Work-related musculoskeletal disorders in Polish sonographers-A questionnaire study.

PURPOSE: The ultrasound specialists face a substantial issue with work-related musculoskeletal disorders (WMSDs), characterized by occupation-related pain, reaching an estimated frequency of up to 90.5%. The type and location of pain vary depending on the sonographers specialty and the specific anatomical areas being examined. Our study aimed to assess the prevalence and intensity of pain among Polish doctors from various specialties conducting ultrasound examinations. MATERIALS AND METHODS: The study has been performed between July and December 2023, involving 90 participants (51.9% women) actively practicing ultrasound diagnostics. The data collection process utilized a structured questionnaire developed by the researchers for this study. The questionnaire covered personal factors, including gender and age, and work-related aspects like workplace, specialty, sonography experience, and the types of examinations conducted. Statistical analysis involved both descriptive statistics and correlation analysis. RESULTS: The age distribution ranged from 26 to 74 years, with mean (SD) of 43.1 (12.2) years. The leading specialties among physicians were radiology (22.2%) and internal medicine (22.2%). Among all physicians, 65.6% reported pain during or after ultrasound scans, with a mean (SD) pain intensity of 6.17 (2) in a 1-10 scale. The analysis indicated no correlation between age and gender and the occurrence of discomfort. CONCLUSIONS: WMSDs pose a significant risk to Polish sonographers, especially those specializing in vascular surgery, general surgery and obstetrics and gynecology specialties. The study underscores a notable deficit, with only 10% of the personnel reporting training in ergonomics for ultrasound work.

Notas sobre Chernobyl¹: análise de alguns aspectos relacionados às situações de trabalho da usina nuclear de Pripyat / About Chernobyl: analysis of some factors related to work situations in Pripyat nuclear power plant

A partir da série televisiva Chernobyl e dos relatos do livro de Svetlana Aleksiévitch, Vozes de Tchernóbyl, que tratam do acidente nuclear em Pripyat, em 1986, este artigo discute os aspectos relacionados às condições e às relações de trabalho que as cenas evocam. A tragédia de Chernobyl pode ser vista como um acidente de trabalho, tendo ocasionado entre 4.000 e 93.000 mortes. Os aspectos que se pretende examinar dizem respeito às relações de poder, à relação entre o trabalho prescrito e o trabalho real e demais fatores. Na análise proposta, serão usadas as contribuições da psicodinâmica do trabalho, da saúde do trabalhador, da ergonomia francófona e de discussões teóricas acerca do mundo do trabalho. Ainda que as reflexões aqui levantadas sejam suscitadas a partir de adaptações constituídas de doses variáveis de ficção, elas podem ser úteis à discussão de aspectos que podem levar ao adoecimento no trabalho.

Based on the sitcom Chernobyl and the stories of Svetlana Aleksiévitch's book, Tchernobyl voices, about the Pripyat's nuclear accident in 1986, this article discusses aspects related to the work relations and conditions that are evoked by the scenes. The Chernobyl tragedy can be seen as a work accident that caused 4000 to 93000 deaths. The aspects to be discussed are related to power relations, the relation between prescribed work and real work, and others. In the proposed analysis, contributions of work psychodynamics, worker health, French ergonomy and theoretical discussions about the work world will be used. And even with the fact that these reflections are caused by some variable parts of fiction, they can be useful to the discussion of the aspects that may lead to disease in work.

Risk management and the complexity of the right to refuse dangerous work in the context of hospital care: Preliminary issues.

BACKGROUND: Risk management analysis at work makes it possible to find individual and collective experiences of recognition and hierarchization of risks in view of the specificities of labor situations and the complex and contradictory application of the right to refuse in health work, whose space and technique are still in a deep structural transformation. OBJECTIVE: To investigate how work organization impacts on the daily life of nursing care, in a general hospital surgical center, (un)enabling individual and collective risk management strategies in the context analyzed and how the right to refuse can be appropriate as a condition and strategy for work management. METHODS: Ergonomics (Work Ergonomic Analysis) was used to bring about the actual work activity and Ergology for epistemological deepening, whose research approach took place in a surgical center with four registered nurses. RESULTS: The results reveal that nursing work is invisible and that individual and collective strategies are used to manage the variability and constraints of the environment. The right to refuse is one of the competencies universe strategies conceived and built at work that ensure the realization of the results found. CONCLUSIONS: The right to refuse is full of meanings. Refusing does not mean "not doing", but also to do otherwise, by other means. It is beyond health and security and can be linked to other variables such as quality, environment, social responsibility.

Assessment of pressure pain threshold at the cervical and lumbar spine region in the group of professionally active nurses: A cross-sectional study.

OBJECTIVES: The problem of spinal pain among nurses and lack of compliance with workplace ergonomy is increasing. The study aimed to assess the pressure pain threshold (PPT) at the cervical and lumbar spine in nursing staff. METHODS: The sample of this prospective and observational study consisted of 30 female nurses with a mean age of 38.6 ± 11.1 years. The standardized Oswestry (ODI) and the Neck Disability Index (NDI) were used, as well as the Authors' Designed Questionnaire (ADQ) was used to assess compliance with ergonomic principles. The PPT analysis using a computerized pressure algometer (CPA) was performed to examine the level of PPT. RESULTS: A mild disability was found in 56% of nurses (NDI and ODI). A value of <4 kg/cm2 (CPA), indicating musculoskeletal overload was observed in 57% of subjects. Also, 60% of nurses work with a lying patient; 73.4% grabs the patient's armpits while transferring in bed; 16.7% never adjusts the height of the bed, and only 13.4% choose specialist footwear for work. There is a correlation between PPT values for trapezius and erector spinae muscles on the same side of the body in nurses with mild and moderate disability (P < .05). CONCLUSIONS: Pain complaints are associated with lower PPT of trapezius and erector spinae muscles and asymmetry of muscle tension. Also, it was noted that the lack of implementation of ergonomic principles by nursing staff affects their degree of disability.

Robotic Technology in Pediatric Neurorehabilitation. A Pilot Study of Human Factors in an Italian Pediatric Hospital.

The introduction of robotic neurorehabilitation among the most recent technologies in pediatrics represents a new opportunity to treat pediatric patients. This study aims at evaluating the response of physiotherapists, patients and their parents to this new technology. The study considered the outcomes of technological innovation in physiotherapists (perception of the workload, satisfaction), as well as that in patients and their parents (quality of life, expectations, satisfaction) by comparing the answers to subjective questionnaires of those who made use of the new technology with those who used the traditional therapy. A total of 12 workers, 46 patients and 47 parents were enrolled in the study. Significant differences were recorded in the total workload score of physiotherapists who use the robotic technology compared with the traditional therapy (p < 0.001). Patients reported a higher quality of life and satisfaction after the use of the robotic neurorehabilitation therapy. The parents of patients undergoing the robotic therapy have moderately higher expectations and satisfaction than those undergoing the traditional therapy. In this pilot study, the robotic neurorehabilitation technique involved a significant increase in the patients' and parents' expectations. As it frequently happens in the introduction of new technologies, physiotherapists perceived a greater workload. Further studies are needed to verify the results achieved.

Baropodometric evaluation of foot load distribution during gait in the group of professionally active nurses.

OBJECTIVES: Nurses are extremely exposed to musculoskeletal overloads. Prolonged standing postural balance distributions, functional deficits and pain may affect the symmetry of the load on the feet. The study aimed to assess the distribution of foot load during gait among nurses. METHODS: The sample of this prospective and observational study consisted of 37 female nurses with mean age of 39 years. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal disturbances and baropodometric gait analysis (BGA) was performed to register distribution of foot load during gait. RESULTS: We showed that 68% of nurses declare that they know the principles of workplace ergonomics, but only 14% comply with them. NMQ results indicate that as many as 73% of the respondents feel ailments in the "lower back" area. An asymmetry was observed in the load of IV-V of the metatarsal head between the left and right foot (P = .000) and in the load of the left and right lateral part of the heel (P = .028) in the BGA test. Correlations between ailments occurring in the neck area and loading of the lateral arch of the right foot (P = .032) were found. Moreover, the load in this area correlated positively with the occurrence of "lower back" pain (P = .045). CONCLUSIONS: Nurses have asymmetric distribution of foot load during gait, which results in a discrepancy between the loads on the three main support points of the foot and which may affect nurses' work productivity.

