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Occupationally Oriented Medical Rehabilitation and Hairdressers' Work Techniques--A one-and-a-half-year follow-up.

This study examined changes in work techniques and musculoskeletal symptoms after occupationally oriented medical rehabilitation arranged for 21 hairdressers who were experiencing neck-shoulder or back pain but were still able to work. OWAS (Ovako Working Posture Analysing System) analyses of working postures and questionnaire data were obtained at the beginning of the courses and one and a half years later. The participants worked with their back bent and twisted or their arms at or over shoulder level more seldom (p <.0001) at the end of the follow-up than at the beginning of the rehabilitation. Subjective work-related physical and mental strain had decreased by 45.4% (p <.001) and 27.1% (p <.05), respectively, and subjective neck and back pain by 40.0% (p <.01) and 45.3% (p <.01), respectively. This study suggests that occupationally oriented medical rehabilitation can have significant and long-lasting effects on the rehabilitee's work techniques and subjective well-being.

Journal Article↗

Participatory ergonomics and an evaluation of a low-cost improvement effect on cleaners' working posture.

Cleaning is a highly physically demanding job with a high frequency of awkward postures and working environments as contributing risk factors. Participatory ergonomics is a method in which end-users take an active role in identifying risk factors and solutions. The aim of this study was to apply the participatory ergonomics method to identify cleaning problems and to evaluate the effect of a low-cost improvement on cleaners' working postures in an office environment. The results show that the cleaning problem was identified, and the low-cost ergonomics solution suggested by the cleaners was implemented. Thus an improved working environment reduced the number of awkward cleaning postures and the Ovako Working Posture Analysis System (OWAS) action category for floor mopping decreased. It can be concluded that working in an improved environment can lead to better working postures which, in turn, leads to the cleaners' better health and better cleaning results.

Ergonomics↗

An ergonomic study on posture-related discomfort among preadolescent agricultural workers of West Bengal, India.

In India, particularly in West Bengal, preadolescents are primarily associated with agricultural work in rural areas. Owing to poor socio-economic conditions, they are compelled to carry out a considerable number of manual, rigorous tasks in agricultural fields. The main aim of this study was to investigate postures adopted by preadolescent agricultural workers during individual agricultural activities and to analyze the causes of discomfort related to those postures. Fifty male and 50 female preadolescent agricultural workers were randomly selected and a detailed posture analysis was performed with the Ovako Working Posture Analysis System (OWAS). It was observed that those workers worked continuously in awkward postures during certain agricultural activities. Consequently they suffered from discomfort in different parts of their body. Even though they were very young, they were likely to suffer from serious musculoskeletal disorders in the future.

Agriculture↗

Modeling prioritized multicriteria decision making.

We consider the problem of multicriteria decision making (MCDM) in the situation in which there exists a prioritization of criteria. A good example of prioritization among criteria occurs in the case of air travel, where concerns about passenger safety have a higher priority then economic concerns. Tradeoffs between saving on gasoline usage and jeopardizing passenger safety are unacceptable. We show how this prioritization of criteria can be modeled by using importance weights in which the weights associated with the lower priority criteria are related to the satisfaction of the higher priority criteria. We provide some models that allow for the formalization of these prioritized MCDM problems using both the Bellman-Zadeh paradigm for MCDM and the ordered weighted averaging (OWA) operator method.

Algorithms↗

Enzymology of butyrate formation by Butyrivibrio fibrisolvens.

