Validity of the Dictionary of Occupational Titles for Assessing Upper Extremity Work Demands

Objectives: The Dictionary of Occupational Titles (DOT) is used in vocational rehabilitation to guide decisions about the ability of a person with activity limitations to perform activities at work. The DOT has categorized physical work demands in five categories. The validity of this categorization is unknown. Aim of this study was to investigate whether the DOT could be used validly to guide decisions for patients with injuries to the upper extremities. Four hypotheses were tested. Methods: A database including 701 healthy workers was used. All subjects filled out the Dutch Musculoskeletal Questionnaire, from which an Upper Extremity Work Demands score (UEWD) was derived. First, relation between the DOT-categories and UEWD-score was analysed using Spearman correlations. Second, variance of the UEWD-score in occupational groups was tested by visually inspecting boxplots and assessing kurtosis of the distribution. Third, it was investigated whether occupations classified in one DOT-category, could significantly differ on UEWD-scores. Fourth, it was investigated whether occupations in different DOT-categories could have similar UEWD-scores using Mann Whitney U-tests (MWU). Results: Relation between the DOT-categories and the UEWD-score was weak (r(sp) = 0.40; p < .01). Overlap between categories was found. Kurtosis exceeded +/- 1.0 in 3 occupational groups, indicating large variance. UEWD-scores were significantly different within one DOT-category (MWU = 1.500; p < .001). UEWD scores between DOT-categories were not significantly different (MWU = 203.000; p = .49). Conclusion: All four hypotheses could not be rejected. The DOT appears to be invalid for assessing upper extremity work demands

Correlates of absolute and excessive weight gain during pregnancy

OBJECTIVE: Factors associated with weight gain during pregnancy that may be linked to maternal overweight and obesity were examined. METHODS: In this observational study, 144 women reported on demographics, (prepregnancy) body weight, and lifestyles in self-reported questionnaires at 30 weeks gestation. Body weight at the end of pregnancy (self-reported at 6 weeks postpartum) was used to determine total gestational weight gain. Multivariate prediction models were developed to identify factors associated with total gestational weight gain and excessive gestational weight gain (i.e., higher weight gain than recommended by the Institute of Medicine). RESULTS: Women gained 14.4 (+/-5.0) kg during pregnancy. Obese women gained almost 4 kg less than normal weight women. Pregnant women judging themselves to be less physically active or women who reported increased food intakes during pregnancy gained significantly more weight. Over one third of women (38%) gained more weight than recommended. Being overweight, judging yourself to be less physically active than others, and a perceived elevated food intake during pregnancy were significantly associated with excessive weight gain (odds ratio [OR] = 6.33, 95% confidence interval [CI]: 2.01-19.32; OR = 3.96, 95% CI: 1.55l, 10.15; and OR = 3.14, 95% CI: 1.18, 8.36, respectively). A higher age at menarche and hours of sleep reduced the odds for excessive weight gain (OR = 0.75, 95% CI: 0.57, 0.99; and OR = 0.35, 95% CI: 0.57, 0.93, respectively). CONCLUSIONS: Mean hours of sleep, perceived physical activity, and measures of food intake at 30 weeks gestation were identified as modifiable behavioral correlates for excessive gestational weight gain. Strategies to optimize gestational weight gain need to be explored, with a focus on the identified factors

Physical activity and aerobic fitness in children after liver transplantation

To determine physical activity (PA), aerobic fitness, muscle strength, health-related quality of life (HRQOL), fatigue, and participation in children after liver transplantation. Children, 6-12 years, at least one year after liver transplantation, participated in this cross-sectional study. Measurements: Time spent in moderate to vigorous PA (MVPA) was measured using an accelerometer, and aerobic fitness (VO2 peak) was measured by cardiopulmonary exercise testing. Muscle strength was measured by hand-held dynamometry. Fatigue was measured using the multidimensional fatigue scale, and HRQOL with the Pediatric Quality of life Core scales and leisure activities was measured using the Children's Assessment of Participation and Enjoyment. Outcomes (medians and interquartile range (IQR)) were compared to norm values. Twenty-six children participated in this study (14 boys, age 9.7 years, IQR 7.7;11.4). Children spent 0.8 hours/d (IQR 0.6;1.1) on MVPA. One child met the recommendation of at least 1 hour of MVPA every day of the week. Aerobic fitness was similar to norms (VO2 peak 1.4 (L)(/min), IQR 1.1;1.7, Z-score -0.3). Z-scores of muscle strength ranged between -1.4 and -0.4 and HRQOL and fatigue between -2.3 and -0.4. Participation was similar to published norms (Z-scores between -0.6 and 0.6). Young children after liver transplantation have similar MVPA patterns and aerobic fitness compared to published norms. Despite lower HRQOL, more fatigue, and less muscle strength, these children have similar participation in daily activities. Although children do well, it remains important to stimulate PA in children after liver transplantation in the context of long-term management

