Advisory councils are community-specific and are major components of agricultural education programs. This descriptive study was conducted to further strengthen what is known about advisory councils and provide a basis for continued improvement in local programs. The specific purpose of the research study was to describe how Idaho agricultural education teachers perceived and used agricultural education advisory councils. Findings included that 90% (n=85) of Idaho agricultural education programs currently had an advisory council. Overall, respondents had positive perceptions of advisory councils, but felt that the opportunity exists for the advisory council to have more influence on the program. The notion that the agriculture teacher is the leader of the program's advisory council was also expressed. Future research is recommended to investigate the barriers to increasing the advisory council's influence and ways to enhance the role of the advisory council in the program. In addition, professional development programs that share best practices on advisory councils should be developed to assist teachers in increasing the effectiveness of their local program advisory councils.
Inserting the femoral intramedullary alignment rod during total knee arthroplasty (TKA) can generate high intramedullary pressure, which increases the risk of intraoperative complications caused by fat embolism. Despite modifications to the surgical procedure, the best method to prevent this increase in pressure remains unknown. The reamer/irrigator/aspirator is a surgical instrument designed for use during femoral canal entry to increase the canal size and remove intramedullary fat and may prevent this pressure increase. We posed two hypotheses: (1) using the reamer/ irrigator/aspirator system will result in lower maximum femoral intramedullary pressure than using only conventional instrumentation during the initial steps of a TKA; and (2) using the reamer/irrigator/aspirator system in the initial steps of TKA will result in a mean maximum intramedullary pressure less than 200 mm Hg. We simulated a TKA on 14 cadaveric femurs to compare the femoral intramedullary pressure using both methods. Considerable decreases in femoral intramedullary pressure of 86% proximally and 87% distally were obtained by using the reamer/irrigator/aspirator system. The mean maximum pressure using the reamer/irrigator/aspirator system was less than 200 mm Hg. Additional clinical studies are needed to confirm any reduction in complications using the reamer/irrigator/aspirator system.
Objectives Older adults with falls are at high risk for returning to the Emergency Department (ED) after their initial visit for a fall. We investigated whether fall-related injuries affected ED recidivism. Design, Setting, Participants, Measurements This was a retrospective chart review of patients ≥65 years old evaluated in an academic Level 1 trauma center ED for a fall from standing height or less and discharged. After Institutional Review Board approval, electronic medical record data was queried. Univariate and multivariable logistic regression models were used to determine factors associated with increased risk of returning to the ED over 90 days. Results Two hundred sixty three adults aged 65 and older were evaluated in the ED for a fall and discharged during the 18 month study period. Average age was 77 years and 70% were female. Injuries suffered include fractures (45%, n=117), head trauma (22%, n=58), abrasions, lacerations, or contusions (34%, n=88), or none (22%, n=57). Patients required emergency care frequently, with 5% (n=13)[95% CI, 2.3-7.6%] returning within 72 hours, 13% (n= 35)[95% CI, 9.2-17%] returning within 30 days and 22% (n=57)[95% CI, 17-27%] within 90 days. Univariately, the odds of returning to the ED within 90 days was over two times higher for those with head trauma compared to those without (odds ratio (OR) 2.66). This remained significant in the multivariable model, which controlled for Charlson Comorbidity Index, fractures, soft tissue injuries, and ED observation unit use. Conclusion Over a third of older adults with minor head trauma from a fall will need to return to the ED in the following 90 days. These patients should receive close attention from primary care providers. The link between minor head trauma and ED recidivism is a new finding.
The goal of EPIC Kids is to promote adoption of behaviors associated with a healthy weight trajectory and prevent excess weight gain while supporting growth and development in children at risk for type 2 diabetes. Objectives include making physical activity integral to life, healthy eating, and creating home environments to ensure healthy behaviors are the easy choice. Target Audience: Children -9-12-years-old -who have $1 type 2 diabetes risk factors and their caregivers. Theory, Prior Research, Rationale: Evidence-based, efficacious community interventions for diabetes prevention in youth remain a critical need. We adapted the successful adult-focused YMCA Diabetes Prevention Program (YDPP) to serve children and families at risk. Prior studies suggest effective interventions are family-centered, target diet and physical activity, and include parents. Description: EPIC Kids is a 12-week program led by YMCA lifestyle coaches consisting of weekly interactive sessions designed to engage families in healthy eating and physical activity, help them set goals around energy balance, and teach them to structure the home environment to support healthy lifestyle behaviors. Evaluation: Potential public health impact was evaluated using program reach, efficacy, adoption, implementation, and maintenance data collected from YMCA administrators (n¼4), lifestyle coaches (n¼12) and families (n¼47) using qualitative and quantitative methods. Thirty six percent of screened families were eligible to participate; participants expressed high program satisfaction (>87% enjoyed weekly activities) and 75% reported high likelihood of adopting recommended changes. Weekly attendance was 65%; program sessions were implemented as planned.Conclusions and Implications: EPIC Kids offers a community-based youth diabetes prevention program delivered by an organization located in over 10,000 U.S. communities.
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