedics. Novel "smart" drug delivery systems that release antibiotics locally in response to stimuli such as pH, temperature, enzymes or antigens; implant surface modification on a nanoscale to inhibit bacterial adhesion and propagation at the surgical site and biological approaches such as gene therapy to neutralize bacterial virulence and biomolecules to inhibit the quorum sensing adhesion of bacteria and disruption of biofilms can be used effectively to prevent orthopaedic implant related bacterial infection.

Development, implementation and evaluation of a patient handoff tool to improve safety in orthopaedic surgery.

PubMed

Gagnier, Joel J; Derosier, Joseph M; Maratt, Joseph D; Hake, Mark E; Bagian, James P

2016-06-01

To develop, implement and test the effect of a handoff tool for orthopaedic trauma residents that reduces adverse events associated with the omission of critical information and the transfer of erroneous information. Components of this project included a literature review, resident surveys and observations, checklist development and refinement, implementation and evaluation of impact on adverse events through a chart review of a prospective cohort compared with a historical control group. Large teaching hospital. Findings of a literature review were presented to orthopaedic residents, epidemiologists, orthopaedic surgeons and patient safety experts in face-to-face meetings, during which we developed and refined the contents of a resident handoff tool. The tool was tested in an orthopaedic trauma service and its impact on adverse events was evaluated through a chart review. The handoff tool was developed and refined during the face-to-face meetings and a pilot implementation. Adverse event data were collected on 127 patients (n = 67 baseline period; n = 60 test period). A handoff tool for use by orthopaedic residents. Adverse events in patients handed off by orthopaedic trauma residents. After controlling for age, gender and comorbidities, testing resulted in fewer events per person (25-27% reduction; P < 0.10). Preliminary evidence suggests that our resident handoff tool may contribute to a decrease in adverse events in orthopaedic patients. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Utah System of Higher Education Data Book, 2014

ERIC Educational Resources Information Center

Utah System of Higher Education, 2014

2014-01-01

The USHE Data Book is a compilation of reports on the Utah System of Higher Education and its eight component institutions. Some form of this book has been published each year since the creation of the Utah State Board of Regents and the Utah System of Higher Education in 1969. The book is intended to allow the Governor's Office, Legislators and…

77 FR 75186 - Notice of Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-19

... Closure, Target Shooting Public Safety Closure on the Lake Mountains in Utah County, UT AGENCY: Bureau of... Lake Mountains in Utah County, Utah, to recreational target shooting to protect public safety. This... shooting closure within the described area will remain in effect no longer than two years from December 19...

Practical Law in Utah. Utah Supplement to "Street Law." Fourth Edition.

ERIC Educational Resources Information Center

Utah State Office of Education, Salt Lake City. Statewide Clearinghouse on Law-Related Education.

This textbook for high school students on law in Utah supplements "Street Law: A Course in Practical Law," a program in law-related education in use across the United States. The introduction explains the meaning of law, how laws are made in Utah, and the functions of the state court system. Following chapters elucidate the branches of…

Developing a state water plan: Ground-water conditions in Utah, spring of 1964

USGS Publications Warehouse

Arnow, Ted; Butler, R.G.; Mower, R.W.; Gates, Joseph S.; Cordova, R.M.; Carpenter, C.H.; Bjorklund, L.J.; Feltis, R.D.; Robinson, G.B. Jr.; Sandberg, G.W.

1964-01-01

This report is the first in a series of annual reports which will describe ground-water conditions in Utah. It was prepared cooperatively by the U.S. Geological Survey and the Utah Water and Power Board and was designed to provide the data for interested parties, such as legislators, administrators, and planners to keep abreast of changing ground-water conditions in the state. Because this report is the first of the series, it necessarily includes certain background and descriptive information which gives a broad general picture of ground-water conditions. Subsequent reports will discuss only changes that have taken place during the previous year.Many of the data used in the preparation of the report were collected by the Geological Survey in cooperation with the Utah State Engineer during past and continuing programs. The well-location map and some statistical information about numbers of wells in the State were prepared by digital computer from the Utah Resources Information System, University of Utah, utilizing records which were compiled largely from the files of the Utah State Engineer. R.E. Marsell, geological consultant to the Utah Water and Power Board, first suggested that this report be prepared.

Diurnal blood pressure variation in quadriplegic chronic spinal cord injury patients.

PubMed

Krum, H; Louis, W J; Brown, D J; Jackman, G P; Howes, L G

1991-03-01

1. Measurement of blood pressure and heart rate over a 24 h period was performed in 10 quadriplegic spinal cord injury patients and 10 immobilized, neurologically intact orthopaedic subjects by using the Spacelabs 90207 automated ambulatory monitoring system. 2. Systolic and diastolic blood pressure fell significantly at night in orthopaedic subjects but not in quadriplegic patients, and night-time blood pressures were similar in both groups. 3. Cumulative summation of differences from a reference value (cusum analysis) confirmed a markedly diminished diurnal blood pressure variation in the quadriplegic patients. 4. These findings could not be accounted for on the basis of blood pressure variations during chronic postural change. 5. Heart rate fell significantly at night in both groups. 6. The findings suggest that the increase in blood pressure during waking hours in neurologically intact subjects is a consequence of a diurnal variation in sympathetic activity (absent in quadriplegic patients with sympathetic decentralization) which is independent of changes in physical activity.

Osteogenesis imperfecta: from diagnosis and multidisciplinary treatment to future perspectives.

PubMed

Bregou Bourgeois, Aline; Aubry-Rozier, Bérengère; Bonafé, Luisa; Laurent-Applegate, Lee; Pioletti, Dominique P; Zambelli, Pierre-Yves

2016-01-01

Osteogenesis imperfecta is an inherited connective tissue disorder with wide phenotypic and molecular heterogeneity. A common issue associated with the molecular abnormality is a disturbance in bone matrix synthesis and homeostasis inducing bone fragility. In very early life, this can lead to multiple fractures and progressive bone deformities, including long bone bowing and scoliosis. Multidisciplinary management improves quality of life for patients with osteogenesis imperfecta. It consists of physical therapy, medical treatment and orthopaedic surgery as necessary. Medical treatment consists of bone-remodelling drug therapy. Bisphosphonates are widely used in the treatment of moderate to severe osteogenesis imperfecta, from infancy to adulthood. Other more recent drug therapies include teriparatide and denosumab. All these therapies target the symptoms and have effects on the mechanical properties of bone due to modification of bone remodelling, therefore influencing skeletal outcome and orthopaedic surgery. Innovative therapies, such as progenitor and mesenchymal stem cell transplantation, targeting the specific altered pathway rather than the symptoms, are in the process of development.

Data, network, and application: technical description of the Utah RODS Winter Olympic Biosurveillance System.

PubMed Central

Tsui, Fu-Chiang; Espino, Jeremy U.; Wagner, Michael M.; Gesteland, Per; Ivanov, Oleg; Olszewski, Robert T.; Liu, Zhen; Zeng, Xiaoming; Chapman, Wendy; Wong, Weng Keen; Moore, Andrew

2002-01-01

Given the post September 11th climate of possible bioterrorist attacks and the high profile 2002 Winter Olympics in the Salt Lake City, Utah, we challenged ourselves to deploy a computer-based real-time automated biosurveillance system for Utah, the Utah Real-time Outbreak and Disease Surveillance system (Utah RODS), in six weeks using our existing Real-time Outbreak and Disease Surveillance (RODS) architecture. During the Olympics, Utah RODS received real-time HL-7 admission messages from 10 emergency departments and 20 walk-in clinics. It collected free-text chief complaints, categorized them into one of seven prodromes classes using natural language processing, and provided a web interface for real-time display of time series graphs, geographic information system output, outbreak algorithm alerts, and details of the cases. The system detected two possible outbreaks that were dismissed as the natural result of increasing rates of Influenza. Utah RODS allowed us to further understand the complexities underlying the rapid deployment of a RODS-like system. PMID:12463938

Data, network, and application: technical description of the Utah RODS Winter Olympic Biosurveillance System.

PubMed

Tsui, Fu-Chiang; Espino, Jeremy U; Wagner, Michael M; Gesteland, Per; Ivanov, Oleg; Olszewski, Robert T; Liu, Zhen; Zeng, Xiaoming; Chapman, Wendy; Wong, Weng Keen; Moore, Andrew

2002-01-01

Given the post September 11th climate of possible bioterrorist attacks and the high profile 2002 Winter Olympics in the Salt Lake City, Utah, we challenged ourselves to deploy a computer-based real-time automated biosurveillance system for Utah, the Utah Real-time Outbreak and Disease Surveillance system (Utah RODS), in six weeks using our existing Real-time Outbreak and Disease Surveillance (RODS) architecture. During the Olympics, Utah RODS received real-time HL-7 admission messages from 10 emergency departments and 20 walk-in clinics. It collected free-text chief complaints, categorized them into one of seven prodromes classes using natural language processing, and provided a web interface for real-time display of time series graphs, geographic information system output, outbreak algorithm alerts, and details of the cases. The system detected two possible outbreaks that were dismissed as the natural result of increasing rates of Influenza. Utah RODS allowed us to further understand the complexities underlying the rapid deployment of a RODS-like system.

Readability of Orthopaedic Patient-reported Outcome Measures: Is There a Fundamental Failure to Communicate?

PubMed

Perez, Jorge L; Mosher, Zachary A; Watson, Shawna L; Sheppard, Evan D; Brabston, Eugene W; McGwin, Gerald; Ponce, Brent A

2017-08-01

Patient-reported outcome measures (PROMs) are increasingly used to quantify patients' perceptions of functional ability. The American Medical Association and NIH suggest patient materials be written at or below 6th to 8th grade reading levels, respectively, yet one recent study asserts that few PROMs comply with these recommendations, and suggests that the majority of PROMs are written at too high of a reading level for self-administered patient use. Notably, this study was limited in its use of only one readability algorithm, although there is no commonly accepted, standard readability algorithm for healthcare-related materials. Our study, using multiple readability equations and heeding equal weight to each, hopes to yield a broader, all-encompassing estimate of readability, thereby offering a more accurate assessment of the readability of orthopaedic PROMS. (1) What proportion of orthopaedic-related PROMs and orthopaedic-related portions of the NIH Patient Reported Outcomes Measurement Information System (PROMIS ® ) are written at or below the 6th and 8th grade levels? (2) Is there a correlation between the number of questions in the PROM and reading level? (3) Using systematic edits based on guidelines from the Centers for Medicare and Medicaid Services, what proportion of PROMs achieved American Medical Association and NIH-recommended reading levels? Eighty-six (86) independent, orthopaedic and general wellness PROMs, drawn from commonly referenced orthopaedic websites and prior studies, were chosen for analysis. Additionally, owing to their increasing use in orthopaedics, four relevant short forms, and 11 adult, physical health question banks from the PROMIS ® , were included for analysis. All documents were analyzed for reading grade levels using 19 unique readability algorithms. Descriptive statistics were performed using SPSS Version 22.0. The majority of the independent PROMs (64 of 86; 74%) were written at or below the 6th grade level, with 81 of 86 (94%) written at or below the 8th grade level. All item banks (11 of 11) and short forms (four of four) of the PROMIS ® were written below the 6th grade reading level. The median reading grade level of the 86 independent PROMs was 5.0 (interquartile range [IQR], 4.6-6.1). The PROMIS ® question banks had a median reading grade level of 4.1 (IQR, 3.5-4.8); the Adult Short Forms had a median reading grade level of 4.2 (IQR, 4.2-4.3) There was no correlation appreciated between the median reading grade level and the number of questions contained in a PROM (r = -0.081; p = 0.460). For PROMs above NIH-recommended levels, following edits, all (five of five) achieved NIH reading level goals and three (three of five) achieved American Medical Association goals. Editing of these PROMs improved readability by 4.3 median grade level (before, 8.9 [IQR, 8.4-9.1], after 4.6 [IQR, 4.6-6.4], difference of medians, 4.3; p = 0.008). Patient literacy has great influence on healthcare outcomes, and readability is an important consideration in all patient-directed written materials. Our study found that more than 70% of PROMs commonly used in orthopaedics, and all orthopaedic-related portions of the PROMIS ® are written at or below the most stringent recommendations (≤ 6th grade reading level), and more than 90% of independent PROMs and all PROMIS ® materials are written at or below an 8th grade level. Additionally, the use of the Centers for Medicare and Medicaid Services guidelines for editing high reading level PROMs yields satisfactory results. Fears of widely incomprehensible PROMs may be unfounded. Future research to identify the most appropriate readability algorithm for use in the healthcare sector, and revalidation of PROMs after readability-improving edits is warranted.

Microbial isolators for use in the hospital.

PubMed

Trexler, P C

1975-02-01

Isolators made of flexible transparant plastic film maintain a physical separation between clean and dirty areas without interfering with the use of the isolated space. The reliability with which isolators maintain sterility has been demonstrated by the germ-free rearing of the common laboratory and domestic animals. Isolators are used routinely in orthopaedic surgery and for protecting patients who have severe congenital immune deficiency disease or are made infection-prone because of therapy.

The Masters of the Bolognese Orthopaedic School.

PubMed

Di Matteo, Berardo; Tarabella, Vittorio; Filardo, Giuseppe; Tomba, Patrizia; Viganò, Anna; Marcacci, Maurilio

2016-11-01

Bologna is one of the most ancient cradles of medical knowledge, as the city hosts one of the oldest medical faculties in the world. Among its best known institutions there is the Rizzoli Orthopaedic Institute, founded in the late nineteenth century, whose history is strictly connected with the evolution and development of the Italian orthopaedic practice of the last 120 years. The present manuscript acknowledges the main contributions by Francesco Rizzoli, Alessandro Codivilla and Vittorio Putti, who prompted the foundation and the international recognition of the Rizzoli Institute and the related Bolognese Orthopaedic School.

[Famous figures of the Poznań orthopaedics of the period of the occupation and post-war years. Coryphees of Polish orthopaedics].

PubMed

Barcikowski, Władysław

2008-01-01

In this article author presents, from a perspective of own memories is portraying persons which he met in his professional activity. They participated in forming the orthopaedics in Poznań and different nooks of Poland. He resembles their, often very dramatic, fates and the influence they had on Polish medicine reviving after the II world war. With the special attention he is reminding one of most well-known and valued celebrities of the Polish orthopaedics professor Wiktor Dega.

Professionalism, social media, and the Orthopaedic Surgeon: What do you have on the Internet?

PubMed

Call, Trevor; Hillock, Ronald

2017-01-01

Unprofessional conduct is detrimental to the Orthopaedic Surgery profession. Currently, no formal guidelines exist to define online professionalism other than the protection of patient confidentiality. This study will extract a random but statistically significant number of practicing Orthopaedic Surgeons and review their online postings. We observed the Internet content posted by 1,021 Orthopaedic Surgeons that were randomly selected from the American Academy of Orthopaedic Surgeons 2013 member directory. Each surgeon's name was entered into the Google.com search engine and on Social Media sites including Facebook.com, Twitter.com, LinkedIn.com, and YouTube.com. The content was evaluated and recorded where it was encountered. Unprofessional content was recorded and reviewed by a panel for appropriateness. Of the 1,021 Orthopaedic Surgeons sampled, 82% have professional websites, 4% have professional blogs, 21% have professional Facebook accounts, 14% have professional Twitter accounts, 26% have professional LinkedIn accounts, and 14% have professional YouTube accounts. Unprofessional content was identified in 3.5% of all surgeons sampled who have some form of content on the Internet. Every Orthopaedic Surgeon should be aware of the content posted on the Internet. Our recommendation is for surgeons to routinely evaluate content posted on publically available venues for professionalism.

National Institutes of Health Funding to Departments of Orthopaedic Surgery at U.S. Medical Schools.

PubMed

Silvestre, Jason; Ahn, Jaimo; Levin, L Scott

2017-01-18

The National Institutes of Health (NIH) is the largest supporter of biomedical research in the U.S., yet its contribution to orthopaedic research is poorly understood. In this study, we analyzed the portfolio of NIH funding to departments of orthopaedic surgery at U.S. medical schools. The NIH RePORT (Research Portfolio Online Reporting Tools) database was queried for NIH grants awarded to departments of orthopaedic surgery in 2014. Funding totals were determined for award mechanisms and NIH institutes. Trends in NIH funding were determined for 2005 to 2014 and compared with total NIH extramural research funding. Funding awarded to orthopaedic surgery departments was compared with that awarded to departments of other surgical specialties in 2014. Characteristics of NIH-funded principal investigators were obtained from department web sites. In 2014, 183 grants were awarded to 132 investigators at 44 departments of orthopaedic surgery. From 2005 to 2014, NIH funding increased 24.3%, to $54,608,264 (p = 0.030), but the rates of increase seen did not differ significantly from those of NIH extramural research funding as a whole (p = 0.141). Most (72.6%) of the NIH funding was awarded through the R01 mechanism, with a median annual award of $343,980 (interquartile range [IQR], $38,372). The majority (51.1%) of the total funds supported basic science research, followed by translational (33.0%), clinical (10.0%), and educational (5.9%) research. NIH-funded orthopaedic principal investigators were predominately scientists whose degree was a PhD (71.1%) and who were male (79.5%). Eleven NIH institutes were represented, with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) providing the preponderance (74.2%) of the funding. In 2014, orthopaedic surgery ranked below the surgical departments of general surgery, ophthalmology, obstetrics and gynecology, otolaryngology, and urology in terms of NIH funding received. The percentage increase of NIH funding to departments of orthopaedic surgery from 2005 to 2014 was not significantly greater than that of total NIH extramural research funding. Funding levels to orthopaedic surgery departments lag behind funding to departments of other surgical disciplines. Funding levels may not match the academic potential of orthopaedic faculty, and interventions may be needed to increase NIH grant procurement.

78 FR 6832 - Notice of Mailing Address Change for the Utah State Office, Salt Lake City, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-31

...The mailing address for the Bureau of Land Management (BLM), Utah State Office, in Salt Lake City, Utah, will be changing from P.O. Box 45155-0155 to 440 West 200 South, Suite 500, Salt Lake City, Utah 84101-1345. The proposed date will be on or about February 1, 2013. The office location address remains the same.

SIAM conference on applications of dynamical systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-01-01

A conference (Oct.15--19, 1992, Snowbird, Utah; sponsored by SIAM (Society for Industrial and Applied Mathematics) Activity Group on Dynamical Systems) was held that highlighted recent developments in applied dynamical systems. The main lectures and minisymposia covered theory about chaotic motion, applications in high energy physics and heart fibrillations, turbulent motion, Henon map and attractor, integrable problems in classical physics, pattern formation in chemical reactions, etc. The conference fostered an exchange between mathematicians working on theoretical issues of modern dynamical systems and applied scientists. This two-part document contains abstracts, conference program, and an author index.

SIAM conference on applications of dynamical systems. Abstracts and author index

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-12-31

A conference (Oct.15--19, 1992, Snowbird, Utah; sponsored by SIAM (Society for Industrial and Applied Mathematics) Activity Group on Dynamical Systems) was held that highlighted recent developments in applied dynamical systems. The main lectures and minisymposia covered theory about chaotic motion, applications in high energy physics and heart fibrillations, turbulent motion, Henon map and attractor, integrable problems in classical physics, pattern formation in chemical reactions, etc. The conference fostered an exchange between mathematicians working on theoretical issues of modern dynamical systems and applied scientists. This two-part document contains abstracts, conference program, and an author index.

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial.

PubMed

Prestmo, Anders; Hagen, Gunhild; Sletvold, Olav; Helbostad, Jorunn L; Thingstad, Pernille; Taraldsen, Kristin; Lydersen, Stian; Halsteinli, Vidar; Saltnes, Turi; Lamb, Sarah E; Johnsen, Lars G; Saltvedt, Ingvild

2015-04-25

Most patients with hip fractures are characterised by older age (>70 years), frailty, and functional deterioration, and their long-term outcomes are poor with increased costs. We compared the effectiveness and cost-effectiveness of giving these patients comprehensive geriatric care in a dedicated geriatric ward versus the usual orthopaedic care. We did a prospective, single-centre, randomised, parallel-group, controlled trial. Between April 18, 2008, and Dec 30, 2010, we randomly assigned home-dwelling patients with hip-fractures aged 70 years or older who were able to walk 10 m before their fracture, to either comprehensive geriatric care or orthopaedic care in the emergency department, to achieve the required sample of 400 patients. Randomisation was achieved via a web-based, computer-generated, block method with unknown block sizes. The primary outcome, analysed by intention to treat, was mobility measured with the Short Physical Performance Battery (SPPB) 4 months after surgery for the fracture. The type of treatment was not concealed from the patients or staff delivering the care, and assessors were only partly masked to the treatment during follow-up. This trial is registered with ClinicalTrials.gov, number NCT00667914. We assessed 1077 patients for eligibility, and excluded 680, mainly for not meeting the inclusion criteria such as living in a nursing home or being aged less than 70 years. Of the remaining patients, we randomly assigned 198 to comprehensive geriatric care and 199 to orthopaedic care. At 4 months, 174 patients remained in the comprehensive geriatric care group and 170 in the orthopaedic care group; the main reason for dropout was death. Mean SPPB scores at 4 months were 5·12 (SE 0·20) for comprehensive geriatric care and 4·38 (SE 0·20) for orthopaedic care (between-group difference 0·74, 95% CI 0·18-1·30, p=0·010). Immediate admission of patients aged 70 years or more with a hip fracture to comprehensive geriatric care in a dedicated ward improved mobility at 4 months, compared with the usual orthopaedic care. The results suggest that the treatment of older patients with hip fractures should be organised as orthogeriatric care. Norwegian Research Council, Central Norway Regional Health Authority, St Olav Hospital Trust and Fund for Research and Innovation, Liaison Committee between Central Norway Regional Health Authority and the Norwegian University of Science and Technology, the Department of Neuroscience at the Norwegian University of Science and Technology, Foundation for Scientific and Industrial Research at the Norwegian Institute of Technology (SINTEF), and the Municipality of Trondheim. Copyright © 2015 Elsevier Ltd. All rights reserved.

Accredited Orthopaedic Sports Medicine Fellowship Websites: An Updated Assessment of Accessibility and Content.

PubMed

Yayac, Michael; Javandal, Mitra; Mulcahey, Mary K

2017-01-01

A substantial number of orthopaedic surgeons apply for sports medicine fellowships after residency completion. The Internet is one of the most important resources applicants use to obtain information about fellowship programs, with the program website serving as one of the most influential sources. The American Orthopaedic Society for Sports Medicine (AOSSM), San Francisco Match (SFM), and Arthroscopy Association of North America (AANA) maintain databases of orthopaedic sports medicine fellowship programs. A 2013 study evaluated the content and accessibility of the websites for accredited orthopaedic sports medicine fellowships. To reassess these websites based on the same parameters and compare the results with those of the study published in 2013 to determine whether any improvement has been made in fellowship website content or accessibility. Cross-sectional study. We reviewed all existing websites for the 95 accredited orthopaedic sports medicine fellowships included in the AOSSM, SFM, and AANA databases. Accessibility of the websites was determined by performing a Google search for each program. A total of 89 sports fellowship websites were evaluated for overall content. Websites for the remaining 6 programs could not be identified, so they were not included in content assessment. Of the 95 accredited sports medicine fellowships, 49 (52%) provided links in the AOSSM database, 89 (94%) in the SFM database, and 24 (25%) in the AANA database. Of the 89 websites, 89 (100%) provided a description of the program, 62 (70%) provided selection process information, and 40 (45%) provided a link to the SFM website. Two searches through Google were able to identify links to 88% and 92% of all accredited programs. The majority of accredited orthopaedic sports medicine fellowship programs fail to utilize the Internet to its full potential as a resource to provide applicants with detailed information about the program, which could help residents in the selection and ranking process. Orthopaedic sports medicine fellowship websites that are easily accessible through the AOSSM, SFM, AANA, or Google and that provide all relevant information for applicants would simplify the process of deciding where to apply, interview, and ultimately how to rank orthopaedic sports medicine fellowship programs for the Orthopaedic Sports Medicine Fellowship Match.

Interprofessional Relationships between Orthopaedic and Podiatric Surgeons in the UK

PubMed Central

Isaac, A; Gwilym, SE; Reilly, IN; Kilmartin, TE; Ribbans, WJ

2008-01-01

INTRODUCTION The first comprehensive report on the interprofessional relationships between foot and ankle surgeons in the UK is presented. MATERIALS AND METHODS A questionnaire was sent to orthopaedic surgeons with membership of the British Foot and Ankle Surgery Society (BOFAS), orthopaedic surgeons not affiliated to the specialist BOFAS and podiatrists specialising in foot surgery. The questionnaire was returned by 77 (49%) of the BOFAS orthopaedic consultant surgeons, 66 (26%) of non-foot and ankle orthopaedic consultant surgeons and 99 (73%) of the podiatric surgeons. RESULTS While most respondents have experience of surgeons working in the other specialty in close geographical proximity, the majority do not believe that this has adversely affected their referral base. The experience of podiatrists of the outcomes of orthopaedic surgery has been more positive than orthopaedic surgeons of podiatric interventions. Podiatrists are more welcoming of future orthopaedic involvement in future foot and ankle services than in reverse. However, there are a sizeable number of surgeons in both professions who would like to see closer professional liaisons. The study has identified clear divisions between the professions but has highlighted areas where there is a desire from many clinicians to work more harmoniously together, such as in education, training and research. CONCLUSIONS While major concerns exist over issues such as surgery by non-registered medical practitioners and the suitable spectrum of surgery for each profession, many surgeons, in both professions, are willing to provide training for juniors in both specialties and there is a wish to have closer working relationships and common educational and research opportunities than exists at present. PMID:18796189

Have levels of evidence improved the quality of orthopaedic research?

PubMed

Cunningham, Brian P; Harmsen, Samuel; Kweon, Chris; Patterson, Jason; Waldrop, Robert; McLaren, Alex; McLemore, Ryan

2013-11-01

Since 2003 many orthopaedic journals have adopted grading systems for levels of evidence (LOE). It is unclear if the quality of orthopaedic literature has changed since LOE was introduced. We asked three questions: (1) Have the overall number and proportion of Level I and II studies increased in the orthopaedic literature since the introduction of LOE? (2) Is a similar pattern seen in individual orthopaedic subspecialty journals? (3) What is the interobserver reliability of grading LOE? We assigned LOE to therapeutic studies published in 2000, 2005, and 2010 in eight major orthopaedic subspecialty journals. Number and proportion of Level I and II publications were determined. Data were evaluated using log-linear models. Twenty-six reviewers (13 residents and 13 attendings) graded LOE of 20 blinded therapeutic articles from the Journal of Bone and Joint Surgery for 2009. Interobserver agreement relative to the Journal of Bone and Joint Surgery was assessed using a weighted kappa. The total number of Level I and II publications in subspecialty journals increased from 150 in 2000 to 239 in 2010. The proportion of high-quality publications increased with time (p < 0.001). All subspecialty journals other than the Journal of Pediatric Orthopaedics and the Journal of Orthopaedic Trauma showed a similar behavior. Average weighted kappa was 0.791 for residents and 0.842 for faculty (p = 0.209). The number and proportion of Level I and II publications have increased. LOE can be graded reliably with high interobserver agreement. The number and proportion of high-level studies should continue to increase.

Telehealth in paediatric orthopaedic surgery in Queensland: a 10-year review.

PubMed

Rowell, Philip D; Pincus, Paul; White, Megan; Smith, Anthony C

2014-12-01

Telemedicine is a patient consultation method commonly available to patients in rural and remote areas throughout Australia. Its use in paediatric orthopaedics has been rarely described. The primary aim of this study was to identify the patient cohort accessing the orthopaedic paediatric telehealth service through the Royal Children's Hospital Queensland, so as to better allocate this resource. The secondary aims were to identify the orthopaedic conditions the patients utilizing this service suffered and to follow-up on treatment outcomes to potentially assess clinical benefit. A retrospective review of prospectively collected data of paediatric orthopaedic patients consulted using telehealth at the Royal Children's Hospital, Queensland over a 10-year period between January 2004 and September 2012 was conducted. One hundred and twenty-six patient records were assessed with a mean age of 6 years. Results showed that 40% of patients seen using telehealth in paediatric orthopaedics had documented cerebral palsy, an intellectual disability or congenital syndrome. Common paediatric orthopaedic conditions were seen, with lower limb malalignment being the most common presenting complaint. About 58% of patients were seen exclusively via telehealth and did not require in-person consultation or operative therapy. We found that the orthopaedic telepaedriatic consultation service at the Royal Children's Hospital reviewed a large proportion of patients with a known disability. We believe there is a role for telehealth medicine for all patients; however, we propose that even greater benefit can be obtained from telehealth consultation in patients with a disability where the cost and inconvenience of patient transport is considerably increased. © 2014 Royal Australasian College of Surgeons.

Well 14-2 Logs and Data: Roosevelt Hot Spring Area, Utah (Utah FORGE)

DOE Data Explorer

Joe Moore

2016-03-03

This is a compilation of logs and data from Well 14-2 in the Roosevelt Hot Springs area in Utah. This well is also in the Utah FORGE study area. The file is in a compressed .zip format and there is a data inventory table (Excel spreadsheet) in the root folder that is a guide to the data that is accessible in subfolders.

Well 52-21 Logs and Data: Roosevelt Hot Spring Area, Utah (Utah FORGE)

DOE Data Explorer

Joe Moore

2016-03-03

This is a compilation of logs and data from Well 52-21 in the Roosevelt Hot Springs area in Utah. This well is also in the Utah FORGE study area. The file is in a compressed .zip format and there is a data inventory table (Excel spreadsheet) in the root folder that is a guide to the data that is accessible in subfolders.

Well 82-33 Logs and Data: Roosevelt Hot Spring Area, Utah (Utah FORGE)

DOE Data Explorer

Joe Moore

2016-03-03

This is a compilation of logs and data from Well 82-33 in the Roosevelt Hot Springs area in Utah. This well is also in the Utah FORGE study area. The file is in a compressed .zip format and there is a data inventory table (Excel spreadsheet) in the root folder that is a guide to the data that is accessible in subfolders.

Well Acord 1-26 Logs and Data: Roosevelt Hot Spring Area, Utah (Utah FORGE)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Joe Moore

This is a compilation of logs and data from Well Acord 1-26 in the Roosevelt Hot Springs area in Utah. This well is also in the Utah FORGE study area. The file is in a compressed .zip format and there is a data inventory table (Excel spreadsheet) in the root folder that is a guide to the data that is accessible in subfolders.

Environmental Assessment: Proposed Training Facilities, Hill Air Force Base, Utah

DTIC Science & Technology

2013-08-08

FA8201-09-D-0002 Facilities, Hill Air Force Base, Utah 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Klein, Randal 5d...PERFORMING ORGANIZATION REPORT NUMBER Streamline Consulting, LLC 1713 N. Sweetwater Lane Farmington, Utah 84025...proposes to construct new training facilities at Hill Air Force Base, Utah . The findings of this EA indicate that the proposed action would not have

Hydrologic and climatologic data, 1965, Salt Lake County, Utah

USGS Publications Warehouse

Iorns, W.V.; Mower, Reed W.; Horr, C.A.

1966-01-01

An investigation of the water resources of Salt Lake County, Utah, was undertaken by the Water Resources Division of the U.S. Geological Survey in July 1963. This investigation is a cooperative project financed equally by the State of Utah and the Federal Government in accordance with an agreement between the State Engineer and the Geological Survey. The Utah Water and Power Board, Utah Fish and Game Commission, Salt Lake County Water Conservancy District, Metropolitan Water District of Salt Lake City, Salt Lake County, Kennecott Copper Corporation, Utah Power and Light Company, Salt Lake City Chamber of Commerce, and the Central Utah Water Conservancy District. contributed funds to the State Engineer's office toward support of the project.The investigation encompasses the collection and interpretation of a large variety of climatologic, hydrologic, and geologic data in and near Salt Lake County. Utah Basic-Data Release No. 11 contains data collected through 1964. This release contains climatologic and surface-water data for the 1965 water year (October 1964 to September 1965) and ground-water data collected during the 1965 calendar year. Similar annual releases will contain data collected during the remainder of the investigation, and interpretive reports will be prepared as the investigation proceeds. Organizations that furnished data are acknowledged in station descriptions and footnotes to tables.

Hydrologic and climatologic data, 1966, Salt Lake County, Utah

USGS Publications Warehouse

Hely, A.G.; Mower, Reed W.; Horr, C.A.

1967-01-01

An investigation of the water resources of Salt Lake County, Utah, was undertaken by the Water Resources Division of the U.S. Geological Survey in July 1963. This investigation is a cooperative project financed equally by the State of Utah and the Federal Government in accordance with an agreement between the State Engineer and the Geological Survey. The Utah Water and Power Board, Utah Fish and Game Commission, Salt Lake County Water Conservancy District, Metropolitan Water District of Salt Lake City, Salt Lake County, Kennecott Copper Corporation, Utah Power and Light Company, Salt Lake City Chamber of Commerce, and the Central Utah Water Conservancy District contributed funds to the State Engineer's office toward support of the project.The investigation encompasses the collection and interpretation of a large variety of climatologic, hydrologic, and geologic data in and near Salt Lake County. Utah Basic-Data Releases 11 and 12 contain data collected through 1965. This release contains climatologic and surface-water data for the 1966 water year (October 1965 to September 1966) and groundwater data collected during the 1966 calendar year. Similar annual releases will contain data collected during the remainder of the investigation, and interpretive reports will be prepared as the investigation proceeds. Organizations that furnished data are acknowledged in station descriptions and footnotes to tables.

Ground-water conditions in southern Utah Valley and Goshen Valley, Utah

USGS Publications Warehouse

Cordova, R.M.

1970-01-01

The investigation of ground-water conditions in southern Utah Valley and Goshen Valley, Utah, was made by the U. S. Geological Survey as part of a cooperative program with the Utah Department of Natural Resources, Division of Water Rights, to investigate the water resources of the State. The purposes of the investigation were to (1) determine the occurrence, recharge, discharge, movement, storage, chemical quality, and availability of ground water; (2) appraise the effects of increased withdrawal of water from wells; and (3) evaluate the effect of the Central Utah Project on the ground-water reservoir and the water supply of Utah Lake.This report presents a description of the aquifer system in the two valleys, a detailed description of the ground-water resources, and conclusions about potential development and its effect on the hydrologic conditions in the valleys. Two supplementary reports are products of the investigation. A basic-data release (Cordova, 1969) contains most of the basic data collected for the investigation, including well characteristics, drillers' logs, water levels, pumpage from wells, chemical analyses of ground and surface waters, and discharge of selected springs, drains, and streams. An interpretive report (Cordova and Mower, 1967) contains the results of a large-scale aquifer test in southern Utah Valley.

Respiratory hospital admissions associated with PM10 pollution in Utah, Salt Lake, and Cache Valleys

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pope CA, I.I.I.

This study assessed the association between respiratory hospital admissions and PM10 pollution in Utah, Salt Lake, and Cache valleys during April 1985 through March 1989. Utah and Salt Lake valleys had high levels of PM10 pollution that violated both the annual and 24-h standards issued by the Environmental Protection Agency (EPA). Much lower PM10 levels occurred in the Cache Valley. Utah Valley experienced the intermittent operation of its primary source of PM10 pollution: an integrated steel mill. Bronchitis and asthma admissions for preschool-age children were approximately twice as frequent in Utah Valley when the steel mill was operating versus whenmore » it was not. Similar differences were not observed in Salt Lake or Cache valleys. Even though Cache Valley had higher smoking rates and lower temperatures in winter than did Utah Valley, per capita bronchitis and asthma admissions for all ages were approximately twice as high in Utah Valley. During the period when the steel mill was closed, differences in per capita admissions between Utah and Cache valleys narrowed considerably. Regression analysis also demonstrated a statistical association between respiratory hospital admissions and PM10 pollution. The results suggest that PM10 pollution plays a role in the incidence and severity of respiratory disease.« less

Social Competence and Temperament in Children with Chronic Orthopaedic Disability

ERIC Educational Resources Information Center

Yagmurlu, Bilge; Yavuz, H. Melis

2015-01-01

The aim of the study was to investigate social competence in children with orthopaedic disability and its concurrent relations to child's temperament, health condition, and maternal warmth. Participants were 68 Turkish children (mean = 5.94 years) with chronic orthopaedic disability and their mothers coming from disadvantaged backgrounds. Mother…

Long Sick Leave after Orthopaedic Inpatient Rehabilitation: Treatment Failure or Relapse?

ERIC Educational Resources Information Center

Mangels, Marija; Schwarz, Susanne; Worringen, Ulrike; Holme, Martin; Rief, Winfried

2011-01-01

We investigated whether short-term versus long-term sick leave after orthopaedic inpatient rehabilitation can be predicted by initial assessment information, the clinical status at discharge, or whether the follow-up interval is crucial for later sick leave. We examined 214 patients from an orthopaedic rehabilitation hospital at admission,…

Building the Capacity to Manage Orthopaedic Trauma After a Catastrophe in a Low-Income Country.

PubMed

Furey, Andrew; Rourke, James; Larsen, Hans

2015-10-01

Providing trauma care in an austere environment is very challenging, especially when the country is faced with a natural disaster. Unfortunately the combination of these elements highlights the deficiencies in managing orthopaedic trauma both in a developing country and in the face of a natural disaster, exponentially amplifying the effects of each. When considering the implementation and practice of orthopaedic trauma care in such an environment, one must consider the initial phase of program development and look further to the future in the development of a resilient program, which is sustainable. Through the use of the example of Haiti and a specific Non-Governmental Organization, we discuss the evidence for and thoughts behind developing orthopaedic trauma care program immediately after a natural disaster. This program aims to build capacity and empower a developing nation's health professionals to advance the care of orthopaedic trauma patients. We describe a model of capacity building that serves as a framework to highlight the strengths and weaknesses of low-to middle-income countries in providing orthopaedic trauma care when faced with such a challenge.

Improvement of research quality in the fields of orthopaedics and trauma: a global perspective.

PubMed

Fayaz, Hangama C; Haas, Norbert; Kellam, James; Bavonratanavech, Suthorn; Parvizi, Javad; Dyer, George; Pohlemann, Tim; Jerosch, Jörg; Prommersberger, Karl-Josef; Pape, Hans Christoph; Smith, Malcolm; Vrahas, Marc; Perka, Carsten; Siebenrock, Klaus; Elhassan, Bassem; Moran, Christopher; Jupiter, Jesse B

2013-07-01

The international orthopaedic community aims to achieve the best possible outcome for patient care by constantly modifying surgical techniques and expanding the surgeon's knowledge. These efforts require proper reflection within a setting that necessitates a higher quality standard for global orthopaedic publication. Furthermore, these techniques demand that surgeons acquire information at a rapid rate while enforcing higher standards in research performance. An international consensus exists on how to perform research and what rules should be considered when publishing a scientific paper. Despite this global agreement, in today's "Cross Check Era", too many authors do not give attention to the current standards of systematic research. Thus, the purpose of this paper is to describe these performance standards, the available choices for orthopaedic surgeons and the current learning curve for seasoned teams of researchers and orthopaedic surgeons with more than three decades of experience. These lead to provide an accessible overview of all important aspects of the topics that will significantly influence the research development as we arrive at an important globalisation era in orthopaedics and trauma-related research.

Ground water in Tooele Valley, Utah

USGS Publications Warehouse

Gates, J.S.; Keller, O.A.

1970-01-01

This short report was written by condensing parts of a technical report on the ground water in Tooele Valley, which was prepared as part of a cooperative program between the Utah Department of Natural Resources, Division of Water Rights, and the U. S. Geological Survey to study water in Utah. If you would like to read the more detailed technical report, write for a copy of the Utah State Engineer Technical Publication 12, “Reevaluation of the ground-water resources of Tooele Valley, Utah” by J. S. Gates. Copies can be obtained free of charge from the Division of Water Rights, State Capitol, Salt Lake City, Utah 84114.

Biological data for water in Lake Powell and from Glen Canyon Dam releases, Utah and Arizona, 1990–2009

USGS Publications Warehouse

Vernieu, William S.

2015-10-06

The results of these analyses are presented in this report. From this record, further interpretation may be made concerning primary and secondary production in Lake Powell. These data provide a linkage between physical and chemical water-quality data and fisheries investigations in Lake Powell. They also provide information regarding the export of biological material from Glen Canyon Dam.

Perspectives on Aging. Exercise and Wellness Programs for Aging Adults. A Conference Held at Brigham Young University (Provo, Utah, August 22, 1983).

ERIC Educational Resources Information Center

1983

Papers presented at a conference on recreation, exercise, and wellness for aging adults included: (1) "Leisure Activity in the 11th Hour or Physical Pursuits of Old Fossils" (Larry L. Neal); (2) "Exercise and Nutrition for the Senior Adult" (Michele Anderson and Jackie A. Smith); and (3) "Senior Wellness Advocacy Network--S.W.A.N.--An Experiment…

Ten-year cardiovascular risk assessment in university students.

PubMed

Uvacsek, Martina; Kneffel, Zs; Tóth, M; Johnson, A W; Vehrs, P; Myrer, J W; Hager, R

2014-09-01

Cardiovascular disease (CVD) is responsible for more than half of all deaths in the European region. The aim of the study was to compare body composition, blood pressure, total cholesterol (TC) and high density lipoprotein cholesterol (HDL-C), family history, activity behaviors, and the 10-year risk of having a heart attack between 166 university students (21.62 ± 2.59 yrs) from Utah (USA) and 198 students (22.11 ± 2.51 yrs) from Hungary. Ninety-two percent of the Hungarian students and 100% of the Utah students had an estimated 10-year Framingham risk score of 1% or less. The high prevalence of low risk was primarily due to the young age of study participants, healthy body composition and non-smoking behavior. Hungarians who had higher 10-year risk of heart attack had significantly higher waist hip ratio (WHR), TC, diastolic blood pressure (DBP) and were smokers compared to those Hungarians with lower risk. The self-reported physical activity levels between the two groups of students were not different. In conclusion the young men and women who participated in this study were, for the most part healthy; however the smoking habits and the lower physical activity of the Hungarian students likely elevated their risk of CVD.

Plantar Fasciitis: Will Physical Therapy Help My Foot Pain?

PubMed

2017-02-01

One out of 10 people in the United States experience persistent pain along the bottom of the foot, a condition known as plantar fasciitis. In 2014, the Orthopaedic Section of the American Physical Therapy Association published updated clinical practice guidelines on the best treatments for patients with plantar fasciitis. The guidelines present evidence that strongly suggests a combination of manual therapy and rehabilitative exercises to help patients with this foot condition. In a more recent study published in the February 2017 issue of JOSPT, researchers reviewed the records of people with plantar fasciitis who were sent to physical therapy. The results of this study support prior studies that show faster recovery time for those who receive evidence-based physical therapy for their foot pain. J Orthop Sports Phys Ther 2017;47(2):56. doi:10.2519/jospt.2017.0501.

Orthopaedic Surgeon Burnout: Diagnosis, Treatment, and Prevention.

PubMed

Daniels, Alan H; DePasse, J Mason; Kamal, Robin N

2016-04-01

Burnout is a syndrome marked by emotional exhaustion, depersonalization, and low job satisfaction. Rates of burnout in orthopaedic surgeons are higher than those in the general population and many other medical subspecialties. Half of all orthopaedic surgeons show symptoms of burnout, with the highest rates reported in residents and orthopaedic department chairpersons. This syndrome is associated with poor outcomes for surgeons, institutions, and patients. Validated instruments exist to objectively diagnose burnout, although family members and colleagues should be aware of early warning signs and risk factors, such as irritability, withdrawal, and failing relationships at work and home. Emerging evidence indicates that mindfulness-based interventions or educational programs combined with meditation may be effective treatment options. Orthopaedic residency programs, departments, and practices should focus on identifying the signs of burnout and implementing prevention and treatment programs that have been shown to mitigate symptoms.

Variation in torpor patterns of free-ranging black-tailed and Utah prairie dogs across gradients of elevation

USGS Publications Warehouse

Lehmer, E.M.; Biggins, D.E.

2005-01-01

We compared over-winter body temperature (Tb) patterns for more than 6 months in adult (> 1 year) black-tailed (Cynomys ludovicianus) and Utah (C. parvidens) prairie dogs from colonies located along gradients of elevation in northern Colorado and southern Utah. In general, black-tailed prairie dogs entered torpor facultatively during winter, whereas Utah prairie dogs hibernated continuously for extended periods. Both black-tailed and Utah prairie dogs displayed significant differences in Tb patterns across elevations, with lower elevation populations entering more shallow and infrequent torpor than prairie dogs at higher elevations. Tb patterns of black-tailed prairie dogs followed 24-h cycles, as most prairie dogs entered into and aroused from torpor between 1100 and 1700 h and bout lengths were clustered around 24-h intervals and multiples thereof. Torpor in Utah prairie dogs did not display the same daily patterns; they entered into and aroused from torpor at all times of the day, and bout lengths were variable. Although black-tailed and Utah prairie dogs are closely related, mechanisms that stimulate and control torpor might differ between them.

Map showing length of freeze-free season in the Salina quadrangle, Utah

USGS Publications Warehouse

Covington, Harry R.

1972-01-01

In general, long freeze-free periods occur at low elevations, and short freeze-free periods occur at high elevations. But some valley floors have shorter freeze-free seasons than the glancing foothills because air cooled at high elevations flows downward and is trapped in the valleys. This temperature pattern occurs in the western part of the quadrangle in Rabbit Valley, Grass Valley, and the Sevier River Valley near Salina.Because year-round weather stations are sparse in Utah, a special technique for estimating length of freeze-free season was developed by Dr. Gaylen L. Ashcroft, Assistant Professor of Climatology, Utah State University, and E. Arlo Richardson, State Climatologist, U.S. Weather Bureau, based on average annual temperature, average annual temperature range, average daily temperature range, and average july maximum temperature. This technique was used in preparation of the map showing “Length of 32°F freeze-free season for Utah,” figure 23 in Hydrologic Atlas of Utah (Utah State University and Utah Division of Water Resources, 1968), from which the data for this map were taken.

Tracking Cumulative Radiation Exposure in Orthopaedic Surgeons and Residents: What Dose Are We Getting?

PubMed

Gausden, Elizabeth B; Christ, Alexander B; Zeldin, Roseann; Lane, Joseph M; McCarthy, Moira M

2017-08-02

The purpose of this study was to determine the amount of cumulative radiation exposure received by orthopaedic surgeons and residents in various subspecialties. We obtained dosimeter measures over 12 months on 24 residents and 16 attending surgeons. Monthly radiation exposure was measured over a 12-month period for 24 orthopaedic residents and 16 orthopaedic attending surgeons. The participants wore a Landauer Luxel dosimeter on the breast pocket of their lead apron. The dosimeters were exchanged every rotation (5 to 7 weeks) for the resident participants and every month for the attending surgeon participants. Radiation exposure was compared by orthopaedic subspecialty, level of training, and type of fluoroscopy used (regular C-arm compared with mini C-arm). Orthopaedic residents participating in this study received monthly mean radiation exposures of 0.2 to 79 mrem/month, lower than the dose limits of 5,000 mrem/year recommended by the United States Nuclear Regulatory Commission (U.S. NRC). Senior residents rotating on trauma were exposed to the highest monthly radiation (79 mrem/month [range, 15 to 243 mrem/month]) compared with all other specialty rotations (p < 0.001). Similarly, attending orthopaedic surgeons who specialize in trauma or deformity surgery received the highest radiation exposure of their peers, and the mean exposure was 53 mrem/month (range, 0 to 355 mrem/month). Residents and attending surgeons performing trauma or deformity surgical procedures are exposed to significantly higher doses of radiation compared with all other subspecialties within orthopaedic surgery, but the doses are still within the recommended limits. The use of ionizing radiation in the operating room has become an indispensable part of orthopaedic surgery. Although all surgeons in our study received lower than the yearly recommended dose limit, it is important to be aware of how much radiation we are exposed to as surgeons and to take measures to further limit that exposure.

Evaluation of the orthopaedics and traumatology resident education in Turkey: A descriptive study.

PubMed

Huri, Gazi; Cabuk, Yusuf Sertan; Gursoy, Safa; Akkaya, Mustafa; Ozkan, Secil; Oztuna, Volkan; Aydingoz, Onder; Senkoylu, Alparslan

2016-10-01

The objective of this study is to describe the current situation regarding the training, working conditions, future plans, fields of interest and satisfaction of orthopaedics and traumatology residents in Turkey. A descriptive survey questionnaire consisting of 24 questions was designed to identify the problems and solution suggestions concerning training of orthopaedic residents. All orthopaedics and traumatology residents who took the 2013 Progress Testing for Speciality in Medicine (UEGS) held by Turkish Orthopaedics and Traumatology Education Council (TOTEK) were surveyed in the class at the end thereof as well as the young orthopaedic surgeons who were reached through the email groups of Turkish Society of Orthopaedics and Traumatology - Residents and Young Attendings Council (TOTBID-AGUH). A total of 725 residents and 132 young attendings were surveyed. The most outstanding answers are as follows: 62,7% of the respondents replied to the question "Is there a training program/Is it being applied" as "yes/yes". It was found out that 94,3% of the respondents wanted to be involved in a rotation abroad. The "patient care" was the most common answer, with a ratio of 36,9%, to the question "What's the priority of the department you are studying in?". Regarding work conditions, "many emergency on-calls" was found to be the most important parameter affecting life conditions (p < 0.05). Aiming to identify the challenges that orthopaedics and traumatology residents in Turkey face as regards their training, this survey stands as a pioneering study with a high participation rate. Analysis of survey data highlights the importance of several key factors such as the development of training programs and increasing the time spent with academicians as well as spreading and promotion of log book application. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Whole-Person Impairment in Younger Retired NFL Players

PubMed Central

Domb, Benjamin G.; Carter, Chris; Finch, Nathan A.; Hammarstedt, Jon E.; Dunne, Kevin F.; Stake, Christine E.

2014-01-01

Background: Professional American football is a physically demanding, high-impact sport with an elevated risk of injury. Orthopaedic injuries may impose acute, short-term or cumulative consequences throughout a player’s lifetime. Several studies have addressed health and psychosocial concerns of an older, retired population of players in the National Football League (NFL); however, minimal research has examined the orthopaedic toll on younger, retired players. Purpose: This study reports total whole-person impairment (WPI) percentages in a cohort of younger, retired NFL players who presented for disability evaluations based on the use of standardized American Medical Association (AMA) impairment guidelines. Study Design: Case series; Level of evidence, 4. Methods: During the study period of February 2011 to August 2013, 65 younger retired NFL players presented for impairment evaluations. The mean time between retirement and impairment evaluation was 3.1 years (range, 0.3-16.4 years). A complete history and physical examination was performed on all symptomatic joints. A retrospective chart review was conducted on 100% of presenting players to assess orthopaedic burden. Body-part impairment (BPI) percentage for each affected joint was generated. The impairment data for each extremity were then combined with spine impairment data to create WPI percentage. Player demographics, including age, position, and playing time, were also recorded. Results: The average WPI percentage was 37% (range, 19%-53%). Players participating in >30 games (n = 54) had a higher mean WPI percentage (38%) than those playing in <30 games (31%; n = 11) (P = .004). Players competing in >5 seasons (n = 46) were 2.4 times more likely to have a WPI of at least 37% (P = .007). The most common joints players reported as symptomatic were lumbar (n = 63; 97%) and cervical spine (n = 58; 89%). The mean age at evaluation was 33.5 years (range, 27-42 years), and the mean number of seasons played was 7.5 (range, 3-14 seasons). The mean number of games played was 98.4 (range, 2-236 games). Conclusion: This study demonstrated high WPI percentages related to symptomatic joints in a cohort of younger, retired NFL players. Further research is warranted to study potential cumulative physical and quality of life factors related to high impairment percentages in younger, retired NFL players. PMID:26535333

Accelerating the pace of discovery in orthopaedic research: A vision toward team science.

PubMed

Bahney, Chelsea S; Bruder, Scott P; Cain, Jarrett D; Keyak, Joyce H; Killian, Megan L; Shapiro, Irving M; Jones, Lynne C

2016-10-01

The landscape of basic science in the United States and around the world is changing, and the field of orthopaedic research is positioned to lead by embracing a culture of collaborative, team science that reflects our field's interdisciplinary nature. In this article we hope to address some of the cultural challenges and programmatic barriers that impede a team science approach in the US and suggest opportunities for change. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1673-1679, 2016. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

The orthopaedic research scene and strategies to improve it.

PubMed

Rankin, K S; Sprowson, A P; McNamara, I; Akiyama, T; Buchbinder, R; Costa, M L; Rasmussen, S; Nathan, S S; Kumta, S; Rangan, A

2014-12-01

Trauma and orthopaedics is the largest of the surgical specialties and yet attracts a disproportionately small fraction of available national and international funding for health research. With the burden of musculoskeletal disease increasing, high-quality research is required to improve the evidence base for orthopaedic practice. Using the current research landscape in the United Kingdom as an example, but also addressing the international perspective, we highlight the issues surrounding poor levels of research funding in trauma and orthopaedics and indicate avenues for improving the impact and success of surgical musculoskeletal research. ©2014 The British Editorial Society of Bone & Joint Surgery.

Automatic Bone Drilling - More Precise, Reliable and Safe Manipulation in the Orthopaedic Surgery

NASA Astrophysics Data System (ADS)

Boiadjiev, George; Kastelov, Rumen; Boiadjiev, Tony; Delchev, Kamen; Zagurski, Kazimir

2016-06-01

Bone drilling manipulation often occurs in the orthopaedic surgery. By statistics, nowadays, about one million people only in Europe need such an operation every year, where bone implants are inserted. Almost always, the drilling is performed handily, which cannot avoid the subjective factor influence. The question of subjective factor reduction has its answer - automatic bone drilling. The specific features and problems of orthopaedic drilling manipulation are considered in this work. The automatic drilling is presented according the possibilities of robotized system Orthopaedic Drilling Robot (ODRO) for assuring the manipulation accuracy, precision, reliability and safety.

Reducing highway litter.

DOT National Transportation Integrated Search

2013-06-01

The objective of this report is to evaluate the status of highway litter in the State of Utah. Under the direction of Russ Scovil, engineer with the Utah Department of Transportation (UDOT), researchers at the University of Utah performed a literatur...

Environmental Assessment for Pond Target at the South Range of the Utah Test and Training Range

DTIC Science & Technology

2004-11-01

Christenson, 1988 , Shallow Ground Water and Related Hazards in Utah) Mr. Marcus Blood, the Hill AFB Natural Resources Manager, has reported a shallow...Christenson, 1988 , Shallow Ground Water and Related Hazards in Utah) Mr. Marcus Blood, the Hill AFB Natural Resources Manager, has reported a shallow...Complex Cultural Resource Inventory, Wendover Air Force Range, Tooele County, Utah, March 1999. Cronquist , A ., Holmgren, A.H., Holmgren, N.H

Environmental Assessment (EA): Proposed Emergency Power Unit Overhaul Complex at Little Mountain Test Annex, Utah

DTIC Science & Technology

2014-03-14

NUMBER FA8201-09-D-0002 Overhaul Complex at Little Mountain Test Annex, Utah 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT NUMBER Streamline Consulting, LLC 1713 N. Sweetwater Lane Farmington, Utah 84025...Hill Air Force Base (AFB) proposes to construct a new emergency power unit overhaul complex at Little Mountain Test Annex, Utah . Buildings 2005

Water-resources activities of the U.S. Geological Survey in Utah, October 1, 1993, to September 30, 1994

USGS Publications Warehouse

Hardy, Ellen E.; Dragos, Stefanie L.

1996-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from October 1, 1993, to September 30, 1994. The water-resources program in Utah during this period consisted of 21 projects; a discussion of each project is presented in the main body of this report.The following sections outline the origin of the U.S. Geological Survey, the basic mission of the Water Resources Division, the organizational structure of the Utah District, office addresses of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1993 to September 1994.

Water-resources activities of the U.S. Geological Survey in Utah, October 1, 1994, to September 30, 1995

USGS Publications Warehouse

Hardy, Ellen E.; Dragos, Stefanie L.

1996-01-01

This report contains summaries of the progress of water-resources studies in Utah done by the U.S. Geological Survey, Water Resources Division, Utah District, from October 1,1994, to September 30, 1995. The waterresources program in Utah during this period consisted of 23 projects; a discussion of each project is presented in the main body of this report.The following sections outline the origin of the U.S. Geological Survey, the basic mission of the Water Resources Division, the organizational structure of the Utah District, office addresses of the Utah District, the distribution of program funding as source of funds and type of activity funded in Federal Fiscal Year (FY) 1995 (October 1, 1994, to September 30,1995), and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1994 to September 1995.

Perspective: Integrating research into surgical residency education: lessons learned from orthopaedic surgery.

PubMed

Atesok, Kivanc I; Hurwitz, Shepard R; Egol, Kenneth A; Ahn, Jaimo; Owens, Brett D; Crosby, Lynn A; Pellegrini, Vincent D

2012-05-01

Orthopaedic research has advanced tremendously in parallel with accelerated progress in medical science. Possession of a fundamental understanding of basic and clinical science has become more essential than previously for orthopaedic surgeons to be able to translate advances in research into clinical practice. The number of medical graduates with prior education in scientific research who choose to pursue careers in orthopaedic surgery is small. Therefore, it is important that a core of research education be included during residency training to ensure the continued advancement of the clinical practice of orthopaedics. The authors examine some of the challenges to a comprehensive research experience during residency, including deficient priority, inadequate institutional infrastructure, financial strain on residency budgets, restricted time, and an insufficient number of mentors to encourage and guide residents to become clinician-scientists. They also present some strategies to overcome these challenges, including development and expansion of residency programs with clinician-scientist pathways, promotion of financial sources, and enhancement of opportunities for residents to interact with mentors who can serve as role models. Successful integration of research education into residency programs will stimulate future orthopaedic surgeons to develop the critical skills to lead musculoskeletal research, comprehend related discoveries, and translate them into patient care. Lessons learned from incorporating research training within orthopaedic residency programs will have broad application across medical specialties-in both primary and subspecialty patient care.

The sound of orthopaedic surgery--the application of acoustic emission technology in orthopaedic surgery: a review.

PubMed

Rashid, Mustafa S; Pullin, Rhys

2014-01-01

Acoustic emission technology has been developed and extensively used as a non-destructive method of testing within engineering. In recent years, acoustic emission has gained popularity within the field of Orthopaedic research in a variety of situations. It is an attractive method in the detection of flaws within structures due its high sensitivity and non-destructive nature. The aim of this article is firstly to critically review the research conducted using acoustic emission testing in a variety of Orthopaedic-related situations and to present the technique to the wider Orthopaedic community. A summary of the principles and practical aspects of using acoustic emission testing are outlined. Acoustic emission has been validated as a method of early detection of aseptic loosening in femoral components in total hip arthroplasty in several well-conducted in vitro studies [1-3]. Other studies have used acoustic emission to detect microdamage in bone and to assess the biomechanical properties of bone and allografts [9]. Researchers have also validated the use of acoustic emission to detect and monitor fracture healing [4]. Several studies have applied acoustic emission to spinal surgery and specifically to assess the biomechanical environment in titanium mesh cages used in spinal surgery [10, 11]. Despite its growing popularity within Orthopaedic research, acoustic emission remains are relatively unfamiliar technique to the majority of Orthopaedic surgeons.

Factors Motivating Medical Students in Selecting a Career Specialty: Relevance for a Robust Orthopaedic Pipeline.

PubMed

Rao, Raj D; Khatib, Omar N; Agarwal, Arnav

2017-07-01

Selection of a career specialty by medical students is a complex and individualized decision. Our goals were to understand the factors that influenced medical students in selecting their career specialty, identify the stage at which this decision was made, and understand the role of demographics, mentors, and curricula in this process. Medical students from 10 institutions participated in a web-based survey. Results were stratified by sex, race/ethnicity, and level of interest in orthopaedic surgery. A total of 657 students responded to the survey. Specialty content (mean rating, 8.4/10) and quality of life/lifestyle/stress level (7.5/10) were the primary motivating factors in selecting a specialty. Interest in orthopaedic surgery was lower in women than in men (2.7 versus 3.9; P < 0.01) and was equivalent among race/ethnicity groups. Although 27% of students reported moderate or extensive medical school curriculum exposure to orthopaedics, this education did not sway them toward the specialty. Levels of interest in orthopaedics among medical students may be lower than generally assumed. Increasing the attractiveness of the specialty will require a multifaceted approach, including recognition of lifestyle factors, adjustments in the orthopaedic clerkship to make the specialty more appealing, mentorship by orthopaedic faculty, and conversion of high levels of interest in the specialty among minority medical students into successful residency applications. IV.

Can Rheumatologists Predict Eventual Need for Orthopaedic Intervention in Patients with Rheumatoid Arthritis? Results of a Systematic Review and Analysis of Two UK Inception Cohorts.

PubMed

Nikiphorou, Elena; Carpenter, Lewis; Norton, Sam; Morris, Stephen; MacGregor, Alex; Dixey, Josh; Williams, Peter; Kiely, Patrick; Walsh, David Andrew; Young, Adam

2017-03-01

The structural damage caused by rheumatoid arthritis (RA) can often be mitigated by orthopaedic surgery in late disease. This study evaluates the value of predictive factors for orthopaedic intervention. A systematic review of literature was undertaken to identify papers describing predictive factors for orthopaedic surgery in RA. Manuscripts were selected if they met inclusion criteria of cohort study design, diagnosis of RA, follow-up duration/disease duration ≥3 years, any orthopaedic surgical interventions recorded, and then summarised for predictive factors. A separate predictive analysis was performed on two consecutive UK Early RA cohorts, linked to national datasets. The literature search identified 15 reports examining predictive factors for orthopaedic intervention, 4 inception, 5 prospective and 6 retrospective. Despite considerable variation, acute phase, x-ray scores, women and genotyping were the most commonly reported prognostic markers. The current predictive analysis included 1602 procedures performed in 711 patients (25-year cumulative incidence 26%). Earlier recruitment year, erosions and lower haemoglobin predicted both intermediate and major surgery (P<0.05). Studies report variations in type of and predictive power of clinical and laboratory parameters for different surgical interventions suggesting specific contributions from different pathological and/or patient-level factors. Our current analysis suggests that attention to non-inflammatory factors in addition to suppression of inflammation is needed to minimise the burden of orthopaedic surgery.

