[Back pain prevention through the correct allocation of school furniture: validation of two instruments.] / La prevención del dolor de espalda mediante la correcta asignación del mobiliario escolar: validación de dos instrumentos.

OBJECTIVE: At school age pain in the lower back is common. There is evidence that an adequate fit between the dimensions of the school furniture and the anthropometric characteristics will result in an improvement in their posture and a reduction in pain. The objectives of this research were to determine the degree of mismatch of furniture in primary education, check if the sizes of the current regulations are adequate and validate two instruments that allow teachers to correctly assign furniture. METHODS: 92 elementary students participated. Measurements to determine the ideal height of the chair and table were made with an anthropometer in a Galician public school in 2019. The recorded values were compared with those obtained by the two measurement instruments to be validated: TAIS and TAIM. The analysis techniques used were: descriptive, one-way ANOVA, t-test and effect size, significance level ρ<0.05. RESULTS: The mismatch between the furniture used in the classrooms and that calculated as ideal was 93.5% for chairs and 97.6% for tables. In 51% of cases they needed different chair and table sizes. The correlational analysis of the instruments to be validated showed an r=0.994 in the chair and r=0.99 in the table. CONCLUSIONS: The level of mismatch between the furniture and the anthropometric dimensions of the students was high. A reorganization of the sizes in the classroom is necessary, being able to follow the European size regulations and using furniture allocation instruments such as those proposed for their high level of correlation.

OBJETIVO: En edad escolar es común el dolor en la zona lumbar. Existe evidencia de que un ajuste adecuado entre las dimensiones del mobiliario escolar y las características antropométricas repercutirá en una mejora en su postura y reducción del dolor. Los objetivos de esta investigación fueron determinar el grado de desajuste del mobiliario en educación primaria, comprobar si las tallas de las normativas vigentes son adecuadas y validar dos instrumentos que permitan al profesorado una correcta asignación del mobiliario. METODOS: Participaron 92 estudiantes de primaria. Las mediciones para determinar la altura ideal de la silla y la mesa se efectuaron con un antropómetro en un centro público gallego en 2019. Los valores registrados se compararon con los obtenidos por los dos instrumentos de medición a validar: TAIS y TAIM. Las técnicas de análisis empleadas fueron: descriptivo, ANOVA de un factor, prueba t y tamaño del efecto, nivel de significación ρ<0,05. RESULTADOS: El desajuste entre el mobiliario utilizado en las aulas y el calculado como ideal fue del 93,5% en las sillas y 97,6% en las mesas. En un 51% de los casos necesitaron tallas de silla y mesa diferente. El análisis correlacional de los instrumentos a validar mostró un r=0,994 en silla y r=0,99 en mesa. CONCLUSIONES: El nivel de desajuste entre el mobiliario y las dimensiones antropométricas del alumnado fue elevado. Es necesaria una reorganización de las tallas en el aula, pudiendo seguir la normativa de tallas europea y empleando instrumentos de asignación de mobiliario como los propuestos por su alto nivel de correlación.

Glass table injuries: A silent public health problem.

BACKGROUND: Glass tables can break and cause traumatic injury. This public health issue is avoidable by adequate regulatory measures. We describe the burden and characteristics of these injuries using the National Electronic Injury Surveillance System (NEISS) database and data from a level 1 trauma center. METHODS: NEISS data was extracted from 2009 to 2015. Injuries were classified by type, severity, and involvement of faulty glass using predetermined criteria. A retrospective chart review of a level 1 trauma center data was performed. Epidemiologic and outcomes data are reported. RESULTS: 3241 cases were reviewed from NEISS. 56% of injuries were attributable to faulty tables. 15% were severe. A bimodal age distribution of age under 7 and early 20s was observed. Commonly injured areas were the upper extremity and forehead. 24 trauma center cases were reviewed. 21% presented with hemodynamic instability, 34% had major organ, body cavity or joint space injuries, and 58% required surgical intervention. 30-day mortality rate was 8%. More than 54% required inpatient care. CONCLUSION: Glass table injuries are common, estimated at over 2.5 million per year. Regulation of glass quality may prevent injury. SUMMARY: Glass table injuries are more common than may be recognized and represent a public health problem that can be mitigated through proper regulatory measures.

Keeping a 2009 Design Award-Winning Intensive Care Unit Current: A 13-Year Case Study.

