Disability management after stroke: its medical aspects for workplace accommodation.

PURPOSE: Return to work (RTW) after stroke is one of the critical issues for both employer and employee. Early RTW is a manifestation of social restoration for the disabled stroke as well as an effective way to reduce social costs related stroke. METHOD: This paper discusses the medical problems referred to RTW after stroke for workplace accommodation. Reviewing the literature, factors influencing RTW after stroke are addressed. RESULTS/CONCLUSION: The process of RTW is extremely individual in each case, and affected by multiple factors. Therefore, it is necessary to individually evaluate precise impact of each factor on RTW.

Functional disabilities of disabled workers in vocational aid facilities and a social welfare factory.

We evaluated functional disabilities of disabled workers at vocational aid facilities and a social welfare factory to reveal whether evaluation of the functional disabilities is useful for occupational health care activities. Subjects were 121 persons with a physical disability working at Fukuoka Colony (FC workers) and 35 persons with mental retardation working at Nanomi Kogei (NK workers). The Self-Rating Barthel Index, Self-Rating Frenchay Activities Index, and Satisfaction in Daily Life (SDL) were used for the evaluation of basic activities of daily living (ADL), lifestyle, and subjective domain of quality of life, respectively. The FC workers were almost independent in basic ADL: had a high capability in self-care activities and moderately disturbed capability in mobility activities, and had a more active lifestyle than the NK workers. The total SDL score indicated that the FC workers were less satisfied with overall daily life, although not significant, and were less satisfied with the SDL items of physical health, gait, house facilities, and having a job than the NK workers. Because these results indicated the features of disabled workers and gave an occupational health physician valuable information about disabilities, the evaluations used in this study can be regarded as useful for occupational health care activities.

[Body density assessment utilizing skinfold thickness and age in Japanese men].

A study was conducted to investigate the validity of skinfold-based prediction equations for body density (g/ml) by Nagamine and Suzuki (1964), and to formulate more convenient and more useful equations for predicting body density from skinfold and age in men. Subjects of the study were 257 healthy men aged 19-60 years in or near Nagasaki City. The regression equation for the dependent variable, body density, was determined by hydrostatic weighing. Independent variables included eight skinfolds, the sum of two skinfolds (triceps, subscapular), the sum of three skinfolds (triceps, subscapular, and abdominal), age, and body surface area. Skinfolds were measured with an Eiken-model skinfold caliper. Age (mean 33.1, range 19-60 yrs.), weight (mean 65.3, range 46.6-107.7 kg), height (mean 168.8, range 152.3-185.4 cm), and body density (mean 1.05874, range 1.00860-1.09020 g/ml) were also recorded. Percent body fat was calculated using the formula by Brozek et al. and ranged from 6.1% to 38.9%. Multiple correlation coefficients (MR) and standard error (SE) of 10 regression equations (A-J) for predicting body density in men were obtained. The best-fitting and the most convenient prediction equation for body density was equation-E.: body density = 1.09556-0.00062 x sum of three skinfolds (mm)-0.00028 x age (MR = 0.815 and SE = 0.0087 g/ml). The equation was cross-validated on a different sample of 45 men. The correlation coefficient between predicted and hydrostatically determined body density was 0.781 (p < 0.001). Equation-E (Tahara's equation) appears to be useful in body density analysis particularly when the subjects are Japanese men, aged 18-50 yrs, with percent body fat 10 to 30%.

Return to work after stroke. A follow-up study.

BACKGROUND AND PURPOSE: Few studies have reported the longitudinal trend of return to work after stroke. The purpose of our study was to evaluate the longitudinal trend of proportion of patients who return to work after stroke and further to examine the predictors of return to work while taking follow-up periods into consideration. METHODS: We conducted a retrospective cohort study on the association between characteristics of stroke patients at admission and return to work after first stroke, taking length of follow-up period into consideration (n = 183). The patients were all younger than 65 years and were working at the time of their stroke. A follow-up questionnaire evaluated return to work and related information. Data were analyzed using the Kaplan-Meier method for curves of the proportion of return to work and Cox's proportional hazards model for odds ratios of return to work. RESULTS: The curve of proportion of return to work had two steep slopes, and the proportion was at a maximum at 18 months from patient admission. The adjusted odds ratios of return to work for patients with normal muscle strength versus severe weakness, without apraxia versus with apraxia, and with white-collar versus blue-collar occupations were 5.16 (P < .05), 4.16 (P < .05), and 1.43 (.05 < P < .10), respectively. CONCLUSIONS: The increase of proportion of return to work after stroke was nonlinear, and this trend was referable to the social security systems available to the patients included in this study. Normal muscle strength and absence of apraxia were significant predictors of return to work after stroke. White-collar occupation showed a tendency to promote return to work.

[Body density assessment utilizing skinfold thickness and age in Japanese women].

A study was conducted to investigate the validity of skinfold-based prediction equations for body density (g/ml) by Nagamine and Suzuki (1964), and to formulate more convenient and more useful equations for predicting body density from skinfold and age in women. Subjects of the study were 512 healthy women aged 18-66 years in or near Nagasaki City. The dependent variable in the multiple regression equation, body density, was determined by hydrostatic weighing. Independent variables included eight skinfolds, the sum of two skinfolds (triceps, subscapular), the sum of three skinfolds (triceps, subscapular, and abdominal), age, and body surface area. Skinfolds were measured with an Eiken-model skinfold caliper. Age (mean 30.1, range 18-66 yrs.), weight (mean 52.6, range 38.0-83.3 kg), height (mean 157.0, range 142.0-172.0 cm), and body density, (mean 1.04125, range 0.98806-1.08650 g/ml) were also recorded. Percent body fat was calculated using the formula by Brozek et al. and ranged from 6.4% to 48.3%. Multiple correlation coefficients (MR) and standard error (SE) of 10 regression equations (A-J) for predicting body density in women were compared. The best-fitting and the most convenient prediction equation for body density was equation-E. The regression equation developed for predicting body density was: body density = 1.07931-0.00059 x sum of three skinfolds(mm)-0.00015 x age (MR = 0.77 and SE = 0.0089). The equation was cross-validated on a different sample of 46 women. The correlation coefficient between predicted and hydrostatically determined body density was 0.813 (p < 0.001). Equation-E (Tahara's equation) appears to be useful in body density analysis particularly when the subjects are Japanese women, aged 18-50 yrs, with percent body fat 17 to 34%.

Metabolism in vivo of 3,4,3',4'-tetrachlorobiphenyl and toxicological assessment of the metabolites in rats.

1. Metabolism in vivo of 3,4,3',4'-tetrachlorobiphenyl (TCB) and toxicological assessment of the metabolites were investigated in the rat. 2. Four metabolites were isolated from faeces of rats dosed with 3,4,3',4'-TCB. Two were identified as 5-hydroxy-3,4,3',4'-TCB and a chlorine-shift metabolite, 4-hydroxy-3,5,3',4'-TCB, by comparison of melting points, chromatographic mobilities and spectral features with those of the synthetic samples. A dihydroxy-TCB and monohydroxy-trichlorobiphenyl were also indicated by mass spectrometry to be excreted in faeces as minor metabolites. 3. Faecal excretion of unchanged 3,4,3',4'-TCB, 5-hydroxy-3,4,3',4'-TCB and 4-hydroxy-3,5,3',4'-TCB was 0.8%, 19.6% and 11.6% of dose, respectively, in 5 days after i.p. injection of 3,4,3',4'-TCB at a dose of 50 mg/kg. 4. From the inability to cause the liver hypertrophy and thymus atrophy, both monohydroxy-metabolites of 3,4,3',4'-TCB are much less toxic than the parent 3,4,3',4'-TCB. In addition, these phenolic metabolites did not induce the activities of benzo[a]pyrene hydroxylase and DT-diaphorase, whereas 3,4,3',4'-TCB greatly induced these activities. These results indicated that unlike PCB congeners with phenobarbital-type inducing ability, 3,4,3',4'-TCB, a prototype of 3-methylcholanthrene-type inducers, is detoxified by metabolic hydroxylation.