Creating a Workplace Culture of Preventive Health: Process and Outcomes of the Colon Cancer-Free Zone at Virginia Cooperative Extension.

Colorectal cancer is the third leading cause of cancer death in the USA, yet is highly preventable and detectable at an early stage through screening. Virginia Cooperative Extension (VCE) implemented a worksite colon cancer awareness program to increase colorectal cancer screening rates and preventive lifestyle behaviors among its employees. The Colon Cancer-Free Zone program is designed using best practice principles of worksite health programs and includes information sessions covering the topics of colorectal cancer, screening guidelines, insurance coverage, and preventive lifestyle behaviors. It is conducted in a campaign format that includes a strategic communication strategy targeting relevant screening barriers and facilitators, peer champions, and incentives. The program was implemented with VCE employees statewide utilizing a web-based system for the information sessions, and resulted in broad participation, a significant increase in screening self-efficacy (4.15 ± 0.64 vs 3.81 ± 0.76, ρ = 0.006), changes in diet and physical activity (50% and 40% of participants, respectively), and a 20.6% increase in the employee colorectal cancer screening rate. A Colon Cancer-Free Zone toolkit was developed for use by Extension Agents to implement the program at worksites in their service communities.

Fracture of femoral component in a resurfacing total knee arthroplasty.

We present a case of an unusual complication after a resurfacing total knee arthroplasty. Fracture of the uncemented porous-coated femoral component occurred 4 years after its implantation. The mechanical axis was restored and collateral ligament balance was achieved at the primary procedure. At revision, the femoral component was found fractured at the junction of the trochlea with the medial condyle, anteriorly to the medial peg. A thin layer of fibrous tissue was interposed between bone and metal under the fracture area. Metallurgical analysis of the fractured component revealed fatigue failure but no structural defect. Lack of bony support and excessive cyclic loading led to fracture of the implant.

Mid-term results and migration behaviour of a ti-alloy cemented stem.

Between 1991 and 1994, 147 patients (154 hips) underwent a primary cemented total hip replacement using the Ultima ti-alloy, collarless, double-tapered stem and a UHMWPE cup. The average age at operation was 66.4 years. Ninety-one patients (97 hips) were available for review with an average follow-up of 76 months. The Harris hip score had improved from pre-operative average of 43.1 (12.5-65.0) to the latest score of 88.9 (67.5-100). There were 11 revisions in total, eight of which were for aseptic stem loosening. The results of Kaplan-Meier survival analysis, based on stem revision for aseptic loosening as an end-point, was 92% at 8 years. Early stem migration analysis at 2 years was possible in 114 cases using digitised radiographs analysed by the EBRA method. Sixty-three stems had not migrated and 35 migrated less than 2 mm with only one of these ending in failure. Sixteen stems showed early migration of more than 2 mm and five of these failed. Early stem migration is predictive of stem failure. Osteolytic lesions occurred in 12 femurs and four of these stems failed.