Preventing Rsi/Wruld: use of esthesiometry to assess hand tactile sensitivity of slaughterhouse workers

This research was conducted with slaughterhouse female workers in the municipality of S?o Miguel do Igua?u, state of Parana, Brazil. The sample was composed of 103 women aged 25 to 40 ( 7.57 years, and the study aimed to verify the nerve conduction of the median nerve. An esthesiometer consisting of a Semmes-Weinstein monofilaments was used to measure the hand skin sensitivity in the region of the median nerve and a Jamar? hand dynamometer, which was used to determine the handgrip strength. About 81% of individuals had normal sensitivity with 0.05 g and average levels of handgrip strength in dominant hand (DH) of 35.30 kgf (( 3.10) and in the non-dominant hand (NDH) of 28.30 ( 3.09 kgf. 14% of individuals had reduced sensitivity, with values equivalent to 0.2 g and 2.0 g (blue and violet) and levels of handgrip strength in the DH equal to 28.10 kgf (( 2.90) and in the NDH of 26.40 kgf (( 3.28). 5% of individuals showed bilateral sensitivity deficit (4.0 g) and levels of handgrip strength in the DH of 16.10 kgf (( 2.10) and in the NDH of 18.20 kgf (( 3.28), resulting in a strong correlation between handgrip strength and sensitivity of the median nerve (r = 0.786) between variables dominant hand (DH) and (r = 0.626) for the non-dominant hand (NDH). It could be concluded that assessing the nerve conduction of the median nerve by hand esthesiometry can be an important tool in preventing the Carpal Tunnel Syndrome.     

Prevention of MSD within OHSMS/IMS: a systematic review of risk assessment strategies

The purpose of this systematic review was to identify and summarize the research evidence on prevention of Musculoskeletal Disorders (MSD) within Occupational Health and Safety Management Systems (OHSMS) and Integrated Management Systems (IMS). Databases in business, management, engineering and health and safety were systematically searched and relevant publications were synthesized. The number of papers that could address the research questions was small. However, the review revealed that many of the techniques to address MSD hazards require substantial background knowledge and training. This may limit employees' involvement in the technical aspects of the risk assessment process. Also these techniques did not usually fit into techniques used by companies to address other risk factors within their management systems. This could result in MSD prevention becoming a separate issue that cannot be managed with company-wide tools. In addition, this review also suggested that there is a research gap concerning the MSD prevention within companies' management systems.     

Participatory design in lean production: which contribution from employees? For what end?

The proponents of lean production have pointed to the positive effects of the work organization on employees in terms of autonomy, enhanced skills and empowerment mainly by their participation into the continuous improvement of work process. But studies that have examined this issue suggest that the increase in autonomy is not sufficient to compensate for increases work intensity. Participatory design has grown extensively in manufacturing since the 1980's under the impulsion of the Scandinavian socio-technical system approach and it's central in the model of lean production performance. Its main objectives are to improve quality, increase productivity and safety through employee's participation to the reduction of non-value added activities, such as defined by lean production. In the line of the studies on participatory design and continuous improvement the present study examines the functioning of work groups, based on the kaizen model, the aim of which was to improve the proportion of "value-added activities" and working conditions, essentially physical constraints. The main results are consistent with the literature and show that accelerated forms of re-conception activities give employees limited room for maneuver to elaborate solutions based on the analysis of the real activity. This study is part of a broader initiative that goes in the direction of continuous improvement of the design process itself so that it integrates the real constraints of work and propose changes bases on work as it actually takes place, beyond pre-established performance goals bases on the reduction of "non added value activities".     

Supporting the scholar role in intensive care nursing

This study investigates how future informatics applications can support and challenge intensive care nurses (ICU nurses) to grow and learn continuously. To this end a research-and-design tool is introduced which is based on a model of the nursing process that starts from the idea that a nurse fulfills three different roles: the role of practitioner (using information immediately to base actions upon), the role of scholar (using information later on to learn from) and the role of human (coping with stress and dealing with emotions). In this paper the focus is on the scholar role. Twenty-eight intensive care staff members from six different hospitals were asked to recount an imposing experience from the perspective of each role. Regarding the scholar role, the participants mentioned 77 learning strategies they adopt for individual as well as organizational learning. Individual learning concerned reflection on former patient cases, reflection on current patient cases to anticipate a change in the patient's condition and reflection on personal behavior and decisions. Organizational learning concerned reflection on former patient cases. Examples of specific strategies were formal team evaluations focused on procedure and understanding the perspective of team members, being present at autopsies, and giving feedback on the nursing skills of colleagues. Based on these strategies design implications are defined for future nursing informatics applications, which will be presented.     

