Ergonomic Analysis of a Hair Salon

Cosmetology involves a number of diverse tasks that have been implicated in cumulative trauma disorders and in other workplace injuries. This case study presents an analysis of injury risk and prevalence in a salon. Individual, occupational, and organizational factors are considered, and potential areas where risk can be reduced are presented

An Occupational Therapy Guide for Entry-Level Therapists not Specializing in the Treatment of Upper Extremity Dysfunction: Three Common Cumulative Trauma Injuries

According to Kasch, Greenberg, and Muenzen (2003), occupational therapists (OTs) who are initiating entry into upper extremity orthopaedic therapy specialization do not have the knowledge and skills of experienced therapists; a concerning viewpoint considering the fairly high rate of cumulative trauma injuries each year in the United States. Carpal metacarpal osteoarthritis occurs in “approximately 8% of all adults” (Hunter, Schneider, Mackin & Callahan, 1990, p. 886), whereas ulnar neuropathy at the elbow occurs in “10 to 15 percent of adults” (Trumble, 2000, p. 327). “Tennis elbow occurs in approximately one third of the tennis population because of the requirements of sustained power gripping and repetitive use of the wrist extensors” (Hunter, Mackin, Callahan, 1995 p. 1816) and there is an overall reporting by the World Health Organization (2008) that one in seven Americans will sustain a musculoskeletal injury. While many occupational therapists subscribe to specialize in this area of patient treatment, there are multitudes of OTs who are required to treat patients with upper extremity orthopaedic injuries in non-specialized clinics. This poses a problem as many entry-level therapists or practicing OTs have limited experience in the areas of upper extremity orthopaedic dysfunction. While entry-level occupational therapy programs often provide overviews of specialty areas, which include upper extremity orthopaedics, an already crowded curriculum provides restrictive time limits and prevents in-depth coverage of these areas. In addition to the limitations of entry-level occupational therapy orthopaedic exposure, there is a dearth of occupational therapy literature for the entry-level occupational therapist audience. Additionally, literature that does exist is often costly and unaffordable for small clinics in which therapists treat a small number of patients with upper extremity orthopaedic dysfunction. The intention of this product is to provide a cost-effective, comprehensive overview of three common cumulative trauma injuries for the entry-level occupational therapist who is not specializing in the care of patients with upper extremity orthopaedic dysfunction. To write this entry-level protocol for therapists not specializing in the treatment of upper extremity dysfunction, a search for references was conducted. References that were utilized were derived from a variety of literary sources which included the Journal of Hand Therapy and The American Journal of Occupational Therapy. Pre-existing hand therapy protocols were also used. This product includes definitions, prevalence, evaluation, and treatment methods of the three most common cumulative hand injuries: lateral epicondylitis, CMC osteoarthritis and ulnar neuropathy. The information provided within the product may be beneficial for use by entry-level occupational therapists who are not experienced with treating patients with upper extremity dysfunction. The handbook will provide entry-level occupational therapists with ideas on which evaluations are commonly used on certain diagnosis. The handbook will also cover the types of treatment interventions used with specific diagnosis along with corresponding timelines when these treatment methods are the most effective

Occupational and Biopsychosocial Risk Factors for Carpal Tunnel Syndrome: A Case-Control Study

The present study was designed to assess the risk factors associated with carpal tunnel syndrome (CTS). Toward this end, a wide range of putative occupational, biological , and psychosocial correlates of CTS was investigated using a case-control methodology. Cases were 87 patients from an orthopedic clinic with clinical symptoms and electrodiagnostic testing results suggestive of CTS. Controls were 74 gender-matched patients from the same orthopedic clinic, without clinical symptoms of CTS and normal electrodiagnostic testing results. Participants completed a self-report questionnaire that included eight potential occupational correlates (i.e., repetition, force, vibration, typing, lifting heavy loads, and standing on feet), 10 potential personological correlates (i.e., obesity, advocational exercise levels, diabetes, thyroid problems, arthritis, gynecological surgery, and menstrual complications), and 11 potential psychosocial correlates (i.e., depression, anxiety, somatization, health locus of control job satisfaction, and physical and mental health indices). Results of multiple logistic regression analyses revealed that occupational repetition , vigorous exercise, physical activities with wrist strain, physical health, and job satisfaction were significant predictors of CTS. In addition, obesity was a borderline significant predictor of CTS. Plausible explanations for the current findings, along with implications, are discussed