Butyrivibrio fibrisolvens is a major butyrate-forming species in the bovine and ovine rumen. The enzymology of butyrate formation from pyruvate was investigated in cell-free extracts of B. fibrisolvens D1. Pyruvate owas oxidized to acetylcoenzyme A (CoA) in the presence of CoA.SH and benzyl viologen or flavin nucleotides. The bacterium uses thiolase, beta-hydroxybutyryl-CoA dehydrogenase, crotonase, and crotonyl-CoA reductase to form butyryl-CoA from acetyl-CoA. Reduction of acetoacetyl-CoA to beta-hydroxybutyryl-CoA was faster with NADH than with NADPH. Crotonyl-CoA was reduced to butyryl-CoA by NADH, but not by NADPH, only in the presence of flavin nucleotides. Reduction of flavin nucleotides by NADH was much slower than the flavin-dependent reduction of crotonyl-CoA. This indicates that flavoproteins rather than free flavin participated in the reduction of crotonyl-CoA. Butyryl-CoA was converted to butyrate by phosphate butyryl transferase and butyrate kinase.

3-Hydroxyacyl CoA Dehydrogenases↗

Assessment of skeletal muscle fatigue of road maintenance workers based on heart rate monitoring and myotonometry.

OBJECTIVE: This research work is dedicated to occupational health problems caused by ergonomic risks. The research object was road building industry, where workers have to work very intensively, have long work hours, are working in forced/constrained work postures and overstrain during the work specific parts of their bodies. The aim of this study was to evaluate the work heaviness degree and to estimate the muscle fatigue of workers after one week work cycle. The study group consisted of 10 road construction and maintenance workers and 10 pavers aged between 20 and 60 years. METHODS: Physical load were analyzed by measuring heart rate (HR), work postures (OWAS) and perceived exertion (RPE). Assessments of the muscles strain and functional state (tone) were carried out using myotonometric (MYO) measurements. The reliability of the statistical processing of heart rate monitoring and myotonometry data was determined using correlating analysis. RESULTS: This study showed that that road construction and repairing works should be considered as a hard work according to average metabolic energy consumption 8.1 +/- 1.5 kcal/min; paving, in its turn, was a moderately hard work according to 7.2 +/- 1.1 kcal/min. Several muscle tone levels were identified allowing subdivision of workers into three conditional categories basing on muscle tone and fatigue: I--absolute muscle relaxation and ability to relax; II--a state of equilibrium, when muscles are able to adapt to the work load and are partly able to relax; and III--muscle fatigue and increased tone. It was also found out that the increase of muscle tone and fatigue mainly depend on workers physical preparedness and length of service, and less on their age. CONCLUSION: We have concluded that a complex ergonomic analysis consisting of heart rate monitoring, assessment of compulsive working postures and myotonometry is appropriate to assess the work heaviness degree and can provide prognosis of occupational pathology or work-related musculoskeletal disorders for the workers under different workload conditions. These results can also be used when deciding on necessary rest time and its periodicity.

Journal Article↗

[Association of working postures and some lifestyles with low back pain in a manufactory].

The aim of this study was to determine the relationship between work and low back pain (LBP) by examining both working postures and the workers' everyday lifestyle. Subjects were 118 male workers in a small-to-medium-sized factory having three kinds of workplaces: the slit line, the packing line, and the crane unit. Working posture analysis with OWAS and interviews were carried out. The result of posture analysis showed that the standing posture with both legs straight and back bent appeared most frequently in all three workplaces. Meanwhile, the prevalence of LBP was almost equal among these groups, with 70% of workers having experienced LBP in each group. But the main cause of LBP differed among the three groups. On the slit line, the result of regression analysis and interview suggested that exercises in the past affected the prevalence of LBP, and that aging and work made LBP worse. On the packing line, many workers were transferred to other positions after a few years, and thus might affect the prevalence of LBP in other workplaces. For the crane unit, it appeared that work in previous positions might affect the occurrence of LBP. Moreover, it seemed that activities in the workplace, rather than lifestyles, contribute to the occurrence of LBP in this factory.

Adult↗

[Prognostic factors for response to treatment and recurrence of uncomplicated symptomatic gastroesophageal reflux in ambulatory care medicine].

