Association between comprehensive workstation and neck and upper-limb pain among office worker.

OBJECTIVES: Our study aimed to investigate the association between comprehensive workstations and neck and upper-limb pain (NUP) among office workers. METHODS: This cross-sectional study included 307 office workers (median age, 39 years; 88% men). Workstations (presence of armrest, armrest position, number of monitors used, mouse position, mouse usage, keyboard usage, and keyboard position) were investigated in terms of 17 items and judged as "adequate" or "inadequate." NUP was assessed using a numerical rating scale. NUP locations included the neck, shoulder, elbow, and wrist. In the statistical analysis, outcome variables were the presence of pain in each part, while explanatory variables were the number of inadequate workstations. Logistic regression analyses were conducted with adjustment for age, gender, working duration, and exercise habit. RESULTS: The prevalence of neck pain was 47% (n = 143), shoulder pain was 50% (n = 153), elbow pain was 7.2% (n = 22), and wrist pain was 13% (n = 40). In the adjusted model, the number of inadequate workstations had significant positive associations with elbow pain (odds ratio [OR], 1.39; 95% confidence interval [CI], 1.06.1.81) and wrist pain (OR, 1.80; 95% CI, 1.17.2.26). However, the number of inadequate workstations was not significantly associated with neck pain or shoulder pain. CONCLUSIONS: Workstation-related factors (presence of armrest, armrest position, mouse usage, and keyboard usage) were significantly associated with elbow and wrist pain. Our findings suggest that workstations can contribute to elbow and wrist pain in office workers.

HMB in DRAM-less NVMe SSDs: Their usage and effects on performance.

Solid-state drives (SSDs) that do not have internal dynamic random-access memory (DRAM) are being widely spread for client SSD and embedded SSD markets in recent years because they are cheap and consume less power. Obviously, their performance is lower than conventional SSDs because they cannot exploit advantages of DRAM in the controller. However, this problem can be alleviated by using host memory buffer (HMB) feature of Non-Volatile Memory Express (NVMe), which allows SSDs to utilize the DRAM of host. In this paper, we show that commercial DRAM-less SSDs clearly exhibit worse I/O performance than SSDs with internal DRAM, but this can be improved by using the HMB feature. We also present methods that reveal how the host memory buffer is used in commercial DRAM-less SSDs to improve I/O performance. Through extensive experiments, we conclude that DRAM-less SSDs evaluated in this study mainly exploit the host memory buffer as an address mapping table cache rather than a read cache or write buffer to improve I/O performance.

Application of a genetic algorithm to the keyboard layout problem.

The number of people who use computers for business and personal purposes increases as technology grows. The application of ergonomic practices on computer workstations reduces the musculoskeletal discomfort experienced and increases the overall satisfaction of the users. Keyboards are available in various systems, from computers to mobile devices, and have difference shapes and sizes. The keyboard size and shape is known to influence the user's upper extremities. Alternative keyboard designs help diminish the pain in the arms that occurs due to awkward arm postures. Most previous studies tried to optimize the keyboard layout based on ergonomic typing and the frequency of letters' co-occurrence. This research considers the frequency of the appearance of the most used 3,000 words in the English language. First, the frequency of each letter pair is calculated by the Text Analyzer. Then, a genetic algorithm is applied to design an ergonomically optimized keyboard to minimize the total distance of finger travel among the selected alphanumeric characters. The results showed that the distance travelled obtained by the proposed keyboard layout is less than that for the QWERTY keyboard in all different types of texts, in which an average of 6.04% improvement was achieved. Therefore, the proposed design can be used for keyboards to reduce time and fatigue.

Differences in typing forces, muscle activity, wrist posture, typing performance, and self-reported comfort among conventional and ultra-low travel keyboards.

This study investigated the relative impact of ultra-low travel keyboards on typing force, muscle activity, wrist posture, typing performance, and self-reported comfort/preference as compared to a conventional keyboard. In a repeated-measures laboratory-based study, 20 subjects were invited to type for 10 min on each of five keyboards with different travel distances of 0.5, 0.7, 1.2, 1.6 (ultra-low travel keyboards), and 2.0 mm (a conventional keyboard). During the typing sessions, we measured typing force; muscle activity in extrinsic finger muscles (flexor digitorum superficialis and extensor digitorum communis), shoulder (trapezius) and neck (splenius capitis); wrist posture; typing performance; and self-reported comfort/preference. While using the ultra-low travel keyboards, subjects typed with less force and wrist extension, and had more ulnar deviation (p's < 0.0001) compared with conventional keyboard. However, these differences in typing forces were less than 0.5 N and less than 4° for both wrist extension and ulnar deviation. The general trend of data did not show any consistent or substantial differences in muscle activity (less than 2 %MVC) and typing performance (<5 WPM in speed; < 3% in accuracy), despite the observed statistical difference in the finger flexors and extensors muscle activity (p's < 0.19) and typing performance (p < 0.0001). However, the subjects preferred using conventional keyboards in most of the investigated self-reported comfort and preference criteria (p's < 0.4). In conclusion, these small differences indicate that using ultra-low travel keyboards may not have substantial differences in biomechanical exposures and typing performance compared to conventional keyboard; however, the subjective responses indicated that the ultra-low keyboards with the shortest key travel tended to be the least preferred.

Disinfection of the Radiologist Workstation and Radiologist Hand Hygiene: A Single Institution Practice Quality Improvement Project.

PURPOSE: The purpose of this study was to evaluate the workstation disinfection rates and hand hygiene of radiologists and trainees at shared departmental workstations and assess the impact of education and reminder placards on daily habits. METHODS: A 10-question survey was administered to all staff radiologists, fellows, and residents at our institution. The questions pertained to workstation disinfection, hand hygiene habits, and accessibility to disinfectant wipes and hand sanitizer stations. Subsequently, a short educational PowerPoint presentation was emailed to the department and small reminder placards were placed at each workstation. A follow-up survey was administered. Chi-square and Wilcoxon signed-rank tests were used to analyse the results. RESULTS: The percentage of participants who disinfect their workstations 1-2 times/week, 3-4 times/week or everyday increased from 53.4% (45 of 84 participants) to 74.3% (55 of 74 participants; P = .01), while the number who disinfect their workstation <1 time/week or never decreased from 46.4% (39 of 84 participants) to 25.7% (19 of 74 participants; P = .01). Hand washing before working at the workstation increased from 41.6% (35 of 84 participants) to 48.7% (36 of 74 participants; P = .76) and hand washing after working at the workstation increased from 50.0% (42 of 84 participants) to 56.8% (42 of 74 participants; P = .49). CONCLUSIONS: At our institution, the implementation of daily reminder placards at each workstation and the administration of an educational PowerPoint presentation improved the rate of radiologist workstation disinfection.

Assessing ergonomic risks of software: Development of the SEAT.

Software utilizing interaction designs that require extensive dragging or clicking of icons may increase users' risks for upper extremity cumulative trauma disorders. The purpose of this research is to develop a Self-report Ergonomic Assessment Tool (SEAT) for assessing the risks of software interaction designs and facilitate mitigation of those risks. A 28-item self-report measure was developed by combining and modifying items from existing industrial ergonomic tools. Data were collected from 166 participants after they completed four different tasks that varied by method of input (touch or keyboard and mouse) and type of task (selecting or typing). Principal component analysis found distinct factors associated with stress (i.e., demands) and strain (i.e., response). Repeated measures analyses of variance showed that participants could discriminate the different strain induced by the input methods and tasks. However, participants' ability to discriminate between the stressors associated with that strain was mixed. Further validation of the SEAT is necessary but these results indicate that the SEAT may be a viable method of assessing ergonomics risks presented by software design.

Evaluating change in user error when using ruggedized handheld devices.

The increasing number of handheld mobile devices used today and the increasing dependency on them in the workplace makes understanding how users interact with these devices critical. This study seeks to understand how user error changes based on user age as well as input content type on ruggedized handheld devices. Participants completed data entry tasks of word and character input on two different devices, a physical keypad and touchscreen device. The number of errors and types of error, corrected and permanent were collected for each participant. Based on results on the study, touchscreen devices proved to be the optimal ruggedized handheld device to minimize user error.

Use of Digital Pens for Rapid Epidemiologic Data Collection During a Foodborne Outbreak Investigation.

OBJECTIVE: Public health investigations require rapid assessment, response, and initiation of control measures. In 2012, the New Hampshire Department of Health and Human Services used digital pens to rapidly acquire epidemiologic data during a gastrointestinal illness outbreak. METHODS: Menus were obtained and a standard questionnaire was administered to exposed persons using digital pens. Questionnaire data were downloaded into an electronic file for analysis. RESULTS: Sixty-nine (74%) of 93 exposed persons completed a questionnaire. Of 6389 data entries made on digital paper, 218 (3%) required correction; of these, 201 (92%) involved a free-form variable and 17 (8%) involved a check-box variable. Digital pens saved an estimated 5 to 6 hours of data-entry time. CONCLUSIONS: This outbreak provided an opportunity to assess the value of digital pens for decreasing data-entry burden and allowing more timely data analysis in an emergent setting. Depending on the size of the outbreak and complexity of the survey, there is likely a threshold when use of digital pens would provide a clear benefit to outbreak response. As new technology becomes available for use in emergency preparedness settings, public health agencies must continuously review and update response plans and evaluate investigation tools to ensure timely disease control and response activities.

Computer use and carpal tunnel syndrome: A meta-analysis.

BACKGROUND: Studies have reported contradictory results on the role of keyboard or mouse use in carpal tunnel syndrome (CTS). This meta-analysis aimed to assess whether computer use causes CTS. METHODS: Literature searches were conducted in several databases until May 2014. Twelve studies qualified for a random-effects meta-analysis. Heterogeneity and publication bias were assessed. RESULTS: In a meta-analysis of six studies (N=4964) that compared computer workers with the general population or other occupational populations, computer/typewriter use (pooled odds ratio (OR)=0.72, 95% confidence interval (CI) 0.58-0.90), computer/typewriter use ≥1 vs. <1h/day (OR=0.63, 95% CI 0.38-1.04) and computer/typewriter use ≥4 vs. <4h/day (OR=0.68, 95% CI 0.54-0.87) were inversely associated with CTS. Conversely, in a meta-analysis of six studies (N=5202) conducted among office workers, CTS was positively associated with computer/typewriter use (pooled OR=1.34, 95% CI 1.08-1.65), mouse use (OR=1.93, 95% CI 1.43-2.61), frequent computer use (OR=1.89, 95% CI 1.15-3.09), frequent mouse use (OR=1.84, 95% CI 1.18-2.87) and with years of computer work (OR=1.92, 95% CI 1.17-3.17 for long vs. short). There was no evidence of publication bias for both types of studies. CONCLUSIONS: Studies that compared computer workers with the general population or several occupational groups did not control their estimates for occupational risk factors. Thus, office workers with no or little computer use are a more appropriate comparison group than the general population or several occupational groups. This meta-analysis suggests that excessive computer use, particularly mouse usage might be a minor occupational risk factor for CTS. Further prospective studies among office workers with objectively assessed keyboard and mouse use, and CTS symptoms or signs confirmed by a nerve conduction study are needed.

Influence of the long term use of a computer on median, ulnar and radial sensory nerves in the wrist region.

OBJECTIVES: Repetitive microtrauma or overuse injuries may often affect upper extremities of the long term computer users. The aim of this study was to compare sensory nerve conduction velocities (SNCV) for median, radial and ulnar nerves in the wrist of computer users with the same parameters in controls who do not use computers regularly. MATERIAL AND METHODS: Twenty one male computer users (age: mean (M) = 28.3 years ± standard deviation (SD) = 7.5 years) and 21 male control subjects (age: M±SD = 24.1±4.6 years) were recruited for the study. Limb length and the perimeters of the dominant arm and forearm were measured for each subject. The neurophysiological study consisted of measuring sensory nerve conduction of the median, ulnar and radial nerves. RESULTS: The sensory conduction velocities of both median and ulnar nerves were significantly delayed in the dominant arm of the computer users compared to the controls. In addition, sensory conduction velocity of the median nerve was significantly delayed in the dominant extremity of the computer users compared to their non-dominant extremity. CONCLUSIONS: This study shows that computer users have a tendency toward developing median and ulnar sensory nerve damage in the wrist region. Mechanism of delayed SNCV in the median and ulnar nerves may be due to sustained extension and ulnar deviation of the wrist during computer mouse use and typing. Reduced SNCV changes were more apparent on the dominant side of the median nerve. This may indicate the increased neural deficits related to an increased use of the dominant side. Further investigation is needed to determine how to reduce potential risk factors at this stage in order to prevent development of median or ulnar neuropathy in the long term computer users.