A novel framework for predicting patients at risk of readmission

Uncertainty in decision-making for patients’ risk of re-admission arises due to non-uniform data and lack of knowledge in health system variables. The knowledge of the impact of risk factors will provide clinicians better decision-making and in reducing the number of patients admitted to the hospital. Traditional approaches are not capable to account for the uncertain nature of risk of hospital re-admissions. More problems arise due to large amount of uncertain information. Patients can be at high, medium or low risk of re-admission, and these strata have ill-defined boundaries. We believe that our model that adapts fuzzy regression method will start a novel approach to handle uncertain data, uncertain relationships between health system variables and the risk of re-admission. Because of nature of ill-defined boundaries of risk bands, this approach does allow the clinicians to target individuals at boundaries. Targeting individuals at boundaries and providing them proper care may provide some ability to move patients from high risk to low risk band. In developing this algorithm, we aimed to help potential users to assess the patients for various risk score thresholds and avoid readmission of high risk patients with proper interventions. A model for predicting patients at high risk of re-admission will enable interventions to be targeted before costs have been incurred and health status have deteriorated. A risk score cut off level would flag patients and result in net savings where intervention costs are much higher per patient. Preventing hospital re-admissions is important for patients, and our algorithm may also impact hospital income

Epidemiology, cost and prevention of road traffic crash injuries in Strathclyde, Scotland

Background Road traffic crash (RTC) injuries affect 20 to 50 million people worldwide every year, causing premature death or disability as well as incurring large costs to individuals and society. In the UK, the number of RTC casualties is underestimated if based solely on police records, as many casualties are unreported to the police. “Safety” (speed and red light) cameras have shown to be an effective way of combating RTCs and in 2000 a national scheme was rolled out in the UK. Aim and objectives The overall aim of the study was: To investigate the epidemiology, cost and prevention of RTC injuries in the Strathclyde police region of Scotland. The specific objectives of the study were: 1. To establish the overall epidemiology and accuracy of reporting of RTC injuries in Strathclyde. 2. To determine the epidemiology of RTC injuries and the effectiveness of safety cameras at the camera sites in Strathclyde with special reference to different road users, RTC types and severity, before and after camera installation. 3. To estimate the economic burden of hospital admissions due to RTC injuries in Strathclyde and at the camera sites before and after installation. Methods Nine years (1997 to 2005) of police road casualty records (STATS19) and National Health Service hospitalisation records (SMR01) from the Strathclyde region were linked. The linkage resulted in nearly 11,000 police casualty records relating to approximately 30,000 hospital and death records. Unlinked RTC hospital and police casualties (nearly 9,000 and 70,000 respectively) were also utilised in the analysis. The study employed a range of epidemiological and economic methods. These included descriptive epidemiology (evaluating distributions of linked and unlinked records, length of stay and cost analysis), analytical epidemiology (examining associations using chi square and logistic regression models) and interventional epidemiology (before and after study). The economic evaluation utilised weighted mean costs. The focus of analysis was threefold: 1. Epidemiology of RTC, injuries and accuracy of police recording, 2. Epidemiological impact of safety cameras, 3. Cost of road traffic crashes a) in Strathclyde and b) at safety camera sites. Results Epidemiology of RTC injuries in Strathclyde: Older age and less protected road users (i.e. pedestrians and two-wheeled vehicle users) had a higher risk of a more severe outcome in RTCs. Head injuries were more common among pedestrians and pedal cyclists, while car occupants more often suffered injuries to the thorax and abdomen/lower back/lumbar spine. Accuracy of police reporting: 45% of RTC hospital admissions were not recorded by police. Casualty characteristics significantly associated with underreporting were: no third party involvement, older age, casualties from early in the study period, type of road user (especially pedal cyclist), hospitalisation as a day case and female gender. Seriously injured casualties recorded by police (STATS19) declined in frequency more than the RTC hospitalised injuries (SMR01) (38% and 21% respectively). Linked SMR01 casualties that were coded “slight” by the police increased by 5% over time, while linked SMR01 casualties coded “serious” declined by 27%. Safety camera impact: Compared to the rest of Strathclyde, there was a significantly greater downward linear time trend of RTC incidence at the camera sites. The impact of cameras on RTCs over time appeared stable. Cameras seemed to be effective in reducing the incidence of serious or fatal RTC injuries, as well as injuries associated with multiple-vehicle and non-junction RTCs. Cost of RTC casualties in Strathclyde: Total inpatient costs were conservatively estimated at £7.3 million yearly (linked records). Head and lower extremity injuries incurred the highest total costs (28% and 34% respectively). Pedestrian injuries, constituting 36% of the total, incurred 44% of total costs. Casualties from deprived areas, and pedestrians in particular, incurred higher hospital costs than other road user groups. Cost of RTCs at safety camera sites: 17% of all injured before safety camera installation were hospitalised, while 13% of casualties after installation were hospitalised. The mean costs of (surviving) casualties admitted to hospital declined by 24% after installation and the mean daily cost declined by 55%. Conclusions RTC injury incidence in Strathclyde declined over the study period, which is in line with expectations of developed countries. Young and elderly people as well as unprotected road users carry a disproportionately great RTC injury burden. Many hospitalised RTC casualties were not recorded by police and there appears to have been an increasing tendency over time for police officers to report injuries as slight rather than serious. National (UK) statistics of RTCs should be interpreted with caution in the light of these findings and routinely linking police and hospital data would enhance the quality of RTC casualty statistics. Linking police and hospital RTC records provide a more comprehensive source for road traffic analysis than any of the sources separately. Routine data linkage would also facilitate the evaluation of time trends in relation to national road casualty reduction targets. The study indicates that the most costly RTCs occur in areas with high levels of deprivation, a history of pedestrian RTCs, elderly and child casualties, roads with many non-junction RTCs and 30 mph speed limits. The evaluation of safety cameras strongly suggests that they are effective in reducing both road casualty incidence and severity and that the reduction in incidence is sustained over time. Additionally, safety cameras in Strathclyde may have contributed to a saving of over £5 million. Cameras thus fulfil an important public health, as well as law enforcement, function and should continue to play a central role in traffic calming. This study has demonstrated the value of utilising multiple data sources in the road traffic injury field