OBJECTIVE: To investigate the prognostic factors of symptom resolution or failure and relapse in patients presenting with symptomatic gastroesophageal reflux (GERD) and treated in the usual conditions of primary care. METHOD: Controlled, non-comparative study consisting of a 4-week treatment phase (omeprazole 10 mg/day) and a 12-week follow-up phase. Initial symptom resolution was defined as no heartburn in the week preceding the assessment at the end of treatment. Following initial symptom resolution, relapse was defined as the occurrence of moderate or severe heartburn and/or acid regurgitation, and/or ingestion of antisecretory agents or prokinetics, or the existence of symptoms justifying upper gastrointestinal endoscopy. The prognostic factors were investigated using a step-by-step multivariate regression logistics, taking into account all the demographic, clinical and therapeutic parameters available. RESULTS: The rate of symptom resolution was of 58% (2775 patients assessed in the intent-to-treat analysis). Failure was associated with the following factors: administration of non-steroid antiinflammatories before/during the study (Odds Ratio [OR] = 1.42, p = 0.015), initial severity of heartburn (OR = 1.37, p < 0.001), previous anti-secretory treatment (OR = 1.32, p = 0.001) and initial severity of acid regurgitation (OR = 1.18 p = 0.002). The relapse rate Owas of 26% (2214 patients assessed) with the following associated factors: previous anti-secretory treatment (OR = 1.98, p < 0.001), duration of GERD history (OR = 1.55, p < 0.001), previous administration of prokinetics (OR = 1.46, p < 0.001), distribution of GERD pain throughout the 24 hr period, body mass index and age of patients, with lower Odds Ratio; these last three factors inciting more reserve as to the results. CONCLUSION: In the presence of these factors, assessment of GERD permits adaptation of the initial management and the eventual relay to a maintenance treatment in patients at risk of failure or relapse.

Adult↗

Ergonomics method for prevention of the musculoskeletal discomforts among female industrial workers: physical characteristics and work factors.

In industrial work, working postures play an important role, separately and combined with other strain factors. The combined effects may be worse than those of single factors. The purpose of this investigation was to compare the body size, work postures and musculoskeletal discomforts between a group of female workers in a pharmaceutical plant and another group in a textile plant. Two hundred workers have participated in the following studies; (i) measuring anthropometric data in the standing and sitting positions, (ii) using the Ovako Working Posture Analysis System (OWAS), and (iii) using the detail Standardized Nordic Questionnaire for analyzing the musculoskeletal troubles in different parts of the body. The investigation has identified five main factors associated with the musculoskeletal discomforts: (i) lack of worker selection and lack of appropriate training to prevent occupational hazards or work-related diseases, (ii) poor ergonomic design of the work place and task including work organization, (iii) poor working postures, (iv) lack of task variation, and (v) insufficient rest breaks. These could be improved by introducing ergonomic interventions for both adjusting the individual work places and the task performed. It is necessary to consider preventive measures for musculoskeletal disorders, especially for female workers in industrially developing countries. Ergonomic aspects of the preventive measures should include: (a) consideration of appropriate worker selection for various works with sufficient training and instruction, (b) ergonomic redesign of work places, and (c) ergonomic considerations in work organization.

Adolescent↗

Occurrence and severity of infections caused by subgroup A and B respiratory syncytial virus in children in southeast Brazil.

The frequency and severity of infections caused by respiratory syncytial virus (RSV) were assessed in children <2 years of age seen at the emergency department. The frequency of RSV detection in the clinical virology laboratory during the past 3 years was also analyzed retrospectively. RSV was found in 21.6% (188/869) of the samples collected from children seen at the emergency department and was found to be more frequent during the autumn, being less frequent or negligible by midwinter. RSV subgroups A and B co-circulated within the same time period in children seen at the emergency department, with varying predominance of either subgroup. There was no significant association of RSV subgroup with disease severity, but only a trend for RSV subgroup B being more frequent in children with risk factors for severe disease.

Acute Disease↗

The blink reflex in neonates with a subsequent poor outcome.