El papel de las pautas ergonómicas en el manejo de la fibromialgia / The role of ergonomic patterns in the management of fibromyalgia

Introducción: La adopción de las pautas ergonómicas en el manejo de la fibromialgia conducen a mejorar la calidad de vida del paciente, en tanto contribuyen a la disminución de los síntomas que caracterizan la enfermedad. Objetivo: reflexionar sobre la correcta observancia de las pautas ergonómicas en el manejo de la fibromialgia. Desarrollo: Para los trabajadores que padecen de fibromialgia, la posibilidad de mantenerse con una vida laboral activa requiere cambios no solamente en ellos como, sino en las condiciones de trabajo, que les son indispensables dada la naturaleza incapacitante de la enfermedad. Estos pacientes, que por demás están obligados a frecuentes justificaciones por su absentismo, se retiran del mercado laboral o finalmente se adaptan a las desfavorables condiciones de trabajo, adoptando estrategias personales que les permiten mantenerse laboralmente activos. Conclusiones: Un elemento de esencial importancia a ser tomado en cuenta en las enfermedades reumáticas, lo constituyen los factores ergonómicos, que deben encaminar sus pasos al fortalecimiento de una cultura de salud laboral y seguridad, por parte de empleadores y pacientes(AU)

Introduction: the adoption of ergonomic guidelines in the management of fibromyalgia leads to improve the quality of life of the patient, as they contribute to the reduction of symptoms that characterize the disease. Objective: to reflect on the correct observance of the ergonomic guidelines in the management of fibromyalgia. Development: for workers suffering from fibromyalgia, the possibility of maintaining an active working life requires changes not only in them but also in the working conditions that are indispensable because of the incapacitating nature of the disease. These patients, who are often forced to frequent justifications for absenteeism, withdraw from the labor market or finally adapt to unfavorable working conditions, adopting personal strategies that allow them to remain active. Conclusions: an element of essential importance to be taken into account in rheumatic diseases, are the ergonomic factors, which should guide their steps towards strengthening a culture of occupational health and safety, by employers and patients(AU)

[Provision of aids to visually impaired people at the workplace]. / Hilfsmittelversorgung sehbehinderter Menschen am Arbeitsplatz.

The provision of aids for occupational use with partially sighted and blind people is not a measure for the necessary care but for an optimal work performance to secure the long-term occupational participation. This objective requires a significantly expanded consultation, which includes the occupational requirements at the specific workplace. The costs are not usually borne by the statutory health insurance but by another social insurance agency depending on the individual case. In this article several aids are presented in an occupational context, as well as the procedure for provision.

Análise ergonômica e postural dos citologistas de um hospital na cidade de Fortaleza (CE) / Ergonomic and posture analysis of cytologists of a hospital in Fortaleza, Brazil

O objetivo deste estudo foi analisar os aspectos ergonômicos e posturais dos citologistas, bem como a identificação das suas condições ergonômicas no ambiente de trabalho e os fatores que causam ou agravam as lesões por esforços repetitivos. Tratou-se de um estudo de caráter descritivo, observacional e transversal com estratégia de análise quantitativa dos resultados, realizado em um hospital localizado na cidade de Fortaleza (CE). A coleta de dados foi realizada de fevereiro a maio de 2013, através da aplicação de um questionário estruturado sobre assuntos ergonômicos e biomecânicos, e em seguida foi avaliada a condição ergonômica e biomecânica do posto de trabalho e a postura dos citologistas. Foram analisados 15 citologistas de ambos os sexos, 87% (n = 13) do sexo feminino e 13% (n = 2) do sexo masculino, com média de tempo de trabalho de 27,2 ± 1,89 anos e de tempo de trabalho na função atual de 18,73 ± 1,77 anos. Em relação à avaliação ergonômica e biomecânica, observamos que todos os citologistas 100% (n = 15) apresentam repetitividade em sua jornada de trabalho e utilizam posições forçadas. A amostra pesquisada apresentou condições ergonômicas e biomecânicas razoáveis. Evidenciou-se a necessidade de mudanças no posto de trabalho com o intuito de melhorar a qualidade de vida, produtividade e postura dos citologistas, além de incentivar as pausas programadas e a adesão dos funcionários ao programa de Cinesioterapia Laboral.

