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Exploring Study Designs for Evaluation of Interventions Aimed to Reduce Occupational Diseases and Injuries

  • van der Molen, Henk F.;Stocks, Susan J.;Frings-Dresen, Monique H.W.
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.83-85
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    • 2016
  • Effective interventions to reduce work-related exposures are available for many types of work-related diseases or injuries. However, knowledge of the impact of these interventions on injury or disease outcomes is scarce due to practical and methodological reasons. Study designs are considered for the evaluation of occupational health interventions on occupational disease or injury. Latency and frequency of occurrence of the health outcomes are two important features when designing an evaluation study with occupational disease or occupational injury as an outcome measure. Controlled evaluation studies-giving strong indications for an intervention effect-seem more suitable for more frequently occurring injuries or diseases. Uncontrolled evaluation time or case series studies are an option for evaluating less frequently occurring injuries or diseases. Interrupted time series offer alternatives to experimental randomized controlled trials to give an insight into the effectiveness of preventive actions in the work setting to decision and policy makers.

Use of Ergonomic Measures Related to Musculoskeletal Complaints among Construction Workers: A 2-year Follow-up Study

  • Boschman, Julitta S.;Frings-Dresen, Monique H.W.;van der Molen, Henk F.
    • Safety and Health at Work
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    • v.6 no.2
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    • pp.90-96
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    • 2015
  • Background: The physical work demands of construction work can be reduced using ergonomic measures. The aim of this study was to evaluate the use of ergonomic measures related to musculoskeletal disorders (MSDs) among construction workers. Methods: A questionnaire was sent at baseline and 2 years later to 1,130 construction workers. We established (1) the proportion of workers reporting an increase in their use of ergonomic measures, (2) the proportion of workers reporting a decrease in MSDs, (3) the relative risk for an increase in the use of ergonomic measures and a decrease in MSDs, and (4) workers' knowledge and opinions about the use of ergonomic measures. Results: At follow-up, response rate was 63% (713/1,130). The proportion of workers using ergonomic measures for vertical transport increased (34%, 144/419, p < 0.01); for measures regarding horizontal transport and the positioning of materials, no change was reported. The proportion of workers reporting shoulder complaints decreased (28%, 176/638, p = 0.02). A relationship between the use of ergonomic measures and MSDs was not found; 83% (581/704) of the workers indicated having sufficient knowledge about ergonomic measures. Lightening the physical load was reported to be the main reason for using them. Conclusion: Only the use of ergonomic measures for vertical transport increased over a 2-year period. No relationship between the use of ergonomic measures and MSDs was found. Strategies aimed at improving the availability of ergonomic equipment complemented with individualized advice and training in using them might be the required next steps to increase the use of ergonomic measures.

Does the prosthesis weight matter? 3D finite element analysis of a fixed implant-supported prosthesis at different weights and implant numbers

  • Tribst, Joao Paulo Mendes;Dal Piva, Amanda Maria de Oliveira;Borges, Alexandre Luiz Souto;Rodrigues, Vinicius Aneas;Bottino, Marco Antonio;Kleverlaan, Cornelis Johannes
    • The Journal of Advanced Prosthodontics
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    • v.12 no.2
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    • pp.67-74
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    • 2020
  • PURPOSE. This study evaluated the influence of prosthesis weight and number of implants on the bone tissue microstrain. MATERIALS AND METHODS. Fifteen (15) fixed full-arch implant-supported prosthesis designs were created using a modeling software with different numbers of implants (4, 6, or 8) and prosthesis weights (10, 15, 20, 40, or 60 g). Each solid was imported to the computer aided engineering software and tetrahedral elements formed the mesh. The material properties were assigned to each solid with isotropic and homogeneous behavior. The friction coefficient was set as 0.3 between all the metallic interfaces, 0.65 for the cortical bone-implant interface, and 0.77 for the cancellous bone-implant interface. The standard earth gravity was defined along the Z-axis and the bone was fixed. The resulting equivalent strain was assumed as failure criteria. RESULTS. The prosthesis weight was related to the bone strain. The more implants installed, the less the amount of strain generated in the bone. The most critical situation was the use of a 60 g prosthesis supported by 4 implants with the largest calculated magnitude of 39.9 mm/mm, thereby suggesting that there was no group able to induce bone remodeling simply due to the prosthesis weight. CONCLUSION. Heavier prostheses under the effect of gravity force are related to more strain being generated around the implants. Installing more implants to support the prosthesis enables attenuating the effects observed in the bone. The simulated prostheses were not able to generate harmful values of peri-implant bone strain.

How to Define the Content of a Job-Specific Worker's Health Surveillance for Hospital Physicians?

  • Ruitenburg, Martijn M.;Frings-Dresen, Monique H.W.;Sluiter, Judith K.
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.18-31
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    • 2016
  • Background: A job-specific Worker's Health Surveillance (WHS) for hospital physicians is a preventive occupational health strategy aiming at early detection of their diminished work-related health in order to improve or maintain physician's health and quality of care. This study addresses what steps should be taken to determine the content of a job-specific WHS for hospital physicians and outlines that content. Methods: Based on four questions, decision trees were developed for physical and psychological job demands and for biological, chemical, and physical exposures to decide whether or not to include work-related health effects related to occupational exposures or aspects of health reflecting insufficient job requirements. Information was gathered locally through self-reporting and systematic observations at the workplace and from evidence in international publications. Results: Information from the decision trees on the prevalence and impact of the health- or work-functioning effect led to inclusion of occupational exposures (e.g., biological agents, emotionally demanding situations), job requirements (e.g., sufficient vision, judging ability), or health effects (e.g., depressive symptoms, neck complaints). Additionally, following the Dutch guideline for occupational physicians and based on specific job demands, screening for cardiovascular diseases, work ability, drug use, and alcohol consumption was included. Targeted interventions were selected when a health or work functioning problem existed and were chosen based on evidence for effectiveness. Conclusion: The process of developing a job-specific WHS for hospital physicians was described and the content presented, which might serve as an example for other jobs. Before implementation, it must first be tested for feasibility and acceptability.

Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest-Posttest Study

  • Ketelaar, Sarah M.;Nieuwenhuijsen, Karen;Bolier, Linda;Smeets, Odile;Sluiter, Judith K.
    • Safety and Health at Work
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    • v.5 no.4
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    • pp.216-221
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    • 2014
  • Background: Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. Methods: We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. Results: One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p < 0.01). Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). Conclusion: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

The role of basolateral amygdala orexin 1 receptors on the modulation of pain and psychosocial deficits in nitroglycerin-induced migraine model in adult male rats

  • Askari-Zahabi, Khadijeh;Abbasnejad, Mehdi;Kooshki, Razieh;Raoof, Maryam;Esmaeili-Mahani, Saeed;Pourrahimi, Ali Mohammad;Zamyad, Mahnaz
    • The Korean Journal of Pain
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    • v.35 no.1
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    • pp.22-32
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    • 2022
  • Background: Migraine headaches have been associated with sensory hyperactivity and anomalies in social/emotional responses. The main objective of this study was to evaluate the potential involvement of orexin 1 receptors (Orx1R) within the basolateral amygdala (BLA) in the modulation of pain and psychosocial dysfunction in a nitroglycerin (NTG)-induced rat model of migraine. Methods: Adult male Wistar rats were injected with NTG (5 mg/kg, intraperitoneal) every second day over nine days to induce migraine. The experiments were done in the following six groups (6 rats per group): untreated control, NTG, NTG plus vehicle, and NTG groups that were post-treated with intra-BLA microinjection of Orx1R antagonist SB-334867 (10, 20, and 40 nM). Thermal hyperalgesia was assessed using the hot plate and tail-flick tests. Moreover, the elevated plus maze (EPM) and open field (OF) tests were used to assess anxiety-like behaviors. The animals' sociability was evaluated using the three-chamber social task. The NTG-induced photophobia was assessed using a light-dark box. Results: We observed no change in NTG-induced thermal hyperalgesia following administration of SB-334867 (10, 20, and 40 nM). However, SB-334867 (20 and 40 nM) aggravated the NTG-induced anxiogenic responses in both the EPM and OF tasks. The NTG-induced social impairment was overpowered by SB-334867 at all doses. Time spent in the dark chamber of light-dark box was significantly increased in rats treated with SB-334867 (20 and 40 nM/rat). Conclusions: The findings suggest a role for Orx1R within the BLA in control comorbid affective complaints with migraine in rats.

Influence of size-anatomy of the maxillary central incisor on the biomechanical performance of post-and-core restoration with different ferrule heights

  • Domingo Santos Pantaleon;Joao Paulo Mendes Tribst;Franklin Garcia-Godoy
    • The Journal of Advanced Prosthodontics
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    • v.16 no.2
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    • pp.77-90
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    • 2024
  • PURPOSE. The study aims to investigate the influence of the ferrule effect and types of posts on the stress distribution in three morphological types of the maxillary central incisor. MATERIALS AND METHODS. Nine models were created for 3 maxillary central incisor morphology types: "Fat" type - crown 12.5 mm, root 13 mm, and buccolingual cervical diameter 7.5 mm, "Medium" type - crown 11 mm, root 14 mm, and buccolingual cervical diameter 6.5 mm, and "Slim" type - crown 9.5 mm, root 15 mm, and buccolingual cervical diameter 5.5 mm. Each model received an anatomical castable post-and-core or glass-fiber post with resin composite core and three ferrule heights (nonexistent, 1 mm, and 2 mm). Then, a load of 14 N was applied at the cingulum with a 45° slope to the long axis of the tooth. The Maximum Principal Stress and the Minimum Principal Stress were calculated in the root dentin, crown, and core. RESULTS. Higher tensile and compression stress values were observed in root dentin using the metallic post compared to the fiber post, being higher in the slim type maxillary central incisor than in the medium and fat types. Concerning the three anatomical types of maxillary central incisors, the slim type without ferrule height in mm presented the highest tensile stress in the dentin, for both types of metal and fiber posts. CONCLUSION. Post system and tooth morphology were able to modify the biomechanical response of restored endodontically-treated incisors, showing the importance of personalized dental treatment for each case.

Ten technical aspects of baseplate fixation in reverse total shoulder arthroplasty for patients without glenoid bone loss: a systematic review

  • Reinier W.A. Spek;Lotje A. Hoogervorst;Rob C. Brink;Jan W. Schoones;Derek F.P. van Deurzen;Michel P.J. van den Bekerom
    • Clinics in Shoulder and Elbow
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    • v.27 no.1
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    • pp.88-107
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    • 2024
  • The aim of this systematic review was to collect evidence on the following 10 technical aspects of glenoid baseplate fixation in reverse total shoulder arthroplasty (rTSA): screw insertion angles; screw orientation; screw quantity; screw length; screw type; baseplate tilt; baseplate position; baseplate version and rotation; baseplate design; and anatomical safe zones. Five literature libraries were searched for eligible clinical, cadaver, biomechanical, virtual planning, and finite element analysis studies. Studies including patients >16 years old in which at least one of the ten abovementioned technical aspects was assessed were suitable for analysis. We excluded studies of patients with: glenoid bone loss; bony increased offset-reversed shoulder arthroplasty; rTSA with bone grafts; and augmented baseplates. Quality assessment was performed for each included study. Sixty-two studies were included, of which 41 were experimental studies (13 cadaver, 10 virtual planning, 11 biomechanical, and 7 finite element studies) and 21 were clinical studies (12 retrospective cohorts and 9 case-control studies). Overall, the quality of included studies was moderate or high. The majority of studies agreed upon the use of a divergent screw fixation pattern, fixation with four screws (to reduce micromotions), and inferior positioning in neutral or anteversion. A general consensus was not reached on the other technical aspects. Most surgical aspects of baseplate fixation can be decided without affecting fixation strength. There is not a single strategy that provides the best outcome. Therefore, guidelines should cover multiple surgical options that can achieve adequate baseplate fixation.

An Overview of the Gifted Education Portfolio for the John Templeton Foundation

  • Saul, Mark E.
    • Research in Mathematical Education
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    • v.12 no.4
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    • pp.301-307
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    • 2008
  • The John Templeton Foundation (JFT) is a large private philanthropic institution with an interest in, among other areas, the development of human genius. This report chronicles the start of a portfolio in gifted education, designed to address this aspect of the Foundation's work.

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