The importance of an ergonomic workstation to practicing sonographers.

Musculoskeletal disorders have been described in a number of professions over the years. They are defined as injuries that are caused by or aggravated by workplace activities, and they account for up to 60% of all workplace illnesses. They are known by different names, such as musculoskeletal disorder, repetitive strain injury, cumulative trauma disorder, and repetitive motion injury. Musculoskeletal disorders have only been identified in sonographers since 1997 but are increasing in incidence. Surveys done among American and Canadian sonographers in 1997 showed an 84% incidence; however, this incidence had increased to 90% by 2008. Understanding the importance of optimal body mechanics and how to maintain neutral postures will enable sonographers to reduce the risk factors associated with their profession. Even with the most advanced equipment, an ergonomic workstation is only as effective as the person using it.

An analysis of occupational factors related to shoulder discomfort in diagnostic medical sonographers and vascular technologists.

OBJECTIVE: Three-fourths of diagnostic medical sonographers (DMS) and vascular technologists (VT) experiencing discomfort due to job demands indicate having discomfort in the shoulder region. An analysis of factors related to shoulder discomfort highlighted salient factors requiring further investigation and intervention. PARTICIPANTS: The respondents were a convenient sample of DMS and VT that answered a survey, hosted on a secure website. METHODS: The responses of 2,163 DMS and VT from a survey of a representative sample were analyzed to determine personal factors, work demands, and workstation design characteristics of those experiencing discomfort in the shoulder region. Frequencies and response distributions were calculated and cross tabulation with chi-square analysis was completed. RESULTS: A majority of respondents with shoulder discomfort have co-morbid reports of discomfort in other locations. While overall sonographer discomfort is linked to age and years of experience, shoulder discomfort was also noted to be linked to specific workstation characteristics. A lack of adjustability in equipment, picture archiving and communication system (PACS) workstations, and positions required to complete bedside exams contributes to discomfort due to sustained and repetitive shoulder abduction and twisting of the neck and trunk. CONCLUSIONS: There is a need for studies investigating redesign of equipment and workstations or interventions with DMS and VT specifically focused on improving adjustability and improved positioning of sonographers in order to reduce shoulder discomfort while performing job demands.

A multicenter study to provide evidence of construct validity in a computer-based outcome measure of neurology clinical skills.

BACKGROUND: Using computer-based simulation to assess clinical skill-a key competence for medical trainees-enables standardization and exposure to a broad sample of physical findings. The purpose of this study is to provide evidence of construct validity for a computer-based outcome measure of neurology clinical skills. METHOD: A total of 128 medical students and neurology residents at four institutions volunteered to take a 34-question computer-based test designed to measure neurology clinical skills. Subjects were classified into three groups based on level of training: novice, intermediate, and experienced. RESULTS: Overall performance increased with level of training. Question difficulty discriminated between groups as predicted. Twenty-six of 34 individual items discriminated between novices and more advanced learners. This test separated learners at different levels of training with a consistency of .92. CONCLUSION: This study provided evidence of construct validity for a computer-based outcome measure of neurology clinical skills.

Dental health of elderly confederate veterans: evidence from the Texas State Cemetery.

Analysis of the skeletal remains of 50 Confederate veterans provided a unique opportunity to explore the dental health of a geriatric sample. These men, who died between 1907-1932, had an average age at death of 76.7 years. Ninety percent were institutionalized at the Confederate Home for Men (Austin, TX) prior to their deaths. This elderly sample was assessed in terms of caries, antemortem tooth loss (AMTL), abscesses, and linear enamel hypoplasias. On a per tooth basis, the AMTL rate was 57.2%. Of 39 dentate men, 33 (84.6%) had dental caries, and 24.4% (121 of 496) of teeth were carious. Ten (25.0%) of the dentate men had hypoplastic teeth. At least one abscess was seen in 14 (28%) of 50 individuals. Results from this geriatric institutionalized sample are compared to contemporaneous historical samples. Disparities in dental health among these groups may be due to differences in average age at death, and these comparisons allow a better understanding of dental changes that occur with age. The sample is also compared to modern elderly samples: modern groups have higher caries rates, possibly because they retained more teeth. This finding may be due in part to diets in the United States becoming increasingly cariogenic over time. In addition, dental care has moved from the reactive practices seen in the nineteenth and early twentieth centuries (such as tooth extractions) to modern proactive solutions dedicated to preserving and restoring teeth (such as tooth brushing, fluoride treatments, and dental fillings).