In a complex medical center environment, the occupants of newly built or renovated spaces expect everything to "function almost perfectly" immediately upon occupancy and for years to come. However, the reality is usually quite different. The need to remediate initial design deficiencies or problems not noted with simulated workflows may occur. In our intensive care unit (ICU), we were very committed to both short-term and long-term enhancements to improve the built and technological environments in order to correct design flaws and modernize the space to extend its operational life way beyond a decade. In this case study, we present all the improvements and their background in our 20-bed, adult medical-surgical ICU. This ICU was the recipient of the Society of Critical Care Medicine's 2009 ICU Design Award Citation. Our discussion addresses redesign and repurposing of ICU and support spaces to accommodate expanding clinical or entirely new programs, new regulations and mandates; upgrading of new technologies and informatics platforms; introducing new design initiatives; and addressing wear and tear and gaps in security and disaster management. These initiatives were all implemented while our ICU remained fully operational. Proposals that could not be implemented are also discussed. We believe this case study describing our experiences and real-life approaches to analyzing and solving challenges in a dynamic environment may offer great value to architects, designers, critical care providers, and hospital administrators whether they are involved in initial ICU design or participate in long-term ICU redesign or modernization.

Ergonomics in the Operating Room: The Cervicospinal Health of Today's Surgeons.

In its many forms, operating can lead surgeons to adopt postures that have damaging long-term effects on physical health through imparting musculoskeletal fatigue. One area that is particularly susceptible is the cervical spine, as surgeons are forced into positions that require sustained cervical hyperflexion. The repercussions of resultant injuries can be steep, as they have the potential to adversely affect one's operative capacity. The purpose of this article is to assess the spinal health of today's surgeons by evaluating available research in various surgical subspecialties. By focusing on the ergonomic principles that govern the surgical arena and identifying unifying themes between plastic surgery and other surgical subspecialties, it is the goal of this article to enhance the understanding of cervical spine health as it pertains to the plastic and reconstructive surgeon.

Ergonomics and the standing desk.

There has been a recent trend in the integration of sit-stand option desks in the work place. Fear-based advertising insinuating that sitting is the health equivalent of smoking has pervaded many work environments. As workers want to remain healthy and pain free, and employers want and need a healthy workforce, it appears that there is a pervasive trend of avoiding sitting as often as possible. Because work tasks that call for an extensive amount of sitting are often times computer-based, this 'standing is healthy' fad is most notably presenting itself at computer-based work stations. The understandably perceived simple fix to the dilemma of sitting, has been the introduction of the sit-stand desk. However, before we all throw out our chairs, it is important to discuss the past and recent research that indicates that prolonged standing can also have detrimental effects on the human system. It is crucial that we expand our idea of a healthy work environment to one that facilitates movement and change in position and empowers the worker to understand their role in their own musculoskeletal and physiological health and wellness, beyond the use of equipment. If we can replace the phrase, 'sitting is the new smoking' with the phrase, 'sedentary is the new smoking', then we can elucidate the idea of what a healthy computer-based work environment and routine would be.

Determinación antropométrica para mobiliario escolar destinado a niños con discapacidad motriz en Ecuador / Anthropometric determination for school furniture designed to children with motor disabilities in Ecuador

Considerando que la inclusión social de personas con discapacidad en los centros de educación es relativamente baja, y tomando en cuenta que a nivel mundial solo un 2% de niños con discapacidad tienen acceso a la educación, se plantea el objetivo de aportar a la inclusión social de niños y niñas con discapacidad motriz en entornos escolares que se acoplen a sus características físicas, para lo cual se planteó una metodología de investigación basada en la definición de 25 variables antropométricas, que sirvieron de guía para la toma de datos antropométricos a una muestra de investigación de 384 niños y niñas que presentan discapacidad motriz leve de la República del Ecuador; obtenido un total de 9600 datos, a los mismos se les aplicó la prueba de Normalidad de Andersons Darling, dando como resultado que todos datos antropométricos se encontraban dentro del rango de normalidad determinado. Así también, con los datos obtenidos se calcularon los percentiles 2,5% y 97,5% con el objetivo de englobar al mayor número de personas en este estudio, además para su posterior análisis comparativo con los medidas especificadas en la Norma Técnica INEN 2583 (2011), obteniendo como resultado una pronunciada disparidad entre ellos, debido a que los primeros se basan en un estudio específico para niños/as con discapacidad motriz, mientras los segundos contemplan medidas estándar para el diseño de sillas y pupitres (mesas) escolares.

