| 1. |
- Hemphälä, Hillevi, et al.
(författare)
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A method for risk assessment within Visual Ergonomics
- 2015
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Ingår i: Proceedings of the 19th Triennial Congress of the International Ergonomics Association. ; , s. nr 1203-
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Konferensbidrag (refereegranskat)abstract
- IntroductionInsufficient visual ability can lead to increased work load and contribute to eyestrain and musculoskeletal discomfort, since “the eye leads the body” (Anshel, 2005). It has been shown that visually demanding work, such as computer work, is associated with eye discomfort, headaches and muscle pains in mainly the neck and shoulders (Rosenfield, 2011).Although the relation between eyestrain and musculoskeletal discomfort is not fully understood, studies have shown that straining the eyes increases the musculoskeletal activity in neck and shoulders (trapezius), and an association between visually demanding work, eye problems, headache and/or muscle problems have been found (Aarås et al., 2001; IESNA, 2011, Richter et al., 2008; Zetterberg et al., 2013). Problems due to insufficient visual ergonomics not only exist in computer intensive jobs, but in other professions as well. For example, surgeons and other surgical personnel that report eyestrain also report twice as much musculoskeletal discomfort from the upper part of the body (Hemphälä et al., 2011). In an intervention study among postmen, both eyestrain and musculoskeletal discomfort decreased after a visual ergonomic intervention. The intervention included providing customized eyeglasses and optimal lighting conditions (Hemphälä et al., 2012). Apart from health and well-being being affected by a poor visual ergonomic work environment, quality and productivity may also be reduced (Eklund, 2009).The aim of this paper is to present the first version of a practical, easy-to-use, and time-efficient risk assessment method for visual ergonomics. The development of the method including the evaluation will also be described. With such a method, risk factors within the visual environment can hopefully be detected, and interventions implemented in order to reduce the prevalence of symptoms related to poor visual ergonomics among workers.MethodsA first version of the method has been developed, mainly based on existing checklists and instruments (Colon et al. 1999; Børsting et al., 2008, Knave et al., 1985, Sheedy and Shaw-McMinn, 2002; Wilson & Corlett, 2005). During spring 2015, 30 ergonomists will be updated about visual ergonomics and introduced to the risk assessment method. Each ergonomist will thereafter use the method in 10 workplaces, yielding data and practical experiences from 300 risk assessments. These data will then be used to test the validity and reliability of the method, and if necessary to further develop it.ResultsThe first version of the risk assessment method for Visual Ergonomics will be presented at IEA 2015, together with results from the approximately 300 risk assessments made by the ergonomists. So far, the factors included in the method are objective measurements such as illuminance, luminance contrast, uniformity values, expert assessment of the risk for glare, and subjective ratings of the visual ability, eyestrain and musculoskeletal discomfort.DiscussionThe presented method will be compared to other similar methods. The used method for development will be discussed in relation to validity and reliability. Finally the presented risk assessment method will be discussed in relation to usefulness in prevention of discomfort and work related disorders at work places.
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| 2. |
- Malinovschi, Andrei, 1978-, et al.
(författare)
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Consequences of Using Post- or Prebronchodilator Reference Values in Interpreting Spirometry
- 2023
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Ingår i: American Journal of Respiratory and Critical Care Medicine. - : American Thoracic Society. - 1073-449X .- 1535-4970. ; 208:4, s. 461-471
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Tidskriftsartikel (refereegranskat)abstract
- RATIONALE: Post-bronchodilator (BD) spirometry is used for diagnosis of chronic obstructive pulmonary disease (COPD). However, pre-BD reference values are used for spirometry interpretation.OBJECTIVES: To compare the resulting prevalence rates of abnormal spirometry and study the consequences of using pre- or post-BD reference values generated within the Swedish CArdioPulmonary bioImage Study (SCAPIS) when interpreting post-BD spirometry in a general population.METHODS: SCAPIS reference values for post-BD and pre-BD spirometry were based on 10,156 and 1,498 never-smoking, healthy participants, respectively. We studied the associations of abnormal spirometry, defined by using pre- or post-BD reference values, with respiratory burden in the SCAPIS general population (28,851 individuals).MEASUREMENTS AND MAIN RESULTS: Bronchodilation resulted in higher predicted median and lower limit of normal (LLN) for FEV1/FVC ratio. The prevalence of post-BD FEV1/FVC < pre-bronchodilator LLN was 4.8% and that of post-BD FEV1/FVC < post-bronchodilator LLN was 9.9% for the general population. An additional 5.1% was identified as having an abnormal post-BD FEV1/FVC ratio and this group had more respiratory symptoms, emphysema (13.5% vs. 4.1%, p<0.001) and self-reported physician-diagnosed COPD (2.8% vs. 0.5%, p<0.001) than subjects with post-BD FEV1/FVC ratio > LLN for both pre- and post-bronchodilation).CONCLUSIONS: Pre- and post-bronchodilator spirometry reference values differ with regard to FEV1/FVC ratio. Use of post-bronchodilator reference values doubled the population prevalence of airflow obstruction; this was related to a higher respiratory burden. Using post-bronchodilator reference values when interpreting post-bronchodilator spirometry might enable identification of individuals with mild disease and be clinically relevant.
