Prostheses

A recent BBC News slide show on Prosthetics through Time caught my attention. The slides are those things that most of us would identify as artificial limbs. The artificial arms look quite similar to the one worn by a co-worker of mine at the Hershey Chocolate Factory in 1972. He had lost his arm when it got caught in an open conveyor belt that still ran in that section of the factory.

The National Library of Medicine has a long list of items under its subject heading of Prostheses and Implants. These include:

• artificial larynx
• bone screws
• cochlear implants
• dentures
• drug eluting stents
• heart valves
• vena cava filters

Some years ago, a high school student visitedi me in the hospital library where I worked. She was an artist, but wanted to go to college to design replacement parts for persons whose faces had been disfigured by trauma and wondered about information resources for someone pursuing such a career. In those pre-Internet days, I likely was not able to provide much assistance.

When I hear the word prosthesis, I tend to think of arms and legs, not facial features or electro-mechanical implants. MedlinePlus has numerous references on its Artificial Limbs page. You don't have to look very far to find stories of athletes with one leg for competitive running and another for everyday wear. When you see the technical advances in these components that allow para-athletes to compete at high levels of performance it is hard not to be impressed.

Still, in looking at the artificial toe from Ancient Egypt, I am equally impressed with the concept of what that provider was trying to accomplish. That does not seem to have changed much in several millennia. The main changes seem to be in the technologies used by the prostheses.

3 comments - Posted by Steve Rauch at 12:25 PM - Categories:

Obesity Trends 2010

According to data from the National Health and Nutrition Examination Survey (NHANES) more than one third of American adults are obese (defined as having a Body Mass Index > 30). The NHANES data are from 2007-2008.

Using their Behavioral Risk Factor Surveillance System (BRFSS), CDC has data that are two years newer, and their findings are similar. Here is the 2010 map for obesity in the United States:

The Obesity Trends web site displays maps from 1985 through 2010, making it easy to see the trend as the map goes from light blue to red. The site includes links to related resources: diabetes, physical inactivity.

Last year, Colorado had been the only state with an obesity rate below 20%, but that ended with last year's assessment. Twelve states have obesity rates of 30% or more. With the association between obesity and other chronic diseases, one would expect to see instances of diabetes and heart disease mirror this same trend.

To see your own individual standing, take the Adult BMI Calculator for a spin.

The first time I saw these maps was in a presentation by Howard Frumkin on Smart Growth. Dr. Frumkin believes that our built environment influences individual health. Read through an illustated transcript of a talk he delivered in Scotland in 2006. As you can see, the maps have continued on their trend.

32 comments - Posted by Steve Rauch at 12:19 PM - Categories:

Growing Future Hospital Leaders

Poudre Valley Health System has been one of the most successful health systems in Colorado. Their hospital in Fort Collins was the first Magnet-designated hospital in Colorado. This spring, PVHS and the University of Colorado Hospital announced their intent to develop a joint operating agreement to form a unified nonprofit health system.

Such success does not come without great people and great leadership. Rulon Stacey, CEO of PVHS, and current chairman of the American College of Healthcare Executives, divulged six steps that PVHS takes to help develop their own staff into the future leaders they will need for continued success:

1. CEO meets with every new employee
2. Donate to local colleges
3. Provide funding for training in an employee's field
4. Set up a formal mentor program
5. Help employees understand strengths and weaknesses
6. Extend succession plan as far down as possible

It is an interesting list, no one item seems to be particularly earth-shattering, yet whatever they are doing seems to be working out for them. Thanks to Becker's Hosptial Review for letting us read the entire article

3 comments - Posted by Steve Rauch at 1:52 PM - Categories:

Cornerstone Time Capsule

During National Hospital Week, Community Hospital will open a box that had been placed in the cornerstone of the newly built Osteopathic Hospital in 1964. Such cornerstone "deposits" were placed during a Masonic ceremony that dates back centuries. One of the earliest written records of the ritual was done from the 1739 celebration of the New Royal Infirmary of Edinburgh.

Such celebrations continue today, where local Masonic Lodges host Masons from around a state and the Grand Lodge to commemorate the construction of a building. The ceremony includes officials, and their guests, of the building being constructed. The Masons parade to the construction site and engage in a ceremony that opens and closes with a prayer. A square, a level, and a plumb are used to check not just the stone itself, but to remind all present of their virtue, equality, and rectitude. The stone is consecrated with corn, wine, and oil. Local officials usually speak at the occasion.

In masonic terminology, the Cornerstone is the first stone placed above ground, and is usually at the northeast corner of the building. The Foundation stone is usually the first stone laid underground in building a masonry structure. The Capstone is the topmost stone that completes the structure. Some abbreviations on the Masonic cornerstone or plaque require explanation: MW Grand Lodge means Most Worshipful, AF & AM means Ancient Free and Accepted Masons. There are sometimes two dates (in our case): A.D. 1964 and A.L. 5964. The A.L.signifies Anno Lucis, year of light in Latin. The Masonic calendar traditionally dated from 4004 BCE; the creation of the universe, Anno Mundi, as computed by Archbishop James Ussher in 1650-54. In the mid-18th century the Masons started using Anno Lucis dates.

While the Masons refer to the objects they place in the Cornerstone as a "deposit", the term "time capsule" has crept into our language. The first use of "time capsule" was applied to the torpedo shaped object buried at the 1939 World's Fair in New York City. The plaque marking the location lists some of its contents: tooth powder, bifocals, asbestos shingle, and zippered tobacco pouch. A second time capsule was buried when the 1964 World's Fair was also held in New York City. This capsule contained artifacts from a newer generation: a checkered bikini, credit cards, a Beatle's record, filter cigarettes, and freeze-dried foods.

