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Abstract: The purpose of this study is to investigate the relationships between subjective measures of discomfort and objective measures related to the assessment of postural stresses based on literature survey. Objective measures included posture holding time, maximum holding time (MHT), torque at joints, lifting index (LI) and compressive force (CF) at L5/S1. The major relationships identified in this literature survey were the following: 1) postural discomfort linearly increased with increasing holding time, and holding force, 2) whole body discomfort was inversely linearly proportional to the MHT, 3) body-part discomfort was related to objective measures such as torque at the relevant joint, 4) discomfort was strongly linearly related to LIs and CFs, and 5) the discomfort measured with the magnitude estimation was linearly related to that measured with Borg CR10. Thus, it is thought that discomfort might be used as a measure for quantifying postural stresses. [Copyright &y& Elsevier]

Many Korean workers are exposed to repetitive or prolonged poor working postures, which are closely related with pains or symptoms of musculoskeletal disorders. Poor working postures in Korea were reviewed and an observational method to assess the postural load was developed. A computer-based postural workload evaluation system based on a macro-postural classification scheme was developed. The macro-postural classification is based on the perceived discomforts for various joint motions. On the basis of the perceived discomfort, postural stress levels for the postures at each joint were also defined in a ratio scale to the standing neutral posture. A neural network approach was used to predict the whole-body postural stresses from the body joint motions. A computer-based postural stress evaluation system was designed to automate the procedure for analyzing postures and enhance the usability and practical applicability. © 2002 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Background: This paper reports on results of a health system strengthening implementation research initiative conducted the Upper East Region of northern Ghana. Transformative interventions to accelerate and strengthen the health delivery were implemented that included empowering community leaders and members to actively participate in health delivery, strengthening the referral systems through the provision of community transport systems, providing basic medical equipment to community clinics, and improving the skills of critical health staff through training. Methods: A mixed method design was used to evaluate the impact of the interventions. A quantitative evaluation employed a flexible research design to test the effects of various component activities of the project. To assess impact, a pre-versus–post randomized cluster survey design was used. Qualitative research was conducted with focus group data and individual in depth interviews to gauge the views of various stakeholders associated with the implementation process. Results: After intervention, significant improvements in key maternal and child health indicators such as antenatal and postnatal care coverage were observed and increases in the proportion of deliveries occurring in health facilities and assisted by skilled health personnel relative to pre-intervention conditions. There was also increased uptake of oral rehydration salts (ORS) for treatment of childhood diarrhoea, as well as marked reductions in the incidence of upper respiratory infections (URI). Conclusions: A pre-and post-evaluation of impact suggests that the programme had a strong positive impact on the functioning of primary health care. Findings are consistent with the proposition that the coverage and content of the Ghana Community-based Health Planning and Services programme was improved by program interventions and induced discernable changes in key indicators of health system performance. [ABSTRACT FROM AUTHOR]

Abstract: Soft drink manufacturing has become one of the largest food industries in Korea, now competing in a 2.5-billion dollar market, with more than 20,000 people employed. Deliveries of a broad line of soft drink products involve the use of a hand truck and, in many cases, a backpack mode of carriage. Workers usually prefer the backpack mode, because they feel safer by carrying beverage boxes on the back on stairs. In this study, the physiological workload involved in backpack-mode carrying was investigated, especially focusing on the effects of load weight and stairway transport. To measure heart rate and oxygen uptake while carrying on the back, a laboratory experiment was conducted and safety guidelines for such tasks were proposed, based on the experimental results. Eight healthy male subjects performed backpack-mode carrying, weight between 40 and 60kg: (1) on level ground, (2) upstairs and (3) downstairs. The results showed that stairways involved an increased physiological burden, and that a load of 60kg entailed a significantly higher physiological cost than carrying a load of 40kg. Although backpack-mode carrying has some biomechanical advantages, the worker should be advised to carry a load of less than 40kg, to avoid a high physiological load. During backpack-mode carrying, it is also recommended that a delivery person makes more trips with a light load rather than fewer trips with a heavier load per trip. [Copyright &y& Elsevier]

Background and Aims: It is difficult to differentiate functional heartburn from proton pump inhibitor (PPI) failure. The aims of this study were to assess the role of early wireless esophageal pH monitoring in patients referred with gastroesophageal reflux disease (GERD) and to identify differences in the clinical spectrum among GERD subtypes. Methods: We enrolled consecutive referred patients with suspected GERD. After endoscopy on the first visit, all underwent wireless esophageal pH monitoring when off the PPI. Results: Two hundred thirty patients were enrolled. These patients were classified into a reflux esophagitis group (20, 8.7 %) and a normal endoscopic findings group (210, 91.3 %). Among the 210 patients in the normal endoscopic findings group, 63 (27.4 %) were diagnosed with pathological reflux, 35 (15.2 %) with hypersensitive esophagus, 87 (37.8 %) with normal acid exposure with negative symptom association, and 25 (10.9 %) with test failure. These groups did not differ in age, body mass index, smoking habit, alcohol consumption, symptom severity, quality of life, presence of atypical symptoms, overlap with irritable bowel syndrome, and the frequency of somatization, depression, and anxiety. PPI responses were evaluated in 135 patients. Fifty patients (37.0 %) were not responsive to the 4-week treatment; 26 (19.3 %) were diagnosed with refractory non-erosive gastroesophageal disease, and 24 (17.8 %) with functional heartburn. The demographics and clinical and psychological characteristics did not differ between the two groups. Conclusions: Demographic characteristics and symptom patterns alone cannot differentiate functional heartburn from various subtypes of GERD. Wireless esophageal pH monitoring should be considered for the initial evaluation of GERD in the tertiary referral setting. [ABSTRACT FROM AUTHOR]