Concurrent cognitive task may improve motor work performance and reduce muscle fatigue

Performance of certain cognitive tasks either during physical load or in rest pauses between boosts might lead to slowing of muscle fatigue and fatigue related decline in performance. Seventeen right-handed healthy volunteers (age 24 ± 1.4, 8 males) participated in this study, aiming to investigate the effect of the level of the cognitive information processing - 1) passive perception of audio stimuli, 2) active stimuli discrimination, 3) active stimuli discrimination following motor response - on motor task performance (handgrip test 30% and 7% of MVC) and muscle fatigue development. Cognitive tasks show the following effects on motor work: i) Perceived fatigue during 30 % MVC (fatiguing) condition developed slower if participant pressed button in response to deviant acoustic stimuli, as compared to passive listening. Counting task, an active task without motor component, took the intermediate position and did not differ significantly from two other cognitive tasks. ii) MVC after 30% MVC (fatiguing) condition tended to decrease stronger when accompanied with passive listening in comparison with both active tasks. iii) Motor task performance during 30% MVC (fatiguing) condition was better for active cognitive task with motor component than for passive task. Active task without motor component took the intermediate position and did not differ significantly from both the other cognitive tasks.     

Nurses' working tasks and MSDs back symptoms: results from a national survey

Healthcare workers, namely registered nurses (RN), are frequently exposed to work-related musculoskeletal disorders (WRMSDs) risk factors. Identifying the symptoms of these disorders is one of the first epidemiological steps to managing them. This study aims to identify WRMSDs prevalence symptoms in Portuguese RN. During 8 months (2010-2011) the National Public Health School and the Portuguese Registered Nurses Board made a call to all RN to answer an online WRMSDs questionnaire. Respondents (n=2140) are mostly females (77.4%) and work mainly in hospitals (n=1396) and in primary healthcare centers (n=421). Results show high symptoms prevalence (last 12 months) in the lower back (60.6%), the upper back (44.5%), and the neck (48.6%). Nurses' activity, especially patient hygiene in bed, is a strong contributor (p>0.05) to pain in the upper back (OR=1.39 [1.09-1.80]) and lower back (OR=1.4 [1.08-1.84]). Patient holdup without mechanical support has the highest relationship (p>0.05) between work tasks and symptoms in the last 12 months in the upper back (OR=1.50 [1.19-1.90]). Prevalence rates of WRMSDs symptoms in Portuguese nurses are no different from other studies with Swedish, Italian and Greek nurses. Maybe changes in healthcare systems didn't change the way care is delivered and we must rethink how to prevent nurses WRMSDs.     

Computer use and ulnar neuropathy: results from a case-referent study

We aimed to evaluate associations between vocational computer use and 1) ulnar neuropathy, and 2) ulnar neuropathy- like symptoms as distinguished by electroneurography. We identified all patients aged 18-65 years, examined at the Department of Neurophysiology on suspicion of ulnar neuropathy, 2001-2007. We mailed a questionnaire to 546 patients with ulnar neuropathy, 633 patients with ulnar neuropathy-like symptoms, and three community referents per case, matched on sex, age, and primary care centre. From a Job Exposure Matrix we extracted estimates of daily hours of computer use. The analysis was performed by conditional logistic regression.There were a negative association between daily hours of computer use and the two outcomes of interest. Participants who reported their elbow to be in contact with their working table for 2 hours or more during the workday had an elevated risk for ulnar neuropathy (OR=2.16, 95 % CI; 1.06-4.44).The two outcomes were not associated with daily hours of computer use. Findings suggested specific effects of pressure on the elbow, and might be an explanation for the overweight of left-sided outcomes in this primarily right-handed group. Preventive efforts would then be straightforward by providing appropriate arm support for the left arm and elbow.     

Evaluation of objectivity, reliability and criterion validity of the key indicator method for manual handling operations (KIM-MHO), draft 2007

Upper extremity musculoskeletal symptoms and disorders are common in the working population. The economic and social impact of such disorders is considerable. Long-time, dynamic repetitive exposure of the hand-arm system during manual handling operations (MHO) alone or in combination with static and postural effort are recognised as causes of musculoskeletal symptoms and disorders. The assessment of these manual work tasks is crucial to estimate health risks of exposed employees. For these work tasks, a new method for the assessment of the working conditions was developed and a validation study was performed. The results suggest satisfying criterion validity and moderate objectivity of the KIM-MHO draft 2007. The method was modified and evaluated again. It is planned to release a new version of KIM-MHO in spring 2012.     

Designing dynamic distributed cooperative Human-Machine Systems

The paper presents a new approach to the development of cooperative human-machine systems in the Transportation domain which is currently researched in the European project D3CoS. A necessary precondition for the acceptance of cooperative human-machine systems with shared control is the confidence and trust of the user into the system. D3CoS tackles this important issue by addressing the cooperative system as the object and the target of the system development process. This new perspective, along with corresponding innovative methods, techniques and tools, shall allow the identification of optimal task and authority sharing approaches supported by intuitive human-machine interaction and user interfaces at an early stage of system development. This will support powerful teamwork between humans and machines or between machines and machines that is transparent, intuitive and easy to understand. The paper describes the research dimensions for the development of the methods, techniques and tools as well as first results.