Inanspruchnahme von Angebotsuntersuchungen in der arbeitsmedizinischen Vorsorge

In den vergangenen zehn Jahren wurde die arbeitsmedizinische Vorsorge zu einem individuellen Arbeitsschutzinstrument weiterentwickelt, das der Aufklärung und Beratung der Beschäftigten über die Wechselwirkungen zwischen Arbeit und Gesundheit dient und bei dem die Selbstbestimmungs- und Datenschutzrechte zu achten sind. In dem vorliegenden Forschungsprojekt hat das Institut für Arbeitsmedizin, Sozialmedizin und Versorgungsforschung der Universitätsklinik Tübingen exemplarisch untersucht, welche Faktoren für die erfolgreiche Durchführung von Angebotsuntersuchungen bedeutsam sind. Die Studie bedient sich hierfür eines multimodularen Ansatzes mit qualitativen und quantitativen Anteilen. Im Ergebnis wird sichtbar, dass die Verordnung zur arbeitsmedizinischen Vorsorge (ArbMedVV) in der Praxis angekommen ist. Zum Teil werden arbeitsmedizinische Vorsorge und Eignungsuntersuchungen jedoch nicht adäquat unterschieden. Mit der Änderung der ArbMedVV Ende Oktober 2013 konnten bereits wichtige Klarstellungen erreicht werden. Unsicherheiten bestehen auch im Zusammenhang mit den so genannten Berufsgenossenschaftlichen Grundsätzen, die teilweise irrtümlich als verbindlich verstanden werden. Hier besteht noch Änderungs- und Klarstellungsbedarf. Übergreifend zeigt die Studie, dass die Inanspruchnahme der arbeitsmedizinischen Vorsorge maßgeblich vom Kenntnisstand aller Beteiligten zur Rechtslage abhängt und das Vertrauensverhältnis zum Betriebsarzt für die Beschäftigten von besonderer Bedeutung ist. Aufklärungsarbeit spielt deshalb auch weiterhin eine wichtige Rolle

EDUCAÇÃO EM SAÚDE NA COMUNIDADE: AÇÕES EXTENSIONISTAS EM UMA COMUNIDADE DO SUL DO BRASIL

Objetivo: Relatar sobre as práticas comunitárias de educação em saúde desenvolvidas pelo projeto de extensão “Educação em Saúde na Comunidade” da Faculdade de Enfermagem da Universidade Federal de Pelotas, em uma comunidade vizinha ao Campus Porto. Método: trata-se de um relato de experiência das atividades realizadas por meio de visitas domiciliárias, oficinas em escolas do bairro e em um grupo de mulheres, além de contato com as lideranças comunitárias. Resultados: Desde a fundação do projeto em 2010, foi realizado um total de 598 visitas domiciliárias. Nas oficinas da escola municipal e no grupo de mulheres da comunidade, foram realizadas, desde 2012, um total de 28 atividades de educação em saúde.  Considerações finais: A extensão universitária possibilita ao estudante uma formação crítica e voltada para o envolvimento social, estimulando o comprometimento e o respeito com cada indivíduo.

Cumulative occupational lumbar load and lumbar disc disease – results of a German multi-center case-control study (EPILIFT)

Background The to date evidence for a dose-response relationship between physical workload and the development of lumbar disc diseases is limited. We therefore investigated the possible etiologic relevance of cumulative occupational lumbar load to lumbar disc diseases in a multi-center case-control study. Methods In four study regions in Germany (Frankfurt/Main, Freiburg, Halle/Saale, Regensburg), patients seeking medical care for pain associated with clinically and radiologically verified lumbar disc herniation (286 males, 278 females) or symptomatic lumbar disc narrowing (145 males, 206 females) were prospectively recruited. Population control subjects (453 males and 448 females) were drawn from the regional population registers. Cases and control subjects were between 25 and 70 years of age. In a structured personal interview, a complete occupational history was elicited to identify subjects with certain minimum workloads. On the basis of job task-specific supplementary surveys performed by technical experts, the situational lumbar load represented by the compressive force at the lumbosacral disc was determined via biomechanical model calculations for any working situation with object handling and load-intensive postures during the total working life. For this analysis, all manual handling of objects of about 5 kilograms or more and postures with trunk inclination of 20 degrees or more are included in the calculation of cumulative lumbar load. Confounder selection was based on biologic plausibility and on the change-in-estimate criterion. Odds ratios (OR) and 95% confidence intervals (CI) were calculated separately for men and women using unconditional logistic regression analysis, adjusted for age, region, and unemployment as major life event (in males) or psychosocial strain at work (in females), respectively. To further elucidate the contribution of past physical workload to the development of lumbar disc diseases, we performed lag-time analyses. Results We found a positive dose-response relationship between cumulative occupational lumbar load and lumbar disc herniation as well as lumbar disc narrowing among men and women. Even past lumbar load seems to contribute to the risk of lumbar disc disease. Conclusions According to our study, cumulative physical workload is related to lumbar disc diseases among men and women

