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How noise discomfort and vibration discomfort depend on duration has not previously been compared. For five durations (2, 4, 8, 16 and 32 s), the subjective equivalence of noise and vibration was investigated with all 49 combinations of 7 levels of noise and 7 magnitudes of whole-body vertical vibration. The rates of increase in discomfort with increasing duration were similar for noise and vibration, whereas they are currently assumed to be 3 dB per doubling of noise duration and 1.5 dB per doubling of vibration duration. The discomfort caused by low levels of noise was masked by high magnitudes of vibration, and the discomfort caused by low magnitudes of vibration was masked by high levels of noise. As stimuli durations increased from 2 to 32 s, the influence of vibration on the judgement of noise discomfort decreased, whereas the influence of noise on the judgement of vibration discomfort was unchanged. Practitioner Summary:For predicting the relative discomfort caused by steady-state noise and steady-state vibration over durations from 2 to 32 s, the combination of average measures of sound and vibration (e.g. sound pressure level and root-mean-square acceleration) provide more accurate estimates than the combination of the principal standardised ‘dose’ measures (e.g. sound exposure level and vibration dose value). [ABSTRACT FROM AUTHOR]

The article discusses the study of evaluating potential for vertical integration in undergraduate and postgraduate education in general practice (GP). The study reveals the four comprehensive themes including interaction between learners at different stages, team work, multi-morbidity, and opportunistic health promotion, and inter-agency collaboration. Also concludes that vertical integration supports GP students and trainees at different levels and enhances their teaching capacity.

Purpose - This paper aims to report on research into human resource management within an operations management environment; specifically, operational team-work amongst health care workers in a hospital. Design/methodology/approach - Eight operational teams within a UK National Health Service hospital took part and the research and a combination of survey and group discussions. Findings - The results show the construct of the team had little operational definition. Key factors identified as contributing to effective team-working include: leadership; frequency of team meetings; a climate of trust and openness. There was limited evidence of truly multi-disciplinary teams and of organisational support for team-working. Research limitations/implications - The methodology applied was appropriate, generating data to facilitate discussion and draw specific conclusions therefrom, A perceived limitation is the single case approach; however, Remenyi et al. argue this can be enough to add to the body of knowledge. In terms of implications this paper demonstrates that team-working is no panacea; as part of a bundle of good operations management practices it is associated with efficiency, effectiveness, and in this case improved patient care. Practical implications - The paper suggests a new input, process, output model of effective team-working and identifies issues to be faced in adopting a strategy of developing an operational team-based organisation. Originality/value - The value of this paper is the conclusion that the importance of operational team-working is as a paradigm for assessing how effectively individuals and groups work together, rather than as a specific organisational form with an optimal size. [ABSTRACT FROM AUTHOR]

Objectives: To assess the prevalence of Raynaud's phenomenon in the general population of Great Britain and to estimate the proportion and number of cases attributable to hand transmitted vibration (HTV).Methods: A questionnaire was posted to a random sample of 22,194 adults of working age. Information was collected on the lifetime prevalence of finger blanching, smoking habits, and occupational and leisure time exposures to HTV. Associations with risk factors were explored by logistic regression, with odds ratios converted into prevalence ratios (PRs).Results: Among the 12 907 respondents, 1835 (14.2%) reported finger blanching at some time, including 1529 (11. 8%) in whom symptoms were induced by cold, and 597 (4.6%) in whom the blanched area was also clearly demarcated. Prevalences were higher in women than men. Around one fifth of cases (2% of respondents) had consulted a doctor about their symptoms. By comparison with men who had never been exposed to HTV, the PR for cold induced blanching in those exposed only at work was 2.0 (95% CI 1.7 to 2.3), and in men exposed both at work and in leisure it was 2. 5 (95% CI 2.1 to 3.1). Higher risks were found in men who consulted a doctor about cold induced blanching, among whom 37.6% of cases were estimated to arise from exposure to HTV. The estimated number of cases attributable to HTV nationally was 222 000 in men who reported extensive blanching (blanching affecting at least eight of the digits or 15 phalanges). Similar patterns of risk were found in women, but the attributable proportion was much lower (5.3% in cases consulting a doctor).Conclusions: Raynaud's phenomenon is common in the general population. Many cases are attributable to HTV, especially in men, emphasising the public health importance of this common occupational hazard. [ABSTRACT FROM AUTHOR]

Presents a survey on prevalence and pattern of occupational exposure to whole body vibration in Great Britain. Estimated number of workers with occupational exposure to whole body vibration; Sources of whole body vibration; Prevention of whole body vibration.

