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[Paper or screen, mother tongue or English--which is better?].

BACKGROUND: The trends in medical publishing are towards electronic versions and the use of the English language. The objective of this study was to compare general practitioners' ability to retain information when reading on paper versus on screen, and in their mother tongue versus in the English. MATERIAL AND METHODS: Randomized controlled trial of 114 Scandinavian general practitioners. They read a review article for 10 minutes either on paper/in English, on screen/in English, on paper/in their mother tongue, or on screen/in their mother tongue. Afterwards they completed a questionnaire with six open questions from the article. The main outcome measure was sum score on a scale from 0 (no correct answers) to 13 (all questions answered correctly). RESULTS: We found no difference between readers of paper and screen versions (median (interquartile range) 4 (2-6) vs. 4 (2-5), p = 0.97). Those who read their mother tongue scored significantly higher than those who read English (4 (3-6) vs. 3 (2-4), p = 0.01). INTERPRETATION: The medium (paper vs. screen) does not influence the ability of general practitioners to retain medical information. Doctors best retain medical information when reading it in their mother tongue.

Adult↗

[Evaluation of the visual function in employees working with computers].

PURPOSE: To evaluate the effects of long-term work with computer monitor on the accommodation, convergence, stereopsis, near and distant visual acuity. MATERIAL AND METHODS: The studies of the accommodation, convergence, stereopsis, near and distant visual acuity have been performed in 50 employees working with the computer 6.5 hours daily, 5-6 days weekly and 5 to 12 years. The same studies have been performed in 50 white-collar workers, who had no contact with the computer in their work. RESULTS: No changes in the accommodation, convergence, stereopsis, near and distant visual acuity have been found in the employees in both studies groups. CONCLUSION: Long-term work with the computer monitor does not cause changes in the visual function of the employees. Reported changes are probably cause by the visual fatigue associated with the near work, and not by the direct influence of the computer monitor.

Accommodation, Ocular↗

[Occupational ophthalmology and ergoophthalmology: a developing field].

In 1979 it was decided to activate, within the Institute of Occupational Health of the Milan "Università degli Studi", a new Unit of Ergophthalmology. This decision was taken owing to the progressive diffusion of "optical instruments", particularly computer-based equipment, in the world of work and to the relevance that this topic assumed among Italian occupational physicians. Since its beginning, one of the main characteristics of the Ergophthalmology Unit was an interdisciplinary approach, where occupational physicians, ophthalmologists, occupational hygienists and lighting engineers were collaborating on a daily basis. Research activities, which developed over many years and in several phases, were concerned with four main topics: 1. analysis and quantification of "near work load"; initially the investigations were mainly aimed at the evaluation of the observation distance in different tasks, followed by the development of a method which, by means of specifically designed electronic equipment, allows quantification of the accommodation and convergence required by the task; 2. development of a new method aimed at evaluating, by a photometric procedure, the luminance ratios in the "occupational visual field"; this research was carried out, both in the laboratory and during on-site investigations, in collaboration with the Dept. of Electrotechnics of Milan Polytechnic; 3. studies on the relationships between indoor microbial pollution and Computer Assisted Design work, considering that ocular conjunctiva and cornea, due to their external position, can be easily inoculated by micro-organisms present on periocular tissue and hands; this research showed that bacteria and fungi pathogenic for the eye (Staphylococcus aureus, Candida sp., Aspergillus sp.) are present on desk, keyboard and mouse, as well as in the conjunctival sac of the exposed operators; 4. studies on "blue light" and its effects on the Pigmented Retinal Epithelium (PRE) in workers exposed to halide lamps, like electricians, installers, maintenance staff, polymerization operators, etc.; the laboratory and on-site investigation that was carried out in cooperation with the Health Physics Dept. of the Milan ICP Hospital, showed that long-term exposure to low levels of irradiation could constitute an eye risk for these working populations.