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| 3. |
- Hemphälä, Hillevi, et al.
(författare)
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A method for assessing risks within visual ergonomics
- 2014
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Ingår i: 11th International Symposium on Human Factors in Organisational Design and Management & 46th Annual Nordic Ergonomics Society Conference. - Santa Monica, CA, USA : The IEA PRESS. - 9788793130135 ; , s. 111-112
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Konferensbidrag (refereegranskat)abstract
- 1. IntroductionInsufficient visual ability can lead to strained work load for employees and can contribute to eyestrain and musculoskeletal discomfort, “the eye leads the body” (Anshel, 2005). An optimal visual environment provides physical conditions for work in the best possible way. Visually demanding work, such as computer work, is associated with eye discomfort, headaches and muscle pains in mainly the neck and shoulders (Rosenfield, 2011). For computer workers in North America studies show that 75-90 % of the workers reported subjective symptoms from the eyes (Anshel, 2005). The causality between eyestrain and musculoskeletal discomfort is not fully understood, but studies have shown that straining the eyes increases the musculoskeletal activity in neck and shoulders (trapezius), and a link between visually demanding work, eye problems, headache and/or muscle problems have been found (Aarås et al., 2001; Richter et al., 2008; Zetterlund et al., 2009; Zetterberg et al., 2013). A study of call-center workers in Sweden showed that 21% of workers have both eyes and neck problems (Wiholm et al., 2007). Ergonomic problems also exist for professions where computer work is not dominant. Surgeons and other surgical personnel, with subjective eye discomfort, reported twice the incidence of musculoskeletal disorders when compared with staff without eye symptoms (Hemphälä et al., 2011). In an intervention study among postmen the eyestrain and musculoskeletal discomfort decreased after visual ergonomic interventions including customized eyeglasses and optimal lighting conditions (Hemphälä et al., 2012). Apart from health and well-being being affected by a poor visual ergonomic work environment, the quality and productivity are also involved (Eklund, 2009).Lighting is an important factor; both the lighting quantity (strength) and quality (e.g. light distribution, direction, glare and contrast). Too low illumination makes it difficult to see clearly and may thus lower performance, high illuminance can cause glare and lead to increased eye fatigue and decreased productivity (IESNA, 2011).2. MethodsThere are several factors to consider when developing a method for visual ergonomics risk assessment of subjective symptoms and discomfort of the eyes (Colon et al. 1999; Børsting et al., 2008, Knave et al., 1985). There are also checklists used in eye exams or medical appointments (Sheedy and Shaw-McMinn, 2002; Wilson & Corlett, 2005). These will be used as basis in the presents the project intended to develop a risk assessment instrument for visual ergonomics.3. ResultsA preliminary version of a risk analysis method for Visual Ergonomics has been developed and will be presented, with a focus on discussing with the audience which factors should primarily be included. The factors included so far in the method are the objective measurements such as illuminance, luminance contrast, uniformity values, expert assessment of the risk for glare; indirect measurements such as subjective ratings of the visual ability, eyestrain and musculoskeletal discomfort. The goal is to develop a practical time efficient method that is easy to use. With such a tool, actions needed to reduce the visual load among the workers, the companies and the society’s negative consequences induced by work-related eyestrain and musculoskeletal discomfort can hopefully be identified.
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| 4. |
- Demmelmaier, Ingrid, 1960-
(författare)
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Behaviours, Beliefs and Back Pain : Prognostic Factors for Disability in the General Population and Implementation of Screening in Primary Care Physiotherapy
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to study prognostic factors for prolonged disability in back pain in the general population and physiotherapists’ screening for prolonged disability, applying a social cognitive learning perspective. Methods and results: Studies I and II were based on a survey in the general population in Sweden. Study I included 1024 individuals aged 20-50 years, reporting non-specific back pain. Four groups (n = 100, 215, 172 and 537) based on duration and recurrence of back pain were formed and compared. After controlling for pain intensity, catastrophising and expectations of future pain were positively correlated to pain duration. Perceived social support was negatively correlated to pain duration. Study II was longitudinal over 12 months and analysed one group reporting first-episode back pain (n = 77), and one group reporting long-term back pain (n = 302). Future pain intensity and disability were predicted by initial levels of pain and disability and pain-related cognitions in both groups. Study III examined the inter-rater reliability of a research protocol for assessment of physiotherapists’ telephone screening for prolonged disability. The results demonstrated sufficient inter-rater reliability. Study IV evaluated the effect of a tailored skills training intervention on physiotherapists’ screening for prolonged disability in back pain. Four physiotherapists in primary care participated in four quasi-experimental single-subject studies. Effects were seen in all participants, with increased screening of prognostic factors and less time spent on detailed discussions about back pain. Conclusions: The identification of mainly cognitive explanatory variables indicates the relevance of a social cognitive perspective of back pain-related disability (studies I and II). Physiotherapists’ telephone screening for prolonged disability in back can be reliably assessed (study III). It is suggested that interventions based on social cognitive theory are effective in producing change in specified clinical behaviours in physiotherapists (study IV).
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| 5. |
- Johansson, Josefin, et al.
(författare)
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Loss of Nexilin function leads to a recessive lethal fetal cardiomyopathy characterized by cardiomegaly and endocardial fibroelastosis
- 2022
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Ingår i: American Journal of Medical Genetics. Part A. - : John Wiley & Sons. - 1552-4825 .- 1552-4833. ; 188:6, s. 1676-1687
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Tidskriftsartikel (refereegranskat)abstract
- The Nexilin F-Actin Binding Protein (Nexilin) encoded by NEXN is a cardiac Z-disc protein important for cardiac function and development in humans, zebrafish, and mice. Heterozygote variants in the human NEXN gene have been reported to cause dilated and hypertrophic cardiomyopathy. Homozygous variants in NEXN cause a lethal form of human fetal cardiomyopathy, only described in two patients before. In a Swedish, four-generation, non-consanguineous family comprising 42 individuals, one female had three consecutive pregnancies with intrauterine fetal deaths caused by a lethal form of dilated cardiomyopathy. Whole-exome sequencing and variant analysis revealed that the affected fetuses were homozygous for a NEXN variant (NM_144573:c.1302del;p.(Ile435Serfs*3)). Moreover, autopsy and histology staining declared that they presented with cardiomegaly and endocardial fibroelastosis. Immunohistochemistry staining for Nexilin in the affected fetuses revealed reduced antibody staining and loss of striation in the heart, supporting loss of Nexilin function. Clinical examination of seven heterozygote carriers confirmed dilated cardiomyopathy (two individuals), other cardiac findings (three individuals), or no cardiac deviations (two individuals), indicating incomplete penetrance or age-dependent expression of dilated cardiomyopathy. RNA sequencing spanning the variant in cDNA blood of heterozygote individuals revealed nonsense-mediated mRNA decay of the mutated transcripts. In the current study, we present the first natural course of the recessively inherited lethal form of human fetal cardiomyopathy caused by loss of Nexilin function. The affected family had uneventful pregnancies until week 23-24, followed by fetal death at week 24-30, characterized by cardiomegaly and endocardial fibroelastosis.
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| 6. |
- Lindberg, Catharina, et al.
(författare)
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Registered nurses' efforts to ensure safety for home-dwelling older patients
- 2023
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 37:2, s. 571-581
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Tidskriftsartikel (refereegranskat)abstract
- Background The international development of health care, an ageing population and rapid technical development mean that more care is being performed in patient homes. This care environment is often unpredictable and involves both formal and informal caregivers, making it potentially unsafe. There is sparse knowledge about how patient safety is protected in home health care in Sweden and how registered nurses work to prevent risks and promote safe care. Aim The aim of the study was to explore registered nurses' efforts to reduce perceived risks for home-dwelling older patients and ensure safe home health care. Method We used a qualitative design with individual interviews with 13 registered nurses working in municipalities in southeast Sweden. The narratives were analysed with inductive content analysis. Findings The findings showed that the registered nurses tried to secure a safe care environment and took an active role in care, striving to stay one step ahead of the patient. These three types of efforts are likely interdependent, suggesting they are all needed to reduce perceived risks for home-dwelling older patients and ensure patient safety in home health care. Conclusions It is a challenge for registered nurses to maintain patient safety when performing care in patient homes. Continuity of care is required and must be based not only on self-reliance among registered nurses but also on trusting relationships with patients, next of kin, colleagues and other personnel, as well as on the development of organisational conditions adapted to patient needs.
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