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At least 1,297 records · Page 72Linked to original sources
PubMed2005

The prediction of safe lifting behavior: an application of the theory of planned behavior.

PROBLEM: Injuries resulting from lifting are costly, and create significant pain and discomfort. While engineering controls are the most effective means of reducing risks, most organizations continue to rely on manual lifting techniques. The problem, however, is that the use of safe-lifting techniques is inconsistent and managers have a difficult time motivating use of these techniques. Consequently, it is important to understand the factors driving safe-lifting behaviors. METHODS: This study used a survey to apply the theory of planned behavior (Ajzen., I., 1991. The theory of planned behavior. Organization Behavior and Human Processes, 50, 179-211) to safe-lifting among 136 materials management employees at a heavy manufacturing organization. Structural equation modeling and factor analysis were employed to analyze relationships among constructs. RESULTS: Results revealed that perceived behavioral control and intention were the strongest predictors of safe-lifting behavior. Subjective norms, to a lesser degree, were also important influences on intention. Attitudes did not surface as effective direct predictors of safe-lifting behavior, but did affect behavior and intent via mediating factors (subjective norms and perceived behavioral control). Finally, the theory of planned behavior was supported as an effective model explaining safe-lifting behavior, and had potential application for many other safety-related behaviors. IMPACT ON INDUSTRY: Results from this study emphasize the importance of perceived behavioral control as a factor associated with safety-related behavior.

Attitude to Health↗
PubMed2004

A randomized clinical trial of treatment for lumbar segmental rigidity.

STUDY DESIGN: A randomized single-blind clinical trial of facet injections plus exercise, versus exercise alone, in chronic disabling work-related lumbar spinal disorders (CDWRLSD), accompanied by pilot interrater reliability and facet syndrome prevalence studies. OBJECTIVES: To systematically investigate the use of facet injections as an adjunct to supervised lumbar stretching exercises in regaining lumbar range of motion (ROM) following prolonged deconditioning after work-related lumbar injuries. To assess interrater reliability of visual assessment of segmental rigidity (SR), and to evaluate the prevalence of facet syndrome in cases of lumbar SR. SUMMARY OF BACKGROUND DATA: Corticosteroid joint injections have often been used to reduce musculoskeletal inflammation to facilitate joint mobilization in the presence of degenerative arthritis. Lumbar segmental rigidity is a recently described entity usually associated with painful chronic spinal disorders and postoperative spine surgery. Previous work has shown that SR and lumbar ROM improves with a brief intervention consisting of facet injections followed by specific stretching exercises. No systematic study has investigated the potential benefits of a combination of facet injections and exercise over supervised exercises alone to treat lumbar SR. Similarly, no study has assessed the association between SR and the facet syndrome. METHODS: From a group of consecutive patients (n = 421) with CDWRLSD referred for tertiary rehabilitation between November 1999 and January 2001, 70 were noted to have SR on intake physical examination. The first part of this study assessed interrater reliability for detecting SR, and intrarater reliability for 3-segment true lumbar ROM measurements. Patients randomly assigned to participate in supervised stretching exercises with the addition of fluoroscopically guided bilateral facet injections at the involved levels (Group A, n = 36) also underwent facet syndrome prevalence assessment at the time of injection. They were compared to a randomly allocated comparison group (Group B, n = 34) undergoing exercises alone in a single-blind design. Physical therapists saw patients an average of twice per week, providing supervision of a progressive home stretching program. Inclinometric joint ROM was measured at the time of group allocation, and again 5 to 7 weeks later. Validated questionnaires of pain (intensity VAS) and disability (Million VAS) related to the CDWRLSD were provided before and after the interventions. RESULTS: Part 1 reliability and facet syndrome prevalence work revealed that interrater reliability for experienced examiners to detect rigid segments was excellent (Pearson's r = 0.97, P < 0.01). Intrarater 3-joint motion measurement reliability was also good for all sagittal/coronal ROM (Pearson's r = 0.95-0.99, P < 0.01). Only 5 of 29 subjects with SR met criteria for facet syndrome (17%), consistent with prior prevalence studies of unselected patients with low back pain. In Part 2, a large majority of patients in both groups improved from the initial to the post-treatment ROM measurements (the primary outcome criterion of the study). However, a higher proportion of Group A (injection) patients (87%-95%) showed ROM improvement, compared to Group B (exercise only) patients (64%-79%). Group A patients showed a significantly greater ROM improvement in all sagittal and coronal movements, both in absolute terms and percent of initial measurement. No significant differences in pain or disability self-report were found between groups, pre- or postintervention, but both groups showed significant improvement from pre- to postintervention in pain and disability assessments. CONCLUSIONS: The detection of SR and measurement of 3-segment true lumbar ROM by experienced examiners is highly reliable. Only 17% of CDWRLSD patients with lumbar SR met criteria for the facet syndrome, a rate approximately equal to that of unselected low back pain cohorts. This indicates that lumbar SR may be found whether or not pain of facet joint origin is present. In the randomized trial, facet injections significantly increased the percentage of patients with SR showing ROM improvement, as well as the degree of improvement in lumbar mobility after treatment. There is no evidence that facet injections increase the improvements in pain/disability report noted in both groups.

