Association between recovery outcomes for work-related low back disorders and personal, family, and work factors.

STUDY DESIGN: Incident cases of work-related low back disorders were identified in an automotive metal stamping plant. Individuals were asked to recall health and work habits at the time of diagnosis of the work-related disorder and to report their current low back pain and physical functioning. OBJECTIVES: To evaluate five measures of health outcomes for work-related low back disorders in an industrial population and to determine potentially modifiable correlates of recovery. SUMMARY OF BACKGROUND DATA: The factors that influence recovery in actively working adults and how to best measure recovery outcome in this population are not well known. METHODS: Eighty-eight hourly employees of a metal stamping plant who experienced a work-related low back disorder were interviewed. Health status, health habits, and family and work relations were assessed with a structured interview to determine their association with various recovery outcomes (low back pain, low back pain disability, physical functioning, general physical health, and lost workdays). Interview information was supplemented with data from the plant's Occupational Safety and Health Administration Form 200 log. RESULTS: The clinical measures of recovery from the work-related low back disorders examined had similar overall predictive ability. However, in multivariate analyses, different potentially modifiable prognostic variables emerged as significant among them. Poorer self-rated health status and high personal stress were correlated with low back pain disability. Higher levels of cigarette smoking were correlated with higher levels of low back pain disability, lower physical functioning, and more severe low back pain at follow-up. CONCLUSION: The choice of measure of recovery from work-related low back disorders should be made in the context of the rehabilitation intervention goal. Interventions designed to modify and promote healthful personal behavior should be given more emphasis in rehabilitation efforts for work-related low back disorders.

Peroxisomes as sites for synthesis of polyhydroxyalkanoates in transgenic plants.

Bacterial genes responsible for poly(3-hydroxybutyrate) (PHB) biosynthesis were targeted to plant peroxisomes by adding a carboxy-terminal targeting sequence. The enzymes evidently were transported into peroxisomes, retained their catalytic activity, and reacted with peroxisomally available precursors because PHB synthesis in transgenic plant cells was localized to peroxisomes. Up to 2 mg/g fresh weight PHB was produced in suspension cultures of Black Mexican Sweet maize cells after biolistic transformation with three peroxisomally targeted bacterial genes. An equilibrium effect is proposed to explain the unexpected existence of (R)-3-hydroxybutyryl-CoA in plant peroxisomes.

Interaction of Cu(II) 3,5-diisopropylsalicylate with human serum albumin--an evaluation of spectroscopic data.

The copper(II) complex of 3,5-diisopropylsalicylate is a lipophilic water-insoluble binuclear complex, Cu(II)2(3,5-DIPS)4, that has attracted interest because of a wide range of pharmacological activities. This study was undertaken to examine bonding interactions between the complex and human serum albumin (HSA) to help elucidate the mode of transport of the complex in vivo. Electron paramagnetic resonance, numerical magnetic resonance and UV-visible absorption spectroscopic studies were performed using 200 microM aqueous solutions (pH 7.5) of HSA to which had been added up to three molar equivalents of CuCl2, CuSO4, or Cu(II)2(3,5-DIPS)4. Both EPR and UV-visible spectra demonstrated the presence of more than one copper bonding site on HSA, and proton NMR spectra showed that the 3,5-DIPS ligand is also bonded to HSA. These results indicate that there is no observable direct coordination of the ligand to copper in the presence of HSA, and that the majority of the copper and 3,5-DIPS bond to HSA at separate sites. Addition of solid Cu(II)2(3,5-DIPS)4 to HSA at pH 7.5 similarly resulted in spectra suggest that there are no ternary Cu(II)(3,5-DIPS), Cu(II)(3,5-DIPS)2, or Cu(II)2(3,5-DIPS)4 complexes formed with HSA. It is concluded that any ternary complexes formed in the presence of HSA are below the spectroscopic detection limits and represent less than 5% of the total copper.

Growth kinetics, nutrient uptake, and expression of the Alcaligenes eutrophus poly(beta-hydroxybutyrate) synthesis pathway in transgenic maize cell suspension cultures.

Transgenic suspension cultures of Black Mexican Sweet maize (Zea mays L.) expressing the Alcaligenes eutrophus genes encoding enzymes of the pathway for biosynthesis of the biodegradable polymer poly(beta-hydroxybutyrate) (PHB) were established as a tool for investigating metabolic regulation of the PHB pathway in plant cells. Cultures were grown in a 2 L modified mammalian cell bioreactor and in shake flasks. Biomass doubling times for transgenic bioreactor cultures (3.42 +/- 0.76 days) were significantly higher than those for untransformed cultures (2.01 +/- 0.33 days). Transgenic expression of the bacterial enzymes beta-ketothiolase (0.140 units/mg protein) and acetoacetyl-CoA reductase (0.636 units/mg protein) was detected by enzyme assays and immunoblots. However, over the first 2 years of cultivation, reductase activity decreased to 0.120 units/mg proteins. Furthermore, the PHB synthase gene, although initially present, was not detectable after 1.5 years of cultivation in suspension culture. These facts suggest that transgenic expression of PHB pathway genes in plant cells may not be stable. A hydroxybutyrate derivative was detected via gas chromatography even after 4 years of cultivation. Although the method used to prepare samples for gas chromatography cannot directly distinguish among PHB polymer, hydroxybutyryl-CoA (HB-CoA), and hydroxybutyric acid, solvent washing experiments indicated that most or all of the signal was non-polymeric, presumably H-CoA. The synthesis of HB-CoA appeared to be linked to substrate growth limitation, with HB-CoA accumulation increasing dramatically and cell growth ceasing upon depletion of ammonium. This suggests that the PHB synthesis pathway in plants is subject to regulatory mechanisms similar to those in prokaryotic cells.

Work-related injuries of the hand: data from an occupational injury/illness surveillance system.

Administrative and clinical data from a network of occupational medicine clinics were combined to evaluate the utility of these data in the surveillance of non-fatal occupational injuries. Incident cases of work-related hand injuries were characterized to evaluate that process. In 1988, hand and finger injuries were found to be among the most common (n = 4,120) of all occupational injuries recorded in the system. Hand/finger injuries accounted for 30.0 percent of all episodes of work-related injuries treated, with the incidence of these decreasing with increasing company size. Hand injuries were found to be potentially severe with nearly 20 percent resulting from a crushing motion and nearly 10 percent being fractures or amputations. Hands being caught in machines or struck by metal items or hand tools accounted for 36.2 percent of the injuries. A surveillance system based upon ambulatory care data can be a feasible method for identifying priority areas for the prevention of work-related injuries.

Work-related injuries to the foot. Data from an occupational injury/illness surveillance system.

In 1988, a total of 990 work-related injuries to the foot of employees from private-sector companies were characterized in an occupational injury/illness surveillance system maintained by a network of occupational health centers. The mean age of the worker with a foot injury was 34.2 years (+/- 12.0), with 83% occurring among men; 22.3% of the cases were fractures or sprains/strains. Jobs involving extensive manual material handling or vehicular operations were the most often listed occupations among those with work-related foot injuries. Across occupational groups, being struck by an object accounted for 58.4% of the foot injuries. Regardless of industry group, metal items and vehicles were related to 50.7% of all work-related foot injuries. Specifically, foot injuries were found to be associated with being struck by boxes, metals, or vehicles, or to being caught in, under, or between vehicles or machinery. A peak of work-related injuries involving the foot is observed during the summer months.

Strong cash flow, balance sheet, management, key to capital needs. Symposium on Healthcare Directions: the capital financing imperative.

For a full day, 10 individuals representing varied health fields and viewpoints within the healthcare industry discussed a number of topics confronting health care and predicted what the environment is likely to be in three years (see accompanying sidebars for symposium participants and purpose). This article focuses on one of the symposium topics, capital availability and financing, and the implications in a time of declining utilization.