Current study analyzes the ergonomic and posture aspects of cytologists, ergonomic conditions in their work milieu and the factors that cause or worsen lesions by repeated activities. The descriptive, observational and transversal analysis features strategies for the quantitative investigation of results in a hospital in Fortaleza CE Brazil. Data were collected between February and May 2013 by applying a structured questionnaire on ergonomic and biomechanical items, coupled to the evaluation of the ergonomic and biomechanical condition of the labor milieu and the posture of the cytologists concerned. Fifteen cytologists, 87% (n = 13) females and 13% (n = 2) males, were analyzed, with average labor period of 27.2 ± 1.89 years and labor period as cytologists of 18.73 ± 1.77 years. In the ergonomic and biomechanical assessment, all cytologists (n = 15) practiced repetitions during their work session and employed forced positions. Sample showed mild ergonomic and biomechanical conditions and demonstrated the need of change in the milieu to improve life quality, productivity and posture, adopt programed pause and adhesion to the program for Work Kinesiotherapy.

[A new human machine interface in neurosurgery: The Leap Motion(®). Technical note regarding a new touchless interface]. / Un nouvel interface homme machine en neurochirurgie : le Leap Motion(®). Note technique sur une nouvelle interface homme machine sans contact.

Currently, cross-sectional imaging viewing is used in routine practice whereas the surgical procedure requires physical contact with an interface (mouse or touch-sensitive screen). This type of contact results in a risk of lack of aseptic control and causes loss of time. The recent appearance of devices such as the Leap Motion(®) (Leap Motion society, San Francisco, USA) a sensor which enables to interact with the computer without any physical contact is of major interest in the field of surgery. However, its configuration and ergonomics produce key challenges in order to adapt to the practitioner's requirements, the imaging software as well as the surgical environment. This article aims to suggest an easy configuration of the Leap Motion(®) in neurosurgery on a PC for an optimized utilization with Carestream(®) Vue PACS v11.3.4 (Carestream Health, Inc., Rochester, USA) using a plug-in (to download at: https://drive.google.com/?usp=chrome_app#folders/0B_F4eBeBQc3ybElEeEhqME5DQkU) and a video tutorial (https://www.youtube.com/watch?v=yVPTgxg-SIk).

Prevalence of Voice Disorders and Associated Risk Factors in Teachers and Nonteachers in Iran.

OBJECTIVES: Teachers are at increased risk for development of voice disorders. Because there is no published study on Iranian teachers, the aim of this study was to compare the prevalence of voice disorders among teachers and nonteachers in Iran and define the causing risk factors. METHODS: In the present study, 104 teachers and 41 nonteacher participants, whose jobs did not involve vocal effort, completed a questionnaire regarding to vocal complaint and four relevant risk factors. RESULTS: According to our gained data, 54.6% of teachers experienced vocal complaints during their work, although this value was 21.1% for the nonteacher group (P < 0.001). Moreover, investigating the prevalence of voice disorders during other periods of life was performed. Analyzing the questionnaire data indicated a significant higher vocal load risk factor for teachers (70.77%; standard deviation [SD], 29.48), in comparison with their nonteacher counterparts (27.44%; SD, 37.83; P < 0.001). In addition, our study revealed the significance of vocal load, as well as physical and environmental risk factors in the development of voice disorders in teachers with voice complaints. CONCLUSIONS: Present findings indicated a higher epidemiology of voice problems among teachers in comparison with nonteacher individuals and introduced vocal load as the most important risk factor in development of voice disorder in Iranian teachers. Accordingly, it is recommended to pay special attention to negative effects of vocal load, although environmental and physical factors are also of importance.