Bacterial contamination of radiologist workstations: results of a pilot study.

PURPOSE: The aim of this study was to quantify and characterize bacterial contamination of radiologist workstations. METHODS: Dictation microphones and computer mice at the most frequently used radiologist workstations from 2 inpatient and 2 outpatient reading rooms at 2 teaching hospitals in 2 states were sampled for bacteria. Reference toilet seat and doorknob sampling was performed in the 4 restrooms nearest those reading rooms. One microphone and one mouse in each reading room were sampled again after quick disinfection with an inexpensive, commercially available antiseptic pad. Sampling was performed using direct trypticase soy agar plating, with sampled areas uniformly approximating 50 cm(2). Colonies were quantified and additionally characterized after 24 hours using mannitol salt agar and MacConkey agar. RESULTS: All sampled radiologist computer workstation and restroom sites were contaminated with bacteria. Mean colony counts were 69.4 ± 38.7 (range, 15-123) for microphones, 46.1 ± 58.1 (range, 1-173) for mice, 10.5 ± 9.7 (range, 1-22) for toilet seats, and 14.8 ± 16.0 (range, 1-36) for restroom doorknobs. Of all workstation sites, 64.3% (9 of 14) grew Staphylococcus aureus, and 21.4% (3 of 14) grew enteric organisms. Overall microphone and mouse bacterial contamination was significantly higher than that of nearby restroom toilets and doorknobs (57.8 ± 49.0 vs 12.6 ± 12.5, P = .005). Microphone and mouse bacterial counts were nearly completely eliminated after brief antiseptic swabbing (from 76.9 ± 53.2 to 0.3 ± 0.7, P = .002). CONCLUSIONS: Bacterial contamination of microphones and computer mice at radiologist workstations is common, with colonization significantly greater than nearby restroom toilet seats and doorknobs. Simple, rapid, and inexpensive disinfection techniques nearly completely eradicate workstation bacterial contamination. The clinical implications of colonization merits further study.

An evaluation of departmental radiation oncology incident reports: anticipating a national reporting system.

PURPOSE: Systems to ensure patient safety are of critical importance. The electronic incident reporting systems (IRS) of 2 large academic radiation oncology departments were evaluated for events that may be suitable for submission to a national reporting system (NRS). METHODS AND MATERIALS: All events recorded in the combined IRS were evaluated from 2007 through 2010. Incidents were graded for potential severity using the validated French Nuclear Safety Authority (ASN) 5-point scale. These incidents were categorized into 7 groups: (1) human error, (2) software error, (3) hardware error, (4) error in communication between 2 humans, (5) error at the human-software interface, (6) error at the software-hardware interface, and (7) error at the human-hardware interface. RESULTS: Between the 2 systems, 4407 incidents were reported. Of these events, 1507 (34%) were considered to have the potential for clinical consequences. Of these 1507 events, 149 (10%) were rated as having a potential severity of ≥2. Of these 149 events, the committee determined that 79 (53%) of these events would be submittable to a NRS of which the majority was related to human error or to the human-software interface. CONCLUSIONS: A significant number of incidents were identified in this analysis. The majority of events in this study were related to human error and to the human-software interface, further supporting the need for a NRS to facilitate field-wide learning and system improvement.

Variance in direct exposure measures of typing force and wrist kinematics across hours and days among office computer workers.

To determine the number of direct measurements needed to obtain a representative estimate of typing force and wrist kinematics, continuous measures of keyboard reaction force and wrist joint angle were collected at the workstation of 22 office workers while they completed their own work over three days, six hours per day. Typing force and wrist kinematics during keyboard, mouse and idle activities were calculated for each hour of measurement along with variance in measurements between subjects and between day and hour within subjects. Variance in measurements between subjects was significantly greater than variance in measurements between days and hours within subjects. Therefore, we concluded a single, one-hour period of continuous measures is sufficient to identify differences in typing force and wrist kinematics between subjects. Within subjects, day and hour of measurement had a significant effect on some measures and thus should be accounted for when comparing measures within a subject. PRACTITIONER SUMMARY: The dose response relationship between exposure to computer related biomechanical risk factors and musculoskeletal disorders is poorly understood due to the difficulty and cost of direct measures. This study demonstrates a single hour of direct continuous measures is sufficient to identify differences in wrist kinematics and typing force between individuals.

