Understanding and managing the long-term cognitive consequences of traumatic brain injuries.

This editorial critically evaluates the current data on traumatic brain injuries and their effects on cognitive function. It discusses management strategies and clinical considerations to improve patient outcomes in light of these findings.

Effects of negatively sloped keyboard wedges on risk factors for upper extremity work-related musculoskeletal disorders and user performance.

Several changes to computer peripherals have been developed to reduce exposure to identified risk factors for musculoskeletal injury, notably in keyboard designs. Negative keyboard angles and their resulting effects on objective physiological measures, subjective measures and performance have been studied, although few angles have been investigated despite the benefits associated with their use. The objective of this study was to quantify the effects of negative keyboard angles on forearm muscle activity, wrist posture, key strike force, perceived discomfort and performance and to identify a negative keyboard angle or range of keyboard angles that minimizes exposure to risk factors for hand/wrist injuries. Ten experienced typists (four males and six females) participated in a laboratory study to compare keyboard angles ranging from 0 degrees to -30 degrees , at 10 degrees increments, and a keyboard with a 7 degrees slope, using a wedge designed for use with standard QWERTY keyboards. Repeatability of exposures was examined by requiring participants to complete two test sessions 1 week apart. Dependent variable data were collected during 10 min basic data entry tasks. Wrist posture data favoured negative keyboard angles of 0 degrees (horizontal) or greater, compared to a positive keyboard angle of 7 degrees , especially for the flexion/extension direction. In general, the percentage of wrist movements within a neutral zone and the percentages of wrist movements within +/-5 degrees and +/-10 degrees increased as keyboard angle became more negative. Electromyography results were mixed, with some variables supporting negative keyboard angles whilst other results favoured the standard keyboard configuration. Net typing speed supported the -10 degrees keyboard angle, whilst other negative typing angles were comparable, if not better than, with the standard keyboard. Therefore, angles ranging from 0 degrees to -30 degrees in general provide significant reductions in exposure to deviated wrist postures and muscle activity and comparable performance.