The article presents an obituary for Doctor Peter Henry Dickinson, consultant vascular surgeon at Durham University Medical School in Newcastle, England.

The article presents an obituary for Joan Campbell Griffin, senior medical officer at Durham University Medical School in England.

To assess whether extra-oesophageal symptoms are predictive of oesophageal malignancy. A prospective, single-centre cross-sectional questionnaire study at a tertiary referral unit for oesophageal cancer using the Comprehensive Reflux Symptoms Scale (CReSS) questionnaire tool. Respondents with oesophageal malignancy were compared with historical cohorts undergoing airway examination or upper gastrointestinal endoscopy and found to have benign diagnoses. We developed a model for predicting oesophageal cancer using linear discriminant analysis and logistic regression, assessed by Monte Carlo cross validation. Respondents with oesophageal malignancy (n = 146; mean age 70.5; male: female, 71:29) were compared with those undergoing airway examination (n = 177) and upper gastrointestinal endoscopy (n = 351), found to have benign diagnoses. No single questionnaire item, or group of co-varying items (factors), reliably discriminated oesophageal cancer from other diagnoses. Individual items which suggested higher risk of oesophageal malignancy included dysphagia (area under the curve (AUC) 0.68), low appetite (AUC 0.66), and early satiety (AUC 0.58). Conversely, throat pain (AUC 0.38), bloating (AUC 0.38) and heartburn (AUC 0.37) were inversely related to cancer risk. A forward stepwise regression analysis including a subset of 12 CReSS questionnaire items together with age and sex derived a model predictive of oesophageal malignancy in this cohort (AUC 0.89). We demonstrate a model comprised of 12 questionnaire items and 2 demographic parameters as a potential predictive tool for oesophageal malignancy diagnosis in this study population. Translating this model for predicting oesophageal malignancy in the general population is a valuable topic for future research. • Oesophageal malignancy remains a diagnostic challenge, often presenting late. • Extra-oesophageal symptoms are not cancer referral criteria in the United Kingdom. • Symptoms can be characterised with the Comprehensive Reflux Symptoms Scale (CReSS). • Extra-oesophageal symptoms may be useful to predict risk of oesophageal malignancy. • This could be used to risk stratify patients for upper gastrointestinal endoscopy. [ABSTRACT FROM AUTHOR]

Objectives: To assist occupational health professionals to interpret the results of standardised tests for components of the hand-arm vibration syndrome by presenting data for healthy subjects and identifying the effects of some of the confounding variables., Method: Thermal thresholds, vibrotactile thresholds, the finger skin temperature (FST) response to cold provocation and percentage finger systolic blood pressures (%FSBP) were measured by standardised procedures. Normative data were obtained for healthy men of working age (17-62 years) during 237 experimental sessions encompassing ten different studies. Hot thermal thresholds and cold thermal thresholds were assessed independently with 38 subjects; 152 measurements of both hot and cold thresholds were made. Vibrotactile thresholds were measured at several locations on 81 subjects, giving a total of 216 measurements at 125 Hz and at 31.5 Hz. The FST response to cold provocation at 15 degrees C was monitored by thermocouples throughout a 2-min settling period, a 5-min immersion period and a 10-min recovery period. A total of 302 measurements was made on 70 subjects. The %FSBPs were measured in four test fingers and one reference finger by strain-gauge plethysmography. Measurements were made on 97 subjects. A total of 351 measurements was made at 15 degrees C, with 341 measurements at 10 degrees C., Results: Normative data and some example normal limits are presented from the current data set and from data presented in other studies. Age was found to influence thermal thresholds, vibrotactile thresholds and the FST response to cold provocation; older subjects exhibited deteriorated vascular and neurological function. Room temperature was found to influence %FSBPs and the FST response to cold provocation; warmer environments resulted in improved vascular response to cold. Outdoor temperature had a small effect on the FST response to cold provocation and on the vibrotactile thresholds. Thermal thresholds showed some influence of smoking habits and of the FST measured prior to testing. For all four tests, any differences between measurement locations were small and there were no differences between left-handed and right-handed subjects., Conclusions: The current data can assist occupational health professionals to interpret the results of the standardised tests. Comparison with the current data is considered valid for men of working age. Age and room temperature should be recognised as being capable of causing changes in neurological and vascular function.