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At least 91 records · Page 5Linked to original sources
PubMed2003

Neck muscle activity in helicopter pilots: effect of position and helmet-mounted equipment.

BACKGROUND: Helicopter pilots usually work in unfavorable ergonomic positions, often with bulky head-worn equipment during flying missions. The purpose of this study was to evaluate and compare immediate muscle response in the dorsal neck muscles to different positions with a variety of head-worn equipment. METHODS: Fourteen healthy male helicopter pilots volunteered for this study. EMG activity in the upper and lower dorsal neck muscles and the trapezius muscle was measured in a laboratory situation for 5 s in different sitting positions (neutral, trunk inclined 20 degrees, neck flexed 20 degrees), including registration of a 30 degrees left and right rotation in every position; all measurements were performed while wearing a helmet, a helmet and night vision goggles (hNVG), and a helmet, night vision goggles, and counterweight (hCW), in random order. RESULTS: There was significant higher EMG activity in the upper neck with hNVG and hCW than with the helmet only when comparing the mean activity level of all positions. However, there was no significant difference in EMG activity between any variations of head-worn equipment when comparing activity levels during each position separately. In the upper and lower neck, respectively, there was significantly higher muscle activity during the ipsilateral rotated positions plus neck flexion and trunk inclination than in most other positions. CONCLUSION: The increased load caused by different positions seems to have a greater influence on muscle activity than the increased load of the head-worn equipment, which must be considered when designing helicopter work-places.

Adult↗
PubMed1991

[The role of molds and dusts in respiratory tract diseases of construction workers].

Silicosis harmful dust produced into the air of working zone during thorough repair of dwelling houses may traumatize the mucous coat of respiratory tract. Simultaneously mould fungi propaguls get into air. Occupational diseases (dust bronchitis) development caused by this dust during capital repair is substituted. It was expressed in the bronchopulmonary pathology with positive reaction of fungi antigen precipitation and detection of the fungi in pathological substances of patients.

Air Pollutants, Occupational↗
PubMed2005

Medical students' views on peer assessment of professionalism.

BACKGROUND: Although peer assessment holds promise for assessing professionalism, reluctance and refusal to participate have been noted among learners and practicing physicians. Understanding the perspectives of potential participants may therefore be important in designing and implementing effective peer assessment. OBJECTIVE: To identify factors that, according to students themselves, will encourage or discourage participation in peer assessment. DESIGN: A qualitative study using grounded theory to interpret views shared during 16 focus groups that were conducted by leaders using a semi-structured guide. PARTICIPANTS: Sixty-one students in Years 1, 3, and 4 in 2 mid-western public medical schools. RESULTS: Three themes students say would promote or discourage peer assessment emerged: personal struggles with peer assessment, characteristics of the assessment system itself, and the environment in which the system operates. Students struggle with reporting an unprofessional peer lest they bring harm to the peer, themselves, or their clinic team or work group. Who receives the assessment and gives the peer feedback and whether it is formative or summative and anonymous, signed, or confidential are important system characteristics. Students' views of characteristics promoting peer assessment were not unanimous. Receptivity to peer reports and close positive relationships among students and between students and faculty mark an environment conducive to peer assessment, students say. CONCLUSIONS: The study lays a foundation for creating acceptable peer assessment systems among students by soliciting their views. Merely introducing an assessment tool will not result in students' willingness to assess each other.

Attitude of Health Personnel↗
PubMed2002

Why is prostate cancer screening so common when the evidence is so uncertain? A system without negative feedback.

The degree of enthusiasm for prostate cancer screening seems high given the limited evidence of benefit and the well-documented harms of treatment that include impotence and incontinence. The purpose of this review is to understand the reasons for enthusiasm and positive reinforcement perceived in clinical decisions about whether to screen, whether to choose aggressive therapy for cancer, and in how to view adverse effects following therapy. We discuss a case of a man who must decide whether to undergo prostate-specific antigen screening and treatment to illustrate the kinds of reinforcement that may occur for each decision.Strong positive reinforcement for each decision would make screening and aggressive therapy appear to be successful and the correct decision even if prostate cancer screening and therapy were not beneficial. A physician is positively reinforced for recommending screening, regardless of the test result, because a negative result makes a patient grateful for reassurance and a positive result makes a patient grateful for early detection. A patient who is impotent and incontinent after a decision for curative treatment may attribute his survival to surgery and be grateful for having his cancer cured. Individual experience provides almost no negative feedback that early detection and aggressive treatment may not work. Although reinforcement operates similarly in other medical decisions, the example of prostate cancer provides insight into the strength of the forces at work because the personal harms, which are relatively common and dramatic, are readily discounted or explained away. Even if prostate cancer screening is eventually demonstrated to provide benefit for asymptomatic persons, it is important to appreciate the strength of forces that may act independently of benefit and reinforce decision makers' choices to be aggressive about screening and treatment. Interventions should be considered to temper possible overenthusiasm for screening and treatment.

Aged↗
PubMed2005

Rethinking procrastination: positive effects of "active" procrastination behavior on attitudes and performance.

Researchers and practitioners have long regarded procrastination as a self-handicapping and dysfunctional behavior. In the present study, the authors proposed that not all procrastination behaviors either are harmful or lead to negative consequences. Specifically, the authors differentiated two types of procrastinators: passive procrastinators versus active procrastinators. Passive procrastinators are procrastinators in the traditional sense. They are paralyzed by their indecision to act and fail to complete tasks on time. In contrast, active procrastinators are a "positive" type of procrastinator. They prefer to work under pressure, and they make deliberate decisions to procrastinate. The present results showed that although active procrastinators procrastinate to the same degree as passive procrastinators, they are more similar to nonprocrastinators than to passive procrastinators in terms of purposive use of time, control of time, self-efficacy belief, coping styles, and outcomes including academic performance. The present findings offer a more sophisticated understanding of procrastination behavior and indicate a need to reevaluate its implications for outcomes of individuals.

Achievement↗
PubMed1998

Ethical considerations in contemporary medicine.

Numerous benefits brought along by the impressive technological progress of the contemporary world are also accompanied by potential hazards of dehumanization of life. As neither medicine has been skipped over by the technological progress, there is a risk for the physician to become dependent on it rather than master it. Therefore, there is the risk of deprivation of medical ethics norms, ever more frequently transforming the patient's position of the subject of medical activities into the position of an object. This pending risk is especially present in surgery, a medical discipline characterized by the highest technological and technical differentiation. If the surgeon is to preserve high ethical standards in his work, he should strictly follow the basic medical ethics norm, that proclaim full respect of the patient's will, forbid doing harm to the patient, and point to equity and compassion on providing medical aid. These ethical norms should be respected not only on performing surgical procedures, but also on making indications for the procedure. The future development of medicine and surgery, with a substantial impact of new, technical and technological advances, will open new, presently unknown ethical issues. All this will require through sociophilosophical and humane-ethical considerations in order to preserve the basic medical ethics norms warranting humaneness and ethics of medicine.

Ethics, Medical↗
PubMedDate not supplied

[The prevention of HIV infection and other blood-contact diseases among intravenous narcotic users in Nizhniy Novgorod within the framework of the Harm Reduction program].

The results of the development and realization principles of the project on the decrease of harm, envisaging work in three directions (the determination of the technology of using drugs, the exchange of syringes/needles and other accessories, as well as laboratory examination for the presence of antibodies to HIV, hepatitis B and hepatitis C viruses and consultations of narcologists). 1075 injecting drug users took part in this project. Out of 611 participants filling-in the questionnaires, 338 persons underwent tests for HIV and 3 of them were found to be HIV-infected; out of 305 persons screened for the presence of markers of hepatitis B virus, positive results were obtained in 98 (32% of cases); in 218 (65%) out of 335 persons antibodies to hepatitis C virus were found (49 persons, i.e. 14%, had hepatitis C registered in the medical history and in the rest antibodies were detected for the first time). The preventive program of the decrease of harm was assessed as effective.

Adolescent↗
PubMed2001

Ventilator-induced lung injury and recommendations for mechanical ventilation of patients with ARDS.

Mechanical ventilation is life sustaining and is the standard therapy for acute respiratory failure. The 16th century anatomist Vesalius is often credited for the earliest account of positive-pressure ventilation. In his work De humani corporis fabrica (On the Fabric of the Human Body), he described how an animal could be resuscitated by blowing into a reed inserted into a hole in its trachea. Although positive pressure ventilation using bellows was first used for drowning victims in the 1700s, there were soon concerns that such therapy could in fact be harmful to the lungs. In 1827, Leroy d'Etoille condemned bellows ventilation after discovering that it could lead to emphysema and tension pneumothoraces. Subsequently, positive pressure ventilation would be virtually abandoned for over 100 years. Despite this early concern about the potential for harm from mechanical ventilation, it is only in the last one to two decades that research into so-called ventilator-induced lung injury (VILI) has blossomed. Indeed, although initial studies have focused on which ventilatory parameters are associated with the most (or least) harm, there has been an explosion of research in the last 5 years attempting to delineate the basic cellular mechanisms by which mechanical ventilation injures the lung. Recently, there has been exciting evidence to suggest that lung injury induced by mechanical ventilation may have important systemic consequences, including multi-organ dysfunction. Lastly and most importantly, there is accumulating data from clinical trials in humans that ventilatory strategies designed to avoid VILI can in fact save lives.

Journal Article↗
PubMed1994

Social work and the development of a smoke-free society.

This article explores reasons for social work's minimal involvement in the development of programs and policies related to smoking cessation and proposes how social workers can engage in a range of micro, mezzo, and macro activities. The extensive literature on the harmful effects of smoking is reviewed, and a rationale for social work involvement is presented, namely, that the profession focus on those populations that are already vulnerable and among whom smoking rates are rising, including poor people, less-educated people, young women, aboriginal people, and some visible minorities. Whereas other health professions have been declarative about their positions on smoking, social work has not registered its concern. However, considerable opportunities exist for counseling individuals, offering group education and support services, developing policies for a smoke-free environment, and influencing government policymakers to promote health.

Health Promotion↗
PubMed2006

'They stand you in a corner; you are not to speak': nurses tell of abusive indoctrination in work teams dominated by bullies.

This paper reports some of the findings from the first qualitative stage of a large national study of bullying in the nursing workplace currently being undertaken in Australia. The findings reported here reveal how relationships between bullies were embedded within informal organizational alliances, enabling bullies to control work teams and use emotional abuse and psychological violence as a means of enforcing bully-defined 'rules of work'. Within nursing teams, bullies controlled work roles, tasks, and status in the nursing hierarchy through enforcing their 'rules'. Bullies enforced these rules through a process of ritual indoctrination, destroying the self-confidence and self-image of those targeted, and forcing them to eventually resign their position or acquiesce to survive. The merciless, calculated and deliberate nature of the bullying resulted in profound harm for many of those targeted. The findings of this research have implications for the understanding and management of workplace bullying.

Aggression↗
PubMed1990

Prophylactic therapy for variceal hemorrhage revisited.

The high mortality of a first variceal bleed in cirrhotic patients even in very recent studies makes some effective form of primary prophylaxis desirable. Controlled studies of shunt and nonshunting surgery have shown that these operations can prevent variceal hemorrhage only at the expense of increased morbidity and mortality. Therefore, this type of surgery has no place in the primary prophylaxis of variceal bleeding. Liver transplantation, however, is becoming a real therapeutic alternative for many patients with chronic liver disease. Obviously, it will prevent bleeding in many patients, but primary prophylaxis of bleeding itself is not an indication for a transplant. The radically different results of randomized controlled trials of prophylactic sclerotherapy indicate that it is either very helpful and will save many lives or very harmful and will lead to death in patients who would otherwise survive. The cumulative evidence from the trials that took appropriate care of effective treatment for the acute bleed and that had no major problems with complications of the procedure itself suggests that prophylactic sclerotherapy is neither helpful nor very harmful. Thus, there is also no indication for prophylactic sclerotherapy in clinical routine. Personally, I even doubt that it should be used in future controlled trials in the light of the positive results of the prophylactic trials of beta-blockers. If there is an indication for prophylactic treatment, it should be the last invasive treatment available. In the near future, work should focus on the confirmation and further development of endoscopic or other simple and safe means to predict the risk of first bleeding; on the development and characterization of effective drugs; and on development of methods to identify at an early stage responders and nonresponders. If I presently had large varices that had not yet bled, I would like to join one of my senior colleagues and look for admission to the Control group of an ongoing randomized beta-blocker trial.

Esophageal and Gastric Varices↗
PubMed1997

Flexion test of the metacarpophalangeal and interphalangeal joints and flexion angle of the metacarpophalangeal joint in sound horses.

This paper describes the application of a measuring device 'Flextest' to control the effect of traction force and traction time during flexion tests of the distal limb joints of the forelimbs. The optimal force for a flexion test is 100 N, over 1 min. A higher force (150 N) was not harmful. A slightly positive flexion response (100 N/1 min) in a horse with no other clinical signs or radiographic abnormalities is not of clinical significance. Individual left and right flexion and extension angles are almost identical and do not depend on age. Stabled horses which have been rested or horses resting at pasture are less likely to have a positive flexion test than working horses.

Animals↗
PubMed1996

Ethical problems in the relationship between health and work.

Throughout history, the relationship between employers and workers has been subject to the equilibrium of power, to legislative norms, to ethical considerations, and more recently to scientific knowledge. The authors examine the ethical conflicts that arise from the application of scientific knowledge to preventive health policies in the workplace. In particular, they discuss the ethical conflicts in the application of screening practices, in the setting of "allowable limits" of harmful work exposures, and in the right of workers to be informed about work hazards. Ethical problems are also created by conflicting interests in the protection of the environment, the health of the general public, and the health of the working population, and by conflicting interests among workers, and even within the individual worker, as in the case of "fetal protection" policies. The authors emphasize the positive use of scientific information and respect for human dignity in resolving these conflicts.

Behavior Control↗
PubMed1995

How reliable are clinical trials? The importance of the criteria for early termination.

The early termination of clinical trials, for either benefit or harm, often generates undue enthusiasm or alarm. The enhanced publicity attending early termination of a trial promotes inappropriate interpretations that are aided by the inherent difficulty of prompt and comprehensive data review. Furthermore, the process of monitoring the accumulating outcome data for early evidence of treatment benefit or harm is fraught with many statistical and methodological difficulties. This article is based on a report from a Task Force convened by the Working Group on Arrhythmias of the European Society of Cardiology. It reviews, as examples to illustrate the importance of suitable trial design and of proper stopping rules, a series of trials terminated appropriately or inappropriately for benefit or harm; it analyses the general design issues and it reviews the main issues in interim analysis with special reference to main strategies for reducing the rate of false-positive claims that could result from early trial termination.

Arrhythmias, Cardiac↗
PubMed2005

Eumelanin and pheomelanin concentrations in human epidermis before and after UVB irradiation.

Pheomelanin is widely thought to be causally related to susceptibility to the harmful effects of ultraviolet radiation: epidemiological studies show that those with a higher ratio of pheomelanin to eumelanin in hair have higher rates of melanoma, and work in mouse and cell culture shows that pheomelanin generates excess free radicals after UVR exposure. By contrast, based on measurements of eumelanin and pheomelanin in human skin, before and following irradiation, we now report that both pheomelanin and eumelanin are positively related to skin colour, and by inference, inversely with cancer susceptibility. The ratio of melanin classes is similar in people with widely different cancer rates and UVR sensitivity. Although our numbers are small, our results extend previous work in man, and lead us to speculate that factors other than the amount of pheomelanin may be important in determining UVR susceptibility in persons with red hair.

Epidermis↗
PubMed2006

Reducing repeat victimization among high-risk victims of domestic violence: the benefits of a coordinated community response in Cardiff, Wales.

The goal of Multi-Agency Risk Assessment Conferences (MARACs) is to provide a forum for sharing information and taking actions to reduce harm to high-risk domestic violence victims. Interviews with participants and victims, observations, and police data reveal how the MARACs work in practice and also what they can accomplish. Results showed MARACs to be invaluable: Agencies assisted victims more efficiently, primarily through enhanced information sharing. MARACs improve victims' safety because both police and victim data revealed that 6 in 10 victims had not been revictimized. These positive results demonstrate the benefits of a coordinated community response.

Community Health Services↗
PubMed1988

Act No. 18.620, 27 May 1987.

This Act approves the Labor Code, which contains the following major provisions: 1) discrimination on the basis of sex is prohibited in contracts of employment; 2) at least 85% of an employer's workers must be of Chilean nationality, including foreigners who have a Chilean spouse or children or who have been resident in Chile for more than five years; 3) women are guaranteed maternity leave with full pay and benefits for six weeks before delivery and 12 weeks afterwards, which can be increased as necessary if the woman becomes ill during pregnancy or after delivery, as demonstrated by a medical certificate; 4) a woman cannot renounce this leave, her position must be kept open during her absence, and her contract cannot be terminated for a year after maternity leave has ended without a judge's approval; 5) a mother is entitled to leave with full pay and benefits to care for a seriously ill child less than one year old, as demonstrated by a medical certificate; 6) during pregnancy, women who are occupied in work considered harmful to their health are to be transferred to other work without a reduction of salary; and 7) establishments that employ 20 or more workers are to provide child-care facilities where mothers can feed their children and the children can remain while the mothers work; the costs of these facilities are to be paid for by the employer.

Americas↗
PubMed2006

[Pathophysiological basis of mechanical ventilation].

Mechanical ventilation is required if ventilatory insufficiency is present. This is typically indicated by hypercapnea. Hypoxemia occurs secondary to hypoventilation. Usually overload of the respiratory muscles (ventilatory pump) will be the underlying mechanism, for the most part caused by acute or chronic disease. In case of sole hypoxemia mechanical ventilation will only be indicated if the oxygen-content (equals oxygen saturation x haemoglobin x 1.39) drops below a critical threshold or if ventilatory pump failure is imminent on account of the underlying disease (eg. pneumonia). The background of our recommendations is to avoid potential damage caused by mechanical ventilation. Especially high inspiratory pressures and oxygen concentrations can be harmful to the lung. Therefore every case has to evaluated for individual target parameters of ventilation. The use of the oxygen-content instead of the arterial oxygen pressure as the target parameter will usually lead to a more careful ventilation. Cardiogenic pulmonary oedema is an exception to this rule since inspiratory positive pressure and PEEP will result in improved diffusion as well as reduction of preload and work of breathing. In recent years progress has been made on the field of ventilation access especially in severe and acute cases. Non-invasive ventilation is superior to invasive ventilation in patients with exacerbated COPD since it improves outcome effectively. This is being caused by a decline in ventilator associated pneumonias, most likely because non-invasive ventilation allows patients to clear their secretions by coughing, resulting in improved lung clearance. Controlled ventilation allows optimal unloading of the respiratory muscles which have been overloaded by the underlying disease. Application of a controlled ventilation mode in acute disease will usually require some kind of sedation. Assisted ventilation will result in improved gas exchange but only incomplete unloading of respiratory muscles and therefore delayed restitution. Permanent controlled ventilation under sedation for a prolonged period (days) requires intermittent periods of assisted- or spontaneous breathing in order to avoid atrophy of the respiratory muscles. This review summarizes background information on the nature of the derangement, the relation between oxygen supply and consumption under special consideration of respiratory muscle insufficiency and impact of different ventilation modes.

Acute Disease↗