Work : a journal of prevention, assessment, and rehabilitation
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We aimed to evaluate associations between vocational computer use and 1) ulnar neuropathy, and 2) ulnar neuropathy- like symptoms as distinguished by electroneurography. We identified all patients aged 18-65 years, examined at the Department of Neurophysiology on suspicion of ulnar neuropathy, 2001-2007. We mailed a questionnaire to 546 patients with ulnar neuropathy, 633 patients with ulnar neuropathy-like symptoms, and three community referents per case, matched on sex, age, and primary care centre. ⋯ The two outcomes were not associated with daily hours of computer use. Findings suggested specific effects of pressure on the elbow, and might be an explanation for the overweight of left-sided outcomes in this primarily right-handed group. Preventive efforts would then be straightforward by providing appropriate arm support for the left arm and elbow.
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Review Meta Analysis
Proper manual handling techniques to prevent low back pain, a Cochrane systematic review.
Training and provision of assistive devices are considered major interventions to prevent and treat low back pain (LBP) among workers exposed to manual material handling (MMH). To establish the effectiveness of training and provision of assistive devices in preventing and treating LBP an update of a Cochrane literature review was performed to November 2010. ⋯ No study on treatment was found. None of the included RCTs and CCTs provided evidence that training and provision of assistive devices prevented LBP when compared to no intervention or another intervention.
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Despite significant medical advances, cardiac surgery remains a high risk procedure. Sub-optimal work system design characteristics can contribute to the risks associated with cardiac surgery. However, hazards due to work system characteristics have not been identified in the cardiovascular operating room (CVOR) in sufficient detail to guide improvement efforts. ⋯ We performed thematic analysis of the qualitative data guided by a work system model. 60 categories of hazards such as practice variations, high workload, non-compliance with evidence-based guidelines, not including clinicians' in medical device purchasing decisions were found. Results indicated that hazards are common in cardiac surgery and should be eliminated or mitigated to improve patient safety. To improve patient safety in the CVOR, efforts should focus on creating a culture of safety, increasing compliance with evidence based infection control practices, improving communication and teamwork, and designing better tools and technologies through partnership among all stakeholders.
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The main objective of this work is to propose a method and a tool to support the development of indicators able to inform an organization about the state of its resilience through a cyclical process of identifying its resilience factors, proposing resilience indicators, assessing its organizational resilience followed by assessing and improving the resilience indicators. The research uses concepts from complex adaptive systems and from resilience engineering to establish an initial set of indicators able to assess elements that contribute to organizational resilience, and structures them temporarily as a hierarchy. A software application to support indicator definition and structuring, questionnaire generation, and result assessment activities was built to assist in speeding up the experiment-adjust cycle. Prototype indicators were instantiated with helicopter operating companies in mind, and were reviewed by a domain expert.
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Endotracheal Intubation (ETI) is an airway procedure commonly used to secure the airway for a variety of medical conditions. Proficiency in ETI procedures requires significant clinical experience and insufficient data currently exists describing the physical ergonomics of successful direct laryngoscopy. The research objectives of this study were to examine how ETI time, error and practitioner biomechanics varied among clinical experience levels and hospital bed heights. ⋯ Expert participants exhibited less ulnar deviation and forearm supination during task trials, as well as a higher utilization of the bicep brachii and anterior deltoid muscles. Expert grasped instrumentation differently, requiring less wrist manipulation required to achieve ideal instrument positions. By encouraging ergonomic best-practices in hand and arm postures during ETI training, the opportunity exists to improve patient safety and reduce the learning curve associated with ETI procedures.