The (cost-)effectiveness of a lifestyle physical activity intervention in addition to a work style intervention on the recovery from neck and upper limb symptoms in computer workers

BACKGROUND: Neck and upper limb symptoms are frequently reported by computer workers. Work style interventions are most commonly used to reduce work-related neck and upper limb symptoms but lifestyle physical activity interventions are becoming more popular to enhance workers health and reduce work-related symptoms. A combined approach targeting work style and lifestyle physical activity seems promising, but little is known on the effectiveness of such combined interventions. METHODS/DESIGN: The RSI@Work study is a randomised controlled trial that aims to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention to reduce neck and upper limb symptoms in computer workers. Computer workers from seven Dutch companies with frequent or long-term neck and upper limb symptoms in the preceding six months and/or the last two weeks are randomised into three groups: (1) work style group, (2) work style and physical activity group, or (3) control group. The work style intervention consists of six group meetings in a six month period that take place at the workplace, during work time, and under the supervision of a specially trained counsellor. The goal of this intervention is to stimulate workplace adjustment and to improve body posture, the number and quality of breaks and coping behaviour with regard to high work demands. In the combined (work style and physical activity) intervention the additional goal is to increase moderate to heavy physical activity. The control group receives usual care. Primary outcome measures are degree of recovery, pain intensity, disability, number of days with neck and upper limb symptoms, and number of months without neck and upper limb symptoms. Outcome measures will be assessed at baseline and six and 12 months after randomisation. Cost-effectiveness of the group meetings will be assessed using an employer's perspective. DISCUSSION: This study will be one of the first to assess the added value of a lifestyle physical activity intervention in addition to a work style intervention in reducing neck and upper limb symptoms of computer workers. The results of the study are expected in 2007

Prevalence of complaints of arm, neck and shoulder among computer office workers and psychometric evaluation of a risk factor questionnaire

<p>Abstract</p> <p>Background</p> <p>Complaints of Arm Neck and Shoulder (CANS) represent a wide range of complaints, which can differ in severity from mild, periodic symptoms to severe, chronic and debilitating conditions. They are thought to be associated with both physical and psychosocial risk factors. The measurement and identification of the various risk factors for these complaints is an important step towards recognizing (a) high risk subgroups that are relevant in profiling CANS; and (b) also for developing targeted and effective intervention plans for treatment. The purpose of the present study was to investigate the prevalence of CANS in a Dutch population of computer workers and to develop a questionnaire aimed at measuring workplace physical and psychosocial risk factors for the presence of these complaints.</p> <p>Methods</p> <p>To examine potential workplace risk factors for the presence of CANS, the Maastricht Upper Extremity Questionnaire (MUEQ), a structured questionnaire, was developed and tested among 264 computer office workers of a branch office of the national social security institution in the Netherlands. The MUEQ holds 95 items covering demographic characteristics, in addition to seven main domains assessing potential risk factors with regard to (1) work station, (2) posture during work, (3) quality of break time, (4) job demands, (5) job control, and (6) social support. The MUEQ further contained some additional questions about the quality of the work environment and the presence of complaints in the neck, shoulder, upper and lower arm, elbow, hand and wrist. The prevalence rates of CANS in the past year were computed. Further, we investigated the psychometric properties of the MUEQ (i.e. factor structure and reliability).</p> <p>Results</p> <p>The one-year prevalence rate of CANS indicated that 54% of the respondents reported at least one complaint in the arm, neck and/or shoulder. The highest prevalence rates were found for neck and shoulder symptoms (33% and 31% respectively), followed by hand and upper arm complaints (11% to 12%) and elbow, lower arm and wrist complaints (6% to 7%). The psychometric properties of the MUEQ were assessed using exploratory factor analysis which resulted in the identification of 12 factors. The calculation of internal consistency and cross validation provided evidence of reliability and lack of redundancy of items.</p> <p>Conclusion</p> <p>Neck and shoulder complaints are more frequently reported among Dutch computer workers than arm, elbow and hand complaints. The results further indicate that the MUEQ has satisfactory reliability and internal consistency when used to document CANS among computer workers in the Netherlands.</p

Prevalence of low back pain and associated occupational factors among Chinese coal miners