Associations between orthopaedic disturbances and unilateral crossbite in children with asymmetry of the upper cervical spine.

PubMed

Korbmacher, Heike; Koch, L; Eggers-Stroeder, G; Kahl-Nieke, B

2007-02-01

The objective of the present study was to detect possible associations between unilateral crossbite and orthopaedic disturbances in children with asymmetry of the upper cervical spine. Fifty-five children aged 3-10 years (22 girls and 33 boys) with a unilateral crossbite and 55 gender- and age-matched children with a symmetric occlusion but no crossbite, who served as the control group, were selected from an orthopaedic cohort of 240 patients. In all children, asymmetry of the upper cervical region was confirmed by radiographs and palpation. The following orthopaedic aspects were investigated: oblique shoulder and pelvis, scoliosis, functional leg length difference, and laxity of ligaments of the foot. The differences between the groups were analysed by means of an unpaired t-test. An increased occurrence of orthopaedic parameters in the frontal plane was observed in children with a unilateral malocclusion. A unilateral crossbite was not necessarily combined with a pathological orthopaedic variable, but statistically, children with a unilateral malocclusion showed more often an oblique shoulder (P = 0.004), scoliosis (P = 0.04), an oblique pelvis (P = 0.007), and a functional leg length difference (P = 0.002) than children with symmetry. The results suggest that a unilateral crossbite in children with asymmetry of the upper cervical spine is associated with orthopaedic disturbances. There is no evidence of a causal link.

Protocol for determining the diagnostic validity of physical examination maneuvers for shoulder pathology

PubMed Central

2013-01-01

Background Shoulder complaints are the third most common musculoskeletal problem in the general population. There are an abundance of physical examination maneuvers for diagnosing shoulder pathology. The validity of these maneuvers has not been adequately addressed. We propose a large Phase III study to investigate the accuracy of these tests in an orthopaedic setting. Methods We will recruit consecutive new shoulder patients who are referred to two tertiary orthopaedic clinics. We will select which physical examination tests to include using a modified Delphi process. The physician will take a thorough history from the patient and indicate their certainty about each possible diagnosis (certain the diagnosis is absent, present or requires further testing). The clinician will only perform the physical examination maneuvers for diagnoses where uncertainty remains. We will consider arthroscopy the reference standard for patients who undergo surgery within 8 months of physical examination and magnetic resonance imaging with arthrogram for patients who do not. We will calculate the sensitivity, specificity and positive and negative likelihood ratios and investigate whether combinations of the top tests provide stronger predictions of the presence or absence of disease. Discussion There are several considerations when performing a diagnostic study to ensure that the results are applicable in a clinical setting. These include, 1) including a representative sample, 2) selecting an appropriate reference standard, 3) avoiding verification bias, 4) blinding the interpreters of the physical examination tests to the interpretation of the gold standard and, 5) blinding the interpreters of the gold standard to the interpretation of the physical examination tests. The results of this study will inform clinicians of which tests, or combination of tests, successfully reduce diagnostic uncertainty, which tests are misleading and how physical examination may affect the magnitude of the confidence the clinician feels about their diagnosis. The results of this study may reduce the number of costly and invasive imaging studies (MRI, CT or arthrography) that are requisitioned when uncertainty about diagnosis remains following history and physical exam. We also hope to reduce the variability between specialists in which maneuvers are used during physical examination and how they are used, all of which will assist in improving consistency of care between centres. PMID:23394210

A Geochemical Investigation of Volcanic Rocks from the San Rafael Volcanic Field, Utah

NASA Astrophysics Data System (ADS)

Koebli, D. J.; Germa, A.; Connor, C.; Atlas, Z. D.

2016-12-01

A Geochemical Investigation of Volcanic Rocks from the San Rafael Volcanic Field, Utah Authors: Danielle Koebli, Dr. Aurelie Germa, Dr. Zackary Atlas, Dr. Charles Connor The San Rafael Volcanic Field (SRVF), Utah, is a 4Ma volcanic field located in the northwestern section of the Colorado Plateau. Alkaline magmas intruded into Jurassic sandstones , known as the Carmel, Entrada, Curtis and Summerville sandstone formations, and formed comagmatic dikes, sills and conduits that became uniquely well exposed as country rocks were eroded. The two rock types that formed from the melts are shonkinite (45.88 wt% SiO2) and syenite (50.84wt% SiO2); with dikes being predominantly shonkinite and sills exhibiting vertical alternation of shonkinite and syenite, a result of liquid immiscibility. The aim of this study is to determine magma temperatures, and mineral compositions which will be used for determining physical conditions for magma crystallization. Research is being conducted using an Electron Probe Micro Analyzer (EPMA) for single crystal analysis, and data were plotted using PINGU software through VHub cyberinfrastructure. EPMA data supports hydrated magma theories due to the large amounts of biotite and hornblende mixed in with olivine, feldspar and pyroxene. The data is also indicative of a calcium-rich magma which is further supported by the amount of pyroxene and plagioclase in the sample. Moreover, there are trace amounts orthoclase, quartz and k-feldspar due to sandstone inclusions from the magma intruding into the country rocks. The olivine crystals present in the samples are all chemically similar, having high Mg (Fo80-Fo90), which, coupled with a lower Fe content indicate a hotter magma. Comparison of mineral and whole-rock compositions using MELTs program will allow us to calculate magma viscosity and density so that the physical conditions for magma crystallization can be determined.

6. Photocopied August 1971 from Photo 13731, Granite Folder #1, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. Photocopied August 1971 from Photo 13731, Granite Folder #1, Engineering Department, Utah Power and Light Co., Salt Lake City, Utah. GRANITE STATION, MAY 24, 1915. - Utah Power Company, Granite Hydroelectric Plant, Holladay, Salt Lake County, UT

78 FR 5489 - Notice of Utah's Recreation Resource Advisory Council/Resource Advisory Council Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-25

... for Utah public lands within the BLM's National Landscape Conservation System; and the RAC's involvement with the Utah Film Commission. On February 22, the RecRAC will listen to fee presentations from...

1. Photocopied from Photo 1645, Wheelon Station Folder #1, Engineering ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photocopied from Photo 1645, Wheelon Station Folder #1, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. UTAH SUGAR CO.'S DAM -- BEAR RIVER CANYON. - Irrigation Diversion Canal, Bear River, Fielding, Box Elder County, UT

Readability of patient education materials from the American Academy of Orthopaedic Surgeons and Pediatric Orthopaedic Society of North America web sites.

PubMed

Badarudeen, Sameer; Sabharwal, Sanjeev

2008-01-01

While experts recommend that the readability of patient education materials should be less than the sixth grade level, the available information pertaining to orthopaedic diseases may be excessively complex for some to read and comprehend. The Flesch-Kincaid grade level is the most widely used tool to evaluate the readability score of a given text, with a lower grade level suggesting easier readability. The goal of our study was to assess the readability of pediatric orthopaedic patient education materials that were developed by the American Academy of Orthopaedic Surgeons (AAOS) and the Pediatric Orthopaedic Society of North America (POSNA) and were accessible to the general public through the Internet. All articles from the "Children" section of the patient education library, "Your Orthopaedic Connection," on the AAOS web site and the "Parent/Patient" section on the POSNA web site were identified. The Flesch-Kincaid grade level of each article was determined with use of Microsoft Office Word software. The mean grade levels of articles that were available in 2001 were compared with those accessible in 2007. Fifty-seven unique articles were available in 2007 on both web sites compared with twenty-five articles available in 2001. The readability score of only one (2%) of the currently available articles was less than sixth grade level. The mean Flesch-Kincaid grade level of the currently available articles was 8.9 compared with 8.7 for the articles available in 2001 (p = 0.71). Our findings suggest that most of the pediatric orthopaedic patient education materials available on the AAOS and POSNA web sites have readability scores that may be too high, making comprehension difficult for a substantial portion of the United States population.

Public reporting of cost and quality information in orthopaedics.

PubMed

Marjoua, Youssra; Butler, Craig A; Bozic, Kevin J

2012-04-01

Public reporting of patient health outcomes offers the potential to incentivize quality improvement by fostering increased accountability among providers. Voluntary reporting of risk-adjusted outcomes in cardiac surgery, for example, is viewed as a "watershed event" in healthcare accountability. However, public reporting of outcomes, cost, and quality information in orthopaedic surgery remains limited by comparison, attributable in part to the lack of standard assessment methods and metrics, provider fear of inadequate adjustment of health outcomes for patient characteristics (risk adjustment), and historically weak market demand for this type of information. We review the origins of public reporting of outcomes in surgical care, identify existing initiatives specific to orthopaedics, outline the challenges and opportunities, and propose recommendations for public reporting of orthopaedic outcomes. We performed a comprehensive review of the literature through a bibliographic search of MEDLINE and Google Scholar databases from January 1990 to December 2010 to identify articles related to public reporting of surgical outcomes. Orthopaedic-specific quality reporting efforts include the early FDA adverse event reporting MedWatch program and the involvement of surgeons in the Physician Quality Reporting Initiative. Issues that require more work include balancing different stakeholder perspectives on quality reporting measures and methods, defining accountability and attribution for outcomes, and appropriately risk-adjusting outcomes. Given the current limitations associated with public reporting of quality and cost in orthopaedic surgery, valuable contributions can be made in developing specialty-specific evidence-based performance measures. We believe through leadership and involvement in policy formulation and development, orthopaedic surgeons are best equipped to accurately and comprehensively inform the quality reporting process and its application to improve the delivery and outcomes of orthopaedic care.

Prospective Evaluation of Posttraumatic Stress Disorder and Depression in Orthopaedic Injury Patients With and Without Concomitant Traumatic Brain Injury.

PubMed

Roden-Foreman, Kenleigh; Solis, Jaicus; Jones, Alan; Bennett, Monica; Roden-Foreman, Jacob W; Rainey, Evan E; Foreman, Michael L; Warren, Ann Marie

2017-09-01

Psychological morbidities after injury [eg, posttraumatic stress disorder (PTSD) and depression] are increasingly recognized as a significant determinant of overall outcome. Traumatic brain injury (TBI) negatively impacts outcomes of patients with orthopaedic injury, but the association of concurrent TBI, orthopaedic injury, and symptoms of PTSD and depression has not been examined. This study's objective was to examine symptoms of PTSD and depression in patients with orthopaedic trauma with and without TBI. Longitudinal prospective cohort study. Urban Level I Trauma Center in the Southwest United States. Orthopaedic trauma patients older than 18 years admitted for ≥24 hours. Questionnaires examining demographics, injury-related variables, PTSD, and depression were administered during hospitalization and 3, 6, and 12 months later. Orthopaedic injury and TBI were determined based on ICD-9 codes. Generalized linear models determined whether PTSD and depression at follow-up were associated with TBI. Of the total sample (N = 214), 44 (21%) sustained a TBI. Those with TBI had higher rates of PTSD symptoms, 12 months postinjury (P = 0.04). The TBI group also had higher rates of depressive symptoms, 6 months postinjury (P = 0.038). Having a TBI in addition to orthopaedic injury was associated with significantly higher rates of PTSD at 12 months and depression at 6 months postinjury. This suggests that sustaining a TBI in addition to orthopaedic injury places patients at a higher risk for negative psychological outcomes. The findings of this study may help clinicians to identify patients who are in need for psychological screening and could potentially benefit from intervention. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

The Future of Biologic Coatings for Orthopaedic Implants

PubMed Central

Goodman, Stuart B.; Yao, Zhenyu; Keeney, Michael; Yang, Fan

2013-01-01

Implants are widely used for othopaedic applications such as fixing fractures, repairing nonunions, obtaining a joint arthrodesis, total joint arthroplasty, spinal reconstruction, and soft tissue anchorage. Previously, orthopaedic implants were designed simply as mechanical devices; the biological aspects of the implant were a byproduct of stable internal/external fixation of the device to the surrounding bone or soft tissue. More recently, biologic coatings have been incorporated into orthopaedic implants in order to modulate the surrounding biological environment. This opinion article reviews current and potential future use of biologic coatings for orthopaedic implants to facilitate osseointegration and mitigate possible adverse tissue responses including the foreign body reaction and implant infection. While many of these coatings are still in the preclinical testing stage, bioengineers, material scientists and surgeons continue to explore surface coatings as a means of improving clinical outcome of patients undergoing orthopaedic surgery. PMID:23391496

Origins of eponymous orthopaedic equipment.

PubMed

Meals, Clifton; Wang, Jeffrey

2010-06-01

Orthopaedists make great use of eponymous equipment, however the origins of these tools are unknown to many users. This history enriches, enlightens, and enhances surgical education, and may inspire modern innovation. We explored the origins of common and eponymous orthopaedic equipment. We selected pieces of equipment named for their inventors and in the broadest use by modern orthopaedists. We do not describe specialized orthopaedic implants and instruments owing to the overwhelming number of these devices. The history of this equipment reflects the coevolution of orthopaedics and battlefield medicine. Additionally, these stories evidence the primacy of elegant design and suggest that innovation is often a process of revision and refinement rather than sudden inspiration. Their history exposes surgical innovators as brilliant, lucky, hardworking, and sometimes odd. These stories amuse, enlighten, and may inspire modern orthopaedists to develop creative solutions of their own. The rich history of the field's eponymous instruments informs an ongoing tradition of innovation in orthopaedics.

Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings

PubMed Central

Zhang, Bill G. X.; Myers, Damian E.; Wallace, Gordon G.; Brandt, Milan; Choong, Peter F. M.

2014-01-01

Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracellular matrix proteins, biological peptides or growth factors impart bioactivity and biocompatibility to the metallic surface of conventional orthopaedic prosthesis that promote bone ingrowth and differentiation of stem cells into osteoblasts leading to enhanced osteointegration of the implant. Furthermore, coatings such as silver, nitric oxide, antibiotics, antiseptics and antimicrobial peptides with anti-microbial properties have also been developed, which show promise in reducing bacterial adhesion and prosthetic infections. This review summarizes some of the recent developments in coatings for orthopaedic implants. PMID:25000263

Understanding and Addressing the Global Need for Orthopaedic Trauma Care.

PubMed

Agarwal-Harding, Kiran J; von Keudell, Arvind; Zirkle, Lewis G; Meara, John G; Dyer, George S M

2016-11-02

➤The burden of musculoskeletal trauma is high worldwide, disproportionately affecting the poor, who have the least access to quality orthopaedic trauma care.➤Orthopaedic trauma care is essential, and must be a priority in the horizontal development of global health systems.➤The education of surgeons, nonphysician clinicians, and ancillary staff in low and middle income countries is central to improving access to and quality of care.➤Volunteer surgical missions from rich countries can sustainably expand and strengthen orthopaedic trauma care only when they serve a local need and build local capacity.➤Innovative business models may help to pay for care of the poor. Examples include reducing costs through process improvements and cross-subsidizing from profitable high-volume activities.➤Resource-poor settings may foster innovations in devices or systems with universal applicability in orthopaedics. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Ground-water conditions in Utah, spring of 2007

USGS Publications Warehouse

Burden, Carole B.; Allen, David V.; Danner, M.R.; Enright, Michael; Cillessen, J.L.; Gerner, S.J.; Eacret, Robert J.; Downhour, Paul; Slaugh, Bradley A.; Swenson, Robert L.; Howells, James H.; Christiansen, Howard K.; Fisher, Martel J.

2007-01-01

This is the forty-fourth in a series of annual reports that describe ground-water conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Resources and Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing ground-water conditions.This report, like the others in the series, contains information on well construction, ground-water withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of ground water. Supplementary data are included in reports of this series only for those years or areas which are important to a discussion of changing ground-water conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of ground-water development in the State for calendar year 2006. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Resources and Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is available online at http://www.waterrights.utah. gov/ and http://ut.water.usgs.gov/newUTAH/GW2007.pdf.

Impact of high efficiency vehicles on future fuel tax revenues in Utah.

DOT National Transportation Integrated Search

2015-05-01

The Utah Department of Transportation Research Division has analyzed the potential impact of : high-efficiency motor vehicles on future State of Utah motor fuel tax revenues used to construct and maintain the : highway network. High-efficiency motor ...

Utah Department of Transportation traffic operation center operator training.

DOT National Transportation Integrated Search

2010-11-01

This paper is a summary of work performed by the Utah Traffic Lab (UTL) to develop training programs for the Utah Department of Transportation (UDOT) Traffic Operations Center (TOC) operators at both the basic and advanced levels. The basic training ...

Alternative Fuels Data Center: Utah Paperbox Adds Workplace Charging to

Science.gov Websites

Finance, Utah Paperbox Utah Paperbox (UPB) in Salt Lake City has a strong commitment to energy efficiency purchase each month," said Teri Jensen, vice president of finance for UPB. "And I am not the only

The productivity of PAs, APRNs, and physicians in Utah.

PubMed

Pedersen, Donald M; Chappell, Boyd; Elison, Gar; Bunnell, Robert

2008-01-01

The physician assistant workforce in Utah is experiencing remarkable growth, with a 9% net annual rate of increase since 1998. An additional 84 PAs provided patient care in Utah in the 4-year period of 1998 through 2001, an average increase of 21 per year. The Utah Medical Education Council believes that the demand for PAs will be high over the next 10 to 15 years, with several factors fueling this growth. Productivity is one of these factors. Even though Utah PAs make up only approximately 6.3% of the state's combined clinician (physician, PA, advanced practice registered nurse [APRN]) workforce; the PAs contribute approximately 7.2% of the patient care full-time equivalents (FTE) in the state. This is in contrast to the 10% FTE contribution made by the state's APRN workforce, which has nearly triple the number of clinicians providing patient care in the state. The majority (73%) of Utah PAs work at least 36 hours per week. Utah PAs also spend a greater percentage of the total hours worked in patient care, when compared to the physician workforce. The rural PA workforce reported working a greater number of total hours and patient care hours when compared to the overall PA workforce.

The orthopaedic profession and industry: conflict or convergence of interests.

PubMed

Crowninshield, Roy

2003-07-01

Many improvements in orthopaedic care have been enabled by the relationship that exists between the orthopaedic profession and the orthopaedic industry. This relationship is multifactorial and includes new technology development, medical education, orthopaedic research, and patient education. Acting individually and collectively, the profession and the industry advance their standing by focusing on improved patient care. Although the industry, the profession, and the patient have many shared interests, they also may have real or potential conflicts of interests. The patient's interest in the quality of treatment outcome is shared by the profession and industry. However, the interests of the profession may include issues related to the success of their practices, management of their time, and advancement of their skills. Industry's interests, in turn, include the support of their customers and the success of their businesses. Conflicts of interest between these parties are potentially neither avoidable nor undesirable. Managed well, the relationship of the orthopaedic profession and the industry achieves the goals of each while advancing patient care. As the profession and the industry each experience change, continued attention should be directed to ensuring that the interest of each is advanced only in the context of serving the interest of the patient with musculoskeletal disorders.

Administrative Databases in Orthopaedic Research: Pearls and Pitfalls of Big Data.

PubMed

Patel, Alpesh A; Singh, Kern; Nunley, Ryan M; Minhas, Shobhit V

2016-03-01

The drive for evidence-based decision-making has highlighted the shortcomings of traditional orthopaedic literature. Although high-quality, prospective, randomized studies in surgery are the benchmark in orthopaedic literature, they are often limited by size, scope, cost, time, and ethical concerns and may not be generalizable to larger populations. Given these restrictions, there is a growing trend toward the use of large administrative databases to investigate orthopaedic outcomes. These datasets afford the opportunity to identify a large numbers of patients across a broad spectrum of comorbidities, providing information regarding disparities in care and outcomes, preoperative risk stratification parameters for perioperative morbidity and mortality, and national epidemiologic rates and trends. Although there is power in these databases in terms of their impact, potential problems include administrative data that are at risk of clerical inaccuracies, recording bias secondary to financial incentives, temporal changes in billing codes, a lack of numerous clinically relevant variables and orthopaedic-specific outcomes, and the absolute requirement of an experienced epidemiologist and/or statistician when evaluating results and controlling for confounders. Despite these drawbacks, administrative database studies are fundamental and powerful tools in assessing outcomes on a national scale and will likely be of substantial assistance in the future of orthopaedic research.

Stereoscopy in orthopaedics

NASA Astrophysics Data System (ADS)

Tan, S. L. E.

2005-03-01

Stereoscopy was used in medicine as long ago as 1898, but has not gained widespread acceptance except for a peak in the 1930's. It retains a use in orthopaedics in the form of Radiostereogrammetrical Analysis (RSA), though this is now done by computer software without using stereopsis. Combining computer assisted stereoscopic displays with both conventional plain films and reconstructed volumetric axial data, we are reassessing the use of stereoscopy in orthopaedics. Applications include use in developing nations or rural settings, erect patients where axial imaging cannot be used, and complex deformity and trauma reconstruction. Extension into orthopaedic endoscopic systems and teaching aids (e.g. operative videos) are further possibilities. The benefits of stereoscopic vision in increased perceived resolution and depth perception can help orthopaedic surgeons achieve more accurate diagnosis and better pre-operative planning. Limitations to currently available stereoscopic displays which need to be addressed prior to widespread acceptance are: availability of hardware and software, loss of resolution, use of glasses, and image "ghosting". Journal publication, the traditional mode of information dissemination in orthopaedics, is also viewed as a hindrance to the acceptance of stereoscopy - it does not deliver the full impact of stereoscopy and "hands-on" demonstrations are needed.

[Dr. Michiharu Matsuoka, founder of the Department of Orthopaedic Surgery, Kyoto University, and his achievements (Part 6: Studying abroad of Dr. Matsuoka and opening to public, reputation and achievement of the department)].

PubMed

Hirotani, Hayato

2011-03-01

Dr. Michiharu Matsuoka studied orthopaedic surgery in Germany, Austria and other countries during the period from August, 1902 to May, 1906. He visited many university pathological institutes and surgical and orthopaedic clinics to study pathology and to learn the practice of orthopaedic surgery. After that, he started his practice at the newly established Department of Orthopaedic Surgery in the Medical School of Kyoto Imperial University in June, 1906. The department was opened in 1907 and in 1911 it was opened to all citizens and practical doctors in Kyoto City and exhibited many orthopaedic specimens and instruments. In particular, the x-ray apparatus of the Department was so well equipped that a German radiologist who visited the Department admired it in his article that was published in the journal of radiology in 1911. The Department was not surpassed by others for the number of patients with the dislocation of the hip and tuberculous spondylitis as well as the advanced quality and variety of roentgenological and pathological researches on these diseases.

2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

PubMed Central

Ekås, Guri Ranum; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J; Feller, Julian A; Karlsson, Jón; Kocher, Minider S; LaPrade, Robert F; McNamee, Michael; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas; Reider, Bruce; Roe, Justin; Seil, Romain; Siebold, Rainer; Witvrouw, Erik; Engebretsen, Lars

2018-01-01

In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. PMID:29478021

9th Chapter of Surgeons' Lecture: the orthopaedic surgeon: historical perspective, ethical considerations and the future.

PubMed

Balachandran, N

1999-05-01

From a fishing village with colonial surgeons from the East India Company, Singapore is now a medical and business hub servicing the region and beyond in trade and medical education. Orthopaedic Surgery is a young specialty and is the fastest growing sub-specialty in Surgery. Orthopaedic education in Singapore has a structured syllabus and training is coordinated with the Royal Colleges and the American Academy of Orthopaedic Surgeons. Part of the training as Fellows is in the United Kingdom and USA on an HMDP Fellowship. Ethics and Continuing Medical Education need further emphasis. Sub-specialisation in Orthopaedic Surgery is now well-established in Trauma, Adult Reconstructive Surgery, Sports Medicine, Spinal Surgery, Hand Surgery and Rehabilitation Medicine. Ageing in the next millennium with osteoporosis and hip fracture problems of gait and balance need more orthopaedic surgeons to be committed to rehabilitation medicine and voluntary service in the community. There is a need for good role models and knowledge on Quality Assurance, Clinical Pathways and Administration. Appropriate use of high technology and care for the aged in the community with dignity is fundamental to good ethical practice. Selfish, pecuniary interests will destroy the very soul and fabric of medicine.

Assessing clinical researchers' information needs to create responsive portals and tools: my Research Assistant (MyRA) at the University of Utah: a case study.

PubMed

Reich, Margaret; Shipman, Jean P; Narus, Scott P; Weir, Charlene; Madsen, Randy; Schultz, N Dustin; Cameron, Justin M; Adamczyk, Abby L; Mitchell, Joyce A

2013-01-01

How can health sciences librarians and biomedical informaticians offer relevant support to Clinical and Translational Science Award (CTSA) personnel? The Spencer S. Eccles Health Sciences Library and the associate vice president for information technology for the health sciences office at the University of Utah conducted a needs assessment. Faculty and staff from these two units, with the services of a consultant and other CTSA partners, employed a survey, focus groups, interviews, and committee discussions. An information portal was created to meet identified needs. A directive white paper was created. The process employed to plan a virtual and physical collaborative, collegial space for clinical researchers at the university and its three inter-institutional CTSA partners is described. The university's model can assist other librarians and informaticians with how to become part of a CTSA-focused infrastructure for clinical and translational research and serve researchers in general.

Federated querying architecture with clinical & translational health IT application.

PubMed

Livne, Oren E; Schultz, N Dustin; Narus, Scott P

2011-10-01

We present a software architecture that federates data from multiple heterogeneous health informatics data sources owned by multiple organizations. The architecture builds upon state-of-the-art open-source Java and XML frameworks in innovative ways. It consists of (a) federated query engine, which manages federated queries and result set aggregation via a patient identification service; and (b) data source facades, which translate the physical data models into a common model on-the-fly and handle large result set streaming. System modules are connected via reusable Apache Camel integration routes and deployed to an OSGi enterprise service bus. We present an application of our architecture that allows users to construct queries via the i2b2 web front-end, and federates patient data from the University of Utah Enterprise Data Warehouse and the Utah Population database. Our system can be easily adopted, extended and integrated with existing SOA Healthcare and HL7 frameworks such as i2b2 and caGrid.

78 FR 9807 - Utah Regulatory Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-12

... DEPARTMENT OF THE INTERIOR Office of Surface Mining Reclamation and Enforcement 30 CFR Part 944... Mining Reclamation and Enforcement, Interior. ACTION: Final rule; approval of amendment. SUMMARY: We are approving an amendment to the Utah regulatory program (the ``Utah program'') under the Surface Mining...

Strong motion instrumentation plan for Utah Department of Transportation.

DOT National Transportation Integrated Search

2012-01-18

The State of Utah, and its people have invested a considerable amount of money to construct and maintain the infrastructure and bridges in the state. This entire transportation network is at risk in the event of an earthquake. To protect Utah's bridg...

Emerging Drug Threats and Perils Facing Utah's Youth. Hearing before the Committee on the Judiciary, United States Senate, One Hundred Sixth Congress, Second Session (Salt Lake City and Cedar City, Utah, July 6-7, 2000).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

This report documents the proceedings of a two-day hearing held in Utah to begin a public dialogue on how professionals can work together to combat the dangers of substance abuse problems among adolescents. The introductory comments by the presiding chairman, Senator Orin Hatch, spell out the present problem in Utah. The senator points out how…

AVIRIS data calibration information: Wasatch Mountains and Park City region, Utah

USGS Publications Warehouse

Rockwell, Barnaby W.; Clark, Roger N.; Livo, K. Eric; McDougal, Robert R.; Kokaly, Raymond F.

2002-01-01

This report contains information regarding the reflectance calibration of spectroscopic imagery acquired over the Wasatch Mountains and Park City region, Utah, by the Airborne Visible/Infrared Imaging Spectrometer (AVIRIS) sensor on August 5, 1998. This information was used by the USGS Spectroscopy Laboratory to calibrate the Park City AVIRIS imagery to unitless reflectance prior to spectral analysis.  The Utah AVIRIS data were analyzed as a part of the USEPA-USGS Utah Abandoned Mine Lands Imaging Spectroscopy Project.

Critical Elements in Produced Fluids from Nevada and Utah

DOE Data Explorer

Simmons, Stuart

2017-07-27

Critical elements and related analytical data for produced fluids from geothermal fields in Nevada and Utah, Sevier thermal belt hot springs, Utah, and Uinta basin oil-gas wells, Utah are reported. Analytical results include pH, major species, trace elements, transition metals, other metals, metalloids and REEs. Gas samples were collected and analyzed from Beowawe, Dixie Valley, Roosevelt Hot Springs, and Thermo. Helium gases and helium isotopes were analyzed on samples collected at Patua, San Emido and two wells in the Uinta basin.

Utah FORGE Site Earthquake Animation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Joe Moore

This is a .kml earthquake animation covering the period of 1991 - 2011 for the Utah Milford FORGE site. It displays seismic events using different sized bubbles according to magnitude. It covers the general Utah FORGE area (large shaded rectangle) with the final site displayed as a smaller polygon along the northwestern margin. Earthquakes are subdivide into clusters and the time, date, and magnitude of each event is included. Nearby seismic stations are symbolized with triangles. This was created by the University of Utah Seismograph Stations (UUSS).

Quality of life during orthopaedic training and academic practice. Part 1: orthopaedic surgery residents and faculty.

PubMed

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2009-10-01

A pilot study of two academic training programs revealed concerning levels of resident burnout and psychological dysfunction. The purpose of the present study was to determine the quality of life of orthopaedic residents and faculty on a national scale and to identify risk factors for decompensation. Three hundred and eighty-four orthopaedic residents and 264 full-time orthopaedic faculty members completed a voluntary, anonymous survey consisting of three validated instruments (the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale) and question sets assessing demographic information, relationship issues, stress reactions/management, and work/life balance. High levels of burnout were seen in 56% of the residents and 28% of the faculty members. Burnout risk was greatest among second-postgraduate-year residents and residents in training programs with six or more residents per postgraduate year. Sixteen percent of residents and 19% of faculty members reported symptoms of psychological distress. Sleep deprivation was common among the residents and correlated positively with every distress measure. Faculty reported greater levels of stress but greater satisfaction with work and work/life balance. A number of factors, such as making time for hobbies and limiting alcohol use, correlated with decreased dysfunction for both residents and faculty. Despite reporting high levels of job satisfaction, orthopaedic residents and faculty are at risk for burnout and distress. Identification of protective factors and risk factors may provide guidance to improve the quality of life of academic orthopaedic surgeons in training and beyond.

Orthopaedic Patient Information on the World Wide Web: An Essential Review.

PubMed

Cassidy, John Tristan; Baker, Joseph F

2016-02-17

Patients increasingly use the Internet to research health-related issues. Internet content, unlike other forms of media, is not regulated. Although information accessed online can impact patients' opinions and expectations, there is limited information about the quality or readability of online orthopaedic information. PubMed, MEDLINE, and Google Scholar were searched using anatomic descriptors and three title keywords ("Internet," "web," and "online"). Articles examining online orthopaedic information from January 1, 2000, until April 1, 2015, were recorded. Articles were assessed for the number of reviewers evaluating the online material, whether the article examined for a link between authorship and quality, and the use of recognized quality and readability assessment tools. To facilitate a contemporary discussion, only publications since January 1, 2010, were considered for analysis. A total of thirty-eight peer-reviewed articles published since 2010 examining the quality and/or readability of online orthopaedic information were reviewed. For information quality, there was marked variation in the quality assessment methods utilized, the number of reviewers, and the manner of reporting. To date, the majority of examined information is of poor quality. Studies examining readability have focused on pages produced by professional orthopaedic societies. The quality and readability of online orthopaedic information are generally poor. For modern practices to adapt to the Internet and to prevent misinformation, the orthopaedic community should develop high-quality, readable online patient information. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Flooding and streamflow in Utah during water year 2005

USGS Publications Warehouse

Wilkowske, C.D.; Kenney, T.A.; McKinney, T.S.