Computer Terminals↗

Preventing work-related musculoskeletal disorders in VDT users: a comprehensive health promotion program.

As we enter the 21st century, technology has revolutionized the workplace, as nearly half of the working population in the United States currently uses a computer at work. Although computers continue to effectively improve productivity in the workplace, the adverse effects of prolonged computer use on the musculoskeletal system cannot go unnoticed. The astounding rise in computer use in the last decade has been paralleled by a rise in work-related musculoskeletal disorders due to repetitive typing or key entry. Because national ergonomic standards aimed at reducing these injuries have not yet been enforced, the prevention of this national health problem lies in the hands of health care professionals. The following will outline a comprehensive health promotion program, based on Green and Kreuter's PRECEDE-PROCEED model, to serve as an example of how health professionals across the nation can begin to effectively prevent this astronomical problem.

Computer Terminals↗

The effects of a continuous passive motion device on myoelectric activity of the erector spinae during prolonged sitting at a computer workstation.

Continuous passive motion (CPM) has been proposed as a method to help individuals with low back pain cope with prolonged sitting. The purpose of this study was to investigate the effects that a commercially available CPM device had on lumbar and thoracic erector spinae (ES) muscle activation (using surface electromyography, "EMG"), and on subjective discomfort during prolonged seated computer work with and without the use of the CPM device. There were no significant differences in average ES muscle activation levels, amplitude probability distribution functions, and EMG gaps number and length when sitting with the CPM device was compared to sitting normally. Subjective ratings of discomfort were also not significantly different between the two sitting conditions. The results indicated that there were no clear mechanisms by which the CPM device may reduce ES muscle pain and fatigue for the tasks and pain-free individuals studied.

Adult↗

Success with Web-based image access.

The University of Mississippi Medical Center in Jackson, Miss., is the only medical school in the state. We performed 235,000 procedures in the 2001-02 fiscal year. All imaging services within the radiology department are networked to a PACS and are filmless. The elimination of film required that we decentralize our traditional file room to allow easy access to our radiology network across the campus. In our facility, there are three levels of image access: Diagnostic Quality, Review Quality and Web Access. Diagnostic Quality requires top-of-the-line workstations and monitors and is the most expensive. Review Quality workstations represent some savings over Diagnostic and are used in the ICU, orthopedics and surgery. Web Access appears to satisfy most areas outside the main diagnostic department. The account set-up procedure is simple because it uses our intranet email system. Images are easily pasted into presentation applications for articles and conferences. However, the main advantage of Web Access is the low cost. The downside of Web Access is that the images are for review only and are limited by the quality of the monitor in use. It is also somewhat cumbersome to retrieve old or comparison images via this method. The Web only holds approximately 45 days of the most recent images, therefore older studies may not be available. The deployment of this Web-based service has aided in our efforts to reduce the amount of film we print and has also been beneficial in improving patient care through faster service.

Computer Communication Networks↗

Justifying the cost of height-adjustable office work surfaces.

To defeat objections about "expensive" ergonomic product solutions, think like your colleagues do in facilities, real estate, human resources, and IT, and more clearly communicate the broader benefits of adjustable office furniture. The question shouldn't be "How are we going to pay for an improved office environment?" The better questions are, "Can we identify the ways that we already pay for a poor office environment?" and "Can we afford to keep paying?".

Computer Terminals↗

Workstation scheme and implementation for a medical imaging information system.

OBJECTIVE: To discuss the scheme and implementation of workstation configuration for medical imaging information systems suitable to the practical situation in China. METHODS: The workstations were logically divided into picture archiving and communication system (PACS) workstations and radiology information system (RIS) workstations. The former applied to three kinds of diagnostic practice: the small matrix images, large matrix images and high resolution grayscale display applications. The latter consisted many different models defined by the usage and function processes. RESULTS: A dual-screen configuration for image interpretation workstations integrated the image-viewing and reporting procedures physically. Small matrix images as CT or MR were operated on 17 inch (1 inch = 2.54 cm) color monitors, while conventional X-ray interpretation was performed on 21 inch color monitors or portrait format grayscale 2 k by 2.5 k monitors. All other RIS workstations not involved in imaging process were set up with a common PC configuration. CONCLUSION: Workstation schemes for medical imaging information systems should satisfy the basic requirements of medical imaging and investment budget.

