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Biomedical subjects

D C Cole

Publications and source records attributed to D C Cole.

31 records · Page 2Linked to original sources
PubMed1996

Prognosis of nonspecific work-related musculoskeletal disorders of the neck and upper extremity.

Reviews of work-related musculoskeletal disorders (WMD) of the neck and upper extremity have typically supplied little information on prognosis. This paper reports on the methods and results of a systematic search for evidence on clinical course and prognosis of nonspecific WMD i.e., those without specific clinical diagnoses. Articles were deemed relevant if they provided primary data on current or former worker cases of WMD followed over time. WMD status had to be based on clinical evaluations. The 13 studies which met these criteria were evaluated using clinical epidemiological criteria for validity of prognostic studies. None of the studies was sufficiently strong across the criteria to provide more than weaker evidence on prognosis. Prognostic factors with promise include duration of symptoms and workplace demands. In order to improve the evidence on prognosis of WMD, we recommend closer attention to the following: clear operational definition of cases; documentation of prognostic factors including duration of symptoms and severity at baseline; incorporation of multiple follow-up assessments; inclusion of a range of outcomes; and analysis using stratified or multivariate methods.

Arm Injuries↗
PubMed1996

Review of applicability of existing functional status measures to the study of workers with musculoskeletal disorders of the neck and upper limb.

Both epidemiologic studies of the factors that contribute to the development of work-related musculoskeletal disorders of the neck and upper limb and intervention studies that test the effectiveness of workplace ergonomic and organizational changes are needed to provide empiric evidence for preventive strategies. This study reviews the relevance and comprehensiveness of existing functional status instruments for epidemiologic studies of work-related neck and upper limb disorders. Twelve domains were identified as the major areas of life affected by workers' neck and upper extremity disorder(s): work, household and family responsibilities, self-care, transportation/driving, sexual activity, sleep, social activities, recreational activities, mood, self-esteem, financial effects, and iatrogenic effects of assessments and treatment. Fifty-two functional status instruments were identified. Of these, 21 met the specified criteria as potentially relevant and were rated on the 3-point scale for relevance and comprehensiveness for each domain. None of the instruments covered all 12 domains adequately.

Arm Injuries↗
PubMed1996

Understanding prognosis to improve rehabilitation: the example of lateral elbow pain.

OBJECTIVE: A systematic overview of evidence aimed at determining the clinical course of lateral elbow pain and prognostic factors that affect elbow pain duration and outcomes. DATA SOURCES: Online bibliographic database searches from 1983 to 1994; information requests from selected authors and bibliography screenings. STUDY SELECTION: One author reviewed 424 articles; 40 met the following eligibility criteria: any study with primary data on soft tissue injuries specific to the elbow which referred to prognosis or reported use of any outcome measure. DATA ABSTRACTION: Strength of evidence grade based on clinical epidemiological validity assessment. Criteria included in the validity assessment included case definition, patient selection, follow-up, outcome, prognostic factors, and analysis. All eligible studies were independently assessed by two investigators. DATA SYNTHESIS: Four studies (10%) were judged to provide moderate strength of evidence; no studies were graded as providing strong evidence on prognosis. All four moderate-quality studies were clinical trials of short duration. One study indicated that site of lesion and prior occurrence may be predictive of poorer outcome in patients with lateral epicondylitis. CONCLUSION: The majority of studies on lateral elbow pain were limited by methodological weaknesses in selection and definition of the study population, length of follow-up, and analysis of prognostic factors. Estimates of duration were only available from weaker studies with longer follow-up times; significant subject heterogeneity in the weaker studies prevented a determination of usual clinical course. More methodologically rigorous research on prognosis could assist clinicians in patient care and evaluation of interventions.

Arthralgia↗
PubMed1995

Use of beta-methylphenylalanine (beta MeF) residues to probe the nature of the interaction of substance P with its receptor: effects of beta MeF-containing substance P analogs on rabbit iris smooth muscle contraction.

The effects of substituting (2S,3S)-beta-methylphenylalanine (S-beta MeF) or (2S,3R)-beta-methylphenylalanine (R-beta MeF) for the Phe7 and/or Phe8 residues of the tachykinin substance P (SP, RPKPQQFFGLM-NH2) upon the ability of SP to stimulate contraction of the rabbit iris smooth muscle were investigated. The eight beta MeF-containing SP analogs (four monosubstituted analogs, four disubstituted analogs) 1-8 were synthesized and found to be agonsts of SP in the smooth muscle contraction assay, having EC50 values ranging from 0.15 to 10.0 nM. Three analogs are significantly more active than SP [8R-(beta MeF)SP (4), 7S,8S-(beta MeF)2SP (5), and 7R,8S-(beta MeF)2SP (6)], three analogs are approximately equipotent with SP [7S-(beta MeF)SP (1), 7R-(beta MeF)SP (2), and 7S,8R-(beta MeF)2SP (8)], and two analogs are significantly less active than SP [8S-(beta MeF)SP (3) and 7R,8R-(beta MeF)2SP (7)]. The effects of the beta MeF substitutions upon the activity of SP are not additive and cannot be explained using simple conformational models which focus only on the side chain conformations of the beta MeF residues. It is postulated that the beta MeF residues induce minor distortions in the peptide backbone with resultant consequences upon peptide-receptor binding which are not dictated soley by the side chain conformations. This idea is consistent with 1H-NMR data for the monosubstituted analogs 1-4, which imply that the beta MeF substitutions cause slight distortions in the peptide backbone and that the beta MeF side chains are assuming trans or gauche(-) conformations.