Carpal tunnel syndrome and keyboard use at work: a population-based study.

OBJECTIVE: To investigate the relationship between carpal tunnel syndrome (CTS) and keyboard use at work in a general population. METHODS: A health status questionnaire was mailed to 2,465 persons of working age (25-65 years) who were randomly selected from the general population of a representative region of Sweden. The questionnaire required the subjects to provide information about the presence and severity of pain, numbness and tingling in each body region, employment history, and work activities, including average time spent using a keyboard during a usual working day. Those reporting recurrent hand numbness or tingling in the median nerve distribution were asked to undergo a physical examination and nerve conduction testing. The prevalence of CTS, defined as symptoms plus abnormal results on nerve conduction tests, was compared between groups of subjects that differed in their intensity of keyboard use, adjusting for age, sex, body mass index, and smoking status. RESULTS: Eighty-two percent responded to the questionnaire, and 80% of all symptomatic persons attended the examinations. Persons who had reported intensive keyboard use on the questionnaire were significantly less likely to be diagnosed as having CTS than were those who had reported little keyboard use, with a prevalence that increased from 2.6% in the highest keyboard use group (> or = 4 hours/day), to 2.9% in the moderate use group (1 to <4 hours/day), 4.9% in the low use group (<1 hour/day), and 5.2% in the no keyboard use at work group (P for trend = 0.032). Using > or = 1 hour/day to designate high keyboard use and <1 hour/day to designate low keyboard use, the prevalence ratio of CTS in the groups with high to low keyboard use was 0.55 (95% confidence interval 0.32, 0.96). CONCLUSION: Intensive keyboard use appears to be associated with a lower risk of CTS.

Characteristics of men who have sex with men on the internet but identify as heterosexual, compared with heterosexually identified men who have sex with women.

We compared men who have sex with other men on the Internet with the remainder of the sample of men who reported only sex with women on the Internet, in a sample of 1,846 Swedish men recruited from a major Swedish portal. We report on the self-identified heterosexual men in the sample who reported engaging in cybersex in the past year, and for whom there was complete data on sexual identity and the gender of cybersexual partners. Of the 244 cases with full data, 76% were heterosexual in both identity and behavior, 16% were gay or bisexual in identity and reported both male and female cybersexual contacts on the Internet, and 8% indicated their sexual preference was heterosexual but also reported at least one male sexual partner on the Internet. Thus, 11% of self-identified heterosexual men had sex with other men online. Comparing the two groups, the men who had sex with men (MSM) who did not identify (MSM-NI) spent significantly more time per week online, although a similar amount of time on sexual pursuits, as the heterosexual men. The MSM-NI were significantly more likely to agree that their online sexuality had affected their sexuality in a positive way, to have bought sex from prostitutes, to agree that they do things online that they would not do offline, have cybersex more often, use a web-camera and microphone more often, flirt and visit contact sites more often, and agree more often that sexual thoughts and behaviors are causing problems, desire to have sex creates problems, and sometimes fail to meet commitments due to their sexual behavior. These data taken together suggest that MSM-NI online are not uncommon and are characterized by the extent of their cybersexual involvement that sometimes extends to other men. Such men may rationalize this cybersex with other men as not, or minimally, sexual in much the same way as Humphreys characterized MSMs in public restrooms.

Personal digital assistant for "real time" assessment of women's health in the clinical years.

OBJECTIVE: To assess in "real time" the degree to which women's health competencies are addressed in the clinical curriculum by using a personal digital assistant. STUDY DESIGN: Competencies for women's health were developed. Twelve students were supplied with a personal digital assistant, pre-loaded with a patient log system, for use in assessment of the inclusion of these competencies in the clinical arena. The students received instruction on completing the log for each patient for whom they were primarily responsible. RESULTS: There were 2690 total encounters. In clerkships other than obstetrics and gynecology, gender was discussed in 10% to 20% of encounters. Other than obstetrics and gynecology diagnostic categories, no more than 15% of diagnoses included gender discussion. CONCLUSION: Student recording of patient encounters reveals a minimal amount of women's health discussion in the clinical years; however, the personal digital assistant is an effective tool with which to monitor curriculum content in the clinical setting.