Occupational related consequences for relatives of firefighters

Firefighters are exposed to a high prevalence of both occupational and traumatic stress, consequently protective factors, such as social support, become highly relevant to the well-being of this population. Accordingly the psychological health of firefighters is maintained, in part, by their family (Regehr, Dimitropoulos, Bright, George, and Henderson, 2005; Beaton, Murphy, Johnson, Pike, and Corneil, 1999). This thesis aimed to inform the published literature by establishing a detailed model of occupational impacts of the firefighting occupation on relatives of firefighters and the resources they use to manage those impacts. This was undertaken using a sequential mixed methods approach through three empirical studies. Findings across the thesis include the development of the firefighter becoming a ‘satellite’ family member in order to protect against unusual working patterns, secondary traumatic reactions and relatives’ perception of danger and harm within the occupation. In addition to this, findings clearly highlight the need for firefighters to share their expertise and job content with their families; facilitating the relatives’ ability to protect their personal resilience and well-being and their firefighter. However if firefighters become disengaged, rather than a ‘satellite’ family member, then their reactions to their job content becomes decontextualised for their relatives. This in turn causes the well-being of relatives to decrease and an increase in secondary trauma of the relative related to their firefighter’s experiences. A prevalence rate of 12% was established for this population of secondary trauma for relatives of firefighters by this thesis. To establish the homogeneity of this population differences were explored based upon rank, length of service of the firefighters, and continent of service, all of which suggest the group is homogenous. Differences of length of time the relative has lived with the firefighter were significant providing further support to the finding that educating relatives about the role of the firefighter is an enabling and protective factor. Implications for theory are discussed, concluding with evidenced-based recommendations to effectively support both firefighters and their families. Practical methods are outlined to develop a positive resource ecology within the fire and rescue service community in order to build collective resilience and protect well-being amongst its membership

Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back

"This critical review of the epidemiologic literature identified a number of specific physical exposures which are strongly associated with specific upper extremity and low back musculoskeletal system disorders (MSDs) when exposures are intense, prolonged, and particularly when workers are exposed to several risk factors simultaneously. Such knowledge would have application in preventive programs in a number of diverse work settings. Specific topics addressed in this review included neck musculoskeletal disorders and the evidence for work relatedness including the impacts of repetition, force, posture, vibration, and the role of confounders; evidence for work relatedness in shoulder musculoskeletal disorders; elbow disorders; hand/wrist disorders including carpal tunnel syndrome, hand/wrist tendinitis, and hand/arm vibration syndrome; low back musculoskeletal disorders with attention given to heavy physical work, lifting and forceful movements, bending and twisting into awkward postures, whole body vibration, and static work postures; and the relationship between work related musculoskeletal disorders and psychosocial factors. Strong evidence was found for increased risk of work related MSDs for some body parts." - p. NIOSHTIC-21. Introduction -- 2. Neck musculoskeletal disorders: evidence for work-relatedness -- 3. Shoulder musculoskeletal disorders: evidence for work-relatedness -- 4. Elbow musculoskeletal disorders (epicondylitis): evidence for work-relatedness -- 5. Hand/wrist musculoskeletal disorders (carpal tunnel syndrome, tendinitis, hand-arm vibration syndrome): evidence for work-relatedness -- 6. Low back musculoskeletal disorders: evidence for work-relatedness -- 7. Work-related musculoskeletal disorders and psychosocial factors -- References -- Appendix A. Epidemiologic review -- Appendix B. Individual factors associated with work-related musculoskeletal disorders (MSDs) -- Appendix C. Summary tables"Second printing"--Cover.Also available via the World Wide Web.Includes bibliographical references (p. R-1 - R-35)

