Interaction between hand span and different sizes of keyboards on EMG activity in pianists: An observational study.

The availability of keyboards with reduced key width has been recently promoted as an ergonomic aid for small-handed pianists to overcome any potential physical disadvantages that may restrict their piano repertoire. However, a lack of biomechanical data exists to support whether reduced piano key size is effective in achieving this outcome. This research investigates the effect of playing on three different key width size pianos (5.5-inch octave, 6.0-inch octave and conventional size with 6.5-inch octave) on hand, arm and shoulder muscle activity levels according to the hand size of the pianists. Results indicate that piano key size affects the muscle activity levels of selected muscles. Furthermore, this effect of different key sizes changed according to the players' hand spans. Small-handed pianists may benefit from using smaller-sized keyboards to reduce muscular exertion during performance. This investigation provides preliminary EMG data supporting the use of different size keyboards to improve the ergonomic fit according to the dimensions of individual pianists.

Trends in skin cancer knowledge, sun protection practices and behaviours in the Northern Ireland population.

BACKGROUND: Sun exposure increases risk of skin cancer, especially melanoma, incidence of which continues to rise. Reported skin cancer knowledge and trends in sun care behaviours are documented in a UK region where there has been 20 years of sun-related health promotion campaigns. METHODS: In 2000, 2004 and 2008, a 'care in the sun' module was included in the Northern Ireland (NI) Omnibus survey. Randomly selected subjects were asked to complete a sun-related questionnaire and proportions of respondents analysed by demographic and socio-economic factors, with differences tested using z-tests and the chi-squared test. RESULTS: Around 3623 persons responded. Skin cancer knowledge was high (97%). Sun avoidance decreased with time and was lowest among younger age groups and males. Sunscreen use was high (70%), unchanged over 8 years, and more likely among younger age groups, females, those in paid employment, and those with tertiary level education. Use of sunscreen with minimum Sun Protection Factor (SPF) 15 (a campaign message) increased from 45% to 70% (P < 0.01). Skin self-examination was infrequent (8%), less common among those aged ≥65 years, males and those with only primary or secondary level education. CONCLUSIONS: Messages on sunscreen use have penetrated the population well, but lower use among the unemployed suggests cost as an issue. Lack of sun avoidance in young people, especially men, poses a risk for further skin cancer increases. Low levels of reported skin self-examination in older people, men and those with lower educational attainment identify areas for further action.

Measures of blood loss and red cell transfusion targets for caesarean delivery complicated by placenta praevia.

OBJECTIVE: The objective of this study was to assess the association between transfusion, per cent drop in haemoglobin (Hb), and estimated blood loss during the delivery and the first postoperative week following caesarean delivery for placenta praevia. Clinical data predictive of an objective laboratory test for risk of haemorrhage and the need for transfusion were investigated. Transfusions outside national Guidelines were noted. DESIGN: Retrospective observational study of patients with placenta praevia, who were delivered consecutively by caesarean section at Royal Brisbane and Women's Hospital from 1999 to 2005. SETTING: University-affiliated tertiary hospital. All caesareans were performed by one or more consultant obstetricians, gynaecology oncology surgeons and registrar assistants. RESULTS: Seventy-one (28.9%) of 246 patients with placenta praevia were transfused, with 45 of these receiving three or more red cell units. The antenatal Hb fell by a mean of 20.2% (SD 13.5). The average operative haemorrhage was estimated as 1225 mL (SD 996). No patient or surgical factors were significantly associated with changes in Hb. There was a significant association between per cent fall in antenatal Hb and both transfusion P < 0.001 and estimated loss P = 0.002. After transfusion, the Hb of 19 patients was higher than that recommended by Guidelines. CONCLUSIONS: Whether transfusion is necessary, but not the number of red cell units, can be planned by the effect of haemorrhage on antenatal Hb during delivery by caesarean section complicated by placenta praevia.

Which heparin during the investigation of chest pain at term pregnancy?

A patient was treated with a therapeutic dose of low-molecular-weight heparin, then required caesarean section immediately following its administration. Reasons for preferring this heparin over unfractionated heparin are acknowledged but not supported for short-term use in an obstetric patient near term.