Whereas the social inclusion of people with disabilities in education centers is relatively low, and considering that globally only 2% of children with disabilities have access to education, it raises the objective of contribute to the social inclusion of children with motor disabilities in school environments, that fit their physical conditions, for which it is defined a methodology raised on definition of 25 anthropometric variables, which served as a guide for taking anthropometric data to a research sample of 384 children who have mild motor impairment of the Republic of Ecuador, obtained a total of 9600 data, the same was applied test Darling Normality Andersons, resulting that anthropometric data are within the range of normal. Well with the data obtained percentiles were calculated percentile 2.5% and 97.5% in order to encompass the largest number of people in this study, also for subsequent comparative analysis with data INEN Technical Standard 2583 (2011), resulting in a pronounced gap between research data and data from the Standard, because the first is based on a specific study for children with motor disabilities, while the latter measures contemplated school standard for the design of chairs and desks (tables).

The sedentary office: an expert statement on the growing case for change towards better health and productivity.

An international group of experts convened to provide guidance for employers to promote the avoidance of prolonged periods of sedentary work. The set of recommendations was developed from the totality of the current evidence, including long-term epidemiological studies and interventional studies of getting workers to stand and/or move more frequently. The evidence was ranked in quality using the four levels of the American College of Sports Medicine. The derived guidance is as follows: for those occupations which are predominantly desk based, workers should aim to initially progress towards accumulating 2 h/day of standing and light activity (light walking) during working hours, eventually progressing to a total accumulation of 4 h/day (prorated to part-time hours). To achieve this, seated-based work should be regularly broken up with standing-based work, the use of sit-stand desks, or the taking of short active standing breaks. Along with other health promotion goals (improved nutrition, reducing alcohol, smoking and stress), companies should also promote among their staff that prolonged sitting, aggregated from work and in leisure time, may significantly and independently increase the risk of cardiometabolic diseases and premature mortality. It is appreciated that these recommendations should be interpreted in relation to the evidence from which they were derived, largely observational and retrospective studies, or short-term interventional studies showing acute cardiometabolic changes. While longer term intervention studies are required, the level of consistent evidence accumulated to date, and the public health context of rising chronic diseases, suggest initial guidelines are justified. We hope these guidelines stimulate future research, and that greater precision will be possible within future iterations.

Ten trends transforming cancer care and their effects on space planning for academic medical centers.

OBJECTIVE: This article aims to define the major trends currently affecting space needs for academic medical center (AMC) cancer centers. It will distinguish between the trends that promote the concentration of services with those that promote decentralization as well as identify opportunities for achieving greater effectiveness in cancer care space planning. BACKGROUND: Changes in cancer care-higher survival rates, increased clinical trials, new technology, and changing practice models-increasingly fill hospitals' and clinicians' schedules and strain clinical space resources. Conflicts among these trends are concentrating some services and dispersing others. As a result, AMCs must expand and renovate intelligently to continue providing state-of-the-art, compassionate care. CONCLUSIONS: Although the typical AMC cancer center can expect to utilize more space than it would have 10 years ago, a deeper understanding of the cancer center enterprise can lead to opportunities for more effectively using available facility resources. Each AMC must determine for itself the appropriate balance of patient volume, clinical activity, and services between its main hospital campus and satellite branches. As well, space allocation should be flexible, as care trends, medical technology, and the provider's own priorities shift over time. The goal isn't necessarily more space-it's better space.

Investigação sobre a satisfação e os efeitos de móveis utilizados por estudantes universitários / Investigation about the satisfaction and effects of furniture used by college students

Este estudo averiguo a opinião de 51 estudantes de Terapia Ocupacional da UFPB, sobre cadeira universitária com prancheta fixa. Foi aplicado o Questionário de Satisfação do Produto que investigou: conforto, segurança, adaptação, praticidade, adequação ao trabalho e aparência da carteira, através de escala visual analógica, e o Questionário Nórdico de Sintomas Osteomusculares para verificação da presença de dor nos segmentos corporais relacionados à utilização da cadeira. Quanto a metodologia, adotou-se a investigação empírica de caráter experimental para mensurar satisfação do usuário, sendo um estudo exploratório que possui elementos descritivos e correlacionais quantitativos. Utilizamos o coeficiente de correlação de Person, o teste Qui- quadrado e o teste exato de Fisher para verificar a associação entre as variáveis pesquisadas. Desta forma percebemos a importância do estudo estrutural aprofundado relacionado aos itens de Design/Ergonomia, realizado por terapeutas ocupacionais e designers, antes da disseminação deste produtos no mercado. Recomenda-se às universidades, aquisição de mobiliário com regulagem de altura/inclinação e profundidade da prancheta, assento e encosto.

This study investigates the opinion of 51 students of Occupational Therapy, of Federal University of Paraíba about their university chair with fixed clipboard. It was the resulting from theapplication of a questionnaire that measured the satisfaction of theobject and investigates: comfort, security, adaptability, practicality,suitability to work and appearance of the chair, using a system of a visual analogue scale. Furthermore, we used the Brazilian version of the Nordic Musculoskeletal questionnaire to verify the presence of pain in the body segments related to the use of the chair. About the methodology, we adopt the empirical experimentally research to measure the user satisfaction, because it is a exploratory study that has descriptive elements and quantitative correlational. We use the correlation coeffi cient Person, the Chi-square test and the exact Fisher test, to assess the association between the variables studied. Thus, we realize the importance of detailed structural study related to items of Design/Ergonomics, held by occupational therapists and designers, before the spread of this product on the market. Hence, we recommended to the universities, purchasing furniture with height/tilt and with depth on the clipboard, seat and back.

Sofas and infant mortality.

OBJECTIVE: Sleeping on sofas increases the risk of sudden infant death syndrome and other sleep-related deaths. We sought to describe factors associated with infant deaths on sofas. METHODS: We analyzed data for infant deaths on sofas from 24 states in 2004 to 2012 in the National Center for the Review and Prevention of Child Deaths Case Reporting System database. Demographic and environmental data for deaths on sofas were compared with data for sleep-related infant deaths in other locations, using bivariate and multivariable, multinomial logistic regression analyses. RESULTS: A total of 1024 deaths on sofas made up 12.9% of sleep-related infant deaths. They were more likely than deaths in other locations to be classified as accidental suffocation or strangulation (adjusted odds ratio [aOR] 1.9; 95% confidence interval [CI], 1.6-2.3) or ill-defined cause of death (aOR 1.2; 95% CI, 1.0-1.5). Infants who died on sofas were less likely to be Hispanic (aOR 0.7; 95% CI, 0.6-0.9) compared with non-Hispanic white infants or to have objects in the environment (aOR 0.6; 95% CI, 0.5-0.7) and more likely to be sharing the surface with another person (aOR 2.4; 95% CI, 1.9-3.0), to be found on the side (aOR 1.9; 95% CI, 1.4-2.4), to be found in a new sleep location (aOR 6.5; 95% CI, 5.2-8.2), and to have had prenatal smoke exposure (aOR 1.4; 95% CI, 1.2-1.6). Data on recent parental alcohol and drug consumption were not available. CONCLUSIONS: The sofa is an extremely hazardous sleep surface for infants. Deaths on sofas are associated with surface sharing, being found on the side, changing sleep location, and experiencing prenatal tobacco exposure, which are all risk factors for sudden infant death syndrome and sleep-related deaths.

Evaluación de los factores ergoambientales en una institución de educación infantil / Environmental ergonomic factors in an institution childhood education

Se presenta un estudio exploratorio, descriptivo, cuantitativo y de observación directa en el que se evalúan los factores ergoambientales tales como iluminación, ruido y temperatura, al igual que el entorno físico dado por el mobiliario, áreas internas y externas, en las instalaciones de una institución de educación infantil. Se utiliza equipo de medición como el luxómetro EXTECH, sonómetro Quest modelo 1100 tipo 1, termómetro ambiental QUESTemp 34 y un flexómetro Tajima G-Lock de 10 metros. Se analizan los criterios de las Normas Oficiales Mexicanas y del Instituto Nacional de la Infraestructura Física y Educativa comparándolos con los resultados. Se encuentra que la iluminación en las aulas incumple con los parámetros de la norma. La temperatura se detecta normal y el nivel de ruido es crítico en ciertas horas de la mañana. Se recomienda realizar el estudio en épocas de frío y calor extremo respectivamente para determinar si los parámetros son los correctos. Cambiar el tipo de iluminación y mobiliario en los salones de clases y taller de juegos así como establecer programas preventivos de mantenimiento para disminuir el ruido. De igual manera, aplicar este estudio en otras escuelas de iniciación infantil.

An exploratory, descriptive, quantitative and direct observation study is presented, in which environmental ergonomic factors such as illumination, noise and temperature, as the the physical environment given by furniture, indoor and outdoor areas are evaluated in the facilities of a childhood education institution. Measuring equipment as the light meter EXTECH, sound level meter Quest Model 1100 Type 1, environmental thermometer QUESTemp 34 and a tape measure Tajima G-Lock of 10 meters. Criteria of Mexican Official Standards and the National Institute of Physical Education Infrastructure are analyzed and compared with the results. It is found that the illumination in classrooms violates the standard parameters. Normal temperature is detected and the noise level is critical in certain hours of the morning. It is recommended to perform the study in times of extreme heat and cold respectively to determine if the parameters are correct. Changing the type of illumination and furniture in classrooms and game workshops and establishing preventive maintenance programs to reduce noise as well. In a like manner, apply this study to other schools of child initiation.

Quality of breast cancer early detection services conducted by well woman clinics in the district of Gampaha, Sri Lanka.

BACKGROUND: Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. AIM: To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. METHODS: The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003- 2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. RESULTS: CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35- 90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7- 20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ≥70%, the cut off set for satisfaction. CONCLUSIONS: Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

Surgeons' vision rewarded.

Surgeons and clinical staff, theatre circulation and scrub personnel, and anaesthetists, as well as the estates and facilities team at Kent's Maidstone Hospital, have worked with specialist supplier of integrated audio, video, and instrumentation systems for the operating room, Olympus Medical, to develop what is claimed is among the UK's most advanced operating theatres yet built for laparoscopic and endoscopic surgery. HEJ editor Jonathan Baillie discussed the project with Amir Nisar, the surgeon who championed efforts to get the facility built, and Olympus Medical national sales manager, systems integration, James Watts.

Hospital outpatient perceptions of the physical environment of waiting areas: the role of patient characteristics on atmospherics in one academic medical center.

BACKGROUND: This study examines hospital outpatient perceptions of the physical environment of the outpatient waiting areas in one medical center. The relationship of patient characteristics and their perceptions and needs for the outpatient waiting areas are also examined. METHOD: The examined medical center consists of five main buildings which house seventeen primary waiting areas for the outpatient clinics of nine medical specialties: 1) Internal Medicine; 2) Surgery; 3) Ophthalmology; 4) Obstetrics-Gynecology and Pediatrics; 5) Chinese Medicine; 6) Otolaryngology; 7) Orthopedics; 8) Family Medicine; and 9) Dermatology. A 15-item structured questionnaire was developed to rate patient satisfaction covering the four dimensions of the physical environments of the outpatient waiting areas: 1) visual environment; 2) hearing environment; 3) body contact environment; and 4) cleanliness. The survey was conducted between November 28, 2005 and December 8, 2005. A total of 680 outpatients responded. Descriptive, univariate, and multiple regression analyses were applied in this study. RESULTS: All of the 15 items were ranked as relatively high with a range from 3.362 to 4.010, with a neutral score of 3. Using a principal component analysis' summated scores of four constructed dimensions of patient satisfaction with the physical environments (i.e. visual environment, hearing environment, body contact environment, and cleanliness), multiple regression analyses revealed that patient satisfaction with the physical environment of outpatient waiting areas was associated with gender, age, visiting frequency, and visiting time. CONCLUSION: Patients' socio-demographics and context backgrounds demonstrated to have effects on their satisfaction with the physical environment of outpatient waiting areas. In addition to noticing the overall rankings for less satisfactory items, what should receive further attention is the consideration of the patients' personal characteristics when redesigning more comfortable and customized physical environments of waiting areas.

Applying ergonomics to nurse computer workstations: review and recommendations.

Nursing is associated with high rates of musculoskeletal disorders from patient handling, and nurses are at high risk for developing cumulative trauma disorders, which can result from computer usage. Although there are many benefits to using computers in the workplace, nurses need to incorporate ergonomic factors into work settings to promote safe workplace environments. This article reviews recent literature about computer workstation ergonomics, discusses related policies, and makes recommendations about computer workstation design and related research in nursing workplace settings.