Aminobutyrates↗
PubMed1994

Toxic health effects including reversible macrothrombocytosis in workers exposed to asphalt fumes.

We investigated an outbreak of irritative and neurotoxic symptoms associated with exposure to asphalt fumes in a commercial lighting factory; 27 symptomatic female workers were clinically assessed including hematologic testing. When compared with a laboratory reference group (n = 107), the workers' mean platelet volume (MPV) was significantly higher and mean platelet count was lower (p = 0.013 and p = 0.048, respectively). Five months later, the factory's ventilation system was substantially modified. Follow-up assessments 6 months postmodification on 15 of the original workers documented a significant decline in acute symptoms and a lowering of the subjects' mean MPV towards normal (p = 0.0007 by paired t-test). The findings suggest that reversible macrothrombocytosis (enlarged platelets) can occur among symptomatic workers exposed to asphalt fumes.

Adult↗
PubMed1981

Nasogastric tube displacement to the right as a sign of acute traumatic rupture of the thoracic aorta.

A study was undertaken to determine the accuracy of nasogastric tube (NGT) displacement to the right as a sign of acute traumatic rupture of the thoracic aorta (ATRTA). In 14 patients with confirmed ATRTA, the sensitivity of NGT displacement to the right was 70% using measurement of displacement from the midline on chest radiography. Two control groups, comprising victims of vehicular trauma and patients with no recent history of trauma, showed significant percentages of false positive findings for ATRTA based on NGT displacement. The presence of this radiographic sign is highly suspicious for this lethal injury; however, the absence of displacement cannot be used to exclude the diagnosis of ATRTA.

Adolescent↗
PubMedDate not supplied

Neurobehavioral outcomes among farm and nonfarm rural Ecuadorians.

International researchers have urged greater use of simple neurobehavioral batteries in developing country settings where higher levels of exposure and a variety of cultural and demographic factors may both occur. We conducted a cross-sectional survey of 144 farm members and 72 age and education frequency-matched controls from rural Ecuador, using an amplified Neurobehavioral Core Test Battery. Farm members ranged from those with only indirect pesticide contact to applicators regularly applying organophosphate and carbamate insecticides by backpack sprayer. The distributors of scores showed those with less than 4 years of formal education and at the extremes of age (< 16 or > 65 years old) contributed sufficiently to nonnormality that they had to be excluded from subsequent analyses (resultant n = 170). After adjustment for age and education, language-based IQ test scores and farm membership were the most consistent determinants of neurobehavioral outcomes. Visual-spatial tasks were the most sensitive to the effects of farm membership. Gender (women better than men), alcohol problems, and solvent use were also important for some neurobehavioral tests.

Adolescent↗
PubMedDate not supplied

Research responses to outbreaks of concern about local environments.

Traditional epidemiological approaches based on biomedical models may be limited with respect to their response to "outbreaks of concern" among work-force or community populations. Three published Canadian "outbreaks" were reviewed in this study. In all three instances, research was initiated because lay persons were concerned about either nonspecific symptoms or hazardous exposures, and individuals publicly called for a response. Epidemiologic analyses were inconclusive as to the reasons for the outbreaks, and they contributed little toward the resolution of concerns. There is a need for a fuller recognition of the role of social context and of the action-oriented nature of such research. The elucidation of multifactorial and culturally mediated causation, as well as the development of remedial actions, require a rethinking of research methods. We specifically call for (a) an expansion of the disciplinary base of research teams to include social scientists, and (b) the adoption of combined qualitative and quantitative research approaches.

Attitude to Health↗
PubMedDate not supplied

Fish consumption by Vietnamese women immigrants: a comparison of methods.

In this study, the measurement properties of an interview-administered fish consumption frequency questionnaire, used with a pilot study of 20 Vietnamese immigrant women, were described. Reproducibility across two summer interviews and one winter interview for estimates of seasonal and yearly intake of Great Lakes fish was moderate (intraclass correlation coefficients: .51-.61). Detailed questioning, by species, resulted in higher estimates of mean overall consumption (44.6-57.8 meals/y) than did asking about any fresh-water fish consumed (33.5-46.1; differences 5.1-15.7). Estimates based on the fish consumption frequency questionnaire (i.e., 6.2+/-2.0 meals per winter season) were comparable with those based on extrapolation from a 1-mo calendar (5.8+/-5.6); however, both estimates of consumption were far less than a weighed record (29.1+/-22.2). The results of this study suggest that measurement variation in fish consumption estimates should be detailed in research reports and should be discussed with respect to risk assessments.

Adult↗
PubMedDate not supplied

A lament by women for "the people, the land" [Nishnawbi-Aski Nation]: an experience of loss.

In response to a hunger fast by five members of the Sandy Lake Band at the Sioux Lookout Zone Hospital in Northern Ontario (Canada)--a cultural protest of the status of health care services in the Zone--the Federal Minister of Health agreed to establish a Panel to review the region's health care system. The year-long study involved hearings in each of the 28 remote communities of the Zone, and interviews with elders and chiefs, women, and health care providers. A consultation team from McMaster University (Faculty of Health Sciences) assisted the Panel with epidemiological survey research, literature reviews, and the interpretation of the data collected in the proceedings. This paper offers our interpretation of data collected from the qualitative study component. Specifically, it provides an interpretation of the discourse of the native women of the Nishnawbi-Aski Nation on their experience of health and health care. An "idiom of loss" captures, we feel, the depth of their concerns, dilemmas and frustrations.

Attitude to Health↗