China↗

Effect of computer keyboard slope on wrist position and forearm electromyography of typists without musculoskeletal disorders.

BACKGROUND AND PURPOSE: Positioning a computer keyboard with a downward slope reduces wrist extension needed to use the keyboard and has been shown to decrease pressure in the carpal tunnel. However, whether a downward slope of the keyboard reduces electromyographic (EMG) activity of the forearm muscles, in particular the wrist extensors, is not known. SUBJECTS AND METHODS: Sixteen experienced typists participated in this study and typed on a conventional keyboard that was placed on slopes at angles of 7.5, 0, -7.5, and -15 degrees. Electromyographic activity of the extensor carpi ulnaris (ECU), flexor carpi ulnaris (FCU), and flexor carpi radialis (FCR) muscles was measured with surface electrodes, while the extension and ulnar deviation angles of the right and left wrists were measured with electrogoniometers. RESULTS: Wrist extension angle decreased from approximately 12 degrees of extension while typing on a keyboard with a 7.5-degree slope to 3 degrees of flexion with the keyboard at a slope of -15 degrees. Although the differences were in the range of 1% to 3% of maximum voluntary contraction (MVC), amplitude probability distribution function (APDF) of root-mean-square EMG data points from the ECU, FCU, and FCR muscles varied across keyboard slopes. DISCUSSION AND CONCLUSION: Wrist extension decreased as the keyboard slope decreased. Furthermore, a slight decrease in percentage of MVC of the ECU muscle was noted as the keyboard slope decreased. Based on biomechanical modeling and published work on carpal tunnel pressure, both of these findings appear to be positive with respect to comfort and fatigue, but the exact consequences of these findings on the reduction or prevention of injuries have yet to be determined. The results may aid physical therapists and ergonomists in their evaluations of computer keyboard workstations and in making recommendations for interventions with regard to keyboard slope angle.

Adult↗

[Role of spectral filters for refraction dynamics in computer users].

The influence of the spectral-filter (SF) spectacles (when used for an extended time period--for 4 years), produced on the eye refraction of computer users, was studied. The persons in the main and control groups (mean age was, respectively, 49.46 +/- 2.27 and 46.0 +/- 3.28 years, and mean refraction was, respectively, -0.71 +/- 0.42 and -0.88 +/- 0.5 diopters) used the computers on the daily basis for as long as 4 hours during 4 years. A reliable weakening of refraction in its both variants (i.e. reduction of myopia by 0.16 +/- 0.06 diopters, and an increase of hypermetropia by 0.19 +/- 0.04 diopters) was registered in the main group in case of a prolonged use of the SF spectacles. As for the control group, a reliable increase of myopia by 0.25 +/- 0.06 diopters was noted in operators with myopia, and a reliable weakening of refraction (a growth in the level of hypermetropia) by 27 +/- 0.05 diopters was found in operators with hypermetropia and emmetropia. According to questionnaire results, 88.2% of computer operators, who used the SF spectacles, managed to preserve the initial improvement of comfort, while the comfort degree worsened in 11.8% of them.

Adult↗

Techno-stress. A psychophysiological study of employees with VDU-associated skin complaints.

Little is known about the causes of health complaints associated with work with video display units (VDUs). The symptoms are to a large degree similar to those of "multiple chemical sensitivity." We observed 47 white-collar employees with and without VDU-associated skin complaints during a regular workday and a day of leisure. VDU workers with skin symptoms had higher levels of the stress-sensitive hormones thyroxin and prolactin compared with employees without symptoms. They also had lower levels of the anabolic hormone testosterone during work. VDU workers with skin complaints also reported more occupational mental strain. A model is proposed in which physiological signals act as unconditioned stimuli and the VDU environment as the conditioned stimuli.