Worker and Public Health and Safety

This book on "Worker and Public Health and Safety: Current Views" brings together current scholarly work and opinions in the form of original papers and reviews related to this field of study. It provides important and recent scientific reading as well as topical medical and occupational information and research in areas of immediate relevance, such as chronic and occupational diseases, worker safety and performance, job strain, workload, injuries, accident and errors, risks and management, fitness, burnout, psychological and mental disorders including stress, therapy, job satisfaction, musculoskeletal symptoms and pain, socio-economic factors, dust pollution, pesticides, noise, pathogens, and related areas

The cognitive antecedents of psychosis-like (anomalous) experiences: variance within a stratified quota sample of the general population

In the general population, psychosis-like experiences have been extensively studied under the psychometric rubric of schizotypy (psychosis-proneness). As such, Phase 1 of this thesis aimed to assess the distribution of schizotypal traits and associated personality correlates displayed within a quota sample of the general population stratified by Gender and Ageband, the emphasis being upon anomalous experiences (positive schizotypy). Respondents (N = 130) completed a battery of established self-report measures assessing thirteen areas of personal experience. Correlational analysis revealed that eleven of the measures of ostensibly anomalous experiences possessed significant intercorrelations. Subsequent principal components analysis identified three factors accounting for 64.91% of the total variance; the factor accounting for the greatest proportion of variance (42.97%) was interpreted as representing a psychological disposition towards reporting ‘Anomalous Cognitions’. The other two factors are named ‘Lifeview System’ (12.60% of total variance) and ‘Social Adaptation Skills’ (9.34% of total variance). From the principal factor inclusion criteria for Phase 2 of the research are explicated. No significant mean Gender differences were revealed for the six self-report measures that provided unique contributions toward anomalous cognitions, the two self-report measures that uniquely contributed toward a lifeview system, or for the single self-report measure that uniquely contributed toward social adaptation skills. Additionally, four of the nine self-report measures which provided unique factorial contributions generated significant mean differences between Agebands, with a further three providing trends toward significant mean differences. Implications for the role of anomalous cognitions, a framework for a lifeview system, and social adaptation skills with regard to psychosis-proneness are discussed. From the primary factor (anomalous cognitions), three experimental groups were identified for cognitive testing: respondents scoring 1) ≤ 20th percentile; 2) 10% ± the mean; and 3) ≥ 80th percentile. This procedure provided a total of 78 participants (three x 26) for Phase 2 testing. Phase 2 of this thesis sought to identify some of the cognitive mechanisms underpinning subclinical anomalous cognitions with a view to deciphering which measures best predicted experimental group membership. A comprehensive literature review highlighted six domains of cognition, five accompanying self-report measures, and two measures of intelligence functioning (verbal and fluid/visuoconstructive), which, following previous research, were utilised as covariate measures. Based on prescribed delineation points, participants were allocated, according to scores on the primary factor from Phase 1, to one of three experimental groups (low-, mid, and high-anomalous cognitions). Of the six cognitive domains—1) sustained visual attention; 2) false (illusory) memory; 3) probability reasoning (decision making); 4) object recognition; 5) reality monitoring; and 6) self-monitoring—four succeeded in eliciting significant mean differences between experimental groups with the noted exceptions of sustained visual attention and self-monitoring. Subsequent canonical discriminant analyses identified that the best predictors of XPG membership were the number of critical lures recognised on the false memory test, the number of correct responses and confidence when uncertain on the object recognition test, plus two self-report measures pertaining to comorbid psychopathology and the vividness of visual imagery. In light of previous research, the inclusion of fasle (illusory) memory biases, the comorbidity of mental pathology (especially, depressive and anxiety-related symptoms), and the vividness of visual imagery are unsurprising; however, the two object recognition variables (the ‘number of correct responses’ and ‘confidence when uncertain’) offer exciting avenues for future research into the continuum of psychosis. Moreover, the ‘confidence when uncertain’ data from the object recognition test (perceptual) and the probability reasoning (decision making) data from the Beads test suggest that cognitive underconfidence may well be an enduring personality disposition in those reporting elevated levels of anomalous cognitions, including positive and disorganised schizotypal personality traits. The results of Phase 2 add confirmatory evidence to previous research suggestive of memory and perceptual biases plus comorbid psychopathology and the vividness of visual imagery as being integral to the psychogenesis of psychosis-like (anomalous) symptomatology

Blinding eye disease in Western Australia: perspectives on data integration

This thesis explores the utility of linked hospital administrative data for evaluating blinding eye diseases and the eye care provided for them in Western Australia. Alternative data sources and methodologies that complement linked data methods were explored. Areas of study were complications of cataract surgery, the epidemiology of blindness, diabetic retinopathy screening and management, causes of vision loss in remote Aboriginals, and the safety of intravitreal anti-vascular endothelial growth factors in age-related macular degeneration