Musculoskeletal Function and Obesity: Implications for Physical Activity.

However quantified, obesity is a global health problem of significant magnitude. The condition is no longer limited to the developed world, with an increasing proportion of low-to-middle income countries burdened by obesity and its comorbidities. Specifically, obesity is a risk factor for a raft of psychosocial, physiological, cardiovascular, and metabolic problems. The carriage of excess body weight, including an unhealthy proportion of body fat, also has important implications for musculoskeletal health. To date, this important relationship has not received as much attention by the research community. Coincidentally, there has been a heightened interest in the role of physical activity and exercise across the lifespan in the prevention, treatment and management of obesity. This paper considers some of the more common musculoskeletal problems in children, adolescents and adults with implications for the overweight and obese and their meaningful engagement in physical activity.

Evaluation of manual and automatic manually triggered ventilation performance and ergonomics using a simulation model.

BACKGROUND: In the absence of endotracheal intubation, the manual bag-valve-mask (BVM) is the most frequently used ventilation technique during resuscitation. The efficiency of other devices has been poorly studied. The bench-test study described here was designed to evaluate the effectiveness of an automatic, manually triggered system, and to compare it with manual BVM ventilation. METHODS: A respiratory system bench model was assembled using a lung simulator connected to a manikin to simulate a patient with unprotected airways. Fifty health-care providers from different professional groups (emergency physicians, residents, advanced paramedics, nurses, and paramedics; n = 10 per group) evaluated manual BVM ventilation, and compared it with an automatic manually triggered device (EasyCPR). Three pathological situations were simulated (restrictive, obstructive, normal). Standard ventilation parameters were recorded; the ergonomics of the system were assessed by the health-care professionals using a standard numerical scale once the recordings were completed. RESULTS: The tidal volume fell within the standard range (400-600 mL) for 25.6% of breaths (0.6-45 breaths) using manual BVM ventilation, and for 28.6% of breaths (0.3-80 breaths) using the automatic manually triggered device (EasyCPR) (P < .0002). Peak inspiratory airway pressure was lower using the automatic manually triggered device (EasyCPR) (10.6 ± 5 vs 15.9 ± 10 cm H2O, P < .001). The ventilation rate fell consistently within the guidelines, in the case of the automatic manually triggered device (EasyCPR) only (10.3 ± 2 vs 17.6 ± 6, P < .001). Significant pulmonary overdistention was observed when using the manual BVM device during the normal and obstructive sequences. The nurses and paramedics considered the ergonomics of the automatic manually triggered device (EasyCPR) to be better than those of the manual device. CONCLUSIONS: The use of an automatic manually triggered device may improve ventilation efficiency and decrease the risk of pulmonary overdistention, while decreasing the ventilation rate.

Gestão de Qualidade de Vida no Trabalho (QVT) no serviço público federal: o descompasso entre problemas e práticas gerenciais / Quality of Life at Work (QLW) management in the federal public service: the unbalance between problems and managerial practices

Os programas de Qualidade de Vida no Trabalho (QVT) têm crescido significativamente nos últimos anos. Todavia, o perfil das práticas de QVT em órgãos públicos brasileiros permanece pouco explorado. A presente pesquisa objetivou caracterizar as práticas de QVT em 10 órgãos públicos federais. Realizou-se análise documental e entrevista semi-estruturada. Os dados foram tratados por análise de conteúdo, modalidade categorial temática. Os resultados mostram que as práticas de QVT se caracterizam por nítido descompasso entre problemas existentes e atividades realizadas, com uma abordagem de QVT de viés assistencialista, que tem no trabalhador a variável de ajuste. A análise dos dados fornece importantes elementos para uma agenda de trabalho, tanto acadêmica quanto organizacional, com uma abordagem de QVT de natureza preventiva.

