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.     

Proper manual handling techniques to prevent low back pain, a Cochrane systematic review

Training and provision of assistive devices are considered major interventions to prevent and treat low back pain (LBP) among workers exposed to manual material handling (MMH). To establish the effectiveness of training and provision of assistive devices in preventing and treating LBP an update of a Cochrane literature review was performed to November 2010. Randomised controlled trials (RCTs) and cohort studies with a concurrent control group (CCTs) were included. Nine RCTs (20.101 employees) and nine CCTs (1280 employees) were included for prevention: six more than in the previous version. No study on treatment was found. None of the included RCTs and CCTs provided evidence that training and provision of assistive devices prevented LBP when compared to no intervention or another intervention.     

State of scientific knowledge about the need of recovery time at specific workplaces and recommendations for further research

Research activities to determine the need of recovery time at work were mainly performed in the 1970s and 1980s. Previous studies were largely based on expert opinions or were generated within small and non-representative groups. Often, laboratory experiments were carried out with a low number of subjects. Especially during the last decade, only little additional scientific knowledge was generated on this topic. The very resource intensive development of more detailed results based on the existing level of scientific knowledge is assumed as one reason for this. In general, it seems to be reasonable to continue further research on the knowledge generated in previous studies, but implement larger samples and more representative groups. Besides, according to monotonous manual work, more research is especially needed regarding relative operating forces and operation frequencies taken grip conditions and hand/body position into account.     

Interventions to prevent needle stick injuries among health care workers

Needle stick injuries (NSIs) are frequently reported as occupational injuries among health care workers. The health effects of a NSI can be significant when blood-to-blood contact occurs from patient to health care worker. The objective of this study was to evaluate whether the number of NSIs decreased among health care workers at risk in one Dutch academic hospital after introduction of injection needles with safety devices in combination with an interactive workshop. In a cluster three-armed randomized controlled trial, 23 hospital divisions (n=796 health care workers) were randomly assigned to a group that was subjected to the use of a 'safety device plus workshop', to a group that was subjected to a 'workshop only' or to a control group with no intervention. The combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention. For practice, the use of relatively simple protective needle safety devices and interactive communication are effective measures for reducing NSI's.     

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.     

Manual flying skills under the influence of performance shaping factors

This paper describes an experimental study investigating pilots' manual flying skills. In today's line oriented flight training, basic flying skills are neglected frequently. So, the study examines the manual flying skills of commercial airline pilots under the influence of several performance shaping factors like training, practice or fatigue in a landing scenario. The landing phase shows a disproportionate high percentage of aircraft accidents and it is typically flown by hand. The study is to be undertaken with randomly selected pilots in a full motion flight simulator to ensure a high validity of the results.     

Sex, self-interest and health care priorities

In this questionnaire study, individuals were asked to prioritise publicly provided preventive health care services, one of which would be unavailable to them by virtue of their sex. The aim was to establish whether men and women would exhibit different degrees of self-interest when making a constrained choice. Around 1800 subjects from east-central England prioritised three different types of cancer screening. Most also provided written explanations for their rankings and these were classified into explanatory themes. Logistic regressions using socio-demographic and attitude data predicted the type of screening chosen as first priority. The analysis revealed that many men and women did indeed assign similar priorities to the different types of screening and, even when the priorities differed, these were often justified by similar arguments relating to technical aspects of the interventions and to self-interest. However, women were far more likely than men to prioritise a type of screening from which they themselves would benefit directly and the variations in preferences and explanations between the sexes occurred primarily because of differences in other-regarding attitudes. The bias towards screening of females was driven by women's greater worries about the disease in question and by men's “benevolent sexism” with respect to women's wellbeing.