Relationship Between Ergonomic Awareness and Work-related Musculoskeletal Disorders Among Staff Nurses in Oman: An Observational Study.

Objectives: To detect the level of ergonomic awareness related to work-related musculoskeletal disorders among 200 staff nurses in a tertiary hospital. The additional objective was to study the relationship of such awareness with the prevalence of these disorders. Methods: A group of 25-45-year-old staff nurses and a body mass index of ≤ 30 kg/m2, with at least one year working experience were randomly selected from different wards of the Royal Hospital, Muscat. The study excluded nurses who were on leave and those who had sustained traffic accidents or sports injuries in the preceding year. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used to measure the work-related musculoskeletal disorders experienced by the nurses. A second questionnaire was administered to measure their ergonomic awareness. The data was statistically analyzed. Correlations were established by Spearman's rank correlation coefficient (ρ). Results: The participants were 200 staff nurses (male = 30 male, female = 170). Analysis of the ergonomics awareness construct indicated 'agreement' as an overall response with a mean of 3.2±0.6, indicating fair ergonomic awareness. For CMDQ, 50.3% reported discomfort in the low back region, 15.0% in the neck, and 6.9% in the right lower leg. The left wrist, left forearm, and right upper arm had the least reported discomfort (< 1.0%). The correlation between ergonomic awareness and working ability was weakly positive, yet statistically significant (ρ = 0.210; p = 0.003). Correlations were not statistically significant between ergonomic awareness and discomfort (ρ = -0.031; p = 0.664) and between ergonomic awareness and total frequency (ρ = 0.109; p = 0.123). Conclusions: There is a strong need to develop practical ergonomic awareness among nursing staff for a sustainable and safe work environment.

Pharyngeal pressure differences between four types of swallowing in healthy participants.

PURPOSE: The aim of this observational study was to identify biomechanical differences, as measured by pharyngeal manometric pressure patterns, between discrete and continuous water swallowing, as well as volitionally initiated and reflexive swallowing. METHODS: Using pharyngeal manometry, swallowing-related pressures from 24 young healthy individuals were recorded at three locations: upper pharynx, mid-pharynx and upper oesophageal sphincter (UES) during four swallowing conditions: discrete saliva swallowing, discrete 10ml water swallowing, volitional continuous water swallowing, and reflexive continuous water swallowing. Measures of peak pressure and pressure duration at each level were compared across conditions using repeated-measures analysis of variance. RESULTS: UES nadir pressure during saliva swallowing was lower than during water swallowing conditions (p<0.05). In addition, nadir pressure during discrete 10ml water swallowing was lower than during reflexive and volitional continuous water swallowing conditions (p<0.05). Saliva swallowing produced longer pressure duration than water swallowing conditions at the upper pharynx (p<0.05). Saliva swallowing produced pressure of greater duration than reflexive continuous water swallowing at mid-pharynx (p<0.05). Further, discrete 10ml water swallowing produced longer UES opening duration and longer pharyngeal pressure generation (p<0.05) than reflexive continuous water swallowing or saliva swallowing. CONCLUSION: Pressure generation differs between swallowing types and bolus types at the level of the UES in particular. These physiological differences between swallowing and bolus types may support clinical decisions for individuals with impaired swallowing.

Effects of repeated volitional swallowing on the excitability of submental corticobulbar motor pathways.

The aim of this study was to examine the effects of repeated volitional saliva swallowing on corticobulbar excitability recorded during two muscle preactivation conditions of the submental muscle group. Motor-evoked potentials (MEPs), elicited by transcranial magnetic stimulation (TMS), were assessed in ten healthy volunteers prior to and at 5, 30, 60, and 90 min after 60 volitional saliva swallows (Protocol A). To control for intrinsic fluctuations in corticobulbar excitability during this assessment period, MEPs were also recorded, on a different day, at 30-min intervals across a 2-h period (Protocol B). At each assessment, 15 MEPs were recorded during two submental muscle preactivation conditions: volitional contraction and contraction associated with the pharyngeal phase of volitional swallowing. There were no significant effects of repetitive volitional swallowing or time on MEP measures (p>0.05). We conclude that volitional saliva swallowing does not have immediate effects on the excitability of corticobulbar projections to the submental musculature during volitionally initiated swallowing motor tasks. These results provide no evidence for use-dependent potentiation of corticobulbar excitability through repetitive saliva swallowing. The lack of effects of time on mean MEP measures supports previous reports of good intrasession reliability of MEPs as a measure of corticobulbar excitability.