2006-01-01

The 2004 and 2005 water years illustrate why water managers in Utah generally describe the water supply as 'feast or famine.' In September 2004, Utah was finishing its sixth year of drought. Most reservoirs were substantially drained and the soil was parched. In contrast, in September 2005 Utah was finishing a water year that set new records for peak discharge and total annual streamflow.The 2004 water year ended on September 30, 2004. The 2005 water year brought with it a significant change in the weather, beginning with intense rainfall in the Virgin River basin of southwestern Utah. Only minor flooding resulted from this storm; however, it provided soil moisture that would contribute to severe flooding during January 2005.

10. Photocopied from Photo 1162, Nunns Station Folder, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

10. Photocopied from Photo 1162, Nunns Station Folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. PENSTOCKS, c. 1920? - Telluride Power Company, Nunn Hydroelectric Plant, Southeast side of Provo River, 300 feet West of US Route 189, Orem, Utah County, UT

26. Photocopied from Photo 1217, Olmstead Folder #2, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

26. Photocopied from Photo 1217, Olmstead Folder #2, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. MACHINE SHOP -- LAB. - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

27. Photocopied from Photo 1216, Olmstead Folder #2, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

27. Photocopied from Photo 1216, Olmstead Folder #2, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. MACHINE SHOP -- LAB. - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

Bibliography of U.S. Geological Survey water-resources reports for Utah

USGS Publications Warehouse

Hardy, Ellen E.; Dragos, Stefanie L.

1994-01-01

This bibliography contains a complete listing of reports prepared by personnel of the U.S. Geological Survey from 1886 through December 31, 1993, that discuss the water resources of Utah. The reports were prepared primarily by personnel of the Water Resources Division, Utah District, in cooperation with State, other Federal, and local agencies. Several reports were prepared as a part of studies directly funded by the U.S. Geological Survey, and several were prepared by contractors for the U.S. Geological Survey.The bibliography is divided into three major parts: (1) publications of the U.S. Geological Survey; (2) publications prepared by the U.S. Geological Survey in cooperation with and published by agencies of the State of Utah; and (3) reports printed in other publications reports prepared by the U.S. Geological Survey but published by other agencies or by professional organizations. Publications of the U.S. Geological Survey still in print may be purchased from the U.S. Geological Survey, Earth Science Information Center, Open-File Reports Section, Box 25286, MS 517, Denver Federal Center, Denver, Colorado 80225. Publications that are out of print at the time of this compilation are marked with an asterisk (*). Except for water-supply papers, most publications that are out of print and unavailable for purchase may be examined at the U.S. Geological Survey Earth Science Information Center, 2222 West 2300 South, 2nd Floor, Salt Lake City, Utah 84119.Reports published by the Utah Department of Natural Resources, Divisions of Water Rights and Water Resources, are available on request from these agencies or from the U.S. Geological Survey, Water Resources Division, Room 1016 Administration Building, 1745 West 1700 South, Salt Lake City, Utah 84104. Water-Resources Bulletins of the Utah Geological Survey may be purchased from that agency at 2363 Foothill Drive, Salt Lake City, Utah 84109-1491.Inquiries as to the availability of reports listed as "reports printed in other publications" must be addressed to the professional organization or agency that published them. Most of these reports are available in larger libraries, such as the library of the University of Utah.Most open-file reports are available for inspection at the U.S. Geological Survey, Water Resources Division, Room 1016 Administration Building, 1745 West 1700 South, Salt Lake City, Utah 84104. A small number of the open-file reports that have been duplicated as Utah basic- (or hydrologic-) data reports are free on request. An index is included in this bibliography for ease of reference. Water-supply papers on the quantity and quality of ground and surface water in Utah that were published in a series are not listed separately in the index but are presented in tables 1 to 4.

Hydrologic and climatologic data, 1967, Salt Lake County, Utah

USGS Publications Warehouse

Hely, A.G.; Mower, Reed W.; Horr, C.A.

1968-01-01

An investigation of the water resources of Salt Lake County, Utah, was undertaken by the Water Resources Division of the U.S. Geological Survey in July 1963. This investigation is a cooperative project financed chiefly by equal contributions of the State of Utah and the Federal Government in accordance with an agreement between the Division of Water Rights, Utah Department of Natural Resources, and the Geological Survey. The investigation was financed during the period covered by this report by the following organizations: Utah Division of Water Rights (formerly State Engineer), Utah Division of Water Resources (formerly Water and Power Board), Salt Lake County, Salt Lake County Water Conservancy District, Central Utah Water Conservancy District, Metropolitan Water District of Salt Lake City, City of Murray, Granger-Hunter Improvement District, Taylorsville-Bennion Improvement District, Holladay Water Company, Magna Water and Sewer District, U.S. Bureau of Reclamation, U.S. Geological Survey.The investigation encompasses the collection and interpretation of a large variety of climatologic, hydrologic, and geologic data in and near Salt Lake County. Utah Basic-Data Releases 11-13 contain data collected through 1966. This release contains climatologic and surfacewater data for the 1967 water year (October 1966 to September 1967) and ground-water data collected during the 1967 calendar year. A similar annual release will contain data collected during the remainder of the investigation, and interpretive reports will be prepared as the investigation proceeds. Organizations that furnished data are acknowledged in station descriptions and footnotes to tables.

Hydrologic and climatologic data, 1968, Salt Lake County, Utah

USGS Publications Warehouse

1969-01-01

An investigation of the water resources of Salt Lake County, Utah, was undertaken by the Water Resources Division of the U.S. Geological Survey in July 1963. This investigation is a cooperative project financed chiefly by equal contributions of the State of Utah and the Federal Government in accordance with an agreement between the Division of Water Rights, Utah Department of Natural Resources, and the Geological Survey. The investigation was financed during the period covered by this report by the following organizations: Utah Division of Water Rights (formerly State Engineer), Utah Division of Water Resources (formerly Water and Power Board), Salt Lake County, Salt Lake County Water Conservancy District, Central Utah Water Conservancy District, Metropolitan Water District of Salt Lake City, City of Murray, Granger-Hunter Improvement District, Taylorsville-Bennion Improvement District, Holladay Water Company, Magna Water and Sewer District, U.S. Bureau of Reclamation, U.S. Geological SurveyThe investigation encompasses the collection and interpretation of a large variety of climatologic, hydrologic, and geologic data in and near Salt Lake County. Utah Basic-Data Releases 11-13 and 15 contain data collected through 1967. This release contains climatologic and surface-water data for the 1968 water year (October 1967 to September 1968) and ground-water data collected during the 1968 calendar year. This is the final annual release of basic data for this investigation. Interpretive reports summarizing the results are in preparation. Organizations that furnished data are acknowledged in station descriptions and footnotes to tables.

Groundwater conditions in Utah, spring of 2014

USGS Publications Warehouse

Burden, Carole B.; Birken, Adam S.; Gerner, Steven J.; Carricaburu, John P.; Derrick, V. Noah; Downhour, Paul; Smith, Lincoln; Eacret, Robert J.; Gibson, Travis L.; Slaugh, Bradley A.; Whittier, Nickolas R.; Howells, James H.; Christiansen, Howard K.; Fisher, Martel J.

2014-01-01

This is the fifty-first in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions.This report, like the others in the series, contains information on well construction, groundwater withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2013. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http://www.waterrights.utah.gov/techinfo/ and http://ut.water. usgs.gov/publications/GW2014.pdf. Groundwater conditions in Utah for calendar year 2012 are reported in Burden and others (2013) and are available online at http://ut.water.usgs. gov/publications/GW2013.pdf

Groundwater conditions in Utah, Spring of 2017

USGS Publications Warehouse

Burden, Carole B.

2017-01-01

This is the fifty-fourth in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions.This report, like the others in the series, contains information on well construction, groundwater withdrawals from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to new wells constructed for withdrawal of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2016. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http://www.waterrights.utah.gov/techinfo/ and http://ut.water.usgs.gov/publications/GW2017.pdf. Groundwater conditions in Utah for calendar year 2015 are reported in Burden and others (2016) and are available online at http://ut.water.usgs.gov/publications/GW2016.pdf.

Groundwater conditions in Utah, spring of 2014

USGS Publications Warehouse

Burden, Carole B.

2014-01-01

This is the fifty-first in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions. This report, like the others in the series, contains information on well construction, groundwater withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2013. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http://www.waterrights.utah.gov/techinfo/ and http://ut.water. usgs.gov/publications/GW2014.pdf. Groundwater conditions in Utah for calendar year 2012 are reported in Burden and others (2013) and are available online at http://ut.water.usgs. gov/publications/GW2013.pdf

Groundwater conditions in Utah, spring of 2013

USGS Publications Warehouse

Burden, Carole B.; Birken, Adam S.; Derrick, V. Noah; Fisher, Martel J.; Holt, Christopher M.; Downhour, Paul; Smith, Lincoln; Eacret, Robert J.; Gibson, Travis L.; Slaugh, Bradley A.; Whittier, Nickolas R.; Howells, James H.; Christiansen, Howard K.

2013-01-01

This is the fiftieth in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions. This report, like the others in the series, contains information on well construction, groundwater withdrawals from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2012. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http://www.waterrights.utah.gov/techinfo/ and http://ut.water. usgs.gov/publications/GW2013.pdf. Groundwater conditions in Utah for calendar year 2011 are reported in Burden and others (2012) and available online at http://ut.water.usgs.gov/ publications/GW2012.pdf

Groundwater conditions in Utah, spring of 2012

USGS Publications Warehouse

Burden, Carole B.; Allen, David V.; Holt, Christopher M.; Fisher, Martel J.; Downhour, Paul; Smith, Lincoln; Eacret, Robert J.; Gibson, Travis L.; Slaugh, Bradley A.; Whittier, Nickolas R.; Howells, James H.; Christiansen, Howard K.

2012-01-01

This is the forty-ninth in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions. This report, like the others in the series, contains information on well construction, groundwater withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2011. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http:// www.waterrights.utah.gov/techinfo/ and http://ut.water.usgs. gov/publications/GW2012.pdf. Groundwater conditions in Utah for calendar year 2010 are reported in Burden and others (2011) and available online at http://ut.water.usgs.gov/ publications/GW2011.pdf.

Groundwater conditions in Utah, spring of 2016

USGS Publications Warehouse

Burden, Carole B.

2016-01-01

This is the fifty-third in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions. This report, like the others in the series, contains information on well construction, groundwater withdrawals from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to new wells constructed for withdrawal of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2015. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http://www.waterrights.utah.gov/techinfo/ and http://ut.water.usgs.gov/publications/GW2016.pdf. Groundwater conditions in Utah for calendar year 2014 are reported in Burden and others (2015) and are available online at http://ut.water.usgs.gov/publications/GW2015.pdf

Open access publishing: a study of current practices in orthopaedic research.

PubMed

Sabharwal, Sanjeeve; Patel, Nirav; Johal, Karanjeev

2014-06-01

Open access (OA) publications have changed the paradigm of dissemination of scientific research. Their benefits to low-income countries underline their value; however, critics question exorbitant publication fees as well as their effect on the peer review process and research quality. This study reports on the prevalence of OA publishing in orthopaedic research and compares benchmark citation indices as well as evidence quality derived from OA journals with conventional subscription based orthopaedic journals. All 63 orthopaedic journals listed in ISI's Web of Knowledge Journal Citation Report (JCR) were examined. Bibliometric data attributed to each journal for the year 2012 was acquired from the JCR. Studies that fulfilled the criteria of level I evidence were identified for each journal within PubMed. Individual journal websites were reviewed to identify their open access policy. A total of 38 (60.3 %) journals did not offer any form of OA publishing; however, 20 (31.7 %) hybrid journals were identified which offered authors the choice to publish their work as OA if a publication fee was paid. Only five (8 %) journals published all their articles as OA. There was variability amongst the different publication fees for OA articles. Journals that published OA articles did not differ from subscription based journals on the basis of 2012 impact factor, citation number, self citation proportion or the volume of level I evidence published (p > 0.05). OA journals are present in orthopaedic research, though in small numbers. Over a third of orthopaedic journals catalogued in the ISI Web of Knowledge JCR® are hybrid journals that provide authors with the opportunity to publish their articles as OA after a publication fee is paid. This study suggests equivalent importance and quality of articles between OA and subscription based orthopaedic journals based on bibliometric data and the volume of level I evidence produced. Orthopaedic researchers must recognize the potential benefits of OA publishing and its emerging presence within the field. Further examination and consensus is required in orthopaedic research to generate an OA system that is robustly regulated and maintains research quality.

Orthopaedic Disorders in Myotonic Dystrophy Type 1: descriptive clinical study of 21 patients

PubMed Central

2013-01-01

Background Myotonic Dystrophy Type 1 (DM1) is the most common form of hereditary myopathy presenting in adults. This autosomal-dominant systemic disorder is caused by a CTG repeat, demonstrating various symptoms. A mild, classic and congenital form can be distinguished. Often the quality of life is reduced by orthopaedic problems, such as muscle weakness, contractures, foot or spinal deformities, which limit patients’ mobility. The aim of our study was to gather information about the orthopaedic impairments in patients with DM1 in order to improve the medical care of patients, affected by this rare disease. Methods A retrospective clinical study was carried out including 21 patients (11 male and 10 female), all diagnosed with DM1 by genetic testing. All patients were seen during our special consultations for neuromuscular diseases, during which patients were interviewed and examined. We also reviewed surgery reports of our hospitalized patients. Results We observed several orthopaedic impairments: spinal deformities (scoliosis, hyperkyphosis, rigid spine), contractures (of the upper extremities and the lower extremities), foot deformities (equinus deformity, club foot, pes cavus, pes planovalgus, pes cavovarus, claw toes) and fractures. Five patients were affected by pulmonary diseases (obstructive airway diseases, restrictive lung dysfunctions). Twelve patients were affected by cardiac disorders (congenital heart defects, valvular heart defects, conduction disturbances, pulmonary hypertension, cardiomyopathy). Our patients received conservative therapy (physiotherapy, logopaedic therapy, ergotherapy) and we prescribed orthopaedic technical devices (orthopaedic custom-made shoes, insoles, lower and upper leg orthoses, wheelchair, Rehab Buggy). We performed surgery for spinal and foot deformities: the scoliosis of one patient was stabilized and seven patients underwent surgery for correction of foot deformities. Conclusions An orthopaedic involvement in DM1 patients should not be underestimated. The most common orthopaedic impairments are contractures, foot deformities and spinal deformities. Contractures are typically located distally in the lower extremities, but can also occur in the hip or shoulder joints. Foot deformities could be treated with orthopaedic custom-made shoes, orthoses or insoles. Surgery is indicated for severe foot deformities or contractures. PMID:24289806

Outcomes in the Orthopaedic Sports Medicine Fellowship Match, 2010-2017.

PubMed

Mulcahey, Mary K; Hayes, Meghan K; Smith, Christopher M; Kraeutler, Matthew J; Trojan, Jeffrey D; McCarty, Eric C

2018-05-01

Sports medicine is one of the most competitive fellowships in orthopaedic surgery. Despite its popularity, fellowship applicants have limited understanding of the orthopaedic sports medicine fellowship match process. To define key outcomes in the orthopaedic sports medicine fellowship match, including the overall match rate, number of programs filled, and number of applicants ranked by programs that filled between 2010 and 2017. Cross-sectional study. This study utilized data regarding the orthopaedic sports medicine fellowship match collected by the American Orthopaedic Society for Sports Medicine (AOSSM) from 2010 through 2017. Applicant data included number of applicants, number of matched and unmatched applicants, and percentage of applicants matching into their top choices. Fellowship program data included number of programs participating in the match and number of applicants ranked by filled and unfilled programs. Between 2010 and 2017, the mean number of orthopaedic sports medicine fellowship applicants was 244.8. On average, 92.0% of applicants matched into a fellowship program. The mean number of programs participating in the fellowship match was 92.9, with a mean of 219.9 accredited positions and 5.4 nonaccredited positions. Over the time period studied, a mean of 75.8% of programs matched all available positions. Programs that matched fully ranked 9.0 applicants per position, on average, compared with a mean of 6.5 applicants ranked per position among programs that did not fully match ( P = .0016). From 2010 to 2017, the number of applicants, positions available, overall match rate, and number of programs participating in the orthopaedic sports medicine fellowship match have remained consistent. The mean number of applicants per position ranked by fully matched fellowship programs was 9.0 compared with a mean of 6.5 applicants per position ranked by programs that did not fully match. These data may be helpful as we look to the future of orthopaedic sports medicine fellowship positions and the match process. In addition, this study reveals characteristics that divide sports medicine fellowship programs that fully match from those that do not. Applicants and/or fellowship program directors may utilize this information to modify their approach to the match process going forward.

Outcomes in the Orthopaedic Sports Medicine Fellowship Match, 2010-2017

PubMed Central

Mulcahey, Mary K.; Hayes, Meghan K.; Smith, Christopher M.; Kraeutler, Matthew J.; Trojan, Jeffrey D.; McCarty, Eric C.

2018-01-01

Background: Sports medicine is one of the most competitive fellowships in orthopaedic surgery. Despite its popularity, fellowship applicants have limited understanding of the orthopaedic sports medicine fellowship match process. Purpose: To define key outcomes in the orthopaedic sports medicine fellowship match, including the overall match rate, number of programs filled, and number of applicants ranked by programs that filled between 2010 and 2017. Study Design: Cross-sectional study. Methods: This study utilized data regarding the orthopaedic sports medicine fellowship match collected by the American Orthopaedic Society for Sports Medicine (AOSSM) from 2010 through 2017. Applicant data included number of applicants, number of matched and unmatched applicants, and percentage of applicants matching into their top choices. Fellowship program data included number of programs participating in the match and number of applicants ranked by filled and unfilled programs. Results: Between 2010 and 2017, the mean number of orthopaedic sports medicine fellowship applicants was 244.8. On average, 92.0% of applicants matched into a fellowship program. The mean number of programs participating in the fellowship match was 92.9, with a mean of 219.9 accredited positions and 5.4 nonaccredited positions. Over the time period studied, a mean of 75.8% of programs matched all available positions. Programs that matched fully ranked 9.0 applicants per position, on average, compared with a mean of 6.5 applicants ranked per position among programs that did not fully match (P = .0016). Conclusion: From 2010 to 2017, the number of applicants, positions available, overall match rate, and number of programs participating in the orthopaedic sports medicine fellowship match have remained consistent. The mean number of applicants per position ranked by fully matched fellowship programs was 9.0 compared with a mean of 6.5 applicants per position ranked by programs that did not fully match. These data may be helpful as we look to the future of orthopaedic sports medicine fellowship positions and the match process. In addition, this study reveals characteristics that divide sports medicine fellowship programs that fully match from those that do not. Applicants and/or fellowship program directors may utilize this information to modify their approach to the match process going forward. PMID:29796398

The Quality of Randomized Controlled Trials in Pediatric Orthopaedics: Are We Improving?

PubMed

Dodwell, Emily; Dua, Shiv; Dulai, Sukhdeep K; Astone, Kristina; Mulpuri, Kishore

2015-01-01

The quality of randomized controlled trials (RCTs) in orthopaedics is a topic of considerable importance, as RCTs play a major role in guiding clinical practice. The quality of RCTs published between 1995 and 2005 has previously been documented. The purpose of the current study was to assess and describe the quality of pediatric orthopaedic RCTs published from 2005 to 2012, by identifying study characteristics associated with higher quality and outlining areas for improvement. A standardized literature search was used to identify pediatric orthopaedic RCTs published in 7 well-recognized journals between September 2005 and July 2012 inclusive. The Detsky Quality Assessment Scale and the CONSORT checklist for Non-Pharmacologic Trials were used to assess the quality of the RCTs. Scores for the Detsky and CONSORT were calculated by 2 independent blinded orthopaedic surgeon reviewers with epidemiologic training. Forty RCTs were included in this analysis. The mean percentage score on the Detsky quality scale was 67%. Sixteen (40%) of the articles satisfied the threshold for a satisfactory level of methodological quality (Detsky >75%). Twenty-five (63%) of these studies were negative studies, concluding no difference between treatment arms. In 52% of the negative studies, an a priori sample size analysis was absent, and 28% were self-described as underpowered. In multiple variable regression analysis, only working with a statistician was significantly associated with higher Detsky percentage scores (P=0.01). There is a trend for improving quality in pediatric orthopaedic RCTs. Compared with past reports, the mean Detsky score improved from 53% to 67%, and the proportion meeting an acceptable level of quality improved from 19% to 40%. One of the most concerning findings of this study was the lack of attention to sample size and power analysis, and the potential for underpowered studies. Ongoing efforts are necessary to improve the conduct and reporting of clinical trials in pediatric orthopaedics. Pediatric orthopaedic surgeons, JPO, and POSNA are working toward improving levels of quality in pediatric orthopaedic research. This paper highlights progress that has been made, and addresses some high-yield areas for future improvement.

Reporting Guidelines and Checklists Improve the Reliability and Rigor of Research Reports.

PubMed

Abbott, J Haxby

2016-03-01

The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) requires the use of robust research reporting guidelines for all research report submissions, including the newly adopted RECORD (REporting of studies Conducted using Observational Routinely-collected health Data) statement. We remind authors submitting research to JOSPT to identify the appropriate guideline and checklist for their study design, and to submit a completely and accurately completed checklist with their manuscript. J Orthop Sports Phys Ther 2016;46(3):130. doi:10.2519/jospt.2016.0105.

77 FR 61652 - Utah Disaster # UT-00015

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... SMALL BUSINESS ADMINISTRATION [Disaster Declaration 13326 and 13327] Utah Disaster UT-00015 AGENCY: U.S. Small Business Administration. ACTION: Notice. SUMMARY: This is a notice of an Administrative declaration of a disaster for the State of UTAH dated 10/01/2012. Incident: Flooding. Incident Period: 09/11...

7. Photocopied August 1971 from Photo 13729, Granite Station Special ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopied August 1971 from Photo 13729, Granite Station Special Folder, Engineering Department, Utah Power and Light Co., Salt Lake City, Utah. GRANITE HYDRO-ELECTRIC PLANT (1500KW) STATION. PENSTOCK AND SPILWAY, NOVEMBER 1914. - Utah Power Company, Granite Hydroelectric Plant, Holladay, Salt Lake County, UT

8. Photocopied August 1971 from Photo 11479, Granite Station Special ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopied August 1971 from Photo 11479, Granite Station Special Folder, Engineering Department, Utah Power and Light Co., Salt Lake City, Utah. GRANITE HYDRO-ELECTRIC PLANT (1500 KW) STATION. PENSTOCK AND SPILWAY, NOVEMBER 1914. - Utah Power Company, Granite Hydroelectric Plant, Holladay, Salt Lake County, UT

Certification Standards for Utah School Personnel.

ERIC Educational Resources Information Center

Utah State Board of Education, Salt lake City. Div. of Staff Development.

This document presents various standards for the accreditation of Utah public school personnel as developed by the Utah State Board of Education, current as of January 1977. Information presented includes the following: (1) Evaluation, Approval, and Accreditation of Teacher Education Programs; (2) Accreditation of Higher Institutions which Prepare…

28. Photocopied from Photo 588 OLM, Olmstead Folder #1, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

28. Photocopied from Photo 588 - OLM, Olmstead Folder #1, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. STATION INTERIOR, DECEMBER 5, 1908. - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

7. Photocopied August 1971 from Photo 11480, Stairs Station Special ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. Photocopied August 1971 from Photo 11480, Stairs Station Special Folder, Engineering Department, Utah Power and Light Co., Salt Lake City, Utah. STAIRS HYDRO-ELECTRIC PLANT (1600 KW) STATION AND PENSTOCK, NOVEMBER 1914. - Utah Power & Light Company, Stairs Hydroelectric Station, Holladay, Salt Lake County, UT

8. Photocopied from unnumbered photo, Nunns Station Folder, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

8. Photocopied from unnumbered photo, Nunns Station Folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. EXTERIOR VIEW. C. 1898. - Telluride Power Company, Nunn Hydroelectric Plant, Southeast side of Provo River, 300 feet West of US Route 189, Orem, Utah County, UT

11. Photocopied from Photo #1, Nunns Station Folder, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Photocopied from Photo #1, Nunns Station Folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. 'INTERIOR NUNNS STATION.' c. 1898. - Telluride Power Company, Nunn Hydroelectric Plant, Southeast side of Provo River, 300 feet West of US Route 189, Orem, Utah County, UT

40 CFR 62.11100 - Identification of plan-negative declaration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLLUTANTS Utah Fluoride Emissions from Existing Phosphate Fertilizer Plants § 62.11100 Identification of... January 30, 2002 that there are no phosphate fertilizer plants in Utah that meet the definition of... Fertilizer Industry. Additionally, there are no phosphate fertilizer plants in Utah that meet the definition...

40 CFR 62.11100 - Identification of plan-negative declaration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTANTS Utah Fluoride Emissions from Existing Phosphate Fertilizer Plants § 62.11100 Identification of... January 30, 2002 that there are no phosphate fertilizer plants in Utah that meet the definition of... Fertilizer Industry. Additionally, there are no phosphate fertilizer plants in Utah that meet the definition...

40 CFR 52.2354 - Interstate transport.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 4 2011-07-01 2011-07-01 false Interstate transport. 52.2354 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Utah § 52.2354 Interstate transport. CAA..., Interstate Transport, of the Utah SIP submitted by the Utah Governor on March 22, 2007, satisfies the...

40 CFR 52.2354 - Interstate transport.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 4 2010-07-01 2010-07-01 false Interstate transport. 52.2354 Section...) APPROVAL AND PROMULGATION OF IMPLEMENTATION PLANS (CONTINUED) Utah § 52.2354 Interstate transport. CAA..., Interstate Transport, of the Utah SIP submitted by the Utah Governor on March 22, 2007, satisfies the...

What is the Utility Of a Limb Lengthening and Reconstruction Service in an Academic Department of Orthopaedic Surgery?

PubMed

Rozbruch, S Robert; Rozbruch, Elizabeth S; Zonshayn, Samuel; Borst, Eugene W; Fragomen, Austin T

2015-10-01

Limb lengthening and reconstruction surgery is a relatively new subspecialty of orthopaedic surgery in the United States. Despite increased awareness and practice of the specialty, it is rarely vested as a separate clinical service in an academic department of orthopaedic surgery. We have had experience growing such a dedicated service within an academic department of orthopaedic surgery over the past 9 years. We explored (1) the use of a limb deformity service (LDS) in an academic department of orthopaedic surgery by examining data on referral patterns, our clinical volume, and academic productivity; and (2) the surgical breadth of cases comprising the patients of the LDS in an academic department of orthopaedic surgery by examining data on caseload by anatomic sites, category, and surgical techniques/tools. We (SRR, ATF, EWB) retrospectively examined data on numbers of surgical cases and outpatient visits from the limb lengthening and complex reconstruction service at the Hospital for Special Surgery from 2005 to 2013 to evaluate growth. We studied 672 consecutive surgical cases performed by our service for a sample period of 1 year, assessing referral patterns within and outside our medical center, anatomic region, surgical category, and surgical technique/tool. Academic productivity was measured by review of our service's publications. During the time period studied (2005-2013), outpatient and surgical volume significantly increased by 120% (1530 to 3372) and 105% (346 to 708), respectively, on our LDS. Surgical volume growth was similar to the overall growth of the department of orthopaedic surgery. Referrals were primarily from orthopaedic surgeons (56%) and self/Internet research (25%). Physician referrals were predominantly from our own medical center (83%). Referrals from within our institution came from a variety of clinical services. Forty-nine peer-reviewed articles and 23 book chapters were published by staff members of our service. Anatomic surgical sites, surgical categories, and technique/tools used on our LDS were diverse, yet procedures were specialized to the discipline of limb deformity. There is a substantial role for an LDS within an academic department of orthopaedic surgery. With establishment of a dedicated service comes focus and resources that establish an environment for growth in volume, intramural and extramural referral, and purposeful research and education. The majority of referrals were from orthopaedic surgeons from our own medical center, suggesting needfulness. The LDS provides patients access to specialized surgery. The number of intramural referrals suggests that the specialty service helps retain patients within our academic orthopaedic department. Future research will try to determine if such a dedicated service leads to improved outcomes, efficiency, and value. Level IV, retrospective study.

Clinical diagnosis of partial or complete anterior cruciate ligament tears using patients' history elements and physical examination tests

PubMed Central

Fallaha, Michel; Belzile, Sylvain; Martel-Pelletier, Johanne; Pelletier, Jean-Pierre; Feldman, Debbie; Sylvestre, Marie-Pierre; Vendittoli, Pascal-André; Desmeules, François

2018-01-01

Objective To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. Design Prospective diagnostic study. Settings Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. Participants Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2). Interventions Not applicable. Main outcome measures History elements and physical examination tests performed independently were compared to the reference standard: an expert physicians’ composite diagnosis including history elements, physical tests and confirmatory magnetic resonance imaging. Penalized logistic regression (LASSO) was used to identify history elements and physical examination tests associated with the diagnosis of ACL tear and recursive partitioning was used to develop diagnostic clusters. Diagnostic accuracy measures including sensitivity (Se), specificity (Sp), predictive values and positive and negative likelihood ratios (LR+/-) with associated 95% confidence intervals (CI) were calculated. Results Forty-three individuals received a diagnosis of partial or complete ACL tear (15.4% of total cohort). The Lachman test alone was able to diagnose partial or complete ACL tears (LR+: 38.4; 95%CI: 16.0–92.5). Combining a history of trauma during a pivot with a “popping” sensation also reached a high diagnostic validity for partial or complete tears (LR+: 9.8; 95%CI: 5.6–17.3). Combining a history of trauma during a pivot, immediate effusion after trauma and a positive Lachman test was able to identify individuals with a complete ACL tear (LR+: 17.5; 95%CI: 9.8–31.5). Finally, combining a negative history of pivot or a negative popping sensation during trauma with a negative Lachman or pivot shift test was able to exclude both partial or complete ACL tears (LR-: 0.08; 95%CI: 0.03–0.24). Conclusion Diagnostic clusters combining history elements and physical examination tests can support the differential diagnosis of ACL tears compared to various knee disorders. PMID:29894492

Resources for your career in orthopaedic traumatology: what can the OTA do for you?

PubMed

Mehta, Samir; Smith, Jeffrey M

2012-09-01

For those choosing a career in orthopaedic traumatology, several resources have been established by the Orthopaedic Trauma Association to facilitate progression from the years in training to the early years in practice. Young practitioners have access to educational programming, such as preparation for Part II of the Board Examination, web-based resources, such as on-line job postings, advocacy in health policy for the issues that will affect their ability to practice, and public relations efforts to increase their presence in the community. Ultimately, the resources set aside for the young practitioner by the Orthopaedic Trauma Association are intended to facilitate a sense of excellence, service, and community.

Pilot assessment of pain of orthopaedic patients in Hong Kong.

