Effects of age, sex, and anthropometric factors on nerve conduction measures

Associations among measures of median, ulnar, and sural nerve conduction and age, skin temperature, sex, and anthropometric factors were evaluated in a population of 105 healthy, asymptomatic adults without occupational exposure to highly repetitive or forceful hand exertions. Height was negatively associated with sensory amplitude in all nerves tested ( P < 0.001), and positively associated with median and ulnar sensory distal latencies ( P < 0.01) and sural latency ( P < 0.001). Index finger circumference was negatively associated with median and ulnar sensory amplitudes ( P < 0.05). Sex, in isolation from highly correlated anthropometric factors such as height, was not found to be a significant predictor of median or ulnar nerve conduction measures. Equations using age, height, and finger circumference for prediction of normal values are presented. Failure to adjust normal nerve conduction values for these factors decreases the diagnostic specificity and sensitivity of the described measures, and may result in misclassification of individuals. © 1992 John Wiley & Sons, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50152/1/880151007_ftp.pd

An anti-inflammatory diet as treatment for inflammatory bowel disease: a case series report

BACKGROUND: The Anti-Inflammatory Diet (IBD-AID) is a nutritional regimen for inflammatory bowel disease (IBD) that restricts the intake of certain carbohydrates, includes the ingestion of pre- and probiotic foods, and modifies dietary fatty acids to demonstrate the potential of an adjunct dietary therapy for the treatment of IBD. METHODS: Forty patients with IBD were consecutively offered the IBD-AID to help treat their disease, and were retrospectively reviewed. Medical records of 11 of those patients underwent further review to determine changes in the Harvey Bradshaw Index (HBI) or Modified Truelove and Witts Severity Index (MTLWSI), before and after the diet. RESULTS: Of the 40 patients with IBD, 13 patients chose not to attempt the diet (33%). Twenty-four patients had either a good or very good response after reaching compliance (60%), and 3 patients\u27 results were mixed (7%). Of those 11 adult patients who underwent further medical record review, 8 with CD, and 3 with UC, the age range was 19-70 years, and they followed the diet for 4 or more weeks. After following the IBD-AID, all (100%) patients were able to discontinue at least one of their prior IBD medications, and all patients had symptom reduction including bowel frequency. The mean baseline HBI was 11 (range 1-20), and the mean follow-up score was 1.5 (range 0-3). The mean baseline MTLWSI was 7 (range 6-8), and the mean follow-up score was 0. The average decrease in the HBI was 9.5 and the average decrease in the MTLWSI was 7. CONCLUSION: This case series indicates potential for the IBD-AID as an adjunct dietary therapy for the treatment of IBD. A randomized clinical trial is warranted

The effectiveness of a joint labor-management program in controlling awkward postures of the trunk, neck, and shoulders: Results of a field study

Awkward working posture at the trunk, neck and shoulders may be caused by a number of factors, including: workstation layout, visual demands of the job, design of equipment and tools, and work methods. Because awkward posture is a recognized risk factor for the development of fatigue, discomfort, and/or disability, the elimination or reduction of awkward work posture is a major objective of many workplace ergonomic programs.A longitudinal study was undertaken in a large automotive corporation to evaluate the effectiveness of a participative union-management program in reducing work-related musculoskeletal injuries and disorders, including those caused by awkward postures. Following a one-week training program, plant personnel used checklists to evaluate posture on 335 jobs in selected departments at four participating plants. The results of these evaluations were used to develop an intervention program in each plant for controlling awkward postures. To evaluate the effectiveness of the intervention programs, a subset of 151 jobs was tracked by an independent team of university-based ergonomists who performed comprehensive posture analyses at six-month intervals.The independent evaluation found that the labor-management teams were generally effective in reducing awkward postures at the trunk and shoulders. There were significant decreases in the time spent in awkward trunk and shoulder postures as a result of interventions that were implemented during the study. However, the teams were not effective in controlling neck postures as the frequency of awkward neck postures actually increased over the course of the study.Most of the successful intervention projects involved modifications to workstation layout in order to reduce or eliminate low, far, or overhead reaches associated with awkward trunk and shoulder postures. Interventions that required changes in product design or major changes in manufacturing processes were generally not observed during the monitoring period.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/31032/1/0000709.pd

A checklist for evaluating ergonomic risk factors resulting from awkward postures of the legs, trunk and neck