<p>Abstract</p> <p>Background</p> <p>Very few studies have evaluated the association between occupational factors and low back pain (LBP) among miners. The epidemiological data on LBP in Chinese miners are limited. The aim of this study was to measure the prevalence of low back pain in Chinese coal miners and to investigate the role of occupational factors.</p> <p>Methods</p> <p>A cross-sectional survey was conducted to examine 1573 coal miners in northern China. The prevalence of LBP over a 12-month period was assessed using the Nordic Musculoskeletal Questionnaire. Odds ratios were calculated to examine the association between the prevalence of LBP over a 12-month period and occupational factors using logistic regression.</p> <p>Results</p> <p>Among the coal miners, 64.9% self-reported LBP in a 12-month period. Occupational factors associated with LBP were identified, including tasks with a high degree of repetitiveness (OR 1.3, 95%CI 1.0-1.6), tasks characterized by a high level of physical demand (OR 1.4, 95% CI 1.1-1.8), posture requiring extreme bending (OR 1.6, 95% CI 1.2-1.7) and insufficient recovery time (OR 1.4, 95% CI 1.0-1.8).</p> <p>Conclusion</p> <p>Low back pain is common among Chinese miners. There were strong associations with occupational factors.</p

Which factors engage women in deprived neighbourhoods to participate in exercise referral schemes?

ABSTRACT: BACKGROUND: Exercise referral schemes (ERS) have become a popular way of promoting physical activity. The aim of these schemes is to encourage high risk patients to exercise. In evaluating these schemes, little attention has been paid to lower socio-economic groups in a multi-ethnic urban setting. This study aimed to explore the socio-demographic and psychosocial characteristics of female participants in ERS located in deprived neighbourhoods. The second aim was to determine which elements of the intervention make it appealing to participate in the scheme. METHODS: A mixed method approach was utilized, combining a cross-sectional descriptive study and a qualitative component. In the quantitative part of the study, all female participants (n=523) filled out a registration form containing questions about socio-demographic and psychosocial characteristics. Height and weight were also measured. In the qualitative part of the study, 38 of these 523 participants were interviewed. RESULTS: The majority of the participants had a migrant background, a low level of education, no paid job and a high body mass index. Although most participants were living sedentary lives, at intake they were quite motivated to start exercising. The ERS appealed to them because of its specific elements: facilitating role of the health professional, supportive environment, financial incentive, supervision and neighbourhood setting. CONCLUSIONS: This study supports the idea that ERS interventions appeal to women from lower socio-economic groups, including ethnic minorities. The ERS seems to meet their contextual, economic and cultural needs. Since the elements that enabled the women to start exercising are specific to this ERS, we should become aware of whether this population continues to exercise after the end of the schem

Nephronophthisis

Nephronophthisis (NPH) is an autosomal recessive disease characterized by a chronic tubulointerstitial nephritis that progress to terminal renal failure during the second decade (juvenile form) or before the age of 5 years (infantile form). In the juvenile form, a urine concentration defect starts during the first decade, and a progressive deterioration of renal function is observed in the following years. Kidney size may be normal, but loss of corticomedullary differentiation is often observed, and cysts occur usually after patients have progressed to end-stage renal failure. Histologic lesions are characterized by tubular basement membrane anomalies, tubular atrophy, and interstitial fibrosis. The infantile form is characterized by cortical microcysts and progression to end-stage renal failure before 5 years of age. Some children present with extrarenal symptoms: retinitis pigmentosa (Senior-Løken syndrome), mental retardation, cerebellar ataxia, bone anomalies, or liver fibrosis. Positional cloning and candidate gene approaches led to the identification of eight causative genes (NPHP1, 3, 4, 5, 6, 7, 8, and 9) responsible for the juvenile NPH and one gene NPHP2 for the infantile form. NPH and associated disorders are considered as ciliopathies, as all NPHP gene products are expressed in the primary cilia, similarly to the polycystic kidney disease (PKD) proteins

Changing from batch to flow assembly in the production of emergency lighting devices.

Current assembly enterprises are under a lot of pressure, as they are faced with increasing volume demands and product variations, needs for shorter delivery times and cost reduction. This pressure is likely to increase the pressure on individual workers. In many small to medium-sized enterprises (SMEs), we observe that traditional assembly concepts are no longer fulfilled. These are challenged to find other concepts to meet today's demands. In a company where emergency lighting devices are assembled in batches (large series of products are assembled step by step), we applied a participatory and integrative approach to set up a mixed flow assembly system including ergonomically designed work stations. In this paper, we describe the approach and the effects which were studied by a within-subject design. We observed an increase of 44% in productivity and a reduction in order lead time of 46%. The time that workers spent to added-value activities increased significantly from 74% to 92%, without any increase in postural and experienced loads. Instead, the workers experienced significantly less overall fatigue at the end of the day in the new situation. The results show the potential benefits of the approach for the many SMEs where products are assembled in batches and faced with the problem of meeting current production demands. © 2005 Taylor & Francis Group Ltd