PubMed

Chan, Shuk Fong; Ho, Samuel M Y; Poon, Kam Wa; Ip, Arthur; Cheung, Ophelia Y Y

2005-04-01

This pilot study examined the internal consistency and concurrent validity of the Chinese version of the Acute Lower Back Pain Screening Questionnaire. A sample of 45 acute low back pain patients (27 men and 18 women; mean age = 47.8) were recruited from the Department of Orthopaedics and Traumatology of the Tuen Mun Hospital in Hong Kong. Three items of the original questionnaire were excluded from the analyses because response was low by 30 of the 45 patients. The questionnaire showed good internal reliability (Cronbach alpha = .88) and correlated significantly with other test scores: the Faces Pain Scale-Revised (alpha = .74), the Chinese (Hong Kong) SF-12 Health Survey (Mental subscale, alpha = -.47; Physical subscale alpha = -.62), and the Chinese Hospital Anxiety and Depression Scale (Anxiety subscale, alpha = .42; Depression subscale, alpha = .43). The questionnaire could be used in research and clinical work to provide data on the multicomponents of a pain experience as well as psychosocial risk factors related to pain among the Chinese. Researchers might examine the course of change in chronic pain.

Sport and activity restrictions following total ankle replacement: A survey of orthopaedic foot and ankle specialists.

PubMed

Macaulay, Alec A; VanValkenburg, Scott M; DiGiovanni, Christopher W

2015-12-01

Despite an increasing utilization of total ankle replacement, surgeons have little guidance with regards to physical activity and sport participation recommendations following the procedure. Orthopaedic foot and ankle specialists were surveyed as to the activity and sports restrictions they place on their patients following ankle replacement. Fifty sports and activities were included and the results were used to derive a set of consensus recommendations. Of the 1063 surgeons that were sent the survey, 173 responded, yielding a response rate of 16.3%. In general, surgeons were comfortable with aerobic or low impact sports and activities. Boot immobilized sports represented a grey area with the determination of whether or not to allow them based largely on the prior experience of the patient. High impact, cutting and jumping sports and activities were largely discouraged. Young age, high BMI and poor bone quality led surgeons to be more restrictive. These consensus recommendations serve as a useful guideline for surgeons and help patients set appropriate expectations for the procedure. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Orthochina.org: case-based orthopaedic Wiki project in China.

PubMed

Ma, Zhen-Sheng; Zhang, Hong-Ju; Yu, Tao; Ren, Gang; Du, Guo-Sheng; Wang, Yong-Hua

2008-10-01

Traditional continuing medical education (CME) depended primarily on periodic courses and conferences. The cost-effectiveness of these courses has not been established, and often the content is not tailored to best meet the needs of the students. Internet training has the potential to accomplish these goals. Over the last 10 years, we have developed a Web site entitled "Orthochina.org," based upon the wiki concept, which uses an interactive, case-based format. We describe the development of online case discussions, and various technical and administrative requirements. As of December 31, 2007, there were 33,984 registered users, 9,759 of which passed the confirmation procedures. In 2007, an average of 211 registrants visited daily. The average number of first page clicks was 4,248 per day, and the average number of posts was 70 per day. All cases submitted for discussion include the patient's complaint, physical examination findings, and relevant images based on specific criteria for case discussion. The case discussions develop well professionally. No spam posting or unauthorized personal advertisement is permitted. In conclusion, online academic discussions proceed well when the orthopaedic surgeons who participate have established their identities.

76 FR 63951 - Notice of Competitive Coal Lease Sale, Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-14

..., UTU85539] Notice of Competitive Coal Lease Sale, Utah AGENCY: Bureau of Land Management, Interior. ACTION: Notice of competitive coal lease sale. SUMMARY: Notice is hereby given that that certain coal resources in the Dry Canyon Coal Tract described below in Carbon County, Utah, will be offered for competitive...

75 FR 52551 - Notice of Utah's Resource Advisory Council (RAC) Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-26

... DEPARTMENT OF THE INTERIOR Bureau of Land Management [LLUT91000-L10400000-PH0000-24-1A] Notice of Utah's Resource Advisory Council (RAC) Meeting AGENCY: Bureau of Land Management, Interior. ACTION.... Department of the Interior, Bureau of Land Management's (BLM) Utah Resource Advisory Council (RAC) will meet...

78 FR 26383 - Environmental Assessment of the Proposed Increase in Operation, Maintenance and Replacement...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

... regulating ponds to accommodate the changing pattern of water demand and increased urbanization. DATES: Date... Water Efficiency Project AGENCY: Central Utah Project Completion Act Office, Interior. ACTION: Notice of... amended, the Department of the Interior, the Central Utah Water Conservancy District, and the Utah...

9. Photocopied August 1971 from Photo 13730, Granite Folder #1, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopied August 1971 from Photo 13730, Granite Folder #1, Engineering Department, Utah Power and Light Co., Salt Lake City, Utah. GRANITE STATION: WESTINGHOUSE 750 K.V.A., 2- PHASE GENERATORS AND SWITCHBOARD, MAY 24, 1915. - Utah Power Company, Granite Hydroelectric Plant, Holladay, Salt Lake County, UT

77 FR 73966 - Utah Regulatory Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-12

... DEPARTMENT OF THE INTERIOR Office of Surface Mining Reclamation and Enforcement 30 CFR Part 944 [SATS No. UT-049-FOR; Docket ID OSM-2012-0015] Utah Regulatory Program AGENCY: Office of Surface Mining... Mining Control and Reclamation Act of 1977 (SMCRA or the Act). Utah proposes to revise references to...

75 FR 41799 - Agenda and Notice of Public Meeting of the Utah Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-19

... COMMISSION ON CIVIL RIGHTS Agenda and Notice of Public Meeting of the Utah Advisory Committee... Civil Rights (Commission), and the Federal Advisory Committee Act (FACA), that a planning meeting of the... regional activities, discuss civil rights issues in the state, discussion regarding the Utah Anti...

9. Photocopied from Photo 1161, Nunns Station Folder, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

9. Photocopied from Photo 1161, Nunns Station Folder, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. VIEW OF SITE SHOWING PENSTOCKS. c. 1920.? - Telluride Power Company, Nunn Hydroelectric Plant, Southeast side of Provo River, 300 feet West of US Route 189, Orem, Utah County, UT

23. Photocopied from Photo 664OLM, Olmstead Folder #1, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. Photocopied from Photo 664-OLM, Olmstead Folder #1, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. INTERIOR OF STATION, APRIL 8, 1909. - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

22. Photocopied from Photo 505OLM, Olmstead Folder #1, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. Photocopied from Photo 505-OLM, Olmstead Folder #1, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. OLD PENSTOCKS, JANUARY 25, 1908. - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

24. Photocopied from Photo 669OLM, Olmstead Folder #1, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

24. Photocopied from Photo 669-OLM, Olmstead Folder #1, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. NEW PENSTOCK, APRIL 8, 1909. - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

2. Photocopied from Photo 11456, Wheelon Station Special Folder, Engineering ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. Photocopied from Photo 11456, Wheelon Station Special Folder, Engineering Dept., Utah Power & Light Co., Salt Lake City, Utah. 'WHEELON HYDRO-ELECTRIC PLANT (7125 KW). INTERIOR OF MAIN BUILDING SHOWING FOUR 1000 KW UNITS. NOV 1914.' - Utah Sugar Company, Wheelon Hydoelectric Plant, Bear River, Fielding, Box Elder County, UT

76 FR 46805 - Notice of Utah Adoption by Reference of the Pesticide Container Containment Rule

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... ENVIRONMENTAL PROTECTION AGENCY [FRL-9447-8] Notice of Utah Adoption by Reference of the Pesticide Container Containment Rule AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: This... Pesticide Container Containment (PCC) Rule regulations. In accordance with State of Utah Agricultural Code...

The Money Mentors Program: Increasing Financial Literacy in Utah Youths

ERIC Educational Resources Information Center

Garcia, Zurishaddai A.; Francis, Dave; Christensen, Amanda; MacArthur, Stacey S.; Memmott, Margie; Hill, Paul A.

2017-01-01

Utah 4-H and Fidelity Investments collaborated on a program for increasing the financial literacy of teens and children. The collaboration resulted in positive impacts for both Extension and Utah youths. Extension benefited through partnership with a corporation that provided content expertise, volunteers, and funding for a financial literacy…

75 FR 44805 - Central Utah Project Completion Act; Notice of Availability, Draft Environmental Assessment...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-29

... DEPARTMENT OF THE INTERIOR Central Utah Project Completion Act; Notice of Availability, Draft Environmental Assessment (Draft EA); Realignment of a Portion of the Utah Lake Drainage Basin Water Delivery System AGENCY: Office of the Assistant Secretary--Water and Science, Interior ACTION: Notice of...

76 FR 51462 - Notice of Final Federal Agency Actions on Proposed Highway in Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

... DEPARTMENT OF TRANSPORTATION Federal Highway Administration Notice of Final Federal Agency Actions on Proposed Highway in Utah AGENCY: Federal Highway Administration (FHWA), USDOT. ACTION: Notice of... highway project, Tooele Midvalley Highway, from I-80 to State Route 36 Tooele County, State of Utah. Those...

78 FR 43225 - Utah Resource Advisory Council Meeting/Conference Call

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-19

... Utah RAC formed a subgroup to review BLM-Utah's draft three-year National Conservation Lands Strategy... draft strategy and this meeting will be held to discuss the changes. A public comment period will take place immediately following the presentation. The meeting is open to the public; however, transportation...

Eastern Utah Career Center at Price: Educational Specifications.

ERIC Educational Resources Information Center

Capson, A. Maurice

Administrators and staff members of the College of Eastern Utah and the Carbon County School District along with specialists of the Utah State Department of Education developed specifications for a proposed career center, which were based on guidelines and decisions established by a vocational planning policy committee. The resulting…

M-X Environmental Technical Report. Environmental Characteristics of Alternative Designated Deployment Areas, Mining and Geology.

DTIC Science & Technology

1980-12-22

Nevada and Utah Great Basin area, can be quickly drawn because of the paucity of known sites. The sole commercially producing area of oil and gas in...good production (in addition to oil shale, tar, sand and Gilsonite) is to be found in the Uinta Basin . Major production in Utah comes from the four...Utah crude came from these four fields. About 3,000 ni 2 (7,800 km 2 ) in the Uinta Basin in northeastern Utah is underlain by oil shale 15 ft (4.5 m

Map showing selected surface-water data for the Huntington 30 x 60-minute quadrangle, Utah

USGS Publications Warehouse

Price, Don

1984-01-01

This is one of a series of maps that describe the geology and related natural resources of the Huntington 30 x 60-minute quadrangle, Utah. Streamflow records used to compile this map were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Transportation. The principal runoff-producing area shown on the map was delineated from a work map (scale 1:250,000) compiled to estimate water yields in Utah (Bagley and others, 1964). Sources of information about recorded floods resulting from cloudbursts included Woolley (1946) and Butler and Marsell (1972); sources of information about the chemical quality of streamflow included Mundorff (1972) and Mundorff and Thompson (1982).

Map showing selected surface-water data for the Price 30 x 60-minute Quadrangle, Utah

USGS Publications Warehouse

Price, Don

1984-01-01

This is one of a series of maps that describe the geology and related natural resources of the Price 30 x 60-minute quadrangle, Utah. Streamflow records used to compile this map were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Transportation. The principal runoff-producing areas shown on the map were delineated from a work map (scale 1:250,000) compiled to estimate water yields in Utah (Bagley and others, 1964). Sources of information about recorded floods resulting from cloudbursts included Woolley (1946) and Butler and Marsell (1972); sources of information about the chemical quality of streamflow included Mundorff (1972; 1977), and Waddell and others (1982).

Prioritizing High-Temperature Geothermal Resources in Utah

USGS Publications Warehouse

Blackett, R.E.; Brill, T.C.; Sowards, G.M.

2002-01-01

The Utah Geological Survey and the Utah Energy Office recently released geothermal resource information for Utah as a "digital atlas." We are now expanding this project to include economic analyses of selected geothermal sites and previously unavailable resource information. The enhancements to the digital atlas will include new resource, demographic, regulatory, economic, and other information to allow analyses of economic factors for comparing and ranking geothermal resource sites in Utah for potential electric power development. New resource information includes temperature gradient and fluid chemistry data, which was previously proprietary. Economic analyses are based upon a project evaluation model to assess capital and operating expenses for a variety of geothermal powerplant configuration scenarios. A review of legal and institutional issues regarding geothermal development coupled with water development will also be included.

Periodic water- and air-temperature records for Utah streams, 1966-70

USGS Publications Warehouse

Whitaker, G.L.

1971-01-01

Since 1967, all Geological Survey hydrographers have been instructed to observe and record the water and air temperatures at times when water-discharge measurements were being made at stream-gaging stations in Utah. The frequency of these observations generally varies from I to 5 weeks, depending upon the magnitude of the stream flow.This report summarizes the periodic water and air temperatures that have been recorded in Utah since that effort began. This information may be of value to individuals or agencies concerned with thermal pollution of streams, or with enforcement of water-quality standards.A compilation of all daily water-temperature records recorded for streams in Utah by the U. S. Geological Survey during the period 1944-68 is contained in Utah Basic-Data Release No. 19.

Water-resources activities in Utah by the U.S. Geological Survey, October 1, 1989, to September 30, 1990

USGS Publications Warehouse

Gates, Joseph S.; Dragos, Stefanie L.

1991-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from October 1, 1989, to September 30, 1990. The program in Utah during this period consisted of 25 projects; a discussion of each project is given in the body of the report.The following sections outline the basic mission and program of the Water Resources Division, the organizational structure of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1989 to September 1990.

Water-resources activities in Utah by the U.S. Geological Survey, October 1, 1988, to September 30, 1989

USGS Publications Warehouse

Gates, Joseph S.; Dragos, Stefanie L.

1990-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from October 1, 1988, to September 30, 1989. The program in Utah during this period consisted of 21 projects; a discussion of each project is given in the main body of the report. The following sections outline the basic mission and program of the Water Resources Division, the organizational structure of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1988 to September 1989.

Behavioral Economics and Physician Board Meetings: Opportunity Cost, Regret, and Their Mitigation in Orthopaedic Surgery.

PubMed

Sinicrope, Brent J; Roberts, Craig S; Sussman, Lyle

2018-01-01

Health care is a business. Health care providers must become familiar with terms such as opportunity costs, the potential loss or gain when one choice is made in lieu of another. The purpose of this study was to calculate the opportunity cost of two orthopaedic surgery society board meetings and discuss these in the context of behavioral economics and regret. A literature search was conducted to determine an orthopaedic surgeon's average yearly salary, hours worked per week, and weeks worked per year. The details of two orthopaedic surgery professional society meetings that one senior author (CSR) attended were used to calculate opportunity cost. Although the true benefits are multifactorial and difficult to objectively quantify, awareness of the cost-benefit ratio can help guide time and resource management to maximize the return on investment while minimizing buyer's remorse and perhaps influence the media by which medical meetings are held in the future. (Journal of Surgical Orthopaedic Advances 27(1):10-13, 2018).

Level of Perception of Individualized Care and Satisfaction With Nursing in Orthopaedic Surgery Patients.

PubMed

Tekin, Fatma; Findik, Ummu Yildiz

2015-01-01

Lately, individualized nursing care and patient satisfaction are important and current issues being discussed. But there is not enough information for patients undergoing orthopaedic surgery. The aim of this study was to determine the individualized care perception and satisfaction in nursing care levels in orthopaedic surgery patients. This descriptive cross-sectional study was conducted with 156 patients who underwent orthopaedic surgery. Data were collected using the personal information form, the Individualized Care Scale, and the Newcastle Satisfaction With Nursing Scale. The Spearman correlation analysis and descriptive statistics were performed. The mean individualized care and satisfaction with nursing care scores were found to be close to the preset maximum value, and it was determined that an increase in the level of awareness about nursing interventions and the level of perceived individualized care caused an increase in satisfaction levels regarding nursing care. Nurses should recognize the importance of performing individualized care in order to increase the level of satisfaction with nursing care in orthopaedic surgery patients.

Decellularized Tissue and Cell-Derived Extracellular Matrices as Scaffolds for Orthopaedic Tissue Engineering

PubMed Central

Cheng, Christina W.; Solorio, Loran D.; Alsberg, Eben

2014-01-01

The reconstruction of musculoskeletal defects is a constant challenge for orthopaedic surgeons. Musculoskeletal injuries such as fractures, chondral lesions, infections and tumor debulking can often lead to large tissue voids requiring reconstruction with tissue grafts. Autografts are currently the gold standard in orthopaedic tissue reconstruction; however, there is a limit to the amount of tissue that can be harvested before compromising the donor site. Tissue engineering strategies using allogeneic or xenogeneic decellularized bone, cartilage, skeletal muscle, tendon and ligament have emerged as promising potential alternative treatment. The extracellular matrix provides a natural scaffold for cell attachment, proliferation and differentiation. Decellularization of in vitro cell-derived matrices can also enable the generation of autologous constructs from tissue specific cells or progenitor cells. Although decellularized bone tissue is widely used clinically in orthopaedic applications, the exciting potential of decellularized cartilage, skeletal muscle, tendon and ligament cell-derived matrices has only recently begun to be explored for ultimate translation to the orthopaedic clinic. PMID:24417915

The disruptive orthopaedic surgeon: implications for patient safety and malpractice liability.

PubMed

Patel, Pranay; Robinson, Brooke S; Novicoff, Wendy M; Dunnington, Gary L; Brenner, Michael J; Saleh, Khaled J

2011-11-02

Disruptive physician behavior imperils patient safety, erodes the morale of other health care providers, and dramatically increases the risk of malpractice litigation. Increasing patient volume, decreasing physician reimbursement, malpractice litigation, elevated stress, and growing job dissatisfaction have been implicated in disruptive behavior, which has emerged as one of the major challenges in health care. Because the aging patient population relies increasingly on orthopaedic services to maintain quality of life, improving professionalism and eradicating disruptive behavior are urgent concerns in orthopaedic surgery. Although many steps have been taken by The Joint Commission to improve patient care and define disruptive behavior, there is further room for improvement by physicians. Barriers to eliminating disruptive behavior by orthopaedic surgeons include fear of retaliation, lack of awareness among the surgeon's peers, and financial factors. Surgeons have a duty to address patterns of negative peer behavior for the benefit of patient care. This manuscript addresses the causes and consequences of disruptive physician behavior as well as management strategies, especially in orthopaedic surgery.

Laser arthroscopic surgery of the shoulder and knee

NASA Astrophysics Data System (ADS)

Smith, Chadwick F.; Johansen, Ed; Bonvalet, Todd; Sutter, Leroy V., Jr.; Marshall, G. June

1990-06-01

The laser is used less in orthopaedics than in any other medical specialty. Improving technology and the impressive effect of the CO2 laser on orthopaedic tissues has, however, accelerated the interest of orthopaedic surgeons over the past two years. The carbon dioxide laser is now commonly used in orthopaedics for difficult to access lesions of the knee - particularly those of a degenerative nature with high surface area and low volume. The results are presented in this paper and reveal no evidence of lasting complications. Although several types of lasers are being experimentally utilized in orthopaedics, the YAG and CO2 lasers are the only lasers commonly utilized. The YAG laser is utilized for shoulder arthroscopy and offers the advantage of passage of energy through fiber and the ability to utilize the tool in an aqueous environment. It is too early to determine as to whether or not the YAG laser or the CO2 laser will be the most efficient energy delivery system for use in the shoulder.

Ingrown toenail

MedlinePlus

... In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics . 13th ed. Philadelphia, ... by: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, Subspecialty Foot ...

American Academy of Orthopaedic Surgeons

MedlinePlus

... Councilors Board of Specialty Societies Core Programs Senior Management Team Governance Volunteer Opportunities AAOS Governing Principles Strategic Plan Bylaws Library Policies AAOS Orthopaedic Disclosure ...

Life impact of ankle fractures: qualitative analysis of patient and clinician experiences.

PubMed

McPhail, Steven M; Dunstan, Joel; Canning, Julie; Haines, Terry P

2012-11-21

Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act?

PubMed

Labrum, Joseph T; Paziuk, Taylor; Rihn, Theresa C; Hilibrand, Alan S; Vaccaro, Alexander R; Maltenfort, Mitchell G; Rihn, Jeffrey A

2017-06-01

A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion. In the survey, the caller assumed a fictitious identity as a 38-year-old male who experienced an ankle fracture 1 day before calling, and attempted to secure an appointment within 2 weeks. During initial contact, the fictitious patient reported Medicaid insurance status. One month later, the fictitious patient contacted the same orthopaedic practice and reported private insurance coverage status. National Orthopaedic Survey: Private and academic orthopaedic practices operating in each state in the United States were called and asked to complete a survey assessing their practice model of Medicaid insurance acceptance. State reimbursement rates for three different Current Procedural Terminology (CPT ®) codes were collected from state Medicaid agencies. Results Simulated Patient Survey: Offices were less likely to accept Medicaid than commercial insurance (30 of 64 [47%] versus 62 of 64 [97%]; odds ratio [OR], 0.0145; 95% CI, 0.00088-0.23639; p < 0.001), and patients with Medicaid were less likely to be offered an appointment within 2 weeks (23 of 64 [36%] versus 59 of 64 [89%]; OR, 0.0154; 95% CI, 0.00094- 0.251; p < 0.001). The Medicaid acceptance rates observed across states sampled in the simulated patient survey were 67% (Pennsylvania), 21% (New Jersey), 58% (Delaware), and 50% (Maryland) (p = 0.04). National Orthopaedic Survey: Adult patients with Medicaid insurance had limited access to care in 109 of 342 (32%) orthopaedic practices: 37% of private and 13% of academic practices (p < 0.001). Practices that accepted Medicaid received higher reimbursement for each CPT ®  code relative to those that did not and acceptance of Medicaid became increasingly more likely as reimbursement rates increased (99243: OR, 1.03, 95% CI, 1.02-1.04 per dollar, p < 0.001; 99213: OR, 1.05; 95% CI, 1.03-1.07 per dollar, p < 0.001; 28876: OR, 1.01, 95% CI, 1.00-1.01 per dollar, p < 0.001). For a given reimbursement rate, private practices were less likely to take an adult patient with Medicaid relative to an academic practice (99243: OR, 0.11, 95% CI, 0.04-0.33, p < 0.001; 99213: OR, 0.11, 95% CI, 0.04-0.32, p < 0.001; 27786: OR, 0.12, 95% CI, 0.04-0.35, p < 0.001). No difference was observed when comparing Medicaid acceptance rates for all practice types between states that have expanded their Medicaid program versus those that have not (OR, 1.02; 95% CI 0.62-1.70; p = 0.934). In this two-part survey study, we found that a simulated patient with commercial insurance was more likely to have their insurance accepted and to gain timely access to orthopaedic care than a patient with Medicaid. Academic practice setting and increased Medicaid reimbursement rates were associated with increased access to care for the patient with Medicaid. Inequality in access to orthopaedic care based on health insurance status likely exists for the adult patient with Medicaid. Furthermore, Medicaid expansion has likely realized minimal gains in access to care for the adult orthopaedic patient. Further research is needed in delineating the patient-payer selection criteria used by orthopaedic practices to aid policymakers in reforming the Medicaid program and comprehensibly addressing this access to care disparity. Level II, prognostic study.

Modern Initial Management of Severe Limbs Trauma in War Surgery: Orthopaedic Damage Control

DTIC Science & Technology

2010-04-01

avoid fat embolism , allow an optimal nursing and medical evacuation without any secondary functional consequences [3]. 2.2.1 Indications: The...decrease the risk of fat embolism . Modern Initial Management of Severe Limbs Trauma in War Surgery: “Orthopaedic Damage Control” RTO-MP-HFM-182 17...injuries. Orthopaedic Imperious: Multiple open shaft fractures with blood loss, complex epiphysal fractures requiring a long difficult surgical bloody

A consensus exercise identifying priorities for research into clinical effectiveness among children's orthopaedic surgeons in the United Kingdom.

PubMed

Perry, D C; Wright, J G; Cooke, S; Roposch, A; Gaston, M S; Nicolaou, N; Theologis, T

2018-05-01

Aims High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland. Results A total of 86 clinicians contributed to both rounds of the Delphi process, scoring priorities from one (low priority) to five (high priority). Elective topics were ranked higher than those relating to trauma, with the top ten elective research questions scoring higher than the top question for trauma. Ten elective, and five trauma research priorities were identified, with the three highest ranked questions relating to the treatment of slipped capital femoral epiphysis (mean score 4.6/ 5), Perthes' disease (4.5) and bone infection (4.5). Conclusion This consensus-based research agenda will guide surgeons, academics and funders to improve the evidence in children's orthopaedic surgery and encourage the development of multicentre clinical trials. Cite this article: Bone Joint J 2018;100-B:680-4.

Development of a method to analyze orthopaedic practice expenses.

PubMed

Brinker, M R; Pierce, P; Siegel, G

2000-03-01

The purpose of the current investigation was to present a standard method by which an orthopaedic practice can analyze its practice expenses. To accomplish this, a five-step process was developed to analyze practice expenses using a modified version of activity-based costing. In this method, general ledger expenses were assigned to 17 activities that encompass all the tasks and processes typically performed in an orthopaedic practice. These 17 activities were identified in a practice expense study conducted for the American Academy of Orthopaedic Surgeons. To calculate the cost of each activity, financial data were used from a group of 19 orthopaedic surgeons in Houston, Texas. The activities that consumed the largest portion of the employee work force (person hours) were service patients in office (25.0% of all person hours), maintain medical records (13.6% of all person hours), and resolve collection disputes and rebill charges (12.3% of all person hours). The activities that comprised the largest portion of the total expenses were maintain facility (21.4%), service patients in office (16.0%), and sustain business by managing and coordinating practice (13.8%). The five-step process of analyzing practice expenses was relatively easy to perform and it may be used reliably by most orthopaedic practices.

Readability of Orthopaedic Oncology-related Patient Education Materials Available on the Internet.

PubMed

Shah, Akash K; Yi, Paul H; Stein, Andrew

2015-12-01

A person's health literacy is one of the most important indicators of a patient's health status. According to national recommendations, patient education materials should be written at no higher than the sixth- to eighth-grade reading level. The purpose of our study was to assess the readability of online patient education materials related to orthopaedic oncology on the websites of the American Academy of Orthopaedic Surgeons (AAOS), American Cancer Society (ACS), Bone and Cancer Foundation (BCF), and National Cancer Institute (NCI). We searched the online patient education libraries of the AAOS, ACS, BCF, and NCI for all articles related to orthopaedic oncology. The Flesch-Kincaid (FK) readability score was calculated for each article and compared between sources. A total of 227 articles were identified with an overall mean FK grade level of 9.8. Stratified by source, the mean FK grade levels were 10.1, 9.6, 11.1, and 9.5 for the AAOS, ACS, BCF, and NCI, respectively (P < 0.003). Only 31 articles (14%) and 1 article (0.4%) were at or below the recommended eighth- and sixth-grade levels, respectively. Online patient education materials related to orthopaedic oncology appear to be written at a level above the comprehension ability of the average patient. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Cutoff value of Japanese Orthopaedic Association shoulder score in patients with rotator cuff repair: Based on the University of California at Los Angeles shoulder score.

PubMed

Imai, Takaki; Gotoh, Masafumi; Tokunaga, Tsuyoshi; Kawakami, Jyunichi; Mitsui, Yasuhiro; Fukuda, Keiji; Ogino, Misa; Okawa, Takahiro; Shiba, Naoto

2017-05-01

The Japanese Orthopaedic Association shoulder score cutoff values were calculated in patients with rotator cuff repair using the University of California at Los Angeles shoulder score. Overall, 175 patients with rotator cuff repair were subjects in this study. The University of California at Los Angeles and Japanese Orthopaedic Association shoulder scores were evaluated before surgery and at 3, 6, 9, and 12 months after surgery. The cutoff value of the Japanese Orthopaedic Association shoulder score was determined using the 4-stage criteria of the University of California at Los Angeles shoulder score and a University of California at Los Angeles shoulder score of 28 points, which is the boundary between an excellent/good group and a fair/poor group. Both the JOA shoulder and UCLA shoulder scores showed significant improvement at 6, 9, and 12 months from the preoperative scores (p < 0.0001). There was a strong correlation between the total values of the two scores (r = 0.85, p < 0.0001). The cutoff value of the Japanese Orthopaedic Association shoulder score based on the highest accuracy from receiver operating characteristic curve analysis was 83 points. A Japanese Orthopaedic Association shoulder score cutoff value of 83 was equivalent to a University of California at Los Angeles shoulder score cutoff value of 28 for distinguishing between excellent/good and fair/poor outcomes after rotator cuff repair. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Are the claims made in orthopaedic print advertisements valid?

PubMed

Davidson, Donald J; Rankin, Kenneth S; Jensen, Cyrus D; Moverley, Robert; Reed, Mike R; Sprowson, Andrew P

2014-05-01

Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims. Fifty claims from 50 advertisements were chosen randomly from six highly respected peer-reviewed orthopaedic journals (published July-December 2011). The evidence supporting each claim was assessed and validated by three orthopaedic surgeons. The assessors, blinded to product and company, rated the evidence and answered the following questions: Does the evidence as presented support the claim made in the advertisement and what is the quality of that evidence? Is the claim supported by enough evidence to influence your own clinical practice? Twenty-eight claims cited evidence from published literature, four from public presentations, 11 from manufacturer "data held on file" and seven had no supporting evidence. Only 12 claims were considered to have high-quality evidence and only 11 were considered well supported. A strong correlation was seen between the quality of evidence and strength of support (Spearman r = 0.945, p < 0.0001). The average ICC between the assessors' ratings was strong (r = 0.85) giving validity to the results. Orthopaedic surgeons must remain sceptical about the claims made in print advertisements. High-quality evidence is required by orthopaedic surgeons to influence clinical practice and this evidence should be sought by manufacturers wishing to market a successful product.

Etiology of Readmissions Following Orthopaedic Procedures and Medical Admissions. A Comparative Analysis.

PubMed

Maslow, Jed; Hutzler, Lorraine; Slover, James; Bosco, Joseph

2015-12-01

The Federal Government, the largest payer of health care, considers readmission within 30 days of discharge an indicator of quality of care. Many studies have focused on causes for and strategies to reduce readmissions following medical admissions. However, few studies have focused on the differences between them. We believe that the causes for readmission following orthopaedic surgery are markedly different than those following medical admissions, and therefore, the strategies developed to reduce medical readmissions will not be as effective in reducing readmissions after elective orthopaedic surgery. All unplanned 30-day readmissions following an index hospitalization for an elective orthopaedic procedure (primary and revision total joint arthroplasty and spine procedure) or for one of the three publicly reported medical conditions (AMI, HF, and pneumonia, which accounted for 11% of readmissions) were identified at our institution from 2010 through 2012. A total of 268 patients and 390 medical patients were identified as having an unplanned 30-day readmission. We reviewed a prospectively collected data base to determine the reason for readmission in each encounter. A total of 233 (86.9%) orthopaedic patients were readmitted for surgical complications, most commonly for a wound infection (56.0%) or wound complication (11.6%). Following an index admission of HF or AMI, the primary reason for readmission was a disease of the circulatory system (55.9% and 57.4%, respectively). Following an index admission for pneumonia, the primary reason for readmission was a disease of the respiratory system (34.5%). The causes of readmissions following orthopaedic surgery and medical admissions are different. Patients undergoing orthopaedic procedures are readmitted for surgical complications, frequently unrelated to aftercare, and medicine patients are readmitted for reasons related to the index diagnosis. Interventions designed to reduce orthopaedic readmissions must focus on reducing surgical complications, differing from interventions designed to reduce readmissions following medical admissions, which focus on medical diagnoses.

Lack of diversity in orthopaedic trials conducted in the United States.

PubMed

Somerson, Jeremy S; Bhandari, Mohit; Vaughan, Clayton T; Smith, Christopher S; Zelle, Boris A

2014-04-02

Several orthopaedic studies have suggested patient race and ethnicity to be important predictors of patient functional outcomes. This issue has also been emphasized by federal funding sources. However, the reporting of race and ethnicity has gained little attention in the orthopaedic literature. The objective of this study was to determine the percentage of orthopaedic randomized controlled clinical trials in the United States that included race and ethnicity data and to record the racial and ethnic distribution of patients enrolled in these trials. A systematic review of orthopaedic randomized controlled trials published from 2008 to 2011 was performed. The studies were identified through a manual search of thirty-two scientific journals, including all major orthopaedic journals as well as five leading medical journals. Only trials from the United States were included. The publication date, journal impact factor, orthopaedic subspecialty, ZIP code of the primary research site, number of enrolled patients, type of funding, and race and ethnicity of the study population were extracted from the identified studies. A total of 158 randomized controlled trials with 37,625 enrolled patients matched the inclusion criteria. Only thirty-two studies (20.3%) included race or ethnicity with at least one descriptor. Government funding significantly increased the likelihood of reporting these factors (p < 0.05). The percentages of Hispanic and African-American patients were extractable for studies with 7648 and 6591 enrolled patients, respectively. In those studies, 4.6% (352) of the patients were Hispanic and 6.2% (410) were African-American; these proportions were 3.5-fold and twofold lower, respectively, than those represented in the 2010 United States Census. Few orthopaedic randomized controlled trials performed in the United States reported data on race or ethnicity. Among trials that did report demographic race or ethnicity data, the inclusion of minority patients was substantially lower than would be expected on the basis of census demographics. Failure to represent the true racial diversity may result in decreased generalizability of trial conclusions across clinical populations.

Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day.

PubMed

Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K

2017-12-01

Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year, with each applicant participating in an average of 2 to 4 individual interviews per interview day and interviews commonly lasting between 5 and 15 minutes.

Safety syringes and anti-needlestick devices in orthopaedic surgery.

PubMed

Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

2011-09-07

The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting safety-engineered devices for an orthopaedic clinic, conventional syringes larger than 20 mL and conventional needles longer than 1.5 in (3.8 cm) are necessary.

Pediatric Orthopaedic Workforce in 2014: Current Workforce and Projections for the Future.

PubMed

Sawyer, Jeffrey R; Jones, Kerwyn C; Copley, Lawson A; Chambers, Stephanie

2017-01-01

The changing nature of the United States (US) health care system has prompted debate concerning the physician supply. The basic questions are: do we have an adequate number of surgeons to meet current demands and are we training the correct number of surgeons to meet future demands? The purpose of this analysis was to characterize the current pediatric orthopaedic workforce in terms of supply and demand, both present and future. Databases were searched (POSNA, SF Match, KID, MGMA) to determine the current pediatric orthopaedic workforce and workforce distribution, as well as pediatric orthopaedic demand. The number of active Pediatric Orthopaedic Society of North America (POSNA) members increased over the past 20 years, from 410 in 1993 to 653 in 2014 (155% increase); however, the density of POSNA members is not equally distributed, but correlates to population density. The number of estimated pediatric discharges, orthopaedic and nonorthopaedic, has remained relatively stable from 6,348,537 in 1997 to 5,850,184 in 2012. Between 2003 and 2013, the number of pediatric orthopaedic fellows graduating from Accreditation Council for Graduate Medical Education and non-Accreditation Council for Graduate Medical Education programs increased from 39 to 50 (29%), with a peak of 67 fellows (71%) in 2009. Although predicting the exact need for pediatric orthopaedic surgeons (POS) is impossible because of the complex interplay among macroeconomic, governmental, insurance, and local factors, some trends were identified: the supply of POS has increased, which may offset the expected numbers of experienced surgeons who will be leaving the workforce in the next 10 to 15 years; macroeconomic factors influencing demand for physician services, driven by gross domestic product and population growth, are expected to be stable in the near future; expansion of the scope of practice for POS is expected to continue; and further similar assessments are warranted. Level II-economic and decision analysis.

The validity of claims made in orthopaedic print advertisements.

PubMed

Bhattacharyya, Timothy; Tornetta, Paul; Healy, William L; Einhorn, Thomas A

2003-07-01

Orthopaedic surgeons are frequently presented with advertisements for orthopaedic and medical products in which companies make claims of clinical and scientific fact. This study was designed to evaluate the statements made in orthopaedic print advertisements and determine whether they are supported by scientific data. Fifty statements from fifty advertisements were chosen at random from six peer-reviewed orthopaedic journals. The companies that placed the advertisements were contacted to provide supporting data for the statement of clinical or scientific fact. Three senior orthopaedic surgeons evaluated the data for quality and support. A high-quality study was defined as a study that could be published in the peer-reviewed literature. A well-supported statement was defined as a statement with enough supporting evidence to be used in clinical practice. The evaluating surgeons were blinded to product and company identification. The supporting data were from a published source for eighteen claims (36%), from a presentation at a public forum or a scientific meeting for twelve claims (24%), or were "data on file" only at the company for twelve claims (24%). Interobserver agreement among the surgeons evaluating the advertisements for quality and support was good (the average intraclass correlation coefficient was 0.72). Of the fifty claims, twenty-two were considered unsupported by scientific data, seventeen were classified as possibly supported, seven were well supported, and four were from companies that did not respond despite three requests. Claims that were supported by published data were significantly more likely to be rated as well supported (p < 0.001). All twelve claims that were supported purely by "data on file" at the company were considered to be poorly supported. Orthopaedic surgeons should interpret claims made in orthopaedic print advertisements with caution. Approximately half of the claims are not supported by enough data to be used in a clinical decision-making process.

"Take me seriously and do something!" - a qualitative study exploring patients' perceptions and expectations of an upcoming orthopaedic consultation.

PubMed

Samsson, Karin S; Bernhardsson, Susanne; Larsson, Maria Eh

2017-08-24

Patients' perceptions of care is an important factor in evaluation of health care, in quality assessment, and in improvement efforts. Expectations of assessments or procedures such as surgery have been found to be related to perceptions of outcome as well as satisfaction, and are therefore of interest to both clinicians and researchers. Increased understanding of these patient views is important so that orthopaedic assessments, regardless of who performs them, can be further developed and patient-centred to better meet patients' needs. The purpose of this study was therefore to explore patients' perceptions and expectations of an upcoming orthopaedic consultation. This was an explorative qualitative study with an inductive approach. Thirteen patients who were referred for orthopaedic consultation were included using a purposeful sampling strategy. Patients participated in individual, semi-structured interviews that were recorded, transcribed verbatim and analysed with qualitative content analysis. The participants' expressed perceptions and expectations of the upcoming orthopaedic surgeon consultation were classified into 5 categories: Hoping for action, Meeting an expert, A respectful meeting, Participating in the consultation, and A belief that hard facts make evidence. Across the categories, an overarching theme was formulated: Take me seriously and do something! The participants emphasised a desire to be taken seriously and for something to happen, both during the consultation itself and as a result of the orthopaedic consultation. They described a trust in the expertise of the orthopaedic surgeon and stressed the importance of the surgeon's attitude, but still expected to participate in the consultation as well as in the decision-making process. The study findings illuminate aspects that are important for patients in an orthopaedic consultation. The descriptions of patients' perceptions and expectations can serve to improve patient-clinician relationships as well as to inform the development of new models of care, and a greater understanding of these aspects may improve the patient experience.

How does the knowledge environment shape procurement practices for orthopaedic medical devices in Mexico?

PubMed

Lingg, Myriam; Wyss, Kaspar; Durán-Arenas, Luis

2016-07-08

In organisational theory there is an assumption that knowledge is used effectively in healthcare systems that perform well. Actors in healthcare systems focus on managing knowledge of clinical processes like, for example, clinical decision-making to improve patient care. We know little about connecting that knowledge to administrative processes like high-risk medical device procurement. We analysed knowledge-related factors that influence procurement and clinical procedures for orthopaedic medical devices in Mexico. We based our qualitative study on 48 semi-structured interviews with various stakeholders in Mexico: orthopaedic specialists, government officials, and social security system managers or administrators. We took a knowledge-management related perspective (i) to analyse factors of managing knowledge of clinical procedures, (ii) to assess the role of this knowledge and in relation to procurement of orthopaedic medical devices, and (iii) to determine how to improve the situation. The results of this study are primarily relevant for Mexico but may also give impulsion to other health systems with highly standardized procurement practices. We found that knowledge of clinical procedures in orthopaedics is generated inconsistently and not always efficiently managed. Its support for procuring orthopaedic medical devices is insufficient. Identified deficiencies: leaders who lack guidance and direction and thus use knowledge poorly; failure to share knowledge; insufficiently defined formal structures and processes for collecting information and making it available to actors of health system; lack of strategies to benefit from synergies created by information and knowledge exchange. Many factors are related directly or indirectly to technological aspects, which are insufficiently developed. The content of this manuscript is novel as it analyses knowledge-related factors that influence procurement of orthopaedic medical devices in Mexico. Based on our results we recommend that the procurement mechanism should integrate knowledge from clinical procedures adequately in their decision-making. Without strong guidance, organisational changes, and support by technological solutions to improve the generation and management of knowledge, procurement processes for orthopaedic high-risk medical devices will remain sub-optimal.

Groundwater conditions in Utah, spring of 2011

USGS Publications Warehouse

Burden, Carole B.

2011-01-01

This is the forty-eighth in a series of annual reports that describe groundwater conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing groundwater conditions. This report, like the others in the series, contains information on well construction, groundwater withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of groundwater. Supplementary data are included in reports of this series only for those years or areas that are important to a discussion of changing groundwater conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of groundwater development in the State for calendar year 2010. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is also available online at http:// www.waterrights.utah.gov/techinfo/ and http://ut.water.usgs. gov/publications/GW2011.pdf. Groundwater conditions in Utah for calendar year 2009 are reported in Burden and others (2010) and available online at http://ut.water.usgs.gov/ publications/GW2010.pdf.Analytical results associated with water samples collected from each area of groundwater development were compared to State of Utah Maximum Contaminant Levels (MCLs) and secondary drinking-water standards of routinely measureable substances present in water supplies. The MCLs and secondary drinking-water standards can be accessed online at http://www.rules.utah.gov/publicat/code/r309/r309-200. htm#T5. The U.S. Environmental Protection Agency (EPA) drinking-water standards can be accessed at http://www.epa. gov/safewater/mcl.html#mcls. Maximum Contaminant Levels and secondary drinking-water standards were developed for public water systems and do not apply to the majority of wells sampled during this study.

Organic/Inorganic Hybrid Perovskite FETs for Electrically Injected Laser Action

DTIC Science & Technology

2015-09-01

UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION Wake Forest University REPORT NUMBER Department of Physics...Action PI, Oana D. Jurchescu, Wake Forest University In collaboration with Z. Valy Vardeny ( University of Utah) -supported under N00014-15-1-2524 ONR...between mob ili ty and y can be clearly observed. The mobility increases over fi ve orders of magnitude as a result of decreasing y by about 20 times

Proceedings of the International Conference on Stiff Computation, April 12-14, 1982, Park City, Utah. Volume I.

DTIC Science & Technology

1982-01-01

physical reasoning and based on computational experience with similar equations. There is another non- automatic way: through proper scaling of all...1979) for an automatic scheme for this scaling on a digitial computer . Shampine(1980) reports a special definition of stiffness appropriate for...an analog for a laboratory that typically already has a digital computer . The digitial is much more versatile. Also there does not yet exist " software

Dynamics Days Arizonia 1993. A Workshop held at Tempe, Arizona on 5-9 January 1993

DTIC Science & Technology

1993-01-09

78712 1617 W. NOPAL CT. E-mail: arnone@utpapa.ph.uterxas.edu CHANDLER, AZ 85224 E-mail: attgb@asuacad.bitnet LANCE ARSENAULT UNIVERSITY OF ILLINOIS...biham@nova.npac.syr.edu 765 FIRST, ISYE GEORGIA TECH HANS-RICHARD BLANK ATLANTA, GA 30332-0205 PHYSIKALISCHES INSTITUT E-mail: JOHN.BARTHOLDI...SCHOOL OF PHYSICS UTAH STATE UNIVERSITY GEORGIA INSTITUTE OF TECHNOLOGY DEPARTMENT OF CHEMIISTRY ATLANTA, GA 30332 LOGAN, UT 84322-0300 USA E-mail

78 FR 27165 - Approval and Promulgation of Implementation Plans; Utah; Revisions to Utah Rule R307-107; General...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-09

... grant the Utah executive secretary exclusive authority to decide whether excess emissions constituted a... requires breakdown incident reports to include the cause and nature of the event, estimated quantity of... appeared to give the executive secretary exclusive authority to determine whether excess emissions...

75 FR 80838 - Notice of Invitation to Participate In Coal Exploration License, Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-23

...] Notice of Invitation to Participate In Coal Exploration License, Utah AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Invitation to Participate in Coal Exploration License. SUMMARY: All interested... program for the exploration of coal deposits owned by the United States of America in Emery County, Utah...

78 FR 2424 - Notice of Competitive Coal Lease Sale, Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

...-LVEMJ12CJ610, UTU89060] Notice of Competitive Coal Lease Sale, Utah AGENCY: Bureau of Land Management, Interior. ACTION: Notice of competitive coal lease sale. SUMMARY: Notice is hereby given that the United States Department of the Interior, Bureau of Land Management (BLM), Utah State Office will reoffer certain coal...

Spatial Relative Risk Patterns of Autism Spectrum Disorders in Utah

ERIC Educational Resources Information Center

Bakian, Amanda V.; Bilder, Deborah A.; Coon, Hilary; McMahon, William M.

2015-01-01

Heightened areas of spatial relative risk for autism spectrum disorders (ASD), or ASD hotspots, in Utah were identified using adaptive kernel density functions. Children ages four, six, and eight with ASD from multiple birth cohorts were identified by the Utah Registry of Autism and Developmental Disabilities. Each ASD case was gender-matched to…

Telepractice Services at Sound Beginnings at Utah State University

ERIC Educational Resources Information Center

Blaiser, Kristina M.; Edwards, Marge; Behl, Diane; Munoz, Karen F.

2012-01-01

The Utah State University Sound Beginnings program originated in 2007 as a laboratory school to serve children with hearing loss from birth to age 6 years old living in Northern Utah. Sound Beginnings offers an interdisciplinary listening and spoken language educational option for families through the following services: toddler and preschool…

Standardization of the Functional Assessment and Intervention Program (FAIP) with Children Who Have Externalizing Behaviors

ERIC Educational Resources Information Center

Hartwig, Laurie; Heathfield, Lora Tuesday; Jenson, William R.

2004-01-01

The purpose of this study was to develop standardization data for the Functional Assessment Intervention Program (FAIP; University of Utah, Utah State University, & Utah State Office of Education, 1999), a computerized, functional behavioral assessment expert system. Reliability, validity, and utility analyses were conducted with students serving…

76 FR 18245 - West Tavaputs Plateau Road Restriction Order, Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-01

... Tavaputs Plateau Road Restriction Order, Utah AGENCY: Bureau of Land Management, Interior. ACTION: Notice...) is restricting the use of certain roads in the Price Field Office, Utah, as follows: The public is prohibited from driving a motorized vehicle on Horse Bench, Jack Canyon, Jack Ridge, and Cedar Ridge Roads on...

75 FR 21225 - Agenda and Notice of Public Meeting of the Utah Advisory Committee

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-23

... COMMISSION ON CIVIL RIGHTS Agenda and Notice of Public Meeting of the Utah Advisory Committee... Civil Rights (Commission), and the Federal Advisory Committee Act (FACA), that a planning meeting of the... activities, discuss civil rights issues in the state, hear from a subcommittee on the Utah Anti...

75 FR 430 - Notice of Intent To Prepare an Environmental Impact Statement for the Sigurd-Red Butte...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

...; UTU-83067] Notice of Intent To Prepare an Environmental Impact Statement for the Sigurd-Red Butte...) Cedar City Field Office, Cedar City, Utah, intends to prepare an Environmental Impact Statement (EIS... Fishlake National Forests), State of Utah, Millard County, Sevier County, Beaver County, Utah Division of...

Teaching Russian Via Distance Learning, the EdNet Experience.

ERIC Educational Resources Information Center

Zsiray, Stephen W., Jr.; And Others

In Utah, the statewide distance education network (EdNet) enables students from five rural and suburban high schools to learn Russian and earn college credits. Courses in Russian are offered through a partnership involving the Cache County School District, Utah State University, and the Utah State Office of Education. Classes are taught on one…

Wellness Works: A Collaborative Program for Youth and Adults in Rural Utah

ERIC Educational Resources Information Center

Shirley, Lindsey; Roark, Mark F.; Lewis, Lisa

2012-01-01

Utah State University Cooperative Extension programming, provided through the historic land-grant system, is one method used to meet the needs of residents located in rural communities. Residents in a Central Utah county need Cooperative Extension programs to address the health and wellness of their rural community. According to the Utah…

40 CFR 147.2250 - State-administered program-Class I, III, IV, and V wells.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the Federal Register on June 25, 1984. (1) Utah Water Pollution Control Act, Utah Code Annotated... Executive Secretary of Utah Water Pollution Control Committee on August 16, 1990). (b) Other laws. The... Department of Health, Division of Environmental Health, Bureau of Water Pollution Control, to EPA Region VIII...

40 CFR 147.2250 - State-administered program-Class I, III, IV, and V wells.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of the Federal Register on June 25, 1984. (1) Utah Water Pollution Control Act, Utah Code Annotated... Executive Secretary of Utah Water Pollution Control Committee on August 16, 1990). (b) Other laws. The... Department of Health, Division of Environmental Health, Bureau of Water Pollution Control, to EPA Region VIII...

40 CFR 81.345 - Utah.

Code of Federal Regulations, 2012 CFR

2012-07-01

... area of Utah County that lies west of the Wasatch Mountain Range (and this includes the Cities of Provo... Weber County that lies west of the Wasatch Mountain Range with an eastern boundary for Weber County to... within Utah: Township 15 North Range 1 East; Township 14 North Range 1 East; Township 13 North Range 1...

40 CFR 81.345 - Utah.

Code of Federal Regulations, 2013 CFR

2013-07-01

... area of Utah County that lies west of the Wasatch Mountain Range (and this includes the Cities of Provo... Weber County that lies west of the Wasatch Mountain Range with an eastern boundary for Weber County to... within Utah: Township 15 North Range 1 East; Township 14 North Range 1 East; Township 13 North Range 1...

Measures of Child Well-Being in Utah, 1996.

ERIC Educational Resources Information Center

Utah Children, Salt Lake City.

This 1996 Kids Count report presents data and analysis for 20 indicators of children's well-being in Utah. The report's introductory section discusses the impact of social and economic trends, which may contribute to a polarization of "have's" and "have nots" in Utah. The bulk of the report provides statistics on the 20…

The northern goshawk in Utah: Habitat assessment and management recommendations

Treesearch

Russell T. Graham; Ronald L. Rodriguez; Kathleen M. Paulin; Rodney L. Player; Arlene P. Heap; Richard Williams

1999-01-01

This assessment describes northern goshawk (Accipiter gentilis) habitat in the State of Utah. Because of fire exclusion, insect and disease epidemics, timber harvest, livestock grazing, or a combination of these factors the forests and woodlands of Utah have changed drastically since the early 1900's. Forests are now dominated by mid- and late...

78 FR 2434 - Notice of Inventory Completion: Natural History Museum of Utah, Salt Lake City, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... Inventory Completion: Natural History Museum of Utah, Salt Lake City, UT AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Natural History Museum of Utah has completed an inventory of human... culturally affiliated with the human remains and associated funerary objects may contact the Natural History...

78 FR 2430 - Notice of Inventory Completion: Natural History Museum of Utah, Salt Lake City, UT

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-11

... Inventory Completion: Natural History Museum of Utah, Salt Lake City, UT AGENCY: National Park Service, Interior. ACTION: Notice. SUMMARY: The Natural History Museum of Utah has completed an inventory of human... culturally affiliated with the human remains and associated funerary objects may contact the Natural History...

76 FR 53926 - Utah; Major Disaster and Related Determinations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... follows: I have determined that the damage in certain areas of the State of Utah resulting from flooding... of a major disaster for the State of Utah (FEMA-4011-DR), dated August 8, 2011, and related determinations. DATES: Effective Date: August 8, 2011. FOR FURTHER INFORMATION CONTACT: Peggy Miller, Office of...

Twice Considered: Charter Schools and Student Achievement in Utah

ERIC Educational Resources Information Center

Ni, Yongmei; Rorrer, Andrea K.

2012-01-01

A relatively small state, Utah presents an interesting case to study charter schools given its friendly policy environment and its significant growth in charter school enrollment. Based on longitudinal student-level data from 2004 to 2009, this paper utilizes two approaches to evaluate the Utah charter school effectiveness: (a) hierarchical linear…

76 FR 9770 - Utah Board of Water Resources Notice of Successive Preliminary Permit Application Accepted for...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... Water Resources Notice of Successive Preliminary Permit Application Accepted for Filing and Soliciting Comments, Motions To Intervene, and Competing Applications On February 1, 2011, the Utah Board of Water... reservoir. Applicant Contact: Mr. Eric Millis, Utah Board of Water Resources, 1594 W. North Temple, Salt...

75 FR 70024 - Notice of Expansion of the Lisbon Valley Known Potash Leasing Area, Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

... expressions of interest. Any competitive leases issued will be subject to the oil and gas leasing stipulations... of Expansion of the Lisbon Valley Known Potash Leasing Area, Utah AGENCY: Bureau of Land Management... classification standards for the Utah portion of the Paradox Basin geologic province, which includes Lisbon...

30 CFR 944.15 - Approval of Utah regulatory program amendments.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 816/817.61; 850; Memorandum of Agreement between the Board and Division of Oil, Gas, and Mining and... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Approval of Utah regulatory program amendments..., DEPARTMENT OF THE INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944...

30 CFR 944.15 - Approval of Utah regulatory program amendments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 816/817.61; 850; Memorandum of Agreement between the Board and Division of Oil, Gas, and Mining and... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Approval of Utah regulatory program amendments..., DEPARTMENT OF THE INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944...

30 CFR 944.15 - Approval of Utah regulatory program amendments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 816/817.61; 850; Memorandum of Agreement between the Board and Division of Oil, Gas, and Mining and... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Approval of Utah regulatory program amendments..., DEPARTMENT OF THE INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944...

30 CFR 944.15 - Approval of Utah regulatory program amendments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 816/817.61; 850; Memorandum of Agreement between the Board and Division of Oil, Gas, and Mining and... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Approval of Utah regulatory program amendments..., DEPARTMENT OF THE INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944...

30 CFR 944.15 - Approval of Utah regulatory program amendments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 816/817.61; 850; Memorandum of Agreement between the Board and Division of Oil, Gas, and Mining and... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Approval of Utah regulatory program amendments..., DEPARTMENT OF THE INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944...

76 FR 69217 - Approval and Promulgation of State Implementation Plans; State of Utah; Smoke Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

... perspective. Five regional planning organizations (RPOs) were developed to address regional haze and related... Promulgation of State Implementation Plans; State of Utah; Smoke Management Requirements for Mandatory Class I...). R307-204 contains smoke management requirements for land managers within the State of Utah as required...

A tree-ring based reconstruction of Logan River streamflow, northern Utah

Treesearch

Eric B. Allen; Tammy M. Rittenour; R. Justin DeRose; Matthew F. Bekker; Roger Kjelgren; Brendan M. Buckley

2013-01-01

We created six new tree-ring chronologies in northern Utah, which were used with preexisting chronologies from Utah and western Wyoming to reconstruct mean annual flow for the Logan River, the largest tributary of the regionally important Bear River. Two reconstruction models were developed, a ''Local'' model that incorporated two Rocky Mountain...

The San Juan Canyon, southeastern Utah: A geographic and hydrographic reconnaissance

USGS Publications Warehouse

Miser, Hugh D.

1924-01-01

This report, which describes the San Juan Canyon, San Juan River and the tributary streams and the geography and to some extent the geology of the region, presents information obtained by me during the descent of the river with the Trimble party in 1921. The exploration of the canyon, which was financed jointly by the United States Geological Survey and the Southern California Edison Co., had as its primary object the mapping and study of the San Juan in connection with proposed power and storage projects along this and Colorado rivers.1 The exploration party was headed by K. W. Thimble, topographic engineer of the United States Geological Survey. Other members of the party were Robert N. Allen, Los Angeles, Calif., recorder; H. E. Blake, jr., Monticello, Utah, and Hugh Hyde, Salt Lake City, Utah, rodmen; Bert Loper, Green River, Utah, boatman; Heber Christensen, Moab, Utah, cook; and H. D. Miser, geologist. Wesley Oliver, of Mexican Hat, Utah, served as packer for the party and brought mail and provisions by pack train twice a month to specified accessible places west of Goodridge.

Library outreach: addressing Utah's “Digital Divide”

PubMed Central

McCloskey, Kathleen M.

2000-01-01

A “Digital Divide” in information and technological literacy exists in Utah between small hospitals and clinics in rural areas and the larger health care institutions in the major urban area of the state. The goals of the outreach program of the Spencer S. Eccles Health Sciences Library at the University of Utah address solutions to this disparity in partnership with the National Network of Libraries of Medicine—Midcontinental Region, the Utah Department of Health, and the Utah Area Health Education Centers. In a circuit-rider approach, an outreach librarian offers classes and demonstrations throughout the state that teach information-access skills to health professionals. Provision of traditional library services to unaffiliated health professionals is integrated into the library's daily workload as a component of the outreach program. The paper describes the history, methodology, administration, funding, impact, and results of the program. PMID:11055305

Map showing selected surface-water data for the Nephi 30 x 60-minute quadrangle, Utah

USGS Publications Warehouse

Price, Don

1984-01-01

This is one of a series of maps that describe the geology and related natural resources of the Nephi 30 x 60 minute quadrangle, Utah. Streamflow records used to compile this map were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, and the Utah Department of Transportation. The principal runoff-producing areas shown on the map were delineated from a work map (scale 1:250,000) compiled to estimate water yields in Utah (Bagley and others, 1964). Sources of information about recorded floods resulting from cloudbursts included Woolley (1946) and Butler and Marsell (1972); sources of information about the chemical quality of streamflow included Hahl and Cabell (1965) Mundorff (1972 and 1974), and Waddell and others (1982).

Water-resources activities in Utah by the U.S. Geological Survey, October 1, 1990, to September 30, 1991

USGS Publications Warehouse

Gates, Joseph S.; Hardy, Ellen E.

1992-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from October 1, 1990, to September 30, 1991. The program in Utah during this period consisted of 23 projects; a discussion of each project is given in the main body of this report.The following sections outline the origin of the U.S. Geological Survey, the basic mission of the Water Resources Division, the organizational structure of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1990 to September 1991.

Water-resources activities in Utah by the U.S. Geological Survey, October 1, 1991, to September 30, 1992

USGS Publications Warehouse

Hardy, Ellen E.; Gates, Joseph S.

1993-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from October 1, 1991, to September 30, 1992. The program in Utah during this period consisted of 20 projects; a discussion of each project is presented in the main body of this report.The following sections outline the origin of the U.S. Geological Survey, the basic mission of the Water Resources Division, the organizational structure of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1991 to September 1992.

An information revolution in orthopaedics.

PubMed

Goldberg, A J; MacGregor, A; Spencer, S A

2012-04-01

With the established success of the National Joint Registry and the emergence of a range of new national initiatives for the capture of electronic data in the National Health Service, orthopaedic surgery in the United Kingdom has found itself thrust to the forefront of an information revolution. In this review we consider the benefits and threats that this revolution poses, and how orthopaedic surgeons should marshal their resources to ensure that this is a force for good.

A basic introduction to statistics for the orthopaedic surgeon.

PubMed

Bertrand, Catherine; Van Riet, Roger; Verstreken, Frederik; Michielsen, Jef

2012-02-01

Orthopaedic surgeons should review the orthopaedic literature in order to keep pace with the latest insights and practices. A good understanding of basic statistical principles is of crucial importance to the ability to read articles critically, to interpret results and to arrive at correct conclusions. This paper explains some of the key concepts in statistics, including hypothesis testing, Type I and Type II errors, testing of normality, sample size and p values.

Marfan Syndrome: A Clinical Update.

PubMed

Bitterman, Adam D; Sponseller, Paul D

2017-09-01

Marfan syndrome is a connective tissue disorder that can affect many organ systems. Affected patients present with orthopaedic manifestations of the syndrome during all phases of life. Pain caused by musculoskeletal abnormalities often requires definitive orthopaedic treatment. Orthopaedic surgeons must understand the phenotypes of Marfan syndrome so they can recognize when screening is warranted and can appropriately address the skeletal manifestations. Through medical advancements, patients with Marfan syndrome are living longer and more active lives. Knowledge of the latest diagnostic criteria for the disorder, as well as of advances in understanding the skeletal phenotype, clinical trials of medication therapy, and lifestyle considerations is important for orthopaedic surgeons who treat these patients because these clinicians often are the first to suspect Marfan syndrome and recommend screening.

Ground-water conditions in Utah, spring of 2008

USGS Publications Warehouse

Burden, Carole B.; Allen, David V.; Danner, M.R.; Fisher, Martel J.; Freeman, Michael L.; Downhour, Paul; Wilkowske, C.D.; Eacret, Robert J.; Enright, Michael; Swenson, Robert L.; Howells, James H.; Christiansen, Howard K.

2008-01-01

This is the forty-fifth in a series of annual reports that describe ground-water conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Resources and Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing ground-water conditions.This report, like the others in the series, contains information on well construction, ground-water withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of ground water. Supplementary data are included in reports of this series only for those years or areas which are important to a discussion of changing ground-water conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of ground-water development in the State for calendar year 2007. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Resources and Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is available online at http://www.waterrights.utah.gov/techinfo/ and http://ut.water.usgs.gov/publications/GW2008.pdf.

Field guide to geologic excursions in southwestern Utah and adjacent areas of Arizona and Nevada

USGS Publications Warehouse

Lund, William R.; Lund, William R.

2002-01-01

This field guide contains road logs for field trips planned in conjunction with the 2002 Rocky Mountain Section meeting of the Geological Society of America held at Southern Utah University in Cedar City, Utah. There are a total of eight field trips, covering various locations and topics in southwestern Utah and adjacent areas of Arizona and Nevada. In addition, the field guide contains a road log for a set of Geological Engineering Field Camp Exercises run annually by the University of Missouri at Rolla in and around Cedar City. Two of the field trips address structural aspects of the geology in southwestern Utah and northwestern Arizona; two trips deal with ground water in the region; and along with the Field Camp Exercises, one trip, to the Grand Staircase, is designed specifically for educators. The remaining trips examine the volcanology and mineral resources of a large area in and around the Tusher Mountains in Utah; marine and brackish water strata in the Grand Staircase-Escalante National Monument; and the Pine Valley Mountains, which are cored by what may be the largest known laccolith in the world. The "Three Corners" area of Utah, Arizona, and Nevada is home to truly world-class geology, and I am confident that all of the 2002 Rocky Mountain Section meeting attendees will find a field trip suited to their interests.