Programs of Quality of Life at Work (QLW) have been increasing significantly in the last years. However, the profile of QLW practices in Brazilian public organs remains little explored. This research aimed at characterizing the QLW practices in 10 federal public organs. A documental analysis and semi-structured interviews were performed. The data were treated by content analysis, thematic categorical modality. Results show that QLW practices are characterized by a clear unbalance between existing problems and activities done, with an assistencialist bias to the QLW approach, which considers the employee as the adjust variable. The data analysis provides important elements to build a work agenda, as academic as organizational, with a preventive nature of the QLW approach.

Prevalencia de sintomatología dolorosa recurrente del ejercicio profesional en cirujanos dentistas

El cirujano dentista está constantemente expuesto a un elevado número de dolencias ocupacionales. Así siendo, el objetivo a través de este estudio fue evaluar la prevalencia de sintomatología dolorosa decurrente del ejercicio profesional en 76 cirujanos dentistas del municipio de Araçatuba, São Paulo, Brasil. Los datos fueron colectados por medio de un cuestionario auto administrable lo cual se verificó que 67 cirujanos dentistas (88,16%) presentaron quejas de dolor decurrentes de la práctica odontológica. Las regiones anatómicas con mayor acometimiento de dolor, según los profesionales, fueron a la espalda, cuello y hombros siendo que, las causas más citadas, en los dos géneros, estuvieron relacionadas a la postura de trabajo inadecuada, realización de movimientos repetitivos y vida sedentaria. Otro dato preocupante está relacionado al elevado valor porcentual de profesionales (17,41%) formados ha menos de 5 años presentando sintomatología dolorosa. Los clínicos generales (22,37%) y los especialistas en dentistica (27,63%) fueron los que presentaron mayores quejas de sintomatología dolorosa. Así siendo, se puede observar delante a este estudio, la necesitad de una mayor conciencia de los cirujanos dentistas sobre los problemas relacionados al elevado numero de profesionales con sintomatología dolorosa, en la busca de la minimización de las dolencias ocupacionales decurrentes de la practica clínica.

Dental Surgeon is frequently exposed at an high number of occupational diseases. So, the aim of this study was evaluate prevalence of painful symptomatology resulting from professional exercise on 76 dental surgeons from Araçatuba City, São Paulo State, Brazil. Data were collected by a self-applied instrument. It was possible to verify that 67 dental surgeons (88,16%) had complaining about pain due dental practice. Anatomic areas with larger occurrence of pain according professionals, were backside of body, neck and shoulder. The more cited causes, had relation with inadequate work posture, realization of repetitive moviments and sedentary life. Another preoccupant data is about high perceptual value of professionals (17,41%) with painful symptomatology and these profissionals conclued their courses before 5 years ago. General dentists (22,37%) and specialists on dentistry (27,63%) were the persons who showed more complaints about painful symptomatology. It was possible to observe the dental surgeons’ necessity of bigger knowledge about the problems related at high number of professionals with painful symptomatology, wishing minimization of occupational diseases resulting from clinic practice.

Reseña histórica de las jornadas costarricenses de medicina legal / Historical review of the jornadas Costarricenses de medicina legal

En noviembre de 1986 se iniciaron las Jornadas de Medicina Legal, gracias al apoyo del Dr. Eduardo Vargas Alvarado y del Dr. Fernando Garzona Messeguer y por supuesto el empeño y empuje de Doña Felicia Montealegre, secretaria del Departamento de Medicina Legal. Desde su inicio la actividad lleno las espectativas de los organizadores y los participantes. En 1993 se hizo un alto, en 1994 el Dr. Jorge Mario Roldán Retana les imprime un nuevo aire. Este segundo aire hoy nos hace sentirnos orgullosos al cumplir quince años de Jornadas.

In november 1986, we started with the Seminary of Legal Medicine, with the support of the Doctors Eduardo Vargas Alvarado and Fernando Garzona Messeguer, also with the support of Mrs. Felicia Montealegre, secretary of the Legal Medicine Department. Since the beginning this activity filled the expectations of the organizers and participants. In 1993 we had a brief stop, in 1994 Doctor Jorge Mario Roldan Retana gave to this activity a new vision. This second chance makes us happy and proud today, as we reach 15 years of annual Seminars.