We examined maturational changes in the electrical blink reflex in 11 handicapped children, i.e., 4 cases of developmental delay, 4 of cerebral palsy, 2 of congenital hydrocephalus, and 1 of congenital cytomegalovirus infection. The developmental delay and cerebral palsy cases were all born at 25-36 weeks' gestation. In all cases, prolonged latency, low amplitude, or the absence of the late component of the blink reflex was observed in the follow-up study. These results indicate that prematurity and some congenital impairment mainly influence the maturation of the long-loop reflex arc in the blink reflex.

Blinking↗

Prognosis after hepatic resection in patients with hepatocellular carcinoma, estimated on the basis of the morphometric indices.

To determine whether the morphometric indices of hepatocellular carcinoma (HCC) correlated with the prognoses, the microscopic morphometric values for 84 HCC cases treated by hepatic resection were studied using an image analyzer in relation to the survival rate and the gross classification. The mean survival time (MST) was 58 months in cases with a nucleocytoplasmic area ratio (N/C) of less than 0.28; this was significantly longer than the 38-month MST in cases with an N/C of more than 0.28 (P < 0.05). In stage III disease, the MST for cases with an N/C of less than 0.28 was 63 months, which was significantly longer than the MST of 13 months for cases with an N/C of more than 0.28. After relatively noncurative hepatic resection, the MST for cases with an N/C of less than 0.28 was 49 months, and this was significantly longer than the MST of 8 months for cases with an N/C of more than 0.28. The MST was 71 months for cases with a coefficient of variance of the nuclear form factor (NCV) of less than 5.5%, which was significantly longer than the MST of 33 months for cases with an NCV of more than 5.5% (P < 0.05). In stage III disease, the MST was 69 months for cases with an NCV of less than 5.5%, and this was significantly longer than the MST of 29 months for cases with an NCV of more than 5.5% (P < 0.05). In cases with an N/C of less than 0.28, 18% had vascular invasion and 38% had intrahepatic metastases, whereas in those with an N/C of more than 0.28, 62% had vascular invasion and 67% had intrahepatic metastases (P < 0.01, P < 0.05). Based on the results of these morphometric studies on HCC cases treated by hepatic resection, N/C and NCV may be useful as prognostic factors.

Carcinoma, Hepatocellular↗

Acute chest syndrome in children with sickle cell disease.

Acute chest syndrome (ACS) is an acute pulmonic process in patients with sickle cell disease. We prospectively studied 50 patients with ACS admitted to the Pediatric Medical Ward during one year period (Jan. 1993 through Dec. 1993). Twenty eight of them were males and twenty two were females giving a male: female ratio of 1.2:1. The age ranged between one and 12 years. Twelve (24%) of the patients had chest pain on presentation. Twenty seven (54%) patients had significant temperature (> 38 degrees C). The x-ray findings showed that the right lung was involved in 30 patients, the left in 10 patients and both lungs in 10 patients. Three patients had pleural effusion that required chest tube insertion. Laboratory profiles showed that the erythrocyte sedimentation rate ranged between 15 and 90 mm/h, and their hemoglobin ranged between 4.2 gm and 12 gm/dl. Seven (14%) patients had significantly positive mycoplasma pneumoniae titer. None of the blood cultures was positive. All of our patient received antibiotic, usually either Cefuroxime or Ceftriaxone with Erythromycin in addition to other supportive measures such as blood transfusion, oxygen therapy and hydration therapy.

Anemia, Sickle Cell↗

Neonatal morbidity and mortality in Nigeria.

A retrospective analysis of neonatal morbidity and mortality was conducted over a ten-year period (1981-1990) at a tertiary hospital in Ilesa, Nigeria, to determine the trends in neonatal morbidity and mortality in relation to places of delivery. 7,225 babies were admitted into the neonatal unit during the period wherein 3,232 (44.7%) were inborns and 3,993 (55.3%) outborns. Places of delivery of outborn babies were government hospitals/maternity centres (44.1%), home (28.5%), private hospitals/clinics (18.8%), and mission houses (8.7%). Major indications for admission among inborns were neonatal jaundice (45.6%), low birthweight (18.6%), birth asphyxia (14.2%), and neonatal infections (9.3%), while those for outborns were neonatal jaundice (39.5%), low birthweight (23.2%), neonatal infections (18.0%), neonatal tetanus (5.7%), birth asphyxia (4.8%). Overall mortality rate was 13.0%. It was higher in outborns than inborns (p < 0.001). Mortality was lowest in 1983 and peaked in 1987 and 1988. It was higher in outborns than inborns during the period (p < 0.001). Major causes of death were low birth weight (42.8%), neonatal jaundice (14.1%), neonatal tetanus (12.8%), infections (12.4%), and birth asphyxia (11.6%). In almost all cases, case fatality rates were higher among the outborns (p < 0.001). Similarly, mortality was higher in outborns than inborns in almost all the weight range. Among the outborns, mortality was highest in babies delivered at home and private hospitals. Improved access to neonatal medical and antenatal care will significantly reduce neonatal morbidity and mortality in Nigeria.

Cause of Death↗

A comparative study of elemental composition of human breast milk and infant milk substitutes.

Instrumental neutron activation analysis (INAA) and proton-induced X-ray emission (PIXE) analysis have been employed to determine the concentration of 13 elements in human breast milk, various infant formulas, and locally produced cereals from Nigeria, as well as from various infant formulas and natural cow and goat milk available in the UK. The study shows that if the locally produced cereal is to be used on a regular basis for babies in Nigeria, then their diet must be supplemented with essential trace elements. Furthermore, parents should be discouraged from giving their infants cow and goat milk because of the high concentration of major elements compared to human breast milk.

Adult↗

Electrophysiological studies of a child with presumed botulism.

Electrophysiological studies of a child with presumed botulism showed that the amplitude of the serially and electrically elicited blink reflexes Rl, R2 and R2' was reduced during recovery. These findings suggest a conduction block of the facial nerves. Other nerve conduction studies and an incremental response to repetitive stimulation demonstrated a block of the presynaptic neuromuscular transmission. Results of the biological tests were negative, but those of electrodiagnosis and clinical examination favored a diagnosis of botulism. A combination of electrically elicited blink reflexes and rapid repetitive stimulation of the peripheral nerves was found to be a sensitive method of assessing the integrity of neuromuscular junctions and the subclinical impairment of muscle nerves.

Blinking↗

Body fat and blood lipids in postmenopausal women are related to resting autonomic nervous system activity.

The present study investigated the activity of the autonomic nervous system (ANS), a major influence in normal physiological function, and its association with unfavorable postmenopausal states in body composition, lipid and/or glucose metabolism, or cardiovascular profiles. Body composition, blood pressure, and blood profiles of lipid and glucose of 175 postmenopausal women were measured. Resting ANS activity was assessed by heart rate variability (HRV) power spectral analysis. To scrutinize the influence of ANS activity levels on postmenopausal obesity-related factors, we divided the subjects into a low group ( < 220 ms(2)) and a high group ( > 220 ms(2)), based on the total power of HRV. Low-frequency (P < 0.01) and high-frequency power (P < 0.01) were both significantly lower in the low group. No significant difference was found in age, age at menopause, or years after menopause between the two groups. In contrast, body mass index (P < 0.05), percentages of body fat (P < 0.01), and systolic (P < 0.01) and diastolic (P < 0.01) blood pressure were significantly greater in the low group. As to blood lipid profiles, triglycerides (P < 0.05), total cholesterol (P < 0.05), and low-density lipoprotein cholesterol (P < 0.05) were significantly higher in the low group. Our findings indicate that reduced sympatho-vagal activity is associated with higher postmenopausal body fat content, blood pressure, and blood lipid concentrations. This study further implies that such autonomic depression could be a crucial risk factor in undermining the health and, ultimately, the quality of life, of postmenopausal women.

Autonomic Nervous System↗