Ground-water conditions in Utah, spring of 2009

USGS Publications Warehouse

Burden, Carole B.; Allen, David V.; Rowland, Ryan C.; Fisher, Martel J.; Freeman, Michael L.; Downhour, Paul; Nielson, Ashley; Eacret, Robert J.; Myers, Andrew; Slaugh, Bradley A.; Swenson, Robert L.; Howells, James H.; Christiansen, Howard K.

2009-01-01

This is the forty-sixth in a series of annual reports that describe ground-water conditions in Utah. Reports in this series, published cooperatively by the U.S. Geological Survey and the Utah Department of Natural Resources, Division of Water Resources and Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality, provide data to enable interested parties to maintain awareness of changing ground-water conditions. This report, like the others in the series, contains information on well construction, ground-water withdrawal from wells, water-level changes, precipitation, streamflow, and chemical quality of water. Information on well construction included in this report refers only to wells constructed for new appropriations of ground water. Supplementary data are included in reports of this series only for those years or areas which are important to a discussion of changing ground-water conditions and for which applicable data are available.This report includes individual discussions of selected significant areas of ground-water development in the State for calendar year 2008. Most of the reported data were collected by the U.S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Resources and Division of Water Rights, and the Utah Department of Environmental Quality, Division of Water Quality. This report is available online at http://www.waterrights. utah.gov/techinfo/ and http://ut.water.usgs.gov/publications/ GW2009.pdf.

Estimating ages of Utah chubs by use of pectoral fin rays, otoliths, and scales

USGS Publications Warehouse

Griffin, Kayla M; Beard, Zachary S.; Flinders, John M.; Quist, Michael C.

2017-01-01

Utah chub Gila atraria is native to the Upper Snake River system in Wyoming and Idaho and to the Lake Bonneville Basin in Utah and southeastern Idaho. However, the Utah chub has been introduced into many other waterbodies in the western United States, where it competes with ecologically and economically important species. The objectives of this study were to evaluate between-reader precision and reader confidence in age estimates obtained from pectoral fin rays, lapilli (otoliths), asterisci (otoliths), and scales for Utah chubs collected from Henrys Lake, Idaho. Lapilli have been previously shown to provide accurate age estimates for Utah chubs; therefore, we sought to compare age estimates from fin rays, asterisci, and scales to those from lapilli. The between-reader coefficient of variation (CV) in age estimates was lowest and the percent of exact reader agreement (PA-0) was highest for pectoral fin rays (CV = 4.7, PA-0 = 74%), followed by scales (CV = 10.3, PA-0 = 52.3%), lapilli (CV = 11.6, PA-0 = 48.2%), and asterisci (CV = 13.0, PA-0 = 41.7%). Consensus age estimates from pectoral fin rays showed high concordance with consensus age estimates from lapilli. Our results indicate that pectoral fin rays provide the most precise age estimates for Utah chub. Pectoral fin rays are easily collected and processed and also provide age estimates without requiring fish sacrifice.

The integration of a Podiatrist into an orthopaedic department: a cost-consequences analysis.

PubMed

Walsh, Tom P; Ferris, Linda R; Cullen, Nancy C; Brown, Christopher H; Loughry, Cathy J; McCaffrey, Nikki M

2017-01-01

The aim of this study was to evaluate the cost-consequences of a podiatry-led triage clinic provided in an orthopaedic department relative to usual care for non-urgent foot and ankle complaints in an Australian tertiary care hospital. All new, non-urgent foot and ankle patients seen in an outpatient orthopaedic department were included in this study. The patients seen between 2014 and 2015 by Orthopaedic Surgeons were considered 'usual care', the patients seen between 2015 and 2016 by a Podiatrist were considered the 'Podiatry Triage Clinic'. Data on new and review patient appointments; the number of new patients / session; the number of appointments / patient; the number of patients discharged; the surgical conversion rate; staff time; and imaging use were collected. A cost-consequences analysis, undertaken from a healthcare provider perspective (hospital) estimated the incremental resource use, costs and effects of the Podiatry Triage Clinic relative to usual care over a 12-month period. The Orthopaedic Surgeons and Podiatrist consulted with 72 and 212 new patients during the usual care and triage periods, respectively. The Podiatrist consulted with more new patients / session, mean (SD) of 3.6 (1.0) versus 0.7 (0.8), p  < 0.001 and utilised less appointments / patient than the Orthopaedic Surgeons, mean (SD) of 1.3 (0.6) versus 1.9 (1.1), p  < 0.001. The percentage of patients discharged without surgery was similar in the Podiatry Triage Clinic and usual care, 80.3% and 87.5% p  = 0.135, respectively, but the surgical conversion rate was higher in the Podiatry Triage Clinic, 76.1% versus 12.5% p  < 0.001. The total integrated appointment cost for the 12-month usual care period was $32,744, which represented a cost of $454.78 / patient. The total appointment and imaging cost during the triage period was $19,999, representing $94.34 / patient. Further analysis, suggests that the projected annual saving of integrating a Podiatry Triage Clinic versus an orthopaedic clinic alone is $50,441. The integration of a Podiatrist into an orthopaedic department significantly increases the number of patients seen, is cost-effective, improves the surgical conversion rate and improves the utilisation of Orthopaedic Surgeons.

The Impact of Competency-Based Teacher Education and Certification Programs in Utah.

ERIC Educational Resources Information Center

Mouritsen, Roger C.

Utah is a member of a nine-state consortium to study competency-based teacher education and certification programs. This paper presents an overview of the nationwide movement for competency-based teacher education, followed by a description of the situation in Utah. The State Board of Education is making an effort through the Teacher Education and…

Training Interpreter Paraprofessionals to Assist in the Language Assessment of English Language Learners in Utah.

ERIC Educational Resources Information Center

Yoakum, Susie; Manuel-Dupont, Sonia

1997-01-01

Describes development of an interpreter paraprofessional (IP) program by Utah State University and Granite (Utah) school district in response to the unavailability of certified interpreters to assist in special education assessment of students who are English Language Learners. Stresses the importance of providing IPs with job-relevant training,…

Utah Educational Quality Indicators. The Fifth in the Report Series: How Good Are Utah Public Schools?

ERIC Educational Resources Information Center

Nelson, David E.

This report, the fifth in a series assessing educational quality in Utah public schools, focuses on students' achievements and provides performance measures based on statewide results of various testing programs and special studies. The report presents three types of data relevant to major state board of education programs (such as Utah…

Child Care and Utah's Economy: Making the Connection. A Special Utah KIDS COUNT Report.

ERIC Educational Resources Information Center

Utah Children, Salt Lake City.

Recent growth in high technology and substantial entrepreneurial activity in Utah has resulted in an economic boom in different regions of the state. This boom has led to economic prosperity for many, but also economic decline for others, and subsequent increasing economic inequality throughout the state. This special KIDS COUNT report presents an…

Do You Really Want to Know? Elementary Music Personnel and Potential in Utah

ERIC Educational Resources Information Center

Walker, Loretta Niebur

2015-01-01

This is the second of two articles reporting the results of a study by the author regarding the status of elementary music education in the state of Utah. This article focuses on the qualifications of Utah's elementary music teachers (music certified, elementary classroom certified, artists-in-residence, volunteers, and paraprofessionals) and the…

Baseline Survey of Educational Technology Access and Application in Southeastern Utah.

ERIC Educational Resources Information Center

Tyner, Kathleen; And Others

Utah's Southeastern Education Service Center has devised a five-phase vision plan for improving the educational technology infrastructure in the southeastern region of the state. The fourth phase involves the creation of the Southeastern Utah Regional Wide Area Network (SURWAN), which will link all K-12 schools to the Internet by 1996. This…

Utah's Transition Guidelines for Students at Risk and Students with Mild/Moderate Handicaps.

ERIC Educational Resources Information Center

Utah State Board of Education, Salt Lake City.

These transition guidelines are designed to give Utah school districts direction in planning transition programs for Utah students at risk and/or students with disabilities. The guidelines present best practices in planning to assist these special needs students from school to life in their communities. The five-step process includes planning,…

Utah Guidance and Toolkit for Student Learning Objectives: Instructions and Materials. Utah SLOs. Updated

ERIC Educational Resources Information Center

Utah State Office of Education, 2014

2014-01-01

This document is intended to help teachers understand and create Student Learning Objectives (SLOs). This resource is a practical guide intended to provide clarity to a complex but worthwhile task. This resource may also be used by administrators for professional learning. As Utah moves toward providing a "Model for Measuring Educator…

Revegetation of Reconstructed Reaches of the Provo River, Heber Valley, Utah

Treesearch

John A. Rice

2006-01-01

In 1999, the Utah Reclamation Mitigation and Conservation Commission began the Provo River Restoration Project to create a more naturally functioning riverine ecosystem between Jordanelle Dam and Deer Creek Reservoir. The purpose of the project was to mitigate for past impacts to riverine, wetland, and riparian habitats caused by the Central Utah Project and other...

Roosevelt Hot Springs, Utah FORGE Regional Well Locations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nash, Greg

This archive contains a GIS point feature shapefile that shows the locations of wells in the general region of the Utah FORGE project, near Roosevelt Hot Springs. This includes Utah FORGE deep well 58-32 and wells for which data has been uploaded to the Geothermal Data Repository. The attribute table has a field that contains well names.

Banning Weapons on Campuses: The Battle Is Far from Won

ERIC Educational Resources Information Center

McLelland, Sandra J.; Frenkil, Steven D.

2009-01-01

Utah is the only state that prohibits its state institutions from barring guns on its campuses. The University of Utah fought that statutory requirement vigorously in court, but the interests of pro-gun groups prevailed. In 2006 the Supreme Court of Utah held that the university lacked the authority to issue firearms policies, including barring…

Utah geothermal commercialization planning. Semi-annual progress report, January 1, 1979--June 30, 1979

DOE Office of Scientific and Technical Information (OSTI.GOV)

Green, S.; Wagstaff, L.W.

1979-06-01

The effects of the Utah geothermal planning project were concentrated on the Utah geothermal legislation, the Roosevelt Hot Springs time phased project plan and the Salt Lake County area development plan. Preliminary findings indicate a potential for heat pump utilization, based on market interest and the existence of suitable groundwater conditions. (MHR)

Knowledge Assessment of Food Safety Managers in Utah and Its Implications on the Exam and Instruction

ERIC Educational Resources Information Center

Nummer, Brian A.; Guy, Stanley M.; Bentley, Joanne P. H.

2010-01-01

Food Safety Manager's Certification is offered through a state-local Extension partnership in Utah using an online course management system. Exams and course materials were created by an Extension Specialist at Utah State Univ. Extension Agents provide exam and curriculum facilitation in each county. This form of distance education enables access…

76 FR 46838 - Notice of Proposed Class II Reinstatement of Terminated Oil and Gas Leases, Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-03

... Proposed Class II Reinstatement of Terminated Oil and Gas Leases, Utah AGENCY: Bureau of Land Management, Interior. ACTION: Notice. SUMMARY: In accordance with Title IV of the Federal Oil and Gas Royalty... petition for reinstatement of oil and gas leases UTU-85226 and UTU-85230 lands in Uintah County, Utah, and...

30 CFR 944.20 - Approval of Utah abandoned mine plan.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Division of Oil, Gas and Mining, Department of Natural Resources, 3 Triad Center, Suite 350, 355 West North... 30 Mineral Resources 3 2012-07-01 2012-07-01 false Approval of Utah abandoned mine plan. 944.20... INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944.20 Approval of...

30 CFR 944.20 - Approval of Utah abandoned mine plan.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Division of Oil, Gas and Mining, Department of Natural Resources, 3 Triad Center, Suite 350, 355 West North... 30 Mineral Resources 3 2014-07-01 2014-07-01 false Approval of Utah abandoned mine plan. 944.20... INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944.20 Approval of...

77 FR 24978 - Notice of Proposed Class II Reinstatement of Terminated Oil and Gas Leases, Utah.

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-26

... Proposed Class II Reinstatement of Terminated Oil and Gas Leases, Utah. AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Proposed Class II Reinstatement of Terminated Oil and Gas Leases, Utah. SUMMARY: In accordance with Title IV of the Federal Oil and Gas Royalty Management Act (Pub. L. 97-451...

30 CFR 944.20 - Approval of Utah abandoned mine plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Division of Oil, Gas and Mining, Department of Natural Resources, 3 Triad Center, Suite 350, 355 West North... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Approval of Utah abandoned mine plan. 944.20... INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944.20 Approval of...

76 FR 14686 - Notice of Proposed Class II Reinstatement of Terminated Oil and Gas Lease, Utah

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-17

... Proposed Class II Reinstatement of Terminated Oil and Gas Lease, Utah AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Proposed Class II Reinstatement of Terminated Oil and Gas Lease, Utah. SUMMARY: In accordance with Title IV of the Federal Oil and Gas Royalty Management Act (Pub. L. 97-451...

30 CFR 944.20 - Approval of Utah abandoned mine plan.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Division of Oil, Gas and Mining, Department of Natural Resources, 3 Triad Center, Suite 350, 355 West North... 30 Mineral Resources 3 2013-07-01 2013-07-01 false Approval of Utah abandoned mine plan. 944.20... INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944.20 Approval of...

30 CFR 944.20 - Approval of Utah abandoned mine plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Division of Oil, Gas and Mining, Department of Natural Resources, 3 Triad Center, Suite 350, 355 West North... 30 Mineral Resources 3 2011-07-01 2011-07-01 false Approval of Utah abandoned mine plan. 944.20... INTERIOR PROGRAMS FOR THE CONDUCT OF SURFACE MINING OPERATIONS WITHIN EACH STATE UTAH § 944.20 Approval of...

Utah Publications Depository Program. Manual of Guidelines for State Agencies, Revised [and] Manual of Guidelines for Depository Libraries, Revised.

ERIC Educational Resources Information Center

Utah State Library, Salt Lake City.

Two manuals provide guidelines for users of the Utah Publications Depository Program. The first, "Guidelines for State Agencies," is designed to assist agencies in complying with the depository law. The program is designed to collect Utah State Governmental publications and to make them available through libraries. State publications…

Assuring the research competence of orthopedic graduates.

PubMed

Konstantakos, Emmanuel K; Laughlin, Richard T; Markert, Ronald J; Crosby, Lynn A

2010-01-01

To assure that orthopaedic residents have the knowledge needed to critically appraise the medical/surgical literature and the skills needed to design and conduct musculoskeletal and orthopaedic research. Residency program of the Department of Orthopaedic Surgery, Sports Medicine and Rehabilitation at Wright State University Boonshoft School of Medicine, Dayton, Ohio. Established in 2005, members of the residency program's Research Team (RT) include orthopaedic faculty and residents, university faculty and graduate students, community scientists, and department staff. The membership and responsibilities of the Research Team are described. The goals of the three-month research rotation during the second year of residency and the activities of the assigned resident are reported. The work of the two research residents during the second year of their six-year program is explained. Helpful educational resources are noted, the role of the faculty research mentor defined, funding sources listed, and the financial support for RT members and research staff presented. The scholarly activity of orthopaedic surgery residents increased substantially from the five-year period before the implementation of the Research Team (September 2000 through August 2005) to the four-year period after initiation of the RT (September 2005 through November 2009). For peer-reviewed scholarship activity, publications on which residents were authors increased from 1 to 10 per year, national presentations at professional meetings increased from 6 to 11 per year, and local and regional presentations increased from 2 to 4 per year. The Research Team is an effective strategy for assuring that orthopaedic residents have the knowledge and skills to evaluate clinical care evidence and to conduct musculoskeletal and orthopaedic research. Copyright (c) 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Using financial incentives to improve value in orthopaedics.

PubMed

Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J

2012-04-01

A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.

Retractions in orthopaedic research: A systematic review.

PubMed

Yan, J; MacDonald, A; Baisi, L-P; Evaniew, N; Bhandari, M; Ghert, M

2016-06-01

Despite the fact that research fraud and misconduct are under scrutiny in the field of orthopaedic research, little systematic work has been done to uncover and characterise the underlying reasons for academic retractions in this field. The purpose of this study was to determine the rate of retractions and identify the reasons for retracted publications in the orthopaedic literature. Two reviewers independently searched MEDLINE, EMBASE, and the Cochrane Library (1995 to current) using MeSH keyword headings and the 'retracted' filter. We also searched an independent website that reports and archives retracted scientific publications (www.retractionwatch.com). Two reviewers independently extracted data including reason for retraction, study type, journal impact factor, and country of origin. One hundred and ten retracted studies were included for data extraction. The retracted studies were published in journals with impact factors ranging from 0.000 (discontinued journals) to 13.262. In the 20-year search window, only 25 papers were retracted in the first ten years, with the remaining 85 papers retracted in the most recent decade. The most common reasons for retraction were fraudulent data (29), plagiarism (25) and duplicate publication (20). Retracted articles have been cited up to 165 times (median 6; interquartile range 2 to 19). The rate of retractions in the orthopaedic literature is increasing, with the majority of retractions attributed to academic misconduct and fraud. Orthopaedic retractions originate from numerous journals and countries, indicating that misconduct issues are widespread. The results of this study highlight the need to address academic integrity when training the next generation of orthopaedic investigators.Cite this article: J. Yan, A. MacDonald, L-P. Baisi, N. Evaniew, M. Bhandari, M. Ghert. Retractions in orthopaedic research: A systematic review. Bone Joint Res 2016;5:263-268. DOI: 10.1302/2046-3758.56.BJR-2016-0047. © 2016 Ghert et al.

An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice.

PubMed

Thornley, P; de Sa, D; Evaniew, N; Farrokhyar, F; Bhandari, M; Ghert, M

2016-04-01

Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns. A total of 353 surgeons completed the survey. Surgeons achieved consensus on the 'importance' of three key designs on their practices: randomised controlled trials (94%), meta-analyses (75%) and systematic reviews (66%). The vast majority of respondents support the use of current evidence over historical clinical training; however subjective factors such as journal reputation (72%) and investigator profile (68%) continue to influence clinical decision-making strongly. Although intrinsic factors such as study design and sample size have some influence on clinical decision-making, surgeon respondents are equally influenced by extrinsic factors such as investigator reputation and perceived journal quality.Cite this article: Dr M. Ghert. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016;5:130-136. DOI: 10.1302/2046-3758.54.2000578. © 2016 Ghert et al.

Retractions in orthopaedic research

PubMed Central

Yan, J.; MacDonald, A.; Baisi, L-P.; Evaniew, N.; Bhandari, M.

2016-01-01

Objectives Despite the fact that research fraud and misconduct are under scrutiny in the field of orthopaedic research, little systematic work has been done to uncover and characterise the underlying reasons for academic retractions in this field. The purpose of this study was to determine the rate of retractions and identify the reasons for retracted publications in the orthopaedic literature. Methods Two reviewers independently searched MEDLINE, EMBASE, and the Cochrane Library (1995 to current) using MeSH keyword headings and the ‘retracted’ filter. We also searched an independent website that reports and archives retracted scientific publications (www.retractionwatch.com). Two reviewers independently extracted data including reason for retraction, study type, journal impact factor, and country of origin. Results One hundred and ten retracted studies were included for data extraction. The retracted studies were published in journals with impact factors ranging from 0.000 (discontinued journals) to 13.262. In the 20-year search window, only 25 papers were retracted in the first ten years, with the remaining 85 papers retracted in the most recent decade. The most common reasons for retraction were fraudulent data (29), plagiarism (25) and duplicate publication (20). Retracted articles have been cited up to 165 times (median 6; interquartile range 2 to 19). Conclusion The rate of retractions in the orthopaedic literature is increasing, with the majority of retractions attributed to academic misconduct and fraud. Orthopaedic retractions originate from numerous journals and countries, indicating that misconduct issues are widespread. The results of this study highlight the need to address academic integrity when training the next generation of orthopaedic investigators. Cite this article: J. Yan, A. MacDonald, L-P. Baisi, N. Evaniew, M. Bhandari, M. Ghert. Retractions in orthopaedic research: A systematic review. Bone Joint Res 2016;5:263–268. DOI: 10.1302/2046-3758.56.BJR-2016-0047. PMID:27354716

Male orthopaedic surgeons and anaesthetists: equally good at estimating fluid volumes (and changing light bulbs) but equally poor at estimating procedure duration.

PubMed

Chua, Weiliang; Kong, Chee Hoe; Murphy, Diarmuid Paul

2015-05-01

How many orthopods does it take to change a light bulb? One - to refer to the medics for 'Darkness ?Cause'. Additionally, anaesthetists and surgeons often disagree on the estimated blood loss during surgery and the estimated procedure duration. We designed this study to compare the ability of orthopaedic surgeons and anaesthetists in: (a) estimating fluid volumes; (b) estimating procedure durations; and (c) changing light bulbs. Participants had to either be a specialist in anaesthesia or orthopaedic surgery, or a trainee in that specialty for at least two years. Three different fluid specimens were used for volume estimation (44 mL, 88 mL and 144 mL). Two videos of different lengths (140 seconds and 170 seconds), showing the suturing of a banana skin, were used for procedure duration estimation. To determine the ability at changing light bulbs, the participants had to match eight different light sockets to their respective bulbs. 30 male anaesthetists and trainees and 31 male orthopaedic surgeons and trainees participated in this study. Orthopaedic surgeons underestimated the three fluid volumes by 3.9% and anaesthetists overestimated by 5.1% (p = 0.925). Anaesthetists and orthopaedic surgeons overestimated the duration of the two procedures by 21.2% and 43.1%, respectively (p = 0.006). Anaesthetists had a faster mean time in changing light bulbs (70.1 seconds vs. 74.1 seconds, p = 0.319). In an experimental environment, male orthopaedic surgeons are as good as male anaesthetists in estimating fluid volumes (in commonly seen surgical specimens) and in changing light bulbs. Both groups are poor at estimating procedure durations.

Review of the current literature as a preparatory tool for the trauma content of the Orthopaedic in-Training Examination.

PubMed

Farjoodi, Payam; Marker, David R; McCallum, Jeremy R; Frassica, Frank J; Mears, Simon C

2011-05-18

Currently, the only standardized evaluation of trauma knowledge throughout orthopedic training is found in the Orthopaedic In-Training Examination, which is administered annually to all residents by the American Academy of Orthopaedic Surgeons. Our goals were to assess the Orthopaedic In-Training Examination to (1) determine the content of the trauma questions, (2) identify the content of the 3 most frequently referenced journals on the answer keys, and (3) evaluate the correlation between those contents.We reviewed the trauma-related Orthopaedic In-Training Examination questions and answer keys for 2002 through 2007. Content for test questions and cited literature was assessed with the same criteria: (1) category type, (2) anatomic location, (3) orthopedic focus, and (4) treatment type. For each of the 3 most frequently referenced journals, we weighted content by dividing the number of times it was referenced by the number of its trauma-related articles. We then compared the journal data individually and collectively to the data from the Orthopaedic In-Training Examination trauma questions. A chi-square analysis with Yates correction was used to determine differences. Questions and literature were similar in the most frequently addressed items in each of the 4 areas: category type (taxonomy 3, treatment), 52.4% and 60.7%, respectively; anatomic location (femur), 23.3% and 27.7%, respectively; orthopedic focus (fracture), 51.0% and 56.5%, respectively; and treatment type (multiple/nonspecific), 39.0% and 35.4%, respectively.The content correlation found between the questions and literature supports the idea that reviewing current literature may help prepare for the trauma content on the Orthopaedic In-Training Examination. Copyright 2011, SLACK Incorporated.

[Application of three-dimensional printing technique in orthopaedics].

PubMed

Luo, Qiang; Lau, Tak Wing; Fang, Xinshuo; Leung, Frankie

2014-03-01

To review the current progress of three-dimensional (3-D) printing technique in the clinical practice, its limitations and prospects. The recent publications associated with the clinical application of 3-D printing technique in the field of surgery, especially in orthopaedics were extensively reviewed. Currently, 3-D printing technique has been applied in orthopaedic surgery to aid diagnosis, make operative plans, and produce personalized prosthesis or implants. 3-D printing technique is a promising technique in clinical application.

Does virtual reality simulation have a role in training trauma and orthopaedic surgeons?

PubMed

Bartlett, J D; Lawrence, J E; Stewart, M E; Nakano, N; Khanduja, V

2018-05-01

Aims The aim of this study was to assess the current evidence relating to the benefits of virtual reality (VR) simulation in orthopaedic surgical training, and to identify areas of future research. Materials and Methods A literature search using the MEDLINE, Embase, and Google Scholar databases was performed. The results' titles, abstracts, and references were examined for relevance. Results A total of 31 articles published between 2004 and 2016 and relating to the objective validity and efficacy of specific virtual reality orthopaedic surgical simulators were identified. We found 18 studies demonstrating the construct validity of 16 different orthopaedic virtual reality simulators by comparing expert and novice performance. Eight studies have demonstrated skill acquisition on a simulator by showing improvements in performance with repeated use. A further five studies have demonstrated measurable improvements in operating theatre performance following a period of virtual reality simulator training. Conclusion The demonstration of 'real-world' benefits from the use of VR simulation in knee and shoulder arthroscopy is promising. However, evidence supporting its utility in other forms of orthopaedic surgery is lacking. Further studies of validity and utility should be combined with robust analyses of the cost efficiency of validated simulators to justify the financial investment required for their use in orthopaedic training. Cite this article: Bone Joint J 2018;100-B:559-65.

The role of chairman and research director in influencing scholarly productivity and research funding in academic orthopaedic surgery.

PubMed

Stavrakis, Alexandra I; Patel, Ankur D; Burke, Zachary D C; Loftin, Amanda H; Dworsky, Erik M; Silva, Mauricio; Bernthal, Nicholas M

2015-10-01

The purpose of this study was to determine what orthopaedic surgery department leadership characteristics are most closely correlated with securing NIH funding and increasing scholarly productivity. Scopus database was used to identify number of publications/h-index for 4,328 faculty, department chairs (DC), and research directors (RD), listed on departmental websites from 138 academic orthopaedic departments in the United States. NIH funding data was obtained for the 2013 fiscal year. While all programs had a DC, only 46% had a RD. Of $54,925,833 in NIH funding allocated to orthopaedic surgery faculty in 2013, 3% of faculty and 31% of departments were funded. 16% of funded institutions had a funded DC whereas 65% had a funded RD. Department productivity and funding were highly correlated to leadership productivity and funding(p< 0.05). Mean funding was $1,700,000 for departments with a NIH-funded RD, $104,000 for departments with an unfunded RD, and $72,000 for departments with no RD. These findings suggest that orthopaedic department academic success is directly associated with scholarly productivity and funding of both DC and RD. The findings further highlight the correlation between a funded RD and a well-funded department. This does not hold for an unfunded RD. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries.

PubMed

Ardern, Clare L; Ekås, Guri Ranum; Grindem, Hege; Moksnes, Håvard; Anderson, Allen F; Chotel, Franck; Cohen, Moises; Forssblad, Magnus; Ganley, Theodore J; Feller, Julian A; Karlsson, Jón; Kocher, Minider S; LaPrade, Robert F; McNamee, Michael; Mandelbaum, Bert; Micheli, Lyle; Mohtadi, Nicholas; Reider, Bruce; Roe, Justin; Seil, Romain; Siebold, Rainer; Silvers-Granelli, Holly J; Soligard, Torbjørn; Witvrouw, Erik; Engebretsen, Lars

2018-04-01

In October 2017, the International Olympic Committee hosted an international expert group of physiotherapists and orthopaedic surgeons who specialise in treating and researching paediatric ACL injuries. Representatives from the American Orthopaedic Society for Sports Medicine, European Paediatric Orthopaedic Society, European Society for Sports Traumatology, Knee Surgery & Arthroscopy, International Society of Arthroscopy Knee Surgery and Orthopaedic Sports Medicine, Pediatric Orthopaedic Society of North America and Sociedad Latinoamericana de Artroscopia, Rodilla y Deporte attended. Physiotherapists and orthopaedic surgeons with clinical and research experience in the field, and an ethics expert with substantial experience in the area of sports injuries also participated. Injury management is challenging in the current landscape of clinical uncertainty and limited scientific knowledge. Injury management decisions also occur against the backdrop of the complexity of shared decision-making with children and the potential long-term ramifications of the injury. This consensus statement addresses six fundamental clinical questions regarding the prevention, diagnosis and management of paediatric ACL injuries. The aim of this consensus statement is to provide a comprehensive, evidence-informed summary to support the clinician, and help children with ACL injury and their parents/guardians make the best possible decisions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A review of virtual reality based training simulators for orthopaedic surgery.

PubMed

Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G

2016-02-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Evidence-based Medicine in Pediatric Orthopaedics: Evidence-based Practice Committee Summary of Levels of Evidence, Clinical Practice Guidelines, Appropriate Use Criteria, and Best Practice Guidelines.

PubMed

Gandhi, Jigar S; Shea, Kevin G; Sponseller, Paul D; Brighton, Brian K; Ganley, Theodore J

2018-04-30

The concept of evidence-based medicine has evolved over the past 2 decades, and has become a cornerstone to clinical decision-making in virtually every aspect of medicine. With a commitment to providing its members with high-quality evidence-based guidelines, the American Academy of Orthopaedic Surgeons has instituted concerted efforts since 2006 to develop clinical practice guidelines (CPGs) and appropriate use criteria (AUCs) for certain orthopaedic conditions. Many of these CPGs and AUCs detail the management of pediatric orthopaedic conditions. By the same token, members of the Pediatric Orthopaedic Society of North America (POSNA) Evidence Based Practice Committee have been publishing succinct evaluations of randomized controlled trials in pediatric orthopaedic surgery to create an evidence-based repository for quick reference to available high-level evidence as well as resource to identify gaps in the current research and identify opportunities for future investigation. In instances where higher-level evidence needed to develop CPGs is not available to address a critically important clinical question, consensus recommendations from experts in the field have been obtained to develop best practice guidelines (BPGs). The purpose of this review is to provide readers with a deeper understanding of the key principles of evidence-based medicine and methodologies used for the development of CPGs, AUCs, and BPGs.

Miscellaneous High-Resolution Seismic Imaging Investigations in Salt Lake and Utah Valleys for Earthquake Hazards

USGS Publications Warehouse

Stephenson, W.J.; Williams, R.A.; Odum, J.K.; Worley, D.M.

2007-01-01

Introduction In support of earthquake hazards and ground motion studies by researchers at the Utah Geological Survey, University of Utah, Utah State University, Brigham Young University, and San Diego State University, the U.S. Geological Survey Geologic Hazards Team Intermountain West Project conducted three high-resolution seismic imaging investigations along the Wasatch Front between September 2003 and September 2005. These three investigations include: (1) a proof-of-concept P-wave minivib reflection imaging profile in south-central Salt Lake Valley, (2) a series of seven deep (as deep as 400 m) S-wave reflection/refraction soundings using an S-wave minivib in both Salt Lake and Utah Valleys, and (3) an S-wave (and P-wave) investigation to 30 m at four sites in Utah Valley and at two previously investigated S-wave (Vs) minivib sites. In addition, we present results from a previously unpublished downhole S-wave investigation conducted at four sites in Utah Valley. The locations for each of these investigations are shown in figure 1. Coordinates for the investigation sites are listed in Table 1. With the exception of the P-wave common mid-point (CMP) reflection profile, whose end points are listed, these coordinates are for the midpoint of each velocity sounding. Vs30 and Vs100, also shown in Table 1, are defined as the average shear-wave velocities to depths of 30 and 100 m, respectively, and details of their calculation can be found in Stephenson and others (2005). The information from these studies will be incorporated into components of the urban hazards maps along the Wasatch Front being developed by the U.S. Geological Survey, Utah Geological Survey, and numerous collaborating research institutions.