Adrenal Cortex Hormones↗
PubMed1996

Age-related accident risks: longitudinal study of Swedish iron ore miners.

The study investigated whether occupational accident risks were equally distributed across age categories over time in the context of production reorganization and work rationalization in a Swedish iron ore mine between 1980 and 1993. Three phases of reorganization, defined by productivity levels, and four age categories were related to age-related accident risk ratios using the Poisson-regression method. Accident risk ratios (ARRs) were found systematically to be higher during the two first phases and also for younger workers, in the cases of both nonspecific and specific accident risks. The steady reduction in accident rates observed did not favor all age groups of workers to the same extent. For two accident patterns out of five, workers in their thirties and forties recorded higher ARRs than those in their fifties.

Accidents, Occupational↗
PubMed1983

A study of the average workers' compensation case.

Investigated information derived from a group of 200 patients seen for psychiatric evaluation that involved Workers' Compensation litigation. Data for these cases include demographic data and MMPI data, including mean profiles and frequent two-point code patterns. Also included in this study are frequencies of presenting complaints grouped into five broad categories. Male vs. female testing patterns are compared. Spanish version patterns on the MMPI are reported. Also, the Spanish version patterns on the MMPI are compared with standard MMPI English versions. This study provides useful information to the practicing clinician who is involved in the diagnostic evaluation process with Workers' Compensation cases. Results are discussed, and special reference is made to validity indicators.

Affective Symptoms↗
PubMed1988

Toward a more valid and reliable Health Locus of Control Scale.

The Multidimensional Health Locus of Control Scale was administered in conjunction with a back care program offered to staff at a psychiatric hospital (N = 82). Validity and reliability of the alternate forms were examined, as was the addition of Forms A and B. The factor structure failed to replicate the original multidimensional construct; hence, suggestions are made to return to the earlier internal/external model and to add the alternate forms to increase reliability.

Adolescent↗
PubMed2002

Early identification and intervention in the prevention of musculoskeletal pain.

BACKGROUND: A large number of people suffer from upper extremity disorders, but a few apparently consume the majority of the resources. Early interventions are badly needed to prevent the development of persistent disability. Since psychological factors are central in the development of a chronic problem these might be utilized in this endeavor. METHODS: A series of studies are described where a screening procedure based on psychological risk factors was employed to help identify people at risk for developing long-term work disability. The utility of a cognitive-behavioral group intervention that focuses on coping strategies as prevention was assessed in three randomized-controlled studies where participants had low, medium, and high risk, respectively. RESULTS: The study with low risk showed no significant difference between the groups, while the studies with medium- and high-risk populations demonstrated significantly lower work disability than control groups receiving treatment as usual. CONCLUSIONS: It appears to be feasible to identify patients with high levels of risk and to subsequently lower the risk for work disability by administering a cognitive-behavioral intervention focusing on psychological aspects of the pain problem.

Arm Injuries↗
PubMed1993

Traumatic rupture of an aortic ulcerative atherosclerotic plaque producing aortic dissection: a complication of interscapular back blows used to dislodge objects from the esophagus.

Penetrating atherosclerotic ulcer of the aorta is a rare entity which usually occurs in the descending thoracic aorta. Herein, we report an unusual case of penetrating aortic ulcer which ruptured into the mediastinum. Interscapular back blows were performed on our patient in an attempt to dislodge an aspirin which she thought was lodged in her esophagus. Unlike previously reported cases of this entity, the penetrating aortic ulcer in our patient was located in the distal thoracic ascending aorta. Diagnosis of penetrating aortic ulcer can be made by utilizing aortography, contiguous dynamic contrast-enhanced computed tomography or magnetic resonance imaging. Treatment consists of adjunctive medical therapy until surgery can be performed.

Aged↗
PubMed2006

High-repetition cyclic loading is a risk factor for a lumbar disorder.

Epidemiological data suggest that prolonged exposure to cyclic lumbar flexion elicits a chronic neuromuscular disorder and disability in workers. This study provides a physiological and biomechanical assessment of various repetitions of cyclic lumbar flexion sessions as a risk factor for development of an acute neuromuscular disorder. An in vivo feline model was subjected to 10 minutes of cyclic (0.25-HZ) loading, followed by a 10-minute rest period, repeated three times in one experimental group, six times in a second group, and nine times in the third group, followed by rest for 7 hours. Displacement of the lumbar viscoelastic tissue and reflex electromyographic (EMG) activity from the lumbar multifidus muscle were monitored. Creep developed and accumulated during each load/rest period and partially recovered during the subsequent rest. Loading periods were characterized by a decrease in reflex EMG activity with superimposed spasms. In the 7-hour recovery period, initial hyperexcitability was present in all groups, whereas only the six- and nine-repetition groups displayed significant delayed hyperexcitability, indicating the presence of acute inflammation. The mathematical model developed fit the data reasonably well, as the R2 values were generally near 0.90. It was concluded that the resulting delayed muscular hyperexcitability constitutes an acute neuromuscular disorder associated with exposure to many repetitions of cyclic lumbar flexion. The acute disorder can become chronic if not allowed sufficient rest to resolve itself. Workers engaged in cyclic lumbar flexion (e.g., loading/unloading, assembly workers) should avoid long-term exposure in order to prevent the development of a chronic neuromuscular condition known as cumulative trauma disorder.

Animals↗
PubMed1978

An assessment of emergency medical technicians' performance as related to seasonal population influx.

The periodic influx of large numbers of people into resort areas substantially increases the use of emergency medical services. This investigation assesses the effects of such a threefold increase in the summer population of the Cape Cod area upon the accuracy of emergency medical technicians' diagnoses and treatments. The technicians' diagnoses for ambulance patients were evaluated against those given by the emergency room physicians during the months of August 1975 and February 1976. The distribution of conditions was similar for both months and the observed frequency of correct diagnoses for common conditions was more than 90% in both months. The overdiagnosis rate of 25% to 50% for common conditions and the correct treatment rate for suspected myocardial infarction of 65% did not vary significantly between summer and winter. Thus, a large influx in population does not seem to affect adversely EMT diagnosis rates. Although misdiagnoses were uncommon, a failure to follow through with a correct treatment for patients with suspected myocardial infarctions, thus indicating the need for better quality control on EMT performance.

Allied Health Personnel↗
PubMed1999

Posttraumatic torsion of accessory lobe of the liver and the gallbladder.

Torsion of an accessory lobe of the liver and of the gallbladder is a rare etiology for acute abdominal pain in children and infants. We report a case of an 8-year-old girl who was admitted with acute epigastric pain and vomiting, after her brother had jumped on her back. Physical examination revealed an afebrile child with a nontender right upper quadrant (RUQ) mass. Color Doppler ultrasound and contrast-enhanced CT demonstrated a heterogeneous, avascular mass with displacement of a thickened-wall gallbladder. A contorted, congested accessory lobe of the liver and the gallbladder were resected at laparotomy. Imaging and operative findings are presented and a differential diagnosis is discussed in order to increase awareness of this rare condition.

Abdominal Pain↗
PubMed2005

The Michel Benoist and Robert Mulholland yearly European Spine Journal Review. A survey of the "surgical and research" articles in the European Spine Journal, 2004.

The Deputy Editor has explained in his editorial the reason for this review. I found it a challenging but very rewarding project. The overall quality of papers was so good that it was very difficult to select the necessarily few which space would allow me to review. Inevitably I am influenced by my particular interests, and hence very many excellent papers will not be discussed; failure to discuss a paper is not a reflection on its quality or importance. Criticisms of papers again reflect my own prejudices.

Athletic Injuries↗
PubMed1995

Treated injuries in northern Vermont.

OBJECTIVES: To study characteristics of injury events and injuries requiring treatment in a Vermont population. METHOD: A one year 30% prospective sample was studied of persons from 22 communities who received first physician care for injury at the Medical Center Hospital of Vermont. RESULTS: Modal injuries were-superficial involving skin only among children below age 10, overexertion injuries among 10-59 year olds, and fractures among older persons. Among interviewed males ages 20-59, 31% of injuries were work related. Among females 26% were work related. Examining hospitalized cases only would have overemphasized falls, chemical injuries, leg fractures, transportation and nursing home injuries, and undercounted overexertion injuries, especially to the back, arm fractures, and injuries during recreation, work and home activities. Most common products/materials in use when injured were recreational equipment (24%) and motor vehicles (9%). Those most often causing injury were ground (20%) and home structures/construction materials (17%). No product was involved in 39% of injury event initiation and 15% of injury causation. CONCLUSION: In order to adequately reflect the distribution of treated injuries in the community by anatomical area, age, and event type studies must examine both emergency department and hospitalized cases and use a data collection system capable of recording several parameters to describe injury events and products/materials involved.

Accident Prevention↗