A one-page checklist for determining the presence of ergonomic risk factors associateed with awkward postures of the lower extremities, trunk and neck was developed and evaluated as part of a joint labor-management ergonomics intervention program. This checklist was used by plant personnel at four work sites to assess the postural requirements on 335 cyclical (i.e., work-cycle duration less than five minutes) manufacturing and warehouse jobs. In addition, results generated by the checklist were compared to the results of ergonomic analyses performed by persons with advanced training in occupational ergonomics.Workers were observed using awkward postures for most of the jobs in the survey. Awkward postures of the lower extrimities were relatively uncommon, occuring in 25 percent or less of the jobs. Awkward postures of the trunk and neck were common, occuring in more than 70 percent of the jobs. Results generated by the checklist were generally in agreement with results generated by the experienced ergonomists; however, the checklist was found to be more sensitive in identifying the presence of awkward postures.The checklist was found to be an effective rapid-screening instrument for identifying cyclical jobs that expose workers to potentially harmful postures. However, the checklist methodology did not include sufficient documentation of work methods to identify the specific job attributes associated with these exposures. Furthermore, the checklist was not used to evaluate non-cyclical jobs (e.g., maintenance and skilled trades).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30007/1/0000375.pd

Pilot Testing a Novel Treatment for Inflammatory Bowel Disease

Background: Inflammatory Bowel Disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), are chronic non specific inflammatory conditions. Standard IBD treatment typically employs a combination of anti-inflammatory and immune suppressive medications; however, the pharmacological approach is not by itself curative. The Anti-Inflammatory Diet for IBD (IBD-AID), which is derived and augmented from The Specific Carbohydrate Diet (SCD), is a nutritional regimen that restricts the intake of complex carbohydrates such as refined sugar, gluten-based grains, and certain starches from the diet. These carbohydrates are thought to provide a substrate for pro-inflammatory bacteria. The second component of the diet involves the ingestion of pre- and probiotics to help restore an anti inflammatory environment. Study Objective: To assess the efficacy and feasibility of the Anti –Inflammatory Diet (IBD-AID) intervention for the treatment of IBD. Intervention: Patients were recruited from the UMMHC gastroenterology clinic upon referral from their gastroenterologist. They received individual instruction of the diet and its restrictions through 5 individual nutrition sessions over approximately a 6-10 month period. Support materials were provided. Cooking classes were also available to the patients. Conclusion: This case series indicates the potential for the IBD-AID to be used as an adjunctive or alternative therapy for the treatment of IBD. Notably, 9 out of 11 patients were able to be managed without anti-TNF therapy, and 100% of the patients had their symptoms reduced. To make clear recommendations for its use in clinical practice, randomized trials are needed alongside strategies to improve acceptability and compliance with the IBD-AID

Evaluation of in-plant ergonomics training

Plant personnel involved in a joint labor-management Ergonomics Pilot Project attended an introductory ergonomics course. The training was developed to provide trainees with the ergonomic knowledge necessary to perform their functions as part of the Ergonomic Pilot Project. A Train-the-Trainer program for Introductory Ergonomics was developed and implemented to provide Pilot Project plants with in-plant Introductory Ergonomics trainers. Trainee course satisfaction, ergonomic knowledge, and performance did not differ significantly for those trained by in-plant trainers compared to those trained by University instructors. This suggests that the Train-the-Trainer approach is a viable way of meeting the increasing demand for ergonomics training in industry.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/29101/1/0000137.pd

'Insightful D-branes'

We study a simple model of a black hole in AdS and obtain a holographic description of the region inside the horizon. A key role is played by the dynamics of the scalar fields in the dual gauge theory. This leads to a proposal for a dual description of D-branes falling through the horizon of any AdS black hole. The proposal uses a field-dependent time reparameterization in the field theory. We relate this reparametrization to various gauge invariances of the theory. Finally, we speculate on information loss and the black hole singularity in this context

The Inside Story: Quasilocal Tachyons and Black Holes

We analyze the fate of excitations in regions of closed string tachyon condensate, a question crucial for understanding unitarity in a class of black holes in string theory. First we introduce a simple new example of quasilocal tachyon condensation in a globally stable AdS/CFT background, and review tachyons' appearance in black hole physics. Then we calculate forces on particles and fields in a tachyon phase using a field theoretic model with spatially localized exponentially growing time dependent masses. This model reveals two features, both supporting unitary evolution in the bulk of spacetime. First, the growing energy of fields sourced by sets of (real and virtual) particles in the tachyon phase yields outward forces on them, leaving behind only combinations which do not source any fields. Secondly, requiring the consistency of perturbative string theory imposes cancellation of a BRST anomaly, which also yields a restricted set of states. Each of these effects supports the notion of a black hole final state arising from string-theoretic dynamics replacing the black hole singularity

Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers

BACKGROUND: Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes. OBJECTIVE: This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors. METHODS: 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models. RESULTS: After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS. CONCLUSIONS: In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS