Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.
Objectives : The purpose of this study was to determine the association between musculoskeletal workload and job stress in early childcare teachers. Methods : This study was based on The Korean Working Condition Survey conducted on wage workers. The total number of individuals included in the analysis was 395 (286 childcare teachers and 109 kindergarten teachers) early childcare teachers in 2011. The collected data were analyzed by frequency statistic, cross-tabulation analysis and logistic regression. Results : The adjusted odds ratio showed a statistically effective association for job stress exposure. The results were as follows: education level, service environment, emotional labor, fatigue or posture led to pain for a high level of job stress. Additionally, for childcare teachers, the results showed that fatigue or posture led to pain when moving a heavy object frequently. Conclusions : When childcare teachers are assigned a task to lift heavy or awkward or objects, care should be taken on who is assigned the task, and it should be done safely. An intervention program should be developed to train childcare teachers to safely and efficiency do heavy labor in early childcare education classes.
Purpose: The purpose of this study was to examine the effect of the yoga during pregnancy on the maternal weight, delivery experience and infant birth weight. Method: The nonequivalent control group pre test-post test design was used. The participants were the healthy pregnant women, whose pre-pregnancy BMI was normal, gestational period was more than 20 weeks. The final sample consisted of 21 mother-infant dyads for experimental group and 20 dyads for control group and who agreed to participate in this study. Data were collected from February I st to December 15th, 2006. The Qi exercise prenatal program was carried out for 90 minutes a day, 2 times a week for 12 weeks. The data were analyzed using SPSS 16.0 Program. Result: The degree of maternal weight gain(p<.001), labor pain(p<.001), discomfort after delivery(p<.001) and infant's birth weight(p<.00I) were significantly different between two groups. Conclusion: The yoga during pregnancy managed weight gain of mothers. Therefore, this study suggests that yoga during pregnancy to promotes stabilization can be beneficial for maintaining healthy weight, decreasing labor pain and discomfort after delivery for pregnant women and increasing infant's birth weight.
Avulsion of spinous process, also called Clay-shoveler's fracture, is most prevalent among those engaged in hard physical labor. To the best of the author's knowledge, only one case of multiple spinous process fractures of the upper thoracic spine in a novice golfer has been reported. A 45-year-old female presented with intractable posterior neck pain. The patient experienced a sharp, sudden pain on the neck while swinging a golf club, immediately after the club head struck the ground. Dynamic cervical radiographic findings were C6 and C7 spinous process fractures. Magnetic resonance imaging revealed C6 and C7 spinous process fractures without spinal cord pathology. The patient was treated with pain medications and cervical bracing. The patient's pain gradually improved. The injury mechanism was speculated to be similar to Clay-shoveler's fracture. Lower cervical spinous process fractures can be associated with a golf swing. If the patient complains of long lasting neck pain and has a history of golf activity, further study should be conducted to rule out lower cervical spinous fracture.
Purpose: This study was conducted to identify the association between emotional labor and job stress in bus drivers, as well as to propose management strategies for job stress. Methods: The study was conducted in February 2013 and involved 182 bus drivers working in the Gyeonggi area. Results: emotional labor was $9.5{\pm}2.34$ on average, and job stress was higher than the median of the same indicator among Korea's workers in the areas of physical environment, job autonomy, and relationship conflicts. Factors that affected job stress was lower if the subjects' Higher values for emotional labor indicated a higher level of job stress. Conclusion: To reduce among drivers, the following measures are necessary: increase the comfort of the driver's seat within the vehicle, provide adequate rest between bus headways, provide comfortable in-house rest facilities, and establish physical training spaces to reduce musculoskeletal disorders as well as programs for reducing back pain. In addition, relationship conflicts may be relieved by increasing job autonomy as much as possible, by granting autonomous control of working hours and bus headways, as well as by banning long work hours. Moreover, various club activities, exercise programs, and counseling programs that workers can be involved in together may be beneficial. This study is significant in that it identified the relationship of the bus drivers' emotional labor and job stress, which has previously been ignored as a research topic. Through its results, this study provides baseline data for the preparation of management strategies that can address the job stress of bus drivers.
Objectives: This study examines the occurrence of disease resulting from low back pain and factors of working environment meaningfully influencing the occurrence of lumbago as well as analyzes '2nd Korean Working Condition Survey (KWCS)' conducted in 2010 so as to establish the prevention and improvement measures. Methods: The analysis method is that it is to compare the prevalence rate of low back pain according to working environment via odds ratio and to implement the test about the factors having the difference in working environment between low back pain group and normal group through weighted t-test. Results: As a result, it indicates that there is a meaningful difference for prevalence rate of low back pain according to age, status in employment and education level which are socio-demographical factors. The analysis in working hours shows that the period of work is a factor raising the prevalence rate of low back pain rather than weekly working hours. The analysis in the work risk factor indicates that the increase in prevalence rate of low back pain takes place to either workers with repetitive movement and continuously standing posture or those with heavy stress and emotional labour. Conclusions: Workers with low back pain have suffered from accident, depression, anxiety disorder and sleep. The factors in which the prevalence rate of low back pain decrease are to provide information on health and safety and working speed, and enough rest.
Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.
The purpose of this study was to analyze various forms of musculoskeletal pain during different stages such as antenatal, pregnancy, delivery, and postpartum. The data for this study were collected through a self-administered survey with a structured questionnaire to 113 subjects. The survey was administered from May, 2003 to March, 2004 with subjects selected from postpartum centers in 3 different areas: Kangnam, Kangbook, and Bucheon. Analytical tools used for this study were frequency analysis, crosstabulation, percentage analysis, independent t-test, chi-square, and multiple response analysis. The findings of this study were as follows: 1. Comparison study of musculoskeletal pain according to variables including a pregnant woman's age, delivery techniques, different types of delivery such as primiparity, multiparity, dystocia, easy delivery, shows that these relationships are statistically not significant (p>0.05). 2. A total of 61.9% gave positive responses for the question about the relationship between musculoskeletal pain during postpartum and that in preparation of labor, but shows that this relationship was statistically not significant (p>0.05). 3. Relationships between forms of musculoskeletal pain in different phases are significant (p<0.05). The compared phases are: premarriage and pre-pregnancy, premarriage and antenatal, premarriage and postpartum, premarriage and lactiferous phase, pre-pregnancy and antenatal, pre-pregnancy and postpartum, and pre-pregnancy and lactiferous phase. However, results for the comparison between antenatal and postpartum, antenatal and lactiferous phase, and postpartum and lactiferous phase show that these relationships are statistically not significant (p>0.05). According to this study, musculoskeletal pain which occurred during antenatal is significantly related to the pain occurring during postpartum. Results produced from this study might be used as a helpful tool for developing educational programs aiming at teaching self pain-detection performable at home or at the workplace and body maintenance during the course of antenatal and postpartum.
This study was conducted to investigate the prevalence rate of low back pain during past one year and its risk factors. The data were collected from 1,384 manufacturing factory workers from March 1, 1992 to August 30, 1992. The results obtained were as follows: 1. The one year prevalence rate of low back pain by manufacturing company was 38.4% in textile manufacturing, 35.2% in concrete reenforcement, 31.0% in cigarette and 26.1% in metal part(P<0.01). 2. In textile manufacturing, age groups with high prevalence rate of low back pain were 30's(36.8%) and 40's(36.4%) (P<0.05), and the one year prevelence rates of low back pain by marital state were 34.9% in married workers and 28.5% in unmarried(P=0.0511). 3. The one year prevelence rates of low back pain by job part are 35.0% in labor workers and 26.1% in clerical(P<0.05), and by work hour per day it was 34.9% in 9 or more and 28.9% in 8 or less(P<0.05). 4. The highest group of low back pain by work posture was 43.5% in 'lifting and transfering materials', and it by fitness of chair was 56.0% in uncomfortable one, and by height of working board was 33.6% in low working one. 5. In logistic regression analysis, significant determinants with low back pain were marital state(p<0.05), work hour per day(P<0.05), height of working board(P<0.01), and work posture(P<0.01).
Introduction: Although shift work is an inevitable form of labor in modern society, it has been identified as a cause of many ailments, such as cancer and musculoskeletal disorders. Meanwhile, previous studies have also shown that musculoskeletal disorders account for a large proportion of total industrial accidents and a high prevalence rate of these ailments has been found in shift workers. Methods: Among the respondents to the 5th Korea Working Conditions Survey(KWCS) 3,916 shift workers(2,658 of whom have not experienced musculoskeletal pain and 1,258 who have experienced musculoskeletal pain) were asked how the work regularity of shift workers affected musculoskeletal pain. Results: The results of a dichotomous logistic regression by correcting the demographic characteristics of the study subjects showed a lower prevalence of musculoskeletal pain in the 'High' regularity group compared to the 'Intermediate' regularity group for the criterion 'Regularity of Time Fixation'. A lower prevalence of musculoskeletal pain was shown in the 'High' and 'Moderate' regularity group compared to the 'Very Low' regularity one. Conclusions: Based on these findings, it was found that musculoskeletal pain occurs less when the work regularity of shift workers is 'Very high' or 'Intermediate', and the effect of working regularity on musculoskeletal pain varies for each shift type of work. It is deemed that more precise observation and understanding are required when managing the working environment of shift workers, and further study of regarding this issue is needed.
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