The time capsule concept seems to run throughout history and across cultures. Artifacts about buildings were intentionally placed in caches in ancient Assyria. When a statue toppled at the Christchurch cathedral in their recent earthquake, two time capsules were found in the plinth. Time capsules have played major roles in the plots of some recent films: the 2009 science fiction thrilling Knowing and the 2001 South Korean romantic comedy My Sassy Girl (although not in its 2008 American remake).

What can we expect when ours is opened in May? In some other cases, the cornerstone artifacts include a local newspaper, business cards of persons attending the ceremony, information about the ceremony, and objects placed in the deposit by the Masons. We will find out if the employees and trustees entrusted any other relics to the box for our discovery.

Feel free to visit some of the sources I consulted for this article:
The 1964 marker
The 1939 marker
Cornerstones: A Masonic Tradition of Dedication
2002 Cornerstone Ceremony at the Elko Airport
Wikipedia on the Time Capsule
Freemasons and the U.S. Capitol Cornerstone

32 comments - Posted by Steve Rauch at 4:16 PM - Categories:

The Diabetes Belt

Researchers with the US Centers for Disease Control and Prevention (CDC) have just published an article identifying the diabetes belt: 644 counties in 15 mostly-southern states that have estimated adult diabetes rates greater than 11%. The counties are in close proximity, most touch another such county, and form a coherent unit when mapped.

The study, to be published in the April 2011 issue of the American Journal of Preventive Medicine has been made available in a pre-publication version. (At the time of this writing, the article is openly accessible on the publisher's web site.)

The researchers took data from the Behavioral Risk Factor Surveillance System (BRFSS) surveys from 2007 and 2008, combined it with estimates of diagnosed diabetes among adults, and have compiled it into a group of maps that can be viewed at CDC's Diabetes Data and Trends web site.

Users can choose among three indicators: Diagnosed Diabetes, Obesity, and Physical Activity and select the year of interest and the type of data. Even staying within a single indicator, changing the other parameters will alter the map display.Switching from percentages to numbers of adults, one sees a switch from those counties with small populations and lots of diabetics, to the urban centers in each state. Users can also drill down to a specific state using the drop-down menu and see the map and estimated values for each county.

As you might guess from the maps, Colorado has the lowest obesity rate of any state, and its residents engage in regular physical activity, both appear to have positive effects on preventing diabetes.

3 comments - Posted by Steve Rauch at 1:03 PM - Categories:

The Haptics of Writing

When we took our daughter to law school last summer, we made a pilgrimmage to an Apple Store to purchase a new Macbook to replace her five-year old Powerbook. Surely many of you have made similar pilgrimmages on behalf of your own children.

During one of our conversations last fall I asked our daughter if she were using the laptop to take notes in class. No, she was not. She preferred to take notes by hand and transcribe them to the computer later. Perhaps she was also being somewhat smug by not joining all the students who used their computers during lectures to checkout Facebook pages, read e-mail, or tweet their opinion on the latest trends. A recent Doonesbury touched on this aspect of life in the contemporary college lecture hall.

When the fall semester was ending, I asked our daughter if she could use her computer for her final exams. Yes, she could. You had to install software from the college that blocked access to the Internet and did not allow the student to write outside the alloted time. However, our daughter chose to handwrite her exams. Only two students chose to handwrite, and they met in a room of their own. Our daughter acknowledged that handwriting was slower than typing, but thought it gave her time to better formulate her ideas. With only two students in the room, it was a quiet location for thinking.

Today, I read a news item about a paper in the Advances of Haptics: "Digitizing literacy: reflections on the haptics of writing". The authors, Anne Mangen and Jean-Luc Velay, look at the relationship between how we write with cognitive development. They are primarily interested in handwriting versus word processing. The study draws on evolutionary biology, biopsychology, and neuroscience to explore how handwriting – the manual formation of letters in the process of writing – affects our reading which thereby influences our whole process of learning.

My simplified synopsis of the two modalities is that handwriting is a unimanual activity with a focus on a single physical point - where the pen or pencils meets the paper. Word processing is a bimanual activity that has two separated spaces: the keyboard and the display. Plus the writer does not form the letters in word processing, but does in handwriting.

Even if you do not have a child leaving their newest laptop at home during lectures and exams, you might enjoy reading this article.

6 comments - Posted by Steve Rauch at 11:50 AM - Categories:

C25K

If you are one of the 2011 resolutionaries who vowed to become more active and fit in new year, you might want to visit c25k.com which is both the URL for web site and the acronym for the Couch to 5K program.

Although this program has been around since 1996, I was not aware of it until seeing it mentioned on an NHS web site this week. The nine-week approach uses three training sessions a week to get the participant from alternating walking and running to being able to run for an entire 30 minute stretch.

The program's web site includes a plethora of useful information:

• Written instructions in more than 20 languages
• A version for treadmill users
• Podcasts to put on your favorite MP3 to accompany your sessions
• C25K apps for iPhone and Android
• Inspirational stories
• What to do beyond 5K

Before beginning any exercise program, especially if you were the ultimate couch potato in 2010, you should check-in with your healthcare provdier.

If that New Year's Resolution feels old, and you did make it last year, you might want to check out C25K and find our how others have gone from the living room to 3.1 miles in nine weeks. And that treadmill version might come in handy until the snowpack and ice have melted from the streets.

6 comments - Posted by Steve Rauch at 2:55 PM - Categories: