Synchrotron radiation X-ray microtomography for the visualization of intra-cochlear anatomy in human temporal bones implanted with a perimodiolar cochlear implant electrode array.

Recently, synchrotron radiation computed microtomography (SRµCT) has emerged as a promising tool for non-destructive, in situ visualization of cochlear implant electrode arrays inserted into a human cochlea. Histological techniques have been the `gold standard' technique for accurate localization of cochlear implant electrodes but are suboptimal for precise three-dimensional measurements. Here, an SRµCT experimental setup is proposed that offers the benefit of a high spatial and contrast resolution (isotropic voxel size = 4.95 µm and propagation-based phase-contrast imaging), while visualizing the soft-tissue structures and electrode array of the cochlear implant simultaneously. In this work, perimodiolar electrode arrays have been tested, which incorporate thick and closely spaced platinum-iridium contacts and wiring. These data can assist cochlear implant and hearing research, can be used to verify electrode segmentation techniques for clinical computed tomography or could be utilized to evaluate cochlear implant electrode array designs.

Magnetic resonance imaging and bone anchored hearing implants: pediatric considerations.

OBJECTIVE: Recent developments in bone conduction hearing systems have seen the introduction of transcutaneous devices comprising of magnetic components. Our aim was to identify the number of children implanted with a traditional, non-magnetic percutaneous bone anchored hearing implant (BAHI) who would not have been eligible for a transcutaneous implant based on magnetic resonance imaging (MRI) need. METHODS: A retrospective case review of 206 children who had a percutaneous BAHI at the Birmingham Children's Hospital (January 2009-October 2012) for auditory rehabilitation. RESULTS: Twenty-eight percent (56/206) of children required at least one MRI scan after receiving a BAHI and 10 percent of patients (20/206) required two or more MRI scans. The main indication for MRI scanning was for neurological co-morbidities; a MRI brain was the most common scan performed. CONCLUSION: Although transcutaneous hearing devices/middle ear implants have their clear benefits, it may be argued that these relatively more invasive surgical procedures may not be the best option for the child who will require MRI scanning at some point in the future. Clinicians should be mindful of any need for MRI scanning when considering implant choices in the pediatric population.

Injury and illness costs in the Certified Safe Farm study.

CONTEXT: The Certified Safe Farm (CSF) intervention program aims to reduce occupational injuries and illnesses, and promote wellness to reduce health care and related costs to farmers, insurers, and other stakeholders. PURPOSE: To evaluate the cost effectiveness of CSF. METHODS: Farms (316) located in a 9-county area of northwestern Iowa were recruited and randomized into intervention and control cohorts. Intervention farms received occupational health screenings, health and wellness screening, education, on-farm safety reviews, and performance incentives. For both cohorts, quarterly calls over 3 years were used to collect self-reported occupational injury and illness information, including costs to the farmers and their insurers. FINDINGS: Annual occupational injury and illness costs per farmer paid by insurers were 45% lower in the intervention cohort ($183) than in the control cohort ($332). Although out-of-pocket expenses were similar for both cohorts, combined costs of insurance and out-of-pocket expenses were 27% lower in the intervention cohort ($374/year per farmer) compared to the control cohort ($512/year per farmer). Within the cohort of intervention farmers, annual occupational injury and illness cost savings were directly associated with on-farm safety review scores. Reported health care costs were $237 per farmer in the safest farms (those farms scoring in the highest tertile) versus $485 per farmer in the least safe farms (lowest tertile). CONCLUSIONS: Results suggest that farmers receiving the intervention had lower health care costs for occupational injuries and illnesses than control farmers. These cost savings more than cover the cost of providing CSF services (about $100 per farm per year).

Farmer assessment of the certified safe farm program.

This article summarizes the qualitative findings from a study evaluating a novel agricultural health and safety program called Certified Safe Farm (CSF). Results are presented from focus groups held in 2002 and 2006 as well as mail-out surveys conducted in 2001 and 2002. Focus group participants and survey responders were farmers involved in CSF intervention studies. CSF aims to remove hazards through on-farm safety reviews, detect health concerns through clinical screenings, provide personalized occupational health and wellness education, and provide incentives for meeting farm safety targets. Farmers overwhelmingly felt that CSF was beneficial for their health and safety by improving their knowledge and behaviors. In both the focus groups and questionnaires, farmers felt that occupational health screening was the most important component of CSF, and on-farm safety review was the second most important component. Farmers also helped to identify areas in which CSF could be improved in the future. Major areas of suggested program improvement included increased involvement of entire farm families, increased enrollment of younger farmers, increased program incentives such as reduced insurance premiums, and increased ease of access to program providers (AgriSafe clinics), among other recommendations.