In-situ estimation of ice crystal properties at the South Pole using LED calibration data from the IceCube Neutrino Observatory

The IceCube Neutrino Observatory instruments about 1 km3 of deep, glacial ice at the geographic South Pole using 5160 photomultipliers to detect Cherenkov light emitted by charged relativistic particles. A unexpected light propagation effect observed by the experiment is an anisotropic attenuation, which is aligned with the local flow direction of the ice. Birefringent light propagation has been examined as a possible explanation for this effect. The predictions of a first-principles birefringence model developed for this purpose, in particular curved light trajectories resulting from asymmetric diffusion, provide a qualitatively good match to the main features of the data. This in turn allows us to deduce ice crystal properties. Since the wavelength of the detected light is short compared to the crystal size, these crystal properties do not only include the crystal orientation fabric, but also the average crystal size and shape, as a function of depth. By adding small empirical corrections to this first-principles model, a quantitatively accurate description of the optical properties of the IceCube glacial ice is obtained. In this paper, we present the experimental signature of ice optical anisotropy observed in IceCube LED calibration data, the theory and parametrization of the birefringence effect, the fitting procedures of these parameterizations to experimental data as well as the inferred crystal properties.</p

TXS 0506+056 with Updated IceCube Data

Past results from the IceCube Collaboration have suggested that the blazar TXS 0506+056 is a potential source of astrophysical neutrinos. However, in the years since there have been numerous updates to event processing and reconstruction, as well as improvements to the statistical methods used to search for astrophysical neutrino sources. These improvements in combination with additional years of data have resulted in the identification of NGC 1068 as a second neutrino source candidate. This talk will re-examine time-dependent neutrino emission from TXS 0506+056 using the most recent northern-sky data sample that was used in the analysis of NGC 1068. The results of using this updated data sample to obtain a significance and flux fit for the 2014 TXS 0506+056 "untriggered" neutrino flare are reported

Galactic Core-Collapse Supernovae at IceCube: “Fire Drill” Data Challenges and follow-up

The next Galactic core-collapse supernova (CCSN) presents a once-in-a-lifetime opportunity to make astrophysical measurements using neutrinos, gravitational waves, and electromagnetic radiation. CCSNe local to the Milky Way are extremely rare, so it is paramount that detectors are prepared to observe the signal when it arrives. The IceCube Neutrino Observatory, a gigaton water Cherenkov detector below the South Pole, is sensitive to the burst of neutrinos released by a Galactic CCSN at a level >10σ. This burst of neutrinos precedes optical emission by hours to days, enabling neutrinos to serve as an early warning for follow-up observation. IceCube\u27s detection capabilities make it a cornerstone of the global network of neutrino detectors monitoring for Galactic CCSNe, the SuperNova Early Warning System (SNEWS 2.0). In this contribution, we describe IceCube\u27s sensitivity to Galactic CCSNe and strategies for operational readiness, including "fire drill" data challenges. We also discuss coordination with SNEWS 2.0

All-Energy Search for Solar Atmospheric Neutrinos with IceCube

The interaction of cosmic rays with the solar atmosphere generates a secondary flux of mesons that decay into photons and neutrinos – the so-called solar atmospheric flux. Although the gamma-ray component of this flux has been observed in Fermi-LAT and HAWC Observatory data, the neutrino component remains undetected. The energy distribution of those neutrinos follows a soft spectrum that extends from the GeV to the multi-TeV range, making large Cherenkov neutrino telescopes a suitable for probing this flux. In this contribution, we will discuss current progress of a search for the solar neutrino flux by the IceCube Neutrino Observatory using all available data since 2011. Compared to the previous analysis which considered only high-energy muon neutrino tracks, we will additionally consider events produced by all flavors of neutrinos down to GeV-scale energies. These new events should improve our analysis sensitivity since the flux falls quickly with energy. Determining the magnitude of the neutrino flux is essential, since it is an irreducible background to indirect solar dark matter searches