Arousal↗

Contrast sensitivity and the near point of accommodation after work with a visual display unit.

After several hours of work with a visual display unit (VDU), operators become myopic for a short time. Such transient myopia may be evaluated by measuring contrast sensitivity to a modulated grating pattern. The aim of the present study was to determine whether there are any accumulative myopic effects after 1 day of VDU work. We examined grating contrast sensitivity in a group of 13 full-time workers and in 13 office employees who used VDUs only sporadically. The results, which were compared with the near point of accommodation, clearly illustrated that there is no decrease in contrast sensitivity. In the VDU group the decrease in the near point of accommodation was uniformly distributed between zero and 1.0 diopter, whereas among the non-VDU workers 77% of the decrease was between zero and 0.25 diopter. We conclude that the myopic changes in the refractive status of operators after VDU work are not evident in a decrease in contrast sensitivity. However, in VDU workers the dynamic range of accommodation was smaller, suggesting that the visual fatigue and visual stress that developed at work hindered visual activities after work.

Accommodation, Ocular↗

Increasing compliance with stretch breaks in computer users through reminder software.

In order for a repetitive strain injury (RSI) prevention program to be effective, it is important to implement strategies to maintain a client's compliance with the program. This quantitative study explored the effectiveness of computer reminder software in increasing compliance with a stretching program designed to prevent RSI associated with prolonged computer use. Data were collected from a convenience sample of 26 participants who were instructed in a preventative stretching program and assigned to either a treatment group with the computer reminder software, or a control group without the software. To measure compliance, all participants recorded the number of times per day they stretched. Although a statistically significant difference was not found in the mean number of stretch breaks taken by the two groups (p = 0.09), further analysis suggested a type II error may have occurred. The effect size, d, revealed a large effect suggesting that the computer software had an impact on the frequency of stretch breaks, with the mean number of breaks per hour of work greater for the treatment group. Results strongly suggest that further research is warranted in this area.

Adult↗

A comprehensive work injury prevention program with clerical and office workers: phase I.

The risk for the development of musculoskeletal disorders and associated conditions in clerical and office workers is well documented. The majority of work injury prevention programs for this population were single-faceted (education, workstation redesign, or task modification) and yielded both positive and negative findings. This pilot study was conducted with 16 full-time clerical and office workers at a small private college. In a randomized control trial, the intervention group received four hours of individualized training through a multi-faceted injury prevention program. Between group differences in musculoskeletal symptom frequency and intensity and perceived stress and energy levels existed, although were statistically insignificant. There was a statistically significant decrease in Lower Back ache/pain from pre to post measures for the intervention group.

Accidents, Occupational↗

[Postural tenosynovitis caused by misuse of a computer input device (mouse)].

Several reports of postural problems among video display unit workers are available, most frequently involving the back, neck and shoulder. The case described is an example of tenosynovitis of the right wrist at the point where the wrist rests on the work surface while operating the mouse in a computer workstation (2-3 hours/day 6 days/week). The alteration was caused by a combination of friction and pressure on the wrist joint tendon due to the faulty positioning of the hand and wrist. This is the normal resting position for the wrist (inclined towards the ulnar side), and is thus the most natural position to adopt. The reported alteration, which responded to a short period of rest and treatment with non-steroid anti-inflammatory drugs for 2-3 days, is described as an example of common injury caused by an unusual faulty posture of the hand. The preventive measures suggested to avoid the occurrence of this type of injury include: (i) instead of resting the weight of the hand on the ulnar side of the wrist it should be distributed between the two pads of fatty tissue which form the base of the palm, (ii) the mouse button could be clicked with the third finger instead of the index finger in order to avoid the tendency of hand to roll into the faulty rest position.

Computer Terminals↗