Strategies for Enhancing Racially Diverse Student Satisfaction in Graduate-Level Occupational Therapy Programs

A survey investigated satisfaction levels of racially diverse, graduate-level OT students at NSU and strategies for enhancing student satisfaction to ultimately meet the OT profession’s diversity goals. Overall, racially diverse students were satisfied with their OT program experience and identified diverse faculty and scholarship opportunities as desired resources needed for continuation in OT programs

A Prospective Randomized Comparison of Patient Specific Instruments with Standard TKA Instrumentation

Introduction: Patient specific instruments (PSI), an alternative to standard total knee arthroplasty (TKA) technology, have shown mixed results regarding effectiveness in previous studies. This study evaluated the accuracy of the predicted PSI plan, compared incremental cost savings with PSI, and compared outcomes of PSI and standard TKA patients. Patients and Methods: This randomized, prospective feasibility study included 19 primary TKA patients receiving a cruciate-retaining cemented prosthesis from a single surgeon (DCA). 9 patients randomized to PSI received a pre-operative knee MRI for PSI fabrication using proprietary software.10 standard TKAs were completed. Operative data collected included operating times, implant details, femoral (medial/lateral distal and posterior) and tibial (medial/lateral) resections, and instrument trays used. Hospitalization data collected included length of stay, blood loss, drain output, and transfusions. SF-36 and WOMAC scores, routine radiographic analysis, and femoral-tibial angles were collected pre- and post-operatively. Costs of operating room use and anesthesia, implants, and hospitalization were collected. Statistical analyses included t-tests and chi-square tests. Results: All implant sizes matched surgical team adjusted PSI software plans. Flexion gap resection (posterior medial/lateral femur) was extremely accurate (averagemm). Sagittal plane tibial component posterior slope was larger in PSI TKA (mean 7.3 degrees) than standard instrumentation (mean 4.2 degrees) (p0.05). There were no differences in operating room times or hospitalization data, and there were no significant differences in functional outcomes between the two groups (p\u3e0.05). PSI patients used 4 fewer instrument trays per case (p\u3c0.0001). Conclusion: PSI TKA demonstrated outstanding accuracy in bone resection when compared with the pre-operative plan, and resulted in appropriate limb and component alignment with primary TKA. The number of instrument trays used in PSI TKA was significantly less than standard TKA, which led to less cost for instrument sterilization and assembly

Healthy Kids & Families: Overcoming Social, Environmental and Family Barriers to Childhood Obesity

Healthy Kids & Families, the applied research project of the UMass Worcester Prevention Research Center, is testing the impact of a community health worker (CHW)-delivered intervention aimed at helping families overcome barriers to childhood obesity prevention. The intervention addresses social, environmental, and family issues that may pose as barriers to healthy choices. The intervention is compared to a comparison condition consisting of a CHW-delivered intervention aimed at helping families improve positive parenting skills. The intervention and comparison condition are identical in format, Both use multiple delivery modalities to maintain novelty and prevent attrition/burden. These include home visits, telephone contacts, print (literacy sensitive newsletters), social media (Facebook), and community events. Parents and children will complete scheduled assessments at baseline, 6-, 12-, 18- and 24-month follow-up. Study participants are 240 parent-child dyads recruited from nine elementary schools. Inclusion criteria include: adult and their K-6th grade children attending a participating school, have access to a telephone, speak English or Spanish, and plan to live in the neighborhood for at least two years. Exclusion criteria include medical condition or advice from a doctor that precludes the child from walking or eating fruits and vegetables. Healthy Kids & Families is being implemented in racial/ethnically diverse underserved communities in Worcester, Massachusetts. Funded by the US Centers for Disease Control and Prevention, it involves a partnership between UMass Worcester Prevention Research Center of UMass Medical School, the Worcester Public Schools, and Oak Hill Community Development Corporation

Radiostereometric Analysis of Tantalum vs. Titanium Acetabular Shells in Young THR Patients

Introduction: In the active total hip replacement (THR) population, maintaining acetabular component stability and limiting polyethylene wear are crucial components to preventing premature implant failure. Titanium with Co/Cr/Mo fiber metal coating is among the most common materials used in cementless THR. Trabecular metal, composed of porous tantalum, has a metallic strut design resembling trabecular bone, designed to improve tissue infiltration and limit migration. This study assesses the stability and clinical outcomes of tantalum versus titanium acetabular shells using radiostereometric analysis (RSA) technology. Methods: In this IRB approved, prospective, randomized, blinded study, 46 patients received a primary THR by a single surgeon (DCA). Each patient was randomized to receive a titanium (23) (Trilogy, Zimmer) or tantalum (23) (Modular tantalum shell, Zimmer) uncemented hemispheric cup and either a highly-crosslinked or conventional polyethylene liner. Tantalum RSA markers were implanted around the liner periphery, femur, and periacetabular bone in each patient. RSA examinations, Harris Hip, UCLA, WOMAC, SF-36 scores were obtained at 10 days, 6 months, and annually with the furthest patients evaluated through 5 years. Results: Median translation was greater at all time points for the tantalum mesh cups except for the 3-year follow-up, however due to large standard errors, there was no significant difference between the two designs (p\u3e0.05). These large standard errors were predominantly caused by two outliers, neither of which had clinical evidence of loosening at 5 years follow-up. Mean UCLA, WOMAC, Harris Hip, and SF-36 PCS and MCS scores improved similarly in both groups. Conclusions: In this young THR population, both titanium and tantalum acetabular shells demonstrated excellent stability at five years follow up. Tantalum shells demonstrated slightly greater micromotion, but there was no statistically significant difference in shell migration. Outstanding clinical outcomes with statistically significant improvements in function and pain relief were observed in both groups

Radiostereometric Analysis of Femoral Head Penetration in Cross-Linked Polyethylene in THR Patients

Background: In the young total hip replacement (THR) population limiting polyethylene liner wear is crucial to preventing premature implant failure. Highly cross-linked ultra-high molecular weight polyethylene (HXLPE) liners were designed to improve wear resistance of polyethylene liners. Radiostereometric analysis (RSA) provides highly precise measurements of liner wear. This study utilized RSA to characterize wear of conventional versus HXLPE liners up to five years following THR. Methods: This IRB-approved, prospective, randomized, blinded study, involved 46 patients with a mean age of 58 and BMI of 30. Each patient was double randomized to receive a conventional or HXLPE liner with an uncemented titanium mesh or tantalum trabecular metal cup. Both liners were prepared from compression-molded GUR 1050 resin without calcium stearate, while HXLPE liners undergo further e-beam irradiation and annealing. At the time of surgery, 1mm tantalum RSA markers were implanted around the liner periphery, femur and periacetabular bone. RSA examinations, Harris Hip, UCLA, WOMAC, SF-36 scores were obtained pre-operatively, post-operatively, at six weeks, six months and annually through five years. Results: All patients had statistically significant improvement in Harris Hip, WOMAC and SF-36 PCS scores following THR with no difference between cohorts. On RSA examination, of titanium shells, HXLPE liners revealed significantly lower femoral head penetration at each follow up except six weeks and six months (p Conclusion: In this young THR population RSA shows significantly less femoral head penetration in the HXLPE liners compared to conventional liners. Novel RSA techniques have been developed to determine polyethylene wear in patients