Water-resources activities in Utah by the U.S. Geological Survey, July 1, 1987 to September 30, 1988

USGS Publications Warehouse

Dragos, Stefanie L.; Gates, Joseph S.

1989-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from July 1, 1987, to September 30, 1988. The program in Utah during this period consisted of 29 projects; a discussion of each project is given in the main body of the report. Short descriptions are given at the end of the report for three projects proposed to be started on or after October 1, 1988. The following sections outline the basic mission and program of the Water Resources Division, the organizational structure of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from July 1987 to September 1988.

Water-resources activities in Utah by the U.S. Geological Survey: July 1, 1986, to June 30, 1987

USGS Publications Warehouse

Dragos, Stefanie L.

1988-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from July 1, 1986 to June 30, 1987. The program in Utah during this period consisted of 24 projects; a discussion of each project is given in the main body of the report. Short descriptions are given at the end of the report for six projects proposed to be started on or after July 1987. The following sections outline the basic mission and program of the Water Resources Division, the organizational structure of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from July 1986 to June 1987.

Water-resources activities in Utah by the U.S. Geological Survey, July 1, 1985, to June 30, 1986

USGS Publications Warehouse

Gates, Joseph S.; Dragos, Stefanie L.

1987-01-01

This report contains summaries of the progress of water-resources studies in Utah by the U.S. Geological Survey, Water Resources Division, Utah District, from July 1, 1985 to June 30, 1986. The program in Utah during this period consisted of 22 projects, and a discussion of each project is given in the main body of the report. Short descriptions are given at the end of the report for six proposed projects to be started on or after July 1986. The following sections outline the basic mission and program of the Water Resources Division, the organizational structure of the Utah District, the distribution of District funding in terms of source of funds and type of activity funded, and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from July 1985 to June 1986.

Hydrologic reconnaissance of the southern Great Salt Lake Desert and summary of the hydrology of west-central Utah

USGS Publications Warehouse

Gates, Joseph S.; Kruer, Stacie A.

1981-01-01

This report is the last of 19 hydrologic reconnaissances of the basins in western Utah. The purposes of this series of studies are (1) to analyze available hydrologic data and describe the hydrologic system, (2) to evaluate existing and potential water-resources development, and (3) to identify additional studies that might be needed. Part 1 of this report gives an estimate of recharge and discharge, an estimate of the potential for water-resources development, and a statement on the quality of water in the southern Great Salt Lake Desert part of west-central Utah. Part 2 deals with the same aspects of west-central Utah as a whole. Part 2 also summarizes the evidence of interbasin ground-water flow in west-central Utah and presents a theory for the origin of the water discharged from Fish Springs.

Water-resources activities of the U.S. Geological Survey in Utah, October 1, 1996, to September 30, 1997

USGS Publications Warehouse

Hardy, Ellen E.; Dragos, Stefanie L.

1998-01-01

This report contains summaries of the progress of water-resources activities of the U.S. Geological Survey (USGS), Water Resources Division, Utah District, from October 1, 1996, to September 30,1997. The waterresources program in Utah during this period consisted of 25 projects, and a discussion of each project is presented.The following sections outline the origin of the USGS, the mission of the Water Resources Division, the organizational structure of the Utah District, office addresses of the Utah District, the distribution of program funding as source of funds and type of activity funded in Federal Fiscal Year 1997 (FY97) (October 1,1996, to September 30, 1997), and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1996 to September 1997.

Water-resources activities of the U.S. Geological Survey in Utah, October 1, 1995, to September 30, 1996

USGS Publications Warehouse

Hardy, Ellen E.; Dragos, Stefanie L.

1997-01-01

This report contains summaries of the progress of water-resources activities of the U.S. Geological Survey (USGS), Water Resources Division, Utah District, from October 1, 1995, to September 30, 1996. The waterresources program in Utah during this period consisted of 22 projects; a discussion of each project is presented in the main body of this report.The following sections outline the origin of the USGS, the mission of the Water Resources Division, the organizational structure of the Utah District, office addresses of the Utah District, the distribution of program funding as source of funds and type of activity funded in Federal Fiscal Year 1996 (FY96) (October 1, 1995, to September 30, 1996), and the agencies with which the District cooperates. The last part of the introduction is a list of reports produced by the District from October 1995 to September 1996.

European Working Time Directive and the use of simulators and models in Irish orthopaedics.

PubMed

Egan, C; Elliott, R; Fleming, P

2012-03-01

To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

A Perspective on the Effect of the 80-Hour Work Week: Has It Changed the Graduating Orthopaedic Resident?

PubMed

Pellegrini, Vincent D

2017-06-01

Orthopaedic residency education has changed substantially in recent decades because of the imposition of the 80-hour work week, a decrease in quality and quantity of general surgical education, regulations mandating closer trainee supervision, and an expansion of orthopaedic subspecialty rotations. These factors pose a challenge in efforts to prepare competent, confident, cautious, caring, and communicative orthopaedic residents within the traditional 5-year program. Evidence suggests that contemporary graduates are more intelligent, better balanced in life and work, and more in touch with humanistic aspects of medicine than were earlier graduates. Yet insufficient competence and confidence in surgical skills after residency and a lack of "ownership" of patient care have become an increasing concern of educators and trainees. The concept of 10,000 hours of deliberate practice to achieve mastery of a technical skill applies to orthopaedic residency education. A different approach to graduate medical education must address the critical minimum training time required to achieve the necessary skills to support independent medical and surgical practice.

II Italian intersociety consensus statement on antithrombotic prophylaxis in orthopaedics and traumatology: arthroscopy, traumatology, leg immobilization, minor orthopaedic procedures and spine surgery.

PubMed

Randelli, F; Romanini, E; Biggi, F; Danelli, G; Della Rocca, G; Laurora, N R; Imberti, D; Palareti, G; Prisco, D

2013-03-01

Pharmacological prophylaxis for preventing venous thromboembolism (VTE) is a worldwide established procedure in hip and knee replacement surgery, as well as in the treatment of femoral neck fractures, but few data exist in other fields of orthopaedics and traumatology. Thus, no guidelines or recommendations are available in the literature except for a limited number of weak statements about knee arthroscopy and lower limb fractures. In any case, none of them are a multidisciplinary effort as the one here presented. The Italian Society for Studies on Haemostasis and Thrombosis (SISET), the Italian Society of Orthopaedics and Traumatology (SIOT), the Association of Orthopaedic Traumatology of Italian Hospitals (OTODI), together with the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) and the Italian Society of General Medicine (SIMG) have set down easy and quick suggestions for VTE prophylaxis in a number of surgical conditions for which only scarce evidence is available. This inter-society consensus statement aims at simplifying the approach to VTE prophylaxis in the single patient with the goal to improve its clinical application.

Regenerative Medicine Will Make Orthopaedic Implants Obsolete In Our Time Orthopaedic Research Society First Annual Meeting Debate, San Diego, March 21st , 2017.

PubMed

Johnstone, Brian; Jacobs, Joshua J; Sandell, Linda J; Wilkinson, J Mark

2018-05-10

The mission of the Orthopaedic Research Society is to promote and advance musculoskeletal research worldwide. With this in mind, the Annual Meeting Program Committee sought to establish a debate as a key component of the meeting. Our purpose was to provoke discussion on topics that are core to our mission and to engage all constituencies within the society by examining questions of broad relevance. To this end, the topic "Regenerative medicine will make orthopaedic implants obsolete in our time" was selected as the title of the inaugural debate. The arguments for and against the motion are presented in this perspectives article. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

OASYS: a computerized auditing system for orthopaedic surgery.

PubMed

Stoodley, M A; Sikorski, J M

1991-11-01

Medical auditing based on individual diagnoses or specific therapies is well established. Auditing of all medical activity has an expanding role in quality assurance and research. In an attempt to overcome the limitations of existing auditing systems, a fundamentally different, flexible, high quality and easily accessible orthopaedic auditing system has been developed. This records a description of each component of patients' orthopaedic diagnoses, records treatment and complications, produces discharge letters and surgical log books and allows flexible and comprehensive audits. It has been in use in an orthopaedic service since January 1990 and has been successful in identifying problems and monitoring the effectiveness of changes. It is anticipated that the system will become more widely used and provide the basis for a 'user group' which will share the accumulated data and further development costs.

Cold-fusion television show angers APS

NASA Astrophysics Data System (ADS)

Cartwright, Jon

2009-06-01

Cold fusion has been controversial since its inception on 23 March 1989, when chemists Martin Fleischmann and Stanley Pons at the University of Utah in the US announced that they had achieved a sustained nuclear-fusion reaction at room temperature. Two decades on, a US television documentary about the field has stirred up fresh debate after it linked the American Physical Society (APS) to an evaluation of some cold-fusion results by Robert Duncan, a physicist and vice chancellor of the University of Missouri.

78 FR 885 - Approval and Promulgation of Air Quality Implementation Plans; Utah; Determination of Clean Data...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-07

... finalizing a determination that the Ogden City nonattainment area in Utah is currently attaining the 24-hour... monitoring data for the years 2009 through 2011. The State of Utah submitted a letter dated March 30, 2000... attaining the 24-hour PM 10 NAAQS based on certified and quality-assured data from the most recent three...

Utah's 1988-93 Vocational-Technical Education Master Plan: A Powerful Resource for Human and Economic Development.

ERIC Educational Resources Information Center

Utah State Board of Higher Education, Salt Lake City.

For Utah residents to remain in the forefront or even stay competitive economically, the state's work force must acquire the knowledge and skills that match or exceed those of their most technically advanced competitors. A powerful engine for economic growth is a high-quality system of vocational-technical education. The majority of Utah public…

The Utah Educational Technology Initiative Year Two Evaluation: Program Implementation, Computer Acquisition and Placement, and Computer Use.

ERIC Educational Resources Information Center

Mergendoller, John R.; And Others

This evaluation report describes program implementation, computer acquisition and placement, and computer use during the second year (1991-92) of the Utah Educational Technology Initiative (ETI). In addition, it discusses the various ways computers are used in Utah schools and reports the opinions and experiences of ETI coordinators in the 12…

Perceived Factors Influencing Post-Secondary Enrollment and Economic Stability of Single and Married Mothers in Utah

ERIC Educational Resources Information Center

Campos-Rosenthal, Angelina M.

2009-01-01

This research explored the perceived factors that influenced the decisions of single and married mothers to enroll or not enroll in post-secondary education. The study then investigated the relationship between educational level and income for single mothers in Utah. From a survey of 1197 Utah mothers, this study concluded that mothers enroll in…

Educational Issues in Utah: Governance, Legislation, Technology, and Finance. 1994-95 Conditions of Education in Utah Yearbook.

ERIC Educational Resources Information Center

Galvin, Patrick F., Ed.; Johnson, Bob L., Jr., Ed.

This document is the third edition of "Conditions of Education in Utah," covering the 1994-95 academic year. The first three chapters analyze issues relative to distance education and the Internet. Chapters 1 and 2 examine the pros and cons of distance education, and chapter 3 describes the construction, maintenance, and staffing costs…

The Economic Impact of Ten Cultural Institutions on the Economy of the Salt Lake SMSA.

ERIC Educational Resources Information Center

Cwi, David

The impact of 10 cultural institutions on the Salt Lake City economy was determined by measuring their 1978 direct and indirect financial effects. The institutions are Ballet West, Pioneer Memorial Theatre, Repertory Dance Theatre, Salt Lake City Art Center, Theatre 138, Tiffany's Attic, Utah Museum of Fine Arts, Utah Symphony, Utah Opera Company,…

Measures of Child Well-Being in Utah, 2003: Counting on a Better Future for Utah's Kids.

ERIC Educational Resources Information Center

Haven, Terry, Ed.

This Kids Count report examines statewide trends in the well-being of Utah's children. The statistical portrait is based on 28 indicators of children's well-being in five areas: (1) child health (prenatal care, low birth-weight births, infant mortality, child injury deaths, injury-related hospital discharges, child abuse, childhood immunizations,…

Practical Law in Utah, Second Edition. Utah Supplement to Street Law.

ERIC Educational Resources Information Center

Astin, Katherine, Ed.; And Others

This guide on law education is designed for high school students. Objectives are to give a fundamental understanding of Utah law in those areas that may be encountered personally, show how laws are made, and explain what to do if you become involved with the law. This volume is arranged in seven chapters. Topics include: (1) an introduction to…

The Relevance of Campus Outdoor Recreation Programs to Higher Education: A University of Utah Example

ERIC Educational Resources Information Center

Dustin, Daniel; Furman, Nate; Bricker, Nate; Cederquist, John; Schumann, Scott

2017-01-01

This paper illustrates the relevance of campus recreation to higher education through a University of Utah case study. Offering Utah's Experiential Learning and Outdoor Recreation Education (U-EXPLORE) program as our exemplar, we advance four lines of thought. First, we establish the relationship between an active body and an active mind. Second,…

Utah's Post-Secondary Participation and Completion Patterns. Issue Brief, No. 2017-2

ERIC Educational Resources Information Center

Ma, David; Hartley, Julie

2017-01-01

In 2016, the Utah State Board of Regents adopted a 10-year strategic plan, including two specific goals related to students' participation in and completion of higher education: first, that 75% of Utah's 12th graders would enroll in post-secondary education within five years of high school graduation by the year 2025; and, second, that degree…

Measures of Child Well-Being in Utah, 2001. A Pledge to Our Children. Utah KIDS COUNT.

ERIC Educational Resources Information Center

Haven, Terry, Ed.

This KIDS COUNT report details statewide trends in the well-being of Utah's children. The statistical portrait is based on 26 indicators of children's well-being: (1) prenatal care; (2) low birth weight infants; (3) infant mortality; (4) child injury deaths; (5) unintentional injuries; (6) untreated tooth decay; (7) immunization rates; (8) suicide…

HigherEdUtah2020. 2014 Report

ERIC Educational Resources Information Center

Utah System of Higher Education, 2014

2014-01-01

Utah has set the goal of having 66% of its 25-35 age population with a post-secondary degree or certificate by 2020. To achieve this goal, Utah must increase the number of degrees and certificates awarded annually, to a level 25% above the 2010-11 base year level. This requires a continuing focused effort in creating a highly-educated workforce. A…

Annual Estimated Minimum School Program of Utah School Districts, 1984-85.

ERIC Educational Resources Information Center

Utah State Office of Education, Salt Lake City. School Finance and Business Section.

This bulletin presents both the statistical and financial data of the Estimated Annual State-Supported Minimum School Program for the 40 school districts of the State of Utah for the 1984-85 school year. It is published for the benefit of those interested in research into the minimum school programs of the various Utah school districts. A brief…

Occurrence and density of breeding passerine birds in shrubland habitats in Utah

Treesearch

Jimmie R. Parrish; Dan A. Roberts; Frank P. Howe

2005-01-01

The Utah Avian Conservation Strategy (Parrish et al. 2002) published by the Utah Partners in Flight (UPIF) Program ranked a total of 24 habitat types and 231 bird species with respect to their need for conservation action. The 24 habitat categories were grouped within five major categories, Riparian, Shrublands, Grassland, Forest, and a collection of additional...

Measures of Child Well-Being in Utah, 2002: Counting the Kids Who Count on Us. Utah KIDS COUNT.

ERIC Educational Resources Information Center

Haven, Terry, Ed.

This Kids Count report details statewide trends in the well-being of Utah's children. The statistical portrait is based on 29 indicators of children's well-being in five areas: (1) child health and safety (prenatal care, low birthweight, infant mortality, child injury deaths, injury-related hospital discharges, child abuse, childhood…

Measures of Child Well-Being in Utah, 1997. State and County Profiles of Child Well-Being.

ERIC Educational Resources Information Center

Haven, Terry, Ed.

This Utah Kids Count report examines statewide trends in the well-being of Utah's children. The statistical portrait is based on five general areas of children's well-being: (1) demographics; (2) health; (3) education; (4) safety; and (5) economic security. Key indicators in these five areas include the following: (1) population; (2) poverty; (3)…

Reengineering the Community College: Data Support for a Two Tier Institution. AIR 1994 Annual Forum Paper.

ERIC Educational Resources Information Center

Hill, Nancy Smith; And Others

This paper discusses the role that the Office of Institutional Research and Strategic Planning played in providing data support, planning, and cohesiveness as Utah Valley Community College worked to become Utah Valley State College. The two tier model adopted at Utah Valley State College aspires to describe a cost-effective four-year college with…

Utah braces for the future

USGS Publications Warehouse

Machette, Michael N.; Brown, William M.

1995-01-01

Almost 75 percent of Utah's population lives near the Wasatch Fault. Earth scientists have shown that this fault has repeatedly experienced strong earthquakes of magnitude 7 or larger and will continue to do so in the future. Efforts to increase public awareness of earthquake hazards in Utah have resulted in residents and community leaders taking actions that will save lives and reduce damage in future earthquakes.

Aviation Turbine Fuels from Tar Sands Bitumen and Heavy Oils. Part 1. Process Analysis.

DTIC Science & Technology

1984-09-01

Uinta Basin .......................too.... 11 b . Asphalt Ridge ........................ 13 c.* Tar Sand Triangle ..... to .. .. . .. .. . 15 e...Estimated ............**..* 7 3 CHARACTERISTICS OF UTAH’S MAJOR TAR SANDS ....... 12 4 UINTA BASIN DEPOSITS ................... *........ 13 *.5 UINTA ...7 UINTA BASIN , UTAH PROPERTIES -SUNNYSIDE ........ 20 8 UINTA BASIN , UTAH PROPERTIES -P. R. SPRINGS . 22 r9 ESTIMATED CALIFORNIA TAR SAND DISTRIBUTION

75 FR 19999 - Notice of Proposed Class II Reinstatement of Oil and Gas Lease, Utah, UTU-79113

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... Proposed Class II Reinstatement of Oil and Gas Lease, Utah, UTU-79113 AGENCY: Bureau of Land Management, Interior. ACTION: Notice of Proposed Reinstatement of Oil and Gas Lease. SUMMARY: In accordance with Title... reinstatement of oil and gas lease UTU-79113, for lands in Carbon County, Utah. The petition was accompanied by...

77 FR 26575 - Notice of the Establishment of the Ten Mile (Utah) Known Potash Leasing Area (KPLA)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-04

... the oil and gas leasing stipulations contained in the 2008 Moab Resource Management Plan (Moab RMP...] Notice of the Establishment of the Ten Mile (Utah) Known Potash Leasing Area (KPLA) AGENCY: Bureau of... sent to the State Director (UT-923), Bureau of Land Management, Utah State Office, 440 West 200 South...

Application of Advanced Sensor Technology to DoD Soil Vapor Intrusion Problems

DTIC Science & Technology

2012-10-01

19 Figure 10. Photographs of: a) Layton , Utah, ASU SERDP project study house and b) basement...relative to sub-slab; line). ..................... 24 Figure 18. Spatial distributions of TCE in Layton , Utah, house without VI and emplaced indoor...technical advice and use of ASU’s Strategic Environmental Research and Development Program (SERDP) VI study house in Layton , Utah, is very

Educational Reform in Utah: The Years of Promise. 1993-94. Conditions of Education in Utah.

ERIC Educational Resources Information Center

Galvin, Patrick F., Ed.; Sperry, David J., Ed.

This volume, which describes the status of public education in Utah for the year 1993-94, focuses on the issue of educational reform. Following the introduction and overview, chapter 1 reviews reform legislation and implementation efforts during the last decade. It describes the context for reform in political, demographic, and economic terms.…

25. Photocopied from Photo 1103, Olmstead Folder #2, Engineering Department, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

25. Photocopied from Photo 1103, Olmstead Folder #2, Engineering Department, Utah Power & Light Co., Salt Lake City, Utah. GENERAL VIEW OF SITE, c.1920? (PHOTO SHOWS DENVER & RIO GRANDE WESTERN RR BRIDGE, MOVED TO SITE IN 1919.) - Telluride Power Company, Olmsted Hydroelectric Plant, mouth of Provo River Canyon West of U.S. Route 189, Orem, Utah County, UT

Hydrologic reconnaissance of Curlew Valley, Utah and Idaho

USGS Publications Warehouse

Bolke, E.L.; Price, Don

1969-01-01

This report is the fifth in a series of reports prepared by the U. S. Geological Survey in cooperation with the Utah Department of Natural Resources, Division of Water Rights, that describe the water resources of selected basins in western Utah. Previously published reports in this series are listed on page 35 and the areas covered by them are shown in figure 1. The purpose of this report is to present available hydrologic data on the Utah part of Curlew Valley, to provide an evaluation of the potential water-resource development of the valley, and to identify needed studies that would help provide an understanding of the valley's water supply.

Map showing principal drainage basins, principal runoff-producing areas, and selected stream flow data in the Kaiparowits coal-basin area, Utah

USGS Publications Warehouse

Price, Don

1978-01-01

This is one of a series of maps that describe the geology and related natural resources in the Kaiparowits coal-basin area. Streamflow records used to compile this map and the accompanying table were collected by the U.S. Geological Survey in cooperation with the Utah State Engineer and the Utah Department of Transportation. The principal runoff-producing areas were delineated from a work map (scale 1:250,000) compiled to estimate water yields in Utah (Bagley and others, 1964). Information about Lake Powell was furnished by the U.S. Bureau of Reclamation.

Draft Environmental Impact Statement. MX Deployment Area Selection and Land Withdrawal/Acquisition DEIS. Volume IV. Part II. Environmental Consequences to the Study Regions and Operating Base Vicinities.

DTIC Science & Technology

1980-12-01

desert tortoise distribution at Coyote Spring OB and vicinity. 4-179 4.3.1.9-3 Utah Prairie Dog distribution and Proposed Action conceptual project...layout. 4-185 4.3.1.9-4 Distribution of Utah prairie dog in the vicinity of the Milford OB. 4-187 4.3.1.9-5 Distribution of Utah prairie dog in the...Coyote Spring. 4-180 4.3.1.9-2 Potential impact to the Utah prairie dog around operating bases (OBs) for the Proposed Action and Alternatives 1-8. 4-188

New geothermal database for Utah

USGS Publications Warehouse

Blackett, Robert E.; ,

1993-01-01

The Utah Geological Survey complied a preliminary database consisting of over 800 records on thermal wells and springs in Utah with temperatures of 20??C or greater. Each record consists of 35 fields, including location of the well or spring, temperature, depth, flow-rate, and chemical analyses of water samples. Developed for applications on personal computers, the database will be useful for geochemical, statistical, and other geothermal related studies. A preliminary map of thermal wells and springs in Utah, which accompanies the database, could eventually incorporate heat-flow information, bottom-hole temperatures from oil and gas wells, traces of Quaternary faults, and locations of young volcanic centers.

EPA Enviropod. A summary of the use of the Enviropod under a Memorandum of Understanding among EPA Region 8, the State of Utah, and the University of Utah Research Institute

NASA Technical Reports Server (NTRS)

Ridd, M. K.

1984-01-01

Twenty-three missions were flown using the EPA's panoramic camera to obtain color and color infrared photographs of landslide and flood damage in Utah. From the state's point of view, there were many successes. The biggest single obstacle to smooth and continued performance was unavailable aircraft. The Memorandum of Understanding between the State of Utah, the Environmental Protection Agency, and the Center for Remote Sensing and Cartography is included along with forms for planning enviropod missions, for requesting flights, and for obtaining feedback from participating agencies.

Quality of surface water in the Sevier Lake basin, Utah

USGS Publications Warehouse

Hahl, D.C.; Cabell, R.E.

1965-01-01

Few data are available on the quality of surface waters in the Sevier Lake basin. Because of the need for information not only on the chemical-quality but also on the other water-quality characteristics of the basin, the U.S. Geological Survey, as part of its cooperative program with the Utah State Engineer, evaluated the available data in 1963. Based on this evaluation, a reconnaissance was designed to obtain some of the needed water-quality information. To extend the applicability of the basic information, the Utah State Engineer, the Utah State Department of Health, the Water Commissioner for the Sevier River, and the Soil Conservation Service and Forest Service of the U.S. Department of Agriculture assisted in the planning and in the selection of sampling sites.This report presents the results of the data-collection phase of the reconnaissance. A companion interpretive report will be prepared later. The data were collected primarily by the U.S. Geological Survey as part of its cooperative programs with the State Engineer of Utah and the Utah Geological and Mineralogical Survey. The work was under the supervision of R. H. Langford, district chemist of the Quality of Water Branch, Water Resources Division, U.S. Geological Survey.

Flood on the Virgin River, January 1989, in Utah, Arizona, and Nevada

USGS Publications Warehouse

Carlson, D.D.; Meyer, D.F.

1995-01-01

The impoundment of water in Quail Creek Reservoir in Utah began in April 1985. The drainage area for the reservoir is 78.4 square miles, including Quail Creek and Leeds Creek watersheds. Water also is diverted from the Virgin River above Hurricane, Utah, to supplement the filing of the reservoir. A dike, which is one of the structures impounding water in Quail Creek Reservoir, failed on January 1, 1989. This failure resulted in the release of about 25,000 acre-feet of water into the Virgin River near Hurricane, Utah. Flooding occurred along the Virgin River flood plain in Utah, Arizona, and Nevada. The previous maximum discharge of record was exceeded at three U.S. Geological Survey streamflow-gaging stations, and the flood discharges exceeded the theoretical 100-year flood discharges. Peak discharge estimates ranged from 60,000 to 66,000 cubic feet per second at the three streamflow-gaging stations. Damage to roads, bridges, agricultural land, livestock, irrigation structures, businesses, and residences totaled more than $12 million. The greatest damage was to agricultural and public-works facilities. Washington County, which is in southwestern Utah, was declared a disaster area by President George Bush.

Mental imagery and learning: a qualitative study in orthopaedic trauma surgery.

PubMed

Ibrahim, Edward F; Richardson, Martin D; Nestel, Debra

2015-09-01

Good preparation for surgical procedures has been linked to better performance and enhanced learning in the operating theatre. Mental imagery is increasingly used to enhance performance in competitive sport and there has been recent interest in applying this in surgery. This study aims to identify the mental imagery components of preoperative preparation in orthopaedic trauma surgery and to locate these practices in existing socio-material theory in order to produce a model useful for surgical skills training. Semi-structured interviews were conducted with nine orthopaedic surgeons. Participants were identified by personal recommendation as regularly performing complex trauma operations to a high standard, and by affiliation to an international instruction course in trauma surgery. Interviews were audio-recorded and transcripts were independently analysed using thematic analysis. Analysis revealed that surgeons interact intensively with multiple colleagues and materials during their preparatory activities. Such interactions stimulate mental imagery in order to build strategy and rehearse procedures, which, in turn, stimulate preparatory interactions. Participants identified the discussion of a preoperative 'plan' as a key engagement tool for training junior surgeons and as a form of currency by which a trainee may increase his or her participation in a procedure. Preoperative preparation can be thought of as a socio-material ontology requiring a surgeon to negotiate imaginal, verbal and physical interactions with people, materials and his or her own mental imagery. Actor-network theory is useful for making sense of these interactions and for allowing surgeons to interrogate their own preparative processes. We recommend supervisors to use a form of preoperative plan as a teaching tool and to encourage trainees to develop their own preparatory skills. The ability of a trainee to demonstrate sound preparation is an indicator of readiness to perform a procedure. © 2015 John Wiley & Sons Ltd.

Effect of in-hospital comprehensive geriatric assessment (CGA) in older people with hip fracture. The protocol of the Trondheim Hip Fracture Trial

PubMed Central

2011-01-01

Background Hip fractures in older people are associated with high morbidity, mortality, disability and reduction in quality of life. Traditionally people with hip fracture are cared for in orthopaedic departments without additional geriatric assessment. However, studies of postoperative rehabilitation indicate improved efficiency of multidisciplinary geriatric rehabilitation as compared to traditional care. This randomized controlled trial (RCT) aims to investigate whether an additional comprehensive geriatric assessment of hip fracture patients in a special orthogeriatric unit during the acute in-hospital phase may improve outcomes as compared to treatment as usual in an orthopaedic unit. Methods/design The intervention of interest, a comprehensive geriatric assessment is compared with traditional care in an orthopaedic ward. The study includes 401 home-dwelling older persons >70 years of age, previously able to walk 10 meters and now treated for hip fracture at St. Olav Hospital, Trondheim, Norway. The participants are enrolled and randomised during the stay in the Emergency Department. Primary outcome measure is mobility measured by the Short Physical Performance Battery (SPPB) at 4 months after surgery. Secondary outcomes measured at 1, 4 and 12 months postoperatively are place of residence, activities of daily living, balance and gait, falls and fear of falling, quality of life and depressive symptoms, as well as use of health care resources and survival. Discussion We believe that the design of the study, the randomisation procedure and outcome measurements will be of sufficient strength and quality to evaluate the impact of comprehensive geriatric assessment on mobility and other relevant outcomes in hip fracture patients. Trials registration ClinicalTrials.gov, NCT00667914 PMID:21510886

Heterogeneity in health status and the influence of patient characteristics across patients seeking musculoskeletal orthopaedic care - a cross-sectional study.

PubMed

Perruccio, Anthony V; Gandhi, Rajiv; Rampersaud, Y Raja

2013-03-07

Health status is an important predictor of patient outcomes. Consequently, identifying patient predictors of health status is essential. In musculoskeletal orthopaedic care, the majority of work examining the association between patient characteristics and health status has been undertaken among hip/knee cohorts. We investigate these associations comparing findings across four musculoskeletal cohorts (hip/knee; foot/ankle; neck/back; elbow/shoulder). Patients seeking elective musculoskeletal orthopaedic care were recruited prior to consultation. Questionnaires captured health domain status (bodily pain, physical functioning, and mental and general health) and covariates: demographics; socioeconomic characteristics; and comorbidity. Scores were compared across cohorts. Two path regression analyses were undertaken. First, domain scores were simultaneously examined as dependent variables in the overall sample. Subsequently, the model was assessed stratified by cohort. 1,948 patients: 454 neck/back, 767 hip/knee, 378 shoulder/elbow, 349 foot/ankle. From stratified analyses, significant variability in covariate effects was observed. Worse bodily pain scores were associated with increasing age and female sex among hip/knee, low income among foot/ankle, and overweight/obese for foot/ankle and hip/knee. Worse mental health scores were associated with low income across cohorts except elbow/shoulder, low education within neck/back, and compared to Whites, Blacks had significantly worse scores among foot/ankle, better scores among hip/knee. Worse general health scores were observed for Asians among hip/knee, Blacks among foot/ankle, and South-Asians among elbow/shoulder and neck/back. The substantial heterogeneity across musculoskeletal cohorts suggests that patient- and cohort-specific approaches to patient counsel and care may be more effective for achieving optimal health and outcomes.

Foot pain

MedlinePlus

... Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 117. Kadakia AR. Heel pain ... Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 119. Molloy A, Selvan D. ...