853 research outputs found
The New Agent: A Qualitative Study to Strategically Adapt New Agent Professional Development
The qualitative study reported here assessed the needs of agents related to new agent professional development to improve the current model. Agents who participated in new agent professional development within the last 5 years were selected to participate in focus groups to determine concerns and continued needs. Agents enjoyed networking and struggled with the time away from their home counties. Recommendations for improvement include integrating the idea of pre-entry competencies, developing online new agent professional development sessions, introducing new agents to existing communities of practice, developing new communities of practice, and developing more resources for new agents
A Home Device for Vestibular Stimulation
The goal of this project, which was presented to the team by Kevin Maher (President of Advanced Therapeutic devices), was to develop a product prototype for safe, vestibular stimulation for children with developmental disabilities. Vestibular stimulation is a form of therapy that increases muscle coordination. It works by stimulating the canals and sacs within the inner ear that detect accelerations. The project targeted children from ages two to seven years old, under 48 inches tall, and less than 100 lbs. The production device also sought to differ from stimulation devices found in hospitals in a few respects: it would cost under 1700 and no more than 500 lb. The design met all of the requirements and had adequate safety for any child’s needs, but the team thought the design needed significant changes before it became a final product
Independent predictors of failure up to 7.5 years after 35 386 single-brand cementless total hip replacements: a retrospective cohort study using National Joint Registry data
The popularity of cementless total hip replacement (THR) has surpassed cemented THR in England and Wales. This retrospective cohort study records survival time to revision following primary cementless THR with the most common combination (accounting for almost a third of all cementless THRs), and explores risk factors independently associated with failure, using data from the National Joint Registry for England and Wales. Patients with osteoarthritis who had a DePuy Corail/Pinnacle THR implanted between the establishment of the registry in 2003 and 31 December 2010 were included within analyses. There were 35 386 procedures. Cox proportional hazard models were used to analyse the extent to which the risk of revision was related to patient, surgeon and implant covariates. The overall rate of revision at five years was 2.4% (99% confidence interval 2.02 to 2.79). In the final adjusted model, we found that the risk of revision was significantly higher in patients receiving metal-on-metal (MoM: hazard ratio (HR) 1.93, p < 0.001) and ceramic-on-ceramic bearings (CoC: HR 1.55, p = 0.003) compared with the best performing bearing (metal-on-polyethylene). The risk of revision was also greater for smaller femoral stems (sizes 8 to 10: HR 1.82, p < 0.001) compared with mid-range sizes. In a secondary analysis of only patients where body mass index (BMI) data were available (n = 17 166), BMI ≥ 30 kg/m2 significantly increased the risk of revision (HR 1.55, p = 0.002). The influence of the bearing on the risk of revision remained significant (MoM: HR 2.19, p < 0.001; CoC: HR 2.09, p = 0.001). The risk of revision was independent of age, gender, head size and offset, shell, liner and stem type, and surgeon characteristics. We found significant differences in failure between bearing surfaces and femoral stem size after adjustment for a range of covariates in a large cohort of single-brand cementless THRs. In this study of procedures performed since 2003, hard bearings had significantly higher rates of revision, but we found no evidence that head size had an effect. Patient characteristics, such as BMI and American Society of Anesthesiologists grade, also influence the survival of cementless components
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